Kornimate/medical-research-clean huggingface dataset:
inspiratory muscle training and hospital complications

Conditions: Muscle Weakness

Summary: the inspiratory muscle training (imt) is a feasible and safe strategy for patients and athletes, your goal is to recondition the respiratory muscles, providing optimization of lung capacity, either for high performance sport as to support metabolic wear caused by illness. it is generally agreed the positive impact of the application of a tmi protocol on maximal inspiratory pressure (mip), this benefit encourages individuals sick since weaning from mechanical ventilation (mv), to the optimization of physical performance in cardiac and / or pulmonary rehabilitation. the tmi is based on the principles: the burden imposed on the muscle; the specificity of training; the reversibility of the gain and muscle atrophy.

this prospective double-blind (patient and evaluator) randomised controlled trial compared the efficacy of inspiratory muscle training and inspiratory muscle training. the study protocol for this trial was described elsewhere. this study was conducted in accordance with consolidated standards of reporting trials recommendations. the trial was performed at the roberto santos general hospital in salvador, bahia, brazil. this study was approved by the institutional hospital ethics committee (approval reference number 03/2014). before enrolment, written informed consent was obtained from participants or their legal guardians.

Eligibility criteria:
inclusion criteria: * admission to the hospital ward; * at least two of the following risk factors for prolonged hospitalization: two or more comorbidities; sepsis; liver, lung, or kidney diseases; neoplasia; mechanical ventilation; and use of vasopressor or dialysis therapy. exclusion criteria: * patients with a cognitive disability that made them unable to perform the respiratory training; * uncontrolled cardiac arrhythmias; * circulatory shock; * acute ischemic heart disease; * acute respiratory failure (characterised by a partial pressure of arterial oxygen \ 50 mmhg); * neuromuscular disease or myopathies; * diaphragmatic paresis or paralysis were excluded from the protocol.

Keywords: respiratory muscles muscle weakness hospitalization length of stay mortality
effect of delayed vs immediate umbilical cord clamping on maternal blood loss in term spontaneous vaginal delivery

Conditions: Post Partum Hemorrhage

Summary: policies for timing of cord clamping vary, with early cord clamping generally carried out in the first 60 seconds aler birth, whereas latercord clamping usually involves clamping the umbilical cord greater than one minute after the birth or when cord pulsation has ceased


Eligibility criteria:
inclusion criteria: * singleton pregnancy * at term * cephalic presentation * spontaneous labor * spontaneous vaginal delivery exclusion criteria: * multiple gestation * preterm gestation * induced labor * operative delivery * hypertension or preeclampsia * fetal anomaly * abnormal placentation * planned cord blood banking * maternal bleeding disorder
extended application of intraoperative parathyroid scores system(ipss) in thyroidectomy

Conditions: Intraoperative Parathyroid Scores System

Summary: after established the intraoperative parathyroid scores system (ipss) for thyroidectomy we further extented the clinical value of intraoperative parathyroid scores system in treatment decisions of calcium treatment time and improve recognition skills of parathyroid in clinicians

ipss includes transplantation parathyroid scores and in situ parathyroid scores, the investigators will establish the intraoperative parathyroid scores system by parathyroid size and blood supply, and recording ipss, according to certain rules. we expand ipss, including the description of the location of parathyroid after postoperative.parathyroid hormone and calcium were test in d0, d1, d14, d60 post operation. the correlation between intraoperative parathyroid scores and pth calcium were calculated, and roc curve and logistic regression were tested for the prediction value.and after that we further evaluate the relationship between ipss and calcium supplement time.and whether ipss enhance ability of parathyroid recognition for clinical doctors.

Eligibility criteria:
inclusion criteria: 1. postoperative pathology confirmed as thyroid papillary carcinoma; 2. for the first time to undergo thyroid surgery, no history of neck surgery and external radiotherapy; 3. preoperative serum calcium, parathyroid hormone levels were normal; 4. intraoperative and postoperative clinical data integrity, standardized follow-up patients; 5. parathyroid is a tumor violation. exclusion criteria: 1. serious underlying disease; 2. age greater than 60 years of age or combined with arteriosclerotic disease; 3. patients with postoperative loss; 4. patients with parathyroid disease.

Keywords: intraoperative parathyroid scores system total thyroidectomy thyroid cancer hypoparathyroidism prediction
impact of using mini-bronchoalveolar lavage as a diagnostic test for ventilator-associated pneumonia

Conditions: Ventilator-Associated Pneumonia

Summary: the proposed study will evaluate adult patients admitted to the medical or surgical intensive care units (icus) at san francisco general hospital (sfgh). on admission, patients will be randomized in a 1:1 manner to the mini-bronchoalveolar lavage (bal) quantitative culture arm in the setting of suspected ventilator-associated pneumonia (vap) versus the tracheal aspirate culture arm, which is the current test available at sfgh.

patients will be randomized to either mini-bal or tracheal aspirate then samples will be taken to the lab for culture. comparative analysis will then be performed based upon lab results.

Eligibility criteria:
inclusion criteria: * all adult patients (\> age 18) admitted to 5e, 5r, and 4e intensive care units and are on the ventilator for greater than 48 hours and expected to remain on the ventilator for awhile * study procedures would be performed only in patients clinically suspected of having vap. exclusion criteria: * severe respiratory distress at the time of suspected vap defined by: * fio2 ≥ 0.7 * peep ≥ 12
the effect of extracorporeal shock wave therapy in the treatment of post burn scars

Conditions: Cicatrix, Hypertrophic

Summary: a prospective, randomized, controlled study. the patients were divided into two groups with twenty patients per group. the control group received the standard treatment for postburn scars. the treatment group received the standard treatment and treatment of postburn scars with extracorporeal shock wave therapy 512 impulses of 0.15mj/mm 2 in each session, twice per week for 4 weeks. the investigators assessed the appearance of scar with the vancouver scar scale (vss), pruritus and pain with visual analog scale (vas) before the start of the treatment and at 2 weeks and 5 months after the treatment.


Eligibility criteria:
inclusion criteria: * patients with hypertrophic post burn scars of approximately 64 cm2 surface area. exclusion criteria: * patients younger than 18 year. * pregnant women. * having a known skin condition (e.g. psoriasis, skin cancer etc.). * immunosuppression. * hemophilia . * matured scars. * scars located above the lungs, the bowels, the gonads or electronic implants.
a clinical trial to assess the safety and efficacy of subjects with dry eye disease

Conditions: Dry Eye Disease

Summary: a multicenter, phase 3, randomized, double-masked, parallel-group, vehicle-controlled, environment exposure clinical trial to assess the efficacy and safety of 0.25% reproxalap


Eligibility criteria:
inclusion criteria: * at least 18 years of age; * written informed consent and sign the health information portability and accountability act (hipaa) form; * history of use or desire to use eye drops for dry eye symptoms within 6 months of visit 1 exclusion criteria: * ongoing ocular infection (bacterial, viral, or fungal) or active ocular inflammation at visit 1; * contact lenses within 7 days of visit 1 or anticipate using contact lenses during the trial; * eye drops within 2 hours of visit 1; * laser-assisted in situ keratomileusis (lasik) surgery within the last 12 months; * topical ocular cyclosporine, lifitegrast, corticosteroid, or any other topical ocular prescription medication within 90 days of visit 1
nac for hematopoietic recovery in saa

Conditions: Aplastic Anemia

Summary: this is a prospective single-arm clinical study to evaluate the role of nac among patients with severe aplastic anemia (saa) can promote hematopoietic recovery after haploidentical transplantation.

allogeneic hematopoietic stem cell transplantation (allo-hsct) is an effective treatment of severe aplastic anemia (saa). however, poor hematopoietic reconstitution including poor graft function (pgf) and prolonged isolated thrombocytopenia (pt), remains a life-threatening complication after allo-hsct. especially with the increasing use of haploidentical allo-hsct (haplo-hsct) in the past ten years, pgf and pt have become growing obstacles contributing to high morbidity and mortality after allo-hsct. a previous clinical prospective cohort study showed that nac could improve the function of bone marrow endothelial progenitor cells and promote hematopoietic recovery among leukemia patients after haploidentical transplantation. therefore, we hypothesized that the prophylactic administration of nac could facilitate the recovery of hematopoietic capacity by improving the bone marrow microenvironment of patients with saa after haploidentical transplantation.

Eligibility criteria:
inclusion criteria: 1. diagnosed with saa or vsaa 2. aged 18-50 3. no severe organ injury 4. no uncontrolled active infections 5. sign informed consent form, have the ability to comply with study and follow-up procedures exclusion criteria: 1. hypersensitivity to nac or history of bronchial asthma 2. life expectancy less than 30 days post-transplantation 3. uncontrolled infections pre-transplantation 4. cardiac dysfunction (particularly congestive heart failure, unstable coronary artery disease and serious cardiac ventricular arrhythmias requiring antiarrhythmic therapy) 5. respiratory failure ( pao2 ≤60mmhg) 6. hepatic abnormalities (total bilirubin ≥2 times the upper limit of normal \[uln\], alanine aminotransferase or aspartate aminotransferase ≥2 times the uln) 7. renal dysfunction (creatinine ≥1.5 times the uln or creatinine clearance rate \< 30 ml/min) 8. ecog performance status ≥3 9. with any conditions not suitable for the trial (investigators' decision)

Keywords: hematopoietic recovery nac hsct
correlation between muscle strength and thickness in critically ill patients

Conditions: Critical Illness; Muscle Weakness

Summary: mechanical ventilation (mv) is associated with adverse outcomes in ventilated patients, and impact of mv-induced diaphragm changes are still unclear. the objective of this prospective observational study is to assess muscle thickness and strength, specifically in limb muscles such as the quadriceps, among critically ill patients who undergo extended mechanical ventilation during their intensive care unit (icu) stay. the primary inquiries this study seeks to address are: * is there an association between muscle thickness and strength in the limbs of critically ill patients undergoing prolonged mv? * how much thickness and strength variation can be expected in respiratory and limb muscles in critically ill patients undergoing prolonged mv?

the methodology for measuring the thickness of the diaphragm and quadriceps involves the use of bedside ultrasound. in terms of diaphragmatic assessment, to ensure consistency over multiple timepoints, the areas of the lower limbs evaluated (quadriceps thickness, qthick and cross section area, csa) will be marked on the skin using a dermatographic pen during the peripheral assessments. muscle strength in the limbs will be assessed utilizing the medical research council (mrc) score, specifically in patients who are awake and cooperative (rass 0 +/- 1). additionally, a dynamometer will be employed for the precise measurement of quadriceps strength, serving as the gold standard. the timeline for data collection during the observational period is structured as follows: t1: 48-72 hours from the start of invasive mv after intubation t2: at the initial trial in pressure support mode. t3: immediately prior to extubation. t4: before discharge from the intensive care unit.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * intubated patients on mechanical ventilation presumably for 48 hours; * informed consent exclusion criteria: * contraindication (absolute or relative) to assessment: acute bleeding, multiple fractures or trauma, spinal instability; * hemodynamic instability during assessment; * icu admission due to thoracic surgery, including lung transplant patients; * history of preexisting neuromuscular diseases; * history of preexisting functional impairment; * pheripheral neural disease; * cervical spine injury;

Keywords: intensive care units respiration, artificial limb muscle assessment diaphragm thickness respiratory distress syndrome
investigation of flare and remission in subjects with atopic dermatitis

Conditions: Atopic Dermatitis

Summary: the trial is an exploratory, single-centre, uncontrolled, open-label, interventional trial of up to 19 weeks' duration to investigate flare and remission in subjects with moderate-to-severe atopic dermatitis (ad) treated with cyclosporine a (csa).

40 subjects with moderate-to-severe ad will be treated with a 3-week course of high-dose csa, which is a standard-of-care treatment regimen. after 3 weeks, all responders shift to oral low-dose csa treatment (2-2.5 mg/kg/day) until onset of a second flare or until week 16 (day 113). in case of a second ad flare, the subjects shift back to oral high-dose csa treatment (4-5 mg/kg/day) for 3 weeks.

Eligibility criteria:
main inclusion criteria: * diagnosis and history of chronic, moderate-to-severe ad (by the eichenfield revised criteria of hanifin and rajka) for at least 3 years before the screening visit. * subjects who have an ad flare at the start of the trial (easi score ≥10 at screening and ≥16 at the baseline visit). main exclusion criteria: * treatment with allergen immunotherapy within 6 months before the baseline visit. * treatment with leukotriene inhibitors, systemic glucocorticoids, or other systemic treatment for ad (including immunosuppressive treatment, ultraviolet therapy, and biologics) within 4 weeks before the baseline visit. * treatment with topical corticosteroids or topical calcineurin inhibitors within 1 week before the baseline visit. * chronic or acute infection requiring treatment with oral or intravenous antibiotics, anti-virals, anti-parasitics, anti-protozoals, or anti-fungals within 4 weeks before the screening visit or superficial skin infections within 1 week before the screening visit. * history of malignancy within 5 years before the baseline visit, with the following exceptions: subjects with a history of completely treated carcinoma in situ of cervix, and non-metastatic squamous or basal cell carcinoma of the skin are allowed. * hypertension (\>150/95 mmhg) at the screening visit. * planned surgical procedure during the length of the subject's participation in this trial. * use of a tanning booth/parlour within 4 weeks before the screening visit. * pregnant, breastfeeding, or lactating women. * laboratory abnormalities at the screening visit.

Keywords: atopic dermatitis cyclosporine a atopic dermatitis pathophysiology
spinal anaesthesia vs. general anaesthesia for tha, tka and uka

Conditions: Osteoarthritis, Hip; Osteoarthritis, Knee

Summary: the goal of this randomized clinical trial is to investigate the postoperative recovery following hip and knee arthroplasty procedures depending on the use of either spinal anaesthesia (sa) or general anaesthesia (ga). the main questions are: * are more patients able to be safely mobilized within 6 hours postoperatively when using ga compared to sa? * does postoperative pain, nausea and vomiting, dizzyness, occurence of delirium and urinary retention differ between the anaesthetic methods? participants, scheduled for total hip, total knee and unicomartmental knee arthroplasty, will be randomized to recieve spinal anaesthesia or general anaesthesia in relation to surgery. at 6 hours postoperatively a physiotherapist will conduct a 5-meter walking test to evaluate whether the participant can be safely mobilized.


Eligibility criteria:
inclusion criteria: * clinical and radiological hip or knee osteoarthritis meeting the indications for primary total hip, total knee, or unicompartmental knee arthroplasty. * ≥18 years of age. * able to speak and understand danish * able to give informed consent and must be cognitively intact. exclusion criteria: * lives in an institution. * uses walking aid such as a walker or a wheelchair. * terminal illness. * has contraindications for either general or spinal anaesthesia. * has objections to receiving either general or spinal anaesthesia. * requires anxiolytics as premedication prior to anaesthesia. * traumatic aetiology as a basis for surgical indication. * altered pain perception and / or neurologic affection due to diabetes or other disorders. * daily preoperative use of opioids \> 30 mg of morphine milligram equivalents (mme). * standard primary arthroplasty procedure is evaluated not to be suitable. * women considered fertile but without sufficient birth control.

Keywords: hip arthroplasty knee arthroplasty unicompartmental knee arthroplasty general anaesthesia spinal anaesthesia hip osteoarthritis knee osteoarthritis fast-track surger
clinical evaluation of osna breast cancer system to extensive frozen section histopathology

Conditions: Breast Neoplasms; Breast Diseases

Summary: the study will determine the sensitivity, specificity, negative predictive value and positive predictive value of the osna breast cancer system by comparing its performance to an extensive intraoperative frozen section protocol for sentinel lymph nodes removed during standard sentinel lymph node biopsy procedures from breast cancer subjects.


Eligibility criteria:
inclusion criteria: * male or female; * 18 years of age or older; * diagnosed pre-surgically with t1 or t2 breast cancer without clinical evidence of axillary lymph node involvement and scheduled for surgery including sentinel lymph node dissection; * subjects (or the subjects' legal representatives) who have read, understood to the best of their ability and signed the informed consent form. exclusion criteria: * subjects diagnosed pre-surgically with large or locally advanced (t3 \& t4) breast cancer; * pregnant subjects, confirmed by interview with either subject or treating physician; * subjects diagnosed with inflammatory breast cancer; * subjects diagnosed with ductal carcinoma in situ (dcis) when breast conservation is to be done; * subjects with clinically suspicious, palpable axillary lymph nodes; * subjects previously treated for or previously diagnosed with another type of invasive cancer. subjects with skin cancer (basal cell and squamous cell carcinoma) may be included, except for subjects diagnosed with melanoma; subjects with non-invasive carcinoma of the cervix may also be included in this study. * subjects who have received pre-operative systemic therapy; * subjects who are incapable of providing written informed consent; * subjects who have been judged to be an inappropriate candidate by any medical care provider (e.g., surgeon, oncologist or pathologist). * subjects participating in other clinical studies where the sln evaluation will be negatively impacted by this study.

Keywords: breast neoplasms breast diseases
vestibular schwannoma organoids

Conditions: Vestibular Schwannoma

Summary: in standard of care regularly planned surgery, tissue will be obtained from patients who are suspicious for having vestibular schwannoma (on mri). the tissue that remains after the pathologist gathered sufficient for analysis, the remaining tissue is used for creating tumour stem cell organoids.

this project constitutes scientific research since the presence of tumor stem cells has not been shown in schwannoma before. secondly the organoid model has not yet been described for vss. the correlation between effect in schwannoma organoids and in patients has to be evaluated but can proof to be very valuable since it has been shown in a number of tumors. the tumor tissue will be acquired during regularly planned surgery. the tissue that is used is what is left after sufficient material has been sent to the pathologist to make the diagnosis. so the tissue that is used is removed routinely during surgery, but instead of banking it at the pathology department, it is used for the research project. blood samples that can be used to compare normal dna to tumor cells dna will be acquired from central lines that are routinely placed during these procedures, so no additional interventions will be done in acquiring the tissue and blood for this study.

Eligibility criteria:
inclusion criteria: * mri with suspicion for vestibular schwannoma * indication for surgery in the skull base committee * 18 years or older exclusion criteria: * refusal to participate * younger than 18 years * incapacitated
impaact p1107: effects of cord blood transplantation with ccr5δ32 donor cells on hiv persistence

Conditions: HIV Infection

Summary: impaact p1107 will describe the outcomes of hiv-infected persons, ages 12 months and older, who undergo transplantation with ccr5δ32 cord blood stem cells for treatment of cancer, hematopoietic disease, or other underlying disease.


Eligibility criteria:
inclusion criteria: * confirmed hiv-1 infection * 12 months of age or older * willing to provide written informed consent * pre-transplant cohort: underlying disease appropriate for stem cell transplant, as determined by the transplant team as part of standard of care. * pre-transplant cohort: availability of an appropriately matched (as determined by the transplant center) ccr5δ32 cord blood unit (homozygous or heterozygous) and intention to proceed with transplantation. note: double cord transplants are allowed. if a double cord is used, at least one cord blood unit should be ccr5∆32 (homozygous or heterozygous). * pre-transplant cohort: received a ccr5δ32 homozygous cord blood or bone marrow transplant within the last two years. exclusion criteria: • received, or planning to receive, more than one ccr5δ32 homozygous cord blood or bone marrow transplant.

Keywords: cord blood transplantation ccr5δ32 hiv cure