Kornimate/medical-research-clean huggingface dataset:
evaluating adrenal insufficiency in adults with eosinophilic esophagitis on chronic swallowed topical steroids

Conditions: Eosinophilic Esophagitis

Summary: eosinophilic esophagitis (eoe), a chronic inflammatory disease of the esophagus, is a clinical and financial burden to patients if left untreated. often the natural history of the disease includes development of fibrosis and stricturing of the esophagus, acute food impactions, unplanned emergency room visits, and invasive procedures such as endoscopy. currently there are no food and drug administration (fda) approved medications for the treatment of eoe. as such, pharmacologic options approved for use in asthma are used for treatment of eoe and include proton pump inhibitors and swallowed topical steroids. these medications are prescribed chronically as eoe is considered a lifelong disease. chronic administration of exogenous steroids, when given in inhaled or systemic preparations, can lead to adrenal insufficiency (ai). ai is seen in 7.8% of patients receiving chronic inhaled steroids and 48.7% of patients receiving chronic systemic steroids. the administration of steroids in eoe is unique, as patients typically swallow topical preparations of the drug. the risk of secondary ai from taking swallowed topical steroids is currently unknown, as there has been no study in an adult population assessing this risk as a primary endpoint. pediatric studies of patients with eoe have shown the risk of ai from swallowed topical steroids to be 5-10%. based on the risk of ai with inhaled steroids (7.8% prevalence) and the prevalence of ai from swallowed topical steroids in pediatric populations (5-10%), we hypothesize that the risk with swallowed topical steroids is \>5%. this could warrant consideration of screening given the potentially serious consequences of undiagnosed ai. to address this hypothesis, this project aims to define the prevalence of developing ai in adults with eoe taking swallowed topical steroids and compare that prevalence to a similar control population of adults with eoe who are taking proton pump inhibitors.


Eligibility criteria:
inclusion criteria: * 300 adult male or female patients between 18 and 85 years of age with a diagnosis of eosinophilic esophagitis who have been on swallowed topical steroids or proton pump inhibitor therapy (any dosing) for at least 3 months. exclusion criteria: * we will exclude control patients on proton pump inhibitor therapy if they have used any form of exogenous steroids within the past one year.
uvx as an adjuvant in the treatment of fungal keratitis

Conditions: Treatment

Summary: in this study, investigators want to find the effect of adjuvant collagen cross-linking in the treatment of fungal keratitis


Eligibility criteria:
inclusion criteria: * fungal keratitis documented by culture or confocal scanning without any previous treatment exclusion criteria: * previous treatment * thinning at presentation * perforation * associated with other microbial or viral keratitis
evaluation of sleep quality in patients with chronic neck pain

Conditions: Neck Pain; Sleep

Summary: this study aimed to investigate the effect of chronic neck pain on sleep quality and to determine the factors that may be related to sleep disturbance.

it is thought that chronic neck pain affects sleepiness negatively. however, there are no studies on chronic neck pain and sleep quality. in this study, we would like to determine whether there is a link between chronic neck pain and sleep quality and the factors that may be related.

Eligibility criteria:
inclusion criteria: * patient has chronic mechanical neck pain for at least 3 months and without radicular pain * patient's visual analogue scale score is 3 and over exclusion criteria: * history of neurological deficit * history of cervical stenosis, cervical surgery, spondylolisthesis, scoliosis * history of central or peripheral nervous system disorders * history of inflammatory neck pain * pregnant or breast feeding * history of fibromyalgia disease * history of severe osteoporosis or osteomalacia * history of infectious, malignancy, and active psychiatric disease * noncooperative * patient has chronic pain in a region other than the neck region

Keywords: cervicalgia
using mobile health (mhealth) to improve sti treatment adherence among adolescents

Conditions: Sexually Transmitted Diseases

Summary: we will conduct a randomized trial to compare differences in sexually transmitted infection (sti) treatment adherence between patients receiving text messages versus those receiving usual care (e.g. no text messages). we hypothesize that sti treatment adherence will be 20% higher among patients randomized to receipt of two-way text messaging services.


Eligibility criteria:
inclusion criteria: * adolescent patients seen in the emergency department who test positive for gonorrhea, chlamydia, or pelvic inflammatory disease and are prescribed outpatient antibiotic treatment. exclusion criteria: * patients will be excluded if they are unable to understand english, are critically ill, have cognitive impairment or if they do not have access to a cellular telephone with text messaging capabilities.
neuromuscular fatigue during exercise in copd-hf overlap

Conditions: Pulmonary Disease, Chronic Obstructive; Heart Failure

Summary: rationale. chronic obstructive pulmonary disease (copd) and heart failure (hf) coexist in approximately one third of patients presenting with one of these conditions. from a clinical standpoint, impaired tissue oxygen (o2) delivery stands as a common pathological mechanism of these cardiorespiratory diseases. recent evidence suggest that muscle and cerebral blood flow and oxygenation are further impaired during exercise in patients with copd-hf overlap compared to isolated diseases. however, it remains unknown whether impaired o2 delivery is associated with exaggerated manifestations of peripheral and central fatigue in copd-hf overlap. in addition, improving cardiopulmonary interactions through non invasive positive pressure ventilation or through the addition of a hyperoxic gas mixture during exercise have been associated with enhanced cerebral and muscle o2 delivery and oxygenation in patients with copd or hf. it is, therefore, conceivable that improved o2 delivery to these structures have beneficial influence on exercise capacity in patients with copd-hf overlap due to less peripheral and central fatigue. aims. to investigate the influence of impaired o2 delivery during exercise, and its alleviation with different interventions (non invasive positive pressure ventilation or hyperoxia), on neuromuscular fatigue in patients with copd-hf.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * copd: mild-to-severe airflow obstruction (forced expiratory volume in 1 second (fev1)/forced vital capacity ratio \ 30% predicted); * hf: reduced left ventricular ejection fraction (\<50%, for copd-hf patients only); * hf: new york heart association functional classification i to iii (for copd-hf patients only); * clinical stability for both diseases (copd and/or hf) and no recent (within 3 months) exacerbation requiring a change in medications; * patient benefiting from health care coverage; * patient able to provide written informed consent. exclusion criteria: * inability to perform cycle ergometry; * medical device incompatible with magnetic stimulation; * counter-indication to perform exercise test; * patient refusing to sign written informed consent; * patient not benefiting from health care coverage; * patient exceeding the annual ceiling of authorized compensation received following participation to a clinical trial; * patient deprived of freedom by judicial or administrative decision; * patient subject to a measure of legal protection (safeguard of justice, guardianship, curatorship), who cannot be included in clinical trials; * pregnant or nursing woman.

Keywords: exercise tolerance hypoxia, brain muscle fatigue oxygen spectroscopy, near-infrared ultrasonography, doppler, transcranial
south korean pitavastatin heart failure study

Conditions: Chronic Heart Failure

Summary: we want to evaluate the utility of statins on heart function according to potency. patients with chronic ischemic heart failure are administered pitavastatin 4mg or pravastatin 10mg for 52 weeks. then we evaluate the effect of pitavastatin and pravastatin primarily on rate of hospitalization for cardiovascular cause and lipid profile secondarily biomarker, echocardiography parameter, 6-minute walk, change of nyha class distribution, cardiovascular mortality.


Eligibility criteria:
inclusion criteria: 1. patients who accepted to enter the study by written informed consent 2. age ≥ 30 years 3. ldl-cholesterol ≥ 70mg/dl 4. chronic heart failure of : * nyha class ii \~ iii * ischemic etiology * left ventricular ejection fraction \< 45% * optimal therapy for chronic heart failure and stable clinical condition over the two weeks. exclusion criteria: 1. patients who participated in other studies 3 months before enrollment 2. statin treatment within 2 months before enrollment 3. unstable decompensated heart failure at enrollment 4. acute coronary syndrome or cerebral vascular disease within 3 months before enrollment 5. coronary revascularization within 3 months before enrollment or planned at enrollment 6. any other serious disease or condition which might effect life expectancy such as malignancy, life-threatening infectious disease. 7. serum creatinine levels \>= 3.0 mg/dl 8. ast or ast levels \>=2.5 times of uln 9. ck levels \>=2 times of uln 10. uncontrolled hypothyroidism : tsh level \>= 2 times of uln 11. pregnant or breastfeeding women, women who want to bearing 12. patients who might to be unsuitable by the decision of investigators

Keywords: heart failure pitavastatin pravastatin statin
postoperative vomiting in children: comparison tri - versus bi -prophylaxis

Conditions: Postoperative Vomiting

Summary: the purpose of this study is to evaluate the benefit of addition of droperidol to prophylaxis with ondansetron and dexamethasone in children with high risk of postoperative vomiting (pov). in adults some authors showed that the effectiveness of prophylaxis is correlated to the number of molecules or specific procedures used.

the overall incidence of postoperative vomiting between 25 and 30% for the pediatric population, but it can reach a much higher incidence associated with certain types of surgery, about 80% in some studies like strabismus surgery for example. the identification of patients at high risk of pov is possible through the use of risk score. it is currently only one pediatric validated risk score, but the investigators conducted a multicenter study on this subject, whose results are being analyzed. this should allow us to identify children at high risk of pov. in this targeted population, the prophylaxis should allow a significant reduction in the incidence of pov. in children only one study tried to evaluate the association of ondansetron, dexamethasone and droperidol to prevent postoperative vomiting. however, different doses of the different molecules were combined, the extremely complicated design of this study and important methodological bias do not provide evidence about the superiority of the combination of three anti-emetics compared with two anti-emetics. our present randomized, double-blind study is designed to compare the effectiveness of droperidol in combination with a conventional bi-prophylaxis (dexamethasone/ondansetron) to the conventional bi-prophylaxis alone to decrease the occurrence of postoperative vomiting in children at high risk. the combination ondansetron and dexamethasone is frequently assessed as an association to prevent postoperative vomiting also in the adult population and in the pediatric population.

Eligibility criteria:
inclusion criteria: * children scheduled for surgery and with high risk of postoperative vomiting, i.e. with vpop score up to 4 * between 3 to 18 years * informed consent signed or the owner (s) of parental * children receiving a social security system exclusion criteria: * ambulatory surgery * preoperative corticosteroids * postoperative sedation * allergy known to droperidol, ondansetron or dexamethasone * known hypokaliemia * known hypomagnesemia * bradycardia (\<55 bpm) * congenital long qt syndrome * treatment that induce prolonged qt * pheochromocytoma * severe depressive syndrome

Keywords: postoperative vomiting children prophylaxis droperidol ondansetron dexamethasone
fixation of fracture neck of femur in children

Conditions: Fracture Neck of Femur

Summary: find the best way for fixation of fracture neck of femur in children either by cannulated screws or wagner's technique

in the pediatric population, fracture of the neck of femur is relatively uncommon usually caused by high-energy trauma, but with high complication rates, despite appropriate diagnosis and management. the high rate of complication is due to the vascular anatomy of proximal femur. fracture neck of femur can be classified into transphyseal , transcervical (which is commonest), basal and pertrochanteric. complications include avascular necrosis, delayed union and non-union. multiple fracture fixation methods have been used, with the overall goal being anatomic reduction with stable fixation. methods of fixation vary based on age, delbet classification and dispalcement of the fracture. two types of fixation of pediatric fracture nof of interest are cannulated screw (cs) and the wagner technique. most studies agree that 3 screws are enough, and they should be inserted parallel in triangular arrangement with an inverted triangle. the cs should apply compression to the fracture (compression screws) to minimize the remaining fracture gap and accelerate the healing process. the use of washers allows for higher compression forces and thus increases the initial stabilization. cs shouldn't pass the physis in pediatrics to allow normal continuation of growth in children. the stability of fixation by cs has been shown to be affected by several factors: screw type, number, thickness, position and direction. some of cs disadvantages are that they are mechanically unstable, failure of stabilization leads to varus malunion and it may lead to slipped capital femora epiphysis (scfe) above the tips of the screws(especially short working distance in transcervical fractures). the wagner technique consists of the use of two or three k-wires bent as close as possible to the shaft and fixed to the shaft by two cerclage wires. some advantages of this method are that k-wires can cross the physis and give good stability to the fracture with normal continuation of growth(especially in transphyseal \& transcerviacal fractures). hip spica is recommended to give more stabilization to the fixation and neutralize forces around the fixed fracture.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of fracture neck of femur * children with age less than 14 years old exclusion criteria: * pathological fracture * patients with cerebral palsy * associated ipsilateral femoral shaft fracture * comminuted fractures * old fracture ( \> 2 weeks)
virtual reality training for trauma resuscitation

Conditions: Virtual Reality

Summary: this study individual training with an immersive virtual reality trauma simulator was compared to live mannequin-based simulation training in a facilitated group. the results showed that virtual reality simulator led to non-inferior effects on trauma resuscitation skills to mannequin-based simulation. trauma simulator had good usability, was well received by the participants, and had minimal adverse effects.

background: despite its high potential, the effect of immersive virtual reality simulation (vrs) in trauma resuscitation training has not been studied. the aim of this study was to test the hypothesis that vrs is non-inferior to mannequin-based simulation (mbs) in trauma resuscitation training. methods: in a single-center, randomized controlled non-inferiority trial, we compared individual training with an immersive virtual reality trauma simulator to live mbs training in a facilitated group. the primary outcome was the trauma score (ranging from 55 (worse) to 177 (best outcome)) during the mbs assessment. the secondary outcomes were the trauma score vrs assessment, system usability scale (ranging from 0 (worse) -100 (best outcome)), and simulation sickness questionnaire (ranging from 0 (worse) to 235.62 (best outcome)).

Eligibility criteria:
inclusion criteria: fluency in english. exclusion criteria: history of motion sickness

Keywords: virtual reality trauma simulation-based education resuscitation
safety and efficacy of idp-122 lotion when applied topically to subjects with moderate to severe plaque psoriasis

Conditions: Psoriasis

Summary: a phase 2, multi-center, double-blind, randomized, vehicle-controlled study.

a phase 2, multi-center, double-blind, randomized, vehicle-controlled study to compare the safety and efficacy of idp-122 lotion (0.01% halobetasol propionate) to ultravate® (halobetasol propionate) cream, 0.05% in the treatment of plaque psoriasis.

Eligibility criteria:
key inclusion criteria: * male or female, of any race, at least 18 years of age (inclusive). * freely provides both verbal and written informed consent. * is willing and able to avoid prolonged exposure of the treatment area to ultraviolet radiation (natural and artificial) for the duration of the study. * subject is willing to comply with study instructions and return to the clinic for required visits. key exclusion criteria: * has spontaneously improving or rapidly deteriorating plaque psoriasis or pustular psoriasis, as determined by the investigator. * presents with psoriasis that was treated with prescription medication and failed to respond to treatment, even partially or temporarily, as determined by the investigator. * presents with any concurrent skin condition that could interfere with the evaluation of the treatment areas, as determined by the investigator. * is pregnant, nursing an infant, or planning a pregnancy during the study period. * has received treatment with any investigational drug or device within 60 days or 5 drug half-lives (whichever is longer) prior to the baseline visit, or is concurrently participating in another clinical study with an investigational drug or device.
single incision laparoscopic varicocelectomy

Conditions: Varicocele

Summary: conventional laparoscopic varicocelectomy using 3 ports has been used for treatment of varicocele in our department since the nineties. however, the relatively several trocar wounds represent a big challenge against its acceptance by many of our patients who prefer the open approach with one or at least two wounds. single incision laparoscopic surgery (sils), since its introduction in 2007, has been proven to be feasible and effective, with high patient satisfaction rates regarding improved cosmotic outcomes, reduced postoperative pain, and rapid return to normal activities. (10, 11) sils for varicocelectomy has been reported to be safe and effective alternative to conventional laparoscopic varicocelectomy in a few studies.


Eligibility criteria:
inclusion criteria: * patients with palpable varicoceles exclusion criteria: * unfit for anesthesia or laparoscopy
trial to understand efficacy of colesevelam in diarrhea predominant ibs patients with bile acid malabsorption

Conditions: Chronic Diarrhea; Irritable Bowel Syndrome With Diarrhea; Bile Acid Malabsorption

Summary: to compare with a randomized trial (n=15 per treatment group), effects of colesevelam and placebo treatment, on colonic transit, bowel functions, permeability and tight junction expression in rectosigmoid mucosa of ibs-d with bile acid malabsorption.

compare the effects of colesevelam versus the placebo on diabetic subjects with chronic diarrhea. in this study, diabetic subjects will get either the colesevelam or the placebo, not both. the plan is to have about 30 subjects complete this study at mayo clinic.

Eligibility criteria:
inclusion criteria: * females and males age 18 -75. * an ibs diagnosis based on the rome iii criteria for at least 3 months, with onset at least 6 months previously, of recurrent abdominal pain or discomfort. * biomarkers serum alpha c4 ≥ 40 ng/ml or fgf19 ≤ 80 pg/ml or fecal bile acid \>2000 micromoles/48h exclusion criteria: * ibs patients with known clinically-relevant inflammation. * ibs patient with known bleeding diathesis * history of abdominal surgery patients participating will not take any of the following disallowed medications for at least 7 days prior to and during the remainder of the study: * any treatment specifically taken for ibs-d, including loperamide, cholestyramine, alosetron * drugs with a known pharmacological activity at 5-ht4, 5-ht2b or 5-ht3 receptors * all narcotics * anti-cholinergic agents * tramadol * oral anticoagulants * antimuscarinics * peppermint oil * systemic antibiotics, as well as antibiotics directed at colonic flora such as rifaximin and metronidazole gastrointestinal preparations: * anti-nausea agents * osmotic laxative agents * prokinetic agents * 5-ht3 antagonists
the pit-tbi pilot study

Conditions: Pituitary Disorders; Traumatic Brain Injury

Summary: damage to the pituitary gland is a frequently overlooked but potentially important complication of traumatic brain injury (tbi). disorders of the pituitary gland can cause dysfunction of the thyroid, adrenals, ovaries and testes. these disorders may occur immediately or several months after tbi, may delay recovery and may have a significant negative impact on quality of life. tbi is the leading cause of disability and major permanent functional impairment among adults under 45 years of age. hormonal deficits may contribute to common symptoms experienced by tbi survivors such as fatigue, poor concentration, depression and low exercise capacity. however, the association between hormonal deficits and disability remains uncertain. the primary objective of this pilot study is to assess the feasibility of a larger study that will evaluate the impact of pituitary disorders on neurological disability and functional recovery. the results of this study will provide key findings in the impact of pituitary disorders following tbi, which is a mandatory step prior testing the effect of hormonal replacement therapy in this population in costly clinical trials. if no relationship between pituitary disorders and disability is observed, the investigators' findings will prevent unnecessary, time-consuming and costly hormonal screening and will discourage potentially harmful hormonal therapy.


Eligibility criteria:
inclusion criteria: * adult (≥ 18 years old) * severe or moderate blunt tbi admitted to the icu with a glasgow coma scale ≤ 12 following initial resuscitation exclusion criteria: * previously diagnosed or suspected pituitary disorder or disease * pregnant or lactating woman * penetrating tbi * solid malignancy with life expectation \<12 months * liver cirrhosis child c * chronic heart failure (new york heart association class iv) * end-stage chronic respiratory disease (o2 dependent) * end-stage renal disease (chronic dialysis or to be expected) * neurological conditions influencing functional status (e.g. spinal cord injury, neuromuscular disease, dementia, prior tbi or stroke) * no fixed address * physician refusal * brain death * unable to return to the study center to attend the follow-up visits * admission to the intensive care unit of the participating center \> 24 hours after tbi

Keywords: pituitary disorders traumatic brain injury critical care outcome research risk factors patient oriented research