Kornimate/medical-research-clean huggingface dataset:
effects of treatment with high flow nasal cannulas on respiratory pattern and work of breathing among patients.

Conditions: Respiratory Failure

Summary: this study evaluates the work of breathing among patients under various conditions of treatment with high flow nasal cannulas. sixteen spontaneously breathing patients with respiratory failure (hypercapnic or hypoxemic) will be included. the design of this study is a cross over of four treatment periods with different flow settings.

high flow oxygen therapy (hfot) is a promising technique increasingly used in the management of acute respiratory failure. in hospitalised hypoxemic patients, recent clinical evidence showed that hfot can reduce endotracheal intubation and reduce mortality. physiologically, the hfot causes a decrease in respiratory rate and minute-ventilation and may be associated with a decrease in paco2. it is possible that these effects are associated with decreased work of breathing, which could explain some of the benefits in terms of comfort and efficiency. the objective of this research is to evaluate the impact of a wash-out of anatomical dead space by high flow nasal cannulas on respiratory parameters and on the work of breathing. the investigators will evaluate the baseline status with conventional oxygen therapy methods (low flows), and then compare it with three different levels of high flow oxygen therapy in a randomised order. the primary endpoint will be the work of breathing.

Eligibility criteria:
inclusion criteria: spontaneously breathing patients exhibiting a respiratory distress defined by a respiratory rate ≥ 20 breaths/min associated with * either hypoxemia (spo2\<90% with o2≥3l/min) ; * or hypercapnia (paco2\>45 mmhg with a respiratory acidosis (ph\<7,38). exclusion criteria: * patients below 18yo, pregnant or breastfeeding women; * patients enrolled in another study excluding co-enrolment; * history of ear nose and throat disease (i.e. surgery, epistaxis, trauma), eso-gastric disease (i.e. esophageal varices, digestive haemorrhage), rheumatologic or neurologic disease possibly interfering with the design of the study; * acute respiratory or cardiovascular disease contra-indicating the enrolment in the study protocol (i.e. acute coronary syndrome, pulmonary embolism, pneumothorax); * need for immediate intubation or for continuous noninvasive ventilation and/or recent (\<6h) arterial blood gases showing a respiratory acidosis with a ph\<7.30; * patient feeling nauseous or under recent fed condition (\<1h).
perioperative fluid therapy optimization in spinal surgery

Conditions: Hypovolemia; Hypervolemia

Summary: the decision to give fluids perioperatively could be based on methods used to identify preload responsiveness, either invasive or noninvasive estimates of stroke volume variation during mechanical ventilation. this study compares fluid management using continuous noninvasive cardiac output measurement with standard perioperative fluid management.

the aim of the study is to optimise fluid managemet and to reduce perioperative risks during spinal procedures in prone position. adequate perioperative management guided by hemodynamic monitoring can help to reduce the risk of complications and thus potentially improve outcomes.

Eligibility criteria:
inclusion criteria: * glasgow coma scale 15 * asa physical status classification system i-iii * planed spinal surgery to 3 hours * postoperative awakening * sinus rhythm exclusion criteria: * nyha iii, iv * bmi over 40 in females and over 35 in men * awake operation * postoperative artificial ventilation

Keywords: fluid responsiveness, haemodynamical monitoring, clearsight
longitudinal hpv pap in cin and vain

Conditions: Cervical Intraepithelial Neoplasia; Hysterectomy; Human Papillomavirus; Vaginal Intraepithelial Neoplasia

Summary: this study will construct a longitudinal risk model of vain according to the hpvs distribution of cervix and vaginal for those had cin2+. the study will include three arms to complete the follow-up data for the previous cohort constructed, and prospectively recruit new subjects with the appropriate inclusion/excluding criteria in order to increase sample size of this study.

the long-term outcomes of patients with antecedent cervical intraepithelial neoplasia (cin) were lacking. a systematic review published in 2008 identified no studies that met the review eligibility criteria for the prevalence of hpv types among vaginal precursors and cancers. two sporadic studies containing 16 and 81 cases were reported in that review. given that vaginal intraepithelial neoplasia (vain) post-hysterectomy for cin is an uncommon disease which has a prevalence of being 1 to 6 %; it has the potential to progress to malignancy. although the etiology of vain has not been as thoroughly investigated as that of cin, evidence implicates that the human papillomavirus (hpv) as the probable carcinogenic agent for the onset and evolution of some vain and vaginal cancers. this study will construct a longitudinal risk model of vain according to the hpvs distribution of cervix and vaginal for those had cin2+.

Eligibility criteria:
inclusion criteria: 1. age \>= 20 years 2. those with a previous history of cin+

Keywords: cervical intraepithelial neoplasia hysterectomy human papillomavirus vaginal intraepithelial neoplasia
wso beat stroke initiative

Conditions: Stroke; PFO - Patent Foramen Ovale; Atrial Fibrillation (AF)

Summary: the wso brain and heart global initiative - stroke (beat-stroke) is a cluster randomized controlled trial, testing whether an educational and implementation neurocardiology tool can improve adherence to best practice recommendations for secondary stroke prevention of cardioembolic strokes, as defined by the wso systematic review and synthesis of global stroke guidelines or more recent high-quality evidence published after the last stroke guidelines1

the world stroke organization (wso) brain and heart task force developed the brain \&amp; heart global initiative (beat), a pilot feasibility program aimed at establishing clinical collaborations between cardiologists and stroke physicians.1 the wso beat pilot project focused on atrial fibrillation (af) and patent foramen ovale (pfo) detection and management, highly prevalent cardioembolic causes of ischemic stroke and transient ischemic attack (tia). the pilot feasibility wso beat program comprised 10 sites from 8 countries, including brazil, china, egypt, germany, japan, mexico, romania, and the usa. of the 10 sites, two belonged exclusively to the public sector and one was public and private. the primary objective of the pilot wso beat program was to assess its feasibility by achieving a composite feasibility outcome including: (1) developing site-specific clinical pathways for the diagnosis and management of af, pfo, and the stroke heart syndrome; (2) establishing regular neurocardiology rounds (e.g., monthly, bimonthly, etc.); and (3) incorporating a cardiologist to the stroke team. overall, the wso beat program successfully achieved the pre-specified goals at most sites. regarding the three primary program objectives, 9/10 (90%) of the sites were able to design or update the proposed clinical care pathways, establish neurocardiology rounds, and designate a dedicated cardiologist for the stroke team, respectively. to date it is unknown whether the implementation of neurocardiology educational tools and collaborations between cardiologists and neurologists can improve adherence to best practice recommendations focused on the management of cardioembolic strokes.

Eligibility criteria:
inclusion criteria: * patients with ischemic stroke or tia of any etiology. exclusion criteria: * n/a

Keywords: cardiac monitoring stroke atrial fibrillation pfo closure
noninvasive ventilation therapy for the treatment of pleural effusion in patients with heart failure

Conditions: Pleural Effusion; Heart Failure

Summary: there are no investigations so far whether an application of positive pressure during non-invasive ventilation might be a therapeutic option for transudative pleural effusion in patients with heart failure. in view of the pathophysiological process with pleural effusion resulting from an increase in intravascular hydrostatic pressure, non-invasive ventilation might provide an improvement. the aim of the present study is to investigate whether an additional non-invasive ventilation therapy leads to an improved suppression of pleural effusion in heart failure patients.


Eligibility criteria:
inclusion criteria: * patients admitted to our hospital on a routine or emergency basis * patients with heart failure according to the current esc guidelines and chronic pleural effusion with clinical indication for pleurocentesis * non-invasively determined cardiac index of \< 2.5 l/min/m² * bnp \> 300 pg/ml * transudative pleural effusion according to light criteria * effective pleurocentesis with residual effusion on the side affected of \< 500 ml * tolerance of non-invasive ventilation without subjective or objective hemodynamic impairment as verified during a test ventilation * no change in drug or other therapy for the duration of the study (5 days) exclusion criteria: * psychological or neurological concomitant disease making an informed consent impossible * pregnancy * pneumothorax or pneumomediastinum * pathologically low blood pressure, particularly associated with intravascular volume depletion * liquor discharge, recent head surgery or trauma * severe bullous lung disease * dehydration * current ventilation therapy * bilateral pleural effusion \> 500 ml at the time of enrolment * exudative pleural effusion
the efficacy and safety study of a new cross-linked hyaluronan hydrogel in the reduction of postsurgical peritoneal adhesions

Conditions: Myomas; Ovary Cysts; Endometriotic Cysts; Adhesions

Summary: the purpose of this study was to determine whether the new crosslinked hyaluronan hydrogel was safe to use, and was effective for the prevention/reduction of adhesion formation following gynecological surgery

postsurgical adhesions are a common medical complication of gynecologic and pelvic surgeries, and are frequently associated with chronic or recurrent pelvic pain, intestinal obstruction and infertility. this randomized, controlled, multicenter, clinical study was designed to evaluate the safety and performance of the new crosslinked hyaluronan hydrogel versus the standard of care for the reduction of postoperative adhesions in subjects undergoing laparoscopic surgeries. subjects were scheduled to return at 9 weeks after the initial surgical procedure. at that time, a second-look laparoscopy was performed for postsurgical adhesion assessment. adhesions were graded using a modified american fertility society (mafs) scoring system.

Eligibility criteria:
inclusion criteria: * female. * aged 18-45 years. * been scheduled for removal of myomas, ovary cysts, endometriotic cysts or adhesions. * been willing to comply with all aspects of the treatment and evaluation schedule. * agreed to a second-look laparoscopic procedure to assess and lyse any adhesions formed at 9 weeks following the primary surgery. * provided voluntary written informed consent. exclusion criteria: * acute or severe infection. * autoimmune diseases such as diabetes etc. * abnormal liver/renal and cardiovascular function * abnormal blood coagulation * medical histories of peripheral vascular disease, alcohol or drug abuse, and mental illness. * known or suspected intolerance or hypersensitivity to hyaluronan or its derivatives. * concurrent use of systemic antiinflammatory drugs. * clinical evidence of cancer. * use of anticoagulant, fibrin glue, other thrombogenic agents, or any other anti-adhesion agent during the procedure. * concurrent peritoneal grafting or tubal implantation.

Keywords: adhesions hyaluronan gynaecological surgery clinical outcomes
an open labeled pilot study of atorvastatin in systemic lupus erythematosus

Conditions: Systemic Lupus Erythematosus

Summary: the aim of this study is to to determine whether atorvastatin 40mg per day is effective in the treatment of sle.

background: statins are lipid-lower agents with pleiotropic effects. beyond the traditional effect as inhibitors of 3-hydroxy-3methylglytaryl coenzyme a (hmg-coa) reductase, it has anti-inflammatory and immunomodulatory properties. the administration of atorvastatin to lupus-prone model nzb/w f1 mice results in a significant reduction in serum igg anti-dsdna abs and decreased proteinuria. in a pilot study with three patients with sle, simvastatin induced rapid and significant reduction in proteinuria levels. however, further randomized double-blinded placebo-controlled study is pending. objective: the goal of this study was to evaluate the clinical efficacy and laboratory effect of atorvastatin in sle. methods: forty patients with sle will randomize in two groups to receive atorvastatin or not as an adjuvant to immunosuppressive agent therapy. patients who received atorvastatin for 6 months will stop atorvastatin for 8 weeks as a washout period. we will cross over the placebo and experimental groups, then given atorvastatin for another 6 months. primary outcome is improvement of lupus disease status measured by sledai and microcirculation improvement via nailfold capillaroscopy.

Eligibility criteria:
inclusion criteria: 1. 16-80 years of age, fulfilling acr criteria for the classification of sle (no limit on disease duration) 2. active disease status including (1) active nephritis with moderate proteinuria (between 1.0gm/day and 2.5gm/day) despite ongoing immunosuppressive therapy or (2) moderate active extra-renal component of the sledai score in the range of 3 to 10. the sle-dai score should have been stable for at least two weeks prior to screening. 3. the type and number immunosuppressive agents were not changed in recent one months exclusion criteria: 1. inability to give informed consent; 2. myositis (ck\>3×normal value); 3. dialysis or serum creatinin\>2.5mg/dl; 4. abnormal liver function (alt\>3×normal value); 5. pregnant or breastfeeding; 6. life-threatening illness that would interfere with ability to complete the study; 7. current drug or alcohol abuse 8. already under statin therapy 9. active sle disease need added new immunosuppressive agent or increased current drug dosage for more than 50%.

Keywords: statin systemic lupus erythematosus microcirculation
study of a 1-millimeter resolution clinical positron emission tomography (pet) system in head and neck cancer imaging

Conditions: Head and Neck Cancer

Summary: the purpose of this study is to gain initial experience imaging hnc patient using a new pet camera, a 1mm spacial resolution. the goal is to understand image quality of the system and to see how it works in a clinical environment.

primary objective(s): gain initial experience imaging head/neck cancer patients using a novel pet camera comprising two opposing panels with 1 millimeter spatial resolution. secondary objective(s): 1. determine the radioactive dose and scan time required for this novel 1 millimeter (mm) resolution clinical pet camera. 2. images obtained with the 1 mm resolution pet camera will be compared to conventional pet imaging (which will serve as gold standard) for image quality and lesion/node visualization.

Eligibility criteria:
inclusion criteria: 1. biopsy-confirmed diagnosis of hnc 2. patient scheduled to undergo surgery for hnc 3. scheduled to have a pet/ct study on a conventional pet/ct system 4. age greater than or equal to 19 years of age. exclusion criteria: 1. additional condition, or extenuating circumstance that, in the opinion of the investigator, may interfere with study compliance.
vorinostat (mk-0683, saha [suberoylanilide hydroxamic acid]) + lenalidomide + dexamethasone in multiple myeloma (mm) (mk-0683-074)

Conditions: Relapsed or Refractory Multiple Myeloma

Summary: the purpose of this phase i study of vorinostat in combination with lenalidomide and dexamethasone in participants with relapsed or refractory multiple myeloma is to determine the maximum tolerated dose (mtd) as estimated by the incidence of dose-limiting toxicities (dlts) and recommended phase 2 dose (rp2d) as estimated by the incidence of drug-related adverse events (aes).


Eligibility criteria:
inclusion criteria: * is a male or female at least 18 years old * has relapsed or refractory mm and has had at least one prior therapy * female participants of childbearing potential must have 2 negative serum pregnancy tests prior to receiving the first dose of study drugs * female participants who can become pregnant must agree to use 2 separate forms of effective birth control at the same time, 4 weeks before, while taking, and for 4 weeks after stopping lenalidomide; post menopausal participants should be free from menses for \>2 years, or are surgically sterilized * male participant agrees to use an adequate method of contraception for the duration of the study, even if the participant has undergone a successful vasectomy * male participants must agree to use a latex condom during sexual contact with a pregnant female or a female who can become pregnant; this is required for the duration of the study, and for 4 weeks after stopping therapy * has at least 3 weeks washout prior to treatment * is able to swallow capsules and is able to take or tolerate oral medications on a continuous basis exclusion criteria: * has prior treatment with a histone deacetylase (hdac) inhibitor * has prior allogenetic bone marrow transplant * has received intravenous antibiotics, antiviral, or antifungal agents within 2 weeks prior to the start of the study drug * uses illicit drugs, substance abuse or had a recent history (within the last year) of drug or alcohol abuse * is pregnant or breast feeding or expecting to have a baby during the course of the study * has human immunodeficiency virus (hiv) infection * has hepatitis b/c infection * is currently receiving treatment for another type of cancer other than skin or cervical cancer that has not been in remission for 5 years or longer
a within-subject study to evaluate the efficacy and safety of diclofenac sodium topical gel 1% compared to placebo in subjects experiencing delayed onset muscle soreness

Conditions: Muscle Soreness

Summary: this study will assess the analgesic efficacy of dsg 1% compared to placebo in the reduction of the pain associated with doms


Eligibility criteria:
inclusion criteria: * male or female subjects aged 18-35 years * not engaged in regular lower extremity fitness activities in the past 6 months prior to screening * willing to refrain from use of ice, heat and massage during the study * doms score ≥4 pain at rest (par) and a doms score ≥5 pain on walking (pow), with moderate or severe on categorical scale exclusion criteria: * pain medication \& corticosteroids prior to randomization * topical analgesic or anti-inflammatory treatment over the previous month * body mass index of \>32 kg/m2 other protocol-defined inclusion/exclusion criteria may apply
the effects of bimanual laryngoscopy on post-operative sore throat in adults

Conditions: Postoperative Sorethroat; Bimanual Laryngoscopy

Summary: post-operative sore throat, cough, and hoarseness of voice are common, uncomfortable, distressing sequelae after tracheal intubation. it was postulated that these effects are because of irritation and inflammation of the airway. bimanual laryngoscopy is known to improve visual field during intubation. this procedure might reduce laryngeal trauma during intubation and therefore reduce the incidence or degree of post-operative sore throat. this is the first prospective, double-blinded, controlled study, which is focused on the effects of bimanual laryngoscopy on first 24-houred post-operative sore throat (post).


Eligibility criteria:
inclusion criteria: 1. asa i or ii 2. 20-70 y/o 3. gaet for a. breast op b. gyn op c. upper/lower extremities op d. ophthalmology op e. gu op f. minor surgery exclusion criteria: 1. emergency surgery 2. head and neck surgery 3. recent uri symptom in last one weeks with medication 4. post op pca use 5. on ng/og 6. perioperative bucking
preventing obstetric complications with dietary intervention

Conditions: Gestational Diabetes; Gestational Hypertension; High Risk Pregnancy; Preeclampsia

Summary: the goal of this study is to learn whether access to healthy and fresh food, health coaching, and nutrition support intervention can reduce adverse birth outcomes in pregnant women. the main questions it aims to answer are: * does access to healthy and fresh food, health coaching and nutrition support reduce the risk of gestational diabetes or preeclampsia and ultimately improve health outcomes for mothers and their newborns? * are participants able to successfully utilize the health program? are participants satisfied and self-equipped to apply the teachings of the program within their lives following their participation in the study? participants will be randomly assigned to one of two groups. participants in the standard of care will be asked to: * complete surveys * biometric screenings participants in the intervention group will be asked to: * complete surveys * biometric screenings * participate in weekly personal health coaching * receive and consume provided weekly meals. researchers will compare the standard of care to those who receive the intervention to see the impact of the intervention on clinical outcomes including: gestational weight gain, blood pressure, diagnosis of gestational diabetes, diagnosis of gestational hypertension or preeclampsia, and gestational age at birth.


Eligibility criteria:
inclusion criteria: 1. age at enrollment ≥ 18 years of age 2. receiving prenatal care at froedtert 3. ≤ 16 weeks and 6 days of gestation 4. at risk of preeclampsia, defined as being eligible for low dose aspirin treatment and/or at risk for gestational diabetes defined as having a history of gestational diabetes, or previously given birth to an infant weighing ≥ 4000 g, or has a diagnosis of pcos 5. pre-pregnancy body mass index ≥ 25 kg/m\^2 6. resides in milwaukee county at time of consent 7. low socio-economic status (\<200% of fpl defined as receiving medicaid) 8. able to read and communicate in english 9. has access to a smart device/computer with reliable internet connection 10. has access to a working refrigerator 11. viable singleton pregnancy exclusion criteria: 1. diagnosed with type i or type ii diabetes or hemoglobin a1c ≥ 6.5% 2. diagnosed with end stage renal disease 3. use of weight-increasing psychotropic agents 4. active inflammatory bowel disease, or history of bowel resection or malabsorptive syndrome, or history of bariatric surgery 5. significant food allergies, preferences or dietary requirements that would interfere with diet adherence 6. multifetal gestation 7. active substance use that would preclude program adherence 8. chronic use of oral corticosteroids 9. unable to provide informed consent