Kornimate/medical-research-clean huggingface dataset:
cethrin in acute cervical spinal cord injury

Conditions: Spinal Cord Injury

Summary: this is a multicenter, randomized, double-blind, placebo-controlled phase iib/iii study designed to evaluate the efficacy and safety of cethrin as a treatment for acute cervical spinal cord injury. during the trial, high and low doses of cethrin will be compared with placebo.


Eligibility criteria:
inclusion criteria: * males or females, ages 18-62, inclusive * acute cervical spinal cord injury at a neurological level of c4-c6 * ais grade a or b * scheduled to undergo decompression/stabilization surgery within five days of injury * written or verbal consent from patient or legally authorized representative that patient is able and willing to comply with the study protocol, including follow-up visits exclusion criteria: * participation in any other clinical trial for acute sci, including previous cethrin trial * inability to receive study medication within five days of injury * acute sci from gunshot or penetrating/stab wound; peripheral nerve injury; brachial plexus injury; complete spinal cord transection; or multifocal sci * significant hemorrhage on mri/ct scan * females who are breastfeeding or have a positive serum pregnancy test * body mass index (bmi) of ≥ 35 kg/m2 at screening * history of an adverse reaction to a fibrin sealant or its human or bovine components * use of intravenous heparin in previous 48 hours, aspirin-containing products in previous 24 hours, thrombolytics in previous 12 hours * hemophilia or other bleeding abnormality (platelet level lower than 100 x 109/l, activated partial thromboplastin time or international normalized ratio higher than the upper limit of normal, or baseline hematocrit lower than 0.25) * unconsciousness or other impairment that precludes reliable asia examination * known immunodeficiency, including human immunodeficiency virus, or use of immunosuppressive or cancer chemotherapeutic drugs * clinically significant pre-existing neurological, cardiac, respiratory, hepatic, or renal disease

Keywords: sci spinal cord injury biologic drug rho paralysis paraplegia tetraplegia quadriplegia trauma central nervous system fibrin sealant neurosurgery cervical regeneration neurotrauma
trial of two techniques to assess postoperative voiding function

Conditions: Urinary Retention

Summary: stress urinary incontinence (sui) is a common condition that affects up to 35% of women. many surgical procedures have been developed to treat sui, and midurethral slings have gradually become the first line treatment. voiding dysfunction, or inability for a patient to empty her bladder, immediately after surgery is common. a bladder test is often performed in the recovery area to see if the patient is able to empty her bladder. this typically consists of filling the bladder with 300 ml of saline through the foley catheter. the catheter is then removed and the patient is asked to void. the investigators then measure the voided volume and the residual left inside the bladder to determine if she is able to empty her bladder sufficiently or not. a successful voiding trial is defined as voiding 2/3 of the total volume in the bladder and having less than 100 ml left inside the bladder as residual. our goal of this study was to evaluate efficiency and effectiveness of a retrograde postoperative voiding trial that is initiated in the operating room. our hypothesis was that a retrograde postoperative voiding trial initiated in the operating room would be as effective as a standard retrograde postoperative voiding trial to predict postoperative voiding dysfunction while allowing for patients to spend less time in the recovery unit.


Eligibility criteria:
inclusion criteria: * english-speaking * women over the age of 18 * patients with stress urinary incontinence planning to undergo midurethral sling placement exclusion criteria: * prior incontinence surgery * concomitant surgery for pelvic organ prolapse except for anterior repair * intraoperative cystotomy * patients taking anticholinergic medication

Keywords: midurethral sling voiding study voiding trial retrograde voiding trial
laparoscopic spleen-preserving no. 10 lymph node dissection for agc

Conditions: Gastric Cancer; Gastrectomy; Laparoscopic Surgery; Lymphadenectomy

Summary: the purpose of this study is to explore the safety and feasibility of laparoscopic spleen-preserving no. 10 lymph node dissection for patients with advanced middle or upper third gastric cancer.

radical resection is the primary treatment for patients with advanced middle or upper third gastric cancer. and d2 lymphadenectomy, including no. 10 lymph node dissection, should be performed according to the japanese treatment guidelines for gastric cancer. because of the complexity of the anatomy around the spleen, spleen-preserving no. 10 lymph node dissection is difficult. although professor huang from fujian medical university union hospital has proposed the "huang's three-step maneuver" to dissect no. 10 lymph node with preserved spleen laparoscopically, such method is far from popularized, especially in north china. in addition, the safety, feasibility and oncological efficacy of this method was not confirmed in such area, either. in this study, a prospective, single center, single-arm, non-inferiority clinical trial will be conducted to evaluate the short and long-term outcome of the laparoscopic spleen-preserving no. 10 lymph node dissection for patients with locally advanced middle or upper third gastric cancer in beijing.

Eligibility criteria:
inclusion criteria: * patients age older than 18 years (including 18 years old); * the primary lesion is located in the upper or middle third of the stomach, including siewert ii type and siewert iii type adenocarcinoma of the esophagogastric junction; * pathologically confirmed primary gastric adenocarcinoma by endoscopic biopsy (including papillary, tubular, mucinous, signet ring cell and poorly differentiated adenocarcinoma); * preoperative cancer stage ct2-4an0-3m0 (according to ajcc-7th tnm staging); * the eastern cooperative oncology group performance status of 0 or 1; * the american society of anesthesiology classes of i, ii or iii; * signed informed consent. exclusion criteria: * pregnant or lactating women; * suffering from severe mental disorder; * previous gastrectomy, including endoscopic submucosal dissection and endoscopic mucosal resection; * integrated or enlarged lymph node with maximum diameter larger than 3 cm according to preoperative imaging, including significantly enlarged or bulky no. 10 lymph nodes; * siewert i type adenocarcinoma of the esophagogastric junction; * other malignant diseases (within 5 years); * other illnesses needed operation concurrently; * complications (bleeding, perforation or obstruction) required emergency surgery due to primary gastric malignancy; * pulmonary function tests fev1 less than 50% of predicted value; * patient suffered from bleeding tendency disease such as hemophilia or took anti-coagulant medication due to deep vein thrombosis. * patients with obvious tumor infiltration in the spleen and splenic vessels which require splenectomy.
adherence to anti-rabies post-exposure prophylactic protocols

Conditions: Rabies

Summary: this study aims to investigate physicians' adherence to advisory committee on immunization practices (acip) guidelines regarding anti-rabies post-exposure prophylaxis in egypt.

there is no known effective treatment for rabies, and virtually all cases are fatal. although the prognosis is poor in patients who develop rabies, the disease is usually preventable with proper wound care and post-exposure prophylaxis. following a thorough risk assessment, the decision to initiate rabies post-exposure prophylaxis should be made. the risk assessment should consider the type of exposure, local rabies epidemiology in animals, vaccination history of the animal, circumstances of the exposure incident, and the availability of the animal for observation or rabies testing . the world health organization (who) and the advisory committee on immunization practices (acip) have adopted guidelines for starting post-exposure prophylaxis (pep) against rabies. the decision to start anti-rabies pep is usually made in primary health care units or emergency departments . lack of adherence to these guidelines might result in unnecessary costs and medical risks, such as injection site reactions and systemic hypersensitivity reactions . this malpractice of inappropriate anti-rabies pep prescription is not uncommon.

Eligibility criteria:
inclusion criteria: * physicians who treat patients with animal bites potentially requiring post-exposure anti-rabies prophylaxis. the sample will include emergency physicians, general practice or family physicians, and surgeons of both sexes, with varying degrees of experience and post-graduate clinical training. exclusion criteria: * incomplete record filling
phase 1 study of ezn-2968 weekly in adult patients with advanced solid tumors or lymphoma

Conditions: Carcinoma; Lymphoma

Summary: this is a phase 1, open-label, non-randomized, dose-escalation study to determine the maximum tolerated dose (mtd), safety, tolerance, and pharmacologic profile of ezn-2968, a locked nucleic acid antisense oligonucleotide against hypoxia-inducible factor 1α administered as a 2-hour intravenous (i.v.) infusion weekly for 3 weeks per 6-week cycle. in patients treated at a recommended phase 2 dose of ezn-2968, dose intensification will proceed by maintaining the dose, but gradually increasing the number of doses per 6-week cycle. up to 3 intensification cohorts will receive the recommended phase 2 dose of ezn-2968.

this is a phase 1, open-label, non-randomized, dose-escalation study to determine the maximum tolerated dose (mtd), safety, tolerance, and pharmacologic profile of ezn-2968, a locked nucleic acid antisense oligonucleotide against hypoxia-inducible factor 1α (anti-hif-1α lna as odn) administered as a 2-hour intravenous (i.v.) infusion weekly for 3 weeks per 6-week cycle. in patients treated at a recommended phase 2 dose of ezn-2968, dose intensification will proceed by maintaining the dose, but gradually increasing the number of doses per 6-week cycle. up to 3 intensification cohorts will receive the recommended phase 2 dose of ezn-2968.

Eligibility criteria:
inclusion criteria: patients must meet all of the following criteria to be eligible for enrollment into the study. * histologically or cytologically confirmed diagnosis of advanced and/or metastatic solid tumor or lymphoma (hodgkin's or non-hodgkin's) * patients who have failed standard therapy and have no known effective therapy available to them * patients may have a tumor amenable to biopsy * measurable or evaluable disease. * age 18 years or older exclusion criteria: patients meeting any of the following exclusion criteria will not be eligible for enrollment. * concurrent serious medical illness * known, clinically suspected, or history of central nervous system (cns) tumor involvement * prior chemotherapy, immunotherapy, investigational agent, or other therapy used to treat the cancer within 4 weeks (6 weeks for prior treatment with mitomycin c or nitrosoureas) before the scheduled administration of ezn-2968. luteinizing hormone-releasing hormone (lhrh) agonist therapy is permitted for patients with hormone refractory prostate cancer.

Keywords: carcinoma, lymphoma
clinical study of oral midazolam combined with esketamine administered intranasally for pediatric preoperative sedation

Conditions: Anxiety

Summary: children are prone to anxiety and even fear before surgery, and such adverse emotions may not only lead to poor induction of anesthesia, but also increase the incidence of postoperative agitation and even lead to postoperative behavioral changes in children. there are many ways to relieve pediatric anxiety, including preoperative medication, games, and cartoons. preoperative medication is the most commonly used method to relieve pediatric anxiety.the most commonly used pediatric preoperative sedation drugs are midazolam and esketamine.however, oral midazolam may not produce a sedative effect in 20-40% of patients. a good preoperative anxiety-reducing effect was seen in only 60-80% of cases.therefore, this trial investigates whether the intranasal combination of esketamine with oral midazolam can produce better results than each of the two drugs alone. this will provide a reference for the selection of safe, reliable and appropriate preoperative sedation methods for pediatric patients and provide evidence-based support for comfort care.

a trained member of the research team obtained a baseline the modified yale preoperative anxiety scale(mypas) after obtaining consent. and corresponding study medication is administered about 30-40 minutes before the anesthesia induction.vital signs were measured every 5 min after study medication administration.the sedation scores of the children were recorded with university of michigan sedation scale (umss) every 10 minutes.the onset time of satisfactory sedation and parental separation anxiety scale was noted.then recorded the degree of cooperation during inhalation anesthesia induction and recovery times.moreover, recorded the pediatric anesthesia emergence delirium scale (paed) during the recovery period.

Eligibility criteria:
inclusion criteria: 1. with american society of anesthesiologists (asa) physical status i or ii； 2. aged 2-6 years； 3. children with weight for age within the normal range 4. were scheduled lower abdominal and perineal surgery with an expected operation time shorter than 30 minutes. exclusion criteria: 1. children who had gastrointestinal,cardiovascular or endocrine dysfunction; 2. contraindication to preoperative sedation or had a known allergy or hypersensitive reaction to either esketamine or midazolam; 3. with any nasal pathology,organ dysfunction; 4. recently respiratory infection, mental disorder; 5. other reasons that researchers hold it is not appropriate to participate in this trial.
improved prediction of recurrent stroke and detection of small volume stroke

Conditions: Ischemic Stroke

Summary: rationale: over 20.000 people suffer an ischemic stroke in the netherlands each year. large artery occlusions are easy to identify and can be treated with endovascular clot removal. 70% of patient will however suffer from a more distal occlusion resulting in small volume stroke or a transient ischemic attack (tia). small ischemic lesions are hard to detect with current acute stroke protocols. tia and small volume stroke patients, are at an increased risk for recurrent stroke, making immediate diagnosis critical. because thrombo-embolic sources often cause these strokes, identifying and treating the underlying aetiology has the potential to radically lower the risk of recurrence and improve the outcome of these patients. objectives: 1) to identify clinical and imaging predictors of recurrent stroke; 2) to improve early detection of small volume stroke with admission computed tomography perfusion (ctp) in patients with suspected acute ischemic stroke with small volume stroke or no ischemia on admission imaging. study design: prospective, multicenter cohort study. study population: all patients who visited the university medical center (umc) utrecht, the amsterdam university medical centers (amsterdam umc), location academic medical center (amc) or the st. antonius hospital and who underwent a ct-scan of the brain within 9 hours after onset of stroke symptoms with an age ≥18 years. within 36 months, 720 patients will be enrolled in the study. of these patients, 300 patients will be included for the follow-up magnetic resonance imaging (mri). main study parameters/endpoints: the main study endpoints are: 1) stroke recurrence rate at 2 years; 2) presence and volume of acute ischemic lesions on follow-up diffusion weighted imaging mri.


Eligibility criteria:
inclusion criteria: * age ≥18 years; * time from symptom onset until imaging is \<9 hours\*; * clinical diagnosis of acute ischemic stroke or tia; * informed consent from patient or family after the admission scan (unless the patient died). * patients who awaken with stroke symptoms can only be included if they went to sleep without any stroke symptoms and the time from going to sleep until imaging is less than 9 hours. exclusion criteria: * patients with another diagnosis such as intracerebral hemorrhage, subarachnoid hemorrhage or tumor; * patients with known contrast allergy or renal failure.

Keywords: recurrence infarct detection ct mri diagnosis prognosis
influenza vaccination, acei and arb in the evolution of sars-cov2 infection

Conditions: COVID19; Influenza Vaccination; ACE Inhibitors; ARB; Antihistamine Allergy; Amantadine

Summary: some authors have proposed the use of the flu vaccine to reduce the severity of covid-19 cases, while some have proposed the use of ace inhibitors (acei) or angiotensin receptor blockers (arb), since this virus shares hemagglutinin as a transmission mechanism and acts on the ace2 enzyme during infection. other authors described how none of the elderly patients receiving antihistamines and azythromycin in two nursing homes in toledo -spain- during the first wave died or needed hospital admission, even considering that 100% of residents had a positive serological test after that wave. other authors have described a positive evolution in patients receiving amantadine for their parkinson's disease. the aim is to evaluate whether the admitted patients who are previously vaccinated or those who were already receiving these treatments showed a better evolution.

the number covid cases would be related to hospital admissions. among hospital admissions, the number of previous treatments, the length of admission, the need or not of the intensive care unit (icu) and their final status (survivors or non survivors) would be studied. if patients that previously received the influenza vaccine or treated with acei, arb, antihistamines or amantadine showed a better evolution, it would be proposed to extend vaccination and the inclusion of ace inhibitors, arb, antihistamines or amantadine in the treatment of infection.

Eligibility criteria:
inclusion criteria: * hospital admissions at the hospital of terrassa from march 1, 2020 for any cause. exclusion criteria: * none. * for comparison of percentage of influenza vaccination, acei and arb vs general population, patients from outside the reference area of the terrassa health consortium would be excluded.
clinical characteristics and long-term prognosis of 2019-ncov infection in children

Conditions: 2019-nCoV

Summary: the study is designed to clarify the clinical characteristics, risk factors and long-term prognosis of children with 2019-ncov infection in china.

as of february 10th, 2020, more than 40,000 human have been confirmed infected with a novel coronavirus (2019-ncov) in china, with at least 800 reported deaths. additional cases have been confirmed in multiple countries, and some are reported in children. patients with confirmed 2019-ncov infection have reported respiratory illness with fever, cough, et al. some are asymptomatic carriers. however, there are relatively few diagnosed cases of children, and the long-term prognosis is unknown. therefore, a multicenter observational study is needed to better understand the clinical characteristics of 2019-ncov infection in children. this observational study will last from february to december 2020. the patients enrolled were diagnosed with 2019-ncov infection or 2019-ncov pneumonia by beijing children's hospital and other members of chinese national clinical research center for respiratory diseases in 2019-2020. at the same time, children hospitalized with pneumonia other than 2019-ncov pneumonia during the same period are classified as the control group by 3\~5:1 matching for age and sex to the 2019-ncov group. after guardians signing the informed consent forms, all the participants' clinical data, laboratory examination results, image data and also the follow-up information after six months of their treatment will be collected. the trial will be completed in 10 months, with subjects recruited from the hospitals that in partnership with clinical research collaboration of national clinical research center for respiratory diseases.

Eligibility criteria:
1. for the 2019-ncov infection group inclusion criteria: diagnosed with 2019-ncov infection (with direct laboratory evidence). 1. respiratory or blood samples tested positive for novel coronavirus nucleic acid with rt-pcr. 2. gene sequencing of respiratory or blood samples show highly homologous with known novel coronaviruses. exclusion criteria: subjects will be excluded if the children or their parents disagree to conduct this study. 2. for the control group inclusion criteria: 1. diagnosed with pneumonia, and excepted of novel coronavirus infection. 2. the hospitalization time is the same as that of novel coronavirus pneumonia. exclusion criteria: subject will be excluded if she or he has one of the following: 1. first diagnosis is not pneumonia. 2. any one of the novel coronavirus laboratory test results show positive. 3. children or their parents disagree to conduct this study.

Keywords: 2019-ncov infection 2019-ncov pneumonia children
effect of inspiratory muscle training on ventilated patients in an intensive care unit

Conditions: Critically Ill, Subacute Adult Patients; Mechanically Ventilation

Summary: the goal of this clinical trial is to learn if inspiratory muscle training facilite the liberation of mechanical ventilation. the main questions it aims to answer are: does inspiratory muscle training facilitate weaning from mechanical ventilation and enhance muscle strength in critically ill, subacute adult patients? the main questions it aims to answer are: does pulmonary rehabilitation facilitate wwaning form mechanical patients? does the intervention improve respiratory muscle strength and respiratory patterns? participants received: inspriatory muscle training twice daily for three consecutive weeks or until the subject no longer required ventilator support.

patients on mechanical ventilation often experience rapid diaphragm atrophy on the second day, resulting in muscle fiber changes, respiratory muscle weakness. clinical studies have explored enhancing diaphragm and respiratory muscle strength and endurance through inspiratory muscle, expiratory muscle, and combined respiratory muscle training. this study was to determine if inspiratory muscle training significantly facilitates liberation from mechanical ventilation and improves muscle strength when compared to without imt among subacute critically ill adult patients.

Eligibility criteria:
inclusion criteria: * requiring invasive mechanical ventilation for 2 days in an icu exclusion criteria: * hemodynamic instability (heart rate 120 beats/min, unstable blood pressure, vasopressor infusion) * inadequate oxygenation (peep 8 cmh2o, fio2 50%) * body temperature 38.5°c * sepsis * use of sedative infusion * steroid administration * home ventilator use before icu admission

Keywords: sub-acute critical ill mechanical ventilation respiratory muscle training respiratory muscle strength rapid shallow breathing index