Kornimate/medical-research-clean huggingface dataset:
cotrifazid safety and efficacy against malaria

Conditions: Clinical Malaria

Summary: the purpose of this study was to assess the safety and efficacy of cotrifazid to treat uncomplicated resistant malaria and to compare the outcome with mefloquine or quinine+sulfadoxine/pyrimethamine (sp)

design: open-label, block-randomised, comparative, multicentric trial. setting: four primary care health facilities, two in urban and two in rural areas of madang and east sepik province, papua new guinea. participants: patients of all ages with recurrent uncomplicated malaria intervention: random assignment to receive either cotrifazid, mefloquine or the standard treatment of quinine+sulfadoxine/pyrimethamine (sp). outcome measures: incidence of clinical and laboratory adverse events; rate of clinical and/or parasitological failure at day 14

Eligibility criteria:
inclusion criteria: all subjects \> 6 months of age who presented at the centres and who were diagnosed with malaria (history of fever, optimal® test positive, no other major symptom) and who had already been treated for malaria in the 28 days before, could be included in the study, if the subject or legal guardian (for children) gave informed consent and if the clinician in charge would have given the standard treatment for resistant malaria independent of the study - exclusion criteria: a subject was not to be included if the clinician preferred to use quinine for whatever reason, if the patient had one of the symptoms or signs of complicated or severe malaria (i.e. history of recent convulsion, any neurological sign or impairment of consciousness, heavy vomiting, haemoglobinuria, respiratory distress, bleeding, circulatory collapse, shock, jaundice, haemoglobin \< 5 g/dl), had contra-indications for mefloquine (history of psychiatric disorder, epilepsy), or was pregnant. -

Keywords: malaria treatment cotrifazid clinical trial efficacy
the neuroprotective effects of dexmedetomidine during brain surgery

Conditions: Brain Tumor; Cerebrovascular Disorders

Summary: dexmedetomidine (dex) is a alpha-2 specific agonist, is a common icu sedation medication. in brain tumor resection craniotomy, it is proven to be effective in improving postoperative hypertension and tachycardia, mitigates postoperative nausea and vomiting and relives postoperative pain. in addition, many animal experiments show that dex inhibits the proapoptosis in the mitochondrial in vivo and therefore avoids neuronal injury. it is also reported to be neuroprotective to isoflurane-induced neurotoxicity and to improve cerebral focal ischemic region (penumbra). however, the neuroprotective effects were never investigated clinically in patients undergoing brain tumor resection surgery.


Eligibility criteria:
inclusion criteria: * patients undergoing elective craniotomy for supratentorial brain tumor resection or cerebral vascular surgery * age between 20 to 80 yr exclusion criteria: * fever, elevated white blood cell or c-reactive protein * impaired liver function, eg. ast or alt \>100; liver cirrhosis \> child b class * impaired renal function, cgfr\< 60 ml/min/1.73 m2 * cardiac dysfunction, such as heart failure \> nyha class ii
development of visual function evaluation method (2)

Conditions: Retinitis Pigmentosa

Summary: the objective of this study is to develop the comprehensive visual function evaluation method in severe visually impaired patient.


Eligibility criteria:
inclusion criteria: * subjects with severe visual disturbance (count-fingers or worse vision for severe eyes) at the time of obtaining the consent and at screening exclusion criteria: * subjects should not have participated in any other clinical trial or clinical study involving visual function evaluation within 6 months * history of surgery, past history, and complications (cardiac/ hepatic/ renal/ respiratory/ hematological diseases, optic nerve diseases causing marked loss of visual field, and uveitis etc.) that potentially affect evaluation and safety of the study * pregnant women * subjects who are judged that continuation of the study is difficult during the study period * subjects who are employed by the company sponsoring this study, an organization or institution related to this study

Keywords: retinitis pigmentosa visual function evaluation
holmium laser uretherotomy in combination with intralesional steroids in bulbar uretheral stricture

Conditions: Urethral Stricture

Summary: the purpose is to evaluate the outcome of visual internal uretherotomy with holmium laser along with intralesional steroid injection.

in this study, the investigator evaluates the efficacy of holmium laser in combination with intra lesional steroid injection in the treatment of bulbar urethral strictures

Eligibility criteria:
inclusion criteria: 1. presence of obstructive symptoms, 2. short segment strictures (stricture length \<2 cm) as evident on radiological studies, i.e. retrograde urethrography and micturating cystourethrography. 3. peak flow rate on uroflowmetry less than 15 ml/s exclusion criteria: 1. complete obliteration of lumen of urethra on urethroscopy, 2. balanitis xerotica obliterans, 3. age less than 18 years, 4. multiple strictures, 5. active urinary tract infection, 6. recurrent strictures. 7. prior internal uretherotomy 8. prior urethroplasty 9. pan-anterior urethral strictures 10. posterior stenosis 11. those who lost to follow up
correlation between genetic variants and long-term cardiac effects induced by doxorubicin in breast cancer patients

Conditions: Breast Cancer

Summary: the purpose of this study is to identify the genetic variants that are associated with higher risk of doxorubicin-induced cardiotoxicity can contribute towards developing a predictive algorithm comprising both clinical and genetic factors to select patients who should avoid treatment with anthracyclines. hypothesis of this study is certain functional variants in genes that encode for metabolizing enzymes and/or targets in the doxorubicin pharmacology pathway may increase the risk of doxorubicin-induced cardiomyopathy

doxorubicin is one of the cornerstone therapies in adjuvant chemotherapy in early stage breast cancer. cumulative doses of 240mg/m2 (4 cycles of doxorubicin/cyclophosphamide) and 300mg/m2 (6 cycles of doxorubicin/cyclophosphamide) are typically administered in the adjuvant setting, which is associated with \<1% chance of severe cardiotoxicity, and are thus considered 'safe dose ranges'. however, blanco et al recently reported childhood cancer survivors with the cbr3 (a metabolizing enzyme of doxorubicin) v244m homozygous g genotypes to be at increased risk of cardiomyopathy following exposure to anthracyclines doses as low as 101-150mg/m2, suggesting that there is no safe dose threshold for individuals with certain genotypes. we have previously studied several genes in the doxorubicin pharmacology pathway, including cbr1, cbr3, and akr1c3, and found correlation between functional variants in cbr3 and akr1c3 with doxorubicin-induced myelosuppression. the cbr3 g allele is present in about 50-60% of the singapore population, and we postulate that these common variants may similarly modify the risk of anthracyclines-induced cardiomyopathy in adult breast cancer patients. post-treatment echocardiography is not routinely performed in patients who complete adjuvant anthracyclines-containing chemotherapy. we believe that some of these high-risk individuals may have subclinical reduced left ventricular ejection fraction that may in the future increase the risk of congestive cardiac failure in the presence of other risk factors (eg hypertension, anemia, serious infection, etc). identifying these individuals could therefore be important as early treatment with ace inhibitors may improve cardiac function. confirming the correlation between genetic variants including the cbr3 v244m can also help to develop a predictive algorithm in the future to identify patients in whom anthracyclines should be avoided.

Eligibility criteria:
inclusion criteria: * age \>= 21 years * signed informed consent from patient or legal representative. exclusion criteria: * pregnancy * breast feeding.
effect of a commercially available carbohydrate rich gel on maternal fatigue: a randomized controlled trial

Conditions: Effect of Carbohydrate Ingestion During Active Labor

Summary: women in active labor will be given energy gel at 45-60 minute intervals and their fatigue level will be compared to women receiving usual practice care i.e. clear liquids only.


Eligibility criteria:
inclusion criteria: * patients must be 18 years or older as well as willing and able to provide informed consent * patients with bmi \< 35 kg/m\^2 * gestational age \>37 weeks exclusion criteria: * - patients younger than 18 years, * patients unable or unwilling to provide informed consent, * patients who are illiterate, * patients who are non-english speaking or reading, * patients who are university hospital employees, * patients undergoing induction of labor for maternal or fetal indications other than elective induction after 39 weeks or induction for post-term pregnancy * multi-fetal gestations (\>1 intrauterine pregnancy), * patients with a history of gi disorders such as hyperemesis gravidarum, inflammatory bowel disease or irritable bowel syndrome * patients with an increased risk of aspiration such as bmi \>35 kg/m\^2, severe gerd, gastroesophageal motility disorders, * patients with acute or chronic platelet dysfunction (e.g.: idiopathic thrombocytopenic purpura, hellp syndrome) which may necessitate need for general anesthetic for cesarean delivery * patients with history of peptic ulcer disease, * patients who have a contraindication to epidural placement and would require general anesthestetic in event of cesarean delivery * patients with suspected or proven placenta accreta, increta or percreta, * patients with excessive nausea or vomiting during labor * patients with a history of food allergies or allergies to specific components found in the energy gel.
phase ii study of carmustine, streptozocin, and mercaptopurine for refractory or recurrent brain neoplasms

Conditions: Anaplastic Astrocytoma; Anaplastic Oligodendroglioma; Mixed Gliomas; Glioblastoma Multiforme; Recurrent Brain Tumor

Summary: objectives: i. assess the clinical response of patients with refractory or recurrent brain neoplasms treated with carmustine, streptozocin, and mercaptopurine.

protocol outline: patients receive mercaptopurine iv on days 1-3, carmustine by continuous infusion on days 3-5, and streptozocin iv over 20 minutes on days 2-5. patients receive treatment every 42 days, for up to 4 courses. completion date provided represents the completion date of the grant per oopd records

Eligibility criteria:
protocol entry criteria: --disease characteristics-- histologically proven refractory or recurrent brain neoplasms glioblastoma multiforme anaplastic astrocytoma gliosarcoma anaplastic oligodendroglioma mixed anaplastic glioma unequivocally progressive primary brainstem tumors following primary therapy measurable disease --prior/concurrent therapy-- biologic therapy: not specified chemotherapy: at least 4 weeks since prior chemotherapy at least 6 weeks since prior nitrosoureas or mitomycin endocrine therapy: not specified radiotherapy: prior radiotherapy allowed surgery: prior surgery allowed --patient characteristics-- age: not specified performance status: ecog 0-2 karnofsky 60-100% hematopoietic: granulocyte count at least 1,500/mm3 platelet count at least 100,000/mm3 hepatic: bilirubin no greater than 2.0 mg/dl sgot no greater than 4 times normal renal: creatinine no greater than 2.0 mg/dl pulmonary: fev1 greater than 1 l if symptomatic pulmonary disease present other: no other concurrent malignancies not pregnant or lactating negative pregnancy test fertile patients must use effective contraception

Keywords: adult anaplastic astrocytoma adult anaplastic oligodendroglioma adult brain stem glioma adult brain tumor adult glioblastoma multiforme adult infiltrating astrocytoma brain tumor genetic condition miscellaneous sites/terms mixed gliomas nervous tissue tumors oncologic disorders rare disease recurrent adult brain tumor
how well do we feed the critically ill patients

Conditions: Enteral and Supplement Feeds Adverse Reaction; Nutrition Deficiency Due to Insufficient Food; Critically Ill; Parenteral Nutrition Associated Liver Disease; Feeding Patterns

Summary: the present prospective observational multicentric study will assess the nutritional status of critically ill patients, cumulative calorie and protein balance and the effect of calorie and protein balance on clinical outcomes.

nutritional therapy is a very important aspect of the management of critically ill patients. these patients need intensive monitoring, various organ supports in the form of vasopressors and inotropes, mechanical ventilation, dialysis, extracorporeal organ supports, infection controls, etc. in this very complex, critical and demanding scenario, nutritional therapy often gets a back seat in the initial period at least till the time patient is stabilised. but this nutritional deprivation has much more deleterious effects in sepsis and systemic inflammatory response syndromes induced catabolic state than that of fasting in healthy persons. various studies showed that inadequate feeding has been associated with an increased hospital length of stay, incidence of complications, infections, incidence of organ failure, and risk of mortality. a single centre prospective study that analyzed 768 patients reported that 69% were calorie deficient and 90% were protein deficient. they also observed a positive correlation between calorie deficit and infectious complications, length of intensive care unit (icu) stay and days of mechanical ventilation. the main factors may hinder enteral feeding and adequate nutrition delivery. that includes delay in the initiation of enteral nutrition (en) and slow infusion rate; low adherence to en practice guidelines; frequent disruptions to en due to diagnostic or therapeutic procedures. in observational studies, patients in the icu who were fed early through the enteral route have had a better outcome than those who were not. similarly, overfeeding has also been associated with various complications, including hyperglycemia, hypertriglyceridemia, hepatic steatosis, azotemia, hypercapnia, and an increased rate of mortality among patients. therefore, optimum nutrition is vital to a patient's survival. the present prospective observational multicentric study will assess the nutritional status of critically ill patients, cumulative calorie and protein balance and the effect of calorie and protein balance on clinical outcome

Eligibility criteria:
inclusion criteria: * all adult patients who receive either enteral or parenteral nutrition will be included in the study. exclusion criteria: * age less than 18 years old * pregnant women * patient is expected to die within 48 hours of icu admission.
analysis of the impact of the fragility of the over 70 years of tiaprognosis

Conditions: Vascular; Stoke; Ischemic; Transient Ischemic Attack

Summary: fragility, geriatric concept recent identification is defined by simple physical indicators. the literature suggests that it is related to the risk of hospitalization, falls, institutionalization and death. some studies have shown a link with heart disease, including heart failure. the link with the tia (transient ischemic attack) has however never been studied. a fortiori, the impact of the fragility of the risk of recurrent stroke after tia is unknown. several questions need to be asked: among older patients hospitalized for tia, what proportion of those completing the criteria of frailty? in this same population, is there a correlation between fragility and scores abcd2 score itself predictive of the risk of subsequent ischemic stroke? in other words, fragile subjects who have a tia have a higher risk of ischemic stroke (which could cause a strengthening of prevention measures)?

hypotheses : * frailty is common among the elderly patient population who have a tia. compared to control groups of literature. * patients with high fragility score abcd2 also have a high score. * patients with a high score of fragility also have a significant number of vascular risk factors (including atrial fibrillation) * patients with a high score of fragility also have an average length of stay (alos) higher than the others. so underlying the question is: can we learn to better identify patients who are going to need a bigger structure their output at home. objectives: * assess the feasibility of placing a fragile test in acute phase of ait in usinv. * to evaluate the frequency of frailty among the population of elderly patients who have a tia. * compare in ait over 70 years those with fragile high score to those with low scores, especially for abcd2 score, vascular risk factors and the dms. * statements parameters: o the fragility score: * choice of fragility score: among the fragility of scores, the most used in international literature is the score of linda fried. moreover, the stress of the study is related to the environment of the usinv (shortly, short dms, often tired patients). it is therefore important to use this study for a test only, but quick handover. the score fried also has the advantage (j gerontol a biol sci med sci 2001, 56 (3): m146-56) the first 4 items are simple clinical evaluation. the 5th (grip test) will be performed with a device (single gauge measuring the fingers bending strength) loan from the geriatric ward.

Eligibility criteria:
inclusion criteria: * the tia is defined pragmatically: any sudden deficit with blood systematization ≤ 1 hour. among these "tia", we know that a subgroup may possibly have an mri with diffusion lesion, indicating a recent ischemic stroke. this subgroup of transient accident is recognized as being at higher risk of recurrence. this criterion will be taken into account in the data analysis. exclusion criteria: * history of stroke with rankin score of ≥ 2. * dementia * severe depression * evolutionary cancer * heart failure
continuous fascia iliaca compartment block in geriatric hip fracture

Conditions: Hip Fractures; Acute Pain Due to Trauma

Summary: the patient with hip fracture who has numerical rating scale (nrs) ≥ 5 at rest or on movement will be indicated for usg ficb at emergency department or patient's ward. the aim of this prospective observation study was evaluated the efficacy and complications of cficb in adult hip fracture preoperatively.

the enhance recovery program of pain management in geriatric hip fracture has been set up as a part of fast track at siriraj hospital since september 2017. the ultrasound-guided (usg) fascia iliaca compartment block (ficb) is routinely offered to patients with a hip fracture by acute pain service (aps) anesthesiologist. the patient with hip fracture who has numerical rating scale (nrs) ≥ 5 at rest or on movement will be indicated for usg ficb. the aim of this prospective observation study was evaluated the efficacy and complications of cficb in adult hip fracture preoperatively.

Eligibility criteria:
inclusion criteria: * patient age equal or more than 65 years old * patient with acute hip fracture within 7 days * patient with nrs ≥ 5 exclusion criteria: * patient refusal * history of local anesthetic allergy * inability to communicate or cognitive dysfunction * multiple fracture involvement
blood flow restriction training following total knee arthroplasty

Conditions: Total Knee Arthroplasty; Osteoarthritis

Summary: this study will evaluate blood flow restriction training as a rehabilitation modalities following total knee arthroplasty in order to determine if patient reported outcomes and objective functional outcomes can be improved through post-operative rehabilitation compared to standard physical therapy modalities currently in use.

patients will be enrolled preoperatively in order to measure preoperative functional measures. they will then be followed at predetermined intervals post-operatively. all subjects will begin the study related physical therapy 6 weeks post-operatively and continue for 12 sessions. at the conclusion of 12 sessions, subjects will be retested to determine improvement. subjects will then be followed for two years post-operative.

Eligibility criteria:
inclusion criteria: * s/p primary total knee arthroplasty and cleared by surgeon for continued physical therapy * males and females 50-79 years of age * ability to consent to study enrollment * able to participate fully in physical therapy * tricare beneficiary * implant restricted: primary cruciate retaining or posterior stabilized total knee arthroplasty * knee range of motion of surgical extremity from a minimum of 5 degrees from full extension to 90 degrees of flexion\*\* * only screened at secondary screening exclusion criteria: * unable to consent for study participation * unable to participate in preoperative testing * any ligamentous or bony reconstruction performed at time of surgery that limits weight bearing or rehabilitation protocol * history of deep venous thrombosis * injury or recent procedure to contralateral extremity within past 6 months * history of endothelial dysfunction * history of peripheral vascular disease * patient endorsement of easy bruising * revision total knee arthroplasty * history of surgical wound complication on involved extremity * history of cerebral vascular event * history of dementia * history of neuromuscular disorder * history of chronic obstructive pulmonary disease requiring oxygen supplementation or limiting participants ability to perform therapy and/or testing * history of previous intra-articular fracture of surgical extremity requiring open reduction and internal fixation or external fixation * history of sickle cell trait and/or disease * previously participated in blood flow restriction training interventions * planned or unplanned additional surgical procedures affecting their ability to complete all session of physical therapy or testing during the following 6 months from their primary intervention * patient reported history of functionally limiting arthritis in non-surgical lower extremity or ipsilateral hip or ankle * history or previous contralateral total knee arthroplasty * any history of previous total hip arthroplasty

Keywords: blood flow restriction training occlusion training total knee arthroplasty post-operative rehabilitation
ric (remote ischemic conditioning) in older individuals

Conditions: Old Age; Mobility Limitation; Debility

Summary: the purpose of this study is to examine the feasibility and acceptability of a technique called remote ischemic conditioning (ric) that aims to improve muscle strength, muscle mass, exercise tolerance, resilience (i.e. how well someone responds to a stressor), quality of life, physical activity, and physical function when added to rehabilitative exercise training in individuals over age 65 who have some difficulty with mobility.


Eligibility criteria:
inclusion criteria: * age: ≥ 65 years and referred to an exercise program for functional decline, deconditioning, or fall risk exclusion criteria: * unstable heart disease as determined by the investigator or study physician * history of any orthopaedic, neurologic, or metabolic condition that would contraindicate exercise testing/training as determined by the investigator * cognitive inability to follow directions and safely participate in exercise

Keywords: exercise strength training conditioning ric remote ischemic conditioning ischemic conditioning