Kornimate/medical-research-clean huggingface dataset:
modified hospital elder life program at intensive care unit

Conditions: ICU Delirium

Summary: delirium, a form of acute brain dysfunction, occurs in up to 81% of patients receiving mechanical ventilation in the intensive care unit (icu). delirium occurring in the icu is associated with increased functional dependency, cognitive impairment, longer length of hospital stay, and mortality. this study aim to develop a nursing-driven icu delirium intervention to reduce incidence of delirium, increase the delirium-and coma-free days (dcfds), and improve icu patients' function, cognition, and mortality outcomes 3 months following their icu admission. the "modified hospital elder life program at the icu (mhelp@icu)" will be provided to ensure critically ill patients are cognitively engaged, physically active, and nutritionally well-fed. this three-year study is divided into two phases. the first phase aims to ensure the accuracy of delirium assessment using the intensive care delirium screening checklist (icdsc) by icu nurses of three participating icus. the icdsc records assessed by icu nurses will be abstracted from medical records and compared with a gold standard icdsc evaluation by a well-trained, independent assessor. cohen's kappa will be reported to represent the consistency of the icdsc assessment between delirium data from medical records and the independent assessor. when the cohen's kappa is less than 0.8, a 3-month bedside teaching and real-time feedback education program will be implemented at three icu units to improve the accuracy of icdsc assessment by icu nurses. the second phase will be a clinical trial using a stepped-wedge cluster randomized controlled trial design. adult (18 years and older) critically ill patients receiving mechanical ventilation will be consecutively enrolled from three mix-medical icus at a studied medical center. estimated 266 participants will be cluster-randomized into the intervention and control groups. participants in the intervention group will receive a 14-day mhelp@icu, provided by a trained mhelp nurse, while the participants who received the usual care will serve as controls. effects of mhelp@icu will be evaluated using the daily delirium and coma data (max 14 days, or until death or icu discharge) retrieved from the medical records, along with the participants' mortality, cognitive, and functional outcomes, which a blinded outcome assessor will assess at 48 hours, 14 days, 30 days, and 90 days after icu admission.


Eligibility criteria:
inclusion criteria of the second phase * participants who are 18 years old or older. * participants who receive oral endotracheal intubation with mechanical ventilation and are expected intubation greater than 48 hours. * participants are free from delirium or coma before icu admission. exclusion criteria of the second phase * participants who are placed on droplet or contact precautions (e.g., open tb, sars, covid-19 )

Keywords: delirium intensive care units intervention mortality mobility cognitive function stepped-wedge cluster randomized controlled trial
a 28-day clinical study on facial skin rejuvenation

Conditions: Wrinkle; Skin Laxity; Skin Manifestations; Skin

Summary: this clinical trial aims to learn about the efficacy of mlyaat-1002® (a proprietary anti-aging complex, mlyaat is short for "multi-layer anti-ageing technology" ) in female subjects who have newly received the rejuvenation treatment by comparing visual clinical scores, skin attributes measurement and image analysis.

the main expectation it aims to answer are: * after the 4-week continuous use of the test skin product with mlyaat-1002®, the skin aging problem is significantly improved compared with it of controlled product. * after the single use of the test skin product with mlyaat-1002®, the instant skin irritation after the fotona4d pro® treatment ( a nonablative fractional laser treatment for facial skin rejuvenation) is significantly lower compared with it of controlled product. * after the 4-week continuous use of the test skin product with mlyaat-1002®, the skin tewl (transepidermal water loss) is significantly recovered from the fotona4d pro® treatment compared with it of controlled product. and the skin tewl after the 4-week continuous use of test product is improved or not significantly worse than it before the fotona4d pro® treatment. * after the 4-week continuous use of the test skin product with mlyaat-1002®, no skin irritation symptom is worsen compared to it after the fotona4d pro® treatment.

Eligibility criteria:
inclusion criteria: * females aged 30-50 * no history of cosmetic allergies * according to skin aging atlas 2(asian type), the scores of under-eye wrinkles, pore appearance, forehead wrinkles are all \> 2 * non-sensitive skin * acceptable for split-face use of products for 28 days * no using history of antibiotic in the past three months * written informed consent and portrait right consent were obtained from all participants before study entry exclusion criteria: * subjects with known allergies or sensitivities to the ingredients in any of the study products * anyone who is pregnant, nursing an infant, or planning a pregnancy during the study * any symptoms of facial flushing, erythema, papules, desquamation, or edema as evaluated by a physician prior to initial screening or fotona4d pro treatment * unhealed skin lesions * participated in any other clinical trial within one month * received facial skin treatments including but not limited to lasers, chemical peels, dermal fillers within one year * taken/injected anti-allergy medication in the past one month * other medical reasons that could affect the test results * participants in other clinical trials at the same time
shear stress endothelial/hemodynamics in aortic dissection and endothelial shear stress-biological profile

Conditions: Aortic Dissection

Summary: aortic dissection (ad) is a clinical condition belonging to the broader spectrum of acute aortic syndromes, with high morbidity and mortality and characterised by the sudden formation of a breach within the tonaca intima of the aortic wall, from which the so-called false lumen originates.the most common risk factor for ad is hypertension, present in more than 70% of. imaging, biomarkers and genetic predisposition are critical in confirming a suspected diagnosis and in determining the appropriate intervention for each patient. specific features influencing management decisions are the presence of rupture, extent of dissection, origin of true or false lumen vessels and signs of organ ischaemia.

the aim of this study is to investigate the diagnostic value of circulating biomarkers and in aortic tissue in patients with ad and to assess the prognosis of patients with ad and its complications in relation to the aforementioned markers, integrating biological data with clinical and instrumental data relating to the patient's hospitalisation. the study involves a comparison between two arms, one experimental and the other control (healthy outpatients). a longitudinal evaluation will be carried out on the experimental arm with a follow-up visit (fup) at 3, 6 and 12 months.

Eligibility criteria:
inclusion criteria: * partecipants admitted to our department of cardiovascular sciences with a radiological diagnosis of ad within 14 days of the onset of symptoms; * healthy outpatient or inpatient controls at our department with another diagnosis and no evidence of ad, matched for demographic and clinical characteristics exclusion criteria: * evidence of inflammatory diseases, infectious diseases, neoplasms, immunological or haematological disorders; * treatment with anti-inflammatory drugs with the exception of low-dose aspirin (75-160 mg); * age \> 85 years; * advanced chronic kidney disease with glomerular filtration rate (egfr) estimated by mdrd equation \<30 ml/min./1.73 m2; 5) pregnancy; * dissection with traumatic aetiology; * failure to sign informed consent;

Keywords: hypertension vasospasm
effect of add-on montelukast to inhaled corticosteroids on airway responsiveness

Conditions: Asthma

Summary: leukotriene receptor antagonists appear to posses additive anti-inflammatory effects to the effect of inhaled corticosteroids. hypothesis: treatment with oral montelukast will lower the dose-response plateau to inhaled methacholine in patients with mild to moderate persistent asthma treated with a stable dose of inhaled corticosteroids.


Eligibility criteria:
inclusion criteria: * non-smoking adults with mild to moderate persistent asthma: * fev1 \> 70 % pred * pd20 methacholine \< 3.9 mmol * treated for at least 3 months with a stable dose of inhaled corticosteroids * documented dose-response plateau to inhaled methacholine on two occasions * males and non-pregnant females exclusion criteria: * asthma medication other than inhaled corticosteroids and inhaled b2-agonists * viral respiratory tract infections within the 3 weeks prior to enrollment

Keywords: asthma airway responsiveness dose-response plateau montelukast add-on to inhaled corticosteroids
effectiveness of es and mt vs es and pnf technique among bells palsy patients

Conditions: Bell Palsy

Summary: to determine the effectiveness of electrical stimulation with mime therapy versus electrical stimulation with pnf technique for improving strength \& restoring lost motor function in the patients of bell's palsy


Eligibility criteria:
inclusion criteria: * • acute, unilateral, lower motor neuron bells palsy patient with house-backmann scale 4 * acute onset 1-3 weeks * age group 20-40 years * who were are willing to be a part of the study * patients with the bell's palsy (facial paralysis , idiopathic facial paralysis and the herpetic facial paralysis) exclusion criteria: * • patient who had the autoimmune disorder, tumors, recent head injury * the subject long with the surgery for ear and the fascial nerve palsy * metal dental implants, and pregnant women * the patient with any peripheral vascular diseases * central fascial palsy
extrapulmonary interventional ventilatory support in severe acute respiratory distress syndrome (ards)

Conditions: Acute Respiratory Distress Syndrome

Summary: a prospective, randomized study will be performed investigating the effects of a pumpless extracorporeal interventional lung assist \[ila\] on the implementation of a lung-protective ventilatory strategy in patients with acute respiratory distress syndrome \[ards\] with a pao2/fio2 ratio \< 200. the duration of ventilation, intensive care and hospital stay and in-hospital mortality will be investigated.

evaluation group: implantation of the ila - adaptation of the ventilation strategy, explantation of the ila after corresponding improvement (see treatment plan for details) - weaning from the ventilation and extubation according to specified criteria. control group: ventilation strategy based on the concept of lung-protective ventilation without extracorporeal support, weaning from the ventilation and extubation according to specified criteria (see treatment plan for details).

Eligibility criteria:
inclusion criteria: * the trial subjects are patients aged 18 years or older who have developed severe ards. following the american-european consensus conference on ards, severe ards is defined as an oxygenation index (pao2/fio2) \< 200 mmhg. these parameters must be present for a duration of at least 2 hours. exclusion criteria: * age \< 18 years * decompensated heart insufficiency * acute coronary syndrome * severe chronic obstructive pulmonary disease * advanced tumour conditions with life expectancy \< 6 months * chronic dialysis treatment * lung transplant patients * proven heparin-induced thrombocytopenia (hit) * morbid obesity (bmi \>) 40 * child class b and c cirrhosis of the liver, acute fulminant hepatic failure * severe peripheral arterial occlusive disease (pavk iii - iv), absence of limb doppler pulse * brain injury (gcs \< 9 + ct pathology)

Keywords: acute respiratory distress syndrome extracorporeal lung support hypoxia hypercapnia acute respiratory distress syndrome (ards)
assessment of peripheral gaba receptors for local pain relief

Conditions: Pain

Summary: the effect of peripheral gabaa receptor activation on pain and sensitivity in healthy human subjects has never been investigated. however, as earlier studies suggest that activation of peripheral gabaa receptors is anti-nociceptive in rats, it is important to determine if these findings can be translated into human subjects to determine if peripheral gabaa receptors are a viable target for future analgesic drug development.

subproject i this study will test if oral administration of gaba containing solutions will reduce the pain and sensitivity induced by application of capsaicin to the tongue of healthy human subjects. thirty, pain-free men (n=15) and women (n=15) for the oral cavity study. subproject ii this study will test the hypothesis that intramuscular injection of gaba alone will not be painful, but will reduce muscle pain sensitivity in healthy human subjects. thirty, pain-free men (n=15) and women (n=15) will be recruited for the intramuscular gaba injection studies subproject iii this study will test the hypothesis that intramuscular injection of gaba with glutamate will decrease the intensity of glutamate-evoked muscle pain in healthy human subjects. thirty, pain-free men (n=15) and women (n=15) will be recruited for the intramuscular glutamate and gaba injection studies.

Eligibility criteria:
inclusion criteria: * aged 20-40 years * free from ongoing or chronic pain * adequate conversational english exclusion criteria: * pregnancy or intent to become pregnant, breast feeding * signs or symptoms of any serious systemic diseases * current malignancies * high blood pressure * requirement for chronic administration of psychiatric, analgesic or other medications that might influence their response to pain * frequent recreational drug or alcohol use * previous neurologic, musculoskeletal or mental illnesses * lack of ability to cooperate

Keywords: craniofacial pain masticatory muscle burning mouth syndrome temporomandibular disorders
differential regulation of raas-axis in patients undergoing cardiac surgery

Conditions: Vasoplegia; Vasoplegic Shock

Summary: this study investigates the question of whether there are differences in the plasma concentration of hormones of the raas-axis between patients undergoing on-pump cardiac surgery and those receiving off-pump surgery

in patients undergoing cardiac surgery, the occurrence of vasoplegia or vasoplegic shock is a common and sometimes very severe complication. although there are multiple factors that may affect the incidence and severity of vasoplegia, it remains unclear which role the use of cardiopulmonary bypass may play in the pathogenesis of this complication. the heart normally pumps blood through the lungs where the blood primarily gets oxygenated. however, it is also known that pulmonary blood flow is also essential for the activation of various hormones, some of which are central to the regulation of vascular tension and blood pressure. if the pulmonary circulation is bypassed, as is the case in on-pump cardiac surgery, it is likely that the resulting differential activity of hormones may cause or contribute to the incidence of vasoplegia. this study aims to show whether cardiopulmonary bypass leads to the differential regulation of hormones of the renin-angiotensin-aldosterone-system which could explain why some patients suffer from vasoplegia or vasoplegic shock following such procedures.

Eligibility criteria:
inclusion criteria: 1. adult patients undergoing on- or off-pump coronary artery bypass graft surgery 2. written informed consent exclusion criteria: 1. emergency surgery in the context of acute coronary syndrome 2. ace-inhibitor or angiotensin 1 (at1)-receptor-blocker intake that was not paused on the day of surgery 3. chronic kidney disease with estimated glomerular filtration rate (egfr)\<30ml/min/1.73m² 4. severe structural lung disease (asbestosis, silicosis, severe sarcoidosis, tuberculosis, severe emphysema, chronic obstructive pulmonary disease (copd) gold 3-4, lung fibrosis) 5. chronic pulmonary hypertension 6. pregnancy or breastfeeding 7. persons with any kind of dependency on the investigator or employed by the institution responsible or investigator 8. persons held in an institution by legal or official order

Keywords: vasoplegia vasoplegic shock cardiopulmonary bypass cardiac surgery
comparative study of two radiological modalities, ultrasonography versus stress radiography, in the urgent care and prognosis of lateral ankle sprain (talos)

Conditions: Lateral Ankle Sprain

Summary: the aim of our study is to determine the most efficient radiologic examination to assess the ankle sprain seriousness and so improve the therapeutic care.

the lateral ankle sprain is the most frequent purpose of consultation in emergency traumatology of the locomotive system. if the ankle sprain is neglected or badly cared, it can induce a recurrence or several complications particularly functional ones. so a gravity diagnosis is necessary in order to choose the most accurate treatment. considering the difficulty of the clinical estimation, additional examinations aim to support the positive diagnosis, to clarify the gravity and to dismiss differential diagnosis. thus we suggest to evaluate three strategies in order to get a gravity diagnosis, make a better choice of treatment and so decrease the long-term functional complications : instability and recurrence. the patients are randomly separated into three groups of 130 people. all the patients have a radiography and then, according to their group, they have either an ultrasonography or an ultrasonography and a stress radiography or only a stress radiography. the patients are followed up during two years by sending two questionnaires (cait and lefs) at one and two years. the functional scores of these questionnaires assess and compare the functional complications for each group. thus the radiologic examinations can be assessed in term of prognosis.

Eligibility criteria:
inclusion criteria: * lateral ankle sprain. * sprain occurred for less than 48 hours. * age between 18 and 55. * person affiliated at the social security. exclusion criteria: * recurrent lateral ankle sprain occurred for less than 2 years and diagnosed by a doctor. * bilateral sprain, medio-tarsal sprain, syndesmosis sprain, subtalar sprain. * tendinous luxation (fibular, posterior tibial). * homolateral ankle fracture occurred for less than 2 years. * cuboid fracture, external tubercle of astragalus fracture, calcaneum fracture, fracture of the talus extremity, base of the fifth metatarsal bone fracture. * tearing of internal malleolus, tearing of astragalus posterior tubercle. * osteochondral lesions of the astragalus dome. * probable difficulty to follow up the patient. * patient taking anticoagulant. * pregnant woman, parturient, breast-feeding mother. * person deprived of freedom after a judicial or an administrative decision, person with legal protection measure.

Keywords: ankle diagnosis sprain care injury stress radiography ultrasonography
study of immune deficiency patients treated with subcutaneous immunoglobulin (igpro20, hizentra®) on weekly and biweekly schedules

Conditions: Primary Immune Deficiency; Secondary Immune Deficiency

Summary: the purpose of the study is to assess the impact of immunoglobulin treatment by subcutaneous injections every 2 weeks (biweekly) on a cohort of patients with primary and secondary immune deficiencies. the full study will consist of safety, efficacy and quality of life (qol) evaluations and a pharmacokinetic (pk) sub-study. the primary objectives of the study are to determine tolerability and safety of biweekly igpro20 injection regimen and to compare pk outcomes on weekly and biweekly igpro20 therapy. patients who have received and/or are currently receiving immunoglobulin g (igg) in intravenous (ivig), or subcutaneous (scig) infusions are eligible for inclusion if they meet inclusion/exclusion criteria. the study consists of two parts. in part 1 of the study enrolled subjects will receive igpro20 weekly for either 12 weeks (for patients on scig infusion prior to the study) or 24 weeks (for patients on ivig infusion prior to the study). part 2 will consist of a biweekly treatment with igpro20 for 52 weeks, for both groups. additionally, study subjects meeting inclusion criteria for the pk sub-study will undergo a pk sample collection for 1 week and 2 weeks in study parts 1 and 2, respectively.


Eligibility criteria:
inclusion criteria: full study: * female or male patients with primary or secondary immunodeficiency, aged from 5 to 64 years, receiving steady state immunoglobulin g replacement therapy. pharmacokinetic sub-study: * female or male patients with primary immunodeficiency, aged between 12 and 64 years of age, on steady-state igpro20 replacement therapy and willing to undergo pharmacokinetic sample collection on weekly and biweekly igpro20 dosing regimens. exclusion criteria: * patients with protein losing conditions such as: lymphangiectasis, nephrosis, status post cardio-thoracic surgery requiring drainage tubes for more than 48 hours, protein-losing enteropathy. * concomitant treatment with plasma or other blood products (including any iggs other than igpro20 \[hizentra\]) within 21 days before study entry and/or during the study. * any other condition or treatment that, in the opinion of the investigator, would interfere with obtaining valid results for that subject. * women of childbearing potential with a positive pregnancy test. * active infection at the time of screening.
rectal misoprostol in women undergoing total abdominal hysterectomy for intraoperative blood loss reduction

Conditions: Intraoperative Blood Loss

Summary: comparing of the intraoperative blood loss between group rectal misoprostol group and control group

this open-labeled randomized controlled trial was conducted at the department of obstetrics and gynecology, queen savang vadhana memorial hospital, chonburi, thailand, from february 2022 to september 2022, after approval of the institution of review board of queen savang vadhana memorial hospital (irb no. 001/2565). fifty six (56) women with diagnosis of benign uterine disease who were scheduled to perform total abdominal hysterectomy with or without bilateral salpingo-oophorectomy between february 2022 to september 2022 at queen savang vadhana memorial hospital were enrolled in this study. the participants were randomly allocated into two groups, study and control group. the randomization list was kept in a sealed opaque envelope. study group received two tablets of 200 mcg misoprostol; the drug was inserted rectally 1 hour before operation. few drops of normal saline were used to dissolve tablets before insertion. control group that did not receive the drug. the drug was administered by a nurse at gynecologic ward. the primary outcome was intraoperative blood loss that recorded by measuring amount of blood on the surgical gauzes and swabs by standardized scales and another was recorded from blood in suction container. the secondary outcome was hemoglobin differentiation, rate of blood transfusion and adverse events of misoprostol usage.

Eligibility criteria:
inclusion criteria: female undergoing total abdominal hysterectomy (elective case) with * no history of bleeding tendency * no history of anticoagulant drug used within 7 days before surgery * no contraindications of misoprostol drug used * no history of allergic to misoprostol exclusion criteria: * can not communicate with thai language * malignancy case * emergency case