Kornimate/medical-research-clean huggingface dataset:
thiamine supplementation in patients with septic shock

Conditions: Septic Shock; Shock, Septic; Lactic Acidosis; Thiamine Deficiency

Summary: to determine if intravenous thiamine would decrease the time to reversal of shock in patients with septic shock.

patients will be randomized to thiamine supplementation or placebo in a 1:1 ratio. randomization will be done by the hospital pharmacy department whom will be the only unblinded participants. patients will receive 200mg thiamine in 50ml of 5% dextrose or matching placebo (50ml 5% dextrose) once daily for 7 days or until discharge from the intensive care unit. the drug will be mixed by the pharmacy. administration will be done in the patients room in the intensive care unit by the patient's assigned nurse. blood will be collected on admission to the hospital in order to determine baseline lactate level and study eligibility. the measurement of lactate is standard of care in patients with sepsis. thiamine level will be collected upon enrollment into the study. the icu nurse or emergency room nurse taking care of the patient at the time of enrollment will draw the blood sample. standard procedure for measuring thiamine levels will be maintained including protecting the blood sample from light and keeping it on ice while it is delivered to the lab. serum lactate will be measured daily for 7 days or until discharge from the intensive care unit. the serial measurement of serum lactate is considered standard of care in patients with sepsis.

Eligibility criteria:
inclusion criteria: * age\>18 * sepsis (defined as presence of two or more sirs criteria with documented or suspected infection) * sirs: systemic inflammatory response syndrome (sirs) is the occurrence of at least two of the following criteria: temperature \>38.0ºc or \ 90 beats/minute, respiratory rate \>20 breaths/minute, white blood cell count \>12,000 or \<4000. * lactate \>3mmol/l at the time of consent and randomization * hypotension (systolic blood pressure \ 2l fluid bolus * vasopressor dependence (defined as the continuous infusion of norepinephrine, dopamine, phenylephrine, vasopressin or epinephrine.) exclusion criteria: * known cirrhosis or chronic liver disease * current thiamine supplementation * clinical indication for thiamine (e.g. alcohol abuse) * comfort measures only designation * inability to provide consent * other causes for lactate elevation (seizure, use of medications that can cause lactic acidosis such as metformin, linezolid and anti-retrovirals, carbon monoxide, known or suspected bowel or limb ischemia, cardiac arrest prior to enrollment)
monitoring neonatal resuscitation trial

Conditions: Resuscitation; Neonatal Prematurity; Positive-Pressure Respiration

Summary: this is a randomized trial to determine if a visible respiratory function monitor (rfm) displaying realtime measurements of delivered inflations improves clinical providers ability to perform positive pressure ventilation (ppv) within a pre-defined target tidal volume in preterm infants after birth.

recently, it has been demonstrated that the use of a respiratory function monitor (rfm) can guide ppv in the dr.(wood, schmolzer) in this study, the new life box, (advanced life diagnostics, weener, germany) a neonatal respiratory monitor (rfm), will be used to measure and calculate inflation pressures, flow, and tidal volumes in all enrolled infants. the new life box uses a small variable orifice anemometer to measure gas flow in and out of a face-mask or endotracheal tube. this signal is automatically integrated to provide inspired (vti) and expired (vte) tidal volume. the difference equals the leak from the facemask or endotracheal tube. complete airway obstruction occurs when no flow of gas into or away from the infant is seen during a positive pressure inflation. the rfm can also calculate and measure respiratory rate and minute volume, inflations and spontaneous inspirations, and all ventilation pressures. using customized software heart rate, oxygen saturation and expired carbon dioxide can be integrated into the rfm. the newlife box monitor presents graphical information for pressure, flow, and volume. in addition, the monitor displays numeric data for pressure (pip and peep), tidal volume (vti, vte), flow, respiratory rate and percent leak. the monitor integrates and displays physiologic data streaming from the patient (heart rate and oxygen saturation) as well as fio2 from an oxygen analyzer in the inspiratory limb of the respiratory circuit. if enabled, the monitor can incorporate video captured from an external camera. the video serves as a helpful aid in the interpretation of the events during the rfm waveform recordings. the use of an rfm in the dr has the potential to improve neonatal respiratory support and reduce lung injury. the primary objective of this study is to test the hypothesis that observing the data and waveforms displayed on an rfm during the provision of ppv to preterm infants (24-27 6/7 weeks gestation) after birth will increase the proportion of inflations performed with a predefined vte "safe range" of 4 - 8 mls/kg.

Eligibility criteria:
inclusion criteria: * gestational age (ga) 24 - 27 6/7 weeks at birth, by best obstetrical * receive positive pressure ventilation during delivery room resuscitation exclusion criteria: * known major anomalies including that may affect measured cardiorespiratory parameters: congenital diaphragmatic hernia, trachea-oesophageal fistula, cyanotic heart disease, pulmonary hypoplasia * rfm not available during resuscitation

Keywords: resuscitation neonatal prematurity positive-pressure ventilation respiratory function monitor
gestational diabetes

Conditions: Gestational Diabetes

Summary: due to a changed lifestyle with less physical activity, unfavorable diets rich in fat and calories and obesity, the prevalence of diabetes mellitus is increasing worldwide. the diabetes epidemic is associated with significant personal and socio-economic consequences. despite attempts to prevent the complications of diabetes, this disease is still the leading cause of blindness, chronic renal insufficiency and non-traumatic amputation. it is important to detect early on an increase in blood sugar and treat it accordingly to reduce costs and to minimize the personal suffering of those affected. as the number of patients with type 2 diabetes mellitus continues to rise, the number of young women with gestational diabetes mellitus (gdm) also increases. this is a disorder og glucose metabolism, which occurs for the first time in pregnancy. the causes for this are manifold. among other causes, the increasing age of the mothers and weight gain during pregnancy are risk factors for gestational diabetes. although it has been recommended that women with gestational diabetes should be re-examined after the birth of their child, many women have not. the study is a follow-up study to clarify whether insulin secretion disorder in women with and after gdm is a risk factor for the occurrence of type 2 diabetes mellitus.


Eligibility criteria:
inclusion criteria: - signed and dated informed consent enrollment is possible during and after gestation: * baseline visit (pregnancy): gestational week 24+0 till 31+6 * postpartum visits: documented occurence of gdm in previous pregnancy exclusion criteria: * age \< 18years * diabetes mellitus type 1 or type 2 * gfr \< 60 ml/min/1,73 m2 * crp \> 1 mg/dl * increased levels of transaminases 2 fold above uln * preexisting cardiac conditions * weight loss \> 10% within 6 months prior to inclusion * psychiatric disorders * chronic alcohol or substance abuse * blood sugar increasing or decreasing drug therapy, e.g. steroids, antidiabetics, insulin * only postpartum visits: pregnancy or lactation

Keywords: gestational diabetes insulin
the effects of anesthetic techniques and palonosetron administration on the incidence of ponv

Conditions: PONV; Palonosetron; Anesthesia

Summary: the incidence of postoperative nausea and vomiting (ponv) after thyroidectomy have been shown to be relatively high compared other surgeries, with a reported incidence 65-75 %. ponv may increase patient discomfort, delay patient discharge, and increase the cost of patient care, the risk of postoperative bleeding which may potentially cause airway obstruction. it is reported that the maintenance of anesthesia with propofol-remifentanil or sevoflurane-propofol-remifentanil decreased the incidence of ponv compared sevoflurane alone, but failed to demonstrate the decreased incidence of ponv in 6-24 hr postoperative period in patients undergoing thyroidectomy. administration of palonosetron, newly developed 5-ht3 antagonists with long half life (48 hrs) may decrease the incidence of ponv particularly during this period. the purpose of this study was to evaluate and compare the incidence of ponv after thyroidectomy with three different anesthetic methods, sevoflurane or sevoflurane-propofol-remifentanil or sevoflurane-propofol-remifentanil-palonosetron in woman patients.


Eligibility criteria:
inclusion criteria: * patients undergoing thyroidectomy euthyroid status american society of anesthesiology physical status 1,2 exclusion criteria: * ideal body weight \>130% gastrointestinal disease prior administration of anti-emetics (24hr)
different types of cupping therapy and ankle range of motion

Conditions: Healthy

Summary: the purpose of this study was to determine the acute effects of different manual cupping therapy protocols on ankle range of motion, compared to sham treatments, in generally healthy adults with limited ankle range of motion (i.e., ankle dorsiflexion less than 40 degrees).

the purpose of this study was to determine the acute effects of different manual cupping therapy protocols on ankle range of motion, compared to sham treatments, in generally healthy adults with limited ankle range of motion (i.e., ankle dorsiflexion less than 40 degrees). participants had their baseline ankle dorsiflexion measured with a digital inclinometer in a weight-bearing modified lunge position by a certified athletic trainer. participants who were eligible for the study were then randomly assigned to one of 4 groups; 2 of which were intervention groups (i.e., dynamic cupping, static cupping) and 2 of which were sham treatments (i.e., static sham cupping, dynamic sham cupping). each participant was blinded to the therapy they were randomized to and all received a total of 10 minutes of the cupping therapy (either actual or sham). in general, cupping therapy consisted of creating a negative pressure in four 2" diameter plastic cups placed on the gastrocnemius. sham cups had small holes in them allowing air to leak out. cups were also attached with adhesive tape to all participants to ensure blinding. depending on the treatment received, participants either were asked to lie still in the prone position or perform ankle exercises during the 10 minutes while the cups were attached. immediately after receiving treatment, participants had their ankle dorsiflexion measured again using the same procedure described for baseline measurement.

Eligibility criteria:
inclusion criteria: * limited ankle dorsiflexion (less than 40 degrees of weight bearing ankle dorsiflexion at baselines) * never received cupping therapy prior to the study * no lower extremity injuries in the past 6 months * no contraindications associated with cupping therapy (e.g., deep vein thrombosis, pregnancy, bone fracture, or sunburn/rash) * generally healthy exclusion criteria: * ankle dorsiflexion greater than or equal to 40 degrees during weight bearing ankle dorsiflexion at baseline * received cupping therapy in the past * has a lower extremity injury or has had a lower extremity injury in the past 6 months * self-reported a contraindication associated with cupping therapy (e.g., deep vein thrombosis, pregnancy, bone fracture, or sunburn/rash).

Keywords: ankle dorsiflexion dynamic cupping static cupping
renin angiotensin system blockade in renal transplant patients with presence of pecs in urine

Conditions: Chronic Kidney Allograft Nephropathy

Summary: by means of a personalized medicine strategy, investigators are going to evaluate if the treatment with an angiotensin ii receptor antagonist (araii) in renal transplant patients with the presence of renal progenitor cells (pecs) in the urine is able to prevent the expected loss of glomerular filtration (gfr) observed in this subgroup of patients. in addition, investigators intend to deepen the mechanisms of glomerular damage and glomerular repair involved in the process of chronic allograft damage.

a randomized, double-blind clinical trial will be performed in renal transplant patients in month 6 post-transplant, at the time of protocol renal biopsy. after verifying the inclusion and exclusion criteria, informed consent will be obtained. patients with urinary pecs will be randomized to 80 mg of valsartan vs. placebo (sample size calculated for a superiority study, 45 patients per group). patients without pecs in urine will be followed according to usual clinical practice. the follow-up will be up to 2 years post-transplant. at baseline (6 m post-transplant) and at 2 years the gfr will be measured by means of iohexol clearance (main variable) and, in addition, we will analyze safety variables such as patient and graft survival and ragis. by means of morphometry techniques on renal biopsy and by measuring the renal cortical volume by high resolution ct, the number of glomeruli will be determined, which in turn, will allow to calculate the sn-gfr. finally, in 5 patients per study group and in 5 controls, pecs of renal tissue will be isolated by means of laser microdissection techniques to perform single-cell rna sequencing techniques to assess the molecular pathways involved in the glomerular damage and repair process and how the raas blockade modifies such molecular pathways.

Eligibility criteria:
inclusion criteria: * written informed consent * stable renal function understood as a variation of egfr of less than 15% in the last 3 months * immunosuppression maintenance based on tacrolimus and mmf / mpa exclusion criteria: * chronic active infection by hcv, hbv, hiv. * treatment with inhibitors of the renin angiotensin system. * double kidney transplant or combined with another organ. * immunosuppression of maintenance other than tacrolimus and mmf / mpa. * egfr \<20 ml / min / 1.73m2. * history of allergy or intolerance to inhibitors of the renin angiotensin system. * physically fertile women who plan to become pregnant, are pregnant and / or breast-feeding, or who do not want to use effective contraception during their participation in the study. * any other medical condition that, in the opinion of the investigator, based on the counting or review of clinical records, could affect the completion of the study, including, but not limited to, visual problems or cognitive impairment.

Keywords: renin angiotensin kidney transplant pec's
radiofrequency-assisted hepatectomy on the outcomes of hcc patients with cirrhosis

Conditions: Hepatocellular Carcinoma; Cirrhosis

Summary: surgical resection is the most effective treatment of primary and secondary liver tumors. technical innovations have mainly focused on minimizing bleeding during transection of the hepatic parenchyma because excessive hemorrhage and the need for blood transfusion are associated with increased postoperative morbidity and mortality. recently,radiofrequency-assisted（rfa）hepatectomy has developed rapidly and gained widespread acceptance for the treatment of hepatocellular carcinomas（hcc），but its influence on the prognosis of hcc patients，especially for those with cirrhosis，is still controversial. therefore, we design this prospective clinical trial to explore the effect of rfa hepatectomy versus the conventional hepatectomy on the outcomes of perioperative period and prognosis of hcc patients with cirrhosis.


Eligibility criteria:
inclusion criteria: * aged from 18 to 65 years , no gender restriction. * clinical diagnosis of resectable hcc. * preoperative liver function test showed child-pugh class a or b. * indocyanine green retention at 15 minutes (icg-15) of \<30%. * acceptable clotting profile :platelet count \> 50 x 109/l and a prolonged prothrombin time of \< 5 seconds. * enough relative residual liver volume (%rlv) ≥ 40%. * no tumor invasion in primary branch of portal vein, hepatic vein, or inferior vena cava. * no other anti-tumor therapy received before the treatment. * no metastasis in lymphnode or other organs. * written consent inform assigned. exclusion criteria: * pregnancy. * intraoperative findings of tumor rupture，extrahepatic tumor or lymphnode metastasis. * tumor invasion in primary branch of portal vein, hepatic vein, or inferior vena cava.

Keywords: radiofrequency-assisted（rf） hepatectomy postoperative liver injury
using equine therapy in dementia cognitive stimulation

Conditions: Dementia

Summary: the goal of this clinical trial is to learn if integrating equine therapy in memory workshops in mild to moderate dementias can improve cognitive function, quality of life and mood. the main question\[s\] it aims to answer is: does the mediation of a horse in memory workshops increase its effects ? researchers will compare traditional memory workshops, memory workshops using equine therapy and a control group to see if the equine therapy mediation will increase cognitive functions, mood and quality of life in individuals with mild to moderate dementias. participants will participate in 8 weekly sessions of equine therapy memory workshops / traditional memory workshops / a control group will not have any interventions during that period. all subjects will be evaluated pre and post intervention period.


Eligibility criteria:
inclusion criteria: * have been medically diagnosed with major neurocognitive disorders * scores between 0.5 and 2 on the cognitive dementia rating scale (cdr) (berg, 1982) * adults of all genders, aged 65 and over; and * willingness to participate in a memory workshop; e) willingness to interact with a horse. exclusion criteria: * expressed fear, aversion, or has had a negative experience with horses * allergy or other medical condition which did not allow contact with horses.

Keywords: dementia equine therapy neurocognitive stimulation memory workshop quality of life alzheimer&#39;s depression
a comparison of two adjunctive treatments in arthroscopic cuff repair

Conditions: Rotator Cuff Tear

Summary: this clinical trial is being conducted to study two adjunctive treatments for rotator cuff repair; soft tissue and bone trephination. "trephination" is a procedure that involves making small perforations either in the torn tendon near its edge, or in the bone that the tendon is repaired to. the rotator cuff is repaired by sewing the tendon down to the bone in the shoulder. trephination is a new technique that is used in addition to the standard method of repairing the rotator cuff tendon. this study will help to determine whether this technique improves the speed of healing, the strength and the re-tear rate of the repair. you are being asked to take part in this study because you have a tear of the rotator cuff that requires surgical treatment. a total of 90 participants will participate in this study.


Eligibility criteria:
inclusion criteria: * patients who have failed standard non-surgical management of their rotator cuff tear, and who would benefit from a surgical repair of the cuff. * failed medical management will be defined as persistent pain and disability despite adequate standard non-operative management for 6 months. medical management will be defined as: * the use of drugs including analgesics and non-steroidal anti-inflammatory drugs * physiotherapy consisting of stretching, strengthening and local modalities (ultrasound, cryotherapy, etc) * activity modification * imaging, and intra-operative findings confirming a full thickness tear of the rotator cuff. exclusion criteria: 1. characteristics of the cuff tear that render the cuff irrepairable: fatty infiltration in the muscles grade iii (50%) or greater; superior subluxation of the humeral head; retraction of the cuff to the level of the glenoid rim. 2. partial thickness cuff tears. 3. significant shoulder comorbidities e.g. bankart lesion, osteoarthritis 4. previous surgery on affected shoulder e.g. previous rotator cuff repair. 5. patients with active worker's compensation claims 6. active joint or systemic infection 7. significant muscle paralysis 8. rotator cuff tear arthropathy 9. charcot's arthropathy 10. significant medical comorbidity that could alter the effectiveness of the surgical intervention (eg. cervical radiculopathy, polymyalgia rheumatica) 11. major medical illness (life expectancy less then 1 year or unacceptably high operative risk) 12. unable to speak or read english/french 13. psychiatric illness that precludes informed consent 14. unwilling to be followed for 1 year 15. advanced physiologic age

Keywords: rotator cuff tear
prediction of pain during old people care measured by skin conductance

Conditions: Pain

Summary: the purpose of the project is to validate the use of pain monitor™ device, not invasive and simple of employment, for old people able to answer to a digital scale of pain intensity. the main objective is to develop and to validate a model of prediction of the pain in old subject at the time of the care, using the measure of variation of the skin conductance.


Eligibility criteria:
inclusion criteria: * hospitalized patient; * patient over 65 years of age; * communicating, without cognitive impairment; * having to undergo an act presumed to be painful during which the patient's mobility is limited: nursing care (removal of a drain, dressing of a chronic wound, urinary catheterization, etc.), medical examination, etc.; * benefiting from a social security scheme or having rights; * having given their prior informed written consent; * person able to read. exclusion criteria: * cutaneous anomaly on the site of measure; * pacemaker or internal defibrillator; * extremities twitching; * treated by neostigmine.

Keywords: 65 years old
a study to compare pharmacokinetics, efficacy and safety of subcutaneous ct-p44 and darzalex faspro in combination with lenalidomide and dexamethasone in patients with refractory or relapsed multiple myeloma

Conditions: Refractory or Relapsed Multiple Myeloma

Summary: this study is a phase 1/3 study to compare pharmacokinetics, efficacy and safety of subcutaneous ct-p44 and darzalex faspro in combination with lenalidomide and dexamethasone in patients with refractory or relapsed multiple myeloma


Eligibility criteria:
\[main inclusion criteria\] * male or female with 18 years of age or older. * patient must have documented multiple myeloma (mm) according to imwg criteria * patient must have a documented relapsed or refractory disease. * patient must have achieved a response (pr or better based on investigator's determination of response by the imwg criteria) to at least one prior regimen. * patient must have a pd as defined by the imwg criteria on or after their last line of therapy. \[main exclusion criteria\] * patient has received daratumumab or any other drug specifically targeting cd38 previously. * patient's disease shows evidence of refractoriness or intolerance to lenalidomide. * patient is known or suspected of not being able to comply with the study protocol (e.g., psychological disorder) or the patient has any condition for which, in the opinion of the investigator, participation would not be in the best interest of the patient (e.g., compromise their well-being) or that could prevent, limit, or confound the protocol-specified assessments.