Kornimate/medical-research-clean huggingface dataset:
inhaled steroids for the treatment of early pediatric acute respiratory distress syndrome

Conditions: Acute Respiratory Distress Syndrome

Summary: the purpose of this study is to show that inhaled steroids in patient with pards can decrease the days on mechanical ventilator measured by ventilator-free days,to improve the oxygenation index (oi) or oxygenation saturation index (osi) in patients receiving inhaled steroids and to show the relevance and feasibility of a larger study by assessing the hypothesis in a small cohort of patients. patient will be treated for a maximum of 10 days. secondary objectives are to reduce the length of stay (los) in the pediatric intensive care unit (picu) and hospital admissions; to show less inflammation in the patients receiving inhaled steroids by measuring inflammatory markers from tracheal aspirates like interleukin (il6, il8, tumor necrosis factor (tnf) α, matrix metalloproteinase8 (mmp8) and matrix metalloproteinase9 (mmp9). lastly, to show that inhaled steroids can improve residual lung disease evaluated by pulmonary function test (pfts) and impulse oscillometry (ios).


Eligibility criteria:
inclusion criteria: * pediatric patients older than 30 days and up to 18 years of age admitted to the picu with a diagnosis of pards enrolled within 72 hours of diagnosis. * patients requiring invasive mechanical ventilation. * criteria of pards as defined by the pediatric acute lung injury consensus conference (palicc), on june 2015 in pediatric critical care journal exclusion criteria: * patients with diffuse alveolar hemorrhage. * patients terminally ill with limitation of care or in hospice care. * patients receiving inhaled steroids or systemic steroids as chronic therapy before admission. * patients with high dose systemic steroids for anti-inflammatory purposes. the investigators will not exclude patients receiving hydrocortisone for shock.

Keywords: pediatric acute respiratory distress syndrome pards budesonide inhaled steroids
enbd after endoscopic sphincterotomy plus large-balloon dilation for preventing pep

Conditions: Post-ERCP Acute Pancreatitis

Summary: endoscopic retrograde cholangiopancreatography (ercp) has become one of the most important techniques in the treatment of bile duct stones. a number of studies have been conducted using large-balloon dilation (lbd) after adequate est to extract large bile duct stones. in those studies, the authors suggested that est plus lbd might lower the risk of post procedure pancreatitis (pep) by directing balloon dilation toward the bile duct rather than the pancreatic duct. it has been reported that epbd followed by insertion of nasobiliary drainage catheter can prevent pep. however, it is still unclear that nasobiliary drainage after endoscopic sphincterotomy plus large-balloon dilation for preventing postoperative pancreatitis in treating of large bile duct stones.the investigators therefore designed a prospective randomized trial to determine whether nasobiliary drainage prevent pep after endoscopic sphincterotomy plus lbd for the treatment of large bile duct stones.

patients enrolled were confirmed the presence of cbd stones using magnetic resonance cholangiopancreatography. patients with large bile duct stones were randomly assigned to est+lbd+enbd group and est+lbd group. a descriptive analysis will be performed on primary endpoint, containing frequency of number and percentage of patients. a two proportion equality test will be conducted to explore whether incidence rates are different. descriptive statistics including number (n), mean, median, standard deviation, minimum and maximum, will be produced for all continuous variables. frequency tables of number (n) and percentage of subjects will be produced for all categorical variables.

Eligibility criteria:
inclusion criteria: * patients with visualized bile duct stones ≥12 mm in maximum transverse diameter. - males and females, age \> 18 years. * normal amylase level before undergoing ercp. * signed inform consent form and agreed to follow-up on time. exclusion criteria: * bleeding diathesis * prior est or epbd or enbd * billroth ii or roux-en-y anatomy * distal extrahepatic bile duct stenosis * acute pancreatitis * intrahepatic bile duct stones.
long-term outcomes of different surgical techniques for sacral tarlov cysts: a prospective cohort study

Conditions: Sacral Tarlov Cysts; Symptomatic Sacral Cysts; Chronic Pain Related to Sacral Cysts; Neurological Dysfunction Associated With Tarlov Cysts

Summary: brief summary the goal of this observational study is to evaluate the long-term outcomes of different surgical techniques for sacral tarlov cysts in adult patients aged 18-75 years diagnosed with symptomatic sacral tarlov cysts. the main questions it aims to answer are: * does one surgical technique result in better pain relief (measured by vas score) and functional recovery (measured by joa score) compared to others? * how do different surgical techniques impact the long-term recurrence rate and complication rate? researchers will compare three surgical techniques: 1. partial cyst wall resection with nerve root sleeve plasty. 2. partial cyst wall resection with nerve root sleeve reinforcement and reconstruction. 3. autologous fat/muscle with fibrin glue microscopic cyst filling. participants will: * undergo one of the three surgical procedures based on clinical indications. * complete preoperative and postoperative assessments, including pain and functional scoring, as well as mri evaluations at baseline and during follow-up. * participate in a follow-up program for up to 2 years to monitor outcomes and recurrence.


Eligibility criteria:
inclusion criteria 1. age 18-75 years. 2. diagnosed with symptomatic sacral tarlov cysts confirmed by mri. 3. presence of at least one of the following symptoms: * persistent sacral or lower back pain (vas score ≥ 4). * neurological deficits such as lower extremity numbness or weakness. * bowel, bladder, or sexual dysfunction attributable to the cyst. 4. eligible for surgical intervention based on clinical evaluation. 5. willing and able to provide written informed consent. exclusion criteria 1. history of prior sacral tarlov cyst surgery. 2. concurrent spinal conditions requiring separate surgical intervention. 3. active infection or systemic inflammatory disease. 4. severe comorbidities that increase surgical risk (e.g., advanced cardiac or pulmonary disease). 5. pregnancy or lactation. 6. inability to comply with follow-up requirements. 7. known allergy or contraindication to surgical materials (e.g., fibrin glue).
efficacy of 851b gel for treating high-risk cervical human papillomavirus infection in women.

Conditions: Papillomavirus Infections

Summary: the purpose of this study was to evaluate efficacy of 851b gel over a range of concentrations and dosing regimens on high-risk cervical human papillomavirus infection in women.

cervical cancer is caused by infection with specific genotypes of the human papillomavirus referred to as oncogenic or high-risk human papillomavirus. current epidemiologic evidence suggests that 80% of sexually active women will become infected during their lifetime with human papillomavirus and 50% of these infections will be due to high-risk human papillomavirus. with us annual rates of cervical cancer now in the range of 13,000/year, a very substantial number of women are left with uncertainty regarding whether their infection will clear spontaneously or progress to cancer. subjects participating in this study were required to visit the clinic for approximately 15 or 16 visits, and maintain a diary of self-dosing and menstruation cycles. the total time of participation in this study was approximately 27 months.

Eligibility criteria:
inclusion criteria: * willing to be on acceptable method of birth control * have a pap smear result of lsil or ascus * is high risk hpv positive exclusion criteria: * no evidence of high-grade disease or glandular abnormalities, * complete visualization of all lesion margins and the transformation zone, * no uncontrolled significant medical illness or sexually transmitted infections, * taking any restricted medications such as interferon, immunomodulators, cytotoxic drugs, investigational drugs, steroids.

Keywords: papillomavirus infections; cervix dysplasia
the effects of alkalised cocoa on human vascular function

Conditions: Cardiovascular Disease

Summary: the primary propose of this study is to determine how processing, in particular alkalisation, alters the vascular effects of high-flavanols foods such as cocoa

a randomised, triple blind, cross-over design human intervention studies will be conducted in 10 healthy human volunteers to test the impact of alkalisation on the absorption, metabolism and vascular reactivity of cocoa flavanols. participants will be requested to consume a standardised high flavanol-rich cocoa, non-alkalised (1745 mg of flavanols), a low-flavanol cocoa, heavily alkalised (1.3 mg of flavanols) and a flavanol-rich cocoa, medium alkalisation (410 mg of flavanols). the three intervention diets are otherwise matched for macro- and micronutrient content. vascular measurements will be performed by using flow mediated dilation (fmd), laser doppler imaging (ldi) and digital volume pulse (dvp). blood and urine samples will be taken to measure the concentration of flavonoids from the cocoa drinks and markers of blood vessel function. a number of other biochemical and physiological measures will be recorded including blood glucose, lipoproteins, cytokine levels and blood pressure.

Eligibility criteria:
inclusion criteria: * male * signed consent form * age of 18-35 years inclusive * bmi between 18.5-30 exclusion criteria: * blood pressure \> 150/90 mmhg * haemoglobin (anaemia marker) \< 125 g/l * gamma gt (liver enzymes) \> 80 iu/l * cholesterol \> 6.5 mmol/l * had suffered a myocardial infarction or stroke in the previous 12 months * suffers from any reproductive disorder * suffers from any blood-clotting disorder * suffers from any metabolic disorders (e.g. diabetes or any other endocrine or liver diseases) * any dietary restrictions or on a weight reducing diet * drinking more than 21 units per week * on any lipid-modifying medication * on any blood pressure lowering medication * on any medication affecting blood clotting * planning on altering consumption of vitamin supplements/fish oil capsules during the course of the study * regular or vigorous exercise (3 times/week, 20 minutes each session) * smoking

Keywords: flavanol cocoa vascular function absorption metabolism alkalisation
autogenous bone mixed with xenograft versus xenograft alone versus absorbent gelatin sponge

Conditions: Bone Resorption; Alveolar Bone Loss; Alveolar Bone Resorption; Bone Graft Failure

Summary: alveolar bone atrophy post-extraction has been well documented in the past years. normal healing event results in a minimal loss of vertical height (around 1 mm), but a substantial loss of width in the buccal-lingual plane (4-6 mm). alveolar socket preservation is thought to deal with this issue as to prevent the loss of alveolar bone dimensions post extraction in the case of delayed implant placement


Eligibility criteria:
inclusion criteria: * adult patients with hopeless mandibular molars indicated for extraction and implant placement in two stages that indicate socket preservation. * both sexes. * no intraoral soft and hard tissue pathology. * no systemic condition that contraindicate implant placement. exclusion criteria: * presence of fenestrations or dehiscence of the residual bony walls after extraction. * heavy smokers more than 20 cigarettes per day .(24) * patients with systemic disease that may affect normal healing. * psychiatric problems * disorders to implant are related to a history of radiation therapy to the head and neck neoplasia, or bone augmentation to implant site. * patients that refuse to be called back for implant placement post extraction. * patients that have exceeded bone resorption surrounding the tooth prior to extraction and require guided bone regeneration. * pregnant females.
effectiveness of rifabutin for treatment of helicobacter pylori

Conditions: Helicobacter Infections; Resistance Bacterial; Gastritis H Pylori

Summary: the aim of this study is to determine the effectiveness of rifabutin triple therapy for the treatment of h. pylori infection in the israeli population. patients with or without a prior history of h. pylori eradication failure will be randomized to receive one of three possible treatments: group 1-amoxicillin 1000mg bd and rifabutin 150 mg bd and esomeprazole 40 mg bd group 2- amoxicillin 1000mg bd and rifabutin 150 mg d and esomeprazole 40 mg bd group 3- standard of care

patients who present to the outpatient gastroenterology clinic at our institution with a positive diagnostic test for h pylori will be screened. included patients will undergo randomisation into 3 groups. randomization will be performed by a random sequence generator to create equal sized groups in boxes of 12. group 1-amoxicillin 1000mg bd and rifabutin 150 mg bd and esomeprazole 40 mg bd group 2- amoxicillin 1000mg bd and rifabutin 150 mg d and esomeprazole 40 mg bd group 3- standard of care standard of care in previously untreated patients will consist of concomitant treatment (amoxicillin 1000mg, clarithromycin 500 mg, tinidazole 500 mg and esomeprazole all given twice daily for 14 days). in previously treated patients standard of care will consist of bismuth quadruple therapy, quinolone based therapy, or other susceptibility guided treatment where available. treatment duration will be 14 days in all groups. patients who are randomised to group 3 and fail treatment will be offered open label rescue treatment with amoxicillin 1000mg bd, rifabutin 150 mg bd and esomeprazole 40 mg bd (14 days).

Eligibility criteria:
inclusion criteria: * patients presenting to outpatient clinic with evidence of h. pylori infection exclusion criteria: * allergy to any of the study drugs * prior exposure to rifamycin drugs * inability to provide informed consent * pregnancy or lactation * liver disease * haematological disease * renal failure * active malignancy * immune suppression * patients not expected to benefit from helicobacter pylori eradication
mitochondrial function in patients with severe liver disease

Conditions: Hepatic Insufficiency; Hypoalbuminemia

Summary: the researchers will recruit patients with liver disease at parkland hospital. patients will fast overnight, and the next morning will receive an oral mixture of \[u-13c3\]glycerol (25 mg/kg) plus unlabeled glycerol (25 mg/kg). the total dose of glycerol will be 50 mg/kg in 100 milliliters of water. the taste is slightly sweet. blood will be drawn at 60 min and 120 min after the ingestion. blood glucose will be isolated and analyzed by nmr. the presence of \[5,6-13c2\]- and \[4,5-13c2\]glucose indicates preserved mitochondrial function. the researchers anticipate that patients with severe liver disease will show a decrease in mitochondrial function and will inform biosynthetic function of liver mitochondria. after the first 6 successful exams (see power analysis, below), healthy volunteers (age-, gender-, and race-matched) will be studied at the airc and subject to the same protocol.

the researchers will recruit patients with severe liver disease at parkland hospital where the procedure will be performed. age-, gender- and race-matched healthy subjects will be recruited from general population, and the procedure will be performed at the procedure room of the airc. patients at parkland will be screened and selected by dr. jeffrey browning and dr. rodney infante. after ingestion of 25 mg/kg \[u-13c3\]glycerol plus 25 mg/kg unlabeled glycerol in water (total glycerol dose, 50 mg/kg), blood will be drawn at +60 and +120 min. healthy subjects will make two visits to the airc for screening and study procedures. the screening visit will take an hour and the study visit will take 3 hours. volunteers will be made comfortable in the procedure room of the research center. all the study procedures at both parkland and airc will be under the direction of the principal investigator, dr. jeffrey browning.

Eligibility criteria:
inclusion criteria: * severe liver disease defined as known liver disease plus at least one of the following: serum albumin less than 3.0 g/dl or inr more than 2.0. exclusion criteria: * portal systemic encephalopathy * pregnancy or breastfeeding. * anemia (hematocrit \< 32%) * significant weight loss or use of diet pills within previous 6 months. * cannot give informed consent, understand the protocol, or tolerate any aspect of the protocol.
dose optimization by pharmacokinetic/pharmacodynamic of antibiotics to improve clinical outcome of carbapenem resistant klebsiella pneumoniae bloodstream infections in critically ill patients at phramongkutklao hospital

Conditions: Carbapenem Resistant Klebsiella Pneumoniae

Summary: the patients who infected with carbapenem resistant klebsiella pneumoniae were high mortality rate. appropriate antibiotics therapy adjusted by pharmacokinetic/pharmacodynamic plays an important role in determining outcomes in critically ill patients. consequently, standard antibiotics dose may not be adequate to achieve pharmacokinetic/pharmacodynamic target in critically ill patients. the purpose of this study is to compare the clinical outcomes between the critically ill patients who received antibiotics dose adjusted by pharmacokinetic/pharmacodynamic using monte carlo simulation and historical critically ill patients who received antibiotics from standard practice.


Eligibility criteria:
inclusion criteria: 1. 20 years and older who admitted at phramongkutklao hospital 2. patients who was diagnosed blood stream infection with crkp between april 10th, 2023 to march 31st, 2024 (prospective study) and january 1st, 2012 to march 31st, 2023 (retrospective study); historical group 3. patients who had signs and symptoms at least 1 criteria following: 3.1. patients who had signs and symptoms of systemic inflammatory response syndrome (sirs) at least 2 criteria: * temperature above 38 oc or below 36 oc * heart rate more than 90 beats/min * respiratory rate more than 20 /min or paco2 less than 32 mmhg (4.3 kpa) * white blood cell more than 12,000 cell/mm3 or less than 4,000 cell/mm3 3.2. patients who was diagnosed sepsis or sofa score or qsofa score at least 2 score 3.3. patients who was diagnosed septic shock or who had hypotension with adequate fluid and need for vasopressor to maintain mean arterial pressure over 65 mmhg and serum lactate above 2 mmol/l 4. patients who received antibiotics at least 48 hours which are as follow: * ceftazidime-avibactam or * combination antibiotics (eg. meropenem-colistin, imipenem-colistin, tigecycline-amikacin, tigecycline- gentamicin, tigecycline-meropenem or tigecycline-colistin) exclusion criteria: 1. patients who were pregnancy or breastfeeding 2. patients who had drug allergy (eg. ceftazidime-avibactam, tigecycline, amikacin, gentamicin, imipenem, meropenem or colistin) 3. patients who not to received resuscitation. 4. patients who were end stage cancer.

Keywords: antibiotics dose optimization clinical outcome crkp critically ill
hippocampal plasticity of young adults with childhood adversity

Conditions: Depression; Anxiety

Summary: this study investigates the clinical and neural effects of stress management skill building programs for young adults with childhood adversity. the investigators will recruit a total of 60 young adults (21-35 years old) who will be randomized into two different stress management skill building programs, both of which are 8 weeks long. mri and psychological assessments will be acquired from all subjects before and after the intervention programs in order to investigate changes in clinical symptoms (such as depression, anxiety and stress) and hippocampus structure and function as well as other neural changes.


Eligibility criteria:
inclusion criteria: * having childhood adversity * no history of psychiatric disorders of psychotic features or neurological disorders * verified age between 21-35 years old; * no suicidal attempts during the past six months; * being determined by the clinician to have the capability to comply with the program requirements and not detrimental to other participants in the group; * passing mri eligibility criteria. * provided written informed consent to participate in this study; * committed to meeting the requirement of refraining from using marijuana or illicit drugs. exclusion criteria: * psychosis * active suicidal attempts during the past 6 months * psychoactive substance abuse * mri exclusion criteria

Keywords: childhood adversity
clinical feasibility of microwave ablation using two channel microwave generator and two antennas for small hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma

Summary: to compare safety and efficacy of microwave ablation with simultaneous ablation using two antennas versus overlapping ablation with single antenna for small hepatocellular carcinoma


Eligibility criteria:
inclusion criteria: * child-pugh class a or b * chronic hepatitis b or chronic hepatitis c or liver cirrhosis * presence of hepatocellular carcinoma (hcc) confirmed by pathology or imaging studies including contrast enhanced computed tomography (ct) or magnetic resonance imaging (mri) according to liver imaging reporting and data system (li-rads) v2018 * single lesion less than or equal to 3 cm, or up to 3 lesions, each greater than less than or equal to 3 cm at the time of locoregional treatment exclusion criteria: * number of recurrent hccs, equal or more than 3 * largest recurrent hcc size over 3 cm * presence of vascular invasion by hcc * diffuse infiltrative type hcc * hccs located less than 5 mm from central bile duct or large portal vein or large hepatic vein * platelet count less than 40,000 per mm3 or international normalized ratio (inr) prolongation over 50% * presence of extrahepatic metastasis
safety and efficacy evaluation of fx-1006a in subjects with transthyretin amyloidosis

Conditions: ATTR-PN

Summary: this is a phase 3, open-label study designed to obtain additional long-term safety and efficacy data for oral tafamidis (20 mg soft gelatin capsule) administered once daily (qd). in addition, this study continued to provide tafamidis to val30met subjects who had completed protocol fx-006 (a 1-year, open-label extension study to protocol fx-005 which was a randomized, double-blind, placebo-controlled, 18-month study to evaluate the safety and efficacy of tafamidis) or non-val30met subjects who had completed protocol fx1a-201 (a phase 2, open-label study to evaluate ttr stabilization, safety, and tolerability of tafamidis) for up to 10 years or until subjects had access to tafamidis for attr-pn via prescription. upon regulatory approval for the treatment of attr-pn in their respective country and access to prescription tafamidis, subjects may have been withdrawn from the study. such subjects were considered study completers.


Eligibility criteria:
key inclusion criteria: * subject had successfully completed either protocol fx-006 or fx-1a-201. * male or female subjects with attr-pn who had not undergone liver or heart transplantation at time of enrollment. * if female, subject was post-menopausal, surgically sterilized, or willing to use an acceptable method of birth control key exclusion criteria: * chronic use of non-protocol approved non-steroidal anti-inflammatory drugs (nsaids) * pregnant or breast feeding female subjects. * clinically significant medical condition that, in the opinion of the investigator, would place the subject at an increased risk to participate in the study. * an alanine aminotransferase (alt) and aspartate aminotransferase (ast) value \>3 × upper limit of normal (uln) that, in the medical judgment of the investigator, was due to reduced liver function or active liver disease. * sexually active males with partners of childbearing potential not using highly effective contraception or not agreeing to continue highly effective contraception for at least 3 months after last dose of study drug.