Kornimate/medical-research-clean huggingface dataset:
the use of 5-ala in paediatric patients with high grade brain tumours

Conditions: Brain Tumor

Summary: the aim of the study is to examine the safety and feasibility of using 5-ala in children who have mri scans showing an aggressive looking brain tumour. it will also study if 5-ala can help the surgeon achieve maximal tumour removal and discriminate between normal brain tissue and tumour. patients will be between 3-18 years (inclusive) and all patients will receive 5-ala 3-6 hours prior to resection surgery.


Eligibility criteria:
inclusion criteria: * magnetic resonance imaging confirmation of diagnosis consistent with either: primary presentation of high grade brain tumour or patient relapsing with previously confirmed ependymoma or high-grade glial tumour * tumours will be either intrinsic supratentorial or infratentorial / posterior fossa, non-brainstem, tumours * patient is appropriate for maximal safe resection of tumour, based on investigator and multidisciplinary team judgement * 3 - 18 years inclusive * adequate liver and kidney function * creatinine - less than one and a half times the upper limit of normal. * haemoglobin above the lower limit of normal * alanine transferase or aspartate transferase less than twice the upper limit of normal (if both performed, then both results must be lower than twice the upper limit of normal * bilirubin lower than one and a half times the upper limit of normal * normal coagulation profile o prothombin time, activated partial prothombin time and thrombin time all within normal limits * urine porphyrin - test to be completed and sent for analysis * blood pressure lower than or equal to the upper limit of normal * negative pregnancy test in women of childbearing potential\* * informed consent \*a positive pregnancy test that is suspected to be due to the location of the tumour is to be queried with the tmg prior to registration of the patient exclusion criteria: * patients with low grade tumours (either radiological or histological diagnosis) * patient is appropriate for biopsy only, based on investigator and mdt judgement * known history (including family history) of porphyria * hypersensitivity to the active substance or to porphyrins * history of light sensitivity reactions * pregnant or breastfeeding women

Keywords: ependymoma glioma paediatric 5-ala brain tumour
european non-interventional study in chronic obstructive pulmonary disease (copd) patients

Conditions: Chronic Obstructive Pulmonary Disease (COPD)

Summary: this study is investigating how patients with severe stable state copd perceive the variability of their symptoms throughout the day, the week and the year; the impact of these variations on their daily activities or sleep quality and how they deal with their treatments. for this purpose patients will be asked to answer a questionnaire over the phone


Eligibility criteria:
inclusion criteria: * outpatients with a diagnosis of copd * fev1\<50% and fev1/fvc\<0.7 according to lung function data in medical records. * smoker or ex-smoker \> 10 pack-years * informed consent obtained exclusion criteria: * ongoing exacerbation of copd or within the previous 3 months * any other significant respiratory disease (including asthma and allergic rhinitis)

Keywords: severe copd copd symptoms variability of symptoms patient's perception
london valvular heart disease and reduced ejection fraction detection in a multi-ethnic community using cardiac ultrasound

Conditions: Heart Valve Diseases; Left Ventricular Dysfunction

Summary: heart valve disease and heart failure contribute to 25% of hospital emergency admissions while heart failure alone has become one of the most common causes for hospitalisation in people over the age of 65. the burden of disease is likely to be high in a multi-ethnic community but there is a paucity of data. management of heart valve disease requires appropriate surveillance and timely surgery. similarly heart failure management requires treatment with medications aimed at slowing prevention of symptoms and preventing premature death. the nhs long term plan priorities early detection and treatment of valve disease and heart failure in order to reduce the burden on emergency services and improve the health of the population. diagnosis is made using cardiac ultrasound, however staff with the required skills-set are critically limited in the community. the investigators will train non-expert staff within primary care to perform abbreviated cardiac ultrasound to detect heart valve disease or heart failure. this will be opportunistic scanning to reduce healthcare footfall. all scans will be reviewed by an expert and the investigators will use the anonymised data to develop machine learning tools to begin working with academic partners to develop tools that can improve the reliability of diagnosis from ultrasound. the investigators hope to identify the proportion with the above conditions in a multi-ethnic community and assess the feasibility of developing a program where staff can be trained for community detection, streamlined referrals can be created bridging the gap between primary and secondary care, reducing hospital emergency admissions, while ensuring patients are managed optimally.


Eligibility criteria:
inclusion criteria: - greater or equal to 65 years old exclusion criteria: * clinical diagnosis of alzheimer's disease or vascular dementia * palliative care patients.
is myocardial revascularization really necessary in patients with ≥50-70% coronary stenosis undergoing valvular surgery?

Conditions: Coronary Artery Disease; Heart Valve Diseases

Summary: it is well documented in the literature that myocardial revascularization during valve surgery increases the risk of early mortality and morbidity. according to the most recent version of the european guidelines, the possibility of myocardial revascularization via coronary artery bypass should be evaluated in patients with an indication for surgical treatment of heart valve disease but with coronary artery stenosis ≥ 50-70%. in this study, patients hospitalized for surgical heart valve disease, with occasional pre-operative finding of ≥ 50-70% coronary artery stenosis, without angina, are examined. after interdisciplinary discussion in the heart team, it was decided not to treat coronary artery disease during valve surgery. the aim is to evaluate the short and medium-term results of this "conscious omission".


Eligibility criteria:
inclusion criteria: * adult patients * presence of valve disease of surgical interest. * occasional pre-operative finding of coronary stenosis \>= 50-70%. exclusion criteria: * angina
effect of music on cardiopulmonary exercise capacity in heart failure patients

Conditions: Heart Failure

Summary: the study aims to assess the effect of music on the heart resulting in a change in their exercise capacity among systolic heart failure patients undergoing cardiopulmonary exercise testing.

studies have previously shown the positive impact of music on the autonomic nervous system, neurohormonal and cardiovascular system. in addition, a previously published study found a positive impact of music resulting in an improvement of quality of life (qol) in heart failure patients. proposed mechanisms of benefit of music in heart failure include a reduction in sympathetic activity, and modulation of parasympathetic activity. further, reduction in anxiety and arterial relaxation are thought to be beneficial effects of music. it is hypothesized that heart failure patients listening to music would have better exercise stress test performance and increased exercise time. adult patients with systolic heart failure scheduled to undergo cardiopulmonary exercise (cpx) testing at the gill heart and vascular institute will be recruited. while the patients are undergoing cardiopulmonary exercise testing, patients randomized to the 'music arm' will listen to pre-selected upbeat music during their duration of the exercise testing via headphones that will be provided to patients by the study personnel. the patients who are randomized to 'non-music arm' in which their headphones will not play music and the patients will perform the cardiopulmonary exercise testing as usual. standard clinical care is performing cardiopulmonary exercise testing without any music. the investigators will then compare the results of cpx study of the two arms to assess the impact of music on exercise performance.

Eligibility criteria:
inclusion criteria: * adults (age \>18 years) * able to consent * english speaking exclusion criteria: * severe hearing deficiency * unable to exercise.

Keywords: cardiopulmonary stress test exercise stress test cardiology exercise performance heart failure
the finnish diabetes prevention study

Conditions: Type 2 Diabetes

Summary: the aim of this study is to clarify whether lifestyle intervention provided to people with high type 2 diabetes risk will lower the cumulative incidence of diabetes. furthermore, the aim is to study the effect of lifestyle intervention on cardiovascular risk.


Eligibility criteria:
inclusion criteria: * impaired glucose tolerance (p-glucose 2 hours after a 75 g oral glucose load between 7.8 and 11.0 mmol/l) * body mass index 25 or higher exclusion criteria: * diabetes (previous gestational diabetes accepted) * other chronic disease rendering survival for 6 years * condition or medication affecting glucose tolerance * recent myocardial infarction

Keywords: type 2 diabetes primary prevention diet physical activity intervention impaired glucose tolerance lifestyle randomized controlled study
allium sativum oil as alternative non-vital pulpotomy medicament in primary teeth

Conditions: Non-Vital Tooth

Summary: the purpose of this randomized controlled clinical trial is to use allium sativum oil as non-vital pulpotomy medicament compared to formocresol in primary teeth by evaluating its antibacterial effect against streptococcus mutans and lactobacillus acidophilus. it is hypothesized that there is no difference in the antibacterial effect of allium sativum oil compared with formocresol, when used as non-vital pulpotomy medicaments.

it is a multi-arm parallel randomized controlled trial in which forty patients aged between 4 to 8 years, each containing at-least one non-vital primary molar, will be selected and randomly divided into group a (formocresol) and group b (allium sativum oil). non-vital pulpotomy will be performed by removing the coronal necrotic pulp. sterile paper point will be dipped in the root canals and taken to the laboratory. cotton pellets soaked in the respective medicaments will be placed over the root canal orifices and filled temporarily. patients will be recalled after one week. samples will be again taken, and tooth restored. comparison between bacterial count at baseline and after one week of treatment will be made and expressed as colony-forming units/ml (cfu/ml).

Eligibility criteria:
inclusion criteria: 1. cooperation of patients and consent of parents. 2. patients with asa classification i and ii (mild to moderate systemic disease). 3. non-traumatic extensively carious hence restorable primary molars. 4. no history of antibiotic use for 2 weeks. 5. presence of following clinical signs or symptoms suggestive of non-vital tooth such as tenderness on percussion, non-responsive to cold test, periapical/furcal radiolucency, localized gingival/mucosal soreness/redness/swelling, and/or slight mobility-grade i. exclusion criteria: 1. history of allergy to anesthetics and latex. 2. radiographic evidence of pulpal floor opening into the furcation area. 3. more than half of the roots resorbed.
studying genes in samples from younger patients with ovarian or testicular sex cord stromal tumors

Conditions: Childhood Germ Cell Tumor; Leydig Cell Tumor; Ovarian Cancer

Summary: rationale: studying samples of tumor tissue from patients with cancer in the laboratory may help doctors identify biomarkers related to cancer. purpose: this research trial is studying genes in tumor samples from younger patients with ovarian or testicular sex cord stromal tumors.

objectives: * to assess the role of dicer1 mutations and mirna pathways in the etiology and progression of ovarian or testicular sex cord stromal tumors. outline: archived tumor tissue samples are analyzed for d1cer1 mutation and mrna expression by reverse-transcriptase polymerase chain reaction (rt-pcr) and laser micro dissector. results are then correlated with medical data, including age at diagnosis, diagnosis, pathology report, presenting symptoms, family history, treatment, outcome, and length of follow-up, when available.

Eligibility criteria:
disease characteristics: * fixed and frozen tissue samples from the atbr01 b1 tissue bank and from the international pleuropulmonary blastoma registry, children's hospital of boston, and massachusetts general hospital * tissue samples from patients diagnosed with: * ovarian * sertoli-leydig cell tumor * juvenile granulosa cell tumor * adult granulosa cell tumor * gynandroblastoma * sex cord stromal tumor with annular tubules * sex cord stromal tumor, undifferentiated * sertoli tumor * leydig tumor * testicular: * granulosa cell tumor * sertoli tumor * leydig tumor * sertoli-leydig * undifferentiated stromal tumor patient characteristics: * not specified prior concurrent therapy: * not specified

Keywords: leydig cell tumor ovarian stromal cancer childhood malignant testicular germ cell tumor childhood malignant ovarian germ cell tumor
position intervention to reduce hypoxemia in sedation patients

Conditions: Hypoxemia; Sedation Complication; Emergencies; Airway Remodeling

Summary: hypoxemia was defined as an spo2 of \< 90% for any duration. failure to treat promptly can lead to hypoxemia, which may increase the risks of arrhythmia, nausea and vomiting, and cognitive dysfunction. studies have shown that body position has a direct impact on respiratory function. in special environments, including outside the operating room where emergency airway management for critically ill and injured patients is needed, or in areas with limited medical resources like remote areas, adopting simple interventions by changing position to maintain patients' respiratory function can be more economical, convenient and safe.

hypoxemia was defined as an spo2 of \< 90% for any duration. failure to treat promptly can lead to hypoxemia, which may increase the risks of arrhythmia, nausea and vomiting, and cognitive dysfunction. studies have shown that body position has a direct impact on respiratory function. in special environments, including outside the operating room where emergency airway management for critically ill and injured patients is needed, or in areas with limited medical resources like remote areas, adopting simple positional interventions to maintain patients' respiratory function can be more economical, convenient and safe. this study aims to conduct a prospective, multicenter, randomized controlled trial to observe the level of patients' oxygen saturation and the occurrence of hypoxemia under different body positions (supine and lateral positions), and its impact on prognosis, providing reliable evidence-based medical evidence for the prevention and treatment of complications in patients requiring airway management.

Eligibility criteria:
inclusion criteria: 1. patients with 18 years or older 2. without obvious cardiovascular or pulmonary dysfunction 3. scheduled to undergo procedure or surgery with sedation 4. signed the informed consent form exclusion criteria: 1. preexisting bradycardia (heart rate \<50 beats/min), hypotension (systolic blood pressure \< 80mmhg), or hypoxemia (spo2 \< 90%); 2. requiring supplemental chronic or intermittent oxygen therapy because of preexisting diseases 3. preexisting diseases which unable to tolerate reduced spo2 or partial pressure of carbon dioxide in artery (paco2) diseases, such as severe cardiovascular and cerebrovascular diseases, intracranial hypertension or severe lung diseases; 4. coagulation disorders or a tendency of nose bleeding; 5. patients whose body position cannot be altered; 6. participated in other intervention clinical studies in the past 3 months; 7. other conditions deemed unsuitable for inclusion by the researcher; 8. patients and guardians refused to participate in this trial.

Keywords: position hypoxemia sedation emergency upper airway
synergistic effect of vitamin d supplementation in patients with vitiligo and vitamin d deficiency

Conditions: Vitamin D Deficiency; Vitiligo

Summary: this prospective, randomized, controlled study was approved by the institutional review board of hallym university kangnam sacred heart hospital (irb no. 2018-04-017). all study participants consented the study and agreed the written informed consent. all participants who are applicable to the inclusion criteria were randomly assigned to two groups: the control group and the study group. both groups were treated with phototherapy including 308-nm excimer laser or narrowband ultraviolet b (nb-uvb). study group had vitamin d supplementation through the injection additionally.


Eligibility criteria:
inclusion criteria: 1. patients diagnosed with non-segmental vitiligo based on clinical diagnosis. 2. patients who were ≥ 18 years old. 3. patients with lower serum vitamin d level (\<20ng/ml). exclusion criteria: 1. patients taking medicines such as thiazide, diuretics, lithium which can influence the serum vitamin d level. 2. pregnant or lactating women. 3. patients with diseases which can affect kidney such as chronic kidney disease, hyperparathyroidism, or hypoparathyroidism. 4. patients with uncontrolled chronic diseases like diabetes mellitus, hyperlipidemia, hypertension 5. patients whose spot urine calcium level was over 30mg/dl.
a randomized trial comparing 2 methods for rapid induction of cooling in stroke patients, cold infusions vs. emcools flex.pads (icool 2)

Conditions: Ischemic Stroke; Hemorrhagic Stroke

Summary: mild hypothermia improves outcome in patients with global cerebral ischemia after cardiac arrest. hypothermia seems promising also in other acute hypoxic-ischemic or in brain swelling associated cerebrovascular disease. the narrow-time-frame is a major issue ("time is brain"). to provide immediate cooling without delay, easy to use, mobile and effective methods are needed. cold infusions (4 °c) are an accepted standard worldwide. emcools flex.pads (emergency medical cooling systems ag, wien, austria) is a new non-invasive surface cooling system. a comparison of these two induction methods has never been done before. neither was the effect of emcools flex.pads on brain-temperature measured. for the first time icool 2 compares feasibility, safety and efficacy of the two methods.


Eligibility criteria:
inclusion criteria: * sedation * combined icp-temperature-probe * indication to lower body temperature \> 1.5°c * age ≥ 18 years exclusion criteria: * body weight \> 120 kg * severe renal insufficiency * acute pulmonary embolism * acute myocardial infarction * high-grade heart valve stenosis or insufficiency * severe cardiac insufficiency (nyha ≥ iii) * threatening ventricular dysrhythmia * cardiac dysrhythmia with bradycardia (heart rate \ 450 ms, sick sinus syndrome, av-block ii-iii°). * known hematologic disease with increased risk of thrombosis (e.g. cryoglobulinemia, cold agglutinins, sickle cell anemia) * known vasospastic vascular disorder (e.g. raynaud's phenomenon or thromboangiitis obliterans) * skin lesions not allowing a secure application of the emcools flex.pads

Keywords: hypothermia induction of hypothermia cold infusion whole-body cooling external cooling surface cooling non invasive cooling stroke intracranial hemorrhage cerebrovascular disease neuro intensive care
surgical outcome and differences on histopathology in patients with alcoholic & non alcoholic chronic pancreatitis

Conditions: Pancreatitis, Chronic

Summary: numerous treatment modalities have been proposed to treat pain in alcoholic and non-alcoholic chronic pancreatitis such as analgesic medication, inhibition of gastric acid production, enzyme substitution, somatostatin analogues, nerve blockade,reduction of oxidative stress and endoscopic pancreatic duct stenting, but none of these concepts have shown long lasting benefits as surgery in clinical studies.comparison of surgical outcome in non-alcoholic chronic pancreatitis and alcoholic chronic pancreatitis has limited data and differences on the basis of outcome in between alcoholic and non-alcoholic chronic pancreatitis are not available in literature. although it is well known that pain is the main symptom of chronic pancreatitis, it has until now been assessed in very common and varying categories. pain, however, is only one aspect of the large variety of sensitive facets of daily life. in addition to an improvement in pain symptoms and the preservation of pancreatic exocrine and endocrine function and other parameters, occupational rehabilitation of these mostly young patients and quality of life also should be considered in the evaluation of surgical outcome in alcoholic and non-alcoholic chronic pancreatitis. in this prospective study, we intend to find out if there are any differences in the surgical outcome on the above mentioned parameters in alcoholic and non-alcoholic chronic pancreatitis.we also plan to see if there are differences in the histopathology in these two disease settings.


Eligibility criteria:
inclusion criteria: diagnosis of chronic pancreatitis confirmed by at least 2 of the following: 1. typical chronic epigastric abdominal pain 2. elevation of serum amylase\>3 times upper limit normal or 3. fecal elastase less than 200ug/g stool. 4. confirmatory findings on cross-sectional imaging: 1. changes in size, shape and contour of pancreas 2. dilatation of main pancreatic duct 3. calcification 4. pseudocyst 5. pancreatic duct stricture 5. patients who fulfill the criteria for surgical intervention exclusion criteria: * not agreeing for surgical management * on going acute pancreatitis * postop alcohol intake * pregnancy. * chronic pancreatitis with malignancy

Keywords: alcoholic non alcoholic idiopathic tropical exocrine dysfunction endocrine dysfunction pain control frey's procedure duodenum preserving pancreatic head resection