Kornimate/medical-research-clean huggingface dataset:
high versus low pneumoperitoneum pressure for parenchymal transection in minimally invasive major liver surgery

Conditions: Liver Surgery; Minimal Invasive Surgery; Major Liver Resection

Summary: minimally invasive techniques in liver surgery gain popularity as they facilitate postoperative recovery while achieving comparable oncologic outcomes to the open approach. no consensus on the application of pneumoperitoneum pressure in minimal invasive liver resections (milr) has been reached yet, as prospective clinical studies are scarce. the positive pressure of the co2 pneumoperitoneum reduces intraoperative blood loss during milr alongside the development of new transection devices and advancements in inflow control. low-pressure pneumoperitoneum on the other hand has been shown to decrease postoperative pain scores and analgesic consumption in comparison to standard pneumoperitoneum, and international guidelines recommend the application of "the lowest intra-abdominal pressure allowing adequate exposure of the operative field rather than a routine pressure". nevertheless, evidence for the application of low-pressure pneumoperitoneum is only moderate to low, requiring additional studies to better define its safety. to address this oxymoron, the investigators conduct a randomized non-inferiority trial to investigate the effect of low in comparison to high-pressure pneumoperitoneum during the transection phase of major milr on intraoperative blood loss while also evaluating the risk of embolic complications.


Eligibility criteria:
inclusion criteria: * age equal or older than 18 years and * capacity of consent and * planned elective conventional laparoscopic or da vinci-assisted major liver resection or resections near the liver hilum or the hepatic venous vasculature. major liver resections are defined as the resection of 3 liver segments or more (right and left partial hepatectomies, extended right and left hepatectomies, liver resections of 3 or more segments). right posterior sectionectomies and mesohepatectomies of ≥2 liver segments are considered resections in proximity to the liver hilum or hepatic venous vasculature. exclusion criteria: * the participation in another trial with interference of intervention and outcome of this study, * being a woman who is pregnant or breast-feeding or planning to become pregnant, * american society of anesthesiologists (as) score \>3, * language barrier, * any contraindication to a minimal invasive surgical approach or intolerance to pneumoperitoneum * a patent foramen ovale (pfo) or any other structural cardiac defect that facilitates paradoxical gas embolisms, * diagnosis of neuromuscular disease, heart failure nyha \> class ii or chronic obstructive pulmonary disease (copd) * being on oral anticoagulation therapy other than aspirin 100mg daily or any other condition known to increase the risk of bleeding.

Keywords: pneumoperitoneum minimal-invasive liver surgery intraoperative blood loss
nanocort in acute exacerbation of relapsing-remitting multiple sclerosis (ms)

Conditions: Acute Exacerbation of Remitting Relapsing Multiple Sclerosis; Clinically Isolated Syndrome

Summary: patients with an acute exacerbation of relapsing-remitting multiple sclerosis or with clinically isolated syndrome receive either one single infusion of nanocort or three daily infusions of solumedrol. main objective is to assess the occurrence of new gadolinium-enhanced t1-weighted lesions at week 8 vs week 1 after treatment.


Eligibility criteria:
inclusion criteria * diagnosis of rrms (per mcdonald criteria, 2005) with dissemination in time and space or a diagnosis of cis confirmed by mri. patients with cis who only have optic neuritis will be excluded from this study * a maximum expanded disability status scale (edss) score of ≤ 6 * new neurological symptoms or exacerbation of prior neurological symptoms of over 24 hours duration but \<7 days duration, verified by neurological examination exclusion criteria: * primary progressive ms. * secondary progressive ms without superimposed relapses. * received systemic corticosteroids within 4 weeks of screening for treatment of ms or other conditions. * any contraindication for treatment with (systemic) corticosteroids

Keywords: peg-liposomal prednisolone sodium phosphate
the association between the duration of acute kidney injury and new-onset chronic kidney disease after cardiac or thoracic aortic surgery

Conditions: Acute Kidney Injury; Chronic Kidney Disease, Stage 3; Chronic Kidney Disease, Stage 5; Cardiac Surgery; Thoracic Aortic Surgery

Summary: the investigators aimed to evaluate the association between the duration and stage of acute kidney injury (aki) and the development of chronic kidney disease during postoperative three years in patients undergoing cardiac or thoracic aortic surgery.

postoperative acute kidney injury (aki) has been investigated as an important contributor to postoperative morbidity and mortality after cardiovascular surgery. also, temporary worsening of renal function after aortic surgery is associated with higher long-term mortality. although the associations between aki and chronic kidney disease (ckd) in medical or other surgical settings were reported, only a few studies evaluated this relationship in patients undergoing cardiac surgery. more specifically, the association of the severity or duration of aki with the risk of the development of new-onset ckd after cardiac surgery has not been clearly elucidated. it would be important to find predictors of the long-term renal function or risk factors for the development of ckd after cardiac surgery because postoperative management of high-risk patients to develop long-term renal dysfunction may prevent further deterioration in renal function and improve patient prognosis. the investigators aimed to evaluate (1) the long-term renal function after cardiac surgery and (2) the association between the duration and stage of acute kidney injury (aki) and the development of chronic kidney disease during postoperative three years in patients undergoing cardiac or thoracic aortic surgery.

Eligibility criteria:
inclusion criteria: * adult patients who underwent cardiac or thoracic aortic surgery under cardiopulmonary bypass at seoul national university hospital between 2008 and 2017 exclusion criteria: * those with off-pump coronary artery bypass * missing baseline serum creatinine * missing postoperative serum creatinine values of more than three among seven postoperative days * preoperative baseline chronic kidney disease with estimated glomerular filtration rate \<60 ml/min/1.73m2

Keywords: acute kidney injury chronic kidney disease cardiac surgery thoracic aortic surgery
the effect of preferred music on emg anxiety and pain

Conditions: Anxiety; Pain; Nerve Injury

Summary: patients often report anxiety and pain related to electromyography (emg) and nerve conduction studies (ncs) which are tests used to look for diseases of the nerves and muscles. unfortunately, for those with very high levels of test related stress, the experience may be very frightening and may impede completion of the study and negatively impact on making a timely and accurate diagnosis. several studies have shown that music can improve anxiety and pain levels in various situations and procedures. our study will allow participants to play music of their choice during emg and ncs in order to determine if the pain and anxiety that they experience is reduced.

this study will be a prospective randomized trial carried out at mount hope centre for long term care in london, ontario. all patients referred for electromyography and a nerve conduction study will be considered for inclusion in the study. those who meet the criteria and verbally consent to the study will sign a consent form and then be randomly assigned to either a music or no-music group using a computer-generated random number series. prior to starting the test, all participants who enroll in the study will complete form y-1 and y-2 of the state-trait anxiety inventory (stai) which measure state (s) anxiety and trait (t) anxiety respectively. they will also complete an 100 mm visual analogue scale (vas) for pain and anxiety prior to beginning the studies. during and following the test they will be asked to complete a vas for pain and anxiety, and the y-1 of the stai to measure state anxiety. aside from having to fill out the stai and visual analogue scales, patients assigned to the no-music group will undergo the emg and ncs as per usual. those in the music group will be given a set of over-ear headphones (sterilized before use) and a tablet device. participants will be allowed to navigate spotify, a digital music service to select whatever music they desire. an app that limits volume will be used to ensure that volume cannot be raised above 80 decibels by the patient. communication with the patient will not be hindered as the emg technician and physician will be speaking into a microphone that transmits the sound directly to the participant's headphones.

Eligibility criteria:
inclusion criteria: * patients 18 years of age or older referred for ncs and emg at mount hope centre for long term care in london, ontario will be eligible and offered entry into the study if the following criteria are met: the ncs/emg are indicated, they have at least a 6th grade reading level in english such that they can complete the stai, and the patient is willing and able to provide signed informed consent. exclusion criteria: 1. use of hearing aids that would preclude or hinder the use of over-ear headphones. 2. profound hearing loss. 3. cognitive impairment
the effect of popliteal plexus block on pain after total knee arthroplasty

Conditions: Popliteal Plexus Block; Total Knee Arthroplasty

Summary: the study aims to investigate the effect of the popliteal plexus block (ppb) on postoperative pain after total knee arthroplasty

cadaver dissection studies have shown a spread of dye to the popliteal fossa and colored the popliteal plexus by injecting in the distal part of the adductor canal. the popliteal plexus is formed by contribution from the tibial and the obturator nerves. investigators hypothesized that a ppb may reduce postoperative pain after total knee arthroplasty.

Eligibility criteria:
inclusion criteria: * patients undergoing total knee arthroplasty in spinal anesthesia * age \> or = 18 years * american society of anesthesiologists (asa) status i-iii * informed consent exclusion criteria: * patients unable to cooperate * patients not able to speak danish * pregnancy * contraindication towards ana medical product used in the study * preoperatively reduced sensation on the medial and lateral part of the lower leg * patients with diabetic requiring medical treatment * preoperative daily intake of opioids
efficacy of mesalazine combined with biologics in the treatment of moderate to severe ulcerative colitis

Conditions: Ulcerative Colitis; Efficacy, Self; Biologics; Mesalazine

Summary: endocopic remission rates of moderate to severe ulcerative colitis are low. biologics including vedolizumab, infliximab, and adalimumab are effective in induction and maintainence of ulcerative colitis. the role of 5-asa in promoting a higher rate of endocsopic remission is unclear. we aim to evaluate the efficacy of combination of 5-asa and biologics in treating ulcerative colitis.


Eligibility criteria:
inclusion criteria: 1. patients with moderate and severe ulcerative colitis; 2. subjects were above 18 years old and below 80 years; 3. indications of 5-asa or biological treatment; 4. according to the clinical symptoms, ulcerative colitis was diagnosed by endoscopic changes, pathological manifestations. the disease activity of uc was assessed according to the modified mayo scoring system (modified mayo: 6\~12 for patients with moderate to severe ulcerative colitis); 5. if the subject is a woman, a pregnancy test at baseline is needed to exclude pregnancy. female patients must follow the contraceptive recommendations of the project; 6. subjects must be able and willing to provide written informed consent and comply with the requirements of this study protocol. exclusion criteria: 1. no indications of 5-asa or biological treatment; 2. ulcerative colitis patients who had previously undergone a partial colectomy; 3. patients who are unable to use 5-asa for a long time; 4. patients with severe, progressive, or uncontrolled kidney, liver, blood, or endocrine diseases or symptoms; 5. presence of infected persons, patients with a contraindication to the use of biological agents such as c. difficile infection or other intestinal pathogens, active tuberculosis or intestinal tuberculosis infection, human immunodeficiency virus (hiv) infection, active hepatitis b or hepatitis c (defined as: ① hbv: hepatitis b surface antigen (hbs ag) positive (+), or patients with positive for hepatitis b core antibody (hbcab) and the qualitative test results of hbv deoxyribonucleic acid (dna) polymerase chain reaction (pcr) meet the detection criteria; ② hcv: any patient with an anti-hcv antibody (hcv ab) -positive patient with a detectable hcv ribonucleic acid (rna); 6. patients with a history of gastrointestinal dysplasia, or dysplasia on any biopsy performed on endoscopy, excluding low-grade dysplasia lesions; known history of lymphoproliferative disease (including lymphoma), or signs and symptoms (e. g., lymphadenopathy and / or splenomegaly); patients with current or previous malignancy; 7. has been involved in other clinical studies.

Keywords: ulcerative colitis biologics mesalazine
gemcitabine and pemetrexed in primary unknown adenocarcinoma

Conditions: Adenocarcinoma

Summary: there is no standard treatment for the patient population being asked to participate in this study. although one current regimen, used by some investigators, has a high rate of response compared to other therapies, it is associated with moderate to severe toxicity. as gemcitabine and pemetrexed have a broad range of activity against cancer it is reasonable to determine how active and safe they are against patients with this type of cancer.the objective of this study is to determine the anti-tumor activity of pemetrexed and gemcitabine in patients with this condition.


Eligibility criteria:
inclusion criteria: * histologically proven adenocarcinoma * no obvious primary on routine history, physical examination, and investigations * patients greater than or equal to 18 years of age * ecog performance status 0-1 * patients requiring opioids for pain control must be on a fixed analgesic regimen aimed to provide adequate pain control with no more than 3 breakthrough (supplemental) doses of analgesics per day to control pain; additional inclusion criteria due apply, but not are not listed here. exclusion criteria: * have received treatment within the last 30 days with a drug that has not received regulatory approval for any indication at the time of study entry * unable to stabilize pain and analgesics for a period of 7 days prior to starting study treatment * prior treatment with chemotherapy * bilirubin greater than or equal to 40 mol/l * ast or alt greater than or equal to 5 times the upper limit of normal (uln); additional exclusion criteria due apply, but not are not listed here.
laser-assisted flapless corticotomy in accelerating canine retraction

Conditions: Class II Division 1 Malocclusion; Maxillary Prognathism; Protrusion, Incisor

Summary: erbium lasers have been suggested to accomplish corticotomy without flap reflection due to their attractive advantages. the current trial aimed to evaluate the efficacy of laser-assisted flapless corticotomy in accelerating orthodontic tooth movement. the secondary aim was to evaluate the patients' responses to laser application. it was postulated that canine retraction after laser-assisted flapless corticotomy would be accomplished within a shorter period compared with the conventional canine retraction method, with no significant degree of pain and discomfort.

comprehensive orthodontic treatment with fixed appliances usually takes more than 18 months in mild and severe cases. prolonged treatment time can cause many adverse effects such as pain, discomfort, external root resorption, white spots and dental caries. decreasing the treatment time for tooth movement has been the focus of both the clinicians and the patients. for the last few decades, investigators have recommended many treatment approaches intending to reduce overall treatment time such as low friction and self-ligating bracket systems, low-level laser irradiation, electrical currents, pharmacological approaches, local platelet-rich plasma (prp) injection and surgical approaches like dentoalveolar distraction and selective alveolar decortication or corticotomy

Eligibility criteria:
inclusion criteria: * class ii division 1 patients requiring orthodontic treatment with fixed appliances and a need for upper first-premolar extraction using a two-step retraction technique. * permanent dentition with an age range from 16 to 24 years. * healthy with no systemic conditions. * adequate oral hygiene and healthy periodontal tissues * no previous orthodontic treatment * absence of canine endodontic treatment. exclusion criteria: * bimaxillary dentoalveolar severe protrusion. * previous orthodontic treatment. * subject with psychological abnormalities. * subject with systemic diseases.

Keywords: tooth movement acceleration of tooth movement er:yag laser-assisted corticotomy
a study of xw001 in healthy adult subjects

Conditions: Respiratory Syncytial Virus Infections

Summary: this is the first-in-human, single-center, randomized, double-blinded, placebocontrolled, single-dose and multiple-dose escalation phase ia study

single ascending dose (sad), healthy participants will be randomized to receive a single inhalational dose of either xw001 or placebo in each of the planned sad cohorts. multiple ascending dose (mad), healthy participants will be randomized to receive inhalational doses of xw001 or placebo in each of the planned mad cohorts.

Eligibility criteria:
inclusion criteria: 1. healthy subjects aged 18-45 years (including both ends), male or female; 2. body mass index (bmi) of 19.0-28.0 kg/m2 (including both ends); 3. subjects who fully understand the trial objectives, have a basic understanding of the pharmacological effects and possible risks of the investigational drug, and voluntarily sign an informed consent form; 4. subjects who can communicate well with the investigators, and understand and abide by the requirements of this study. exclusion criteria: 1. (screening period) subjects participated in any drug clinical trial or used the investigational drug within 3 months prior to the trial; 2. (screening period/admission) subjects with a medical history of diseases in cardiovascular system, digestive system, endocrine system, urinary system, nervous system, hematological, immunological (including personal or family history of hereditary immunodeficiency), or metabolic abnormalities, etc., that are still considered as clinically significantly by the investigators. 3. (screening period) subjects with previously diagnosed chronic obstructive pulmonary disease (copd), asthma, or other clinically significant lung diseases, or with a medical history of acute upper and lower respiratory infection requiring intravenous injection of antimicrobial drugs or other hospitalization treatment within the past 3 months; 4. (screening period/admission) subjects who had underwent a surgery that is considered affecting the pharmacokinetics(pk) behaviors of the drug by the investigator within 6 months prior to the trial; 5. patients with positive endogenous interleukin 29 (il-29) level (i.e., the test result in the screening period is higher than the lower limit of quantification); 6. subjects with lung function abnormality (measured forced expiratory volume in one second #fev1)/predicted fev1 ≤ 80% or measured forced vital capacity (fvc)/predicted fvc ≤ 80%); 7. subjects who are unable to complete the study for other reasons or are not suitable to participate in the trial as judged by the investigators.
effect of immune-enhancing enteral nutrition on immunomodulation in critically ill patients

Conditions: Critical Illness

Summary: to determine whether high-protein (24% of total calorie from protein) enteral nutrition of immune modulating nutrients (eg, ω-3 fatty acids and antioxidants) enriched with β-glucan stimulates immune functions compared with standard enteral nutrition (control: 20% of total calorie from protein) or high-protein (24% of total calorie from protein) enteral nutrition of immune modulating nutrients without β-glucan in critically ill patients.

to determine whether high-protein (24% of total calorie from protein) enteral nutrition of immune modulating nutrients (eg, ω-3 fatty acids and antioxidants) enriched with β-glucan stimulates immune functions compared with standard enteral nutrition (control: 20% of total calorie from protein) or high-protein (24% of total calorie from protein) enteral nutrition of immune modulating nutrients without β-glucan in critically ill patients. in a randomized double-blind placebo-controlled study, 30 patients consumed 1 of 3 enteral nutrition: control, enteral nutrition of immune modulating nutrients enriched with β-glucan (250mg/l) or enteral nutrition of immune modulating nutrients without β-glucan. enteral nutrition was initiated within 24 hours of icu admission and continued during the icu stay for a 7 days.

Eligibility criteria:
inclusion criteria: * icu patients exclusion criteria: * icu patients who could not receiving enteral nutrition