Kornimate/medical-research-clean huggingface dataset:
detection and neurological impact of cerebrovascular events in cardiac surgery patients

Conditions: Silent Stroke; Cognitive Decline

Summary: the investigators conducted a prospective observational pilot study to explore the incidence of peri-operative covert strokes (detected by brain mri) and the potential impact on delirium and cognitive decline in post-operative cardiac surgery patients at the hamilton general hospital. this pilot study assessed the feasibility of a larger prospective international cohort study exploring this objective.

delirium and cognitive decline are common following cardiac surgery and increase the burden on patients and health care resources. covert (sub-clinical) strokes are associated with these complications. the investigators conducted a prospective cohort pilot study enrolling consecutive cardiac surgery patients to receive a post-operative brain mri and a series of questionnaires to assess for changes in cognition, physical function and delirium. regional cerebral oxygen saturation (rso2) was recorded during surgery with the use of near-infrared spectroscopy (nirs) sensors placed on the patients' forehead. the primary aim was to determine the feasibility of conducting a larger study to establish an association between covert stroke and long-term cognitive decline in cardiac surgery patients.

Eligibility criteria:
inclusion criteria: 1. male or female ≥ 21 years old 2. provide written informed consent 3. scheduled to undergo isolated cabg through a median sternotomy approach 4. have at least one of the following risk factors: 1. peripheral vascular disease (previous peripheral arterial bypass, amputation due to ischemia, abpi \<0.9, or previous aaa repair) 2. cerebrovascular disease (history of stroke, tia, or carotid stenosis \>70%) 3. renal insufficiency (egfr \<60 ml/min/1.73m2) 4. diabetes mellitus (on oral hypoglycemic agent(s) and/or insulin replacement) 5. urgent cabg (in-patient awaiting revascularization for acs or mi) 6. recent smoker (within the last year) 7. left ventricular ejection fraction \<35% exclusion criteria: 1. concomitant cardiac procedure with cabg prior enrolment in this study 2. emergency cabg surgery (immediate revascularization for hemodynamic instability) 3. redo cabg 4. circulatory arrest planned during the cardiac operation 5. diagnosed dementia of any types 6. contra-indication for dw mri e.g. claustrophobia, unable to lie flat for the duration of the study, pacemaker or icd in-situ, or other metal implants

Keywords: covert stroke cognitive decline delirium clinical stroke cabg surgery near infrared spectroscopy cerebral oxygenation
pulse oximetry readings and hourly variation in oximetry readings with chd

Conditions: Congenital Disorders

Summary: the aim of this study is to describe the presenting pulse oximetry reading in patients who have a known lesion which will cause them to have a low presenting oximetry reading. the study hypothesis is that there is a low presenting pulse oximetry in patients with congenital heart disease and that there will be no significant variation in the hourly variation in oximetry readings in these patients.

congenital heart disease is a relatively common disease seen in 8/1,000 live births. many of these diseases are associated with hypoxemia. hypoxemia results from the mixing of pulmonary and systemic blood or from the mixing of parallel circulations as seen in transposition of the great vessels. pulse oximetry can be used to measure hypoxemia. pulse oximetry estimates oxygen saturation by measuring absorption of light in human tissue beds. the amount of light absorption varies depending on the amount of deoxygenated blood in the tissue measured. measuring the changes in light absorption allows for an estimation of arterial oxygen saturation and therefore the amount of hypoxemia. most manufacturers claim a confidence interval of 4% for their oximeters. there have been a few studies recently describing the presenting pulse oximetry of known congenital heart disease. however, these were small studies with a small sample size of patients. moreover, there is no literature describing the hourly variation in pulse oximetry among know congenital heart disease patients. we hypothesize that there is a low presenting pulse oximetry in patients with congenital heart disease and that there will be no significant variation in the hourly variation in oximetry readings in these patients. this is a retrospective chart review examining the presenting pulse oximetry of patients with known cyanotic heart lesions. the treatment group will be untreated patients with known lesions. all charts of children presenting to sibley heart center with known cyanotic heart lesions from january 1, 2004 to december 31, 2004 will be reviewed. the aim of the study is to describe the presenting pulse oximetry reading in patients who have a known lesion which will cause them to have a low oximetry reading. the following information will be collected from the charts: * presenting pulse oximetry * heart lesion the second aim will be to characterize the hourly variation in pulse oximetry from these patients. the following information will be collected: * hourly pulse oximetry readings * heart lesion * clinical course

Eligibility criteria:
inclusion criteria: * congenital heart lesion * presenting to sibley heart center * initial visit between jan. 1, 2004 and dec. 31, 2004 exclusion criteria: * those who do not meet inclusion criteria

Keywords: pulse oximetry readings pediatrics cardiac congenital heart disease
hepatitis a vaccination in the elderly

Conditions: Hepatitis A

Summary: a lot of elderly people travel to hepatitis a endemic areas. the prevalence of hepatitis a igg positivity is declining in the netherlands, also in the elderly. studies show that people above 40 years of age have a slower immune response to hepatitis a vaccination. however, a lot of travelers seek pre-travel advice only shortly before their journey. more information about the time to adequate antibody response after hepatitis a vaccination is required to provide good protection during travelling. alternative protection with immunoglobulins are available. study design: observational, longitudinal pilot study study population: 20 adults over 60 years of age with a negative hepatitis a igg, (with a estimated 50% positivity for hepatitis a igg in this age group, 40 patients in this age group) 20 adults 18-40 years of age as controls. intervention (if applicable): when hepatitis a vaccination is indicated and informed consent is obtained, hepatitis a igg wil be measured at day 0, 7, 14, 21 en 28. main study parameters/endpoints: time to protective hepatitis a igg. nature and extent of the burden and risks associated with participation, benefit and group relatedness: hepatitis a vaccination will be given also outside this study. in the study 5 venous punctures of 7 ml of blood.


Eligibility criteria:
exclusion criteria: * previous hep a vaccination * known hepatitis a serology status * immunodeficiency

Keywords: hepatitis a vaccination elderly protection to hepatitis a after vaccination
itch and pain characteristics in skin carcinomas

Conditions: Skin Carcinoma; Skin Cancer; Pruritus

Summary: the objective of this study is to have better knowledge about sensations of patients with skin carcinomas and to have data about characteristics of pain and pruritus . all patients presenting with a suspicions lesion for skin carcinomas will be included and will respond to a questionnaire. demographics data, and histological data about skin carcinomas will be collected.


Eligibility criteria:
inclusion criteria: all patients with suspected skin carcinoma aged 18 years or more exclusion criteria: * age under 18 years, * inability to complete the questionnaire because of cognitive impairment
newborn cortical response to pain and non pharmacological analgesia

Conditions: Analgesia

Summary: minor painful procedures are frequently performed on newborn infants and non-pharmacological analgesia is commonly used. as more than one analgesic method may be applied simultaneously in clinical practice, the relative contribution and efficacy of analgesic components still needs to be further elucidated. in the present study neonatal cortical brain response during four types of non-pharmacological analgesia (oral glucose, expressed breastmilk, maternal holding plus oral glucose, maternal holding plus breastfeeding) will be studied. the aim is to assess the differential effect of oral solutions (glucose, breastmilk), when given alone or in combination with maternal relationship (holding, breastfeeding). the study will test the hypothesis that the mother-infant relationship would improve the analgesic effect of oral solutions.


Eligibility criteria:
inclusion criteria: * full term healthy infants, needing a heel-prick for metabolic screening; * informed consent obtained from parents. exclusion criteria: - presence of sedation or analgesia (other than non pharmacological analgesia given during the experimental procedure)

Keywords: pain infant near-infrared spectroscopy non pharmacological analgesia
baloxavir versus oseltamivir for nursing home influenza outbreaks

Conditions: Influenza; Influenza, Human; Influenza -Like Illness

Summary: influenza outbreaks are a prevalent event in nursing homes (nhs). we will study baloxavir compared to oseltamivir when used for influenza prophylaxis when facilities identify an index incident case of influenza. this study will help guide nursing home's decision making and demonstrate the effectiveness of a novel antiviral for preventing influenza outbreaks.

a random study sample of about 1000 u.s. nursing homes (nhs), housing approximately 112,000 overall residents and 92,000 over the age of 65 years, of whom 64,500 are long-stay nh residents, will be recruited for the study. participating facilities will be randomly allocated in a 1:1 ratio to oseltamivir or baloxavir for antiviral treatment and prophylaxis. primary study data provided by facilities monthly during the influenza season will support primary and secondary endpoints along with administrative claims and public use datasets containing information on facility characteristics.

Eligibility criteria:
inclusion criteria: - medicare-certified nhs in any location in the united states with at least 50 long-stay residents 18 years of age or older. exclusion criteria: * hospital-based facilities * facilities not submitting mds data

Keywords: antiviral medication influenza nursing home influenza outbreak outbreak oseltamivir baloxavir
tranexamic acid for alloplastic breast reconstruction

Conditions: Hematoma Postoperative; Breast Cancer; Tranexamic Acid

Summary: hematoma is a common complication of alloplastic breast reconstruction. this can lead to pain and discomfort experienced by the patient, in addition to greater use of valuable healthcare resources. previous studies have shown correlation between the use of tranexamic acid (txa), an anti-fibrinolytic, and reduced post-surgical bleeding complication events. in this randomized control trial (rct) assessing txa use in alloplastic breast reconstruction, one breast will be randomized to have txa applied topically, while the other will have normal saline (ns) placebo applied. the primary objective of this prospective blinded randomized control trial study is to determine if the administration of topical txa in alloplastic breast reconstruction reduces the incidence of surgical site hematoma compared to placebo within 2 weeks following surgery. the results of this study will be used to inform the design of a larger multicentered rct on txa in breast surgery.

the primary objective of this study is to investigate the use of topical application of tranexamic acid (txa) to the surgical wound as a means to decrease hematoma formation compared to placebo in patients undergoing alloplastic breast reconstruction. this project is designed as a single-center rct to evaluate the effectiveness of topical txa in this patient population. if enrolled in this study, patients individual breasts will be randomly assigned to one of two treatment groups for to apply to the wound before it is closed. one breast will have an intravenous form of txa applied topically to the surgical site. the other will be have a topical normal saline solution applied to the wound before closure (a placebo). the patients will have the standard number of drains and postoperative instructions for breast reconstruction. they will follow-up at two weeks time in clinic for assessment, and emergency room visits will be also be evaluated. standard of care will be practiced with respect to all procedures and visits.

Eligibility criteria:
inclusion criteria: * are 18 years or older; * are undergoing one- or two-stage bilateral alloplastic breast reconstruction immediately after bilateral mastectomy at either hamilton health sciences or st. joseph's hospital hamilton. exclusion criteria: * taking therapeutic anticoagulation; * taking antiplatelet drugs; * pregnant or breast feeding; * allergic to txa; * cannot provide informed consent; * alloplastic reconstruction is not performed immediately after mastectomy; * have a documented coagulopathy or bleeding disorder, acquired disturbances of colour vision, subarachnoid hemorrhage, hematuria, irregular menstrual bleeding, or seizure disorder.

Keywords: alloplastic breast reconstruction
assisted device for freezing in parkinson disease

Conditions: Parkinson Disease

Summary: freezing of gait (fog) is a particular and troublesome symptom occurring in some parkinsonian patients. our objective is to adapt and extend fog detectors in order to include other associated gait pattern changes, like festination.our purpose is to develop a wearable assistant which would trigger the most appropriate cueing aid just before occurrence of the freezing episode.

freezing of gait (fog) is a particular and troublesome symptom occurring in some parkinsonian patients .this brief, episodic absence or marked reduction of forward progression of the feet despite the intention to walk is associated to a fall risk. automatized fog episode detection would allow systematic assessment of patient state and objective evaluation of the clinical effects of treatments. techniques have been proposed in the literature to identify fog episodes based on the frequency properties of inertial sensor signals. our objective here is to adapt and extend these fog detectors in order to include other associated gait pattern changes, like festination. the proposed approach is based on a single wireless inertial sensor placed on the patient's lower limbs. based freezing detectors are not sufficient to detect all fog and festination episodes. stride length and cadence are valuable inputs to anticipate the occurrence of upcoming fog events. the investigators have developed a solution based on a minimal number of embedded sensors and detection algorithms for future real-time applications. it is well known that auditory rhythmic stimulation or visuals marks on the ground would improve dramatically gait in patients with fog. this sensibility to cueing leads some teams to develop some mobility aid devices rhythmic. our purpose is to develop a wearable assistant which would trigger the most appropriate cueing aid just before occurrence of the freezing episode.

Eligibility criteria:
inclusion criteria: * troublesome freezing exclusion criteria: * dementia
incidence and risk factors of parastomal hernia in patients with permanent colostomy in china

Conditions: Hernia; Stoma Colostomy

Summary: parastomal hernia refers to the protrusion of the area around the stoma or the ectopic protrusion of abdominal contents from the stoma (colostomy, ileostomy, ileostomy for bladder) in the abdominal wall defect. parastomal hernia is one of the common complications after permanent colostomy. according to guidelines published by the european hernia society, the overall incidence of parastomal hernia is unknown, but it can be predicted to be over 30% at 12 months, over 40% at 2 years, and over 50% at longer follow-up periods. parastomal hernia may have no obvious symptoms at the beginning or only protrusion around the stoma. however, with the progression of the disease, the protrusion site may gradually increase, resulting in leakage, skin ulcers, perforation, incarceration, obstruction, strangulation and other serious complications. it will seriously affect the quality of life of patients and increase the medical burden and cost. risk factors related to parastomal hernia are currently considered to be mainly related to the patient's own factors and surgical factors. studies have shown that female, old age, obesity, cardiopulmonary diseases, diabetes, long-term use of cortisol and other factors can increase the incidence of parastomal hernia in patients . methods of stoma including extraperitoneal stoma, appropriate aperture of stoma and preventive mesh placement can reduce the incidence of parastomal hernia in patients. in this study, patients with permanent colostomy and relevant information of surgery as well as the current incidence of parastomal hernia will be retrospectively collected in some high-level and high-volume tertiary hospitals in china. this study will be helpful to provide data reference for subsequent studies in this field.


Eligibility criteria:
inclusion criteria: * permanent colostomy after colorectal surgery for benign or malignant diseases * no previous colostomy history exclusion criteria: * no ct scan follow-up at 1 year after surgery * another ileocolonic diversion was performed except for the cause of parastomal hernia
transcutaneous pulsed radiofrequency in migraine

Conditions: Migraine Disorders

Summary: the aim of the investigator is to compare the efficacy of greater occipital nerve block and transcutaneous pulsed radiofrequency treatment in migraine.

migraine is the second most common primary headache. greater occipital nerve (gon) block is an effective method in the treatment of migraine. transcutaneous pulsed radiofrequency (rf) therapy is used in the treatment of pain. however, its use in headaches is not widespread yet. investigator aimed to compare the efficacy of transcutaneous pulsed radiofrequency therapy applied through the gon trace and gon block therapy. a 60-patient study was designed. gon block was planned for 30 patients and transcutaneous pulsed rf was planned for 30 patients. the block will be applied once at the level of c2 vertebra with ultrasound.transcutaneous pulsed rf will be applied twice, once a week, for 8 minutes.all patients will have pre-treatment migraine disability assessment score (midas) scores filled. a headache diary will be provided to all patients. frequency and severity of pain will be followed for 1 month. pain intensity will be evaluated on the visual analog scale (vas). investigator aimed to evaluate the efficacy of transcutaneous pulsed rf therapy, which is a noninvasive method, in migraine.

Eligibility criteria:
inclusion criteria: * chronic migraine exclusion criteria: * other headaches will not accompany (tension-type headache, cluster...) * pregnancy

Keywords: transcutaneous pulsed radiofrequency pulsed radiofrequency treatment headache gon block
role of immunoglobulin in male infertility

Conditions: Male Subfertility

Summary: to investigate the role of ivig in male infertility and to determine its benefits in term of semen parameters and assisted reproduction outcome


Eligibility criteria:
inclusion criteria: * male patients exclusion criteria: * female
satisfaction of hiv-infected patients treated with cabotegravir-rilpivirine injectable dual therapy

Conditions: HIV Infections

Summary: question arises as to whether this new treatment "cabotegravir-rilpivirineactually" improves patient satisfaction and whether it is well suited to everyone, especially those with a history of irregular follow-up. also, inconvenience of two intramuscular injections every two months and constraint of care organization could represent a barrier to treatment for some patients.

cabotegravir-rilpivirine prolonged-release injectable dual therapy antiretroviral treatment recently obtained marketing authorization in france to treat human immunodeficiency virus (hiv) infection. it would meet the demand of patients for less frequent treatment to overcome constraints associated with daily drug intake such as stigma due to hiv, weight of daily pill recalling disease or difficulties in compliance. this authorization follows the results of flair and atlas phase iii clinical trials, which showed non-inferiority of monthly injectable treatment in terms of virological control compared to conventional oral triple therapy. 1-4 atlas-trial 2m showed non-inferiority of injectable treatment every two months compared to every month.5 main risk factors for virological failure highlighted were a low residual plasma concentration of rilpivirine, viral subtype a1/a6, existence of archived resistance mutations to rilpivirine and obesity (bmi \> 30 kg/ m²).6 discontinuation rate of injectable treatment at one year was 9% in flair trial and 8% in atlas versus 8% and 6% respectively for control group under oral treatment. most treatment discontinuations were due to adverse effects. most commonly reported adverse reactions were injection site reactions (up to 84%), headache (up to 12%) and fever (10%). in these studies, patient satisfaction was assessed through multiple scales or questionnaires. results of these evaluations did not make it possible to conclude on the impact of injectable treatment on patients quality of life.

Eligibility criteria:
inclusion criteria: * hiv-1 infected patient * patient over 18 years of age * patient for whom dual injectable sustained-release cabotegravir-rilpivirine therapy is implemented according to the decision of the referring physician in the context of care. * patient who understands, reads and writes french well exclusion criteria: * patient opposing to participate in the study. * patient subject to legal protection measures (guardianship, curatorship or safeguard of justice)

Keywords: hiv cabotegravir-rilpivirine
risk of ectopic pregnancy and variation of luteal estradiol and progesterone levels in ivf

Conditions: Ectopic Pregnancy

Summary: this study evaluates the increased risk of ectopic pregnancy associated with marked variation of estradiol during the early luteal phase and high progesterone on hcg day in ivf.

this is a retrospective cohort study of 578 patients who had no risk of ep (672 fresh transfer ivf cycles) between january 2005 and december 2014. few studies have reported the relation between hormonal levels and ectopic pregnancy (ep) in ivf. investigators describe ep incidence according to estradiol (e2) and progesterone (p4) levels on hcg day and seven days later (hcg+7) or their variation between both days.

Eligibility criteria:
inclusion criteria: * normal fallopian tubes in hsg and /or laparoscopy * normal uterus: abscence of myomas and müllerian anomalies . exclusion criteria: * previous ectopic pregnancy . * recurrent abortion . * tubal factor : pelvic inflammatory disease, hydrosalpinx * previous abdominal surgery (except laparoscopy) . * prior peritonitis * smoking (at least 1 cigarette/day) .
effects of nateglinide vs acarbose on postprandial glucose fluctuation, dyslipidemia, and inflammatory factors

Conditions: Diabetes Mellitus, Type 2

Summary: this study was conducted to demonstrate superiority of nateglinide in postprandial glucose fluctuation, dyslipidemia, and inflammatory status improvement.


Eligibility criteria:
inclusion criteria: * newly diagnosed type 2 diabetes mellitus patients * hba1c \> 6.5 and \< 9.0% * fasting fingertip capillary blood glucose (fcbg) \< 9 mmol/l after 2 weeks diet control exclusion criteria: * history of acute metabolic complications in the past 3 months or of severe diabetic complications or severe infections or active substance abuse * liver disease * patients under oral hypoglycemic drugs and/or insulin treatment, or corticosteroid treatment within past 4 weeks other protocol-defined inclusion/exclusion criteria applied to the study.

Keywords: diabetes mellitus, type 2 nateglinide acarbose hyperglycemia dyslipidemias c-reactive protein