Kornimate/medical-research-clean huggingface dataset:
single-port robotic transanal total mesorectal excision

Conditions: Rectal Cancer Patients

Summary: this is a phase 2a clinical trial based on the ideal framework to evaluate the safety, feasibility and clinical efficacy of single-port robotic transanal total mesorectal excision (spr-tatme )surgery. for safety, intraoperative adverse events and 30-day morbidity. for efficacy, successful completion of predefined procedural steps without conversion. the transanal surgical platform consists of a single-port robotic system, while the transabdominal approach can be performed laparoscopically or with single-port robotic assistance.

the study assessed the intraoperative adverse events (device-related and/or procedure-related), postoperative complications, perioperative recovery outcomes, surgical specimen quality, and pathological indices of spr-tatme in the treatment of mid-to-low rectal cancer.

Eligibility criteria:
inclusion criteria: * (1) mid or low rectal cancer, 0-10 cm from the anal verge (mri definition); (2) histological biopsy showing adenocarcinoma; (3) stage i-iii (mri and abdominal ct), including the downstaged after neoadjuvant therapy; (4) intention for primary anastomosis; (5) obtain the informed consent of the patient and his family; (6) suitable for robotic or laparoscopic surgery. (7) over 18 years old. exclusion criteria: 1. t3 tumour with margins less than 1 mm to the mesorectal fascia or t4 tumour, determined by mri-scan (staged after (chemo)radiotherapy if applicable) ; 2. the anal sphincter complex or levator anal muscle is involved; 3. previous prostate or rectal surgery (excluding local excision) ; 4. emergency surgery was performed due to complications of a rectal tumor; 5. malignancy other than adenocarcinoma at histological examination; 6. pregnancy; 7. signs of acute intestinal obstruction; 8. multiple colorectal tumours; 9. familial adenomatosis polyposis coli (fap), hereditary non-polyposis colorectal cancer (hnpcc), active crohn's disease or active ulcerative colitis; 10. planned synchronous abdominal organ resections; 11. other malignancies in medical history, except adequately treated basocellular carcinoma of the skin or in situ carcinoma of the cervix uteri; 12. absolute contraindication to general anaesthesia or prolonged pneumoperitoneum, as severe cardiovascular or respiratory disease (asa class \> iii)

Keywords: single-port robotic transanal total mesorectal excision rectal cancer
comparison of long-term outcomes between upfront surgery and neoadjuvant therapy followed by surgery in patients with node-negative gastric cancer

Conditions: Lymph Node-negative; Gastric Cancer

Summary: patients with lymph node-negative gastric cancer, the prognosis of patients who underwent neoadjuvant therapy was poor than that of those who had upfront surgery.

we retrospectively analyzed the clinicopathological data of patients who underwent curative surgery for gastric cancer and were pathologically confirmed to have node-negative metastases between january 2010 and june 2021 at 8 institutions in china. data from the surveillance, epidemiology, and end results (seer) database (2004-2020) were used as the validation cohort. the patients were divided into two groups based on whether they received neoadjuvant therapy before surgery: the upfront surgery (ufs) group and the neoadjuvant therapy followed by surgery (nats) group. a 1:1 propensity score matching analysis was employed to reduce the potential selection bias between the two groups.

Eligibility criteria:
inclusion criteria: (1) preoperative clinical staging of ct2-4nxm0; (2) primary gastric adenocarcinoma confirmed via pathology; (3) no distant metastasis to the liver, lungs, or abdominal cavity as confirmed through preoperative chest x-ray or chest ct, abdominal ultrasound, and abdominal ct; (4) underwent radical gastrectomy (r0) and d2 lymphadenectomy; (5) postoperative pathology confirmed no lymph node metastasis (i.e., lymph node-negative); and (6) follow-up for at least 3 years. exclusion criteria: (1) considered early-stage gastric cancer before surgery; (2) distant metastasis detected preoperatively or intraoperatively; (3) failure to achieve r0 resection and d2 lymphadenectomy during surgery; (4) concurrent diagnosis of other malignancies; (5) remnant gastric cancer; (6) death within 30 days postoperatively; and (7) incomplete baseline data or follow-up records.

Keywords: gastric cancer neoadjuvant therapy long-term outcomes lymph node-negative seer database
comparison of different preoperative fasting times in pediatric patients undergoing elective general anaesthesia

Conditions: Pulmonary Aspiration of Gastric Contents

Summary: rationale of this study is to provide an evidence on minimal safe clear fluid fasting duration without the risk of aspiration of gastric contents during elective pediatric procedures under general anesthesia.

pre-operative fasting is a specific time period before a procedure in which participants will be advised not to take any liquid or solid by mouth. nil per oral (npo) is a universally accepted practice before elective general anesthesia in order to reduce gastric contents aspiration. in the period of chloroform anesthesia npo was introduced because of vomiting and discomfort associated with anesthesia. hence prevention from aspiration of gastric contents was a main focus during general anesthesia. with introduction of better anesthesia drugs recommendations were given to keep minimal fasting time before general anesthesia. recent guidelines suggest six, four and two hours fasting for solids/ infant formula milk, breast milk and clear fluids respectively. it is common practice to keep children npo for 6 hours before surgery. but many times, children have to suffer excessive unnecessary fasting due to delayed surgery that lead to reduction in systolic blood pressure, induce catabolic state and behavioral effects. moreover prolonged fasting increases insulin resistance and may increase the inflammatory response to surgery.

Eligibility criteria:
inclusion criteria: 1. both male and female patients 2. age between 1 to 12 years 3. patients undergoing elective surgical procedures ( orchidopexy, lymph node biopsy, skin grafting, tongue ties and hernia repair ) under general anesthesia exclusion criteria: 1.patients with co-morbidities like acid peptic disease with history of dyspepsia and family history or self-history of diabetes mellitus.
age-related correlates of treatment for late-acquired sounds

Conditions: Speech Sound Disorder; Phonology Disorder; Phonology Impairment; Phonological Disorder; Articulation Disorders in Children; Developmental Phonological Disorder; Speech Disorders; Speech Delay; Articulation Disorders, Developmental

Summary: late-acquired sounds, such as /r/ are difficult to learn and many children experience persistent errors on these sounds. the purpose of the present study is to determine whether treating these sounds earlier in the child's life may result in better outcomes.

late-acquired sounds, such as /r/ are difficult to learn and many children experience persistent errors on these sounds. however, these sounds are often treated later in a child's life because they are not expected to be fully acquired until quite late--age 7-8 for some sounds. this practice places treatment in a time of the child's development in which they struggle to learn new sounds.the purpose of the present study is to determine whether treating these sounds earlier in the child's life may result in better outcomes, and to examine treatment efficacy and efficiency for two methods of treatment.

Eligibility criteria:
inclusionary criteria: * normal hearing * typical receptive language * speech sound disorder * no motor speech impairment * typical non-verbal intelligence * produces at least one late-acquired sound with \<7% accuracy * monolingual english-speaking * typical in terms of motoric and neurological development exclusionary criteria: * neurological disorder * hearing loss * nonverbal iq \< 16th percentile

Keywords: treatment efficacy efficiency late-acquired sounds
effects of chios mastiha essential oil on cholesterol levels of healthy volunteers

Conditions: Hyperlipidemias; Hypercholesterolemia

Summary: a prospective, randomized, placebo-controlled study was designed to study the hypolipidemic effect of cmo capsules on healthy volunteers with elevated cholesterol levels.

background chios mastiha essential oil (cmo) is a natural product extracted from the resin of mastiha, possessing antioxidant, anti-microbial, anti-ulcer,anti-neoplasmatic and cholesterol lowering capabilities in vitro, and its hypolipidemic effect was confirmed in animal studies. yet, there are no randomized, placebo-controlled clinical studies in the literature regarding cmo's hypolipidemic effects in humans. design a prospective, randomized, placebo-controlled study was designed to study the hypolipidemic effect of cmo capsules on healthy volunteers with elevated cholesterol levels. methods 192 healthy volunteers were screened and eventually 160 of them with total cholesterol\> 200 mg/dl participated in the study. they were randomized with a 2:1 ratio of receiving cmo capsules (containing 200 mg mastiha oil per capsule) and placebo for a total of 8 weeks respectively. 113 patients received cmo and 47 were randomized in the control group, and all of them completed the follow-up period.

Eligibility criteria:
inclusion criteria: - increased total cholesterol \>200 mg/dl, in adult volunteers (≥18 years old) of any gender, not amenable or not willing to receive pharmaceutical therapy. exclusion criteria: * participation in any other study during the recruitment period * contribution in the design or accomplishment of the study * known cardiovascular disease (coronary artery disease, carotid artery disease, peripheral vascular disease, stroke, diabetes mellitus, aortic aneurysm) * patients in high or very high risk of cvd according to score2 * subjects amenable to pharmaceutical lipid-lowering regimens according to current guideline, or any other pharmaceutical regimen with hypolipidemic effects
early intracordal hyaluronic acid injection during spontaneous reinnervation for unilateral recurrent laryngeal nerve paralysis

Conditions: Paralysis, Unilateral, Vocal Cord

Summary: backgrounds: unilateral vocal cord paralysis caused from recurrent laryngeal nerve (rln) injury is not an unusual disease and may deteriorate patients'voice and swallowing outcomes. although the long term treatment effect is encouraged, the point when to perform surgical treatment is not conclusive. previous reports suggested late treatment principle because patients may spontaneous reinnervation to some degree within 4-5 months after injury. the vocal cord position and tone may change during reinnervation. others delineated laryngeal synkinesis by misdirected reinnervation is common and suggested early temporary injection laryngoplasty. they implied early injection laryngoplasty may improve patients'not only short term voice outcomes but also decrease the incidence of transcervical laryngeal framework surgery as a determined surgery. however, lacking of prospective study and objective data makes the treatment-time policy still controversial. purposes: 1. to find incidence of spontaneous reinnervation or synkinetic regeneration. 2. to detect the relationship between changing of glottal gap and laryngeal synkinesis. 3. to detect the impaction of early intracordal hyaluronic acid injection on vocal cord position change in patients with laryngeal synkinesis. study design: forty patients is planned to be enrolled in the study. twenty of them will undergo hyaluronate intracordal injection at three-six month from rln damage. the other 20 patients will follow the watch-and wait policy. laryngoscope, laryngeal emg (electromyography), voice analysis and voice outcome survey will be done at 3-6 month and 12-month after rln injury. at the end of follow up, the glottal gap, voice laboratory data and quality of life will be compared. the outcomes will also be correlated with laryngeal electromyography (lemg) data and the impact of synkinetic reinnervation.


Eligibility criteria:
inclusion criteria: * patients of untreated unilateral vocal cord paralysis with a known cause of rln injury within 3-6 month will be enrolled exclusion criteria: * patients proved to be not suitable for transcutaneous intracordal injection under topical anesthesia. those who had previous phonosurgery or can't follow the observation rule will also be excluded.
left ventricular hypertrophy reduction with statins in hypertensives patients (mk0653a-168)

Conditions: Hypertension

Summary: evaluate pleiotropic effects of simvastatin in hypertensive patients.


Eligibility criteria:
inclusion criteria: * females or males over 18 years old * patients with systemic arterial hypertension grade i and ii according with the european society of cardiology * left ventricular hypertrophy demonstrated by echocardiography * mild to moderated hypercholesterolemia * willing to participate and sign the informed consent form (icf) exclusion criteria: * type 1 or 2 diabetes mellitus * familiar hypercholesterolemia * low density lipoprotein-cholesterol (ldl-c) \> 190 mg/dl * history of myocardial infarction or stable chronic angina * triglycerides \>250 mg/dl
recessive dystrophic epidermolysis bullosa screening for possible gene transfer

Conditions: Epidermolysis Bullosa Dystrophica

Summary: recessive dystrophic epidermolysis bullosa (rdeb) is a severe inherited blistering skin disease caused by absence of type vii collagen. patients with rdeb develop large, severly painful blisters and open wounds from minor trauma to their skin. in the future, we hope to start a gene transfer study on a specific group of rdeb subjects and we are screening subjects for that potential trial now.

this study is a preparation for a gene transfer trial. in the gene transfer trial, we will transfect autologous rdeb keratinocytes with a type vii collagen containing retrovirus vector. we then plan to graft the genetically engineered and corrected autologous keratinocytes back on to wounds of the rdeb subject. we expect the grafts to attach as normal keratinocytes and replace the damaged skin with skin that is able to make type vii collagen and anchor normally to the dermis. we are trying to define the number of subjects 18 or older who meet the criteria for the gene transfer trial. we are offering the subjects the opportunity to be evaluated for the potential trial.

Eligibility criteria:
inclusion criteria:1. clinical diagnosis of rdeb by local dermatologist 2. 18 years of age or more and willing to give consent 3. estimated to have at least 100 to 200 sq. cm. areas of open erosions on the trunk or extremities suitable for skin grafting 4. ability to undergo adequate anesthesia to allow grafting procedures to take place 5. parents are alive, do not have eb, and they are willing to give consent for genetic testing exclusion criteria:1. medical instability limiting ability to travel to stanford university medical center 2. participation in another clinical trial without prior approval 3. the presence of medical illness expected to complicate participation and/or compromise the safety of this technique
cold atmospheric plasma device extension study

Conditions: Verruca Vulgaris; Molluscum Contagiosum

Summary: patients between 4-21 years of age with at least one wart or molluscum lesion are eligible to participate in this study. the duration of the study is a minimum of 4 weeks with the maximum duration of monthly treatments for one year, depending on lesion clearance. the number of lesions will be chosen by the dermatologist. patients who opt to participate will receive non-thermal, or cold, atmospheric plasma to treat all lesions selected. safety profile as well as changes in size, pain and appearance will be measured. photographs and dermatologist impressions will be used to measure treatment response.


Eligibility criteria:
inclusion criteria: * all patients from 4-21 years old with at least 1 lesion of vercurra or molluscum. * willingness of the participant and their guardian to provide consent when applicable. exclusion criteria: * unwillingness to participate in the study * received any treatment on the lesion in the past month determined by review of their medical record * immunodeficiency determined by review of their medical record. * adverse response to prior treatments determined by review of medical record. * signs of self-resolution determined by study team members. * conditions that lead to excessive scarring determined by study team members. * face and genital lesions determined by study team members.

Keywords: plasma warts molluscum pediatric dermatology
rtms in elderly depressed:neuronavegated study

Conditions: DEPRESSION

Summary: this double-blind, controlled and randomized study intents to investigate the antidepressive response of rtms on the elderly population.this is the first neuronavegated pulse intensity corrected study of rtms in elderly depressed patients.

most part of the studies uses samples of severe depressive patients with refractoriness and/or psychotic symptoms, which leave lacuna about the effects on depressive disorder with low or moderate scores. the literature is poor about the use of repetitive transcranial magnetic stimulation (rtms) in the old age population.therefore, we chose this group to research for the antidepressive effect of tms; other interests are to identify modifications in the magnetic resonance imaging, evaluate cognitive functions and to verify the occurrence of collateral effects and safety use for this specific population.

Eligibility criteria:
methods:forty patients with the following criteria: inclusion criteria * patients who meet criteria for major depressive episode (mde) (dsm-iv, 1994; scid-p, 1994); * severity of the episode of mild to moderate * aged between 60 and 75 years; * both genders; * in case of previous depressive episode, complete remission of the same for at least 6 weeks as measured by the clinical history; * washed out of psychotropic drugs for one week, including antidepressants; except fluoxetine, which must have three week interval; * granting a written informed consent to participate in the study (annex ii) exclusion criteria: * metallic cerebral implants * history of severe trauma or brain injury * organic brain disease * severe somatic disease * history of other psychiatric diseases * history of epilepsy * non cooperating patients scales and tests of clinical evaluation: 1. hamilton depression rating scale-17 items 2. geriatric depression scale (gds) 3. mini mental state examination 4. clock drawing test 5. clinical dementia rating 6. visual analogue scale 7. clinical global impression.

Keywords: tms elderly depression neuronavegation neurocognition
a study of the effect and safety of hs-10390 in the treatment of patients with primary iga nephropathy

Conditions: Immunoglobulin a Nephropathy

Summary: this study will evaluate the efficacy and safety of hs-10390 in subjects with primary iga nephropathy, and explore the optimal dose for the treatment.


Eligibility criteria:
inclusion criteria: * male or female, between 18 and 65 years age. * biopsy-proven primary iga nephropathy. * currently on stable dose of acei and/or arb therapy, for at least 12 weeks prior to screening (the patient's maximum tolerated dose and is at least one-half of the maximum labeled dose). * average 24-hour urine total protein ≥ 0.75 g/24 h at screening. * estimated gfr (using the ckd-epi 2009) ≥ 30 ml/min per 1.73 m\^2 at screening. * systolic bp between 100 and 150 mmhg and diastolic bp between 60 and 100 mmhg. exclusion criteria: * iga nephropathy secondary to another condition * iga nephropathy with rapid decline of renal function; kidney pathology indicated that more than 50% of the glomerulus had large crescent body formation, which may affect the study results; tubule atrophy - interstitial fibrosis of more than 50%; * chronic kidney disease (ckd) in addition to igan * patients treated with any systemic non-biologic immunosuppressive drugs (including systemic corticosteroids) within 12 weeks prior to randomizing； * require any prohibited medications prior to randomizing; * exposure to an investigational drug within 30 days or 5 half-lives (whichever is longer) prior to screening * history of organ transplantation, with exception of corneal transplants * platelet\< 100×109/l or hemoglobin value \< 90 g/l) or hematocrit value \< 27% (0.27 v/v) at screening * elevations of transaminases (alt and/or ast) \>2 times upper limit of normal or total bilirubin and/or direct bilirubin exceeding 1.5 times the upper limit of normal (uln) at screening * potassium \>5.5 mmol/l at screening

Keywords: immunoglobulin a nephropathy
pvf in decongestion of heart failure

Conditions: Heart Failure，Congestive

Summary: evaluate pvf alterations in patients with adhf at arrival and after decongestive treatment

hospitalizations from heart failure have been shown to be preceded by a gradual increase in cardiac filling pressures using invasive ambulatory monitoring measurements \[1, 2\]., this technique does not directly assess congestion. the use of point-of-care ultrasound (pocus) to evaluate lung congestion has been shown to decrease decompensations and urgent heart failure visits \[3, 4\]. however, besides lung congestion, the abdominal compartment contributes significantly to deranged cardiac as well as renal function in congestive heart failure (chf) \[5\].there is increasing recognition that worsening renal function in chf is related to altered renal blood flow \[6, 7\]. recently, alterations in renal venous flow (irvf) assessed by doppler imaging have been associated with worse outcomes in patients with chf \[8, 9\]. besides irvf alterations, portal vein flow (pvf) alterations have been proposed as a marker of venous congestion and right ventricular dysfunction \[10, 11\]. pvf and irvf alterations have been shown to correlate with each other and were independently associated with the development of subsequent acute kidney injury (aki) in patients undergoing cardiac surgery \[12, 13\]. portal vein (pv) doppler is easily obtainable and less time consuming than intra renal venous doppler. given the potential usefulness of evaluating venous congestion via pocus of pvf, we decided to study the dynamic changes that occur during decongestion in patients presenting with heart failure to the emergency department optimal method for noninvasive assessment of venous congestion remains an unresolved issue. portal vein (pv) and intra renal venous flow alterations are markers of abdominal venous congestion and have been associated with acute kidney injury (aki) in cardiac surgery patients. it is currently unknown if portal vein flow (pvf) alterations in heart failure can be reversed with diuretic treatment and track decongestion

Eligibility criteria:
inclusion criteria: 1. age above 18 years. 2. patients presented with acute decompensated heart failure (either de novo hf or chronic decompensated hf) fulfilling the following criteria: new or worsening hf symptoms (including dyspnea, decreased exercise capacity, fatigue, or other volume overload symptoms), physical examination findings compatible with hf (peripheral edema, pulmonary congestion, increased jugular venous pressure or third heart sound) exclusion criteria: 1. age below 18. 2. pregnant. 3. cardiogenic shock, or hemodynamic instability. 4. patients with previously diagnosed child-pugh b or c liver cirrhosis, liver transplant, or esrd on renal replacement therapy