Kornimate/medical-research-clean huggingface dataset:
role of endoscopic third ventriculostomy in management of malfunctioning ventriculoperitoneal shunt

Conditions: Hydrocephalus; Shunt Malfunction

Summary: the aim of this study is to analyze our experience in management of malfunctioning ventriculoperitoneal shunt by using endoscopic third ventriculostomy (etv).

cerebrospinal fluid shunting remains the most common line of treatment for hydrocephalus. endoscopic third ventriculostomy (etv) is an alternative to cerebrospinal fluid (csf) shunting that is potentially favorable due to the lack of implanted hardware. most previous studies of etv have focused on its role as an initial treatment for hydrocephalus and on comparing etv with csf shunting. however ,some patients who have previously been treated with a csf shunt then developed malfunction are candidate for etv. the etv success score (etvss) is the most widely used scale to estimate the likelihood of etv success for a given patient . although the age of the patient is the most important component of the etvss, history of previous treatment with a shunt is also included in the model. according to the etvss, previous shunting reduces the likelihood of etv success by approximately 10%. there have been numerous previous studies of etv in patients with a history of a csf shunt (post shunt etv), reporting success rates from 50% to 80% . two review articles also covered this topic, one of which reported etv success by meta-analysis in 68% of 519 pooled patients . most patients with shunt malfunction and or infection are treated with revision procedures, but etv can be used as an alternative treatment in such cases .the role of endoscopic management of hydrocephalus in shunt malfunction was not investigated extensively so far. there are several studies which have considered etv as the main treatment of hydrocephalus inpatients with shunt failure. therefore, this is an attractive topic in neurosurgery especially in pediatric neurosurgery that can work and make a different kind of studies to explore the role of etv for shunt failure. the goal of the current study was to present our experience with endoscopic third ventriculostomy for management of shunt malfunction.

Eligibility criteria:
inclusion criteria: * • all patients with malfunctioning vp shunt will be included in this study. exclusion criteria: * patients with contraindications for endoscopic procedure such as intracranial infection or bleeding disorders * previous unsuccessful attempts of endoscopic third ventriculostomy. * active infection or inflammation in the central nervous system. * recent history of intracranial hemorrhage. * medically unfit for surgery.

Keywords: endoscopic third ventriculostomy
adjuvant chemotherapy combined with huaier granule for treating high-risk stage ii, stage iii colorectal cancer

Conditions: Colorectal Cancer

Summary: a randomized, paralleled control clinical study investigating huaier granule for prevention of recurrence and metastasis of colorectal cancer after radical surgery, to evaluate the efficacy and safety.


Eligibility criteria:
inclusion criteria: * the subjects volunteer to sign the informed consent * aged: 18 to 75 years old * colorectal cancer (ajcc-tnm, high-risk stage ii and stage iii) * the diagnosis and colorectal cancer has been confirmed by pathological examination after radical surgery * the liver and kidney function satisfies the following conditions within 15 days after surgery (excluding day 15): aspartate aminotransferase (ast), glutamic-oxalacetic transaminase (alt), alkaline phosphatase (alp)\< 2 upper limit of normal (uln), total bilirubin ≤ 1.5 uln, serum creatinine \< 1.5 uln; normal coagulation function * other laboratory tests meet the following requirements within 15 days after surgery (excluding day 15): white blood cells count ≥ 3.0×109/l, absolute neutrophil count ≥ 1.5×109/l, platelet count ≥ 100×109/l * ecog：0-2 points * no other previous history of malignancy. exclusion criteria: * multiple primary cancer * not recover from the colorectal surgery * presence of organ, bone, or skin metastases * pregnant or lactating women * those with active bleeding due to various reasons * those with hiv infection or aids-associated diseases * those with severe acute and chronic diseases * those with severe diabetes * those with serious infectious diseases * those who can not take drugs by oral route * drug abusers or those with psychological or mental diseases that may interfere with study compliance * conditions that are considered not suitable for this study investigators

Keywords: huaier granule after radical surgery prevention of recurrence and metastasis efficacy and safety
surgical treatment of the patients with restrictive phenotype of the hypertrophic cardiomyopathy without lvot obstruction

Conditions: Apical Hypertrophic Cardiomyopathy

Summary: hypertrophic cardiomyopathy - is an inherited disease characterized by pronounced genetic and phenotypic heterogeneity. there are two most common anatomic variants of cardiac hypertrophy: subaortic and submitral phenotypes. subaortic phenotype is characterized by hypertrophy of the basal parts of the heart, mainly in the interventricular septum (ivs), manifesting by a high pressure gradient in the lvot. submitral phenotype is characterized by localization of hypertrophic zone downward to the apex and apical phenotype is without a pressure gradient in the lvot. the morphology, nature of hemodynamic abnormalities not well studied in patients with apical phenotype of hcm, and surgical treatment are controversial, and for those patients with advanced stage of the hf the orthotopic heart transplantations (htx) is usually considered. one of the surgical techniques available for this category of patients is apical myectomy. the main goal of this intervention is increasing the left ventricular volume and improving of the lv compliance with an increase of the diastolic relaxation. limited data of such procedures in hcm patients were already published but it still requires further investigation on larger cohort of patients. in this study, the investigators hypothesize that along with left ventricular septal hypertrophy, a small cavity is formed in patients with submittal-apical phenotype due to an increased number of hypertrophied papillary muscles. they are displaced to the apex and tightly fixed both among themselves and to the left ventricular walls. this causes a significant reduction in diastolic volume and left ventricular relaxation capacity. the present study will analyze the experience of performing resection of hypertrophied trabeculae and mobilization of papillary muscles performed through the aorta. throw this approach procedure can be done without the need for traumatic access and suturing in the apex of the left ventricle.


Eligibility criteria:
inclusion criteria: * hypertrophic apical cardiomyopathy according to medical records * surgical left ventricular remodeling performed exclusion criteria: * lvot gradient greater than 30 mmhg

Keywords: apical hypertrophic cardiomyopathy midventricular obstruction and cavity obliteration septal myectomy hypertrophic cardiomyopathy sudden cardiac death
delirium prediction in the intensive care unit: head to head comparison of two delirium prediction models

Conditions: Delirium

Summary: currently, two icu delirium prediction models are available: the pre-deliric model and the early prediction model (e-pre-delric). however, the use of these prediction models is not yet implemented as standard in clinical practice, as it is unknown which delirium prediction model can best be used to predict delirium in icu patients.therefore the main aim of this study is to compare the performance of the pre-deliric model and the e-pre-delric model.

delirium often occurs in icu patients and is associated with negative consequences, requiring prevention. a prediction model facilitates the identification of those patients at risk for delirium and therefore need prevention the most. at present, two icu delirium prediction models are available. first the pre-deliric model was developed. this recently recalibrated model reliably predicts icu patients' risk for delirium within 24 hours after icu admission. because a relevant number of patients develops delirium during the first 24 hours after icu admission, and prevention ideally should be deployed as soon as possible, the investigators developed the 'early prediction model' (e-pre-deliric) which reliably predicts delirium immediately after icu admission. to implement a delirium prediction model in clinical practice, one needs to know which model best can be used. currently, the use of a delirium prediction model is not implemented as standard in clinical practice, as this information is unavailable. therefore the main aim of this study is to compare the (predictive and clinical) performance of the pre-deliric model and the e-pre-delric model.

Eligibility criteria:
inclusion criteria: * icu patients aged ≥18 years; * surgical, medical, neurology/neurosurgical, or trauma patients. exclusion criteria: * delirious at icu admission; * expected icu stay shorter than 6 hours; * unable to reliably assess icu delirium due to: * sustained coma during entire icu stay; * unable to understand the language spoken; * severely mentally disabled; * serious receptive aphasia; * serious auditory or visual disorders.

Keywords: delirium intensive care unit adult clinical prediction
the effectiveness of auricular acupuncture on improving secretion of saliva among institutional older population

Conditions: Salivary Gland Diseases

Summary: the study aims to examine the effect of auricular acupuncture on improving oral health in older population. the hypothesis of this study is that older people receiving auricular acupuncture can increase salivary secretion. by identifying the effectiveness of auricular acupuncture can increase salivary secretion; suitable care can be suggested to improve oral health in older population living in long-term institutions.

the elderly living in long-term institutions are mostly limited to physical dysfunction and highly dependence. in addition, the chronic diseases are affected by taking a variety of drugs, which may easily lead to dry mouth. thus, providing oral health to increase secretion of saliva is high recommended to those older population. the study is used to examine the effect of auricular acupuncture on improving oral health in older population. the eligible participants are random assign to experimental group receiving auricular acupuncture and control group having ineffective auricular acupuncture. outcome measures include demographic variables, general health status and secretion of saliva, such as: subjective dry mouth condition and objective mouth condition. generalized linear model will be used to examine the effect of auricular acupuncture on improving oral health. by identifying the effectiveness of auricular acupuncture can increase salivary secretion; suitable care can be suggested to improve oral health in older population living in long-term institutions.

Eligibility criteria:
inclusion criteria: 1. residents in long-term institutions aged over 65 years old 2. living in long-term institutions at least six months and above 3. having normal cognitive functions with mini-mental state examination scores more than 25 scores. exclusion criteria: 1. the resident whose acupuncture point has trauma, eczema or ulcer. 2. incapable of salivary secretion caused by disease,sush as radiation-induced xerostomia among patients with nasopharyngeal carcinoma, sjogren's syndrome,acute sialadenitis,chronic recurrent sialadenitis,viral salivary gland infection,salivary gland stones.
topical and oral regimen for skin health

Conditions: Skin Abnormalities

Summary: the overall objective of this study is to assess how oral supplementation with inner calm and the use of topical super calm can affect the appearance of skin and inner wellness, such as redness, skin sensitivity, and reactionary skin.

the landscape for skin health has expanded past a focused use of topicals to incorporate the use of supplementation. notable examples include the ingestion of carotenoids and beta-carotene to augment skin antioxidant status or the role of diet on different skin conditions. the role of this investigation is to define how inner calm (oral supplementation) may promote healthier skin and how this may work in synergy with super calm (topical supplementation).

Eligibility criteria:
inclusion criteria: * women aged 18-55 * fitzpatrick skin type 1-4 * self-perception as sensitive skin exclusion criteria: exclusion criteria: * adults unable to consent * individuals who are not yet adults (infants, children, teenagers) * pregnant or breast-feeding women * prisoners * those who have used isotretinoin in the last 6 months * those who have used products containing salicylic acid, beta hydroxyl acids or vitamins a, c, or e or topical retinoids or topical depigmenting agents (such as hydroquinone, kojic acid, azelaic acid, or others in opinion of the investigator) in the last 14 days * those who are currently smoking or have smoked within the past 3 years. * those who have had a recent surgical or cosmetic procedure in the last 3 months that can affect facial wrinkles, redness, or hyperpigmentation, such as botulinum toxin injections, chemical peels, laser-based therapies to the face, or face lift surgeries * subjects with known allergy to any of the components of inner calm or skin calm * those that are unwilling to discontinue use of any other nutritional supplements including antioxidants, herbs, or protein-based supplements for 2 weeks prior to and during their participation. * subjects with a diagnosis of acne

Keywords: skin dermatology
the effect of preoperative chewing gum on anxiety and sore throat in patients with laryngeal mask airway

Conditions: Laryngeal Mask; Throat Pain; Anxiety

Summary: this study was planned to investigate the effect of chewing gum in the preoperative period on patients' sore throat and anxiety levels.

postoperative sore throat is a common complaint (1,2). it is reported in the literature that there are various pharmacological methods to reduce this condition, such as the use of nebula, corticosteroids, nonsteroidal anti-inflammatory drugs, or lidocaine. however, these methods have various advantages and disadvantages (3,4). chewing gum, one of the non-pharmacological methods may be safer for the patient. chewing gum increases salivary gland secretion and provides lubrication of the oral cavity (5). for this reason, it was thought that chewing gum before surgery could reduce throat pain after using a laryngeal mask due to the effect it provides. it has been determined that there are few experimental studies on the subject in the literature (6,7). the presence of preoperative anxiety may lead to an increase in the need for intraoperative anesthesia and analgesic consumption in the postoperative period (8,9). however, it may cause a decrease in patient satisfaction and prolong the recovery process in the postoperative period (8,9). pharmacological approaches can be applied to address this concern. however, non-pharmacological approaches may be safer for patients. chewing gum during this process can also reduce patients' anxiety levels. a sufficient number of studies on the subject could not be found (10). the study will conduct as a prospective randomized controlled trial. after obtaining verbal and written consent from the patients before and after the surgery, the study will conduct with various data collection forms. these forms are; patient identification form, amsterdam preoperative anxiety and information scale (apais), visual analogue scale (vas). patients will randomize. the chewing gum group in group- i (n=46), and group ii (n=46) will be the control group. we have two stage.in first stage; anxiety levels will be measured for both group. in second stage; throat pain will evaluated at 2.-4.-6. hours.

Eligibility criteria:
inclusion criteria: * undergoing elective surgery * being intubated with a laryngeal mask * being asa (american society of anesthesiologists) i-ii exclusion criteria: * using cigarette * having asthma * having chronic laryngitis * having gastroesophageal reflux * steroid use in the preoperative or intraoperative period * mallampati score greater than two

Keywords: laryngeal mask pain chewing gum anxiety
inhaled iloprost in adults with abnormal pulmonary pressure and associated with idiopathic pulmonary fibrosis

Conditions: Pulmonary Fibrosis; Pulmonary Hypertension

Summary: the primary purpose of this study is to determine whether iloprost inhalation solution is safe in subjects with idiopathic pulmonary fibrosis (ipf) and elevated pulmonary arterial pressure. the secondary purpose is to evaluate the effectiveness of this treatment in subjects with this disease.

while there are no fda approved therapies for the treatment of ipf, there are therapies that have been shown to be effective in ameliorating the effects of pulmonary hypertension in patients with pah (pulmonary arterial hypertension), including inhaled iloprost. however, these therapies have not been used extensively in patients with ipf who have pulmonary hypertension as a complication. the potential benefits of treatment of pulmonary hypertension complicating ipf include: improvement in pulmonary hemodynamics, with reduction in pulmonary artery pressure and pulmonary vascular resistance, and increase in cardiac output.

Eligibility criteria:
inclusion criteria: * diagnosis of idiopathic pulmonary fibrosis according to american thoracic society criteria * diagnosis of elevated pulmonary pressures * six minute walk distance between 50-380 * nyha functional class ii - iv exclusion criteria: * pulmonary fibrosis related to a systemic disorder * significant chronic obstructive pulmonary disease * history of thromboembolic disease within the previous year * awaiting lung transplantation within next 36 weeks * active lung infection * survival prognosis of less than 1 year * significant left-sided heart failure, active coronary artery disease * clinically relevant liver disease * concurrent medications: epoprostenol, treprostinil, bosentan, pde-5 inhibitor, investigational agents

Keywords: active iloprost idiopathic pulmonary fibrosis pulmonary arterial hypertension
effect of supplemental hydrocortisone during stress in prednisolone-induced adrenal insufficiency

Conditions: Adrenal Insufficiency; Polymyalgia Rheumatica; Giant Cell Arteritis

Summary: in this double-blinded randomised placebo-controlled clinical trial, the aim is to determine the effect of supplemental hydrocortisone compared with placebo during mild to moderate physical or mental stress on health related quality of life in patients with polymyalgia rheumatica (pmr)/giant cell arteritis (gca) on ongoing low-dose prednisolone diagnosed with glucocorticoid-induced adrenal insufficiency. the main emphasis is on fatigue (primary outcome) and daily variation hereof during periods of stress.

the study will include patients with pmr/gca on ongoing prednisolone treatment in a low dose of \> 0 mg/day and ≤5mg/day. eligible patients will undergo a synacthen® test and 250 patients with a stimulated cortisol level \ 5mg/day for e.g. 5 weeks the study is prolonged accordingly 5 weeks. seventy-five patients with stimulated cortisol ≥420 nmol/l (normal adrenal function) will be used as a reference group. the participants will undergo screening and baseline examinations, 3 month's reporting of hrqol, and with patient consent follow-up through medical records on prednisolone treatment characteristics, and number of hospitalisations.

Eligibility criteria:
inclusion criteria: * age ≥ 50 years * women must be postmenopausal (fsh is measured at the screening visit) * a diagnosis of pmr/gca, or both conditions combined. * treatment with prednisolone ≥12 weeks * ongoing prednisolone treatment, with current daily prednisolone dose \> 0 mg and ≤5 mg. the dose must have been ≤5 mg for minimum 2 weeks at the time of the screening visit. exclusion criteria: * known primary or secondary adrenal insufficiency * known cushing's syndrome * known allergy towards study medication ingredients * severe comorbidity: heart failure (new york heart association class iv); kidney failure with an estimated glomerular filtration rate \<30 ml/min (chronic kidney disease stage 4-5); liver disease in the form of cirrhosis; active cancer; known severe immune deficiency; a history of psychiatric disease requiring treatment by a psychiatric department (for affective disorders only if within the last year before study entry) * alcohol consumption \>21 units per week * planned major surgery during the study period at study entry. * use of drugs that interfere with cortisol metabolism/measurements: systemic oestrogen treatment (discontinued \< 1 month before inclusion), treatment with strong cyp3a4 inhibitors or inducers, use of other glucocorticoid formulations (inhaled corticosteroids, intraarticular or intramuscular injections, steroid creams european steroid group iv-v used in the genital area. note: permitted glucocorticoid formulations: eye-drops, nasal spray, glucocorticoid creams european steroid group i-iii, and european steroid group iv-v used in the non-genital area only.) * inability to provide written informed consent.

Keywords: glucocorticoid-induced adrenal insufficiency prednisolone glucocorticoids hypothalamic-pituitary-adrenal axis
evaluation and treatment strategy development of coronary heart disease guided by oct based on multimodal deep learning

Conditions: Coronary Disease; Coronary Artery Disease

Summary: this is a retrospective, multicenter, observational study aimed at assessing stent apposition for coronary stent implantation by an optical coherence tomography system constructed by deep learning algorithms and evaluating the prognosis of patients after stent implantation in conjunction with multimodal diagnostic and therapeutic information.

in this study, we planned to retrospectively collect 2,000 subjects who underwent optical coherence tomography-guided percutaneous coronary stent implantation with an optical coherence tomography system constructed by a deep learning algorithm from 3 centers to assess stent apposition for coronary stent implantation, and to classify subjects into a group with poor stent apposition (axial distance \>400 μm or length \>1 mm) and a group with good stent apposition. all subjects were followed up within 12 months after the procedure.

Eligibility criteria:
inclusion criteria: * age ≥20 years old; * angiography was performed, and oct imaging of criminal blood vessels was performed before intervention; * type of coronary heart disease: unstable angina pectoris (ua), st elevation myocardial infarction (stemi) and non-st elevation myocardial infarction (nstemi); exclusion criteria: * lack of medical records; * failure to complete follow-up; * previous coronary artery bypass grafting; * severe liver or kidney insufficiency; * infectious diseases, malignancies and bleeding diseases; * oct image quality was caused by large thrombus volume or residual blood in lumen and percutaneous coronary angiography poor and further excluded.