Kornimate/medical-research-clean huggingface dataset:
ultrasound assessment of metoclopramide's effect on stomach volume in urgent pediatric trauma surgery

Conditions: Gastric Volume

Summary: assess the efficacy of metoclopramide in reducing the gastric contents and volume in pediatric trauma prepared for urgent surgical interventions.

gastric volume is a critical consideration in pediatric patients undergoing urgent surgical procedures, particularly in trauma cases where rapid sequence induction is required to minimize the risk of aspiration. point-of-care gastric ultrasonography (gastric pocus) allows evaluation of the volume and type of stomach contents. previous studies have reported that gastric contents and volume measured using gastric pocus are significantly correlated with cross-sectional antral area. as a result, bedside gastric pocus is considered a reliable and reproducible technique. gastric pocus scan can distinguish an empty stomach from a full stomach based on qualitative results by distinguishing the physical properties of gastric fluid. the presence of thick fluid and solid contents indicate a full stomach.in contrast, the presence of clear gastric fluid is normal in healthy, fasted individuals at low risk of aspiration. as a result, assessing the volume of clear fluid in the stomach may have utility in identifying high stomach volumes that are incompatible with the fasting state. metoclopramide is a prokinetic chlorobenzamide derivative that accelerates gastric emptying and reduces gastric volume. metoclopramide can be safely used preoperatively prior to cesarean section (cs). metoclopramide has been extensively studied as a premedication for abdominal surgery, particularly in obstetric populations. due to favorable effect of reducing gastric fluid volume, metoclopramide is commonly used to reduce the risk of aspiration pneumonia during surgery. metoclopramide reportedly has synergistic dual activity in parturient women; an antiemetic effect on the chemoreceptor trigger zone and peripheral activity in increasing the tone of the lower esophageal sphincter and decreasing the time required for gastric emptying. the mortality of aspiration pneumonia-related is reportedly as high as 5%, with aspiration pneumonia responsible for up to 9% of all anesthesia-related deaths. metoclopramide is well known for its ability to enhance gastric emptying however, to the best of our knowledge, the effectiveness of metoclopramide in enhancing gastric emptying has yet to be evaluated with ultrasonography in preoperative settings, particularly in urgent pediatric trauma.

Eligibility criteria:
inclusion criteria: * paediatric urgent trauma exclusion criteria: * guardian' refusal. * presence of head trauma.
balanced knee system clinical protocol for irb approval

Conditions: Osteoarthritis, Knee; Rheumatoid Arthritis of Knee; Post-traumatic Osteoarthritis of Knee Nos; Valgus Deformity

Summary: the protocol will define the clinical study for ortho development's balanced knee® system (bks) for subsequent review and approval by an institutional review board (irb).this clinical study will compare the clinical outcomes of bks to currently marketed devices.

the rationale is based on the potential effectiveness of the bks to: * return patient to normal activities or increase mobility by restoring knee function. * provide stability to enhance rehabilitation without external support. * eliminate or reduce knee pain. * assess the clinical efficacy after total knee replacement. * determine implant survivorship and viability. * evaluate patient function and satisfaction.

Eligibility criteria:
inclusion criteria: * loss of joint configuration and joint function. * osteoarthritis of the knee joint. * rheumatoid arthritis of the knee joint. * post-traumatic arthritis of the knee joint. * moderate valgus, varus, or flexion deformities. exclusion criteria: * any patient not experiencing a compromised quality of life by loss of joint function and/or joint configuration, or pain from arthritis disease. * any patient whose knee cannot be returned to normal function and normal stability through reconstructive procedures, including ligamentous balancing. * active infection in or near the knee joint, fever and/or local inflammation signs, and elevation of sedimentation rate unexplained by other diseases should not be treated unless preoperative infection is ruled out. * distant foci of infection, such as genitourinary, pulmonary, skin (chronic lesions or ulcerations), and other sites, which may result in hematogenous spread to the implant site. * rapid joint destruction or bone absorption apparent on roentgenograms. * neuromuscular disorders in which the potentially adverse effects on prosthesis function are not outweighed by the benefits gained by the patient from usage of the prosthesis. * mental disorders which would compromise essential patient post-operative care. * a painless, stable arthrodesis in a functional position. * allergic reactions to implant materials, and/or tissue reactions to the products of corrosion or wear. * skeletal immaturity. * any patient who is unwilling or unable to comply with post-operative instructions or clinical study requirements.
circulating tumor dna methylation guiding postoperative adjuvant chemotherapy in stage iii colorectal cancer

Conditions: Colorectal Cancer

Summary: the goal of this randomized controlled trial is to investigate whether ctdna methylation is a more precise indicator to guide postoperative adjuvant chemotherapy in stage ill colorectal cancer. the main questions it aims to answer are: 1. whether ctdna methylation-guided escalation strategy is superior to standard treatment for stage iii high-risk crc patients. 2. whether ctdna methylation-guided de-escalation strategy is non-inferior to standard treatment for stage iii low-risk crc patients. 325 cases were included in the high-risk cohort (t4 and/or n2) and 665 cases were included in the low-risk cohort (t1-t3, n1). then patients in each cohort were randomly assigned to ctdna-guided treatment (ctdna-guided group) and standard treatment (standard treatment group) in a ratio of 2:1. the standard treatment group and ctdna-negative group in the high-risk cohort were treated with xelox regimen for 6 months, and the ctdna-positive group in the high-risk cohort was treated with cmfolfoxiri regimen for 6 months. the standard treatment group and the ctdna-positive group in the low-risk cohort were treated with xelox regimen for 3 months, while the ctdna-negative group in the low-risk cohort did not receive adjuvant chemotherapy.


Eligibility criteria:
inclusion criteria: 1. 18 years old ≤ age \< 75 years old. 2. stage iii (t1-4, n1-2, m0) colorectal cancer patients. 3. patients who can undergo r0 resection. 4. ecog score 0 \~ 2. 5. expected survival ≥ 6 months. 6. no history of other malignant tumors. 7. voluntarily participate in this study and sign the informed consent. if the subject does not have the ability to read the informed consent (e.g., illiterate subjects), a witness must witness the informed process and sign the informed consent. exclusion criteria: 1. patients who have received neoadjuvant chemotherapy. 2. known high clinical risk of adjuvant chemotherapy. 3. patients with clear contraindications to adjuvant chemotherapy (i.e. due to physical condition, comorbidities, active second cancer, or age). 4. patients who are unable to undergo subsequent chemotherapy due to other reasons (travel distance, compliance). 5. vulnerable groups, including people with mental illness, people with cognitive impairment, critically ill patients, minors, pregnant women, etc. 6. there are any other circumstances that the researcher deems unsuitable for inclusion.

Keywords: colorectal cancer ctdna methylation adjuvant chemotherapy
tb-capt exultant - hiv

Conditions: Tuberculosis; HIV Coinfection; Diagnoses Disease

Summary: the overall aim of this study is to assess the potential of an expanded tb testing strategy to increase the number of hiv-positive patients with microbiologically diagnosed tb who are started on treatment in adult wards of sub-saharan africa.

to investigate the effect of an expanded tb screening strategy among hiv-positive patients admitted to hospital (including ultra on sputum, stool and urine, and alerelam on urine, performed regardless of presence of tb symptoms) on the proportion of microbiologically-confirmed tb cases starting treatment within 72 hours of enrolment, compared to ultra testing (on sputum/any tissue) and alerelam (on urine) in only those patients who are symptomatic for tb or fulfilling who testing recommendations. to assess the impact of this screening strategy on 2-month all-cause mortality. • to assess the feasibility of multiple specimens' collection for tb diagnosis within 72 hours of enrolment.

Eligibility criteria:
inclusion criteria: 1. adults (18 years old and above) 2. confirmed hiv infection by serology (including both antiretroviral (art)- naïve and experienced) 3. admitted to the hospital (adult medical wards) at the time of enrolment. exclusion criteria: 1. unable to provide informed consent (if no authorized relatives are in the position to provide the consent) 2. living outside the catchment area of the participating hospital(s) 3. with plans to migrate outside the catchment area within 2 months after recruitment. 4. currently receiving anti-tb therapy or having received anti tb therapy in the last 6 months prior to enrolment 5. receiving preventive tb treatment in the preceding 6 months 6. patients admitted for traumatic reasons, acute abdomen, delivery (maternal conditions), or for planned/scheduled surgery. 7. referred from other hospital.
evaluation of inflammatory markers in larc patients

Conditions: Locally Advanced Rectal Cancer

Summary: introduction: in locally advanced rectal cancers (larc), tnm staging is far from optimal. we aimed to investigate the value of previously described circulating biomarkers as predictors of prognosis. methods: retrospective analysis of 245 larc patients diagnosed between january 2010 and december 2022, who underwent neoadjuvant chemoradiotherapy and surgery at two centers. a cox regression and kaplan-meier analysis were performed.


Eligibility criteria:
inclusion criteria: * patients diagnosed pathologically with rectal adenocarcinomas, located within 12cm from the anal verge (measured by mri), clinically staged t3-4 and/or n+ and treated with neoadjuvant chemoradiotherapy (ncrt) followed by radical surgery exclusion criteria: * evidence of distant metastasis at diagnosis, emergent or palliative surgery, local excision or "watch and wait" approach and evidence of inflammatory or hematological disorders
surgimend in two-stage implant-based breast reconstruction in patients with pre-mastectomy radiotherapy

Conditions: Breast Cancer

Summary: this is a prospective clinical study comparing two-stage breast reconstruction following mastectomy with and without the use of surgimend® prs fetal bovine collagen matrix in patients with pre-mastectomy radiation therapy.


Eligibility criteria:
inclusion criteria: * patient is at least 18 years of age * patient is female * patient is undergoing immediate, two-stage breast reconstruction following mastectomy with or without the use of surgimend® prs * patient has previously undergone pre-mastectomy xrt for breast cancer, with lumpectomy or partial mastectomy, with the previously irradiated breast now being reconstructed (with or without contralateral mastectomy \& reconstruction) * patient utilized a textured expander only * patient utilized a smooth gel permanent implant only * patient has agreed and is able to comply with the study follow-up requirements * patient or guardian has provided consent for participation exclusion criteria: * patient is undergoing single-stage breast reconstruction * patient is undergoing a delayed reconstruction * patient is undergoing reconstruction using a smooth tissue expander, textured gel breast implant or any saline breast implant. * patient is undergoing planned reconstruction using autologous tissue * patient has a known hypersensitivity to collagen or bovine derived materials * patient is currently pregnant, nursing, or planning a pregnancy during the course of the study * patient who has had pre-mastectomy xrt bilaterally for breast cancer (either at the same time or separated in time)

Keywords: mastectomy breast reconstruction bovine adm breast cancer breast implants breast expanders radiation therapy
community support program for lung cancer screening volume ii

Conditions: Lung Cancer

Summary: this is a west philadelphia based community project to improve adherence to lung cancer screening. the overall objective of this project is to demonstrate the impact of a community support program (csp) on improve adherence to lcs follow-up guidelines in an urban environment. the study will target individuals in the penn medicine healthcare system residing in philadelphia with an upcoming or missed follow-up screening or orders placed but who have not yet scheduled their screenings by offering free transportation coordination to and from the appointment. the study team will also offer to connect those with placed but unscheduled low dose ct orders to connect with penn medicine's scheduling staff.


Eligibility criteria:
inclusion criteria: * upcoming or missed low dose ct for lung cancer screening * philadelphia resident exclusion criteria: * lives outside philadelphia city limits
efficacy and safety of regorafenib maintenance therapy in patients with metastatic colorectal cancer (mcrc)

Conditions: Colorectal Cancer

Summary: regorafenib in third-line treatment of metastatic colorectal cancer(mcrc) significantly prolongs the survival of patients, and its advancement has a sensitizing effect on postline chemotherapy and thus improves the prognosis of patients. therefore, the present study was designed to include patients who achieved stable disease/partial response(sd/pr) after 3 months of second-line therapy and advance regorafenib to investigate the role of advance regorafenib in prolonging progression-free survival, prolonging the efficacy of overall survival, safety, and quality of life in patients with mcrc compared with standard second-line and third-line therapy.


Eligibility criteria:
inclusion criteria: * patients with histologically or cytologically confirmed metastatic colorectal cancer who have measurable metastatic disease according to the resolute efficacy criteria for solid tumors (recist) version 1.1. * received standard second-line therapy, achieved stable disease(sd) and above by recist1.1 tumor assessment and maintained for 3 months. * eastern oncology collaborative group(ecog) physical status of 0 or 1 at trial entry and life expectancy ≥ 3 months. * no bone marrow suppression and normal heart, lung, liver and kidney function. * voluntary participation in research. exclusion criteria: * concurrent primary tumors of other types. * msi-h/dmmr type mcrc patients. * heart, liver, kidney, bone marrow insufficiency or mental abnormalities. * intolerant to treatment methods * concurrent participants in other clinical trials. * pregnant or lactating women. * patients deemed unsuitable for study participation by the remaining investigators.
effects of prolonged continuous theta burst stimulation on pain and neural excitability

Conditions: pcTBS; Pain

Summary: numerous studies have confirmed the analgesic effect of m1-rtms on both induced pain and various chronic pains and subsequently found that pctbs is more time-efficient and can produce the same or even stronger analgesic effect, however, its study in pathological pain h has not been thoroughly investigated. due to the dynamic nature of the injury sensory system, pain also exhibits a dynamic process, but there is a lack of specific methods or biomarkers to document this process. surface electromyography (emg) is a common technique used in rtms studies to reflect changes in cortical excitability. in turn, both pain and rtms interventions can cause changes and thus can be used as a potential biomarker to predict pain onset and progression. in addition, the number of sessions of rtms treatment is an important factor influencing the analgesic effect of rtms. in summary, this study intends to explore the best pain predictor by using a capsaicin-induced pain model in healthy volunteers, monitor the dynamic changes of cortical excitability index and vas score before and after pctbs intervention, and also verify the relationship between the number of pctbs treatments and analgesic effect, to provide a new strategy for the prevention and treatment of neuropathic pain.

this study was a prospective, single-blind, sham-controlled, crossover-design trial. each subject was randomized to receive 3 sessions of rtms intervention, consisting of 2 consecutive pctbs stimulations and 1 sham stimulation, with no less than 3 days between each session. the pain was induced by applying capsaicin to the dorsum t of the right hand and recording electromyographic (emg) signals with surface electrodes on the right first interosseous muscle. subjects received m1- pctbs or sham stimulation (sham) intervention at 40 minutes of capsaicin application (t40). subjects' cortical excitability was measured at 5-minute intervals at baseline, 40 minutes after capsaicin application and pctbs intervention, and pain perception was assessed at 10-minute intervals (each assessment to be performed at the end of the measurement).

Eligibility criteria:
inclusion criteria: 1) 18-65 years of age; 2) physical and mental health, free of chronic pain (through interviews and mcgill questionnaires); 3) right-handed exclusion criteria: 1) inability to receive tms interventions (e.g. pacemaker); 2) mental illness or suicidal tendencies; 3) history of previous seizures/epilepsy; 4) previous craniocerebral surgery for stroke or other reasons; 5) drug/substance dependence; 6) inability to sit upright to cooperate with assessment and treatment; 7) pregnancy or planning to become pregnant within half a year
pathophysiology of inflammation after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Conditions: Peritoneal Cancer

Summary: the purpose of this study is to assess the dynamics of inflammatory parameters in presence or absence of infectious complications after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is the treatment of choice in patients with primary or secondary peritoneal surface malignancies. however the survival benefit is achieved at the cost of increased morbidity and mortality due to an extensive surgery and intraoperative chemo-therapy. among complications infectious complications are the most common. the early diagnosis of a potential fatal infection is therefore crucial to ensure a good outcome in patients.

Eligibility criteria:
inclusion criteria: * consecutive adult patients (more than 18 years) subjected to crs and hipec due to peritoneal malignancy. * written informed consent by the participant after information about the research project exclusion criteria: * no primary or secondary peritoneal surface malignancy * no crs and hipec * pregnancy * younger than 18 years

Keywords: peritoneal surface malignancies cytoreductive surgery hyperthermic intraperitoneal chemotherapy
wakobo-ti-kodro: improving identification of pregnancy at risk of obstetric complications at community level

Conditions: Maternal Health; Pregnancy Complications

Summary: this project aims to improve maternal health indicators in a national context where the maternal mortality rate is one of the highest in the world. our hypothesis is that an intervention combining (i) the training of traditional birth attendant in the identification and monitoring of high-risk pregnancies, (ii) their integration into the health system and (iii) the use of a digital decision-support application installed on a smartphone and adapted to their profile, could strengthen the identification and monitoring of high-risk pregnancies, increase attendance at facilities and thus the rate of assisted deliveries in health facilities, in bimbo district around the capital bangui in the central african republic.

this is a quasi-experimental study with a before (baseline measurement) and after (final measurement) approach combined with 2) an exploratory prospective observational cohort study and 3) a sub-study using a mixed methodology. the main objective is to assess a composite intervention implementation combining the integration of traditional birth attendants (tbas) into the health system through a strengthened collaboration with health facilities with the support of a numeric application aiming at registering pregnant women \& identifying those at high risk of obstetric complications. the secondary objectives are to: 1. describe the characteristics of antenatal care, pregnancy outcomes, postnatal care, maternal and neonatal mortality, and changes in the use of health facilities by pregnant women. 2. to assess the acceptability and feasibility of this intervention with matrons, community health workers, community representatives, women who have already given birth in the study area and health staff involved in the study, in order to understand the potential levers and barriers to the implementation of the intervention.

Eligibility criteria:
inclusion criteria for the main study (quasi-experimental study with a before-after approach) * aggregated data of pregnant women, regardless of the age of their pregnancy, and * attending the health facilities included in the study inclusion criteria for participating in the observational cohort: * being a pregnant woman residing in the study area and * attending the health facilities included in the study and * with a given individual consent. inclusion criteria for participating in the sub-study on intervention's acceptability and feasibility: * traditional birth attendants (tbas) or * health workers working in health facilities or * community health workers or * community representatives or * women who have already given birth or pregnant women or their husbands and * all with a given individual consent and * all being part of the study area.

Keywords: traditional birth attendant digital health pregnancy at risk of complications identification collaboration with traditional birth attendant africa central african republic
onedoc picopulse™ for the treatment of melasma among malaysian women

Conditions: Skin Diseases; Skin Disorder; Melanoma (Skin)

Summary: onedoc picopulse™ is a radiopulse technology beauty grade device invented for treating melasma.

this is a new attempt to evaluate the effectiveness of onedoc picopulsetm in treating melasma among women of childbearing age in klang valley, malaysia. this pilot feasibility study protocol is to access feasibility of the onedoc picopulse™ in the future definitive trial. the findings of this study would justify onedoc picopulse™ as one of the promising alternative treatment for melasma.

Eligibility criteria:
inclusion criteria: * women presenting dermal melasma with fritzpatrick skin type iii to v * malaysian citizen * agreed to participate * provide informed consent exclusion criteria: * patients who had a laser procedure, phototherapy therapy, peel, oral therapy, topical treatment or used lightening creams in the treatment area within the past 6 months. * patients with pregnancy, lactating, active dermatitis, had a history of immunosuppression/immune deficiency disorders * patients who photosensitivity or taking drugs known to induce photosensitivity, * patients that have been exposed to severe sun exposure, having severe epidermal injury, allergy and sensitivity * patients who could not attend follow-up treatments

Keywords: melasma skin treatment picopulse malaysian women