Kornimate/medical-research-clean huggingface dataset:
msc-ev in acute-on-chronic liver failure after liver transplantation

Conditions: Liver Failure, Acute on Chronic

Summary: acute-on-chronic liver failure refers to a liver failure syndrome in which some patients with chronic liver disease with relatively stable liver function suffer from acute liver decompensation and liver failure due to the effects of various acute injury factors. liver transplantation is the only curative treatment for this type of end-stage liver disease. the potential of mscs to repair or regenerate damaged tissue and suppress immune responses makes them promising in the treatment of liver diseases, especially in the field of liver transplantation. many studies have shown that msc-based therapies can reduce the symptoms of liver disease due to their paracrine effects. therefore, compared to the cells they derive from, mesenchymal stem cells-derived extracellular vesicles (msc-ev) are gradually gaining attention for their enhanced safety, as they do not replicate or cause microvascular embolism, and can be easily stored without losing their properties. it represents a novel and effective cell-free therapeutic agent as alternative to cell-based therapies for liver diseases, and liver failure was also concerned. this study was designed to evaluate the safety and tolerability of msc-ev in acute-on-chronic liver failure after liver transplantation.

in the msc-ev group (experimental group), 15 patients will receive a single injection of msc-ev after their first liver transplantation. in the non-msc-ev group (control group), 15 patients will not receive msc-ev therapy after their first liver transplantation. the outcome of the experimental group will be compared with that of similar control patients undergoing liver transplantation but who will not receive msc-ev. both of the two groups will receive standard immunosuppressive therapy( a regimen based on tacrolimus (tac), mycophenolate mofetyl (mmf) and steroids). patients participated in the experimental cohort will be infused with a single dose of 10 e10 msc-ev particles per 100ml, at an appropriate time during the first 1-5 days after transplantation.

Eligibility criteria:
inclusion criteria: * aged 18-60 years; * acute on chronic liver failure-which is characterized by acute hepatic insult manifesting as jaundice (serum total bilirubin \[tbil\] ≥ 10×uln umol/l) and coagulopathy (international normalized ratio \[inr\] ≥ 1.5 or prothrombin activity \< 40%), complicated within 4 weeks by ascites and/or encephalopathy as determined by physical examination, in patients with previously diagnosed or undiagnosed chronic liver disease; requiring liver transplantation due to acute on chronic liver failure; * obtain the patients' consent after informing patients of the purpose and method of the clinical trial; exclusion criteria: * past history of malignant disease * active uncontrolled infection; * combined transplantation * ebv-negative; * hiv or hcv positive; * retransplantation;

Keywords: msc-ev acute-on-chronic liver failure liver transplantation
maternal & infant morbidity and mortality

Conditions: Preg Complications: Hemorrhagic; Infant, Premature, Diseases; Preg Complications: Hemorrhagic Intervillous of Placenta; Preg Complications: Bleeding From Female Genital Tract; Preg Complic - Malig Hypertension and / or Reason for Care During Childbirth

Summary: the purpose of this project is to evaluate maternal and infant outcomes based on race at uva hospital. health inequities are influenced by a combination of social, political, and clinical determinants of health. our hypothesis is that patients with minority status, particularly black and hispanic americans, are more likely to have poor outcomes (based on various health metrics) compared to non-black, non-hispanic patients. we hypothesize further that it is likely not far off from national trends, which indicate that black parturients are x4 more likely to die during childbirth, and black children are 2.4x more likely to die before their first birthday than non-hispanic white children. the epic database will be used on an institutional basis to obtain information and accessed by uva statistician to perform the research described in this submission. the dataset does contain a few direct identifiers of medical record numbers, dates, and postal number. we anticipate that all statistical analysis will be performed at uva by participating faculty/staff.

the purpose of this project is to evaluate maternal and infant outcomes based on race at uva hospital. health inequities are influenced by a combination of social, political, and clinical determinants of health. our hypothesis is that patients with minority status, particularly black and hispanic americans, are more likely to have poor outcomes (based on various health metrics) compared to non-black, non-hispanic patients. we hypothesize further that it is likely not far off from national trends, which indicate that black parturients are x4 more likely to die during childbirth, and black children are 2.4x more likely to die before their first birthday than non-hispanic white children. the epic database will be used on an institutional basis to obtain information and accessed by uva statistician to perform the research described in this submission. the dataset does contain a few direct identifiers of medical record numbers, dates, and postal number. we anticipate that all statistical analysis will be performed at uva by participating faculty/staff.

Eligibility criteria:
inclusion criteria: * pregnant women exclusion criteria: * n/a

Keywords: pregnancy complications; hemorrhagic; hypertension; premature infants; bleeding
fixed dose rate gemcitabine and cisplatin followed by chemoradiation for locally advanced pancreatic cancer

Conditions: Pancreatic Cancer

Summary: this is a phase ⅱ trial of fixed dose rate gemcitabine and cisplatin chemotherapy followed by chemoradiation with capecitabine in patients with locally advanced pancreatic cancer.

the main purpose of this study is to evaluate the efficacy and safety of fixed dose rate gemcitabine and cisplatin chemotherapy followed by chemoradiation with capecitabine in patients with locally advanced pancreatic cancer.

Eligibility criteria:
inclusion criteria: * unresectable locally advanced pancreatic cancer * no distant metastasis * histologically confirmed adenocarcinoma of pancreas * 18-75 of age * ecog performance status 0-2 * normal marrow function : * wbc at least 3,000/mm3 or absolute neutrophil count at least 1,500/mm3 * platelet count at least 100,000/mm3 * normal liver function : --bilirubin no greater than 2.0 mg/dl ast less than 3 times upper limit of normal (uln) * normal renal function : --creatinine no greater than 1.5 times uln * signed informed consent

Keywords: locally advanced
vitamin d supplementation during lactation

Conditions: Deficiency, Vitamin D

Summary: this randomized, placebo-controlled trial in thai pregnancy is conducted. the study aims to determine whether vitamin d3 1,800 iu/d supplementation in lactating mother improves vitamin d status of breastfed infant.

vitamin d deficiency in pregnancy increases risk of gestational diabetes mellitus, pre-eclampsia, preterm birth, low birth weight and cesarean section. to against these adverse events, vitamin d supplementation in pregnancy and lactation is recommended, but dose ranges are varied. then, this study is carried out in lactating mothers and their breastfed infants with maternal 25 hydroxy-vitamin d (25ohd) levels of 10-30 ng/ml in third trimester. subjects are divided into 2 groups, one is randomly assigned to 1,800 iu/d compared with maternal and infant controls receiving placebo. maternal serum 25ohd and milk vitd will be measured by lc-ms/ms during lactation, and on cord blood at 6 weeks breastfed infants. this study is submitted for ethical consideration by relevant ethics committee.

Eligibility criteria:
inclusion criteria: * pregnant thai women and intends to deliver at rajavithi hospital * insufficient vitamin d levels (25(oh)d \< 30ng/ml) * gestational age at birth and no complications exclusion criteria: * age \< 18 years old * unintended to deliver at rajavithi hospital * insufficient vitamin d levels (25(oh)d \< 10ng/ml)

Keywords: breast-fed infant vitamin d supplementation lactation
preoperative treatment of malleolar fractures

Conditions: Ankle Fractures; Intermittent Pneumatic Compression; Comparative Study; Preoperative Care

Summary: this study investigates, in a randomized setting, the use of intermittent in-cast pneumatic foot-compression (ipc) in the preoperative treatment of malleolar fractures. this is to investigate whether the ipc has any effect on preventing swelling of the ankle, and thereby preventing delay of surgery due to swelling. the investigators will include patients with malleolar fractures that require surgery in two groups, ipc and bandage or bandage only, and measure the time from diagnosis-to-surgery.

malleolar fractures are often complicated by tissue swelling due to soft tissue injury, haemorrhage and secondary inflammation. this can lead to severe oedema which can compromise the ability to perform surgery due to blister formation or the inability to close the skin after surgery. studies have shown that the use of intermittent pneumatic foot-compression (ipc) can reduce waiting time from diagnosis to surgery as well as reduce length of hospital stay. purpose of the study is in a randomized study to investigate whether patients requiring surgery because of malleolar fractures has a lower diagnosis-to-surgery time when using ipc than patients not using ipc. all patients age 18 or above admitted to our hospital with malleolar fractures (ao type 44-a, 44-b, 44-c) requiring surgery, will be randomized to either in-cast ipc or only cast-immobilization. time from diagnosis of the fracture(time of the x-ray) until start of surgery(time of incision) will be the primary outcome. patients will be seen in a postoperative ambulatory follow-up at 14 days, 6 weeks, 3 months and 1 year.

Eligibility criteria:
inclusion criteria: * malleolar fracture requiring surgery. exclusion criteria: * severe arteriosclerosis. * known or suspected acute dvt or flebit. * severe decompensated heart failure. * pulmonary embolism. * acute skin conditions as dermatitis, infected wounds or recent skintransplant. * open fracture. * inability and/or unable to comply with treatment regime and/or to attend postoperative ambulatory follow-up. * pregnancy.
clinical decision support to improve system naloxone co-prescribing

Conditions: Medication Abuse; Harm Reduction; Opioid Overdose; Opioid Prescribing

Summary: the objective of this study is to evaluate the impact of a clinical decision support (cds) alert to facilitate the co-prescribing of naloxone, an opioid overdose reversal agent, with high-risk opioid prescriptions. prescribing naloxone with opioids is a best practice described in the 2022 us center for disease control and prevention (cdc) guidelines on opioid prescribing. the cds can improve quality of care delivered by improving compliance with the guideline defined best practices. the project will compare cds alert facilitated co-prescribing of naloxone with high-risk opioid prescriptions vs usual care to evaluate the effectiveness of the cds alert for improving naloxone prescribing. the patients are not assigned to an intervention and will be receiving any changes in care as part of their routine medical care, rather than a specific intervention that is distinct from their usual medical care. the researchers hypothesize that the cds alert will be acceptable to providers while increasing naloxone co-prescribing which will reduce the number of opioid overdoses in subsequent 6 months.

clinical decision support tools help clinicians make treatment decisions based on routinely collected data and offer a promising strategy to implement evidence-based practices for safe and effective pain management. this project will use clinical decision support tools embedded into electronic health records to help healthcare providers make treatment decisions that align with opioid prescribing guidelines from the centers for disease control and prevention (cdc). the project will also use information from prescription drug monitoring programs, insurance claims, and mortality data to evaluate patient outcomes. this research will evaluate how prescribing practices that align with cdc guidelines affect patient outcomes and whether clinical decision support tools provide an advantage over standard care practices for pain management.

Eligibility criteria:
inclusion criteria: * patients receiving an opioid prescription at discharge from inpatient/ed or close visit in outpatient settings where the clinical decision support (cds) is implemented exclusion criteria: * patients \ 89 year of age * cancer diagnosis * hospice care/palliative care * sickle cell disease diagnosis * patients who arrived in error * patients who were triaged to obstetrics
exbrac - the pilot study

Conditions: Breast Cancer; Quality of Life

Summary: the exbrac pilot study will investigate the quality of life of patients with breast cancer, and the effect of an intervention with expressive writing. this is a pilot study with two purposes, the first is to create a questionnaire specifically developed for the exbrac study, and the second to evaluate the feasibility of the expressive writing.

in the first stage of the study, patients newly diagnosed with breast cancer will be interviewed using a semi-structured method. based on the transcriptions from the interviews, themes will be gathered and transformed into questions. the questions will be compiled into a questionnaire and an expert group will review the questionnaire to ensure no topic is lacking and an adequate number of response options is present. lastly, the questionnaire will be face-to-face validated, meaning a patient completes it with a research nurse present to apprehend any ambiguities or questions needing clarification. in the second part of the pilot study, patients will be included to test the feasibility of the interventions consisting of expressive writing. the intervention consists of expressive writing during 20 minutes. the writing should be of the breast cancer, the treatment or other related topics. the patient is invited to write once every week in a separate place. the intervention ends after four weeks. the written text is not collected. in the pilot study, the intervention will be followed by a telephone call about five weeks after inclusion. to test the feasibility of the intervention, 20 to 25 included patient is considered sufficient.

Eligibility criteria:
inclusion criteria: * newly diagnosed breast cancer exclusion criteria: * does not understand swedish

Keywords: breast cancer quality of life
neuropathic spinal pain in ankylosing spondylitis

Conditions: Ankylosing Spondylitis

Summary: the aim of this study is to investigate prevalence of neuropathic spinal pain in as patients and it's impact on sleep quality. moreover effects of neuropathic pain on quality of life and fatigue will be assessed.

ankylosing spondylitis (as) is a chronic, inflammatory rheumatic disease that mainly presenting with chronic back pain. in general, chronic low back pain is currently defined as a mixed pain including nociceptive and neuropathic properties. nociceptive pain in several rheumatic diseases displays neuropathic characteristics over time. patients with as are suffered from spinal, entheseal pain or pain originated from peripheral and root joints. although being scarce, there are trials investigating and reporting neuropathic component of spinal pain in axial spondyloarthritis/ankylosing spondylitis patients. however these trials either are not controlled or did not specify painful region of interest. in a few controlled trials control subjects were not defined clearly. sleep problems are reported to be prevalent among patients with chronic pain conditions such as inflammatory rheumatic diseases and fibromyalgia. in patients with ankylosing spondylitis sleep disturbance is a well defined issue. the fact that sleep problem is a common problem in as, raises the need to explore it's associates. in the trials measuring spinal neuropathic pain, sleep disturbances and it's association with neuropathic pain were not assessed. so, investigators have aimed to investigate prevalence of neuropathic spinal pain in as patients and it's impact on sleep quality. for this purpose a case-control study design was planned. age- and sex-matched control subjects will be chosen among individuals submitted to out-patient clinic with nociceptive/mechanical pain complaint lasting more than three months. participants in control group will be subjected to same exclusion criteria too. this design will allow the investigators to determine whether spinal pain in as patients displays neuropathic character more frequently than any chronic nociceptive pain does.

Eligibility criteria:
inclusion criteria: * being diagnosed with as according to the 1984 modified new york criteria * visual analogue scale (vas) spinal pain score ≥ 2 exclusion criteria: * diabetes mellitus, renal insufficiency, hypothyroidism * carpal tunnel syndrome, postherpetic neuralgia, spinal cord compression * neurological diseases leading to neuropathic pain * cervical and lumbar radiculopathy * fibromyalgia * malignancy * severe cardiac disease * pregnancy * muscle weakness or hypoesthesia indicating peripheral nerve injury * in the last three months medical treatment leading to neuropathy (colchicine etc.) * in the last three months drug use for the treatment of fibromyalgia, depression and anxiety
accuracy of skin prick test using in-house wheat extract for the diagnosis of ige-mediated wheat allergy: a pilot study

Conditions: Wheat Allergy

Summary: nowadays, commercial wheat extract is widely accessible, and is used for skin prick test for wheat allergy. however, commercial wheat extracted for skin prick test have less precise test result compared to extract from omega-5 gliadin, which is one of the major allergen with immediate wheat allergy.


Eligibility criteria:
inclusion criteria: * a patient with the age of 1-15 year old * a history of symptoms that suspected of type 1 hypersensitivity (eg. urticaria, angioedema, wheezing, anaphylaxis) occur within 4 hours after wheat ingestion. * patients attend in allergy clinic, pediatric department, siriraj hospital since 2007-2012 exclusion criteria: * first sign and symptom happens more than 4 hours since wheat ingestion * have underlying disease such as heart disease, epilepsy etc. * have contraindication for performed skin prick test

Keywords: skin test open wheat challenge
surgery for male stress urinary incontinence

Conditions: Male Stress Urinary Incontinence

Summary: the purpose of this observational prospective study is to evaluate the success rate (cure plus improvement) of procedures for treatment of male stress urinary incontinence (artificial urinary sphincter or male slings) at 5 years of study follow-up and to determine other outcomes of surgical treatment for each of the devices and, to perform a prognostic factor analysis to identify clinical and surgical variables that correlate with (in)continence or revisions for each of the device subtypes. cure is defined as urinary continence with no need for use of pads or the use of 1 light security pad; the improvement is defined as the reduction of≥ 50% of the number of pads with use of no more than two pads.

through the use of a prospective registry, the investigators will collect information on patient characteristics, including age (years), weight (kg), length (cm), previous urological surgeries and other surgeries in the pelvic area, radiotherapeutic treatment of the prostate, and other co-morbidities. also, if applicable, 24h pad test and preoperative urodynamic results, presence of pre-operative urinary tract infections, and results of preoperative cystoscopy will be reported. the surgical procedure for treatment of male stress urinary incontinence is according to standard practice. for artificial urinary sphincters, the date and time of surgery, surgeon name, time of shaving, presence of skin wounds, type of prosthesis, cuff location, cuff size, pressure regulating balloon, type of preoperative antibiotics, type of associated procedures will be reported. for slings, similar data will be reported, including type of sling and if there was a release of central tendon. the patients will fill in the international consultation on incontinence questionnaire (iciq) urinary incontinence (ui) short form (iciq-ui questionnaire sf), the euroqol group questionnaire (eq-5d-5l) for the evaluation of the impact of incontinence on quality of life, and the sexual complaints screener for men (scs-m), the dyadic adjustment scale italian version (das), the international index of erectile function questionnaire (iief-15) and the hospital anxiety and depression scale (hads) questionnaire before the operation, at 12 weeks after surgery and at yearly intervals up to and including year 5. the results of questionnaires will be entered into the database.

Eligibility criteria:
inclusion criteria: * male patients undergoing surgery for stress incontinence using medical devices such as aus or sling * participant is willing and able to complete the questionnaires and give informed consent for participation in the study exclusion criteria: - participant unable to complete the questionnaires and declining informed consent for participation in the study

Keywords: urinary incontinence male incontinence post-prostatectomy incontinence radical prostatectomy male sling artificial urinary sphincter