Kornimate/medical-research-clean huggingface dataset:
low vs standard local anesthetics boluses for continuous adductor canal block in total knee arthroplasty

Conditions: Knee Arthropathy

Summary: to investigate the efficacy of two different regimens of local anesthetic boluses for continuous adductor canal block under ultrasound-guidance in total knee arthroplasty at king chulalongkorn memorial hospital.

total knee arthroplasty (tka) is a commonly performed surgical procedure for patients with severe knee osteoarthritis. however, one of the challenges associated with tka is the significant postoperative pain experienced by patients, which can delay early mobilization and physical therapy. uncontrolled pain worsens patient outcomes and healthcare costs as it can increase the risk of complications after surgery. therefore, effective pain management is important for optimizing patient outcomes and promoting a smooth recovery process.despite the absence of a standardized recommendation for the volume and concentration of bolus administration in continuous adductor canal block (cacb), many previous studies, have demonstrated the efficacy of a high-dose bolus followed by a low-concentration local anesthetic infusion for cacb. however, these trials exhibited differences in the doses and volumes of bolus injection. therefore, the necessity of high concentration and volume bolus cacb in combination with comprehensive multimodal analgesia and lia for postoperative pain management in tka remains uncertain. the aim of this study is to investigate the efficacy of two different regimens of local anesthetic used in boluses for continuous adductor canal block under ultrasound-guidance in total knee arthroplasty at king chulalongkorn memorial hospital.

Eligibility criteria:
inclusion criteria: * patients undergoing tka aged more than 18 years * patients with american society of anesthesiologists (asa) class 1-3 * patients with body weight index (bmi) 18-40 kg/m2 exclusion criteria * patient refusal to participate * patients with known allergic to medications used in the research protocol * patients with contraindications to neuraxial or regional anesthesia, including existing neuropathy or neurological deficits involving the lower extremities, coagulopathy or bleeding diathesis and local skin infections * patients with contraindications to nsaids such as history of coronary artery bypass graft surgery, congestive heart failure, stroke, gastrointestinal bleedings or ulceration, asthma, hepatic and renal disease, abnormal coagulation, or pregnancy * patients with chronic opioid use (opioids have been used daily or almost daily for more than three months or sixty milligrams or more of morphine has been used daily for more than one month) or diagnosed with neuropathic pain * patients that are unable to perform preoperative quantitative sensory testing.

Keywords: adductor canal block local infiltration analgesia postoperative pain management quadriceps strength total knee arthroplasty local anesthesia
patients with type b aortic dissection returning to work after discharge：a cross-sectional survey

Conditions: Type B Aortic Dissection; Return to Work

Summary: this study wants to understand the incidence of returning to work after discharge in patients with type b aortic dissection.

the incidence of aortic dissection in china is increasing year by year. according to the latest research report, the annual incidence of aortic dissection in china is 5 \~ 10 / 100,000, the average age of patients is 51.8 years old, and the age of disease is about 10 years younger than that of european and american countries. rtw after discharge is a measure of disease recovery and recovery to normal state. there are only reports on rtw after discharge in the fields of cancer, stroke, organ transplantation, maintenance peritoneal dialysis and so on. most of the existing literature in the cardiovascular field at home and abroad focuses on assessing the status of rtw and rrtw after discharge. up to now, there is still a lack of research on the promotion and hindrance factors of rtw in tbad patients, the status survey of post-rtw work ability and the related nomogram prediction model. therefore, based on the meleis transformation theory, this study aims to investigate the current status of return to work of tbad patients at 6 months after discharge through quantitative and qualitative research, and to explore its influencing factors in depth. based on the previous results, the rtw visual prediction model of tbad patients was constructed, which provided a theoretical basis for the formulation and implementation of early intervention by medical staff, and further improved the research in this field.

Eligibility criteria:
inclusion criteria: ( 1 ) tbad was diagnosed by computed tomography angiography ( cta ) or magnetic resonance angiography ( mra ) ; ( 2 ) 18 years ≤ age \< 60 years at diagnosis ; ( 3 ) having full-time or part-time job at the time of diagnosis ; ( 4 ) tbad patients were discharged after successful treatment and the discharge time was ≥ 6 months ; exclusion criteria: ( 1 ) reaching the retirement age 6 months after discharge ; ( 2 ) those with disturbance of consciousness, mental illness, inability to complete the interview independently or under the guidance of the researcher ; ( 3 ) participate in other related research ; ( 4 ) clinical end-stage or receiving palliative treatment.
remote ischemic conditioning in acute brain infarction study

Conditions: Cerebral Infarction

Summary: cerebral infarction is the most common form of stroke (80% of strokes). stroke is the first cause of acquired disability, and the 2nd cause of dementia and death. the only approved treatment in the first 4.5 hour is intravenous rt-pa thrombolysis (actilyse ®) whose objective is recanalization of occluded artery and reperfusion of the brain parenchyma. few patients are treated (1-5%) and they keep disability in 50-60% of cases. this handicap is mainly correlated to the final infarct size. the objective of neuroprotective treatments is to reduce the final size of the cerebral infarction. the per-conditioning remote ischemic (per-cid) showed a neuroprotective effect in cerebral ischemia by reducing the final size of cerebral infarction animal models. the per-cid corresponds, in cases of cerebral ischemia, to iterative ischemia realization of a member with a cuff. in humans, the per-cid has shown a cardioprotective effect in a randomized control trial involving 250 patients within 6 first hours of myocardial infarction and candidate for primary angioplasty.


Eligibility criteria:
inclusion criteria: * patients ≥ 18 years * carotid ischemic stroke * nihss score between 5 and 25 * brain mri performed within 6 hours from symptoms onset * obtaining a written informed consent of the patient or a third party (parent or close), or emergency inclusion process * affiliated with a medicare (or rightful beneficiary) exclusion criteria: * presence of a leg ulcer or a bad skin condition in the lower limbs * history of arterial occlusive disease of the lower limbs * sickle cell disease known (risk of vaso-occlusive crisis) * history of phlebitis in the lower limbs * history of cerebral infarction older than 3 months * participation in another interventional acute phase protocol * patients under guardianship * pathologies involving life-threatening within 6 months and making it impossible to evaluate to 3 months * patient non-self before the ischemic stroke (rankin score previous\> 2) * pregnant women
adjunctive intra-arterial tenecteplase following mechanical thrombectomy (ally) ii trial

Conditions: Ischemic Stroke; Acute Disease

Summary: the study objective is to evaluate the safety and efficacy of intra arterial (ia) tenecteplase (tnk) as an adjunctive therapy in acute ischemic stroke (ais) patients with large vessel occlusions (lvo) in the anterior circulation of internal carotid artery (ica), middle cerebral arteries (m1 and m2) who achieve a reperfusion grade of modified treatment in cerebral ischemia scale (mtici) 2b or higher post-mechanical thrombectomy using food and drug administration (fda) approved devices.


Eligibility criteria:
inclusion criteria: 1. age 18-85 2. anterior circulation ischemic stroke symptoms with confirmed occlusion (ica, m1, or m2) on angiogram and mechanical thrombectomy initiated within 24 hours since last known well 3. alberta stroke program early ct score (aspects) score ≥6 on baseline non-contrast head ct (ncct) 4. post-mechanical thrombectomy with ≤5 device passes and mtici grade 2b or higher. 5. ability to obtain signed informed consent prior to randomization from lar or subject exclusion criteria: 1. premorbid modified rankin scale (mrs) score \>1 2. imaging evidence of hemorrhage or mass effect at baseline 3. platelet count \<100,000 4. active hemorrhagic diathesis, or known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency 5. active anticoagulation treatment with novel oral anticoagulant (noacs) taken within the last 48 hours, or inr \>1.7 6. patients requiring active treatment with dual antiplatelet agents (e.g. proximal cervical carotid artery stenting) 7. pregnant or lactating 8. previous known allergy to tnk 9. major surgery in past 30 days 10. patient is on or requires dialysis 11. history of intracranial hemorrhage or serious head trauma at any time 12. any condition in the opinion of the enrolling physician that would preclude the patient from participating 13. pre-existing medical, neurological, or psychiatric disease that would confound the neurological or functional evaluation 14. severe, uncontrolled hypertension (systolic blood pressure \>180 mmhg or diastolic blood pressure \>110 mmhg) that is refractory to treatment 15. history of acute ischemic stroke in the last 60 days and/or has received previous treatment with a thrombolytic within the last 90 days 16. presumed septic embolus; suspicion of bacterial endocarditis 17. suspicion of aortic dissection 18. intracranial neoplasm 19. any terminal medical condition with life expectancy less than 6 months 20. concurrent enrollment in another trial that could confound the results of this study 21. patient is unlikely to return for 90-day follow-up. 22. intravenous tissue plasminogen activator (tpa) administered concurrently with intra-arterial tnk

Keywords: stroke tnk thrombolytic
a study to assess the drug levels of repotrectinib in healthy participants and participants with moderate and severe hepatic impairment

Conditions: Hepatic Impairment; Healthy Volunteers

Summary: the purpose of this study is to assess the drug levels of a single oral dose of repotrectinib in participants with moderate and severe hi, and in healthy matched control participants with normal hepatic function.


Eligibility criteria:
inclusion criteria: - inclusion criteria for all participants (group 1, group 2, group 3):. i) adult female (as assigned at birth) not of childbearing potential or male (as assigned at birth) of any race or ethnicity. ii) must have a body mass index between 18 and 40 kg/m2 (inclusive) and body weight ≥ 50 kg at the time of signing the icf. - inclusion criteria for participants with moderate or severe hepatic impairment (group 1 and group 2):. i) participants have moderate or severe hi or cirrhosis due to chronic hepatic disease and/or prior alcohol use. ii) participants have moderate (group 1), or severe (group 2) hi as defined by child-pugh score. - inclusion criteria for a matched healthy participant (group 3):. i) participant must be free of any clinically significant disease that would interfere with the study evaluations. ii) participant must have liver-related laboratory test results within the respective reference ranges or with clinically insignificant excursions therefrom as agreed by the investigator. iii) participant must be in good health as determined by past medical history, physical examination, vital signs, ecg, and clinical laboratory safety tests. clinical laboratory safety tests (eg, hematology, chemistry, and urinalysis) and 12-lead ecgs must be within normal limits or clinically acceptable as judged by the investigator. exclusion criteria: - exclusion criteria for all participants (group 1, group 2, and group 3):. i) any major surgery within 4 weeks of the study intervention administration. ii) history of drug abuse within 1 year of study intervention administration. iii) history of alcohol abuse within 1 year of study intervention administration. iv) participants who currently smoke, as well as those who have stopped smoking less than 6 months prior to dosing on day 1. - other protocol-defined inclusion/exclusion criteria apply.

Keywords: hepatic impairment healthy volunteers severe bms-986472 repotrectinib liver diseases pharmacokinetics
ex vivo evaluation of immunity activation face to s. aureus antigens and adjuvants of a vaccine candidate in cells from haemodialysis patients

Conditions: Staphylococcus Aureus

Summary: s. aureus is a leading cause of severe infections notably in haemodialysis patients. these patients have a high risk of s. aureus nasal carriage, with a rate of persistent carriage near 30%. these carriers are particularly at risk of s. aureus infections as we previously shown. high risk of s. aureus infections such as bacteremia occurred notably in patients with dialysis catheters. decolonization of carriers may prevent such infections however this approach has limits. development of an effective s. aureus vaccine is crucial. to date, past vaccines tested (phase iii) failed to achieve their end points. target of only one or few antigens, absence of cellular response induction and possibly no impact on carriage are probably the reasons of the failures.

in an attempt to minimize failure in a clinical phase, ex vivo analysis of immune response of leucocytes of haemodialysis patients face to s. aureus and the impact of antigens and adjuvants of a candidate vaccine may help.

Eligibility criteria:
inclusion criteria: * patient starting haemodialysis for chronic hemodialysis. * patient starting haemodialysis on catheter * patient who signed the informed consent form exclusion criteria: * pregnant woman * patient who starts haemodialysis for over 3 months * patient with anemia (hemoglobin \<7 g / dl)

Keywords: staphylococcus aureus haemodialysis vaccine immune response
presurgery anxiolysis in children treated with hydroxyzine versus non-pharmacological intervention (distractoria technique clown)

Conditions: Anxiety

Summary: this study evaluate the change in preoperative anxiety, baseline (m1) and pre-induction anxiety levels (m3), as shown by children undergoing mas determined by the m-ypas scale in the different apo management groups.patients will be allocated in one of this four groups: hydroxyzine+clown; hydroxyzine alone, clowns alone or nothing


Eligibility criteria:
inclusion criteria: * children between 2 and 16 years old * patients with programmed major ambulatory surgery. * assessment of anesthetic risk asa i-ii. * informed consent signed by their legal authorized representatives. * no antihistaminic allergies. * assent signed by children between 12 and 16 years old. exclusion criteria: * patients with previous surgeries. * anesthetic risk asa more than ii. * patients with hypersensitivity to the active substance, to any of the excipients, to cetirizine, to other piperazine derivatives, to aminophylline or etilenamida * patients with porphyria * patients with known qt prolongation, either congenital or acquired * patients with known risk factors for qt prolongation including a pre-existing cardiovascular disease, previous electrolyte imbalances, family history of sudden cardiac death, significant bradycardia and concomitant use of drugs with potential known to produce qt prolongation and / or induce torsades de pointes.

Keywords: anxiety surgery clown
an early real-time electronic health record risk algorithm for the prevention and treatment of acute kidney injury

Conditions: Acute Kidney Injury

Summary: this is a single center randomized trial that seeks to determine if the use of an automated real-time electronic medical record acute kidney injury (aki) risk score can improve patient outcomes through the use of an early standardized nephrology focused intervention.


Eligibility criteria:
inclusion criteria: 1. age \>18 years old 2. initial estop aki score ≥0.01 within the last 8 hours. exclusion criteria: 1. voluntary refusal or missing written consent of the patient / legal representative. 2. patients with a known history of end-stage renal disease on dialysis (including renal transplantation). 3. patients without a measured serum creatinine value during their inpatient stay. 4. patients with a creatinine \>4.0 mg/dl at the time of admission or available in the electronic health record (ehr) from the last 6 months. 5. patients with prior episode of kidney disease improving global outcomes (kdigo) defined aki during this same hospitalization- regardless of estop aki score. 6. patients with prior renal consultation during their admission.
evaluation of the link between bladder sensation and changes in skin electrical conductance and heart rate.

Conditions: Overactive Bladder

Summary: measuring sympathetic skin response or heart rate variability can provide an objective biomarker of bladder sensation and its modulation by drug with potential to treat overactive bladder.

evaluation of the link between bladder sensation and changes in skin electrical conductance and heart rate.

Eligibility criteria:
inclusion criteria: * female, healthy volunteers or oab patients 18-65 years old, non pregnant and non lactating exclusion criteria: * history of lower urinary tract pathology * excessive alcohol and tobacco consumption * treatment with investigational drug in the last 30 days * abnormal ecg trace * conditions that would contraindicate the use of tolterodine or any other anti muscarinic agent
whether dexmedetomidine can improve the prognosis of elderly patients with postoperative cognitive dysfunction

Conditions: Postoperative Cognitive Dysfunction; Postoperative Delirium

Summary: the purpose of this study is to determine whether postoperative analgesia pump continuous infusion of dexmedetomidine are effective in the prevention of postoperative delirium and postoperative cognitive dysfunction.

1. collection of cases: this trail is approved by hospital ethics committee, and patients who participated in the study signed the informed consent. the subject will select 300 elder patients (age ≥60 years) routine tumor surgery, american society of anesthesiologists classificationⅰ-ⅲ. preoperative liver and kidney function, blood electrolytes were in the normal range. 2. case group: selected cases divided into the right dexmedetomidine group and control group by computer randomly, 150 patients in each group. dexmedetomidine group (a group) analgesia pump formula is: 3 ug/kg sufentanil and 3 ug/kg dexmedetomi-dine, with 0.9% saline diluted to 150ml. control group (group c) postoperative analgesia formula is: 3 ug/kg sufentanil, with 0.9% saline diluted to 150ml. two group with the same anesthesia program. 3. our primary outcome was the 7-day incidence of postoperative delirium assessed by cam-icu twice daily (8 a.m. and 8 p.m.) and supplemented with a review of medical and nursing records. the assessment was carried out by investigators who had been trained prior to the trial and were unaware of the group assignment.all investigators and patients were unknown of experiments and results. the four clinical criteria for cam-icu are as follows: (1) acute onset with fluctuating course of disease; (2) inattention; (3) altered level of consciousness; (4) disorganized thinking. delirium can be diagnosed by the appearance of both features 1 and 2, with at least one of features 3 or 4. rass was used to measure sedation or agita-tion prior to testing delirium. if the patient was deeply sedated or unable to fall asleep (rass - 4 or - 5), delirium assessment was halted; if rass score was of - 3 or above, delirium was evaluated by cam-icu.

Eligibility criteria:
inclusion criteria: * patients' age ≥60 years * underwent elective non-cardiac surgery under general anesthesia exclusion criteria: * patients with severe bradycardia (heart rate\<55bpm) * severe arrhythmia or cardiac dysfunction (ejection fraction\<35%) * mini-mental scale test (mmse) exclusion criteria: illiteracy \<18, primary school \<21, junior school and above \<25 * preoperative clear systems and spiritual history of neurological disease or long-term use of sedatives or antidepressants * history of alcohol abuse or a history of drug dependence * have brain surgery or trauma * severe vision or hearing impairment * cannot with the completion of tests of cognitive function * refused to participate in the study
fascia iliaca compartment block versus quadratus lumborum block in total hip arthroplasty

Conditions: Nerve Block; Pain, Postoperative

Summary: patients undergoing total hip arthroplasty are randomly assigned to two groups (fascia iliaca compartement block \[ficb\] group or quadratus lumborum block \[qlb\] group). in the ficb group, ultrasound-guided suprainguinal ficb (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is performed on the ipsilateral surgical side at the end of surgery. in the qlb group, ultrasound-guided anterior qlb (30 ml of 0.375% ropivacaine with 75 µg of epinephrine) is done on the ipsilateral surgical side at the end of surgery. a standardized multimodal analgesic regimen is used for postoperative pain control. the total use of opioids including patient-controlled analgesia and rescue analgesics is compared in both groups for 24 hours after surgery. the amount of opioids used is compared by conversion to oral morphine equivalent dose. pain score at rest and movement during postoperative 24 hours, time to first request for analgesics, the incidence of side effects, patient satisfaction for pain control at postoperative 24 hours, quality of recovery at postoperative 24 hours, time to discharge readiness, and hospital length of stay are compared.


Eligibility criteria:
inclusion criteria: * adult patients between the ages of 19 and 70 undergoing total hip arthroplasty under spinal anesthesia * be able to provide written consent to participate in clinical trials, understand the procedures of this clinical trial, and be able to properly fill out patient-reported questionnaires * asa physical status classification 1-2 exclusion criteria: * asa physical status classification 3-4 * patients who are contraindicated to nerve blocks (hypersensitivity to local anesthetics, infection at the injection site, etc.) * patients with chronic pain and taking pain medications, antidepressants, and anticonvulsants * other major medical or psychiatric conditions that will affect response to treatment * refusal of intravenous patient-controlled analgesia * patients determined to be unsuitable for this clinical trial by the researchers
phase i randomized study of cpx for the treatment of adult patients with mild cystic fibrosis

Conditions: Cystic Fibrosis

Summary: objectives: i. evaluate the safety of ascending doses of cpx administered to adult patients with mild cystic fibrosis. ii. evaluate the pharmacokinetics of ascending doses of cpx in this patient population.

protocol outline: this is a randomized, double blind, placebo controlled, dose escalation study. there are 7 experimental cohorts, each treated with a different oral dose of cpx or placebo. within each cohort, 4 patients receive a single dose of cpx and 1 patient receives placebo. each patient is monitored 24 hours postdose. escalation to the next dose level for each subsequent cohort begins only after the safety data obtained from the previous cohort is reviewed and found not to limit dose escalation. all patients return for a follow up evaluation 1 week after dosing.

Eligibility criteria:
protocol entry criteria: * mild cystic fibrosis * not pregnant or nursing negative pregnancy test

Keywords: cardiovascular and respiratory diseases cystic fibrosis genetic diseases and dysmorphic syndromes rare disease