Kornimate/medical-research-clean huggingface dataset:
safety and efficacy of mesenchymal stem cell transplantation for acute-on-chronic liver failure

Conditions: Liver Failure, Acute on Chronic

Summary: safety and efficacy of mesenchymal stem cell transplantation for acute-on-chronic liver failure

acute-on-chronic liver failure (aclf) which occurs in patients with chronic liver disease, is a serious live-threatening disease. currently, the clinical management, such as liver protection, anti-virus medicine, and artificial liver support, has not significantly improve the outcomes, the mortality still remains over 50%. liver transplantation is the only effective treatment of aclf, but this therapy is limited by the shortage of donor organs, potential surgical complications, immunological rejection and high medical costs. mesenchymal stem cell (msc) is one of adult stem cells, which has been suggested to play a role in amelioration of liver disease, such as: trans-differentiation of mscs into hepatocytes, immunomodulation, inhibition of fibrosis development, protective effects on hepatic cell and restoration of hepatic cell proliferation capacity.

Eligibility criteria:
inclusion criteria: 1. informed consent 2. meeting the definition of aclf: patients with previously diagnosed or undiagnosed chronic liver disease acute decompensated within 4 weeks; significant gi symptom as such fatigue, jaundice; serum total bilirubin \[tbil\] ≥10 x the upper limit of normal; coagulopathy (international normalized ratio \[inr\] ≥1.5 or prothrombin activity \[pta\] \<40%); complicated within 4 weeks by ascites and/or encephalopathy as determined by physical examination. 3. model for end-stage liver disease (meld) scores ranging 17-30, (meld(i) = 0.957 × ln(cr) + 0.378 × ln(bilirubin) + 1.120 × ln(inr) + 0.643); 4. chronic liver disease with definitive etiology such as viral hepatitis, alcohol liver disease, drug induced liver injury or autoimmune liver diseases 5. body weight ≥50kg exclusion criteria: 1. serious complications in the previous 2 months (e.g., gastrointestinal bleeding: hemoglobin below 90g/l, serious infection such as sepsis, ascites ultrafiltration, and/or dialysis); 2. malignant jaundice induced by obstructive jaundice or hemolytic jaundice; 3. hepatocellular carcinoma (hcc) diagnosed by radiologic imaging and/or alpha fetoprotein (afp); 4. tumor diagnosed by ultrasound, ct, mr examination; 5. moderate or severe chronic heart failure (nyha iii-iv), renal replacement therapy, severe chronic pulmonary disease (gold iii-iv) 6. extrahepatic cholestasis 7. hepatic, portal and splenic vein thrombosis diagnosed by doppler ultrasound 8. artificial liver support 9. previous liver transplantation 10. drug abuse in the past 5 years; 11. mental disorders and/or has a family history of mental disorder. 12. hiv infection 13. pregnant or breast-feeding females 14. highly allergic 15. patients can not cooperate or mobility 16. enrolled in other clinical trials with 3 months 17. patients who can not provide prior informed consent or refusal to participate

Keywords: mesenchymal stem cell
a phase 2 trial of neoadjuvant modified folfirinox chemotherapy for resectable pancreatic adenocarcinoma

Conditions: Resectable Pancreatic Adenocarcinoma

Summary: within the next decade, pancreatic ductal adenocarcinoma (pdac) is expected to rise to the second leading cause of cancer-related mortality. to increase the survival, various peri-operative treatments have been tested, and adjuvant folfirinox or gemcitabine plus capecitabine is now standard of care after surgical resection for localized pdac. even with superior survival among various disease extent of pdac, resectable pdac still shows poor outcomes with surgery followed by adjuvant chemotherapy. this phase ii study is investigating the role of modified-folfirinox as neoadjuvant treatment for resectable pdac.

this phase ii study is designed to evaluate the efficacy and safety of modified folfirinox as neoadjuvant treatment for resectable pancreatic cancer.

Eligibility criteria:
inclusion criteria: 1. patients with pancreatic ductal adenocarcinoma confirmed by histological or cytopathological examination 2. pancreatic adenocarcinoma patients evaluated as resectable according to the following criteria in imaging tests including ct or mri (nccn guideline criteria, if all of the following criteria are satisfied) a. no tumor contact with the major arterial structures of the celiac axis \[ca\], superior mesenteric artery \[sma\], and common hepatic artery \[cha\]. b. when there is no contact between the tumor and the major vein of the superior mesenteric vein (smv) or portal vein (pv), or within 180° even if there is contact, and there is no venous atypicality. 3. patients who have not undergone surgical resection and systemic chemotherapy for pancreatic cancer. 4. patients whose ecog activity ability index is 0 to 1 5. patients who are willing and able to provide written informed consent for this study. 6. patients over the age of 19 at the time of signing the subject consent form. 7. patients with evaluable lesions according to recist 1.1. 8. patients with adequate organ function. exclusion criteria: 1. histologic diagnosis other than pancreatic ductal adenocarcinoma (eg, neuroendocrine tumor, etc.) 2. patients with distant metastases including central nervous system (cns) metastases or peritoneal metastases 3. patients with moderate acute or chronic medical conditions or abnormal findings on examination, which are judged to affect the results of this study 4. patients who have participated in a study in which investigational drugs are used and are currently receiving investigational drugs or used investigational drugs or medical devices within 4 weeks prior to the first administration of this investigational drug. 5. those who received chemotherapy, targeted small molecule agents, or radiotherapy within 2 weeks prior to day 1 of the study, or who have not yet recovered (grade 1 or lower or baseline level) from adverse reactions due to previously administered drugs patient. 6. patients with known aggravation within the past 3 years or other malignant tumors requiring active treatment.

Keywords: resectable pancreatic cancer neoadjuvant
multi-points and full-thickness biopsy in the diagnosis of ccr after neoadjuvant therapy for rectal cancer

Conditions: Rectal Cancer; Neoadjuvant Therapy; Complete Remission; Metastasis

Summary: background there is currently no reliable means to restage rectal cancers after neoadjuvant chemoradiation. there are still no reliable methods to identify patients with pcr before radical surgery. as a result, clinical complete response (ccr), defined as no clinical detectable tumor by physical examination, endoscopic evaluation, and imaging, is designed as a surrogate endpoint for pcr. however, the concordance between ccr and pcr varies from 22% to 96% in different reports, which questions the clinical value of such strategies. therefore, based on rectal diginal examination, serum cea, mri, endoscopy examination, we suggested to add multi-points and full-thickness biopsy technique to further improve the accuracy of ccr.


Eligibility criteria:
inclusion criteria: * adult male and female, between 18 and 80 years old; * colonoscopy biopsy pathology confirmed colorectal adenocarcinoma; * the distance from the lower margin of the tumor to the anal margin ≤12 cm (endoscope) or to the anorectal ring ≤8 cm; * the hematopoietic functions of heart, lung, liver, kidney and bone marrow meet the requirements of surgery and anesthesia; * initial local mri stage was t2 or t3a or t3b, n0-2, negative for extramural vascular invasion (emvi), circumferential ential resection margin (crm), and no peripheral iliac, common iliac, obturator, or abdominal aortic lymph node metastasis; * ccr patients evaluated after neoadjuvant therapy (no mass or ulcer found on digital rectal examination;endoscopic examination showed no other changes except flat scar, telangiectasia or pallor of mucosa.mri or rectal ultrasound showed no residual tumor in the primary site and lymphatic drainage area.serum carcinoembryonic antigen (cea) was normal. * signing informed consent for surgery. exclusion criteria: * previous history of malignant colorectal tumor; * patients complicated with intestinal obstruction, intestinal perforation, intestinal bleeding and other patients requiring emergency surgery; * unresectable lymph node metastasis; * recently diagnosed with other malignant tumors; * patients who had participated in or were participating in other clinical trials within 4 weeks prior to enrollment; * asa rating ≥iv and/or ecog physical status score ≥2 points; * patients with severe liver and kidney function, cardiopulmonary function, coagulation dysfunction or combined with serious basic diseases cannot tolerate surgery; * a history of serious mental illness; - pregnant or lactating women; * those with uncontrolled infection; * patients with other clinical or laboratory conditions considered by the investigator should not participate in the study

Keywords: rectal cancer neoadjuvant therapy clinical complete remission full-thickness biopsy watch-and wait regrowth
branched-chain amino acid (bcaa) on progression of advanced liver disease

Conditions: Liver Cirrhosis

Summary: protein-calorie malnutrition is frequently observed in patients with advanced liver cirrhosis. there have been continued interests in potential benefits of long-term oral branched-chain amino acid supplement in improving severity of liver disease. however, there are limited evidences in literature. the aim of this study is to evaluate the efficacy of oral branched-chain amino acid in patients with advanced liver cirrhosis.

this study is a multicenter retrospective cohort study involving thirteen centers in korea nation-wide. the inclusion criteria are liver cirrhosis patients with child-pugh score 8 to 10. the major exclusion criteria are abnormal serum creatinine level, and hepatocellular carcinoma with viable tumor. the investigators analyzed improvement of model for end-stage liver disease score, child-pugh score, incidence of cirrhosis-related complications, and event free survival.

Eligibility criteria:
inclusion criteria: * advanced liver cirrhosis patients with child-pugh score 8 to 10 exclusion criteria: * diagnosis of malignancy (except hepatocellular carcinoma) within 3 years or untreated malignancy * major organ failure (heart, lung and kidney) need to admission or medical therapy or dialysis * patients already on a waiting list or being considered for major organ transplantation. * serum creatinine above upper normal range (\>1.5 mg/dl) * patients treating with albumin replacement regularly * viable hepatocellular carcinoma or advanced barcelona clinic liver cancer stage or hepatocellular carcinoma below 6 months life expectancy * patients being impossible to secession of alcohol consumption * patients being impossible to oral ingestion or oral medication * pregnancy or being considered for pregnancy * breast feeding * amyotrophic lateral sclerosis * patients with other metabolic disorder presenting branched-chain ketoaciduria

Keywords: liver cirrhosis branched chain amino acid end-stage liver disease score
effects on ventilation with nhf and asymmetrical nasal cannulas

Conditions: Chronic Obstructive Pulmonary Disease

Summary: the aim of this controlled randomized crossover study is to compare the physiological effects of nasal high flow therapy (nhf) with 2 different nasal cannulas in patients with exacerbated chronic obstructive pulmonary disease (ecopd) and chronic respiratory failure. 20 patients will be treated with nhf therapy (airvo, fisher\&paykel healthcare, nz) during wakefulness. physiological measuremends will take place over three perdiods (visits). one period without nhf, one with nhf via standard cannula (optiflow m) and one with asymmetrical cannula (optiflow duet) in randomised order.

background: nasal high flow (nhf) therapy had shown to increase airway pressure, reduce dead space, and improve mucociliary clearance and gas exchange in patients suffering from chronic obstructive pulmonary disease (copd). the long-term and short-term physiological aspects of nhf are subject of ongoing research. different flow rates and cannula sizes have been studied and found to yield different therapeutic effects. larger sized cannulas tend to seal the nares and produce increased positive airway pressure, while smaller cannulas increase the washout effect. currently, a new cannula is available, with one smaller and one larger opening (optiflow+ duet, fisher\&paykel healthcare, nz). procedure: following a baseline period without high flow therapy, nhf (35l/min) will be applied via the nasal cannula (duet or standard in randomized order). after a wash out phase, the nhf interface will be replaced for another measurement with the respective other cannula (standard or duet). respiratory rate, tidal volume, minute ventilation, inhalation to exhalation ratio (ti/te), transcutaneous pco2 and intercostal emg will be recorded during each partial measurement.

Eligibility criteria:
inclusion criteria: * inpatients with copd gold 3 and 4 in stable phase after acute exacerbation * inpatients with copd gold (2, 3 and 4) * informed consent exclusion criteria: * acute respiratory insuffiency with respiratory acidosis (ph\<7.35) * severe acute physical disease, that do not allow the subject to participate in a clinical trial * language, cognitive, or other barriers that make study participation impossible * pregnancy or nursing

Keywords: nasal high flow (nhf) high flow nasal cannula (hfnc) optiflow copd
low-back pain during pregnancy and its psycho-social implications

Conditions: Pregnancy Related; Low Back Pain; Pelvic Girdle Pain

Summary: pregnancy-related pelvic girdle pain (ppp) and pregnancy-related lumbar pain (plbp) are two distinct symptoms, which can occur together as lumbar-pelvic pain.the primary objective is to measure the impact of osteopathic manipulative treatment on pregnancy-related lumbar and pelvic pain. the secondary objective is to study the interaction between pain and psycho-social factors during the gestational period.


Eligibility criteria:
inclusion criteria: * women aged 18-44 * primiparae * single pregnancy * spontaneous pregnancy - fisiological pregnancy * pregnancy \>= 12 weeks * low-back pain (between the 12th rib and the lumbo-pelvic region) and/or pelvic (in the pubic region and/or in one or both of the sacro-iliac joint and/or of the gluteal region) non specific * consent to treatment * absence of linguistic barriers exclusion criteria: * women aged \ 44 * pathological pregnancy, twins * metabolic pathologies * obstetrician's emergencies * pre-term birth * specific lumbar and/or pelvic pain - genetics disorders * major congenital anomalies * absence of consent to treatment * presence of linguistic barriers

Keywords: osteopathic manipulative treatment pregnancy pain low back pain pelvic girdle pain psychological factors
pilot study of alternative treatments of unexplained chronic fatigue

Conditions: Idiopathic Chronic Fatigue; Chronic Fatigue Syndrome; Myalgic Encephalomyelitis

Summary: the investigators' long-term goal is to identify, and then provide general practitioners with evidence-based recommendations for therapeutic interventions for unexplained chronic fatigue (ucf). the investigators' central hypothesis guiding this application is that some complimentary and alternative medicine (cam) practitioners have developed management approaches that are more helpful to patients with ucf than usual care.

an objective is to identify certain types of clinicians (or individual physicians) who appear to have identified effective treatments for patients with ucf, or to find that clinicians who report themselves to be effective are not. study subjects will be ucf patients new to the practice of one of four groups of participating clinicians: 1) a control group of mds in practice-based research networks, 2) mds trained in cam, 3) naturopathic doctors (non mds trained in special naturopathic schools), and 4) mds who specialize in chronic fatigue. our rationale for this comparison is that its successful completion will potentially guide future searches for effective medical strategies for the treatment of ucf that may have been developed outside the mainstream medical community. it may also provide necessary information for follow-up studies that will help to identify specific effective treatments. this information includes which clinicians provide the best treatments (as evidenced by having patients with the best results), what are the characteristics of patients who respond to a particular treatment, how the data collection procedures might need to be refined and what sample sizes are necessary.

Eligibility criteria:
inclusion criteria: 1. age 21 through 65. 2. has severe debilitating fatigue that substantially reduces the quality of life. 3. does not have any organic, psychological, or lifestyle problems that are the primary disorder and are likely to be the cause of this fatigue (see exclusionary criteria) 4. the severe, unexplained fatigue has persisted for at least six months. 5. has not been previously treated by current physician for chronic fatigue. 6. can speak and read english. 7. is not pregnant or planning to become pregnant within six months. 8. has a telephone. exclusion criteria: no known history of: 1. bipolar disorder 2. psychosis 3. major depressive disorder 4. sleep disorder 5. anemia 6. thyroid disease 7. rheumatoid arthritis 8. systemic lupus 9. cancer 10. heart disease 11. liver disease

Keywords: idiopathic chronic fatigue chronic fatigue syndrome myalgic encephalomyelitis
the role of contrast enhanced ultrasound in appendicitis

Conditions: Acute Appendicitis

Summary: this study seeks to determine the efficacy of contrast enhanced ultrasound (ceus) in improving the diagnosis of acute appendicitis in children, when compared to the standard grey-scale ultrasound.

this will be a single-center, non-randomized trial that will add to our institution's current diagnostic algorithm using contrast enhanced ultra sound (ceus) in subjects who are clinically suspicious for acute appendicitis. for those who consent to study participation, we propose obtaining a ceus after the initial gray-scale ultrasound. once the initial ultrasound is complete, the contrast lumason® (sulfur hexafluoride lipid type-a microspheres) will be administered through an already existing iv catheter and an abdominal scan will be completed. the patient will then continue with standard of care treatment per his treating physician. the ceus image will be read at a future time by a children's mercy hospital radiologist blinded to the results of the gray scale ultrasound and computed tomography (ct) scan if one was obtained; these will be used for comparison.

Eligibility criteria:
inclusion criteria: * present to children's mercy adele hall campus with a clinical concern for acute appendicitis * age 8 through 17 years * seen between institutional review board (irb) approval date and 12/31/2019 * seen monday- friday between the hours of 9:00 a.m. and 4:00 pm * has had an iv catheter placed as part of their standard of care exclusion criteria: * known cardiac abnormality * pulmonary hypertension * known sensitivity to sulfur hexafluoride, polyethylene glycol 4000, distearoylphosphatidylcholine (dspc), dipalmitoylphosphatidylglycerol sodium (dppg-na), or palmitic acid * does not had an iv catheter placed * unable to roll over * unable to assent * pregnant * lactating * received an ultrasound image from a referring facility
the effects of health education about human papilloma virus and cervical cancer prevention on knowledge, attitudes, beliefs and behaviors

Conditions: Health Education

Summary: aim: to determine the effects of health education about human papilloma virus infection and cervical cancer prevention on knowledge, attitudes, beliefs and behaviors of adolescent girls and their mothers. background: to combat with cervical cancer, it is urgent that prevention human papilloma virus related disease all around the world. design: a randomized trial with a control group (n=108) and an intervention group (n=108). methods: the study was applied between january to june 2019 in the two different adolescent outpatient clinics in turkey. the outpatient clinics were randomly assigned as intervention and control groups by numbering and opaque and sealed envelopes. based on the intention-to-treat principle, all participants were analyzed according to the group they were assigned to, regardless of whether they received the intervention or not. in addition to the routine clinical practice, the adolescent girls and their mothers who participated in the intervention group were given health education twice in the first interview and in the fifth week. follow-up continued for 12 weeks. the adolescent girls and their mothers in the control group received routine clinical practice. the effects of health education were evaluated with human papilloma virus knowledge scale and health belief model scale for human papilloma virus and its vaccination. impact: human papilloma virus vaccine, which has an important place in primary protection from cervical cancer, is expected to provide effective results by facilitating access to vaccine accompanied with health education.


Eligibility criteria:
inclusion criteria: to be a girl between the ages of 9 and 18, to be a mother of a girl between the ages of 9 and 18, to be fluent in turkish, to be literate exclusion criteria: to be male, to have previously received human papilloma virus vaccination, to have hearing, speech impairment and mental disorder, not to follow the study regularly, to use medication due to psychotic treatments, to be an adolescent with sexual experience

Keywords: human papilloma virus vaccine health education nursing adolescent health
efficacy of lng-ius for treatment of non-atypical endometrial hyperplasia in perimenopausal women

Conditions: Endometrial Hyperplasia

Summary: the purpose of this study is to compare the efficacy of the levonorgestrel releasing intrauterine system (mirena) and norethisterone acetate for treatment of non-atypical endometrial hyperplasia in perimenopausal women.


Eligibility criteria:
inclusion criteria: * patients with histologically confirmed simple or complex endometrial hyperplasia without atypia exclusion criteria: * endometrial hyperplasia with atypia * other pathology e.g. patients with fibroids of any size, genital infection, adnexal abnormality.

Keywords: endometrial hyperplasia, lng-ius, progestin
study in subjects suspected of having cad undergoing visipaque-enhanced ccta as part of their routine medical care

Conditions: Coronary Artery Disease (CAD)

Summary: to assess prognostic value of ccta examination in subjects who undergo ccta as part of their medical care when compared to a standard of truth, i.e. subject outcomes during each follow-up period.


Eligibility criteria:
inclusion criteria: * the subject is over 18 years old, exhibits chest pain syndrome and is scheduled to undergo a visipaque-enhanced ccta examination for one of the following reasons:- intermediate pre-test probability of cad. * an uninterruptible/equivocal stress test (exercise, perfusion, or stress echo).

Keywords: cad visipaque ccta