Kornimate/medical-research-clean huggingface dataset:
regional anesthesia in thr - comparing the analgesic efficacy of fascia iliaca block and erector spinae plane block

Conditions: Postoperative Pain

Summary: thr (total hip replacement) can be very painful and regional anesthesia is very effective in reducing postoperative pain. fascia iliaca block (fib) and erector spinae plane block (espb) are indirect approaches to the lumbar plexus that resulted to be very promising for thr. however, no studies investigated the analgesic superiority of either fib or espb. in our study the investigators compare fib and espb in terms of pain relief expressed as morphine consumption in the first 24 hours after primary thr.


Eligibility criteria:
inclusion criteria: * primary thr * informed consent exclusion criteria: * allergies to study drugs * spinal anesthesia contraindicated * kidney failure * epilepsy, psychiatric disease, neurologic deficits * revision surgery * neuropathies in the lumbar area * no informed consent * pregnancy * alcohol/opioid abuse * emergency surgery/intensive care
a study to evaluate lung ultrasound as a method to measure changes in extravascular lung water induced by positional changes (lupe)

Conditions: Acute Decompensated Heart Failure

Summary: this is an exploratory study to evaluate lung ultrasound as a method for measuring extravascular lung water in stabilized patients during hospitalization for adhf. subjects who have been stabilized following admission for adhf and capable of lying supine will be evaluated by lung ultrasound to determine the degree of lung congestion as measured by the total b-line score. since different patients may require different degrees of postural change and/or other maneuvers (e.g., leg elevation or exercise) to induce b-line increments, a tailored sequential protocol will be employed to define which maneuvers are sufficient for each patient. control patients, age-matched, will be recruited to provide a comparison group for data analysis.


Eligibility criteria:
inclusion criteria: hospitalized for the management of acute decompensated heart failure reached at least a 12-hour period after hospital admission presence of peripheral edema with a score of at least 1+ (slight pitting in both ankles; 2mm or less depression that disappears rapidly) able to lie supine with no more than one pillow (approximately a 10 cm head elevation) without dyspnea for at least 30 minutes by patient report have not received treatment with any intravenous loop diuretic within the 4 hours prior to initiating study assessments and with no plans for additional intravenous treatment during the series of lung ultrasound measurements exclusion criteria: persistent uncontrolled hypertension (resting systolic blood pressure \> 160 mmhg) significant lung disease including severe chronic obstructive pulmonary disease (see concomitant medication exclusions), pulmonary fibrosis, active asthma or acute pneumonia use of medications specified for the treatment of copd including short- and long-acting bronchodilators (β-agonists and anticholinergics) and inhaled glucocorticoids as well as oxygen therapy use of another investigational product in a clinical study within the following time period prior to the first administration of study medication: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer)
combined modality treatment for resectable non-small cell superior sulcus tumors

Conditions: Lung Cancer

Summary: 1. to determine the outcome of patients with potentially resectable superior sulcus tumors of non-small cell histology treated by surgery followed by accelerated radiation therapy and chemotherapy. 2. to evaluate toxicity, the initial local-regional control rate, sites of and time to local and distant failures.

eligible (surgically resectable and medically operable) patients will have surgery followed by radiation therapy, given twice daily, for 5 weeks if margins are negative and for 5-1/2 weeks for positive margins. grossly positive margins can be treated by brachytherapy followed by external radiotherapy. concomitant chemotherapy consisting of cisplatin given intravenously on days 1 and 8, and etoposide taken by mouth 30-60 minutes prior to each radiotherapy treatment x the first 10 days. the cycle will be repeated start day 29. if the patients are considered to have no evidence of disease in one month after completion of chemotherapy, optional prophylactic radiotherapy to the brain will be give in 10 fractions once daily for 2 weeks.

Eligibility criteria:
inclusion criteria: 1. no previous treatment. 2. tumor must be resectable. 3. \>/= 18 and \</= 70 years of age. 4. zubrod performance status \</= or higher performance status if based only on pain. 5. must have adequate bone marrow, liver and renal function as defined in 3.6. exclusion criteria: 1. cytological or histological proof of n3 disease. 2. evidence of metastatic disease to distant sites. 3. patients with impending cord compression will be ineligible.

Keywords: superior sulcus tumor lung cancer non-small cell multimodality treatment surgery segmentectomy lobectomy cisplatin cddp etoposide vp-16 vepesid radiation therapy radiotherapy chest irradiation prophylactic cranial irradiation pci
effects of altitude on single-breath diffusing capacity for carbon monoxide

Conditions: COPD

Summary: the purpose of this study is to further understand the effects of altitude on the physiology of gas exchange in the pulmonary microcirculation in normal subjects and in people with chronic obstructive pulmonary disease (copd) measured as the single-breath diffusing capacity for carbon monoxide (dlcosb). the study will determine a mathematical formula to allow for altitude corrections in both study populations to be used clinically in pulmonary labs.

the dlcosb is one of the most common and widely tests clinically used across the world in pulmonary function laboratories to assess gas exchange from the lung to hemoglobin in the pulmonary circulation. this test is used in the differential diagnosis of respiratory related symptoms, to grade the degree of severity in lung disease, and to objectively monitor the progression of disease or the response to therapies. therefore, it is important to have standard methods of performing and interpreting this test.this is a prospective study, collecting data from subjects at different simulated altitudes. the study hypothesis is that increasing altitude will increase the dlcosb in a predictable manner that will allow for mathematical corrections to be applied for uniform interpretation in pulmonary labs at differing altitudes.

Eligibility criteria:
inclusion criteria: * ages 20- 80 years * subjects must be either healthy or have been diagnosed with copd exclusion criteria: * anemia (hemoglobin \< 10.0 g/dl) * carboxyhemoglobin \> 3% * active smoking * heart disease or heart failure * pulmonary hypertension * copd exacerbation * pneumothroax within 6 months * bullous emphysema on chest imaging (chest x-ray or ct) * supplemental oxygen use * diabetes mellitus * alcohol dependence * non-english speaking

Keywords: altitude diffusing capacity for carbon monoxide copd pulmonary function testing
diode laser and photodynamic therapy vs. ciclopirox.

Conditions: Onychomycosis

Summary: the main objective of this study is to compare the efficacy of treatment of onychomycosis by: diode laser combined with photodynamic therapy, and topical treatment with ciclopirox hydroxypropyl chitosan (hpch) nail lacquer. the study is a low-intervention, randomised controlled clinical trial. patient recruitment will be done by including in the sample those patients who have diagnostic confirmation of onychomycosis in the chiropodology and surgery service of the university podiatry clinic of the complutense university of madrid. participants in the trial will be assigned with equal probability to each treatment arm, according to their consecutive inclusion in the study. subsequently, treatment assignment will be determined by a random code. the treatment used will be evident to both the participant and the podiatrist responsible for the intervention. visits will be made every 7 days at the start of treatment and for 9 weeks in group 1 (treatment with laser and photodynamic therapy), and monthly visits in group 2 (treatment with ciclopirox nail polish) during the 12 months of follow-up. regardless of the follow-up week at which healing occurs, all patients will be reviewed at 3, 6, 9 and 12 months after the first visit.

visits will be made every 7 days at the start of treatment and for 9 weeks in group 1 (treatment with laser and photodynamic therapy), and monthly visits in group 2 (treatment with ciclopirox nail polish) during the 12 months of follow-up. regardless of the follow-up week at which healing occurs, all patients will be reviewed at 3, 6, 9 and 12 months after the first visit.

Eligibility criteria:
inclusion criteria: * patients diagnosed with toenail onychomycosis with positive microbiological culture/pcr. * patients over 18 years of age. exclusion criteria: * patients who have received topical or systemic antifungal treatment in the previous month. * pregnancy or lactation. * patients with peripheral vascular disease. * patients with an immune system disorder or undergoing treatment with immunosuppressants. * patients with peripheral or central neuropathy. * patients with a coagulation disorder. * patients with raynaud's disease or with any alteration in the perception of cold or heat.

Keywords: onychomycosis laser ciclopirox
effectiveness of hand/eyes/mouth behavior management technique during local anesthesia in preschool children

Conditions: Dental Anxiety; Pain; Infant Behavior; Heart Rate and Rhythm Disorders

Summary: this will be a randomized, controlled, parallel-group clinical trial. the aim of this studio will be to evaluate the effectiveness of "hands/eyes/mouth" behavior management technique versus a conventional technique (covering the patient´s vision) during an inferior alveolar and lingual nerve block in preschool children referred for treatment at the school of dentistry, cardenal herrera ceu university (valencia, spain). the sample will consist of 52 children from 3 years old to 5 years 11 months old who need dental pulp treatment and/or tooth extraction of primary molars. preschool children with no history of allergies to lidocaine or systemic/neurological diseases and who did not take local anesthesia before the study will be include in this research.

children will be randomly allocated to treatment groups (n=26 for each group) according to the technique: 1)"hands/eyes/mouth" and 2) conventional. anxiety and pain will be evaluated by the scale of facial image (eif) and wong-baker pain scale, respectively. the cooperation of the patient will be evaluated by behavioral scale frank

Eligibility criteria:
inclusion criteria: * preschool children with severe dental caries who need dental pulp treatment and/or tooth extraction of inferior primary molars exclusion criteria: * preschool children with history of allergies to lidocaine (local anesthetic) * preschool children with systemic or neurological diseases * preschool children who have received local dental anesthesia before this study * preschool children who do not understand spanish or valencian language

Keywords: pain infant behavior heart rate dental anxiety
turkish adaptation of heart health self-efficacy and self-management scale

Conditions: Coronary Artery Disease

Summary: the importance of lifestyle changes to control risk factors in the prevention, treatment and management of coronary heart disease (chd), a major health problem, has been emphasised. in addition, physical, social, psychological and occupational limitations arising from the disease negatively affect the quality of life and self-efficacy perceptions of individuals, making it difficult to comply with treatment and disease management. there are general self-efficacy and self-management scales for which turkish validity and reliability studies have been conducted previously. however, these scales are not specific to coronary heart disease patients and evaluate either only self-efficacy or only self-management. the aim of this study was to adapt the heart health self-efficacy and self-management scale (hh-sesm) into turkish and to investigate its validity and reliability in patients with coronary heart disease. the study is conducted in cardiology outpatient clinics of karaman training and research hospital. before the study, the purpose and content of the study will be explained to the participants and an informed consent form will be obtained from the participants. since the sample size in validity and reliability studies should be at least 10 times the total number of scale items, at least 120 individuals will be included in the study as the number of items x number of options (12 x 10 = 120). detailed medical history and sociodemographic information (age, gender, height, weight, body mass index, disease duration (months), occupation, daily working hours, educational status, sports/exercise habits) will be recorded. in order to measure self-management and self-efficacy levels, patients will be administered the hh-sesm, self-care management in chronic diseases scale- self-care subgroup questions and general self-efficacy scales.


Eligibility criteria:
inclusion criteria: * being diagnosed with coronary heart disease for at least 6 months * speaking turkish * to be able to read and write * being over 18 years old * volunteering to participate in the study exclusion criteria: * having a serious psychiatric illness such as panic disorder or major depression

Keywords: coronary artery disease validitiy reliability self efficacy self management heart health
ai assisted detection of fractures on x-rays (fract-ai)

Conditions: Fracture; Bone Fracture; Dislocation; Fracture Multiple; Fractures, Closed; Fractures, Open

Summary: this study has been added as a sub study to the simulation training for emergency department imaging 2 study (clinicaltrials.gov id nct05427838). this work aims to evaluate the impact of an artificial intelligence (ai)-enhanced algorithm called boneview on the diagnostic accuracy of clinicians in the detection of fractures on plain xr (x-ray). the study will create a dataset of 500 plain x-rays involving standard images of all bones other than the skull and cervical spine, with 50% normal cases and 50% containing fractures. a reference 'ground truth' for each image to confirm the presence or absence of a fracture will be established by a senior radiologist panel. this dataset will then be inferenced by the gleamer boneview algorithm to identify fractures. performance of the algorithm will be compared against the reference standard. the study will then undertake a multiple-reader multiple-case study in which clinicians interpret all images without ai and then subsequently with access to the output of the ai algorithm. 18 clinicians will be recruited as readers with 3 from each of six distinct clinical groups: emergency medicine, trauma and orthopedic surgery, emergency nurse practitioners, physiotherapy, radiology and radiographers, with three levels of seniority in each group. changes in reporting accuracy (sensitivity, specificity), confidence, and speed of readers in two sessions will be compared. the results will be analyzed in a pooled analysis for all readers as well as for the following subgroups: clinical role, level of seniority, pathological finding, difficulty of image. the study will demonstrate the impact of an ai interpretation as compared with interpretation by clinicians, and as compared with clinicians using the ai as an adjunct to their interpretation. the study will represent a range of professional backgrounds and levels of experience among the clinical element. the study will use plain film x-rays that will represent a range of anatomical views and pathological presentations, however x-rays will present equal numbers of pathological and non-pathological x-rays, giving equal weight to assessment of specificity and sensitivity. ethics approval has already been granted, and the study will be disseminated through publication in peer-reviewed journals and presentation at relevant conferences.


Eligibility criteria:
inclusion criteria: * emergency medicine doctors, trauma and orthopaedic surgeons, emergency nurse practitioners, physiotherapists, general radiologists and radiographers reviewing x-rays as part of their routine clinical practice. * currently working in the national health service (nhs). exclusion criteria: * non-radiology physicians with previous formal postgraduate xr reporting training. * non-radiology physicians with previous career in radiology

Keywords: radiology emergency medicine artificial intelligence xrays fractures
comparison of postoperative outcomes of laparoscopic lateral suspension and v-notes lateral suspension with the salman ketenci gencer technique

Conditions: Pelvic Organ Prolapse

Summary: comparison of early postoperative outcomes of patients undergoing laparoscopic lateral suspension and v-notes lateral suspension with the salman ketenci gencer technique


Eligibility criteria:
inclusion criteria: * patients with stage 3 or 4 pelvic organ prolapse sexually active patients exclusion criteria: * cervical pathology history of loop electrosurgical excision procedure (leep) or conization presence of vaginal, pelvic, or adnexal mass suspicious abdominal malignancy morbid obesity any pelvic infection signs of pregnancy

Keywords: laparoscopy v-notes lateral suspension pelvic organ prolapse
effects of electrical stimulation on osteoarthritis of the knee

Conditions: Osteoarthritis, Knee

Summary: the purpose of this study is to find out whether electrical stimulation can reduce knee pain and increase function in people with osteoarthritis of the knee.


Eligibility criteria:
inclusion criteria: * 50 years of age or older * diagnosis of primary osteoarthritis of the knee (as defined by american college of rheumatology criteria) * knee pain of at least six months duration * moderate or greater knee pain (defined as a score of 3 or greater on an 11 point numeric pain rating scale) for most days in the last month * willing to abide by protocol and treatment schedule. exclusion criteria: * implants, such as pacemaker, tens, or insulin pump, incompatible with electrical stimulation * uncontrolled concomitant disease affecting the knee, such as: rheumatoid arthritis, systemic lupus erythema, psoriatic arthritis * pregnant or breast-feeding * intra-articular corticosteroid or hyaluronic acid injection into the knee within 3 months preceding study * arthroscopy of the knee within the past year * significant injury to the knee within the past 6 months * use of assistive devices other than a cane or knee brace * disease of spine or other lower extremity joints of sufficient degree to affect assessment of the knee
radiation therapy in treating women with localized breast cancer

Conditions: Breast Cancer

Summary: rationale: radiation therapy uses high-energy x-rays to kill tumor cells. giving radiation therapy in different ways and giving it after surgery may kill any tumor cells that remain after surgery. purpose: this randomized clinical trial is studying radiation therapy to see how well it works in treating women with localized breast cancer.

objectives: * compare late normal tissue effects of standard vs 2 different dose levels of hypofractionated adjuvant whole breast radiotherapy, in terms of changes in photographic breast appearance, in women with localized breast cancer who are at average or low risk of recurrence. * compare tumor control in patients treated with these regimens. outline: this is a randomized, multicenter study. patients are stratified according to participating center. patients are randomized to 1 of 3 treatment arms. * arm i (control): patients undergo standard radiotherapy 5 days a week for 5 weeks. * arm ii: patients undergo hypofractional radiotherapy once a week for 5 weeks. * arm iii: patients undergo hypofractional radiotherapy (at a lower dose than arm ii) once a week for 5 weeks. after completion of study treatment, patients are followed annually for 5-10 years. projected accrual: a total of 900 patients (300 per treatment arm) will be accrued for this study within 12 months.

Eligibility criteria:
disease characteristics: * diagnosis of invasive carcinoma of the breast * localized disease * pathological tumor size \< 3.0 cm in diameter * axillary node negative * at average or low risk of local tumor recurrence * must have undergone prior breast-preserving surgery * no prior mastectomy * complete microscopic resection of tumor * hormone receptor status: * not specified patient characteristics: age * 50 and over sex * female menopausal status * not specified performance status * not specified life expectancy * not specified hematopoietic * not specified hepatic * not specified renal * not specified other * fertile patients must use effective contraception prior concurrent therapy: biologic therapy * not specified chemotherapy * no prior neoadjuvant or adjuvant cytotoxic chemotherapy endocrine therapy * not specified radiotherapy * no concurrent lymphatic radiotherapy * no concurrent radiotherapy boost to the breast surgery * see disease characteristics

Keywords: stage i breast cancer stage ii breast cancer