Kornimate/medical-research-clean huggingface dataset:
innovative endotracheal tube design reduces postoperative laryngeal injury

Conditions: Laryngeal Injury; Hoarseness; Cough; Sore-throat; Intubation Complication; Bucking, Anesthesia Related

Summary: the goal of this randomized clinical trial is to compare two different orotracheal tubes in patients which require orotracheal intubation for general anesthesia. the main questions it aims to answer are: * to assess the presence of laryngeal injury * to evaluate the consequences in voice quality * to ask for the presence of symptoms as sore throat, hoarseness, and cough participants will be randomly assigned into two groups, one will use conventional endotracheal tube and the other will use triglotix® endotracheal tube.

endotracheal intubation is necessary in some patients undergoing surgical procedures and patients requiring mechanical ventilation in the intensive care unit. however, endotracheal intubation is associated with known complications. in post-surgical patients subjected to orotracheal intubation, the incidence of dysphagia, sore throat, hoarseness and cough is 43%,38%27%,32% respectivelly. these figures increase in cases of prolonged intubation, such as those in intensive care units, where reported rates are 76% for sore throat, 63% for hoarseness and 49% for dysphagia. no significant endotracheal tube design improvements have been developed over the past few decades addressing these issues. the present study aims to compare the incidence of laryngeal injuries, and related symptoms as sore throat, hoarseness, swallowing problems, bucking and coughing between two defined sample populations: those utilizing a conventional endotracheal tube (ett-c) and those employing the new triglotix® endotracheal tube (ett-t) in patients undergoing elective surgery requiring general anesthesia and mechanical ventilation.

Eligibility criteria:
inclusion criteria: * elective perianal surgery requiring intubation for general anesthesia * duration range 30-90 minutes exclusion criteria: * difficult airway * american society of anesthesiologists physical status (asa) \> iii * morbid obesity (body mass index \>40 kg/m2) * patients not suitable for outpatient surgery * patients with history of previous neck surgery * patients with history of dysphagia * patients with comorbidities as diabetes and hypertension.

Keywords: laryngeal injury endotracheal tube general anesthesia
to establish a novel prototype of clinical pharmacy services by warfarin consultation in a pharmacist clinic

Conditions: Intentional Warfarin Sodium Overdose

Summary: warfarin, the major oral anticoagulant currently available in taiwan, is used for the prevention and treatment of a variety of thromboembolic disorders. under dosing of warfarin may cause treatment failure and over dosing may cause bleeding because of its narrow therapeutic index. therefore, it is important to monitor prothrombin time (pt) and international normalize ratio (inr) periodically in order to evaluate the appropriateness of warfarin dosing. lots of factors influencing warfarin anticoagulation effects include polymorphisms of cytochrome p450 2c9(cyp2c9)and vitamin k epoxide reductase complex subunit 1(vkorc1)genes, age, weight, diet and concurrent medications. taking into consideration of physicians' work load, pharmacist-managed anticoagulation clinics were set up to help strengthen patient care in us to ensure patient medication safety. in addition, differences in genetic polymorphisms between chinese and caucasian have great impacts on warfarin dosage, and there is still no consensus on warfarin utilization guideline in taiwan. pharmacist-managed anticoagulation clinics provide individualized care, consistent monitoring and patient education. through this service, physicians can get the latest integrated information about their patients, patients themselves are more familiar with their medication, and adherence can be improved. therefore, those who take warfarin will get better inr control, less adverse drug-related events and treatment failure. this is the first prototype of pharmacist clinic for a specific medication in our hospital. the adverse drug events and coagulation function data collected through this program can be used for the implementation of warfarin treatment guideline in taiwan in the future. the impact of pharmacist clinic can be evaluated by questionnaire of satisfaction and knowledge survey. it can be used as a model for implementing other pharmacist-managed clinics and improving patient medication safety.


Eligibility criteria:
inclusion criteria: * \>20 y/o * has been received warfarin therapy for 3 months and anticipated treatment duration of more than 3 months and a week * has legitimate indication for warfarin * has the capacity to understand the condition and implications of anticoagulant therapy exclusion criteria: * who can't be regular follow-up at national taiwan university hospital.

Keywords: warfarin pharmacist anticoagulation
relationship between postoperative tempeartive and acute kidney injury

Conditions: Patients Undergoing Valvular Heart Surgery

Summary: the investigators aimed to identify body temperature trajectory classes based on core temperature changes during the first 12 hours post-surgery and to explore their relationship with postoperative acute kidney injury in patients undergoing valvular heart surgery.


Eligibility criteria:
inclusion criteria: * patients who underwent valvular heart surgery between january 2016 and july 2023 at severance cardiovascular hospital of yonsei university health system exclusion criteria: * patients who underwent the same surgery within 30 days, * patients with less than two temperature measurements within 12 hours after surgery, - patients with missing creatinine test values before and within seven days after surgery, * patients who died during surgery
prediction of maternal arterial hypotension after spinal anesthesia by passive leg raise test.

Conditions: Cesarean; Spinal Anesthesia

Summary: spinal anesthesia for cesarean section is associated with a high incidence of low blood pressure. however, the pathophysiology of this arterial hypotension is not unequivocal and could involve, in addition to drug vasoplegia, a mechanical cause linked to lower caval compression or even true or relative hypovolemia. passive leg raise test has been proposed in an attempt to identify parturients who are more likely to develop low blood pressure after spinal anesthesia. nevertheless, the data available on this volume expansion test to predict hemodynamic variations after performing spinal anesthesia are still limited and few objective criteria have been described to predict this arterial hypotension. the objective of the research is to study the hypothesis according to which the presence of hypovolaemia (true or relative) objectified by a positive passive leg raise test would cause hypotension more frequent and more marked in intensity.

spinal anesthesia for cesarean section is associated with a high incidence of low blood pressure. however, the pathophysiology of this arterial hypotension is not unequivocal and could involve, in addition to drug vasoplegia, a mechanical cause linked to lower caval compression or even true or relative hypovolemia. passive leg raise test has been proposed in an attempt to identify parturients who are more likely to develop low blood pressure after spinal anesthesia. nevertheless, the data available on this volume expansion test to predict hemodynamic variations after performing spinal anesthesia are still limited and few objective criteria have been described to predict this arterial hypotension. the objective of the research is to study the hypothesis according to which the presence of hypovolaemia (true or relative) objectified by a positive passive leg raise test would cause hypotension more frequent and more marked in intensity. patients will have a clinical hemodynamic and echocardiographic evaluation, before performing the spinal anesthesia, before and after the passive leg raise test. then, the patients will benefit from a clinical hemodynamic evaluation during the preparation of the parturient in the operating room and finally after the completion of the spinal anesthesia and until the clamping of the umbilical cord.

Eligibility criteria:
inclusion criteria: * adult women admitted to necker enfants malades hospital for scheduled cesarean section under spinal anesthesia * written informed consent exclusion criteria: * no health insurance * urgent cesarean * failure of spinal anesthesia * free and informed consent impossible to obtain (especially due to a language barrier) * severe cardiovascular or neurovascular comorbidities * contraindication to the plr (intracranial hypertension, fractures of the pelvis and / or lower limbs, ...) * background of preeclampsia or eclampsia * severe fetal pathology

Keywords: passive leg raise test (plr) cesarean section spinal anesthesia maternal arterial hypotension phenylephrine requirements norepinephrine requirements
upper airway obstruction in non-obese patients with snoring and obstructive sleep apnea

Conditions: Snoring

Summary: this study aims at :- 1. detecting the prevelance of snoring and osa in non-obese patients 2. identify their diagnostic profile in order to provide proper management

snoring is the vibration of respiratory structures and the resulting sound due to obstructed air movement during breathing while sleeping. snoring during sleep may be a sign, or first alarm, of obstructive sleep apnea (osa). snoring can cause significant psychological and social problems to sufferers. multiple studies reveal a positive correlation between loud snoring and risk of heart attack and stroke. obstructive sleep apnea (osa) is the commonest type of sleep apnea and is characterized by inturpted snoring, repeated attacks of complete or partial pharyngeal closure during sleep despite the effort to breath resulting in nocturnal hypoxemia, frequent arousals during sleep, and excessive daytime sleepiness (eds). obstructive sleep apnea is differentiated from central sleep apnea (csa) which is characterized by changes in the respiratory cycle during sleep but without the effort to breath during the apnea. the episodes of decreased breathing are called "hypopnea " and it's definition requires a \< 30% drop in flow for 10 seconds or longer associated with \< 3% oxygen desaturation , the episodes of breathing cessations are called "apneas" and defined as a\< 90% drop in flow for 10 seconds or longer and associated with \< 3% oxygen desaturation or an arousal it is a serious and potentially life threatening disease that is far more common than generally expected. several risk factors, including obesity, male sex, age, and heritable factors, as well as the supine decubitus position during sleep. have been associated with an increased prevalence of obstructive sleep apnea in the general population. it has become a major health issue all over the world affecting quality of life with an increasing prevalence and associated with high comorbidities such as diabetes mellitus, hypertension, cardiovascular disease, dyslipidemia, malignancies, and overall mortality. results of different studies indicate that approximately 60-70% of patients with osa are obese. snoring and witnessed apnea are more frequent among men but insomnia for example is more frequent among women. the osa frequency increase with age for the women. the mortality is higher for women the data regarding association of osa among nonobese patients is rare and needs great effort as fewer studies have reported magnitude of association.

Eligibility criteria:
inclusion criteria: * older than 18 years * patients complaining of snoring and obstructive sleep panea exclusion criteria: * chronic pulmonary disease ( copd, asthma ,ipf) * pregnancy * sever cardiovascular disease ( unstable angina , sever arrhythmia , mi) * chronic renal failure (crf) * neurological disorders
open-label study of long-term safety and efficacy of intravenous trappsol cyclo (hpβcd) in niemann-pick disease type c

Conditions: Niemann-Pick Disease, Type C1

Summary: the purpose of this study is to provide continued access to treatment for npc-1 after participation and completion of the phase i trial ctd-tcnpc-101, when administered at doses of 1500 mg/kg and 2500 mg/kg by slow iv infusion over a period of 8 to 9 hours every two weeks.

this is an open-label extension study of intravenous hp-β-cd (administered as trappsol® cyclo(tm)) in patients with npc-1 to evaluate long-term safety and efficacy by providing continued access to treatment following completion of study ctd-tcnpc-101. patients will receive medication at their home or local site under the supervision of a home nurse professional or at the parent site under the supervision of the site principal investigator. patients will visit the parent site for safety and efficacy evaluations after receiving treatment for 3 months in the extension protocol. thereafter, visits to the parent site will be every 6 months until cessation. the study will continue until trappsol® cyclo (tm) becomes commercially available or study/site/patient discontinuation. all patients who complete study ctd-tcncp-101 and pass the screening criteria will be eligible for this study. the study will be directed from parent site in the us. vital signs, aes adverse events (aes) and concomitant meds will be recorded by the home nurse professional or deputy at the local site and reported immediately to the parent site for entry into the electronic data capture (edc) and reporting to the sponsor. for logistical reasons home infusions will be permitted as long as aes, infusion details and concomitants medications are reported directly to the parent site by an authorised deputy according to local guidelines. a safety review committee (src) consisting of an independent advisor, the medical monitor, and the principal investigator will be established to review aes and laboratory data throughout the study.

Eligibility criteria:
inclusion criteria: * completion of study ctd-tcnpc-101 with no safety concerns at the final visit * negative urine pregnancy test for females of child bearing potential * patients must be legally resident in the usa with access to healthcare * written, informed consent exclusion criteria: * inability to comply with the proposed protocol assessments or any uncertainty about their ability to give meaningful, informed consent (legal guardian may give consent with subject assent) * concurrent medical conditions representing a contraindication to any of the study medications * grade 3 renal impairment or worse as indicated by estimated glomerular filtration rate (egfr) \< 60ml/min/1.73m2 * clinical evidence of acute liver disease including symptoms of jaundice or right upper quadrant pain or international normalised ratio (inr) \>1.8 * male patients and female patients of childbearing potential who are not willing to use appropriate birth control (i.e. double barrier birth control) from enrollment until the follow-up visit
adjuvant entecavir or tenofovir for postoperative hbv-hcc

Conditions: Hepatocellular Carcinoma

Summary: this study aims to compare the effect of antiviral therapy with entecavir or tenofovir for hepatitis b virus-related hepatocellular carcinoma after radical hepatectomy. included patients will randomly divide into two groups.

hepatocellular carcinoma (hcc) is associated with a poor prognosis, and its incidence has increased dramatically in many countries. hepatectomy is a radical therapy for early-stage hcc. however, even after radical resection, the prognosis for hcc patients remains discouraging because of the high recurrence rate and frequent incidence of intrahepatic metastasis. therefore, preventing hcc recurrence is very important. hepatitis b virus (hbv) infection is the major risk factor for hcc development in china. some retrospective studies have shown that tenofovir or entecavir treatment for hbv-related hcc patients can effectively reduce the hcc recurrence rate and increase the survival rate after hepatectomy. however, which drug has more efficacy has not been addressed.

Eligibility criteria:
inclusion criteria: * underwent hepatic resection. * diagnosis of hcc was confirmed by postoperative histopathology. * positive of hbsag, hbeag, or hbv dna. * child-pugh a or b liver function. exclusion criteria: * anti-hcv(+) * diagnosis of hcc was not confirmed by postoperative histopathology of surgical samples after surgery.

Keywords: adjuvant entecavir hepatocellular carcinoma hepatic resection
optical tomographic imaging of infantile hemangiomas

Conditions: Infantile Hemangioma

Summary: the investigators hypothesize that there are differences between infantile hemangiomas (ih) during the proliferating and involuting phases and in response to medical treatment that can be detected by optical tomography of these hemangiomas.

infantile hemangiomas (ih) are common vascular growths that frequently arise in infants. the clinical presentation is variable, and some hemangiomas have the potential to cause disfiguring and even lifethreatening complications. while there is no fda approved treatment for ih, certain medications have been shown to be effective in shrinking the growths. unfortunately, there is no objective tool to monitor ih or to guide treatment. such a tool would improve the management of these patients. a new handheld wireless device uses diffuse optical imaging (doi) technology to measure blood flow characteristics. the device has been used in studies to assess patients with breast cancer. optical tomography has also been increasingly used to assess neurological function and pathology in newborn infants. the goal of the investigators' study is to assess the utility of doi for characterizing and monitoring ih. fifteen ih will be assessed at three points in time as part of this study, comprising two groups: 'natural history' and 'treatment'. doi measurements will be correlated with clinical findings and existing ultrasound measurements of the ih.

Eligibility criteria:
for the 'natural history' cohort, the following inclusion and exclusion criteria apply: inclusion criteria: * infants with ih who present to our practices within the first 2 months of life. * ih of size \> 2 cm in diameter * ih located on area of skin that is accessible to contact by 4x2cm probe. examples include the lateral face, forehead, scalp, trunk and areas of the extremities not overlying joints. infants with ih that do not necessitate either medical or surgical intervention at time of presentation. exclusion criteria: * ih of size \<2 cm in diameter * complicated ih requiring medical or surgical intervention * ih located within 2 cm of the eye for the 'treatment' cohort, the following inclusion and exclusion criteria apply: inclusion criteria: * infants with ih who present to our practices within the first 2 months of life. * ih of size \>2 cm in diameter * ih located on area of skin that is accessible to contact by 4x2cm probe. examples include the lateral face, forehead,scalp, trunk and areas of the extremities not overlying joints. * ih that necessitate medical intervention with either oral or topical betablockers. exclusion criteria: * ih \<2 cm in size * complicated ih requiring surgical intervention * ih located within 2 cm of the eye

Keywords: hemangioma
theranova versus high-flux dialyzer on preservation of residual renal function

Conditions: End Stage Renal Disease

Summary: theranova is a novel medium cut-off dialyzer and has better performance for removal of middle molecules compared to conventional hemodialysis. the study investigates the effect of theranova dialzyer on preserving residual renal function in the incident hemodialysis pateitns compared to high-flux dialzyer. the primary endpoint is change of glomerular filtration rate, calculated using creatinine and urea clearance. the secondary endpoints are serial changes of glomerular filtration rate and daily urine volume, changes of serum middle molecule concentrations, hospitalization, mortality, and patient reported outcomes.


Eligibility criteria:
inclusion criteria: * incident end-stage renal disease esrd patient receiving hemodialysis for less than 1 month * 18 years old and older * creatinine clearance of more than 2 ml/min * agreement to participate in the clinical study * vascular access by arteriovenous fistula/graft exclusion criteria: * plan for kidney transplantation within 6 months * severe volume overloading state * dialysis through permanent catheter * any hematologic malignancy or monoclonal gammopathy * any malignancy * active infectious disease * hiv infection * patient enrolled to another study within 3 month from starting the present study

Keywords: end-stage renal disease medium cut-off dialyzer high-flux dialyzer residual renal function
aevicemd for pediatric asthma management

Conditions: Asthma; Asthma in Children; Pediatric Asthma; Chronic Respiratory Disease

Summary: a wearable remote patient monitor (aevicemd) is to be used to monitor the respiratory health of pediatric asthma patients in this pilot study. patients prescribed with aevicemd should be able to gain better control over their disease during home management. physicians should be able to optimize treatment for these patients using objective data collected from and of these patients outside of the clinic. the aevicemd should also be used as a remote auscultation device for teleconsultations.

participants are asked to take part in this research study because they have been diagnosed with poorly controlled asthma. as a chronic respiratory disease, management of the disease relies not only on healthcare professionals delivering care at various clinical touch points, but also depends heavily on a participant's own ability to understand, monitor, and manage their conditions when at home. the investigators know that for pediatric patients, like for many other children, self-monitoring is often difficult. this clinical pilot investigates the use of a wearable medical device that can conduct continuous monitoring of vital signs and detect wheezing when worn at home. the continued use of this device (especially during night sleep) gives insight to the course of symptoms, while also providing early warning should a participant's condition worsen. the device can also be used as a digital stethoscope, meaning physicians can examine participants via teleconference and obtain useful data for clinical decision making. study participants include: 20 pediatric patients (between 3 to 18 years of age) who have been diagnosed with poorly controlled asthma while presenting at cedars-sinai medical center guerin children's. participants will be enrolled to use the aevicemd device during night sleeps.

Eligibility criteria:
inclusion criteria: * provision of signed and dated informed consent form * stated willingness to comply with all study procedures and availability for the duration of the study * aged 3 to 18 as of first recruitment * diagnosed with poorly controlled asthma * asthma control test score below * caregiver able operate a mobile application * has access high-speed wireless internet (wifi) at home * able to read english * agreement to adhere to medical device use regimen throughout the study duration exclusion criteria: * known allergy to silicone, gold, or zinc * abnormal skin conditions on chest * sleep apnea diagnosis

Keywords: wearable medical device