Kornimate/medical-research-clean huggingface dataset:
ketamine versus fentanyl as an adjunct to propofol-assisted emergency department procedural sedation

Conditions: Fractures; Dislocations; Abscess; Anesthesia; Analgesia

Summary: we, the investigators at queen's university, propose to conduct a randomized, double-blind, feasibility trial comparing low-dose ketamine versus fentanyl as adjuncts to emergency department procedural sedation with propofol. the outcomes of interest will be safety, with respect to hemodynamic and respiratory adverse effects, as well as efficacy, with respect to adequacy of sedation and analgesia, recovery profiles and patient/physician satisfaction. our hypothesis, based on a review of existing anesthesia literature, is that low-dose ketamine may be a safer and more efficacious alternative to fentanyl when used as an adjunct to propofol-assisted procedural sedation.

this initial, single-centre feasibility study will have the following specific objectives: * comparison of low-dose ketamine with fentanyl as adjunct to propofol-assisted emergency department procedural sedation, with respect to safety and efficacy parameters; * pilot of a blinded emergency department sedation and analgesia protocol, including drug doses, concealment techniques, and data collection tools, to determine the feasibility of a subsequent larger, multi-centre trial; * determination of the true incidence of the primary outcome measures in the study population, using the study drug administration doses and protocol, such that an accurate sample size may be estimated for a future, adequately-powered, multi-centre trial; * validation of a newly-developed ordered, categorical rating scale for the reporting of respiratory and hemodynamic adverse events occurring during emergency department procedural sedation and analgesia.

Eligibility criteria:
inclusion criteria: * individuals presenting or referred to the emergency department at kingston general hospital with a fracture or dislocation requiring manipulation under procedural sedation; or abscess requiring incision and drainage under procedural sedation. * ability to provide informed consent according to institutional requirements. * ability to comprehend and communicate in english. exclusion criteria: * age \ 65 years * any history of significant active cardiac, pulmonary, hepatic or renal disease, as determined by patient history, chart review, or emergency physician. * american society of anesthesiology (asa) classification greater than class ii. * body mass \> 130 kg. * a history of physician-diagnosed obstructive sleep apnea. * chronic use of opioids including methadone and buprenorphine. * a self-reported history of recent substance abuse or prior opioid dependence. * acute intoxication with drugs or alcohol, based on the judgement of the attending physician. * a history of psychotic disorders, as reported by subjects or identified on review of the medical records. * a known history of allergy or sensitivity to any study medication.

Keywords: procedural sedation
enhancing lung cancer screening through human-centered intervention

Conditions: Lung Cancer

Summary: the purpose of this study is to further understand the factors involved in increasing lung cancer screening.

the study aims to identify patient, primary care team and health system factors that facilitate participation in lung cancer screening. additionally, conduct a two-arm randomized comparative effectiveness intervention study to increase lung cancer screening compared with a usual care control arm and further evaluate the differential impact of the intervention conditions compared to usual care.

Eligibility criteria:
inclusion criteria: interviews: * uc davis health systems (ucdhs) primary care providers and clinic staff who provide services to patients ages 50-80. * patients who are eligible for lung cancer screening. screening intervention: - patients ages 50-80 who have a history of smoking per review of their electronic medical record and who receive care at the following ucdh ambulatory care clinics: ellison ambulatory care clinic; elk grove; midtown. exclusion criteria: interviews: * non-consenting patients and patients who do not speak english or spanish * patients aged 49 and younger * non ucdhs primary care providers and clinic staff screening intervention: * ucdhs patients who have already received lung cancer screening * patients with existing cancer diagnosis

Keywords: lung cancer screening
added value of vein of marshal ethanol infusion compared to superior vena cava isolation alone in patients undergoing repeat ablation for recurrent paroxysmal atrial fibrillation despite durable pv isolation

Conditions: Paroxysmal Atrial Fibrillation

Summary: the superior vena cava (svc) is one of the most common non pulmonary vein (pv)-triggers for atrial tachyarrhythmias. svc electrical isolation can be reached by circular radiofrequency (rf)-ablation under close monitoring of the phrenic nerve. however, adding substrate modification and vein of marshal (vom) ethanol infusion to the ablation procedure might substantially improve long-term outcomes. the aim of this study is to evaluate the recurrence rate 1 year after the index ablation in patients undergoing a redo ablation for recurrent paroxysmal atrial fibrillation (paf) despite durable pulmonary vein isolation (pvi) with either svc isolation alone or with substrate modification including vein of marshal ethanolisation in addition to svc isolation alone


Eligibility criteria:
inclusion criteria: * patients older than 18 years * patients scheduled for a repeat ablation of paf after a previous pvi * confirmation of lasting pulmonary vein isolation at the time of randomization exclusion criteria: * patients with persistent atrial fibrillation * previous ablation with isolation of the svc, roofline, mitral line or previous vein of marshal ethanol infusion * left atrial thrombus. left atrial appendage thrombus can be determined by preprocedural imaging: ct, transesophageal echocardiography or mri. * left ventricular ejection fraction \<35%. * cardiac surgery within the previous 90 days. * expecting cardiac transplantation or other cardiac surgery within 180 days. * coronary percutaneous transluminal coronary angioplasty/stenting within the previous 90 days or myocardial infarction within the previous 60 days. * documented history of a thromboembolic event within the previous 90 days. * diagnosed atrial myxoma. * significant restrictive, constrictive, or chronic obstructive pulmonary disease with chronic symptoms. * significant congenital anomaly or medical problem that in the opinion of the investigator would preclude enrollment * women who are pregnant or who plan to become pregnant during the study. * acute illness or active infection at time of index procedure * advanced renal insufficiency * unstable angina. * history of blood clotting or bleeding abnormalities. * contraindication to anticoagulation. * life expectancy less than 1 year. * presence of a condition that precludes vascular access. * international normalized ratio greater than 3.5 within 24 hours of procedure - for patients taking warfarin. * patient cannot be removed from antiarrhythmic drugs for reasons other than af. * unwilling or unable to provide informed consent.
sexual function during covid 19 pandemic

Conditions: Sexual Dysfunction

Summary: the outbreak of a new coronavirus disease (covid-19), caused by the 2019-ncov infection in december 2019 is one of the most severe global epidemic health problems.the rapid contagion of this novel virus has provoked the world health organization (who) to classifying the outbreak as a "public health emergency of international concern" on january 30 2020 to a "pandemic" on march 11th 2020


Eligibility criteria:
inclusion criteria: * health care staff * working during the outbreak exclusion criteria: * refuse to participate
does heart rate variablity (hrv) predict hypotension in patients undergoing cervical myelopathy surgery ?

Conditions: Heart Rate Variability

Summary: cervical myelopathy is commonly associated with degenerative spinal disease. dysfunction of the autonomic nervous system is also evident in many cases of cervical myelopathy. autonomic dysfunction may result in haemodynamic instability and hypotension under anaesthesia. it is important to maintain adequate mean arterial pressure in order to perfuse the spinal cord and prevent cord ischemia. heart rate variability, the physiological variations of the differences between heart beats, has been used to diagnose autonomic dysfunction. in patients with cervical myelopathy it may enable the anaesthetist to predict hypotension thereby allowing for early treatment and prevention of spinal cord ischemia.

protocol 1. standard perioperative management routine standard preparation of the patients will be carried out as per the investigators institutional standard for all patients undergoing cervical spine surgery. all routine physiological monitoring (ecg, invasive arterial blood pressure, spo2, end tidal co2, temperature and depth of anaesthesia monitoring) will be performed. the induction of anesthesia will be performed with propofol (2-5 mg/kg), fentanyl (3mcg/kg) and rocuronium (0.6 mg/kg) for intubation of the patient's trachea once peripheral nerve stimulation shows no muscle twitches. 2. study protocol before general anesthesia, following a 10 minute stabilization period with the patient lying supine and breathing at a rate of 12 - 15 breaths per minute, a 5 minute ecg recording will be obtained. ecg data will be downloaded onto a study laptop for later analysis using labchart software to determine hrv values. hemodynamic data and depth of anaesthesia will be collected from the preinduction period until skin incision at 1 minute intervals. the study will be complete after skin incision. data collection and management data collection the following data will be collected: patient demographics, surgical data including position technique, number of levels, duration, anaesthetic data including agents used, hemodynamic measurements from preinduction to surgical incision, japanese orthopaedic association score. the incidence of hypotension and the number of interventions required to keep mean arterial blood pressure above 70 mmhg will be recorded. significance of the study identifying patients at risk for hypotension can be useful to prevent hypotension and to prepare to treat hypotension sooner so that the risk of spinal cord ischemia can be minimized.

Eligibility criteria:
inclusion criteria: * adults patients, aged 18 - 70 years with the history of cervical myelopathy, presenting for anterior or posterior cervical decompression and fusion. exclusion criteria: 1. patients with arrhythmias or absence of sinus rhythm 2. diabetic patients 3. degenerative neurological disease e.g. parkinson's disease 4. complete sci 5. inherited autonomic dysfunction

Keywords: cervical myelopathy hypotension
assessment of salbutamol effect on arterial oxygenation in copd patients during one-lung ventilation

Conditions: One-lung Ventilation; Chronic Obstructive Pulmonary Disease

Summary: one-lung ventilation (olv) is essential part of anesthesia during thoracic procedures. however, olv induces a drastic increase of intrapulmonary shunt due to maintained pulmonary perfusion through the nonventilated lung, which may result in severe hypoxemia. although the protective mechanisms of hypoxic pulmonary vasoconstriction favorably modulate pulmonary perfusion to the ventilated lung, the effect is attenuated in patients with history of chronic obstructive pulmonary disease (copd), which alters compliance of the pulmonary artery. salbutamol is a selective short-acting beta2-agonist and when inhaled during olv, it acts selectively on the pulmonary vasculature reducing pulmonary vascular resistance of well-ventilated lung. we hypothesized that inhaled salbutamol would alleviate ventilation-perfusion mismatch during olv of copd patients, and aimed to assess the effects of salbutamol on oxygenation in these patients.


Eligibility criteria:
inclusion criteria: * patient age 40\~80yrs, scheduled for videoscope-assisted pulmonary lobectomy * american society of anesthesiologists class iii 또는 iv * moderate or more severe copd according to gold criteria (fev1/fvc\<70%, fev1\<80%) exclusion criteria: * new york heart association class \>ii * ast level ≥100 iu/ml or alt ≥ level 50 iu/l * creatinine clearance \< 30ml/min * history of severe coronary artery occlusive disease, unstable angina, or recent myocardial infarction within 6 months * history of pulmonary hypertension or pulmonary edema * history of cerebrovascular accident within 3 months
learning theory to improve obesity treatment

Conditions: Obesity

Summary: the purpose of this study is to optimize an obesity treatment program targeting overweight 8-12 year old children using "cue exposure training".

the goal of the cue exposure program is to train children to resist cues to eat unhealthy foods. through a series of experimental studies, the investigators will evaluate how many weekly treatment visits there should be, whether children should be exposed to a single food or multiple foods during treatment, whether to use partial reinforcement or not, whether visits should be daily or weekly, and whether the exposures should be in single or multiple contexts. the investigators will be recruiting parent-child dyads in the san diego community to participate in 8 to 16 weekly or daily treatment sessions either in their home, community center, or our lab, depending on the treatment arm. parents and children will complete baseline and post-treatment assessments consisting of collecting psychophysiological data, completing laboratory tasks, and completing questionnaires. the investigators will be evaluating which treatment condition reduces overeating (as measured by our laboratory tasks).

Eligibility criteria:
inclusion criteria: * response to an advertisement for the study, * an overweight or obese child in the family who is between the ages of 8 and 13, * the 8-13 year old child must be above the 85th bmi % for age and gender, * parent willing to participate and attend all meetings, * parent who can read at a minimum of a 5th grade level in english, * parent and child willing to commit to attendance and assessments, * child who eats in the absence of hunger. exclusion criteria: * major child psychiatric disorder diagnoses, * an obese child over the 99.9th bmi % * child or parent diagnoses of diabetes for which physician supervision of diet is needed or diagnosis of serious current physical diseases (such as cancer, multiple sclerosis, lupus) which could significantly decrease their ability to participate in the intervention (parent report), * child taking a medication that can affect cognitive functioning, such as attention, concentration, or mental status. * family with restrictions on types of food, such as food allergies, or religious or ethnic practices that limit the foods available in the home (these restrictions affect their ability participate in the food exposures because it would limit the variety of foods available to do exposures with), * child with an active eating disorder (based on parent and child self-report) * major parent psychiatric or eating disorder.

Keywords: obesity overweight overweight children overweight parents overeating eating in the absence of hunger families with overweight child body mass index bmi weight childhood obesity treatment cue exposure treatment cravings habituation to food cues psychophysiological response to food cues intervention experiments family based treatment behavioral treatment
oxygen consumption required by stroke patients during completion of the modified rivermead mobility index (mrmi)

Conditions: Stroke

Summary: the aim of this study was to measure the oxygen consumption and peak heart rate achieved during modified rivermead mobility index (mrmi) assessment in age-matched, healthy and stroke patients, and assess the efficacy of the mrmi tasks for aerobic training in patients with stroke.


Eligibility criteria:
inclusion criteria: * diagnosis of hemisphere stroke * aged fifty or above * ambulatory with/ without walking aid * had ability to provide informed consent and understand the evaluation procedures exclusion criteria: * brainstem and cerebellar lesion * unconscious or drowsy * musculoskeletal, respiratory or other disease that may limit activity of daily livings * serious cardiovascular disease
analysis of graft function following autologous islet transplantation

Conditions: Chronic Pancreatitis

Summary: analyze inflammatory markers and islet graft function through blood samples collected from subjects with chronic pancreatitis who undergo total pancreatectomy with auto islet transplantation.

a total of 100 subjects will be enrolled in this study; 85 subjects will be enrolled from patients who are scheduled for tp-ait and 15 subjects will be for tp alone at baylor university medical center at dallas or baylor all saints medical center at fort worth. the patients who are enrolled in a clinical study, named 'a phase 2/3, multicenter, randomized, double-blind, placebo-controlled, parallel assignment study to assess the efficacy and safety of reparixin in pancreatic islet auto-transplantation (rep0112, ind# 117390)', can be enrolled in this study.

Eligibility criteria:
inclusion criteria: 1. patients with chronic pancreatitis and who are scheduled for tp alone or tp-ait 2. patients aged 18 or older 3. patients are able and willing to attend required follow-up visits at baylor exclusion criteria: 1. patients who are unable/unwilling to attend follow-up visits at baylor 2. for tp-ait subjects: patients who have advanced stage of chronic pancreatitis. the principal investigator or co-investigators carefully review the medical charts, laboratory results and radiology department reports and determine the suitability for this study.

Keywords: pancreatitis islet cell
safety and efficacy of eletriptan for the treatment of migraine in subjects unsuccessfully treated with nonsteroidal anti-inflammatory drugs

Conditions: Migraine

Summary: to assess the safety and efficacy of eletriptan for the treatment of migraine in subjects who had not been adequately treated with non-steroidal antiinflammatory drugs (nsaids)


Eligibility criteria:
inclusion criteria: * met international headache society diagnostic criteria for migraine with or without aura * expected to suffer one to six acute migraine attacks per month based on past history * experienced migraines for at least one year prior to entering study, and historically have not responded to nsaids exclusion criteria: * frequent migraine or frequent concomitant non-migrainous headache (average of \>6 attacks per month) * atypical migraines that consistently failed to respond to adequate medical therapy * migraine with prolonged aura, familial hemiplegic migraine, basilar migraine, migrainous infarction, migraine aura without headache, or migraine with acute-onset aura
safety and systemic exposure study of bl-7010 in well-controlled celiac patients.

Conditions: Celiac Disease

Summary: the purpose of this study is to evaluate the safety of different amounts of bl-7010 in single oral administration and in repeated oral administration to well-controlled celiac patients. another purpose is to evaluate if bl-7010 is absorbed by the body or not.


Eligibility criteria:
inclusion criteria: * males or females aged 18-75 years who have signed an informed consent form * body mass index (bmi) between 18.5-29.9, inclusive * documented history of biopsy-proven celiac disease. * adherence to a gluten-free diet for the last 6 months prior to randomization * tg2 and ema antibody (iga) negative * women of childbearing potential and all men must agree to use an approved form of contraception * ability and willingness to understand and comply with study procedures and to give written informed consent prior to enrollment. exclusion criteria: * iga deficiency. * history of ige-mediated reactions to gluten. * other food sensitivities or allergies. * use of oral steroids, biologics, immunosuppressants or non-steroidal anti-inflammatory drugs 6 months prior to entry (screening). * female subjects who are pregnant or breastfeeding. * clinically significant, concomitant gastrointestinal disease. * have clinically significant current or historical medical problems such as diabetes mellitus, clinically significant cardiac arrhythmias, arteriosclerotic heart disease, renal insufficiency or failure, autoimmune disease, history of malignant melanoma or history of cancer (excluding basal cell carcinoma) within the past 5 years prior to screening. * subjects receiving drugs or oral devices that, in the opinion of the investigator, possible ineffective treatment with these drugs/oral devices for a duration of two weeks will put the subject at a medical risk * uncontrolled complications of celiac disease. * any other condition that in the opinion of the investigator will place the subject at risk or prevent protocol compliance.
partial neuromuscular blockade in acute respiratory distress syndrome

Conditions: Respiratory Insufficiency; Extracorporeal Membrane Oxygenation Complication; Neuromuscular Blockade

Summary: pneuma is a preliminary safety and feasibility trial of a novel approach to the titration of neuromuscular blockade (nmb) to safe spontaneous breathing in patients with severe acute respiratory distress syndrome (ards) supported with veno-venous extracorporeal membrane oxygenation (vv-ecmo).

controlling respiratory effort in patients with ards can be challenging, as they often exhibit a very high respiratory drive despite receiving high doses of sedatives. consequently, these patients usually receive full neuromuscular blockade, with the goal to avoid such injurious respiratory efforts. unfortunately, full neuromuscular blockade is not without complications. to address this issue, the use of partial neuromuscular blockade has been proposed as a strategy to maintain respiratory muscle activity while providing lung protective ventilation. the objective of this study is to demonstrate the safety and feasibility of safe spontaneous breathing using partial nmb in severe ards patients supported on vv-ecmo. an esophageal balloon and a catheter will be placed. once adequate sedation has been ensured, small boluses of cisatracurium will be administered. then, an infusion of cisatracurium will be started to maintain spontaneous breathing at esophageal pressure swings (pes) of 3-10 cm h2o or selected diaphragm electrical activity (edi) targets. after establishing a sedation and nmb dosing regimen at which safe spontaneous breathing is achieved, we will document whether these targets can be maintained over a 24-hour period.

Eligibility criteria:
inclusion criteria: 1. potentially injurious respiratory efforts as defined by esophageal pressure swings or occlusion pressure swing and riker sedation-agitation scale (sas) ≤2 (if the clinical team has elected to sedate to that depth). 2. the medical team has undertaken a trial of discontinuing neuromuscular blockade and determined that the patient requires reinstitution of neuromuscular blockade to ensure toleration of ecmo and they are willing for the patient undergo a trial of partial neuromuscular blockade 3. the patient is receiving neuromuscular blockade with no plan to discontinue neuromuscular blockade until the next day and the medical team is willing for the patient to undergo a trial of partial neuromuscular blockade exclusion criteria: 1. decannulation from vv-ecmo is anticipated within 24 hours 2. contraindication to esophageal catheterization 3. contraindication to neuromuscular blockade (allergy, history of malignant hyperthermia) 4. patient has a condition deemed by the medical team to require complete nmb