Kornimate/medical-research-clean huggingface dataset:
liver regeneration therapy by intrahepatic arterial administration of autologous adipose tissue derived stromal cells

Conditions: Liver Cirrhosis

Summary: mesenchymal stem cells have capability to differentiate into hepatocyte and will be useful for liver regeneration. adipose tissue is relatively enriched with mesenchymal stem cell compared to bone marrow tissue. in this trial, eligible liver cirrhosis patients will receive autologous adipose tissue derived stromal cells through intrahepatic arterial catheterization.

the population of the liver cirrhosis patients is enormous in japan and the only radical treatment for them is liver transplantation: however, the number of giving donor is extremely limited. mesenchymal stem cells have been capable to differentiate into mesodermal-lineage cells as well as endodermal-lineage cells such as hepatocytes. they reside in the mesenchymal tissues such as bone marrows as well as adipose tissues. the latter tissues are relatively enriched with mesenchymal stem cells compared to bone marrow cells. in this study, the cirrhotic patients will undergo intrahepatic arterial administration of autologous adipose tissue derived stromal cells through catheter.

Eligibility criteria:
criteria defined in the implementation protocol

Keywords: liver cirrhosis
whole-body electromyostimulation versus therapeutic resistance exercise for the treatment of non-specific chronic low back pain

Conditions: Low Back Pain

Summary: non-specific chronic low back pain (nscbp) is considered the leading cause of impairment of normal, symptom-free life (disability-adjusted life years - dalys). nscbp force more people out of work than diabetes, heart disease, hypertension, respiratory disease, asthma and cancer together. strength and stability-oriented training programs in particular can lead to a significant improvement in nscbp. however, back pain patients often cite time limitations and kinesiophobia (fear of movements) as the main reasons for their physical inactivity . the time-effective, joint-friendly and highly customizable whole-body electromyostimulation technology (wb-ems) has been shown to be an effective alternative to conventional back training in two recently published clinical studies following the successful implementation of this concept, dissemination of the positive results and testing of suitable settings for its implementation, the next step is to adapt and implement the concept as part of a knowledge transfer project in outpatient rehabilitation settings. the present project thus aimed to compare the effect of wb-ems versus medical therapeutic therapy (mtt) using dedicated resistances devices as a recognized safe and effective treatment for low back pain.


Eligibility criteria:
inclusion criteria: * women and men 40-70 years old; * chronic pain in the lumbar spine (at least 50 percent of the days of the last 3 months, * average basal pain intensity (average 7 days) in the lumbar spine on nrs 0-10: ≥2.5 exclusion criteria: * orthopedic diagnosis (i.e. specific type of lbp); * frequent intake of analgesics (\>4 days/week); * pharmacological therapy or diseases affecting muscle metabolism (e.g., glucocorticoids); * no contraindications for wb-ems application (e.g., epilepsy, cardiac pacemaker, thrombosis, and total endoprosthesis)

Keywords: exercise whole-body electromyostimulation non-specific chronic low-back pain medical training therapy outpatient clinic
multicentric study comparison between erythropoietin and erythropoietin associated to differentiating therapy with acid 13-cis-retinoic and dihydroxyvitamin d3 in myelodysplastic syndromes without excess of blasts

Conditions: Myelodysplastic Syndromes

Summary: this is a prospective, randomized multicenter phase iii clinical trial designed to evaluate the safety and activity of comparison between erythropoietin and erythropoietin associated to differentiating therapy with acid 13-cis-retinoic and dihydroxyvitamin d3 in myelodysplastic syndromes without excess of blasts


Eligibility criteria:
inclusion criteria: 1. age higher than 18; 2. confirmed diagnosis by osseous biopsy and bone marrow cyto-morphologic counts of blast cells, of myelodysplastic syndrome without excess of blasts: "refractary anemia", "refractary anemia with rings sideroblasts", "refractary citopenya with multilineage dysplasia", " refractary citopenya with multilineage dysplasia and rings sideroblasts" or "5q-syndrome" without excess of blasts based on who classification (appendix). 3. low or intermediate-1 ipss (appendix). 4. hb \< 11g/dl. 5. repo serum level \< 500mu/l. 6. women in menopause from at least one year. 7. informed consent exclusion criteria: 1. myelodisplastic syndrome with excess of blasts (raeb). 2. ipss score intermediate-2 or high (appendix). 3. forecasted allogeneic bone marrow transplant within 1 year after diagnosis(patients younger than 60 years, transfusion dependents or with serious leuko/thrombocytopenia and hla compatible family donor).considering the time needed to perform this procedure, the indication of a transplant from non-consanguineous donor has no contraindication to the inclusion in this protocol of the response to repo therapy ± differentiating therapy. 4. renal failure with creatininemia value greater than 3 times the normal limit. 5. chronic hepatophaty with bilirubinemia value greater than 3 times the normal limit and/or ast or alt or alp values greater than 5 times the normal limit. 6. presence of second tumor or other serious pathology with life expectancy lower than one year. 7. presence of neurologic or psychiatric pathologies that make the patient unreliable in the acquisition of drugs. 8. allergy/intolerance known to use drugs. 9. pregnant women. 10. women of childbearing age or in menopause from less than one year. 11. age \< 18 years old. 12. hiv positive.

Keywords: myelodysplastic syndromes erythropoietin acid 13-cis-retinoic dihydroxyvitamin d3 low or intermediate-1 ipss mds low risk
botswana tenofovir oral hiv prophylaxis trial

Conditions: HIV Infection

Summary: this study will test whether taking a pill of tenofovir (an antiretroviral medicine) is safe for sexually-active young adults in botswana without hiv infection and whether it will reduce their risk of getting an hiv infection.

twelve hundred healthy, sexually active women and men, 18-29 years old, without hiv infection will be enrolled in francistown and gaborone, botswana. they will be provided with free male and female condoms, repeated individualized risk-reduction counseling, diagnosis and treatment of sexually transmitted diseases, and women will be provided with a choice of effective family planning methods. in addition, volunteers will be randomized to receive either tenofovir or a placebo pill to take once a day. volunteers will be seen monthly for at least 12 months to monitor for side effects and toxicities and to test their hiv status. persons who become hiv infected during the trial will receive ongoing supportive counseling, cd4 and viral load monitoring, education about hiv infection/disease, and access to hiv care including free antiretrovirals when clinically indicated. volunteer safety will be monitored by a local ethics committee, centers for disease control institutional review board (cdc irb) and an independent data safety and monitoring board.

Eligibility criteria:
inclusion criteria: * citizen of botswana 18-29 years old * sexually active * hiv uninfected * hepatitis b and c uninfected * calculated creatinine clearance \>= 60 ml/min * hemoglobin \>= 8 gm/dl * alt and ast \<= 2x uln * total bilirubin \<= 1.5 mg/dl * total serum amylase \<= 1.5x uln * serum phosphorus \>= 2.2 mg/dl * willing to use effective contraception * living within 1 hours travel of study clinic * pass comprehension test * willing and able to give informed consent exclusion criteria: * history of significant renal or bone disease * any chronic illness requiring ongoing prescription medication * pregnant or breastfeeding * planning to move away from site in the next year * participating in another hiv prevention or vaccine safety trial * any other clinical condition or prior therapy that, in the opinion of the study physician, would make the volunteer unsuitable for the study or unable to comply with the dosing requirements

Keywords: hiv incidence hiv prevention
the clinical effect of vitamin k administration in type 2 diabetic patients

Conditions: Diabetes Mellitus, Type 2

Summary: the aim of this study is to examine the possible clinical effects associated with vitamin k supplementation on the glycemic control, insulin sensitivity and lipid profile of type ii diabetic patients.


Eligibility criteria:
inclusion criteria: * adult patients 21-65 years old diagnosed with type ii diabetes. * fasting blood glucose concentration ≥ 126 mg/dl . * normal liver function tests defined as alt levels up to 33 u/l for males and up to 25 u/l for females, albumin levels ≥ 3.5 g/dl, bilirubin up to 1.1 mg/dl . * normal clotting function defined as defined by inr. * normal kidney function defined as serum creatinine values up to 1.3 mg/dl. exclusion criteria: * type i diabetic patients. * use of supplements with potential effect on vitamin k level namely supplements containing vitamin k, co-enzyme q10 or vitamin e \> 400 iu . * patients requiring anti-coagulant therapy including patients with prosthetic valves, mitral tissues, dvt, pe, atrial fibrillation and valvular heart disease. * patient with history of coagulation, mi, stroke and embolization. * pregnant or breast feeding women. * being on hormonal therapy or receiving contraceptive pills. * patients treated with glucocorticoids, thiazide diuretics, and atypical antipsychotics. * patients on cholestyramine, antibiotics and coumarins. * patients on lipid lowering agents. * known intestinal malabsorption syndrome, cholestasis or steatorrhea. * smokers.
olfactory change after chemo-radiotherapy for nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma

Summary: this is an observational cohort study aimed to explore the changes of olfactory function at multiple time points from baseline to 1 year after radiotherapy among the local advanced nasopharyngeal carcinoma patients.

newly-diagnosed patients with stage iii or iv non-metastatic nasopharyngeal carcinoma (ajcc 8th) will be recruited. olfactory function of consecutive patients with nasopharyngeal carcinoma was assessed prospectively before treatment and serially up to 1 year after radiotherapy by the sniffin' sticks olfactory function test and by the questionnaire of olfactory disorders (qod) as well as a patient symptom visual analogue scale. the change in olfactory function and it's influence factors in npc patients who receiving induction chemotherapy with concurrent chemoradiotherapy will be investigated.

Eligibility criteria:
inclusion criteria: * age 18-70, regardless of sex. * patients with newly histologically confirmed non-keratinizing nasopharyngeal carcinoma, type of who ii or iii, clinical stage iii-iva (according to the 8th american joint committee on cancer \[ajcc\] edition). * ecog (eastern cooperative oncology group) score: 0-1. * patients receiving induction chemotherapy with concurrent chemoradiotherap. * patients must sign informed consent and be willing, and well understood the objective and procedure of this study. exclusion criteria: * women in pregnancy or lactation. * patients who received additional treatment during the observation period due to disease progression. * patients with significantly lower heart, liver, lung, kidney and bone marrow function. * patient with severe medical condition. * with a condition that could cause olfactory dysfunction, such as septum deviation, nasal polyposis, nasopharyngeal necrosis, congenital olfactory dysfunction, septum surgery, head trauma, chronic rhinosinusitis, allergic rhinitis, or psychiatric or neurological disorders, such as parkinson's, ms and alzheimer's disease, or long history of psychiatric drug, corticosteroids or other drug that may affect olfactory function. * not able to return for evaluation of olfactory function or follow-up (language, practical implementation, mental condition)

Keywords: nasopharyngeal carcinoma olfactory change
celecoxib in treating patients with stage i, stage ii, or stage iiia non-small cell lung cancer

Conditions: Lung Cancer

Summary: rationale: studying samples of tissue, blood, and urine from patients with cancer in the laboratory may help doctors learn more about changes that occur in dna and identify biomarkers related to cancer. purpose: this clinical trial is studying celecoxib in treating patients with stage i, stage ii, or stage iiia non-small cell lung cancer.

objectives: * to assess cyclo-oxygenase-2 (cox-2) activity in patients with early-stage non-small cell lung cancer (nsclc) and correlate the results with serum vascular endothelial growth factor (vegf) levels, tumor microvessel density score, tumor prostaglandin e2 (pge_2) and matrix metalloproteinases (mmp) levels, and the major urinary metabolite of pge_2, pge-m. * to assess the effect of specific cox-2 inhibitors (celecoxib) on cox-2 expression within the primary tumor, serum vegf levels and tumor microvascular density, tumor pge_2 and mmp levels, and urinary pge-m in a cohort of patients with early-stage nsclc. outline: patients receive oral celecoxib 400 mg twice a day for 5 days in the absence of disease progression or unaccepted toxicity. patients with early-stage disease then undergo surgery. biopsy, serum, and urine samples are obtained at baseline and after celecoxib treatment. the biopsy specimen are examined for the expression of cyclo-oxygenase-2 (cox-2), pge_2, and selected mmps by immunohistochemistry, western blotting, and northern blotting. serum and urine samples are analyzed for vegf and pge-m expression. cox-2 tumor expression is correlated with serum vegf levels; tumor mmp-2, mmp-9, and pge_2 expression; urinary pge-m and microvessel density scores.

Eligibility criteria:
disease characteristics: * presumed histological or cytological diagnosis of non-small cell lung cancer * diagnosis to be confirmed upon study entry to collect biopsy material for correlative studies * stage i-iiia disease patient characteristics: * ecog performance status of 0-2 * serum creatinine ≤ 1.5 mg/dl * granulocytes ≥ 1,500/mm\^3 * platelets ≥ 100,000/mm\^3 * ast ≤ 3 times normal * bilirubin ≤ 1.5 mg/dl * not pregnant or nursing * fertile patients must use effective contraception * no active unresolved infection prior concurrent therapy: * at least 7 days since prior and no concurrent non-steroidal anti-inflammatory agents or other cyclo-oxygenase-2 inhibitors * at least 7 days since prior parenteral antibiotics * no prior systemic chemotherapy or radiotherapy

Keywords: stage i non-small cell lung cancer stage ii non-small cell lung cancer stage iiia non-small cell lung cancer
calorie-restricted, ketogenic diet and transient fasting during reirradiation for patients with recurrent glioblastoma

Conditions: Recurrent Glioblastoma

Summary: increased glucose metabolism is characteristic for solid tumors. thereby, glucose is important for the generation of atp, supply of anabolic substrates and defense against reactive oxygen species in tumor cells. in preclinical models, restricting glucose availability using a ketogenic diet, calorie-restriction or transient fasting inhibits tumor growth. therefore, the purpose of the study is to evaluate whether a calorie-restricted, ketogenic diet and transient fasting can enhance the efficacy of reirradiation in patients with recurrent glioblastoma.


Eligibility criteria:
inclusion criteria: * age \>= 18 years * recurrence of a histologically confirmed glioblastoma or gliosarcoma * at least 6 months after first surgery * at least 6 months after first radiotherapy * interdisciplinary recommendation for reirradiation * karnofsky performance status \>= 60, ecog \<= 2 * creatinine \<= 2,0 mg/dl, urea \<= 100 mg/dl * alat, asat \<= 7x upper normal limit exclusion criteria: * bowel obstruction, subileus * insulin-dependent diabetes * decompensated heart failure (nyha \> 2) * myocardial infarction within the last 6 months, symptomatic atrial fibrillation * severe acute infection * malnutrition, cachexia * other medical conditions that might increase the risk of the dietary intervention * pregnancy * uncontrolled thyroid function * pancreatic insufficiency * dementia or other clinically relevant alterations of the mental status which could impair the ability of the patient to apply to the diet or understand the informed consent of the study

Keywords: ketogenic diet glioma fasting reirradiation nutrition
in this study, a retrospective analysis was conducted to explore the risk factors for patients undergoing pancreaticoduodenal surgery (pd) to achieve to, and a nomogram prediction model was further established to promote the standardization and standardization of pd surgical quality evaluation.

Conditions: Pancreatic Carcinoma; Cholangiocarcinoma; Pancreaticoduodenectomy

Summary: this study is committed to exploring the risk factors affecting patients receiving pancreaticoduodenal surgery (pd) to achieve to by retrospective analysis of clinical data of patients receiving pd surgery in changzhou second people hospital from january 2016 to december 2024, and further establishing a nomogram prediction model. in order to promote the standardization and standardization of pd surgical quality assessment.

as we all know, pancreaticoduodenectomy (whipple) involving multiple organ reconstruction for pancreatic cancer is known as the \&#34;surgical ceiling\&#34;, but because of its high postoperative complication rate and poor prognosis, a standardized surgical quality assessment system covering the whole perioperative period is urgently needed. the concept of the textbook ending was born.it first appeared in a 2013 study by kolfschoten et al for colorectal cancer, in which textbook outcomes were evaluated in an all or none ,manner against six independent expected outcome measures: there were no deaths in hospital or within 30 days after surgery, radical resection, no re-intervention, no stomy, no serious postoperative complications, and no prolonged hospital stay. that is, when patients meet the above six indicators at the same time, they are defined as achieving a textbook outcome .in our study, the textbook outcome is the primary outcome, and the reverse is the secondary outcome.this study is committed to exploring the risk factors affecting patients receiving pancreaticoduodenal surgery (pd) to achieve to by retrospective analysis of clinical data of patients receiving pd surgery in changzhou second people hospital from january 2016 to december 2024, and further establishing a nomogram prediction model. in order to promote the standardization and standardization of pd surgical quality assessment.

Eligibility criteria:
inclusion criteria: 1. patients who received radical pd surgery and whose pathological findings were clear tumors; 2. complete clinical data preservation. exclusion criteria: 1. palliative resection; 2. tumor metastasis or other primary tumors; 3. combined with severe organ dysfunction; 4. postoperative pathology was not clear tumor. -

Keywords: textbook outcome pancreatic carcinoma cholangiocarcinoma pancreaticoduodenectomy
comprehensive geriatric assessment in an emergency department

Conditions: Emergencies; Aging; Geriatric Assessment; Patient Discharge

Summary: purpose frailty and multi-morbidity have been associated with increased pressure on emergency departments (ed), higher hospital admissions and more risks for patients arising from the ed stay. the advantages of developing specific attention to frailty in ed have been highlighted. the benefits of these approaches are related to patients but also to organizations. the aim is to present how a program of care for frailty (pcf) in an ed impacts on patient health and flows. objective is to analyze the clinical impact of comprehensive geriatric care (cga) in the emergency department (ed) and on patient flows setting: a tertiary, teaching, 550-bed urban hospital, with 80,000 adult patients/year ed attendances (43%≥65 years). two periods are compared: first period (before cga implantation) del 01/04/2016 - 15/04/2016 and second period (after) 01/04/2017 - 15/04/2017

purpose frailty and multi-morbidity have been associated with increased pressure on emergency departments (ed), higher hospital admissions and more risks for patients arising from the ed stay. the advantages of developing specific attention to frailty in ed have been highlighted. the benefits of these approaches are related to patients but also to organizations. the aim is to observe how a program of care for frailty (pcf) in an ed impacts on patient health and flows. objective 1. analyze the clinical impact of comprehensive geriatric care (cga) in the emergency department (ed). 2. analyze the impact on patient flows following the implementation of a comprehensive geriatric assessment in the emergency department (ed). methods setting: a tertiary, teaching, 550-bed urban hospital, with 80,000 adult patients/year ed attendances (43%≥65 years). first period (before cga implantation) del 01/04/2016 - 15/04/2016 and second period (after) 01/04/2017 - 15/04/2017 intervention: in the second period, the agi was carried out by the emergency medical teams. it basically consists of care adapted to the special needs of geriatric patients, with systematic screening of delirium, delirium prevention, early treatment, pain management with scales adapted to chronicity, conciliation of medication to discharge from the emergency department, among others a comparison will be made of health outcomes and patient flows in ed: direct discharge, admission to emergency observation unit, admission to short stay unit, transfer to intermediate hospital, admission, admission to critical care area, death, time spent in the emergency department (ed) and in intermediate hospital, mortality during admission at one and six months, re-entry or reconsultation in the emergency department at 30 days and six months will be measured.

Eligibility criteria:
inclusion criteria: * all patients older than 65 years attended in the ed exclusion criteria: * none

Keywords: emergency department older frailty