Kornimate/medical-research-clean huggingface dataset:
pediatric caudal injection volume on optic nerve sheath diameter and cerebral oxygenation

Conditions: Anesthesia, Caudal; Pediatrics; Elevated Intracranial Pressure

Summary: caudal anesthesia is a commonly used neuraxial anesthesia method for children. injection of a certain volume of fluid into the epidural space for cauda anesthesia may push some cerebrospinal fluid towards the head, which may lead to mild increase of pressures inside the head. such mild changes are compensated well by healthy individuals and no clinical sequel is seen, however at-risk populations may be affected. we aim to see how different amounts of fluid injected into the epidural space may change two clinical parameters affected by intracranial pressure to determine if a lower volume is safer than a higher one.

caudal epidural injection of local anesthetic solution is a common neuraxial anesthesia technique that provides excellent peri-operative analgesia in children. unfused sacral hiatus allows for easy and safe access into the epidural space. anatomically, injection of a certain volume of fluid over the dural sac inside the closed spinal canal can push the cerebrospinal fluid cranially. this push may lead to increased intracranial pressure. we will measure two findings affected by intracranial pressure (optic nerve sheath diameter and cerebral oxygenation) and compare the effects of two different volumes of caudal injections on these measures. children with closed fontanelles and scheduled to undergo elective surgery, for which caudal anesthesia is an effective method for peri-operative analgesia, will be recruited for this study. injection volume will be determined depending on the level of analgesia required for the surgical procedure. ultrasonographic measurements of optic nerve sheath diameter and near-infrared spectrometry measurement of cerebral oxygenation will be taken before and after caudal anesthesia.

Eligibility criteria:
inclusion criteria: * asa class 1 or 2 * scheduled for elective surgery suitable for caudal anesthesia * parental/guardian consent for caudal anesthesia and measurements obtained * closed fontanelles exclusion criteria: * open fontanelle * parental/guardian refusal * previous intracranial or ocular pathology * coagulapathies * variations in gross and ultrasonographic sacral anatomy * block performence to end of surgery expected to last less than 30 minutes * block volumes more than 30ml needed * laparoscopic surgery * need for long term analgesia with epidural catheter

Keywords: optic nerve sheath diameter cerebral oximetry caudal epidural anesthesia
international ovarian tumour analysis (iota) phase 5

Conditions: Adnexal Masses; Ovarian Cysts; Ovarian Tumors

Summary: the purpose of this study is to learn more about the appearance and behavior of benign-looking adnexal masses. * benign-looking means that when viewed here by ultrasound it has the appearance of looking not harmful or not malignant. * adnexal refers to the 'adnexa', the space in the female pelvis on either side of the uterus (or where the uterus used to be if you previously had a hysterectomy). the adnexa includes, but is not limited to, the ovaries and the fallopian tubes. * masses refers to a variety of structures, including but not limited to: * ovarian cysts that are fluid filled sacs within or attached to an ovary * ovarian tumors that can be solid tissue or a combination of cysts and solid tissue * hydrosalpinges that are fluid collections in the fallopian tube many women have what appear to be benign adnexal masses. many times, removal of the masses with surgery is not necessary. often surgery is performed unnecessarily, for fear that these masses could be cancer. there is not much information available for doctors to know how and when to follow these masses, or which ones will become cancer. this study will combine information from centers all around the world regarding the behavior of all types of benign adnexal masses. the aim of this study is to develop decision tools for doctors to know the best way to treat these masses in order to improve the detection of ovarian cancer while at the same time reduce the number of unnecessary operations.


Eligibility criteria:
inclusion criteria: * any woman at least 18 years old with an adnexal mass. * any mass with benign ultrasound morphology may be suitable for conservative management. * pregnant patients can be included, but their data will be analysed separately. exclusion criteria: * cysts that are deemed to be clearly physiological and less than 3 cm in maximum diameter are not eligible for inclusion. * any cyst with features of malignancy is excluded from the conservative management * the denial or withdrawal of oral informed consent

Keywords: adnexal masses ovarian cysts ovarian tumors
resistance training in patients with diabetic neuropathy

Conditions: Diabetes Mellitus, Type 2; Polyneuropathy Diabetes; Diabetes Complications; Diabetic Peripheral Neuropathy; Muscle Weakness; Fall Patients

Summary: this is a population-based study of type 2 diabetes patients with and without neuropathy recruited from the danish national type 2 diabetes cohort (dd2). diabetic patients with neuropathy may suffer from incapacitating symptoms such as pain, muscle weakness and impaired balance. muscle weakness may cause reduced balance and postural instability increasing the risk of frequent falls and thereby increased morbidity and mortality. thus, diabetic neuropathy is associated with significant disabilities having major impact on activities of daily living and quality of life. the effects of resistance training on neuropathy symptoms, muscle strength and muscle structure in patients with and with diabetic neuropathy will be examined.

perspective: the studies will likely improve the understanding of diabetic neuropathy and the relation between risk of falls in patients with and without motor dysfunction. the results may enable new and more precise recommendations for exercise in diabetic patients with diabetic neuropathy. in addition, the results may lead to a better understanding of the mechanisms underlying the effects of training. the improvement of motor function may lead to improved gait stability, fewer fall injuries and better quality of life for type 2 diabetes patients, resulting in lower morbidity and mortality.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of type 2 diabetes exclusion criteria: * neuropathy due to any other cause * bmi \>40 * pacemaker * comorbidity that contraindicates exercise * history of stroke with affection of the lower extremities * ischemic heart disease * any other neurological disease * pregnancy
vancomycin versus daptomycin for the treatment of methicillin-resistant staphylococcus aureus bacteremia due to isolates with high vancomycin minimum inhibitory concentrations (mics)

Conditions: Bacteremia

Summary: there is an increased failure rate for the treatment of staphylococcus aureus bacteremia (sab) with traditional doses of vancomycin, the standard of care for patients with mrsa bacteremia over the last 40 years. this has been largely attributed to isolates with increased resistance to vancomycin (increased mic). daptomycin is an antibiotic that was approved several years ago for the treatment of sab and is being increasingly used for mrsa bacteremia due to isolates with increased mic. increased doses have been recommended for both of these drugs in the treatment of this infection without a trial demonstrating their relative efficacy or safety at higher doses. this study will randomize patients with sab due to mrsa with an increased mic to determine the relative efficacy and safety of vancomycin and daptomycin used at higher than traditional doses.


Eligibility criteria:
inclusion criteria: * 18 years of age or older * signed informed consent * all cases of suspected mrsa bacteremia as determined by a patient with at least one blood culture growing gram-positive cocci in clusters with a clinical syndrome consistent with true bacteremia including fever, hypothermia (temperature \ 100 beats/minute), hypotension (systolic blood pressure \< 90 mm hg) or other clinical features of sepsis. * all cases of right-sided native valve endocarditis due to mrsa * patients who are diagnosed with left-sided native valve endocarditis after randomization will be continued in the study * patients with mrsa bacteremia associated with infected foreign bodies, including vascular prostheses, orthopedic prostheses

Keywords: methicillin-resistant staphylococcus aureus
the experiences of people who live with glanzmanns thrombasthenia.

Conditions: Glanzmann Thrombasthenia

Summary: to understand the lived experiences of people with glanzmanns thrombasthenia

a qualitative study of people with glanzmanns thrombasthenia including an on-line survey, qualitative in-depth interviews and bleed diary completion.

Eligibility criteria:
inclusion criteria: clinical diagnosis of congenital (inherited) glanzmanns thrombasthenia exclusion criteria: acquired glanzmanns thrombasthenia
the intrepid clinical engineering study

Conditions: Sudden Cardiac Arrest

Summary: the purpose of this research study is to collect clinical data to validate a software update for 12-lead electrocardiogram monitoring.

the purpose of this study is to validate the philips dxl electrocardiogram algorithm works as intended in the heartstart intrepid monitor/defibrillator after a software update was completed to address instances of high impedance. this study will also determine the diagnostic quality of the 12-lead electrocardiogram tracing from the heartstart intrepid monitor/defibrillator.

Eligibility criteria:
inclusion criteria: * able to read, write, speak, and understand english * age: 29 days to 89 years * willing and able to provide informed consent and complete study procedures * willing to have philips representatives present during study procedures. exclusion criteria: * known allergy to medical adhesives, silicone, or latex (per self-report) * any limitation or medical condition, including but not limited to physical or cognitive disability, that would affect the participant's ability to complete study activities (per investigator) * at the time of enrollment, current enrollment in any other interventional research study * an employee, or residing family member of an employee, of a company that designs, sells, or manufactures monitor/defibrillator technology or related products (including philips)

Keywords: monitor
the c-merit screening cohort: contrast-enhanced mammography for breast cancer screening and risk assessment in women with dense breasts

Conditions: Breast Cancer

Summary: to learn whether a new imaging technology, contrast-enhanced mammography (cem), compared to standard mammography, can better detect breast cancers in women with dense breasts

primary objectives: * to establish a cohort of 1,000 female mdacc patients with dense breasts who undergo screening contrast-enhanced mammography. * to establish a comprehensive integrated database of imaging, clinical data, health measurements, and questionnaire data including data from the companion protocol pa17-0584. secondary objectives: * to perform within-subject comparison of the cancer detection rate between cem and ffdm. * to perform within-subject comparison of the sensitivity, specificity, and recall rates of cem compared to low-energy (le) images (ffdm equivalent) and compared to a combination of le and dbt images among women with dense breasts. * to evaluate the effect of the availability of prior imaging for comparison on the recall rates of cem, ffdm and dbt. * in patients who undergo screening breast ultrasound as a standard of care, to evaluate the performance of screening ultrasound for breast cancer detection and compare it with other imaging modalities of cem, le images, and dbt. exploratory objectives: * to combine imaging, blood biomarkers, health measurements and questionnaire data for assessment of breast cancer risk. * to evaluate if the intensity of background parenchymal enhancement on cem predicts breast cancer risk in women with dense breasts. * to evaluate if patients consider cem as a potentially acceptable imaging modality for routine breast cancer screening.

Eligibility criteria:
inclusion criteria: 1. female patients 30-75 years of age with dense breasts (acr bi-rads categories c and d) who undergo routine yearly mammography at participating mdacc sites 2. willingness to co-enroll or currently enrolled in pa17-0584 3. willingness to participate in the study and ability to provide informed consent exclusion criteria: 1. self-reported new breast symptoms since last mammogram including nipple discharge, palpable mass, skin dimpling, or focal pain. 2. current or recent (within the prior 6 months) history of pregnancy or breast feeding 3. personal history of breast cancer (dcis or invasive breast cancer) 4. treatment of any other type of cancer within the past 5 years excluding in-situ cervical and non-melanoma skin cancer 5. breast biopsy within 6 months 6. breast surgery within 12 months 7. breast mri, mbi, or cem performed within 24 months 8. known allergy to iodine-containing contrast agents 9. history of anaphylactic reaction to any substance that required hospitalization or iv placement in a patient with no known prior uneventful exposure to iodine-based iv contrast 10. renal insufficiency (as defined by utmdacc policy 3.30- attachment 1 (appendix d)
surveillance monitoring of opioid abuse in poison and drug treatment centers

Conditions: Opioid-related Disorders; Opioid Addiction; Narcotic Abuse; Drug Abuse

Summary: to conduct surveillance for abuse, misuse, overdose, addiction, and death and to evaluate if the rems meets its surveillance goals, and if it does not, to modify it appropriately based on the metrics. briefly, therefore, the overall surveillance objective is to evaluate for trends before and after the shared rems is implemented to collectively assess for changes in abuse, misuse, overdose, addiction, and death for different risk groups and settings.


Eligibility criteria:
inclusion criteria: any patient with data in the radars system exclusion criteria: none
transcranial magnetic stimulation in progressive supranuclear palsy

Conditions: Palsy Supranuclear; Supranuclear Palsy, Progressive

Summary: the objective of this proposal is to investigate the effect of non-invasive repetitive cerebellar transcranial magnetic stimulation (rtms) on motor control in progressive supranuclear (psp). the central hypothesis is that augmenting cerebellar inhibition via cerebellar rtms will decrease postural instability in patients with psp. we will use functional near infrared spectroscopy (fnirs) to examine changes in motor and premotor cortical activity after cerebellar rtms.


Eligibility criteria:
inclusion criteria: * probable or possible psp by the revised mds psp criteria (hoglinger 2017) * age 40-85 at time of screening * ability to understand and cooperate with simple instructions in english * ability to read at 6th grade reading level in english * ability to stand unassisted for at least 30 seconds and to be able walk independently with a walker * ability to refrain from new physical and speech therapy programs for the duration of the study * ability to remain on stable doses of any cholinergic, dopaminergic, serotonergic sedative or nmda receptor antagonists for the duration of the study * females of child-bearing age must perform a urine pregnancy test and be on reliable birth control during the course of the study exclusion criteria: * other significant neurological or vestibular disorders * presence of electrically, magnetically or mechanically activated implants or history of injurious metal exposure in eyes, head, or body

Keywords: repetitive transcranial magnetic stimulation
efficacy of lactobacillus gg with diosmectite in treatment children with acute gastroenteritis

Conditions: Diarrhea

Summary: treatment diarrhea with lactobacillus gg or smectite has proven efficacy. a randomized, double blind, placebo-control trial was performed to assess the effectiveness of both lgg and smectite in management of children with acute gastroenteritis (age).

espghan agreed to use probiotics, with proven efficacy, and smectite in treatment of age as an adjunct to standard rehydration therapy. among probiotics lactobacillus gg were found to be beneficial in meta-analyses. treatment with lgg was associated with a significant reduction in diarrhea duration. a recent review systematically evaluated the efficacy of smectite in treating acute infections diarrhea in infants and children.

Eligibility criteria:
inclusion criteria: * children \< 5 years old * diarrhea (defined as the passage of 3 or more loose or watery stools per day) for \> 1 day but \< 5 days * inform consent sing exclusion criteria: * diarrhea \ 5 days, * a recent history of diarrhea indicated either by parents/guardian or hospital case notes, * underlying chronic gastrointestinal disease, * undernutrition (weight/height ratio below the 5th percentile), * systematic infection, * immune defects or immunosuppressive treatment

Keywords: diarrhea probiotics diosmectite
clinical analysis of simultaneous pancreas-kidney transplantation for end-stage renal disease associated with diabetes mellitus

Conditions: Diabetes Mellitus；Uremia

Summary: the first pancreas transplantation was performed in 1966, by 2015, more than 40,000 pancreas transplantation have been performed worldwide. nevertheless, only several chinese organ transplant centers carry out spk because of surgery complications. simultaneous pancreas-kidney transplantation is a new and promising therapeutic option for the treatment for type 1 diabetes mellitus patients and end-stage renal disease. the preliminary treatment results are summarized to promote the further development of this work in china.

simultaneous pancreas-kidney transplantation using the surgical technique was performed in our department from september 2016 to january 2023 in the department of transplantation of the second affiliated hospital of guangzhou medical university. patients were followed up for 2 to 36 months to summarize the efficacy and complications. we examined the influence of spk on patient and graft survivals.

Eligibility criteria:
inclusion criteria: 1. clinical diagnosis of diabetes patients with end-stage renal disease; 2. first time receiving spkt; exclusion criteria: 1. pulmonary infection, urinary tract infection, hematuria cmv or bk virus infection occurred during treatment; 2. using a large number of abnormal biological products (blood transfusion, plasma or coagulation factors) may contain foreign dna; 3. loss of graft due to thrombosis or ar; 4. patients who are pregnant or have malignant tumors or patients with a history of cell therapy, whose tumor signals interfere with dd-cfdna detection; 5. patients who have poor compliance during treatment or suffer from mental illness.
personalized dietary advice after discharge from hospital in geriatrics: factors associated with improved nutritional status and autonomy

Conditions: Undernutrition of Elderly Peopole

Summary: the purpose of this study is to identify the factors associated with the effectiveness of home dietary management in these elderly people returning home (personal home or independent residence) after hospitalization in acute geriatrics.

patient recruitment will be carried out in the 6 participating hospital centres. all patients willing to participate, will benefit from an inclusion visit (j0): conducted in hospital in acute geriatric services before discharge from hospital. verification of inclusion criteria, collection of patient consent by investigator, assignment of patient identification number, declaration of inclusion, and collection by investigator of inclusion data (age, sex, weight, height, appetite, dietary intake scale, risk factors for undernutrition by has, albumin, crp, exit treatment, adl, iadl and gir, technical aids for walking, presence of professional and non-professional home workers). home visit j7 (30 min to 1 hour): initial dietary assessment, will be carried out between 24 hours and 7 days after discharge from hospital. during this visit, the dietician will perform several measurements (mna-sf, weight, height, appetite assessment, ingest/24h consumption of nocs if prescribed in hospital, quality of life, adl, iadl, acceptance of visit, follow-up of dietary advice and intercurrent medical events). home visit j30, j60 (30 min to 1h): made by the dietician, during these visits will be carried out various measurements and questionnaires: appetite assessment, weight, ingesta/24h, consumption of nocs, acceptance of the visit, follow up on dietary advice, compendiums of intercurrent medical events. home visit j90 = final visit. this visit is identical to the initial assessment (j7). patients who are undernourished or at risk of undernutrition will receive an additional j15 home visit (15 days after discharge from hospital). this visit will be identical to visits j30, j60.

Eligibility criteria:
inclusion criteria: * unscheduled hospitalization of at least 4 days in acute geriatrics, * direct return to home or independent residence after hospitalization, * to be domiciled in the hauts-de-seine department, * good understanding of the french language, * beneficiary of a social security scheme, * having read the briefing note and having consented to participate in the study by signing a written consent, exclusion criteria: * severe cognitive impairment according to dms-iv criteria, * inflammatory syndrome (crp \> 30 mg/l) * evolving cancer; * chronic respiratory failure, * stage iv heart failure * long-term corticosteroids (\> 10 mg/d prednisolone or equivalent), * enteral and parenteral nutrition at home, * chronic end-stage pathology; * inability to walk without human help * major person subject to a legal protection measure (guardianship, guardianship and safeguarding of justice)

Keywords: elderly peopole undernutrition acute geriatric