Kornimate/medical-research-clean huggingface dataset:
dex as analgesic adjuvant in osa patients

Conditions: Obstructive Sleep Apnea

Summary: the purpose of this study is to assess whether intravenous peri-operative dexmedetomidine reduces opioid requirements and or improves pain control after uvulopalatopharyngoplasty (uppp) in patients with obstructive sleep apnea (osa).

background/study significance patients with osa undergoing surgery have increased surgical risk compared to patients that do not have osa . perioperative medication such as benzodiazepines and opioids can decrease upper airway tone, inhibit central respiratory drive and inhibit upper airway reflexes. the supine position may also worsen the severity of the osa. additionally, this group of patients is more likely to have a higher incidence of complications, particularly post operative hypoxemia , difficult intubation , and complicated extubation course . uvulopalatopharyngoplasty (uppp) along with other tongue base procedures are commonly performed surgical procedures used to help alleviate the symptoms of obstructive sleep apnea (osa). postoperative management of oropharyngeal pain is challenging since narcotic administration may compromise respiratory status in osa patients. the anesthesiology and otorhinolaryngology communities have begun to rethink acceptable narcotic use in osa patients especially following the recent fda announcement highlighting serious adverse effects related to codeine consumption in children who had undergone tonsillectomies. dexmedetomidine (precedex) is a sedative with minimal respiratory depression. its mechanism is via alpha 2 agonism and has 8 times the affinity for the alpha 2 adrenoreceptor than clonidine. it has been shown to have sedative, analgesic, and anxiolytic effects. it produces a predictable and dose dependent decrease in heart rate and blood pressure. dexmedetomidine undergoes extensive metabolism in the liver and is then eliminated as methyl and glucuronide conjugates mostly via the renal system. the pharmacokinetics are markedly affected by hepatic insufficiency .

Eligibility criteria:
inclusion criteria: * age 18 or older * patients scheduled for uppp * patients with diagnosis of osa via polysomnography * american society of anesthesiology (asa) classification 3 or lower exclusion criteria: * bradycardia as defined as resting heart rate \<60 beats per min (bpm) or symptomatic * any degree of heart block diagnosed by ecg * hypotension as defined as \<20% from baseline or symptomatic * liver failure, (two fold rise in liver enzymes) * chronic kidney disease (ckd) iii or greater * history of allergy to opioids or dexmedetomidine * asa classification 4 or higher * icu or step down admission * difficult airway as defined by previous history of difficult intubation or requiring a fiberoptic intubation.

Keywords: dexmedetomidine
biodegradable soaked amiodarone patch use for the prevention of atrial fibrillation after cardiac surgery

Conditions: Atrial Fibrillation (AF)

Summary: the primary objective of the present prospective, randomized, double blind, controlled study is to assess whether the application of 2 oxidized regenerated cellulose (surgiceltm fibrillartm) patches soaked with amiodarone hydrochloride over the anterior wall of the left atrium and the lateral wall of the right atrium results in a reduction in the incidence of poaf


Eligibility criteria:
inclusion criteria: * all patients who are candidates for elective cardiac surgery trough complete sternotomy with indications of coronary artery disease (both off-pump and on-pump), aortic valve disease, mitral valve disease, tricuspid valve disease, and ascending aorta disease, whether as an isolated pathology or in combination exclusion criteria: * patients with a clinical history of atrial or ventricular arrhythmia of any nature and duration, patients undergoing reoperation, patients with emergency surgical indications due to acute myocardial infarction or cardiogenic shock, patients with thyroid disfunction, patients with hocm and those with pacemakers or icds
validity and reliability of the wal-k test

Conditions: Cerebral Palsy; Gait Disorders in Children

Summary: adapting the environment in which a child with cerebral palsy lives or adapting himself according to the environment facilitates independence in daily life activities. there is a need for practical performance tests to evaluate the gait adaptation of children with cerebral palsy in the clinic. however, no study has been found to evaluate gait adaptation in children with cerebral palsy. therefore, the aim of the study is to evaluate the validity and reliability of the walk test, which was previously developed for children with special learning disabilities, in individuals with cerebral palsy.

according to the international classification of functioning, disability, and health, physical, social, and behavioral environmental factors; can affect a child's disability, activity limitations, and participation. adapting the environment in which a child with cerebral palsy lives or adapting himself according to the environment facilitates independence in daily life activities. there is a need for practical performance tests to evaluate the gait adaptation of children with cerebral palsy in the clinic. however, no study has been found to evaluate gait adaptation in children with cerebral palsy. therefore, the aim of the study is to evaluate the validity and reliability of the walk test, which was previously developed for children with special learning disabilities, in individuals with cerebral palsy. the study will be conducted by afyonkarahisar university faculty of health sciences.

Eligibility criteria:
inclusion criteria: * 6-18 years of age; * diagnosed with diparetic, hemiparetic or quadriparetic cerebral palsy; * gmfcs value being ≤3. * communication function classification system (cfcs) for individuals with cerebral palsy ≤3. * children with a modified ashworth scale (mash) ≤ 3 for lower extremity muscles * ability to follow verbal commands * ability to recognize colors or numbers * able to walk ≥10 meters independently with or without an assistive device (orthotics or walking aid) exclusion criteria: * presence of serious hearing, vision or cognitive problems, * nerve block injection or orthopedic surgery in the last 6 months (such as botox injection or muscle lengthening surgery) * joint contracture

Keywords: cerebral palsy gait
intraocular pressure reduction with the bimatoprost/timolol fixed combination

Conditions: Glaucoma; Ocular Hypertension

Summary: the purpose of this study is to examine the ocular hypotensive effect of bimatoprost and the potential additional effect of the bimatoprost/timolol fixed combination in eyes with ocular hypertension, primary open angle glaucoma or exfoliation glaucoma.


Eligibility criteria:
inclusion criteria: * primary open angle glaucoma * exfoliation glaucoma * ocular hypertension exclusion criteria: * younger than 18 years old * inability to understand and/or follow study requirements * women of childbearing potential not using reliable birth control, pregnant or lactating women * history of chronic obstructive pulmonary disease, heart failure, 2nd or 3rd av block * anticipated modification of treatment for systemic hypertension during the study period * history of ocular herpes, corneal scarring, conventional or laser surgery or macular pathology * history of allergy, poor tolerability or poor response to study medication * best corrected visual acuity less than 0.4 * significant visual field defect (md\<15.0 db)

Keywords: glaucoma ocular hypertension lumigan ganfort
observational, long-term extension study for participants of prior vy-aadc01 studies

Conditions: Parkinson's Disease

Summary: an extension study for participants who have completed a prior vy-aadc01 clinical study


Eligibility criteria:
key inclusion criteria: 1. completed participation in the pd-1101 or pd-1102 clinical study of vy-aadc01 gene therapy key exclusion criteria: none

Keywords: parkinson's disease (pd) gene therapy motor fluctuations neurosurgery nbib-1817 aromatic l-amino acid decarboxylase levodopa dopamine aadc ddc aav2-haadc aav vy-aadc
is the cough stress test equivalent to the 24 hour pad test in the assessment of stress incontinence?

Conditions: Stress Urinary Incontinence

Summary: the purpose of this research study is to identify if the cough stress test is equal to the 24hour pad test in assessing stress urinary incontinence.

the 24 hour pad test involves women collecting their pre-weighed incontinence pads for 24 hours and returning them to the clinician for weighing. this allows for accurate quantification of urine loss. this test is often used in clinical studies before and after intervention to assess efficacy of treatment. the cough stress test is an alternative testing modality used to evaluate stress incontinence. it is an easy test to perform in a single visit to the clinician's office and the results are immediately available. it involves the patient coughing forcefully with a full bladder and watching for leakage of urine through the urethra. in our study, our primary aim is to compare the equivalency of the cough stress test to the 24 hour pad test as a measure of stress urinary incontinence. our secondary aim will be to assess patient comfort and satisfaction with each of the testing modalities. if the cough stress test is equivalent, it will provide an additional, easy to use tool for patient evaluation.

Eligibility criteria:
inclusion criteria: * patients with the primary complaint of stress incontinence with minimal or no urge incontinence symptoms. they must be able to read english as the study involves use of validated questionnaires which have only been validated in english. exclusion criteria: * patients unable to stand (to perform standing stress test), patients with leakage from a urinary tract fistula, use of vaginal creams within 72 hours of the pad test, active vaginal infection, sexual intercourse within 24 hours of the pad test and patients who do not read english.

Keywords: stress urinary incontinence
molecular diagnostic methods for detection of plasmodium knowlesi

Conditions: Plasmodium Knowlesi Infection

Summary: this study aims to determine the sensitivity, specificity, and practical value of two new molecular diagnostic assays compared to a more classical nested molecular diagnostic assay and the routine microscopy (both of which are the current gold standard) in detection of p. knowlesi.


Eligibility criteria:
inclusion criteria: * suspected for malaria infection; fever (axillary or tympanic temperature ≥ 37.5 °c or oral or rectal temperature of ≥ 38 °c) with chills, worsening malaise, headache lassitude, fatigue, abdominal discomfort, muscle and joint aches, anorexia, perspiration, or vomiting at the time of evaluation or within the past 48 hours * written informed consent is obtained. * for children (\>7 to \<18 years): parent or legal guardian provides written informed consent. exclusion criteria: * patients living in, or returning from malaria endemic area outside of sarawak within 2 weeks of illness onset * they have a clear alternative diagnosis other than malaria by a trained health care professional.

Keywords: monkey malaria
team approach to polypharmacy evaluation and reduction in a long-term care setting

Conditions: Long-term Care; Polypharmacy; Frailty

Summary: medication side effects and interactions between medications are very common in older adults and are related to negative health outcomes. in this study, the investigators will test a new process aimed at reducing unnecessary medication use and drug side effects in seniors using the best medical evidence and patient preferences for treatment. this study will assess how feasible the implementation of this intervention is within a long-term care facility as well as if it is possible. participants in two long-term care facilities will participate in this study. measures will include feasibility outcomes regarding the logistics of the intervention as well as patients outcomes (falls, hospitalizations, and medications) collected before and after implementation. this trial will be a randomized control trial with an adaptive trial design.

there are substantial associations between polypharmacy and reduced function from older adults and this is likely to be important in frail older adults both in long term care and in the community. the reversibility of drug-induced mobility impairment is unclear therefore the investigators plan to investigate signals of any impact of reducing polypharmacy on mobility. the investigators chose the long-term care setting given the presence of complete medication administration records and this patient population's high prevalence of polypharmacy and risk of adverse drug events. tapermd is an electronic tool for systematic medication reduction that incorporates patient priorities, electronic screening for potentially harmful medicines,supporting evidence tools and a monitoring pathway to support medication reduction. this study will examine the feasibility of this tool in a long-term care setting as well as examine. participants in two long-term care facilities will participate in this study. measures will include feasibility outcomes regarding the logistics of the intervention as well as patients outcomes (falls, hospitalizations, and medications) collected before and after implementation. the study will be an adaptive trial design with two phases. phase 1 will be an internal pilot. this will allow the investigators to re-evaluate and modify outcome measures and processes as necessary. phase 2 of this trial will allow for continuation after adjustments to the process or design has been made in a larger randomized controlled trial.

Eligibility criteria:
inclusion criteria: * residing in 2 long-term care facilities in brampton, on * on 5 or more long-term medications * 70 years of age or older * adequate english language exclusion criteria: * terminal illness or other circumstance precluding 6 month study period * recent (within 12 months) comprehensive medication review
role of ultrasound in diagnosis of placenta previa and map

Conditions: Morbidly Adherent Placenta

Summary: placenta accreta occurs when the placental implantation is abnormal. the marked rise in incidence has been assumed the increasing prevalence of cesarean delivery in recent years.

the most accepted theory is that abnormal placentation . the most important risk factor for placenta accreta is placenta previa after a prior cesarean delivery. the first clinical manifestation of placenta accreta is usually severe , life-threatening hemorrhage. the recommended intervention of suspected placenta accreta is planned preterm cesarean hysterectomy with the placenta left in situ.

Eligibility criteria:
inclusion criteria: * pregnant ladies with previous cesarean sections * ga above 30 weeks exclusion criteria: * primigravida patients * ga below 30 weeks
monitoring patients who are obese surgery for gastric by-pass protein supplementation and physical training (promise)

Conditions: Obesity

Summary: the purpose of the study is to test whether additional protein intake with or without strength training will help to maintain body composition (fat-free mass) after surgical treatment of obesity by gastric by pass. the main hypothesis is that additional protein intake will limit fat-free mass loss during surgery-induced weight loss, and that strength training will have an additional beneficial effect

design: open randomised controlled trial comparing, in obese patients after gbp, an additional oral intake of protein with or without a muscular-strengthening physical training programme (18 weeks) to standard medical and nutritional follow-up after bariatric surgery as control (3 groups). primary outcome: variation at 6 months after gbp in total and appendicular fat-free mass as assessed by dual-energy x-ray absorptiometry (dxa). duration of the study: 36 months. duration of participation for one patient: 7 months. number of centers: monocentric study.

Eligibility criteria:
inclusion criteria: * female gender * age between 18 and 60 years * planned obesity treatment by gastric bypass * written informed consent exclusion criteria: * subject not affiliated with a social security scheme * refusal * regular follow-up not feasible * participation in a structured physical activity program * recent coronary event * uncontrolled hypertension * proliferative diabetic retinopathy or disabling neuropathy, treatment by dialysis, orthopedic problems * pregnancy * specific food intolerance to protein products * abnormal cardiac stress test

Keywords: obesity gastric by-pass body composition nutrition physical activity
a combined lifestyle intervention delivered by physio/exercise therapists for patients with persistent low back pain and overweight or obesity

Conditions: Low Back Pain

Summary: low back pain (lbp) is the leading cause of disability worldwide and is costly. lifestyle factors, such as physical inactivity, stress, sleep, excess weight, and an unhealthy diet contribute to the burden of lbp and the associated increasing demand for care. moreover, approximately 65% of lbp patients who visit the hospital are overweight. this group is considered a complex patient group. of the lbp patients who visit the hospital, 74% are referred back to primary care as medical specialists cannot offer them high value care. targeting both lifestyle factors (e.g., physical activity, sleep and stress) and clinical factors related to low back pain (e.g., muscle strength, endurance, mobility) is important in the management of this group of lbp patients to improve important outcomes (e.g., functioning, physical activity) and reduce costs. addressing lifestyle factors may also offer additional health benefits like decreased risks of diabetes and cardiovascular diseases. the primary objective of this project is to improve the management of this complex group of lbp patients, that is, patients who are overweight or obese and who are referred back to primary care from the hospital because medical specialists cannot offer them high value care, and to reduce healthcare and societal costs. the primary research question is: 'is a combined lifestyle intervention, integrated into standard care for lbp, delivered by physio/exercise therapists effective and cost-effective in improving physical functioning and/or physical activity over a 36-month period compared to usual care in overweight or obese lbp patients who are referred back from the hospital to primary care?' it is hypothesized that the combined lifestyle intervention, integrated into standard care for lbp, is both effective and cost-effective in managing lbp in patients who are overweight or obese over a 36-month period.


Eligibility criteria:
inclusion criteria: * patients with persistent (≥3 months) non-specific lbp who are referred back from the hospital to primary care * either bmi≥30 or bmi≥25 with at least one comorbidity (osteoarthritis, sleep apnea, risk factors for cardiovascular diseases or type 2 diabetes) * decreased physical functioning (rmdq ≥4 out of 24) * average lbp intensity of ≥3 out of 10 over the past week (nprs) * ≥18 years old exclusion criteria: * specific lbp (e.g., tumor or fracture) * back surgery in the past six months * psychiatric diseases that could hinder participation * pregnancy or ≤9 months postpartum

Keywords: low back pain lifestyle intervention
a randomized controlled trial of acyclovir among hiv and hsv-2 co-infected women, chiang rai, thailand

Conditions: HIV; Herpes

Summary: herpes infection is an important co-factor in hiv transmission. a recent meta-analysis demonstrated that hsv infection contributed to a 2-fold increased risk of hiv transmission. suppressive therapy with acyclovir has been a method proposed to reduce hiv transmission. we are conducting a randomized controlled cross-over trial to evaluate the effect of acyclovir suppressive therapy on hiv genital shedding in women co-infected with hiv-1 and herpes simplex virus type-2 (hsv-2) in thailand.

65 women ages 18-49 years old with hiv-1 and hsv-2 co-infection are being recruited from general medicine clinics, family planning clinics, postnatal clinics, community based organizations and community outreach in chiang rai, thailand. our study objectives are: * to evaluate the effect of acyclovir suppressive therapy on hiv genital shedding. * to determine the association between hiv and hsv genital shedding, and the effect of acyclovir suppressive therapy on this association. * to determine the acceptability of acyclovir suppressive therapy for women with hiv infection. * to evaluate the association of genital symptoms and hiv or hsv genital shedding. * to evaluate the association between cervicovaginal (cvl) specimens and self-collected genital swabs for detection of hiv and hsv-2.

Eligibility criteria:
inclusion criteria: * participants will be hiv and hsv-2 seropositive exclusion criteria: * pregnancy, cd4 count \<200, on art

Keywords: acyclovir hiv hsv
risk of squamous cell carcinoma on skin areas treated with ingenol mebutate gel, 0.015% and imiquimod cream, 5%

Conditions: Actinic Keratosis (AK)

Summary: the purpose of the study is to compare the risk of developing squamous skin cancer (scc) or other types of cancer after treatment of aks with ingenol mebutate gel or imiquimod cream. subjects will be randomised to treatment with ingenol mebutate or imiquimod and will receive a second treatment cycle with the same treatment if the first treatment does not clear all aks. subjects will be followed over a period of three year (36 months) after first treatment


Eligibility criteria:
inclusion criteria: 1. signed informed consent form (icf) prior to any trial-related procedures 2. subjects with 5 to 9 clinically typical, visible and discrete aks within a contiguous 25 cm² treatment area on the face or scalp. 3. subject at least 18 years of age 4. female subjects must be of either: 1. non-childbearing potential, or, 2. childbearing potential, provided there is a confirmed negative urine pregnancy test 5. female subjects of childbearing potential must be willing to use highly effective methods of contraception (pearl index \< 1%) exclusion criteria: 1. location of the selected treatment area: * on the periorbital skin * on the perioral skin/around the nostrils * within 5 cm of an incompletely healed wound * within 10 cm of a suspected bcc or scc or other neoplasia 2. selected treatment area lesions that have atypical clinical appearance (e.g., hypertrophic, hyperkeratotic or cutaneous horn). 3. history of scc, bcc, malignant melanoma or other neoplasia in the selected treatment area. 4. history or evidence of skin conditions other than the trial indication that would interfere with evaluation of the trial medication in the selected treatment area 5. use of ingenol mebutate and/or imiquimod in and within 5 cm of the selected treatment area within 2 years prior to screening (visit 1) 6. organ transplant recipients 7. immunosuppressed subjects (for example hiv patients) 8. female subjects who are breastfeeding. 9. subjects who are institutionalised by court order or by the local authority 10. in the opinion of the investigator, the subject is unlikely to comply with the clinical study protocol (e.g. alcoholism, drug dependency or psychotic state)