Kornimate/medical-research-clean huggingface dataset:
optimizing care for children hospitalized with community-acquired pneumonia: novel diagnostics

Conditions: Community-acquired Pneumonia

Summary: children are commonly hospitalized because of community-acquired pneumonia. despite the fact that many of these children have viral disease, a majority is treated with antibiotics. these antibiotics will not accelerate recovery in those with viral pneumonia and can cause harm. we are interested in exploring whether the memed bv - a composite biomarker assay - could be used to improve antibiotic prescribing in these children by identifying those who likely have viral disease. this proposal describes a feasibility randomized trial of this diagnostic intervention.


Eligibility criteria:
inclusion criteria: * children with a history of fever who are hospitalized with cap (ie. 'severe cap') as per the clinical team and who have abnormal chest imaging (eg. radiograph, ultrasound) will be eligible. they must also have at least one of the following: 1. documented tachypnoea (\>60 bpm for age \ 50 bpm for 1-2 y, \>40 bpm for 2-4 y, and \>30 bpm for \>4 y); 2. cough on exam or by history; 3. increased work of breathing on exam; or 4. auscultatory findings (eg. focal crackles, bronchial breathing) consistent with cap. exclusion criteria: * children will be excluded from if they have received \>48h of intravenous antibiotics (eg. if transferred from another healthcare facility) or if they have a lobar consolidation that occupies the majority of a lobe on imaging, a pleural effusion that occupies more than ¼ of a lung field, or a positive blood culture for a bacterial pathogen (not a contaminant). examples of cap pathogens include s. pneumoniae, s. pyogenes (group a streptococcus), s. aureus, s. anginosus. examples of contaminants that would be ignored include the coagulase-negative staphylococci and bacillus spp. children will also be excluded if they have any of the following: chronic lung disease, congenital heart disease (requiring treatment or with exercise restrictions), malignancy, immunodeficiency (primary, acquired, or iatrogenic), a separate episode of pneumonia previously diagnosed within the past 2 weeks, or lung abscess diagnosed within the past six months. children will not be eligible to participate more than once.
3 airway clearance techniques in non cystic fibrosis bronchiectasis

Conditions: Bronchiectasis

Summary: study design: a randomized, crossover trial. each patient performed three different airway clearance techniques (autogenic drainage, slow expiratory with glottis opened in lateral posture \[eltgol\], temporary- positive expiratory pressure \[t-pep\] with not similar autonomy degree in a randomized order. each technique were applied in 3 sessions during one week at alternate days (monday /wednesday/friday or tuesday/thursday/saturday). the time spent in each bronchial session was 40 minutes. seven days were the wash-out time period between the different techniques.


Eligibility criteria:
inclusion criteria: 1. - non cystic fibrosis bronchiectasis diagnosed by high resolution computed tomographic 2. - mean sputum production ≥ 15 ml /24h 3. - clinical stability in the last 6 weeks 4. - not carrying out regular chest physiotherapy 5. - forced expiratory volume in 1 second ≥ 30% pred. ; forced vital capacity ≥ 45% pred. and peak expiratory flow \>270 l/s exclusion criteria: 1. - smoker or non-smoker form less than 2 years 2. - cystic fibrosis 3. - active tuberculosis or sarcoidosis

Keywords: airway clearance techniques mucus clearance chest physiotherapy autogenic drainage slow expiration with glottis opened in lateral posture(eltgol) temporary-positive expiratory pressure (t-pep) non cystic fibrosis bronchiectasis
whole-body electromyostimulation in inpatient rehabilitation

Conditions: Sarcopenia

Summary: based on various studies, scientific evidence has proven the effectiveness of whole-body electromyostimulation (wb-ems) on parameters such as increased physiological performance and body composition. as a pilot project, the aim of the study is to determine the effect of additional wb-ems as part of the inpatient four-week rehabilitation of sarcopenic subjects.

the loss of muscle mass in the age-associated process (sarcopenia) is a common indication in the field of orthopedic and cardiac rehabilitation, which may also be reinforced by previous immobilization and disuse of the muscles (atrophy of muscle). sarcopenia is defined as 2 standard deviations of average of the same sex in middle adult life. the present project focuses on the sarcopenia definition of the foundation for the national institutes of health (fnih). their limits are \< 0.789 (men) and \< 0.512 (women) and are calculated by adding the absolute muscle mass of the extremities divided by the body mass index (bmi). due to reduced muscle mass and thus limited strength / performance, the implementation of conventional training tools with regard to generate corresponding intensities is no longer possible, or in persons with additional cardiac or orthopedic restrictions heavily limited. in view of the existing indications, the alternative training technology whole-body electromyostimulation (wb-ems) is an adequate training tool for the rehabilitation process. the time-saving (max 20 minutes per training session) and effective training method is characterized by low orthopedic and cardiac stress. thus, wb-ems combines both relevant aspects of a joint-friendly training with effects on muscle mass and functionality. through the simultaneous activation of up to 10 muscle regions with corresponding, subjectively decidedly adjustable intensity per muscle group, up to 2,800 cm2 can be addressed. synchronized to a motion video, the participants perform light physical exercises in parallel to the current pulses. the aim of the study is, to evaluate the effect of additional wb-ems during a 4-week period of inpatient rehabilitation, comparing 3 groups: 1. wb-ems, stimulating 8 muscle groups (legs,arms, core, gluteal region) 2. partial-wb-ems, just stimulating the lower extremities (legs, gluteal region) 3. control, just performing the functional, mainly eccentric motion pattern without stimulation

Eligibility criteria:
inclusion criteria: 1. skeletal muscle index (smi) \< 0,789 (men); \< 0,512 (women) 2. a general state of good health 3. medically approved unrestricted sports participation as shown by diagnostic performance test 4. willingness to provide signed informed consent exclusion criteria: 1. post-coronary artery bypass graft (acvb) surgery in the last 3 months 2. condition after pacemaker and defibrillator implantation 3. renal insufficiency from stage 3a 4. epilepsy 5. feverish diseases or infectious diseases 6. taking medicines the affect muscle metabolism 7. severe neurological disorders 8. skin injuries in the area of electrodes

Keywords: wb-ems rehabilitation sarcopenia
angiogenic profile and non-invasive imaging may predict tumor progression of high risk group low grade glioma (lgg)

Conditions: Glioma

Summary: the low grade glioma (lgg) is a type of brain tumor which is generally more common in younger age group patients. most patients with lgg undergo surgery which is mostly incomplete due to concern about loss of function. this is an incurable disease. more than half of these patients progress to a higher grade with a worse outcome within five years of their diagnosis and only one-third survive for up to ten years. post-operative radiation treatment improves local control without survival advantage. efforts are being made without great success to select the patients with a higher risk of progression based on physical characteristics and histological features. tumor vascularity is thought to be the key element in tumor progression. tremendous progress has been made in functional imaging by using magnetic resonance imaging (mri) 3-tesla (3t) and in biotechnology which can be used to investigate angiogenic gene profiles in order to identify gene signature for these tumors. in this study the investigators are proposing that patients of lgg with a higher risk of tumor progression may be selected by functional imaging and angiogenic profiles. these higher risk patients may be candidates for post-operative radiation in the future with a potential survival benefit.

summary: comprehensive analysis of the angiogenesis-related gene expression profiles and tumor perfusion of patients with lgg will provide a novel understanding of subgroup (low and high-risk) of lgg. thus, this study will allow identifying clinically relevant factors predictive for tumor progression and to select patients in high-risk group for adjuvant radiation therapy.

Eligibility criteria:
inclusion criteria: * greater than 18 years of age * brain tumor with no contrast enhancement on conventional mri and confirmed histological of lgg * no adjustment treatment * consent to participate in study * no contra-indication for dynamic contrast-enhanced (dce)-mri

Keywords: non-enhancing lesion low grade glioma high risk group selection
prizma pulse oximeter evaluation

Conditions: Oxygen Deficiency

Summary: this study is intended to evaluate performance of the new design sufficiently to support performance claims for an fda 510k submission or iso technical file. specifically: * spo2 value range 70% to 100% * 10 or more subjects, at least 3 of dark pigmentation * at least 200 data points * meeting the following test required by the 2013 fda guidance on pulse oximeters - premarket notification submissions and by iso 80601-2-61 on pulse oximeters: * 2013 fda guidance on pulse oximeters - premarket notification submissions: * 4.1. accuracy of pulse oximeters * 4.1.1 in vivo testing for spo2 accuracy under laboratory conditions * iso 80601-2-61:2011 annex ee.2 and clause 201.12.1.101.2 * 201.12.1.101 spo2 accuracy of pulse oximeter equipment * 201.12.1.101.2 determination of spo2 accuracy

the device under test was the prizma which is a phone cover biometric device that includes reflectance oximetry. this device is a spot checker that requires the patient to hold their finger on the sensor during the measurement. the subjects were asked not to move during the study. in order to get consistent measurements the fingers were taped to the test device. the tape acted mainly as a reminder, and there were some problems with finger movement. a radial arterial cannula was placed in either the left or right wrist of each subject. blood gas analysis to determine oxyhemoglobin saturation was performed on an osm-3® multi-wavelength oximeter (hemoximeter, radiometer, copenhagen). no subject was anemic (hemoglobin ≤ 10gm•dl-1). each subject had control data taken at the beginning of each experiment, with two control blood samples drawn while breathing room air. hypoxia was induced to different levels of oxyhemoglobin saturation (between 70-100%) by having subjects breathe mixtures of nitrogen, room air, and carbon dioxide. oxyhemoglobin saturation was reduced to a series of targets and stabilized at the plateau value. each plateau level of oxyhemoglobin saturation was maintained for at least 30 seconds. two arterial blood samples were then obtained, approximately 30 seconds apart. a total of 24 samples were obtained per subject. data were recorded by bickler-ye lab and provided for analysis.

Eligibility criteria:
inclusion criteria: * both male and female subjects * healthy subjects capable of undergoing controlled hypoxemia to the levels outlined in the desaturation profile below. * meeting the demographic requirements listed above. exclusion criteria: * smokers or individuals exposed to high levels of carbon monoxide that result in carboxyhemoglobin levels over 3% as tested by the byl. * subjects who would be placed under medical risk under the desaturation profile listed below. * significant arrhythmia * age below 21 or over 50 * pregnant women
comparing ropivacaine adductor canal blockade by surgeon versus anesthesiologist

Conditions: Pain, Postoperative; Satisfaction

Summary: the purpose of this study is to evaluate the efficacy of two methods of administering an adductor canal block (acb) following total knee arthroplasty (tka); intraoperative surgeon performed intra-articular adductor canal block (iacb) and anesthesiologist ultrasound guided adc in the post-anesthesia recovery unit (pacu).


Eligibility criteria:
inclusion criteria: * patients undergoing unilateral primary tka with underlying diagnosis of osteoarthritis * asa i - iii * spinal anesthesia * all patients will have cemented total knee utilizing a medial parapatellar approach with posterior stabilized or cruciate retaining implants. a tourniquet will be used in all cases. * patients must be between 18 and 80 years of age. * active and valid email address for the participant. exclusion criteria: * allergy to anesthetics or study analgesic medications. * contraindication to regional anesthesia * non-english speaking * asa iv or greater * renal insufficiency with cr \> 2.0 or hepatic failure * general or epidural anesthesia * sensory/motor disorder involving the operative limb * patients who consume preoperative opioids for pain control. * pregnant women * mentally disabled patients and patients with psychiatric disorders that would prevent them from properly understanding and evaluating an informed consent process. * prisoners
rtms plus vestibular rehabilitation as an adjunct treatment for fall risk and postural instability for chronic vestibular dizziness patients/ chronic labyrinthitis

Conditions: Peripheral Vestibular Disorders

Summary: falling is one of the most common consequences of vestibular dizziness. most of patients with vestibular dysfunction suffer from balance disorders, postural instability and vertigo that may lead to life threating complications as fractures and brain injuries. non invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rtms) have been investigated as therapeutic interventions for various neurological disorders like motor deficits and balance disorders after various neurological deficits. to investigate the effect of repetitive transcranial magnetic stimulation (rtms) added to supervised vestibular rehabilitation program on balance and postural stability in patients with vestibular dizziness

the subjects of both genders with age 40 to 65 will be allocated randomly into two equal groups a and b. group a outcomes measure will include : berg balance scale, computerized dynamic posturography (cdp) . assessment will be done before and after treatment sessions.

Eligibility criteria:
inclusion criteria: 1. diagnosis with peripheral vestibular disorders from audiologist or neurologist. 2. the patient's age will be ranged from forty five to seventy years old. 3. patients will experience at least two symptoms of common symptoms of peripheral vestibular disorders. 4. symptoms of vertigo and nystagmus lasting from seconds to one minute. 5. vertigo that arises from changes in head position related to gravity. 6. patients who experienced symptoms for more than three months (chronic patients) 7. patients were selected to be ambulant. 8. patients suffer from balance disturbance with low risk falling (41-56) and moderate risk falling ranges (21-40) according to berg balance scale. 9. all patients were medically stable, controlled with medical drugs for at least three months and failed to medical treatment with no other physical, mental or cognitive disorders. exclusion criteria: 1. central vestibular disorders ( ms, ataxia, migraine headache, posterior inferior cerebellar artery syndrome "pica"). 2. vertigo that arises from changes in head position not related to gravity; as vertigo of cervical origin or vascular origin ( vertebro- basilar insufficiency "vbi"). 3. previous surgery of the ear. 4. bilateral peripheral vestibular weakness, central vestibular weakness, mixed vestibular weakness, or acute vestibular weakness. 5. unstable health issues (cardiac dysfunction, end stage renal failure, unstable diabetes, uncontrolled hypertension \>190/110...). 6. pacemaker or other implanted electrically sensitive device. 7. significant orthopedic or chronic pain syndrome (e.g any condition that wouldn't permit to completion of any of the tests). 8. major cognitive dysfunction. neurodegenerative disease or major psychiatric condition ( alzheimer's disease , depression....). 9. chronic use of medications that could influence motor or sensory excitability (e.g aeds, antipsychotic). 10. alcohol abuse. 11. epilepsy.
a post-market registry of the maris-stent (invatec) implanted in the superficial femoral artery

Conditions: Peripheral Artery Disease

Summary: the maris register is a prospective, multicenter registry of implantation in the superficial femoral artery (sfa) with a ce marked stent (maris / invatec) intended to capture initial angiographic success, complication rate and symptomatic related revascularization by following the clinical process and duplex examinations at 6 and 12 month.

recent data suggest that there is some evidence for a reduced restenosis rate for the implantation of a self expanding nitinol stent in the superficial femoral artery (sfa) compared to implantation of balloon expandable stents or single balloon inflation (absolute study/fast study). the purpose of the maris register is to evaluate the primary nitinol stent implantation in an all comer population with diseased sfa. the maris register is a prospective, multicenter registry of the implantation of at least one at most five nitinol stents (maris / invatec) in the sfa without limitations for stenosis or occlusion length. the registry includes 998 patients from 13 german investigational sites. clinical data are captured on electronic case report forms the primary endpoint is the target lesion revascularization after 12 month secondary endpoints are : * restenosis rate \> 50% according to ultrasound criteria * restenosis rate \> 70% according to ultrasound criteria * location of restenosis (proximal, middle, distal afs) * number of stent fractures (grading according to festo criteria) * procedure related complication rate * vascular complication rate within 12 month * amputations within 12 month * deaths within 12 month in order to measure the restenosis the peak systolic velocity (psv) is to be measured in two sections during the duplex ultrasound examinations at 6 and 12 month. first measurement is performed 2cm proximal to the first stent, second measurement at the location where the maximum peak velocity over all lesions/all implanted stents is measured. the clinical status includes the patient´s fontaine classification.

Eligibility criteria:
inclusion criteria * stent implantation in sfa is possible * existing sfa stenosis 70-100 % (visual estimation) * absence of homodynamically relevant stenosis in a. poplitea * at least one lower limb run off vessel exclusion criteria * pregnancy * life expectancy less than 1 year * coagulation disorder * chronic anticoagulation therapy * active gastrointestinal bleeding * thrombolytic therapy within 72 hours before intervention * hyperthyreosis * severe contrast agent allergy * allergy to concomittant medication * severe liver disease * thrombus in target lesion * target lesion extend into a. poplitea * severe calcification of target vessel, where no successful pre-dilatation is feasible

Keywords: nitinol stent superficial femoral artery sfa angioplasty peripheral artery disease peripheral artery obstructive disease paod pad peripheral vascular disease
fast-track discharge with telemedicine

Conditions: Emergencies

Summary: evaluation of discharge after arrival at emergency unit, kolding hospital combined with treatment and rehabilitation in the home either by telemedicine or the usual treatment

participants are acute in-patients at the medical department, kolding hospital. participants shall be informed about the project, and all screened initially within 30 minutes. after 3-4 hours adjusted treatment and possible need for new investigations are conducted. patients are randomized at discharge to home treatment with rounds via telemedicine with support of emergency team of nurses or hospitalization in emergency unit. observations, treatment and rehabilitation follow the same standards and guidelines for all patients. the cohort of patients is recruited between oct 1, 2015 until january 1, 2016. the study is a randomized quality evaluation study of patient satisfaction, of the emergency team at kolding municipality, re-admittance rate, use of other health services, and new services from the municipality.

Eligibility criteria:
inclusion criteria: * municipal home care at admittance * admitted to medical emergency care unit at kolding hospital exclusion criteria: * ketoacidosis, * hyperosmolar diabetic coma, * serious hypercalcemia, * acute renal insufficiency with serum-creatinin \> 175 mmol/l, * serious cardiac failure * septicemia * acute coronary disease * apoplexia cerebri * neuroinfection * progressive or active cancer * hepatic disease * serious psychiatric disease

Keywords: telemedicine, patient satisfaction, randomization
is any additional information gained regarding margins using 3d tomosynthesis vs 2d conventional digital imaging when imaging operative breast specimens?

Conditions: Breast Cancer

Summary: patients who are diagnosed with breast cancer will have surgery to remove the tumour. where this is a local excision not mastectomy, the tissue removed is sent for x-ray imaging to assess that the abnormality has been removed and give an estimation of the distance from lesion to specimen edge. this allows the surgeon to decide whether to remove more tissue or not at the time. this study is designed to compare whether more accurate information about lesion to margin measurement can be obtained using 3 dimensional tomosynthesis imaging compared to 2 dimensional conventional digital imaging which is the type of imaging currently used. this has the potential to prevent some patients requiring a second operation to remove more tissue if the margins of the specimen are still involved with tumour. the study involves x-raying the specimen under both conditions when it arrives from theatre. only the 2d image will be reviewed at the time as is current practice. the 3d image will be reviewed later and the measurements for lesion to specimen margin compared. the lesion to margin measurement as recorded by the pathologist will be taken as the 'gold standard' and the imaging measurements will also be compared to that. in theory, the use of 3d tomosynthesis should allow more accurate lesion to margin measurement because 3d can provide better visualisation of the lesion edges by removing the effect of superimposed tissue. the hypothesis states that the use of 3 dimensional tomosynthesis imaging should provide better lesion visualisation compared to 2 dimensional conventional digital imaging thus allowing more accurate lesion to margin measurement.


Eligibility criteria:
inclusion criteria: * patient requires surgery to remove breast cancer and operative specimen needs to be x-rayed exclusion criteria: * patients with breast cancer who need mastectomy

Keywords: breast cancer surgery specimen imaging