Kornimate/medical-research-clean huggingface dataset:
perioperative risk factors for postoperative delirium in children

Conditions: Delirium, Postoperative

Summary: despite recent advances in postoperative delirium research, the proportion of children with postoperative delirium is still high. although postoperative delirium is a frequent complication and is associated with the need for more inpatient hospital care and longer length of hospital stay, little is known about risk factors for recovery room delirium (rrd) occurred in postanaesthesia care unit. the aim of the study was to determine pre- and intraoperative risk factors for the development of rrd among children undergoing non cardiovascular surgery.

recovery room delirium (rrd) defined as delirium occurred in pacu was diagnosed according to rass-paeds criteria. pre-, intra-, and postoperative data of patients undergoing elective non cardiovascular surgery were prospectively collected, univariate and multivariate logistic regression were performed to find the risk factors related to postoperative delirium.

Eligibility criteria:
inclusion criteria: * between 3 to 12 years old * elective non-cardiovascular surgery * general anesthesia exclusion criteria: * under regional anaesthesia * instable vital sign * without consent form * underwent neurosurgery * history of primary neurologic diseases * stayed less than 10min in pacu * received general anaesthesia but recovered in locations outside the recovery room

Keywords: delirium postoperative non-cardiovascular surgery post-anaesthesia care unit patients between 3 to 12 years old undergoing selective non-cardiac surgery under general anesthesia surgery general anesthesia
performance of junctional tourniquets in normal human volunteers

Conditions: Hemorrhage

Summary: normal human adult volunteers wereused to investigate the performance of medical devices intended to stop junctional bleeding on the battlefield.

four fda-cleared junctional tourniquets (combat ready clamp (croc), abdominal aortic and junctional tourniquet (aajt), junctional emergency treatment tool (jett), and sam junctional tourniquet (sjt)) wereassessed in a laboratory on healthy human volunteers. lower extremity pulses were measured in 10 volunteers before and after junctional tourniquet application aimed at stopping the distal pulse assessed by doppler auscultation. tourniquets were applied in a randomized fashion, with 5 min rest periods between each application. each tourniquet was applied to each subject, such that the subjects acted as their own controls.

Eligibility criteria:
inclusion criteria: * adult human volunteers who are recruited, screened, and consent to participate * ages at least 18 years old to no more than 60 years old (\<61) on the date of consent * male or female * a worker for the us military or us government (active duty military, civilian employees, contractors) exclusion criteria: * active-duty military subjects without their supervisor's permission to participate * detainees or prisoners * evidence of major disease of an artery (e.g., artery or vein surgery, atherosclerotic disease diagnosis, stroke, peripheral vascular disease or dysfunction such as reynaud's phenomenon, migraine headaches, or cardiovascular disease \[uncontrolled hypertension, heart attack, or arrhythmias\]), active abdominal, inguinal, gluteal, or thigh disease, major deformity, or hernias * pregnancy * contracted employees to the us military or us government without contractual permission to participate in the research
fecal microbiota transplantation (fmt) in the management of active crohn's disease

Conditions: Crohn's Disease

Summary: manipulation of the intestinal microbiota through fmt is a potential therapeutic target for cd patients. studies are now required to determine if repeated fmt can overcome the apparent immune response to fmt thereby maintaining sustained clinical improvement and remission. prior to a large randomized controlled trial of fmt in cd we will carry out a feasibility study to determine if serial fmts can sustain a clinical response and maintain stability of transplanted microbiota.

participants receive fmt by colonoscopy at weeks 0, 4, 8 and by enema at weeks 2 and 6. assessments include hbi score, ses-cd score, and serum crp levels.

Eligibility criteria:
inclusion criteria: 1. age \> 18 and \< 65 years at the time of screening 2. diagnosis of ileo-colonic or colonic cd for \> 3 months but \< 5 years prior to screening as determined by the investigators 3. those with mild to moderate cd 4. those who have failed maintenance therapy with stable doses of 5-asa, azathioprine, 6 mercaptopurine (6-mp) or methotrexate for \> 3 months 5. where applicable, those who are taking the following medications must be at a stable dose defined as: i) 5-asa must be at a stable dose for 2 weeks ii) prednisone up to 20 mg/d must be at a stable dose for 2 weeks iii) budesonide up to 6 mg/d must be at a stable dose for 2 weeks iv) azathioprine, 6-mp, and methotrexate must be at a stable dose for \> 8 weeks 6. ability to provide informed consent 7. evidence of active colonic inflammation exclusion criteria: 1. those with prior ileo-cecal resection 2. those who are pregnancy or plan to be pregnant during the trial 3. those who are breastfeeding or plan to breast feed during the trial 4. those who are on or have previously failed a biological agent 5. those who have active perianal disease as determined by investigators 6. those with an active infection requiring antibiotic therapy 7. those with positive stool cultures for known pathogens such as e coli, salmonella, shigella, yersinia, campylobacter, and clostridium difficile toxin within 2 weeks of enrollment 8. those with positive cmv on colonic tissue biopsy within 2 weeks of screening 9. those with allergy to ciprofloxacin and metronidazole
pre hospital evaluation of video laryngoscopy

Conditions: Cardiac Arrest; Respiratory Distress Syndrome; Shock; Acute Post-trauma Stress State; Drug Toxicity; Trauma, Nervous System

Summary: the objective of this work is to compare standard intubation with video laryngoscope (glide scope ranger ) in french pre hospital multicentric study.

introduction: in france, patients in critical status brought to hospital by emergency physicians and nurses experimented in tracheal intubation. it is an invasive act allowing a protection of airways and an optimal oxygenation of the patients in distress. the reference technique is the direct laryngoscopy by macintosh . corresponding data shows that a video laryngoscope - glidescope laryngoscope - improve the conditions of intubation in the surgical unit thanks to a better display(visualization) of the opening. a derived device for pre hospital emergency units (glidescope ranger®) deserves to be compared with the classic laryngoscopy in emergency conditions. objectives: compare the emergency intubation in pre hospital meadow by glide scope ranger with regard to the classic method progress of the study: the patients will be included by emergency physicians working in out of hospital teams of 3 major hospitals of paris. the patients will be randomized in 2 groups: 1 group classic laryngoscopy (group 1) and a group glide scope ranger (group 2). the score ids will be compared for every group as well as the arisen of a complication during the procedure. the consent will be collected on the place or during the hospitalization.

Eligibility criteria:
inclusion criteria: * patients of more than 18 years old * requiring an intubation * by medical out of hospital emergency operators * medical insurance * consent signed exclusion criteria: * age \<18, pregnant women * refusal of consent or inability for understanding study * small mouth opening makes it impossible intubate

Keywords: emergency intubation glide scope ranger pre hospital
transurethral resection of bladder tumor (turbt) combined with adjuvant intravenous gc chemotherapy for non-muscle-invasive bladder cancer

Conditions: Bladder Cancer; Gemcitabine and Cisplatin Chemotherapy; Epirubicin Instillation; Recurrence; Prognosis

Summary: it is still a challenge for urologic surgeon to prevent the post transurethral resection of bladder tumor (turbt) recurrence of moderate-high risk non-muscle invasive bladder tumor. adjuvant chemotherapy is a standard treatment for local progressive bladder tumor, which contains mainstream gc treatment scheme. it is common to observe clinically moderate-high risk nmibc recurrence after routine intravesical instillation.systematic chemotherapy can eliminate remained tumor cells especially those from mucosa basal cells so as to improve the prognosis of patients. our clinical trial aims to investigate whether the utilization of combination of gc treatment scheme and epirubicin instillation would decrease the recurrence of moderate-high risk nmibc.

prevention of the post-transurethral resection of bladder tumor (turbt) recurrence of moderate-high risk non-muscle invasive bladder cancer(nmibc) is still a difficult problem. nmibc was classified as low, moderate and high risk patients. moderate-high risk nmibc contained those are multiple, recurrent, ii-iii grade, tumor diameter \>3cm, invasive to submucosa and associated with carcinoma in situ. for those patients, no matter which treatment was conducted, for example, exchanging instillation drugs, increasing medicine dose, appending adjuvant drugs and prolonging instillation time, would not improve the prognosis of these patients. adjuvant chemotherapy is a standard treatment for local progressive bladder tumor, which contains mainstream gc treatment scheme. for muscle invasive bladder cancer patients, radical cystectomy with neoadjuvant chemotherapy will improve patients' tumor grade and increase overall survival and disease specific survival rate.systematic chemotherapy can eliminate remained tumor cells especially those from mucosa basal cells so as to improve the prognosis of patients. our clinical trial aims to investigate whether the utilization of combination of gc treatment scheme and epirubicin instillation would decrease the recurrence of moderate-high risk nmibc. in addition, we also would like to investigate the improvement of life quality after turbt of moderate-high risk nmibc.

Eligibility criteria:
inclusion criteria: 1. moderate-high risk non-muscle invasive bladder cancer patients: multiple,recurrent, ii-iii grade, tumor diameter\>3cm, invasive to submucosa, associated with carcinoma in situ. 2. normal liver and renal function. exclusion criteria: 1. liver and renal function deficiency (gfr\ 1.5\*normal), lung function deficiency, heart failure, acute myocardial infarction, severe infection and trauma, major surgery and clinical hypotension and anaerobic conditions. 2. attending other drug experiments. 3. performance status, zubrod-ecog-who, zps≥2. 4. pregnant. 5. bone marrow transplantation, severe leukopenia, associated with severe infection or injury.
phenotypic and genotypic characterization of escherichia coli

Conditions: Antibiotic Sensitivity Testing and Genotypic Caharacterization of Ecoli

Summary: collection of urine samples cultivation antibiotic sensitivity test pcr

cultivation on macconkey and emb imvc test dis diffusion test detection of virulence and antibiotic resistance genes by pcr

Eligibility criteria:
inclusion criteria: - catheter associated urinary tract infections in patient with catheter more than two 2 days .fever.urine culture with no more than 2 species organisation catheterization .fever.suprapubic tenderness with urine culture more than 105 cfu/ml exclusion criteria: * asymptomatic bacteriuria uti before 48 hrs
comparison of the isotonic and hypotonic intravenous maintenance fluids in term newborns: neofluid study

Conditions: Newborn Complication; Hyponatremia of Newborn; Hypernatremia of Newborn; Fluid Therapy; Sodium Chloride; Isotonic Dehydration

Summary: considering the physiological changes in fluid and electrolyte balance and providing proper support are one of the important aspects of neonatal intensive care. maintenance intravenous fluids are designed to maintain homeostasis when a patient is unable to uptake required water, electrolytes, and energy. hypotonic fluids are still the most commonly prescribed iv fluids for pediatric hospitalized patients. however, previous studies, including children older than one month of age revealed that traditionally used hypotonic fluids may lead to hyponatremia. because of the absence of evidence-based data, there is currently no clear consensus on the optimal composition of maintenance intravenous fluid therapy in newborns, leading to wide practice variation. the national clinical guideline center (nice) 2015 recommends the use of isotonic fluids in term newborn infants and some newborn centers has begun to use isotonic fluids since guidelines recommendations. since the publication of the nice guideline, no studies have addressed this topic. in this prospective, observational , multicentric study, conventional hypotonic fluids containing sodium chloride (nacl) \< 130 mmol/l compared with isotonic fluids (containing nacl between 131-154 mmol/l) in terms of the risk of hyponatremia, hypernatremia, plasma sodium (pna) level change, treatment morbidities, hospitalization duration and mortality.


Eligibility criteria:
inclusion criteria are: * term newborns (\>37 + 0/7 weeks) aged 24 hours to 30 days with a normal baseline serum sodium level between 135-145 mmol/l,with a treatment plan to include iv fluids at \> 50% of maintenance * infants not received parenteral fluids in the last 24 hours before participation * infants receiving iv fluid administration at 50% to 100% of maintenance exclusion criteria: * newborns with diagnoses that required specific fluid tonicity and volumes such as: * severe dehydration presenting with shock * syndrome of inappropriate antidiuretic hormone secretion (siadh) * renal insufficiency * adrenal insufficiency * diabetes mellitus and diabetes insipidus * hypoxic ischemic encephalopathy * major congenital anomaly * patients receiving diuretic therapy * patients with obvious edema * heart or liver failure, portal hypertension with acid * pre-post operative patients * infants receiving total parenteral nutritional therapy * other: all conditions that require non-standard liquid content and quantities

Keywords: newborn, fluid therapy, isotonic, hypotonic,nacl
weight change and the risk of chronic pain following hip and knee arthroplasties

Conditions: Persistent Postsurgical Pain; Arthritis Knee; Arthropathy of Knee; Arthropathy of Hip; Weight Loss; Weight Gain; Obesity

Summary: the study is a nationwide, register-based cohort survey study. the objective of this study is to investigate whether weight change is associated with the incidence of persistent postoperative pain following total hip arthroplasty and knee arthroplasty across non-obese and obese and patients.


Eligibility criteria:
inclusion criteria: - patients operated with primary hip or knee arthroplasty for osteoarthritis 11-15 months before survey distribution exclusion criteria: * legally incompetent citizens, i.e., persons with a legal guardian, will not be asked to participate.
comparative effectiveness of dementia care strategies in underserved communities

Conditions: Dementia

Summary: dementia is a condition that is growing in prevalence and which harms not only the afflicted individual but also adversely affects the health of their family and other informal caregivers. new methods for delivering comprehensive assistance to persons with dementia and their caregivers are known to be effective and can delay nursing home placement, but this study will discover 1) whether more face-to-face involvement rather than telephone delivery of this assistance will work better among poor patients in los angeles, and 2) if one method is better than the other, what are the differences in costs between them. these data will enable administrators in public health care settings around the us and non-profit foundations addressing dementia patient and caregiver needs to decide what method provides the best value and the best outcome relative to its cost.


Eligibility criteria:
inclusion criteria: * caregivers of persons with dementia * caregivers must either live with the care recipient (person with dementia) or be the identified primary support * caregiver relationship must have been present for the prior 6 months * caregivers must have telephone access * caregivers must speak english or spanish * care recipients must have a prior dementia diagnosis * care recipients must be living in the community other than a nursing facility exclusion criteria: * persons with dementia, lacking an informal caregiver who can communicate in spanish or english, or living in a long term care facility * caregiver lacks the capacity to consent to study participation

Keywords: caregivers comparative effectiveness research cost effectiveness patient care management social work
exploration of blood biomarkers, including whole blood viscosity as a prognostic factor for acute pancreatitis

Conditions: Acute Pancreatitis

Summary: this study aims to evaluate the usefulness of blood viscosity as a prognostic factor in patients with acute pancreatitis. the study design is a single-arm prospective cohort observational study. blood biomarkers including blood viscosity, c-reactive protein, hematocrit, and phosphate are measured and the correlation with the severity of acute pancreatitis will be analyzed.

several scoring systems are used to evaluate the prognosis of acute pancreatitis, but they are rather complicated and clinically less useful. blood viscosity is associated with hematocrit and inflammatory factors known to be related to the prognosis of acute pancreatitis, and our group's previous study which is not yet published showed that blood viscosity better predicts severe acute pancreatitis than other single factors such as c-reative protein. therefore, this study aims to prospectively evaluate the usefulness of blood viscosity as a prognostic factor for acute pancreatitis. during the study period, the study is conducted on patients with acute pancreatitis between the ages of 19 and 70, and patients with acute pancreatitis after ercp are excluded. blood viscosities at initial and 24 hours after hospitalization, and serum phosphate, which have shown potential as a predictor of severity in post-ercp pancreatitis in previous studies are measured. the association of these blood biomarkers with the severity of acute pancreatitis will be analyzed and compared with hematocrit, c-reactive protein, etc., which are known as a single prognostic predictor of acute pancreatitis.

Eligibility criteria:
inclusion criteria: * age 19-70 years old * acute pancreatitis exclusion criteria: * post-endoscopic retrograde cholangiopancreatography (ercp) pancreatitis
the nordsten studies/ the spinal stenosis study

Conditions: Lumbar Spinal Stenosis

Summary: lumbar spinal stenosis (lss) is a clinical entity were narrowing of the spinal canal gives a compression of the the neural and vascular structures in the spinal canal. this often gives neurogenic claudication and sometimes severe low back pain (lbp). surgery for lss is today the most often performed procedure in the adult lumbar spine. beneficial effect of surgical treatment is well documented by several clinical trials, and a cochrane review article from 2005 concludes that surgical treatment is superior to non-surgical treatment. the surgical solution is to decompress the stenotic part of the lumbar spine. there is no consensus in the literature of which surgical method that gives best long term clinical results. the investigators are therefore planning a randomized controlled trial, where they will compare clinical and radiological results of three different surgical methods for lss. the main outcome of this study is to answer which surgical method that gives the best long term clinical results. and, secondary outcome is to find out how much increase of the dural sac cross sectional area is needed to give a long time relief of the patients' symptoms.


Eligibility criteria:
inclusion criteria: * have clinical symptoms of spinal stenosis as neurogenic claudication or radiating pain into the bilaterally to the lower limbs, not responding to at least 3 months of conservative treatment. * radiological findings corresponding to the clinical symptoms of lss. central -stenosis, or lateral recess-stenosis. * be able to give informed consent and to answer the questionnaires. * over 18 years of age-have -not responding to at least 3 months of non-surgical treatment. * be able to understand norwegian language, spoken and in writing exclusion criteria: * have a degenerative lumbar spondylolisthesis, with a slip ≥ 3 mm verified on standing plain x-rays in lateral view. * are not willing to give written consent. * have former surgery in the level of stenosis. * fracture, or former fusion of the thoracolumbal region. * cauda equina syndrome (bowel or bladder dysfunction) or fixed complete motor deficit. * are asa- classified 4 or 5. * are older than 80 years * have a lumbosacral scoliosis more than 20 degrees verified on ap-view * have distinct symptoms in one or both of their legs due to other diseases, e.g. polyneuropaty, vascular claudication or osteoarthtris. * lss in 4 or more levels. * not able to comply fully with the protocol, including treatment, follow-up or study procedures (psychosocially, mentally and physical). * the patient is participating in another clinical trial that may interfere with this trial

Keywords: lumbar spinal stenosis surgical treatment of lss.
determination of the clinical impact of continuous surveillance monitoring (sm) and utility of ipi.

Conditions: Respiratory Depression; Respiratory Insufficiency

Summary: single site prospective observational nested study of bedside cs20p monitor on the gcf impeded into a retrospective review of the frequency of escalation of care with intermittent vitals signs compared to continuous respiratory monitoring.

single site observational study of alarms and workflow on the general care floor where continuous surveillance monitoring (sm) with capnography and pulse oximetry is the standard of care before and after the integrated pulmonary index is enabled within the context of a historical review of frequency of escalation of care as a function of the frequency and method of monitoring respiratory status. observation of alarms will be electronically recorded on a clinical observation tool (cot or ipad) that will have a virtual view of the cs20p measurements and alarm alerts for 24 hours on several patients at the same time. patients will only be enrolled for 24 hours of observation of alarm status with associated patient activity and clinical interventions. observation data with ipi disabled prior to implementation of ipi/ipi alarms will be used to evaluate optimal alarm alert settings including an ipi alert when enabled. observation will continue with ipi enabled and alarms adjusted to study clinical utility of ipi on the gcf.

Eligibility criteria:
inclusion criteria: 1. spontaneous breathing adults ≥ 18 years of age, both male and female 2. on dual parameter cs20p monitoring with both capnography and pulse oximetry per vanderbilt standard of care to monitor patients for respiratory compromise. 3. expected minimum duration of 24 hours of continued capnography and pulse oximetry monitoring. exclusion criteria: 1. those patients who are expected to be discharged within six hours on the randomly selected observation floor. 2. those patients not on the randomly selected floor for observation. 3. those subjects randomly removed from the selected floor for observation pool in order to limit the number of subjects to be observed. 4. those subjects in rooms with limited wi-fi signal quality as per vumc it.

Keywords: respiratory compromise