Kornimate/medical-research-clean huggingface dataset:
unloading respiratory muscles during niv: comparison of a spontaneous and auto-adjusting controlled mode

Conditions: Respiratory Failure

Summary: measurement of work of breathing (wob), as well as pressure time product (ptp) of transdiaphragmatic pressures to evaluate the degree of muscle activity and muscle unloading during non-invasive ventilation. the study makes comparison of a new developed auto adjusting controlled mode and a regular spontaneous mode.

non-invasive ventilation (niv) reduces carbon dioxide in hypercapnic respiratory failure by unloading the respiratory muscles. spontaneous modes of niv are usually being used in these situations. spontaneous modes have the disadvantage, that the patient has to trigger the ventilator. the work to activate the trigger (wt) is estimated to be as high as up to 50% of the total work of breathing dependent on the underlying disease. elimination of wt would increase the degree of respiratory muscle unloading. a new pressure controlled mode incorporated into the ventilogic mechanical ventilator (weinmann, germany) is capable of self adjusting respiratory parameters in a preset range according to the patient requirements. after a short period where the patients spontaneous respiratory parameters are being analyzed, the ventilator slowly implements a pressure controlled mode that matches the patients requirements. this study intends to investigate if this new mode achieves a higher degree of respiratory muscle unloading compared to a spontaneous mode.

Eligibility criteria:
inclusion criteria: * healthy voluntary individuals * pft within normal limits exclusion criteria: * disease of the upper gi-tract * any form of lung disease or disease of the upper airways * any form of muscular disease, especially neuromuscular disease pregnancy

Keywords: work of breathing pressure time product muscle pressures
election of the optimal moment of colecistectomy after mild biliary pancreatitis

Conditions: Pancreatitis, Acute

Summary: introduction acute pancreatitis is the third gastrointestinal cause of hospital admission. it is estimated that 35-60% have a biliary origin, and most of them are mild. after a mild acute biliary pancreatitis (abp), there is a high risk of recurrence of others biliary events. 15-20% of patients will suffer another pancreatitis, cholangitis, choledocolithiasis, or cholecystitis. therefore, is necessary a definitive treatment. although it is suggested to perform cholecystectomy early, there is still insufficient scientific evidence on this subject. all publications have biases and do not allow establish recommendations. in addition, the usual clinical practice tends to postpone the cholecystectomy, because of doubts about the safety of early intervention and for hospital logistical reasons. on the other hand, is discussing if early cholecystectomy carried out more persistence of residual cholelithiasis, explains for the pathophysiology of the abp. finally, it is important to mention, that in our environment 25% of the patients with an abp are more than 75 years old. there are not any trial that includes this age group. objectives demonstrate that early cholecystectomy is feasible in all patients, including elderly patients, and decreases the number of readmissions for other biliary events. material and methods it is being done a multicenter prospective randomized trial. after an abp, patients are randomized in two treatment branches. group a is cholecystectomy within the first week after the abp. group b four weeks later. there are collect data from demographic information, comorbidities, biliary events before the surgery, residual choledocolithiasis, difficulty of the surgical technique, postoperative complications and patients are follow-up for 6 months. to obtain a representative sample of the population, we consider it appropriate to include all age groups, including patients older than 75 years. expected results with this study we pretend to demonstrate that early cholecystectomy is feasible and safe. it does not increase the number of residual choledocolithiasis, and prevents readmissions for new biliary events.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years. * diagnosis of acute mild biliary pancreatitis according to altanta 2012 criteria. * signed informed consent. exclusion criteria * asa iv. * alcohol abuse or chronic pancreatitis. * not having assessed the presence of residual choledocolithiasis (cholangionmr / intraoperative cholangiography) * pregnancy. exclusion criteria: -
radiofrequency and chemical neurolysis of thoracic splanchnic nerve for abdominal cancer pain

Conditions: Abdominal Cancer

Summary: the study compares between the efficacy, safety and impact on the quality of life of radiofrequency thermocoagulation and chemical neurolysis of bilateral thoracic splanchnic nerves in the management of refractory pain which developed in patients suffering from upper abdominal cancer.

radiofrequency thermocoagulation of splanchnic nerves was done bilaterally at level of thoracic vertebra t10 and t11 ( there were no enough studies done to test the efficacy, safety and impact on the quality of life of radiofrequency thermocoagulation of splanchnic nerves at level of t10 ). aim of the study is to compare between the efficacy, safety and impact on the quality of life of radiofrequency thermocoagulation of bilateral thoracic splanchnic nerves at level t10 and t11 vertebra and chemical neurolytic block of them at level of t11 vertebra only in the management of upper abdominal cancer pain.

Eligibility criteria:
inclusion criteria: 1. patients suffering from upper abdominal cancer pain. 2. visceral pain with visual analogue pain score ≥ 4. 3. normal coagulation profile. 4. positive diagnostic test. 5. written informed consent from the patients . exclusion criteria: 1. patients with organ failure. 2. coagulation disorders. 3. local infection at the puncture site or sepsis. 4. allergy to the contrast dye or alcohol. 5. severe displacement of intra-abdominal structures. 6. pregnant women. 7. documented metastatic lesions. 8. psychiatric illness affecting cooperation. 9. de-compensated cardiac disorders. 10. liver and renal dysfunction.
minimally invasive techniques or surgery in the diagnosis of sarcoidosis

Conditions: Sarcoidosis

Summary: the purpose of this study is to evaluate the yield of endoscopic guided fine needle aspirations (by means of transoesophageal endoscopic ultrasound : eus-fna or transbronchial endoscopic ultrasound : ebus-tbna) in patients with a clinical suspicion for sarcoidosis stage i-ii; but in whom the preceding bronchoscopy did not result in a qualifying diagnosis.


Eligibility criteria:
inclusion criteria: * age ≥ 18 y * suspicion of thoracic sarcoidosis and need for tissue confirmation * recent (\<6 weeks) rx and ct-thorax (hrct not compulsory) * fit for bronchoscopy (with or without ebb, tbb, tbna), esophagoscopy and surgery * written informed consent exclusion criteria: * patients with obvious other organ involvement allowing "simple and safe" biopsy * lofgren syndrome * pregnancy
assessment micro-anatomy of the menisci and cartilage after isolated acute acl injury with mri at 7t

Conditions: Meniscus Lesion; Cartilage Injury; ACL Injury

Summary: study population the investigator set the sample size to 200 patients. primary outcome * diagnostic accuracy of ultrahigh field mri (t7) compared to high field mri (t3 or less) for detection of meniscal injuries associated with acute acl injury secondary outcome * influence of 1) location of injury and 2) meniscal tear pattern (modified worms18,19) on the sensitivity of high field mri compared to ultrahigh field mri for detection of meniscal tears

however, there is no evidence that acl reconstruction can actually prevent the development of knee osteoarthritis. however, concomitant meniscal injuries, either at the time of the acl injury or secondary to the acl injury, significantly increase the risk of secondary knee osteoarthritis. therefore, the treatment strategy for acl injuries is strongly influenced by the presence of concomitant meniscal injuries on initial magnetic resonance imaging (mri). to achieve higher spatial resolution and faster image acquisition, there is a clear trend toward higher field strength mri. meniscal injuries repeatedly occur during the course after isolated acl ruptures, and the question is whether these injuries occurred during the original trauma or as a result of the torn acl. therefore, the primary objective of the current study was to evaluate the potential utility of ultrahigh-field mri (t7) in detecting occult meniscal tears or cartilage injuries associated with presumed isolated acute acl injuries compared with high-field mri (t3 or less). the secondary objective was to evaluate the influence of meniscal tear location and meniscal tear pattern on the sensitivity of high-field mri compared with ultrahigh-field mri in detecting meniscal tears. subsequently, different orthopedic surgeons and radiologists will evaluate the images.

Eligibility criteria:
inclusion criteria: * presumed isolated, acute rupture of the anterior cruciate ligament (trauma not older than 4 weeks) diagnosed by high-field mri (3 tesla or less) at balgrist. * written informed consent of the study participant * age 18 years or older exclusion criteria: * previous knee surgery or trauma * presence of concomitant meniscal injury on high-field mri (3 tesla or less) * advanced gonarthrosis (kellgren-lawrence score greater than 2). * contraindication to the performance of mri * unsigned informed consent * inability to follow study procedures (e.g., due to cognitive impairment) or inadequate knowledge of project language * pregnancy
using radiomics to predict neoadjuvant chemotherapy efficacy

Conditions: Gastric Cancer

Summary: neoadjuvant chemotherapy (nc) is an important treatment for advanced gastric cancer (agc). however, tools that effectively predict the efficacy of nc before treatment are lacking. computed tomography images before and after nc were used to construct a deep learning-based radiomics signature to predict the efficacy of nc, prognoses and postoperative adjuvant chemotherapy benefit.

background: neoadjuvant chemotherapy (nc) is an important treatment for advanced gastric cancer (agc). however, tools that effectively predict the efficacy of nc before treatment are lacking. methods: computed tomography images before and after nc were used to construct a deep learning-based radiomics signature to predict the efficacy of nc, prognoses and postoperative adjuvant chemotherapy benefit. tumor regression grade (trg) =0 or 1 was defined as a good response to neoadjuvant chemotherapy (grnc), and trg=2 or 3 was defined as a poor response to neoadjuvant chemotherapy (prnc). 193 patients with agc from january 2010 to december 2018 in two different china university hospitals were included in this study. the before neoadjuvant chemotherapy imaging scoring system (bnciss), imaging change scoring system before and after neoadjuvant chemotherapy (icss), which were constructed based on computed tomography images before after treatment.

Eligibility criteria:
inclusion criteria: * prospective collection and a retrospective analysis of patients seen from january 2010 to december 2018 at fujian medical university union hospital (fmuuh) and the first hospital of lanzhou university (fhlu) who were diagnosed with gastric adenocarcinoma and underwent radical resection exclusion criteria: * patients with concurrent malignant disease, distant metastases, palliative resection, or gastric stump cancer were excluded.

Keywords: tumor regression grade radiomics neoadjuvant chemotherapy advanced gastric cancer chemotherapy benefit
outcomes of the adjustable gastric band in a publicly funded obesity program

Conditions: Morbid Obesity

Summary: the majority of data documenting the outcomes for the adjustable gastric band (lagb) originate from non-publicly funded surgical centres. the investigators aim to investigate the clinical outcomes of lagb from a publicly funded canadian obesity management program. this program recognized obesity as a chronic disease, providing extensive pre-operative multidisciplinary assessment and long term patient follow-up. patients are selected for surgical management carefully by a multidisciplinary team and the lagb is presented as one option to surgical management. further, the investigators will investigate the operational impacts, including direct and indirect costs related the lagb, to determine long term impacts on publicly funded hospitals within canada.


Eligibility criteria:
inclusion criteria: * all patients seen within the weight wise program and selected for surgical management, who have undergone lagb will be included in this analysis. exclusion criteria: * patients who have undergone selection for surgery outside this process, or who have had surgery elsewhere.
a clinical study in children and adolescents with mild to moderate atopic dermatitis

Conditions: Mild to Moderate Atopic Dermatitis

Summary: to show therapeutic efficacy of zarzenda cream compared to elidel cream in children and adolescents with mild to moderate atopic dermatitis


Eligibility criteria:
inclusion criteria: * male and female children and adolescents (aged 2 - 17) * mild to moderate atopic dermatitis * patients in whom a treatment with topical corticosteroids in not recommended or possible * wash out periods to be observed exclusion criteria: * known allergy to one of the two treatments * known immunodeficiency * known hepatic or renal insufficiency * acute skin infections

Keywords: atopic dermatitis
supertropo (better diagnostics of myocardial infarction with a test for special forms of troponin)

Conditions: Myocardial Infarction; Myocardial Ischemia

Summary: the aim of this study is to investigate whether measurement of the long forms of ctnt with the novel supertropo assay would improve the diagnosis of myocardial infarction in patients in the emergency department. the main goals are: 1. to assess whether measuring long forms of ctnt with the novel supertropo assay and determining the ratio of long ctnt and standard high-sensitivity ctnt could separate patients with type 1 nstemi patients from patients with other causes of minor (\> 14ng/l) ctnt elevation in a single admission blood sample in unselected emergency department patients with clinical indication for troponin measurement. 2. to compare the level of long ctnt and the ratio of long ctnt and standard ctnt in patients with type 1 mi and various clinical patient groups admitted to emergency department with elevated standard ctnt, e.g. patients with atrial fibrillation, heart failure or renal impairment. 3. to evaluate optimal cut-off values for long ctnt and its ratio to standard ctnt in the exclusion and diagnosis of mi in a clinical setting with elevated (\>14ng/l) ctnt. 4. to evaluate how time from symptom onset and peak symptom to blood sampling, as well as comorbidities and patients' age impact the discriminative capacity of long ctnt and ctnt ratio between patients with and without type 1 mi. 5. to investigate whether information on long ctnt and its ratio to standard ctnt can be used to cut down unnecessary coronary angiographies and hospital admissions the long forms of ctnt are measured from the residual blood samples routinely collected from patients with suspected myocardial infarction.


Eligibility criteria:
inclusion criteria: * patient has arrived at the emergency department and high-sensitivity ctnt test (p-tnt) has been ordered as part of the routine "cardiac package" of laboratory tests upon arrival * result of \>14 ng/l of the p-tnt test included in the "cardiac package" * age \> 18 * the patient or his/her legal representative has given written informed consent for participation in the study exclusion criteria: * unable to give informed consent * legally incompetent individuals * pregnancy * previously participated in this study

Keywords: troponin myocardial ischemia myocardial infarction high-sensitivity troponin t
role of lymphnode dissection in men with prostate cancer treated with radical prostatectomy

Conditions: Prostate Cancer

Summary: currently, lymph node dissection is standard of care during prostatectomy of intermediate risk tumors at the martini clinic. it allows the assessment of possible but unlikely lymph nodes metastases. in case of lymph node metastasis, depending on the number of affected lymph nodes, an adjuvant radiation with or without additional hormone therapy may be discussed in order to stop or delay further progression of the disease. since the procedure carries additional risks, it is controversial. the risks include prolonged surgery duration, injury of vessels and nerves, as well as disorders of lymphatic circulation after surgery. moreover, formation of lymphoceles (accumulation of lymph fluid in the tissue) are common, which may result in soft tissue swelling, thrombosis, inflammation and additional surgical procedures. therefore, the aim of this study is to evaluate whether the removal of the lymph nodes during prostatectomy positively influences the course of the disease in patients with intermediate risk prostate cancer, or if the lymph node dissection does not have any influence on the recurrence of the disease and therefore further therapies. in this case, the omission of lymph node dissection may avoid an unnecessary expansion of the operation and the potentially associated side effects linked to it. this is particularly of interest considering the rapidly advancing technical possibilities, both in imaging and in the treatment of prostate cancer, since this enables an earlier and more individual intervention in the case of recurrence.

the significance of lymph node dissection in radical prostatectomy has not been conclusively clarified. if a radical prostatectomy is planned, the question occurs if the additional pelvic lymph node dissection (lnd) is justified and to what extent it should be performed (limited lnd, standard lnd or extended lnd). on the one hand, the detection of lymph node metastases is associated with a significantly worse course of the tumor disease and requires immediate or delayed hormone-ablative therapy. on the other hand, the lymph node dissection is associated with risks (lymphoceles, thromboses, lymphedema), so that the indication in negative lymph node findings appears questionable. it must be weighed between the diagnostic advantage and the possibility of increased morbidity due to the lymphadenectomy. for localized intermediate risk prostate cancer (psa\> 10 ng / ml - 20 ng / ml or gleason score 7 or ct category 2b ), there are currently no recommendations for performing a lymph node dissection during prostatectomy.

Eligibility criteria:
inclusion criteria: * localized intermediate risk prostate cancer (intermediate risk (psa\> 10 ng / ml - 20 ng / ml or gleason score 7 or ct category 2b) * scheduled for open radical prostatectomie or davinci prostatectomie exclusion criteria: * american society of anesthesiology classification\> 3 * existing contraindications for performing a lymph node dissection * neoadjuvant hormone therapy

Keywords: prostatectomy lymphadenectomy
an observational study of cpt-11 plus platinum analogues regimens and ugt1a1 genotypes in solid tumors

Conditions: Small Cell Lung Cancer; Non-small Cell Lung Cancer; Cervical Cancer; Ovarian Cancer; Gastric Cancer (Inoperable and Recurrent)

Summary: the purpose of this study is to examine the correlation between ugt1a1 genotypes and the safety of cpt-11 plus platinum analogues (cisplatin, carboplatin and nedaplatin) regimens for patients with lung cancer, cervical cancer, ovarian cancer and gastric cancer.


Eligibility criteria:
inclusion criteria: * has small cell lung cancer, non-small cell lung cancer, cervical cancer, ovarian cancer and/or gastric cancer * has ugt1a1 genotype \*1/\*6, \*1/\*28, \*6/\*6, \*28/\*28 and \*6/\*28 * is receiving cpt-11 plus platinum analogue (cisplatin, carboplatin and nedaplatin) regimens (with or without molecular targeted agents) exclusion criteria: * has contraindication for cpt-11 * has an eastern cooperative oncology group (ecog) performance score (ps) of 3-4

Keywords: ugt1a1, irinotecan
diagnostic and prognostic markers of endometriosis in menstrual blood

Conditions: Endometriosis

Summary: the goal of this observational study is to identify diagnostic and prognostic biomarkers for endometriosis using menstrual blood, an easily accessible yet overlooked biological fluid in women of reproductive age, affected or not by endometriosis the main questions it aims to answer are: * are there relevant differences in the menstrual blood of women affected by endometriosis compared to women without endometriosis? * do some of these differences disappear or lessen when the disease is treated by surgery? participants will answer questions relevant to endometriosis and provide menstrual blood 1 to 3 times (self-collected with a menstrual cup). a subgroup of participants affected by endometriosis that will undergo surgery for their regular care will provide menstrual blood before and after their surgery. researchers will compare the menstrual blood of women with and without endometriosis, and before and after surgery to see if they can identify significant differences.


Eligibility criteria:
inclusion criteria: for all participants: women 18-45 of age who * have their period * have given their written consent * have already used a menstrual cup as a method of hygienic protection * residing or working in ile de france (paris metropolitan area, france) for participants with endometriosis: * diagnosis of endometriosis established by surgery or imaging (ultrasound and/or mri) * presence of one or more painful symptoms \> 3 on a visual scale (dysmenorrhea and/or dyspareunia and/or chronic pelvic pain) and/or infertility * for the surgery subgroup: planned surgery in the next 3 months for participants without endometriosis: * painful symptoms \< or equal to 3 on a visual scale (for dysmenorrhea and dyspareunia and chronic pelvic pain), * absence of intense period pain in adolescence (leading to taking pills to control this pain and/or peri-menstrual school absenteeism) exclusion criteria: for all participants: * autoimmune diseases * chronic diseases other than endometriosis (diabetes, hypertension) * a person who is the subject of a judicial safeguard measure (by declaration) * infectious diseases (hiv, hbv, if known) * history of menstrual toxic shock syndrome for patients with endometriosis: * endometriosis surgery within the last 3 months.

Keywords: biomarker diagnosis prognosis