Kornimate/medical-research-clean huggingface dataset:
ppis and gastroesophageal varices in liver cirrhosis (ppis: proton pump inhibitors)

Conditions: Liver Cirrhosis; Hypertension, Portal

Summary: this study is aimed at investigating the effect of ppis on gastroesophageal varices in liver cirrhosis. half of participants will receive ppi, while the other half will receive a placebo.

ppis can inhibit parietal cell h+/k+-atpase and reduce secretion of gastric acid. ppis can promote platelet aggregation and stabilize the formation of fibrin thrombosis by maintaining the high ph environment in the stomach and inactivating pepsin. the effect of ppis on ulcerative upper gastrointestinal bleeding was confirmed but it is not clear whether ppis is applicable in esophagogastric variceal bleeding whose etiology and bleeding position are different from ulcerative upper gastrointestinal bleeding. there is lack of consensus and sufficient evidences to support to use ppis in esophagogastric variceal bleeding in cirrhotic patients universally. nevertheless, the use of ppis in liver cirrhotic patients with gastroesophageal varices is common.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of cirrhosis * gevs was diagnosed by endoscopy exclusion criteria: * acute gastrointestinal bleeding need emergency surgery * acid-related disease, such as peptic ulcer disease or gastroesophageal reflux diseases (gerd) * hepatocellular carcinoma (hcc) or other malignant tumor * history of esophagus, stomach or liver surgery * child-pugh c and can't be improved to child-pugh a or b * preparing to be pregnant, pregnant or breast feeding * allergic to ppis(proton pump inhibitors) or intolerable * cannot provide informed consent

Keywords: gastroesophageal varices hemorrhage
levobupivacaine to the surgical wound following cesarean

Conditions: Postoperative Pain

Summary: the postoperative period following cesarean is associated with moderate to severe pain that requires a considerable amount of analgesics that carry with them side-effects such as nausea, vomiting, fatigue and immobilization. several studies have tried, with variable results, to find a more effective analgesia alternative such as infusion of local anesthetics through a catheter in the surgical wound sinus, a practice that has currently been widely used in clinical practice. despite existing references on its use in the postoperative period following cesareans there continues to be a lack of information on other aspects. the investigators study hypothesis is that the use of levobupivacaine in the surgical wound will reduce the surface of hyperalgesia compared to the control group.


Eligibility criteria:
inclusion criteria: * full-term pregnant women who undergo scheduled cesarean surgery under intradural anesthesia. * duly informed patients who have signed the informed consent during the preanesthesia consultation, or after a period of consideration if necessary, expressing their consent to be included in the study. * between 18-45 years of age. * asa i and ii. * sufficient intellectual ability to understand the technique as well as the equipment being used. exclusion criteria: * failure to meet any of the above criteria. * presence of a major medical, cardiovascular, pulmonary, metabolic, renal or liver disorder. * preeclampsia and/or hellp syndrome. * coagulopathy * profuse bleeding greater than 1000 ml or that which provokes hemodynamic instability that requires aggressive fluid therapy and/or transfusion. * allergy to any drug included in the protocol. * psychiatric or neurological pathology. * preexisting infection. * previous treatment with opioids or antidepressants or suffer from chronic pain. * history of alcohol or drug abuse or known consumption of medications that interfere with lb metabolism.

Keywords: cesarean section wound infusion local anesthetic levobupivacaine pain management
role of adjuvant chemotherapy in distal cholangiocarcinoma

Conditions: Distal Cholangiocarcinoma; Adjuvant Chemotherapy

Summary: recent studies addressing the role of adjuvant chemotherapy in cholangiocarcinoma (cca) have been published; however, there are challenges in generalizing the findings due to different prognostic characteristics depending on tumor location and resectability. therefore, the aim of this study was to investigate the role of ac in distal cholangiocarcinoma, a common tumor subtype of cca.


Eligibility criteria:
inclusion criteria: * patients with distal cholangiocarcinoma who underwent surgery exclusion criteria: * who underwent neoadjuvant treatment * who underwent r2 resection * non-adenocarcinoma patients in final pathology report * insufficient data * death within 90days of surgery
diagnostic possibilities in ophthalmological diseases using swept source optical coherence tomography

Conditions: Retinal Disease; Diabetic Retinopathy; Macular Degeneration

Summary: in this pilot study we want to investigate morphological features acquired by the novel image modality and gain information regarding disease pathomechanism, development and future possible influence on disease management for patients affected by those diseases.


Eligibility criteria:
inclusion criteria: * age between 5 and 110 years * ability to follow instructions during imaging procedure * written informed consent exclusion criteria: * dementia * inability to follow instructions during imaging procedure * patients who do not give informed consent
imaging of islet transplantation with pet and mrt

Conditions: Islet Transplantation; Diabetes Type 1

Summary: islets of langerhans intended for clinical transplantation are labelled with a radioactive tracer. the tracer is retained in viable cells of the transplant. at infusion (transplantation) of the islets into the portal vein the tracer can be followed for two hours with positron emission tomography (pet). imaging and calculations can give estimates of the proportion of surveying islets and the rate of early destruction. also the distribution of the islets into the liver can be viewed.

background: it is suspected that the current need for repeated islets transplantation to treat diabetes type i is dependent on an early destruction of the islets when infused into the portal vein. aim: to trace the fate of the islet at and after infusion into the portal vein. method: islets are labelled in vitro with a radioactive tracer that can be measured with positron emission tomography. 10-20 percent of the graft is labelled. just prior to start of infusion labelled islets are mixed with unlabelled islets (80-90 percent of the graft). the tracer used is fdg and stands for 2-\[18f\]-2-deoxy-d-glucose. at infusion the patient is placed in the combined computer tomography and pet camera to follow the infusion. the imaging is almost continuous for 2 h at and after infusion. expected results: calculations of proportion of surviving islets and rate of destruction. localisation and distribution of islets in the liver of the recipient.

Eligibility criteria:
inclusion criteria: * patients suitable for clinical islet transplantation. * patient on waiting list for islet transplantation within the nordic network for clinical islet transplantation * written informed concent

Keywords: islet transplantation, coagulation, graft destruction, islet imaging
effect of phosphorus on valvular and vascular calcification in esrd

Conditions: Vascular Calcification

Summary: evaluation of the calcifying effect of phosphorus on vascular smooth muscle and detect the association between serum phosphorus and valvular and vascular calcification in end stage renal disease patients

cardiovascular disease (cvd) is the main cause of death in patients with end stage renal disease(esrd). it is estimated that esrd patients are 5 to 20 times more likely to die because of cardiovascular causes than the general population . traditional cardiovascular risk factors do not completely explain higher mortality rates among hemodialysis patients , and non traditional risk factors such as anemia, bone mineral disease, hyperhomocysteinemia, inflammation, hypercoagulability, and left ventricular hypertrophy (lvh) have been demonstrated to play an important role in this population. a number of factors have been associated with progression of vascular calcification(vc) in dialysis patients. associations with age and duration of dialysis , diabetes mellitus ,abnormalities of mineral metabolism as well as use and dose of calcium based phosphate binders have all been reported. hyperphosphatemia is a common problem among patients with esrd. it is a highly prevalent condition, as almost 40% of the u.s. hemodialysis population has a serum phosphate( po4) greater than 6.5 mg/dl . the overall mortality risk associated with serum phosphate( po4) above 6.5 mg/dl was 27% greater than that of patients with po4 levels between 2.4 and 6.5 mg/dl. it is speculated that elevate po4 may aggravate the effects of coronary atherosclerosis through increased vascular calcification and smooth muscle proliferation . it has also been suggested that myocardial calcification, a consequence of elevated po4, may alter microcirculatory hemodynamics through increased extravascular resistance and further compromise myocardial perfusion. we, therefore, hypothesized that the increased mortality risk associated with elevated po4 levels was primarily related to cardiac rather than non-cardiac causes of death. a number of non-invasive imaging techniques are now available to detect and quantify vascular calcification (vc). indeed, plain x-rays of abdomen and extremities to identify macroscopic calcifications of aorta and peripheral arteries;echocardiography for assessment of valvular calcification;2d-ultrasound for calcification of carotid arteries, femoral arteries and aorta and computed tomography technologies constitute the current armamentarium for detection and quantification of cardiovascular calcification (vc) and its progression. electron beam computed tomography (ebct) and multi-slice computed tomography (msct) represent the gold standard for assessing the extent of coronary artery and aorta calcification.msct is more widely available than ebct

Eligibility criteria:
inclusion criteria: * esrd patients on regular dialysis of five years duration aging 18 to 40 years exclusion criteria: * patients with hypercalcemia or hyperlipidemia or diabetic patients
will restasis eye drops increase your chance of having a successful surgery?

Conditions: Glaucoma

Summary: the purpose of this study is to determine whether reducing inflammation of the surface of the eye with topical restasis after glaucoma surgery will improve surgical outcomes and increase patient comfort.

continued use of glaucoma drops can alter the outer surface of the eye and result in swelling and irritation, changing the structure of the eye. this structural change has been found to be a significant risk factor for the failure of glaucoma surgery. a comparison of how well patients do after glaucoma surgery depending on whether they use restasis (the only prescription medication approved by the fda for treating dry eye) or artificial tears (which can be purchased without a prescription) for 6 months following their surgery.

Eligibility criteria:
inclusion criteria: * patients with uncontrolled glaucoma scheduled for filtering surgery exclusion criteria: * under 18 years of age * unable to understand informed consent

Keywords: glaucoma filtering surgery restasis conjunctival inflammation
heat application to the sacral region and pain level during the first stage of labor

Conditions: Heat Exposure; Labor Pain; Apgar Score; Duration of Labor

Summary: the aim of this study was to determine the effect of hot application applied to the sacral region during first stage of labor on women's pain level and labor process.

it is stated that the pain experienced during labor, which is a physiological process, creates stress and anxiety in women and increases the risk of maternal and neonatal complications. therefore, keeping labor pain under control is important from an obstetrical perspective. pain experienced during labor is caused by dilatation of the cervix and uterine contractions, and occurs in different regions at each stage of labor. due to the descent of the fetal head into the pelvis and the pressure it puts on the lumbosacral plexus, the mother feels pain in her back, waist, legs and hips, especially in the first stage of labor. although pharmacological and non-pharmacological methods are used in the management of labor pain, they have disadvantages such as experiencing drug-related side effects due to pharmacological methods, causing undesirable effects in the woman and the fetus, the woman not being able to actively participate in the labor and not being able to remember what happened during labor.

Eligibility criteria:
inclusion criteria: * women were over 18 years of age * primipara * volunteered to participate in the study * were in the latent phase of labor (cervical dilatation 1-2 cm) * had a single fetus in vertex presentation * had no history of pregnancy complications * had not undergone any intervention in the sacral region were included in the study exclusion criteria: * applied pharmacological pain control methods in the first stage of labor * had a cesarean section decision at any stage
accuracy of the new barrett tal formula with the argos measurements: a multicenter prospective study

Conditions: Cataract

Summary: this study is a prospective, multi-site, multi-surgeon, observational study of refractive accuracy with the argos using btal after successful cataract surgery. subjects will be assessed pre-operatively, operatively and at 5-8 weeks postoperatively. clinical evaluations will include measurement of visual acuity, manifest refraction, and preoperative biometry.


Eligibility criteria:
inclusion criteria: subjects are eligible for the study if they meet the following criteria: * cataract surgery that was completed without complications with biometry measured using the argos biometer. * subjects that elect clareon sy60wf aspheric lens (alcon, fort worth, tx). * potential post-operative visual acuity of better than logmar 0.30 (20/40). * btal was used to determine the iol power implanted. exclusion criteria: if any of the following exclusion criteria are applicable to the subject or either eye, the subject should not be enrolled in the study. * patients with pre-existing ocular pathology that in the opinion of the principial investigator would influence the postoperative refraction. * any disease or pathology, including but not limited to irregular corneal astigmatism and keratoconus, that is expected to reduce the potential postoperative bcdva to a level worse than 20/40. * patients with history of previous ocular surgery. * patients with signs of inability to understand consent for study and procedure planned. * eyes with intraoperative or postoperative complications. * suboptimal surgical outcomes that are not related to the treatment plan, e.g. capsular tear, cystoid macular edema. * astigmatism \>±0.75d. each investigator reserves the right to declare a patient ineligible or non-evaluable based on medical evidence that indicates they are unsuitable for the trial. pregnancy has a known effect on the stability of refractions and visual acuity. as such, subjects who become pregnant during the study will not be discontinued but their data may be excluded from analyses of effectiveness.
efficacy of the "milk ladder" intervention in the development of tolerance and the recognition of b cell epitopes in babies who are allergic to cow's milk proteins

Conditions: IgE-mediated Milk Allergy

Summary: food allergies have become a relevant health problem in westernized societies, particularly, with children. cow's milk (cm), along with hen's eggs, are the most common foods eliciting allergic reactions in children under 4 years of age. the main objective of this intervention study is to evaluate the safety and efficacy of the intervention known as "the milk ladder" in the development of tolerance by children with cm allergies. this will be compared to an historical cohort (coale), which investigated the natural history of this allergy. additionally, the ability of informative epitopes will be evaluated for their potential to predict tolerance and their correlation against clinical variables. the "milk ladder" will be evaluated within a prospective cohort of cm allergic children. this intervention is enacted through the introduction of meals cooked with progressively increasing amounts of cow's milk into the participant's diet. the primary outcome will be the development of tolerance which will be evaluated through a double-blind placebo-controlled food challenge. ige and igg4 epitopes will be described using a peptide microarray immunoassay. quality of life will be determined by administering the faqlq-pf disease-specific questionnaire. finally, within a subgroup of study participants, the ability of different peptides to activate basophils will be analyzed, and cm t cell epitopes will be studied by means of t-cell proliferation and cytokine production assays.


Eligibility criteria:
inclusion criteria: * babies of both sexes. * age \< 12 months. * clinical history of immediate reaction (\<2 hours) after the intake of baby's formula and/or foods containing cow's milk. * sensitization to cow's milk proteins demonstrated by: * sige to cow's milk, alpha-lactoabumin, beta-lactoglobulin and/or casein \>0.1ku/l (immunocap®, themofisher) and/or * skin prick test to cow's milk, alpha-lactoabumin, beta-lactoglobulin and/or casein ≥3mm * if the reaction to milk occurred over 3 months before the recruitment, it will be mandatory to confirm reactivity to milk with an oral food test. * parents / legal representatives of the participant voluntary accept to participate. exclusion criteria: * delayed reactions (\> 2 h) after milk intake. * contact urticaria to milk if ingestion is well tolerated. * previous participation in oral tolerance induction/desensitization protocols. * treatment with any medication that might interfere the evaluation of the primary outcome or any study procedure. * any disease or condition which presents a contraindication to perform an oral challenge, either open or double-blind or any other study procedure. * social circumstances that might interfere with protocol adherence. * egg and/or wheat allergy (this exclusion criterion shall be verified before the beginning of the intervention).
dexamethasone and postoperative bleeding following tonsillectomy in children

Conditions: Pain, Postoperative; Tonsillar Bleeding; Postoperative Nausea and Vomiting

Summary: tonsillectomy is one of the most frequently performed surgical interventions in children. however, it is associated with a high incidence of postoperative nausea and vomiting (ponv), severe pain and haemorrhage. there is strong evidence on the efficacy of dexamethasone in reducing the incidence of ponv and pain after tonsillectomy, which led to consider this drug as a first line treatment in routine anaesthesia practice in such surgical setting. however, in the last decade, there have been arguments about the potential role of dexamethasone in increasing the risk of postoperative bleeding in children and studies addressing the haemorrhage risk following administration of dexamethasone for tonsillectomy are inconclusive.thus, this study is aimed at providing evidence for the safety profile of dexamethasone with regard to the risk of post-tonsillectomy bleeding in children when administered as a single intraoperative dose.

this double-blind (investigator-surgeon-patient blinded), randomized, placebo control, multicentre, international, pragmatic, non-inferiority trial is designed to to provide evidence of the dexamethasone safety profile with regard to the risk of post-tonsillectomy bleeding in children when administered as a single intraoperative dose of 0.15mg/kg. the study is also aimed at characterizing whether the co-administration of non steroidal anti-inflammatory drugs for analgesia potentiates the risk of postoperative haemorrhage. sample size estimation is based on the definition of a minimal clinically important difference between the 2 groups of treatment (dexamethasone or normal saline) to be equal to 2% (non-inferiority margin). thus, 3'794 children in total will be included with 1'897 children in each treatment group. the follow-up will be performed by the parents via an "application" for android and apple that has been developed specifically for this study.

Eligibility criteria:
inclusion criteria: * children aged from 2 to 13 years admitted for tonsillectomy/ tonsillotomy with or without adenoidectomy * parents or legal responsible person willing and capable to follow data collection by the application (android and iphone) developed for this study exclusion criteria: * children under aspirin or any other anticoagulants with or without congenital heart disease * children with any bleeding disorders (ex. haemophilia, von willebrand disease)

Keywords: reintervention children
auricular concha electro-acupuncture for the treatment of depression

Conditions: Depression; Depressive Symptom; Depressive Disorder

Summary: the objective of this study was to compare the therapeutic effects of auricular concha electro-acupuncture and citalopram on patients with major depressive disorder (mdd).

in this study, 106 patients with mdd were randomly divided into the auricular concha electro-acupuncture group and the citalopram group by the evaluation blind method and randomized control design, and were treated for 8 weeks and 4 weeks follow-up. in no. 0, 2, 4, 6, 8, 10, 12 weekend, hamilton rating scale for depression-17 item (ham-d17) and hamilton anxiety rating scale (ham-a) were performed for all patients. during the no. 0/8 weekend, patients were tested and analyzed for peripheral blood ne, 5-ht, da, cortisol, acth, gaba, glutamic acid, bdnf and bfgf, and the brain is also examined and analyzed by fmri.

Eligibility criteria:
inclusion criteria: 1. the diagnosis is consistent with dsm-v diagnostic criteria for mild-to- moderate depression; 2. patients with the first onset or recurrence of the disease have not been treated with antidepressant or without antidepressant treatment before treatment for 3 months; 3. age from 18 to 65 years old, with no gender; 4. outpatient; 5. 17 item hamilton depression rating scale (hamd-17) score \> 7, and \<24; 6. signed informed consent. exclusion criteria: 1. in addition to depression, it conforms to the diagnostic criteria of any psychiatric disease; 2. patients with a history of schizophrenia or other mental illness; 3. patients with cognitive impairment or personality disorder; 4. in the past 6 months, patients who have met the dsm-v criteria for substance related and addictive disorders; 5. before entering the group, any other antidepressant treatment is being accepted; 6. patients with serious body disease, such as heart disease (namely ⅱ and ⅱ above cardiac function) , obvious abnormalities of liver and kidney function (biomarkers more than 3 times normal); 7. serious suicidal ideation or suicidal behavior.

Keywords: depression electro-acupuncture auricular concha