Kornimate/medical-research-clean huggingface dataset:
high type fistula in ano, use staged seton, loose thick sutures

Conditions: Fistula in Ano

Summary: fistula in ano is a chronic problem for the patients. it causes distressing because of foul odor and soiling with recurrent infection and discharge. recurrence and anal sphincter injury were the most critical complications following surgery. loose, thick seton placement was the most promising surgical operation. to reduce the time of seton placement, therefore, decreasing the suffering of patients from soiling and multiple dressing.

background: fistula in ano is a chronic problem for the patients. it causes distressing because of foul odor and soiling with recurrent infection and discharge. recurrence and anal sphincter injury were the most critical complications following surgery. loose, thick seton placement was the most promising surgical operation. to reduce the time of seton placement, therefore, decreasing the suffering of patients from soiling and multiple dressing. patients and methods: a retrospective study. one hundred patients with high type fistula in ano treated surgically in al-sader medical city and al-najaf daily private clinic, najaf city, iraq from feb 2018 to march 2019. fistulography and magnetic resonance imaging have taken from all patients. after that, fistulectomy with loose, thick seton suture placed for three months. patients with the persistence of high fistula tract underwent a second surgery and third operation until complete healing.

Eligibility criteria:
inclusion criteria: * high type fistula in ano recurrent high type fistula in ano non abscess cases exclusion criteria: low type fistula in ano below 16 years old -

Keywords: high type seton loose thick sutures recurrance
effect of neutrophil lymphocyte-platelet lymphocyte ratio on complications in pediatric patients

Conditions: Anesthesia; Complication

Summary: the aim of this study was to investigate the relationship between nlr, plr and postoperative complications in children undergoing adenotonsillectomy and adenoidectomy.

between the dates of february 1, 2018 and june 30, 2018, patients between 2-10 years of age, asa i-ii, elective adenotonsillectomy and adenoidectomy under general anesthesia were planned to be included in the study. the number of neutrophils, lymphocytes and platelets will be taken from the hospital registry system taken preoperatively and the nlr and plr ratios will be calculated. all patients in the operating room will be started with routine monitoring and anesthesia. hemodynamic data during surgery will be recorded. the entrance to the operating room (t1), 5 minutes after the start of anesthesia (t5), 15 minutes (t15), 30 minutes (t30) and 45 minutes (t45) will be recorded in the follow-up form of the anesthesia. the fasting period of the patients and the drugs and fluids applied during surgery will be recorded from the anesthesia form. at the end of the operation, the patients who were taken to the recovery room at the end of the surgery will be evaluated with 1 point, 15 minutes, 30 minutes, 1 hour and 4 hours and 6 hours vomiting using the 4 point nausea scale. introduction to recovery room using modified eastern ontario children's hospital pain scale (mcheops), postoperative pain at 15 min, 30 min, 1 hr and 4 hr. analgesic requirement will be recorded. bronchospasm, agitation, etc. will be recorded by evaluating whether there are complications.

Eligibility criteria:
inclusion criteria: * patients undergoing elective adenotonsillectomy and adenoidectomy under general anesthesia exclusion criteria: * immunodeficiency * children of parents who do not want to participate in the study * use of anticoagulants * children with hematological disease
the efficacy of shear-wave elastography-guided biopsy for diagnosis in pleural disease

Conditions: Pleural Diseases

Summary: to investigate the information from shear-wave elastography on pleural tissues will improve the diagnosis of pleural diseases, as to increase the diagnostic yield in ultrasound-guided transthoracic pleura biopsy.


Eligibility criteria:
inclusion criteria: * patients with radiographic evidence of pleural disease exclusion criteria: * age \< 18 y/o * patients who cannot hold their breath for 5 seconds
medical telephone triage of emergency calls for thoracic pain

Conditions: Acute Coronary Syndrome

Summary: thoracic pain is the main symptom of acute coronary syndrome (acs), urgent and serious illness. whereas hospital mortality decreased until reaching 10%, out-of-hospital mortality remains high: half of the deaths occur during the first two hours. the benefit of an early diagnosis of acs in term of morbidity and mortality is well established. identification of the coronary origin of a thoracic pain by the telephone triage physician of the pre-hospital emergency service (samu) leads to the sending of a physician staffed ambulance (umh) and is thus a key element of the prognosis. the aim of the study is to build a telephone predictive score of acs at the triage of calls for non traumatic thoracic pain. the separate analysis of the questionnaires by sex will authorize the validation of a unique score or two distinct scores for men and women.

in france, approximately 30% of the calls for thoracic pain associated with an acs do not benefit from the sending of an umh. our assumption is that this situation could be improved if telephone triage physicians were guided by recommendations or consensual algorithms of decision. the telephone triage doctor will manage a single questionnaire with the patient, with demographic and simple clinical data. the construction of the score will be done by the analysis of these data confronted with the final diagnosis (effective acs or not). the effective existence of an acs among patients with thoracic pain will be affirmed by an expert committee after collection of the intra-hospital patient's data and the follow-up at one month.

Eligibility criteria:
inclusion criteria: * patient presenting a non-traumatic chest pain. * call to the telephone triage center in first (direct call from the patient) or second intention (call of another person before the patient) exclusion criteria: - inability to speak directly to the patient

Keywords: acute coronary syndrome thoracic pain prehospital diagnostic score
assess reacto- and immunogenicity of pneumococcal conjugate vaccine when given as booster or a 2 dose catch up schedule

Conditions: Infections, Streptococcal

Summary: this is a booster study in 2 groups of healthy children less than 3 years old to measure the reactogenicity, safety and immunogenicity of gsk biologicals' pneumococcal conjugate vaccine, when given as a booster or as a two-dose catch-up vaccination. this protocol posting deals with objectives and outcome measures of the booster phase. the objectives and outcome measures of the primary phase are presented in a separate protocol posting (nct number = nct00338351).

the protocol posting has been updated in order to comply with the fda amendment act, sep 2007.

Eligibility criteria:
inclusion criteria: * male or female between, and including, 18-21 months of age at the time of vaccination. * subjects who previously participated in the primary study and received 3 doses of study or control vaccines during the primary study. * subjects for whom the investigator believes that their parents/guardians can and will comply with the requirements of the protocol. * written informed consent obtained from the parent or guardian of the subject. * free of obvious health problems as established by medical history and clinical examination before entering into the study. exclusion criteria: * use of any investigational or non-registered drug or vaccine other than the study vaccine(s) within 30 days preceding the booster doses of study vaccines, or planned use during the study period (active phase and extended safety follow-up). * planned administration/ administration of a vaccine not foreseen by the study protocol during the period starting one month (30 days) before the booster doses of vaccine(s) and during the active phase of the study (up to the follow-up visit (visit 3)). * history of allergic disease or reactions likely to be exacerbated by any component of the vaccines. * history of seizures (subjects who have had a single, uncomplicated febrile convulsion in the past can be included) or progressive neurological disease. * acute disease at the time of enrolment. * chronic administration (defined as more than 14 days) of immunosuppressants or other immune-modifying drugs within 6 months prior to the booster doses of study vaccines. * any confirmed or suspected immunosuppressive or immunodeficient condition based on medical history and physical examination. * a family history of congenital or hereditary immunodeficiency. * major congenital defects or serious chronic illness. * administration of immunoglobulins and/or any blood products within the last 3 months prior to booster or follow-up vaccination or planned administration during the active phase of the study.

Keywords: immunogenicity pneumococcal disease safety booster vaccination pneumococcal vaccine
effects from a mandibular repositioning appliance in patients with obstructive sleep apnea and snoring

Conditions: Sleep Apnea Syndromes; Snoring; Disorders of Excessive Somnolence

Summary: the purpose of this study is to evaluate effects from a mandibular repositioning appliance on obstructive sleep apneas, symptoms, blood pressure and markers of stress, inflammation and cardiovascular health in patients with mild to moderate obstructive sleep apnea/hypopnea syndrome and in patients with symptomatic snoring.

mandibular repositioning appliances for the treatment of snoring and sleep apneas are increasingly used over the world, although the number of prescriptions of this therapy varies between countries. the appliance widens the upper airways during sleep in order to reduce sleep-disordered breathing. the device is easy to use and has become popular among patients. despite this, the evidence for effects of this treatment is not very strong and based on only a few studies. the aim of this study is therefore to test the hypothesis that a mandibular repositioning appliance reduces sleep apneas, daytime sleepiness and other sleep apnea symptoms and increases the quality of life in sleepy patients with mild to moderate obstructive sleep apnea and in patients with symptomatic snoring. secondary outcomes include effects on headaches, blood pressure and markers of stress, inflammation, cardiovascular health and oxidative stress. at baseline and after 4 month's treatment, the patients will respond to questionnaires about symptoms and quality of life. they will undergo measurements of sleepiness, sleep apneas and blood pressure as well as sampling of saliva, urine and blood. factors that predict a successful treatment outcome will be analyzed in order to more exactly clarify the indications for this treatment modality in a group of patients who have been suggested to benefit from mandibular repositioning appliances according to previous studies and reviews.

Eligibility criteria:
inclusion criteria: * obstructive sleep apnea, apnea-hypopnea index of \<30 with excessive daytime sleepiness * snoring with excessive daytime sleepiness, apnea-hypopnea index of \<5 * body mass index of \<35 exclusion criteria: * unable to give informed consent * psychiatric disorders including dementia that may interfere with the study protocol * other concomitant diseases that demand acute, effective treatment of sleep apnea * pharyngeal soft tissue abnormalities * living to far away from the university hospital * professional drivers * pregnancy * included in other studies * other sleep apnea treatments * severe craniomandibular disorders * acute or advanced periodontal disease * insufficient number of teeth

Keywords: sleep apnea syndromes snoring mandibular advancement activator appliances disorders of excessive somnolence blood pressure inflammation oxidative stress hormones markers of metabolic syndrome x
exciteosa for treatment of mild obstructive sleep apnea

Conditions: Sleep Apnea, Obstructive

Summary: the objective of this study is to assess the efficacy of the exciteosa device amongst a sample of patients with mild osa. the study is a multi-center, prospective, open-label, randomized, parallel-arm trial of exciteosa versus no-therapy for six weeks. up to 200 participants will be enrolled, in order to randomized n=102.


Eligibility criteria:
inclusion criteria: * aged \>=18 years; * diagnosed with mild osa; * smartphone or tablet capable of running the exciteosa app; * fluent in written and spoken english (all sites) or spanish (one site only). exclusion criteria: * bmi \>=35 kg/m2; * implanted medical device; * dental braces and/or intraoral metal jewelry; * any condition impacting the tissue of the oral cavity, including but not limited to ulceration or periodontitis; * symptomatic nasal pathology such as septal deviation, nasal polyposis, or chronic rhinosinusitis; * tonsillar hypertrophy (tonsil size grade 3 or greater); * clinically significant facial or oropharyngeal abnormalities such as class 2 malocclusion; * prior oropharyngeal surgery for sleep-disordered breathing; * at-home use of a mandibular advancement device or pap for sleep-disordered breathing within the previous four weeks; * use of any overnight therapy that cannot be withdrawn during study enrollment; * diagnosed with any sleep disorder other than osa; * chronic use of central nervous system depressants; * driver in a sleepiness-related vehicular accident or near-miss within the two years prior to enrolment (self-report); * employed as a commercial driver, pilot, or other occupation that may be impacted by hypersomnolence; * considered by the pi to be at risk of an ae resulting from hypersomnolence; * any periods of non-connectivity (wifi or cellular data) exceeding 48 hours planned to take place, or likely to take place, during enrollment; * current or planned pregnancy; * member of a vulnerable population, including but not limited to prisoners and those lacking consent capacity; * clinically-significant burden of comorbidities, and/or any other limitation or condition that may impact the patient's ability to complete the study protocol and use the device per the instructions for use (pi discretion); * employee and/or residing household member who is an employee of a company that produces or distributes products designed to diagnose, treat, and/or monitor sleep or sleep-disordered breathing (including the sponsor).
oto-313 in subjects with subjective tinnitus

Conditions: Tinnitus, Subjective

Summary: the purpose of this study is to evaluate the safety, tolerability, plasma pharmacokinetics (pk), and exploratory efficacy of oto-313 administered as an intratympanic injection for the treatment of subjective tinnitus.


Eligibility criteria:
inclusion criteria: * subject has subjective unilateral tinnitus and is consistently aware of their tinnitus throughout much of the waking day. * subject is able to use the electronic diary to complete their daily tinnitus ratings * subject's tinnitus is likely of cochlear origin, e.g., associated with sensorineural hearing loss; acute hearing loss from noise trauma, barotrauma, or traumatic cochlear injury (acute acoustic trauma, blast trauma, middle ear surgery, inner ear barotrauma); age-related hearing loss; resolved otitis media; ototoxic drug exposure. * subject is willing to comply with the protocol and attend all study visits. exclusion criteria: * subject has pulsatile tinnitus, tinnitus resulting from traumatic head or neck injury, or tinnitus resulting from a tumor or stroke. * subject is pregnant or lactating. * subject has other clinically significant illness, medical condition or medical history at screening or baseline (day 1) that, in the investigator's opinion, would likely reduce the safety of study participation or compliance with study procedures.

Keywords: tinnitus, intratympanic injection, gacyclidine
intrathecal opioid study

Conditions: Post-operative Pain

Summary: this is an interventional drug trail to evaluate the effect of different intrathecal opioids on post-operative pain experiences in women who have undergone caesarean section surgery.

1. to evaluate the effect of three different intrathecal opioid mixtures on post-operative pain experiences in women who have undergone caesarean section surgery, relating specifically to: 1. post-operative analgesic requirements at two time points (12 hours and 24 hours) after surgery 2. pain scores at two time points (12 hours and 24 hours) after surgery 3. sedation scores at two time points (12 hours and 24 hours) after surgery 4. post-operative nausea scores at two time points (12 hours and 24 hours) after surgery 5. post-operative pruritis scores at two time points (12 hours and 24 hours) after surgery 2. to determine the impact that the patients' post-operative pain has on their activities in the first 24 hours after surgery

Eligibility criteria:
inclusion criteria: * all patients \> 18years having caesarean section surgery under single shot spinal neuraxial anaesthesia at rahima moosa mother and child hospital exclusion criteria: * pre-operative: b) patient refusal or inability to give informed consent c) severe pre-eclampsia d) eclampsia e) patient unable to understand how to use the patient controlled analgesia (pca) pump, after appropriate counselling and training * intra-operative: a) obstetric complications: i) post-partum haemorrhage ii) ruptured uterus iii) still birth b) conversion to general anaesthesia intra-operatively c) administration of supplementary intravenous opioid analgesics * post-operative: 1. patients who have babies that require additional care, for a prolonged period, after birth eg. neonatal icu admission for ≥ 12hours or congenital abnormalities 2. patients who require icu or high care admission postoperatively for any intra-operative complications
sirolimus for retinal astrocytic hamartoma

Conditions: Retinal Astrocytic Hamartoma

Summary: a single patient study using intravitreal sirolimus to treat a patient with multiple retinal astrocytic hamartomas (rah) of both eyes.

retinal astrocytic hamartomas (rah) are benign tumors of glial cells arising from astrocytes in the nerve-fiber layer of the retina. they are often associated with tuberous sclerosis complex (tsc) and, more rarely, neurofibromatosis type 1 (nf1). rah may be caused by dysregulated tumor suppressors genes tsc1 or tsc2, which play a role in cell cycle regulation in retinal astrocytes via the pdgf-signalling pathway. downregulation of tsc1 or tsc2 can result in hyperactivation of mtor. sirolimus is an inhibitor of mtor, therefore inhibiting cell growth and proliferation of astrocytes. systemic mtor inhibitors (sirolimus and everolimus) have shown impressive reduction in the size of rah in animal models and many human case series. this single patient study is investigating the use of concurrent oral and intravitreal sirolimus to treat a patient with multiple retinal astrocytic hamartomas (rah) of both eyes to improve intraocular response and reduce duration of treatment. the patient has no other clinical features suggestive of neurofibromatosis and a presumed diagnosis of tuberous sclerosis is being considered, with only two hypopigmented skin lesions noted.

Eligibility criteria:
single case diagnosed with multiple retinal astrocytic hamartomas (rah) of both eyes with imminent threat to vision.
ketamine and magnesium in post-operative pain control in patients treated with opioids

Conditions: Chronic Pain

Summary: the goal of this research proposal is to determine if the intraoperative administrative of ketamine and magnesium during laparoscopic gynecologic surgery improves postoperative pain in patients on chronic opioid therapy for management of chronic pelvic pain.

in this randomized control trial, patients' postoperative pain scores will be assessed as scored by the numeric rating score (nrs) system. intraoperative and postoperative narcotic usage, nausea scores and patients' perception of their quality of recovery via the qor-40 survey will also be assessed. the use of intraoperative ketamine and magnesium is predicted to decrease postoperative pain in patients on chronic opioid therapy for management of chronic pelvic pain and will overall improve patients' postoperative experience.

Eligibility criteria:
inclusion criteria: 1. subjects undergoing elective laparoscopic gynecologic surgery 2. patients with chronic pelvic pain defined as pain that has persisted for more than 6 months in duration which is localized to the pelvis, anterior abdominal wall, lower back or buttocks and has leads to functional disability or medical care1 3. patients requiring opioids daily for \>1 month 4. consenting adults age 18-80 5. american society of anesthesiologists (asa) physical status classification ii to asa iii exclusion criteria: 1. patient refusal 2. chronic kidney disease (creatinine\>2) 3. patients treated with methadone 4. known allergy or adverse effect of ketamine or magnesium 5. patient unable to give informed consent 6. patient with limited or no english fluency 7. uncontrolled hypertension
group cbt for depression and aod disorders

Conditions: Depression; Substance Use

Summary: the investigators will adapt and test an existing treatment (group cbt for depression) for use in outpatient substance use treatment settings as delivered by trained substance use counselors. the investigators expect that treatment will lead to improved depression and substance use outcomes.

aim 1. to adapt an existing group therapy (cbt for depression), creating a manualized treatment and accompanying implementation measures and tools for use with clients with persistent depressive symptoms and aod disorders and to obtain preliminary assessments of the treatment from patient and provider perspectives. aim 2. to conduct a pilot test of the revised treatment in which we (a) demonstrate that when the therapy is implemented with fidelity, clinically significant reductions in depressive symptoms and aod use occur; (b) estimate the likely effect size; and (c) investigate the underlying mechanisms of change, including both cognitive-behavioral and group processes and their relationship to depression and aod treatment outcomes.

Eligibility criteria:
inclusion criteria: * enrolled in outpatient substance abuse program * bdi ii score \>13 * probable alcohol or substance use problem exclusion criteria: * cognitive impairment (short blessed \> 10) * probably bipolar or schizophrenic disorder

Keywords: depression substance use group cognitive behavioral therapy