Kornimate/medical-research-clean huggingface dataset:
study of echocardiogram accuracy in patients with mitral valve calcification

Conditions: Mitral Annulus Calcification

Summary: this study aims to evaluate the accuracy of the echocardiographic data obtained from patients with calcifications in the mitral valve who are undergoing a cardiac (heart) catheterization. echocardiography is a non-invasive (does not break the skin) procedure used to see an image of the heart. it uses harmless sound waves to create an image of the heart on a computer screen. these images will show the valves of the heart, how well the heart is pumping blood, the blood flow across these valves and how large the heart is. a silver paddle-shaped device is moved easily over the skin to capture these images. calcification (hardening) of the heart valves and heart rings (fibrous tissue surrounding the valves) is a common finding and it increases with age. the presence of calcification changes the blood flow through the heart valves. this makes any echocardiographic data (information) obtained from patients with calcifications difficult to interpret.

patients with significant mitral annular calcification (mac) have largely been excluded from studies validating non invasive (echocardiographic) measurements of left ventricular filling and diastolic function. the investigators hypothesize that echocardiographic estimates of diastolic function, left atrial pressure (lap) and left ventricular end diastolic pressure (lvedp) are likely to be fallacious in patients with moderate to severe mitral annular calcification due to the structural alterations and technical difficulties involved.

Eligibility criteria:
inclusion criteria: * \>= 19 years of age * undergoing planned cardiac catheterization exclusion criteria: * \< 19 years of age * acute coronary syndrome * decompensated heart failure * not in sinus rhythm * \> mild mr * hypertensive urgency/emergency * severe aortic stenosis * poor echo windows for doppler imaging

Keywords: mitral annular calcification mac left atrial pressure lap left ventricular end diastolic pressure lvedp echocardiogram
field implementation of the autoric device in stemi

Conditions: ST Elevation Myocardial Infarction

Summary: this is a "before and after" observational study of a therapeutic strategy to treat patients with confirmed st-segment myocardial infarction (stemi) with remote ischemic conditioning (ric) before undergoing primary percutaneous coronary intervention (pci). ric is the purposeful application of brief, intermittent cycles of limb occlusion by inflation/deflation of a pneumatic cuff. the autoric device is an automatic ric delivery device (the autoric® device; cellaegis devices inc, toronto, on) that has received clearance from health canada for this use under the direction of a health care professional. paramedics in the peel and halton regional emergency services and the emergency department (ed) staff of brampton civic hospital and mississauga hospital will treat patients experiencing stemi with autoric, and study data will be collected from existing patient records. the 'before' group will include up to 900 patients who were treated before autoric implementation in the services and hospitals. these patients would have had a stemi and undergone pci, but did not receive the autoric device. the 'after' group will include up to 900 eligible patients who have had ric treatment with the autoric device at the two participating sites following implementation in the services and hospitals. the primary analyses will compare the short-term and long-term outcomes of eligible patients who have received completed primary pci for stemi in the time period before the implementation and following the implementation of this ric strategy. in addition, a health economic analysis will be conducted to determine the cost-effectiveness of the therapeutic strategy to treat stemi patients with ric prior to pci.


Eligibility criteria:
inclusion criteria: * 18 years of age and older; * patients diagnosed with stemi in the prehospital environment by responding paramedics from peel regional paramedic services or halton emergency medical service and transported to the pci laboratory of brampton civic hospital or trillium health partners; * walk-in patients diagnosed with stemi in the ed of either of these two facilities. exclusion criteria: * left-bundle branch block; * lymphedema on either arm * picc line on either arm * av fistula or no palpable pulse on either arm; * patient has a known bleeding disorder or known abnormality of blood flow to the left arm; * patient has peripheral nerve injury, abnormal nerve supply, peripheral neuropathy or pre- existing traumatic injury to the limb to be treated (left-arm).
epidural morphine for postoperative analgesia after total knee arthroplasty

Conditions: Adult Patients; Total Knee Arthroplasty; Epidural Analgesia; Femoral Nerve Block; Analgesic Adverse Reaction

Summary: single femoral nerve blockade combined with patient-controlled intravenous analgesia are used for postoperative analgesia for patients after tka in the hospital of the investigators. although this method provides acceptable analgesia, the incidence of opioid-associated side effects is relatively high. low-dose epidural morphine is commonly used in postoperative analgesia after cesarean section, and the effect of single dose morphine lasts more than 20 hours, with low incidences of itching, nausea, vomiting, and respiratory depression. the investigators hypothesize that, for patients undergoing tka, the addition of low-dose epidural morphine to single femoral nerve block and intravenous opioids can improve the postoperative analgesia, reduce the consumption of intravenous opioids and decrease opioid-associated side effects.

total knee arthroplasty (tka) is an important therapy for patients with serious knee osteoarthritis in order to improve quality of life and relieve pain. but a large number of patients who undergo this surgery experience moderate to severe postoperative pain. previously, the investigators used single femoral nerve blockade combined with patient-controlled intravenous analgesia for postoperative analgesia for patients after tka. although this method provides acceptable analgesia, the incidence of opioid-associated side effects is relatively high. low-dose epidural morphine is commonly used in postoperative analgesia after cesarean section, and the effect of single dose morphine lasts more than 20 hours, with low incidences of itching, nausea, vomiting, and respiratory depression. the investigators hypothesize that, for patients undergoing tka, the addition of low-dose epidural morphine to single femoral nerve block and intravenous opioids can improve the postoperative analgesia, reduce the consumption of intravenous opioids and decrease opioid-associated side effects.

Eligibility criteria:
inclusion criteria: * adult patients (age of 18 years or older); * american society of anesthesiologists classification i-iii; * scheduled to undergo unilateral tka under combined spinal and epidural anesthesia. exclusion criteria: * age higher than 90 years old; * presence of any contraindication to neuraxial block or peripheral nerve block; * continuous use of opioid analgesics during the last month; * unable to understand numeric rating scale for pain evaluation or existence of language barrier; * severe renal insufficiency (requirement of renal replacement therapy); * history of asthma; * recruited in another clinical trials.

Keywords: adults unilateral tka single femoral nerve block low-dose epidural morphine effect of postoperative analgesia quality of life
cannabis oil for pain effectiveness

Conditions: Cancer; Chronic Pain

Summary: this project represents a first systematic, prospective, single-arm cohort study of a safe and effective dosing regimen of an orally administered cannabis oil formulation in a cancer subject population with poorly controlled pain.

over a 1-2 year period, 40 cancer patients experiencing poorly controlled pain will be enrolled in to a prospective single-arm cohort study, in which they will receive an orally administered cannabis oil formulation as an add-on therapy to current treatment regimens. subjects entering the acute study phase will be titrated to a tolerated dose at which a sustained pain response is reached, and may subsequently enter a 12 week chronic phase during which safety and durability of pain response will be assessed at their stable dose.

Eligibility criteria:
inclusion criteria: 1. men and women with breast, prostate, lung, gastrointestinal or genitourinary cancer who have poorly controlled pain defined by the use of three or more prn, or as needed, doses of opioids in a 24-hour period for a minimum of three days per week in the week prior to study registration. 2. age 25-70 years. 3. an esas score of 2 or more recorded as their worst pain at the time of study registration. exclusion criteria: 1. current use of cannabis within the last 30 days from date of study consent (urine screen test positive). 2. brain metastases. 3. ecog performance \> 2. 4. life expectancy \< 6 months. 5. daily morphine milligram equivalent (mme) dose \ 120. 6. current major psychiatric illness, such as bipolar disorder, major depression, active suicidal intent or psychosis that could be exacerbated by the administration of cannabis. 7. chemotherapy induced neuropathy. 8. poorly controlled hypertension, unstable angina, or myocardial infarction within the previous 6 months. 9. known history or presence of any clinically significant hepatic, renal/genitourinary, gastrointestinal, cardiovascular (e.g. arrhythmias, ischemic heart disease, tachycardia), cerebrovascular, pulmonary, endocrine, immunological, musculoskeletal, neurological, psychiatric (e.g. depression, disorientation, euphoric mood and dissociation), dermatological or hematological disease or condition unless determined as not clinically significant. 10. women who are not practicing an effective form of birth control (condoms, diaphragm, birth control pill, iud) or are currently pregnant or lactating. 11. anticipated change in chemotherapy or radiotherapy treatment plan during the 43-day course of the acute study. 12. known history of substance abuse. 13. inability to speak or read english. 14. inability to provide informed consent.

Keywords: cannabis oil cannabis pain cancer
68ga-tcr-fapi pet/ct in patients with various types of cancer

Conditions: Malignant Tumor; Positron Emission Tomography; Fibroblast Activation Protein Inhibitor

Summary: adding targeted covalent radiopharmaceutical (tcr) moiety to fibroblast activation protein inhibitor (fapi) can increase tumor uptake and tumor retention in pre-clinical studies. this study is an open-labeled single-arm phase ii diagnostic clinical trial to explore the clinical value of 68ga-tcr-fapi pet/ct in suspected malignant tumor patients.

tcr-fapi can covalently bind to fap that increase tumor uptake and tumor retention in pre-clinical studies, which elevates the ability for cancer imaging and facilitates the targeted radionuclide therapy. this study is an open-labeled single-arm phase ii diagnostic clinical trial to explore the clinical value of 68ga-tcr-fapi pet/ct in suspected malignant tumor patients. quantitative features (i.e., suvmax) will be calculated to evaluate the pet images. alternative imaging modality, including but not limited to, ultrasound, ct, mri, and pet/ct with other radiotracers, might be applied according to clinical needs. for patients who took surgery after multiple examination, tumor tissue and histopathology will also be obtained. for patients who underwent other treatment, treatment response of each individual lesion will be observed.

Eligibility criteria:
inclusion criteria: * suspected to have malignant tumors (supported by mri and/or ct and/or tumor markers and/or pathology report), the tumor may be newly diagnosed or previously treated; * meet the indications for pet examination, show a clear indication and no contraindications; * have a performance status of score ≥ 80 on kps scale or score 0-1 points on ecog scale, a relatively good general situation; * no major organ dysfunction (heart, lung, liver, kidney and other major organ include), acute or life-threatening status of infection; * be ≥ 18 years of age; * be willing and able to understand the research content and provide written informed consent/assent for the trial. exclusion criteria: * have a history of imaging agent allergies; * does not meet the pet-ct scan sedation requirements, or has contraindications for pet-ct examination; * be pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial.

Keywords: malignant tumor positron emission tomography fibroblast activation protein inhibitor
levofloxacin concomitant versus levofloxacin sequential

Conditions: Helicobacter Pylori Infection

Summary: the goal of this trial is to determine the efficacy of levofloxacin based sequential treatment regimen or concomitant levofloxacin based regimens as empirical first-line therapy in the syrian population


Eligibility criteria:
inclusion criteria: * patients are aged greater than 18 years old who have h. pylori infection diagnosed by any of following three methods: * positive rapid urease test (clotest). * histologic evidence of h. pylori by modified giemsa staining. * positive 13c-urea breath test. without prior eradication therapy and are willing to receive therapy. exclusion criteria: * children and teenagers aged less than 18 years. * previous eradication treatment for h. pylori. * patients who took any drug, which could influence the study results such as proton pump inhibitor, h2 blocker, mucosal protective agent and antibiotics. * history of gastrectomy. * gastric malignancy, including adenocarcinoma and lymphoma, * previous allergic reaction to antibiotics (amoxicillin, tinadizole, * doxycycline,bismuth subsalicylate,) and prompt pump inhibitors (es- omeprazole). * contraindication to treatment drugs. * pregnant or lactating women. * severe concurrent disease. * liver cirrhosis.

Keywords: helicobacter pylori levofloxacine concomitant sequential
phase i, open-label, dose-escalation, safety and pk study of azd4877

Conditions: Lymphoma; NHL; Non-Hodgkin Lymphoma

Summary: this study has two parts (a and b). the primary purpose of part a is to find the maximum tolerated dose is for an experimental drug called azd4877 based on the side effects experienced by patients that receive azd4877 on a twice a week basis. for part b, an additional 20 patients will be treated at the maximum dose identified in part a. azd4877 is an eg5 or kinesin spindle protein inhibitor that interferes with tumor cell division leading to tumor growth


Eligibility criteria:
inclusion criteria: * part a: advanced solid tumors (including lymphoma without bone marrow involvement) for which standard treatment doesn't exist or is no longer effective. * part b: b-cell non-hodgkin lymphoma that is not eligible for curative therapy or has relapsed. * relatively good overall health other than your cancer exclusion criteria: * poor bone marrow function (not producing enough blood cells). serious heart conditions. poor liver or kidney function

Keywords: phase i azd4877 lymphoma b-cell non-hodgkin lymphoma
influence of intraoral photobiomodulation in individuals with temporomandibular joint dysfunction

Conditions: Temporomandibular Disorders

Summary: according to the international association for the study of pain (iasp), the temporomandibular pain and dysfunction syndrome (tmd) is characterized as a subset of orofacial pain, whose signs and symptoms include pain or discomfort in the temporomandibular joints. pain is considered one of the most common and limiting clinical manifestations. one of the most used resources to treat muscle pain is the low-level laser therapy (lllt), however, the mechanisms responsible for the effects observed in clinical trials remain poorly elucidated, as well as therapy with light emitting diode therapy (ledt) which, has some advantages, among them the larger area radiation point and low cost. however, its effects remain elusive in intraoral application in temporal muscle, lateral and medial pterygoid muscle. assuming that there is need to investigate therapeutic resources that combine not only different wavelengths as well as different light sources (led and lllt), this study aims to evaluate the effect of photobiomodulation with a combination of different light sources on pain, joint mobility, equity and quality of jaw movements after treatment in patients with tmd. it will be made a randomized, placebo-controlled and double-blind clinical trial. individuals participate with myogenic temporomandibular disorder, being allocated into 2 groups randomly and stratified by the method of sealed envelopes. the results will be evaluated using: rdc/tmd, digital caliper, visual analog scale, and kinematics. the protocols will be used in a 6 sessions and will be evaluated in four different moments. the analyses of the data will be performed by adopting a significance level of 5%.


Eligibility criteria:
inclusion criteria: * women with disfunction temporomandibular. * limitation of mandibular opening below 40 mm. * score of masticatory muscle pain greater than 3 cm in accordance with eva. exclusion criteria: * women who have dental failures, total or partial prosthesis. * systemic diseases . * history of trauma to the face and or atmor the atm dislocation history. * orthodontic treatment and/or medicated that affects the musculoskeletal system.
surgical management of blepharoptosis

Conditions: Blepharoptosis

Summary: comparison of the results of levator resection operation with the use of fixed sutures technique in which the levator muscle is approached through skin incision and the muscle shortened and sutured directly to the tarsus then the skin crease reformed with interrupted sutures which pick up the underlying levator muscle versus the results with the use of adjustable sutures in which the suture passes through the levator muscle into the tarsal plate and out through the skin edge .the skin crease is formed separately so that adjusting the suture doesn't open the wound, the suture can be adjusted according to the result up to 4 days post operative.


Eligibility criteria:
inclusion criteria: * cases of blepharoptosis admitted at assiut university hospital. * cases that are fit for surgery. exclusion criteria: * cases not fit for surgery. * cases of pseudoptosis may result from many conditions that simulate an asymmetry of the upper eyelid level. dysthyroid ophthalmopathy, enophthalmos, or exophthalmos can accentuate a minimal blepharoptosis or produce the appearance of blepharoptosis on the contralateral normal side, * cases with diseases, such as myasthenia gravis; negativity for bell palsy symptoms; and marcus gunn jaw-winking syndrome.
the standard versus imaging substrate aided ablation in severe left ventricular dysfunction vt.

Conditions: Cardiovascular Diseases

Summary: the stable-vt trial aims to determine the safety profile and clinical efficacy of a modified approach to ventricular tachycardia (vt) ablation that integrates myocardial scar as visualized on cardiac magnetic resonance (c-mri) or ct into electroanatomical mapping (eam) for vt ablation.

the stable-vt trial aims to integrate myocardial scar as visualized on cardiac magnetic resonance (c-mri) or ct into electroanatomical mapping (eam) for vt ablation. particularly, we will compare the procedural safety, and acute and long-term clinical efficacy of this imaging-aided vt ablation protocol to standard of care. our hypothesis is that patients with ventricular tachycardia (vt) and severe lv dysfunction randomized to this imaging-aided protocol will have shorter procedure duration, improved procedural hemodynamic stability, fewer acute major adverse cardiovascular events (mace), less need for mechanical support, comparable freedom from vt at noninvasive programmed stimulation (nips) sub-acutely after the procedure, and at two-year follow-up compared to standard ablation approach. herein, our outcomes of interest will be captured during the two years following as part of regular standard of care follow-ups.

Eligibility criteria:
inclusion criteria: * patients (\>18 years old) diagnosed with severely reduced ejection fraction defined as ef≤25% or ef≤ 35% with concurrent nyha class iii/iv heart failure symptoms and/or at least one previous heart failure hospitalization in the previous 6 months) who are referred for vt ablation. * patients with moderate to severe rv dysfunction diagnosed on most recent imaging (echo/c-mri). * patients with must have undergone the imaging (c-mri and/or ct) required for the investigational vt approach to qualify for participation. exclusion criteria: * patients in whom impella/ecmo or anesthesia is indicated prior to or at presentation to the ep lab. * patients for whom an informed consent cannot be obtained. * patients who are found to be pregnant using detection of human chorionic gonadotropin (hcg) as done as part of standard of care, will be excluded.
chemotherapy combined with bevacizumab neoadjuvant therapy for her2-negative breast cancer

Conditions: Solid Tumor

Summary: this is an prospective, multicenter, single-arm clinical study.

prospective, multicenter, single-arm clinical study of chemotherapy combined with bevacizumab neoadjuvant therapy for early or locally advanced her2-negative breast cancer

Eligibility criteria:
inclusion criteria: 1. age ≥18 years old; 2. signed the informed consent and volunteered to join the study with good compliance; 3, histopathologically confirmed her2-negative invasive breast cancer (including triple-negative breast cancer; or luminal breast cancer, that is, er/pr positive and her2 negative) : * her2 negative was defined as 0/1+ on standard ihc test; her2/cep17 ratio was less than 2.0 or her2 gene copy number was less than 4. * er positive and/or pr positive were defined as the proportion of positively stained tumor cells in all tumor cells ≥1%; 4. according to the american joint committee on cancer (ajcc) 8th edition tnm stage ii-iiic (t2-t4 plus any n, or any t plus n1-3, m0); 5. the main organs function well and meet the following standards: a) hemoglobin (hgb)≥90g/l; b) neutrophil absolute value (neut)≥1.5×109/l; c) platelet count (plt)≥ 100×109/l; d) leukocyte ≥3.0×109/l; e) total bilirubin \<1.5 uln (upper limit of normal) f) creatinine \< 1.5×uln g) ast/alt \< 1.5×uln; 6. cardiac ultrasound: left ventricular ejection fraction (lvef≥55%); 7. the investigators determined that the patients were suitable for treatment with bevacizumab. exclusion criteria: 1. stage iv (metastatic) breast cancer; 2. received treatment for the disease, including chemotherapy, endocrine therapy, radiotherapy, immunotherapy, etc.; 3. patients who are participating in other intervention studies; 4. women with confirmed pregnancy or lactation; 5. according to the judgment of the investigator, the subjects have concomitant diseases that seriously endanger the safety of the subjects or affect the completion of the study, or the subjects think that there are other reasons that are not suitable for inclusion.