Kornimate/medical-research-clean huggingface dataset:
diagnostic endoscopic exploration for pancreatic head mass

Conditions: Pancreatic Head Mass

Summary: this study is being done to find out if an endoscope passed down the throat, through the stomach, and into the abdomen can quickly and accurately examine the organs and tissue of the abdomen and take biopsies if needed.

this study is being done to find out if an endoscope (a small, flexible tube with a camera mounted on the end) passed down the throat, through the stomach, and into the abdomen can quickly and accurately examine the organs and tissue of the abdomen and take biopsies if needed. we wish to determine if this endoscopic route is as fast and efficient as the laparoscopic route, which is the current standard of care.

Eligibility criteria:
inclusion criteria: * age range 18-80 * radiographic diagnosis of resectable pancreatic head mass presumed to be pancreatic adenocarcinoma exclusion criteria: * inability to obtain informed consent * pregnancy * intra-abdominal adhesions that preclude endoscopy * contraindication to upper endoscopy such as stricture, stenosis of the foregut * previous gastric surgery * diagnosis of pancreatic body or tail tumor * history or current diagnosis of gastric ulcer * metastatic disease diagnosed by ct, eus, mri, or nuclear imaging * patient is not a candidate for resection based upon ct, eus, mri, or nuclear imaging * antiplatelet medication not stopped at least 7 days prior to procedure * anticoagulant medication not stopped at least 5 days prior to procedure

Keywords: pancreatic head mass pancreatic cancer notes endoscopic peritoneoscopy whipple palliative gastrojejunostomy
pnf with and without electrical stimulation in patients with chronic lumbar radiculopathy

Conditions: Lumbar Radiculopathy

Summary: numerous researches have shown how pnf is been used to treat non specific low back pain, subacromial impingement, cervical radiculopathy and many others. in some studies different techniques like mckenzie method, spinal mobilization and mulligan traction other than pnf were being used to treat lumbar radiculopathy. according to researchers knowledge little literature available to see the effectiveness of pnf with electrical stimulation in patients with chronic lumbar radiculopathy. therefore, the purpose of the current study is to examine the effects of pnf with electrical stimulation in patients with chronic lumbar radiculopathy.


Eligibility criteria:
inclusion criteria: * • diagnosed cases of lumbar radiculopathy * either one or both legs affected by radiating pain * signs of nerve root compression like paresthesia, numbness, tingling, sharp pain * impaired deep tendon reflex(knee jerk, ankle jerk) * both male and female * radiological evidence of lumbar spondylosis with radiculopathy * age group between 40 to 70 years * positive slr test between 45° to 70° * all subjects with symptoms for duration of more than 6 weeks * increase leg pain by coughing and sneezing exclusion criteria: * serious spinal conditions e.g infection, tumor, osteoporosis * uncontrolled hypertension * severe cognitive impairment * other neurological conditions and systemic illness like kidney and visceral diseases * vertebral fracture and spondylolisthesis * pregnant women * history of spinal surgery in previous 6 months * clinical conditions such as oversensitive skin, patients with cardiac pacemakers where application of tens is contraindicated

Keywords: pain disability
cll1-cd33 ccar in patients with relapsed and/or refractory, high risk hematologic malignancies

Conditions: Hematologic Malignancy; Acute Myeloid Leukemia; Myelodysplastic Syndromes; Myeloproliferative Neoplasm; Chronic Myeloid Leukemia

Summary: phase i, interventional, single arm, open label, treatment study to evaluate the safety and tolerability of cll1-cd33 ccar in patients with relapsed and/or refractory, high risk hematologic malignancies.

aml bears heterogeneous cells that can consequently offset killing by single-car-based therapy, which results in disease relapse. leukemic stem cells (lscs) associated with cll1 expression comprise a rare population that also plays an important role in disease progression and relapse for myeloid malignancies. cd33 is widely expressed in aml, high risk myelodysplastic syndromes (mds) and myeloproliferative neoplasms. targeting both cd33 and cll1 surface antigens together may offer two distinct benefits. first, targeting both bulk disease and leukemic stem cells together allows for a more comprehensive ablation of the disease. second, dual targeting of myeloid malignancies by both cd33 and cll1 directed therapy overcomes the pitfalls of single-antigen therapy by preventing relapse due to antigen loss. while loss of a single antigen under antigen-specific selection pressure is possible, loss of two antigens simultaneously is much less likely. cll1-cd33 ccar is a compound chimeric antigen receptor (ccar) immunotherapy with two distinct functional car molecules expressed on a t-cell, directed against the surface proteins cll1 and cd33. ccar intends to target the mechanisms of single-car relapse, specifically antigen escape and leukemic stem cells.

Eligibility criteria:
inclusion criteria: 1. prior hsct relapse beyond 6 months without active gvhd; systematic usage of immunosuppressive drug or corticosteroid must have been stopped for more than 4 weeks 2. de novo aml 3. transformed aml 4. mds with excess blasts (raeb-2) 5. mds that is not a candidate for induction chemotherapy. 6. myeloproliferative neoplasms with blastic transformation 7. patients have exhausted standard therapeutic options exclusion criteria: 1. prior solid organ transplantation 2. potentially curative therapy including hematopoietic cell transplant 3. prior treatment with cd123xcd3 or cll1x3 bispecific agents, t cells expressing cd123 car or cll1 car, or toxin-conjugated to cd123 or cll1 antibodies.

Keywords: cll1 cd33 cll1-cd33 ccar leukemia hematologic malignancies
defining robust predictors of chemotherapy related cardiotoxicity

Conditions: Cardiotoxicity; Gastrointestinal Neoplasms

Summary: observational prospective cohort study designed for patients with gastrointestinal cancers receiving a fluoropyrimidine based chemotherapy regimen.

all enrolled participants will undergo baseline cardiovascular risk assessment (using qrisk3 and score 2 risk calculators), cardiac, oncological and medication history. all participants will have serial cardiac symptom assessment, 12 lead ecg and cardiac biomarker assessments(high sensitivity troponin t and nt pro bnp) at baseline, on completion of the first cycle of treatment and post completion of treatment. participants will be followed up for the development of cardiotoxicity.

Eligibility criteria:
inclusion criteria: * age \>18 * consented to receive fluoropyrimidine chemotherapy for gi malignancies (gastro-oesophageal, colorectal, pancreatic) * capacity to provide consent exclusion criteria: * age \<18 * lacking capacity to consent

Keywords: fluoropyrimidine cardiotoxicity cardio-oncology
nation-wide hepatitis c virus (hcv) registry in taiwan

Conditions: Hepatitis C, Chronic

Summary: to determine the treatment efficacy, safety and long-term outcomes of chronic hepatitis c patients receiving directly acting antivirals in taiwan

the national health insurance administration (nhia) in taiwan supports the use of antivirals against chc. recently, the introduction of directly acting antivirals (daa) has markedly improved the treatment adherence, efficacy and safety issues in well-designed clinical trials. however, the real world community effectiveness and long-term benefits of daa for hcv treatments remain to be determined. since the nhia in taiwan has reimbursed the daa in the treatment of chronic hepatitis c (chc) patients in the near future, establishment of a well prospectively designed registry policy is demanded in the national level to explore the unmet needs of hcv control in taiwan. the primary purpose of the study is to establish a nationwide registry of patients undergoing antiviral treatment with daa regimens for chc at both academic and community practices. based on this database, the clinical gaps regarding to treatment guidelines and management of adverse events will be identified. the registry system will be established as a research network and provide sufficient high-quality clinical information for investigators in taiwan.

Eligibility criteria:
inclusion criteria: 1. patients who are treated with daa and have willingness to participate in this registry. exclusion criteria: chronic hepatitis c patients who are unwilling to participate in the study and do not provide written informed consent for participation.
stress urinary incontinence in elite athletes

Conditions: Pelvic Floor Disorders

Summary: a protocol of pelvic floor muscles training (pfmt) in elite athletes was applied. they will do it for 4 months. then re-evaluated.

the athletes of the portuguese national female's volleyball team were evaluated through perineometry, pad-test and kings health questionnaire. they were taught a plan of pelvic floor muscles training (pfmt) to perform for 4 months. after this time they will be re-evaluated with the same measuring instruments.

Eligibility criteria:
inclusion criteria: * elite female athletes * nulliparous * volleyball team. exclusion criteria: * inability to contract the pfm, elderly * prolapse of the pelvic organs.

Keywords: elite athletes volleyball pelvic floor muscle training
complete mesogastric excision with d2 lympadenectomy for gastric cancer:

Conditions: Gastric Cancer; Gastric Neoplasm; Gastric Cancer Stage

Summary: objective: to define complete mesogastric excision and compare our short term results for the first time in a different population. study design:randomised-controlled study place and duration of the study: gastroenterological surgery clinic,health sciences university,basaksehir city hospital,istanbul,turkey,from april to december 2023. methodology: we compared short term results of open total gastrectomy+ mesogastrectomy with standard total gastrectomy + d2 lymph node dissection at a tertiary center in terms of peroperative results, histopathological findings and postoperative short- term outcomes with review of the literature. conclusion: our aim is to show that mesogastric excision is safe and has advantages over conventional d2 gastrectomy in means of not only peroperative and short-term outcomes, but also disease free survival.our work is the first study from a different population of the world and our initial results can contribute to the literature for universalization.

the curative treatment of gastrointestinal tumors is surgery referring to an en block resection of the primary tumor along with its lymphovascular drainage.unfortunately, despite of these radical resections, published literature shows that recurrences occur in up to 38% of patients in 5 years. morover, these rates may reach to 60% in patients with locally advanced tumor following radical surgery. however, this mesentery-based surgery is harder to apply in gastric cancer due to differences in embriyological development. in our prospective study and a review of the literature, following the descripiton of mesogastrium concept, we aimed to search and analyse former techniques and viewpoints about mesogastric excision by different surgical approaches from various countries. later, we aimed to show our technique of mesogastrectomy, compared our short term results with limited publications from the literature.

Eligibility criteria:
inclusion criteria: * patients with histopathologically confirmed gastric adenocancer without evidence of distal metastasis and resectable tumors which have been treated with open total gastrectomy. exclusion criteria: * patients with prior upper gastrointestinal system surgery * patients with neoadjuvant therapy * patients with peripheral organ involvement and/or distant metastasis * patients who underwent subtotal gastrectomy * patients who underwent laparoscopic and robotic operations

Keywords: gastric cancer d2 lymph node dissection mesogastrectomy
concordance between monitoring systems for organ/space surgical site infections in rectal surgery

Conditions: Rectal Cancer; Organ-Space Surgical Site Infection

Summary: the catalan cancer plan (ccp) undertakes periodic audits of cancer treatment outcomes, including organ/space surgical site infections (o/s-ssi) rates, while the catalan healthcare-associated infections surveillance programme (vincat) carries out standardized prospective surveillance of surgical site infections (ssis) in colorectal surgery. this cohort study aimed to assess the concordance between these two monitoring systems for o/s-ssi following primary rectal cancer surgery.

the healthcare system in catalonia (spain) monitors and reports ssi in cancer patients through two principal mechanisms. first of all, the catalan cancer plan (ccp) is a health department structure that aims to improve the quality of care for cancer patients by means of periodic auditing of outcomes with real-world data and feedback to professionals. one indicator included in these compulsory audits is the occurrence of o/s-ssi. on the other hand, the catalan healthcare-associated infections surveillance programme (vincat) is a nationwide network for hospital-acquired infections (hai) which conducts surveillance in colorectal surgery. the two systems thus operate with an important difference: the ccp audits are mandatory and cover all cancer surgeries performed in centres funded through the public healthcare system, while vincat is a voluntary registry programme among participating centres. the selected cases and methods used to detect o/s-ssi may therefore vary substantially between auditing systems. this retrospective population-based cohort study aims to assess the concordance between clinical audits of the ccp and the vincat registry as a preliminary step to studies correlating local recurrence after rectal cancer surgery and o/s-ssi.

Eligibility criteria:
inclusion criteria: * patients \> 18 years old * eligible patients with tumour ≤ 13 cm from anal verge, as measured by magnetic resonance imaging * primary adenocarcinoma * oncological resection with curative intent * cancer stages: i-ii-iii exclusion criteria: * transanal local resection * emergency colorectal surgeries * presence of metastases found in the diagnostic process or during the surgical procedure * recurrence of the disease treated before the study period * non-resectable tumour or palliative surgery * patients operated in private centres

Keywords: surgical site infection rectal cancer rectal surgery databases concordance
tenofovir alafenamide with fine needle aspiration biopsy in chronic hepatitis b:

Conditions: Hepatitis B, Chronic

Summary: the objective of this study is to identify immunological mechanisms that contribute to normalization of liver inflammation in chronic hepatitis b (chb) patients starting the antiviral nucleoside analogue, tenofovir alafenamide (taf).

investigator-initiated, phase 4 study in which recruited patients will receive, taf 25mg once daily, for 48 weeks (figure 1 and table 1). the total duration of the study to end of follow-up (eof) will be 48 weeks. after week 48, participants will be offered 2 years of taf therapy. sample collection 0, 12, 24 w was chosen to analyze immune responses based on alt normalization rates. this mono-center study will be conducted at toronto centre for liver disease, canada.

Eligibility criteria:
inclusion criteria: * • age \>18 years * chronic hepatitis b (hbsag positive ≥ six months) * hbeag positive or negative * alt \>19 for females and \>30 for males (aasld criteria) * hbv dna\>4 log iu/ml for hbeag positive and \>3 log for hbeag negative patients * no oral antiviral treatment or ifn for ≥6 months * adequate contraception. for males, at least one method of contraception should be used and for females, a barrier contraception method should be used in combination with one other form of contraception. * written informed consent exclusion criteria: * • treatment with any investigational drug within 60 days of entry into this protocol * immune-suppressive treatment within the previous 6 months * history of decompensated cirrhosis (defined as direct (conjugated) * bilirubin \> 1.2 × uln, * prothrombin time (pt) \> 1.2 × uln * platelets \< 100,000/mm3 * serum albumin \< 3.5 g/dl * prior history of clinical hepatic decompensation (jaundice in the presence of cirrhosis, ascites, gastric bleeding, oesophageal varices or encephalopathy) * liver transplantation * co-infection with hepatitis c virus, hepatitis d virus or hiv * other significant liver disease: alcoholic liver disease, drug-related liver disease, auto-immune hepatitis, hemochromatosis, wilson's disease or alpha-1 antitrypsin deficiency * estimated glomerular filtration rate \<50 ml/min/1.73m2 or any significant renal disease. * alpha-fetoprotein \> 50 ng/ml * pregnancy, breast-feeding * other significant medical illness that might interfere with this study: significant pulmonary dysfunction in previous 6 months, malignancy other than skin basocellular carcinoma in previous 5 years, immunodeficiency syndromes (e.g. hiv positivity, auto-immune diseases, organ transplants other than cornea and hair transplant) * substance abuse, such as alcohol (≥80 g/day), i.v. drugs and inhaled drugs in past 2 years. current methadone usage is allowed. * any other condition which in the opinion of the investigator would make the patient unsuitable for enrolment, or could interfere with the patient participating in and completing the study
risk factors for chronic postoperative pain after elective nephrectomy

Conditions: General Anesthesia; Chronic Pain, Postoperative; Acute Pain, Postoperative; Surgery; Anesthesia; Chronic Pain; Analgesic Drugs; Epidural Analgesia; Nephrectomy

Summary: chronic postoperative pain (cpp) is typically defined as pain persisting for 3 months or more after surgery\[1\]. cpp is a common and increasingly prevalent morbidity, leading to long-term psychological issues, reduced quality of life, and impaired functionality\[2\]. to reduce the incidence of cpp, high-risk patients are identified, and various surgical techniques, pharmacological agents, and regional anesthesia techniques are employed\[3\]. the primary aim of our study is to scale chronic pain at 1 hour, 3 months, and 1 year post-nephrectomy using the numeric rating scale (nrs), ranging from 0 to 10. the secondary aim is to evaluate the effects of factors influencing chronic postoperative pain on the nrs scores.

patients gender, age, height(m), weight(kg), body mass index(kg/m2), diagnosis, smoking and alcohol history, comorbidities, surgical technique and duration, complications, lymph node dissection, thrombectomy, adrenalectomy, amount of bleeding(cc), need for blood transfusion, need for intensive care, analgesia technique used, amount of opioids and non-opioid analgesics used perioperatively, amount of vasopressors used, heart rate(bpm) and mean arterial pressure(mmhg) at induction, post-intubation, post-extubation, and 1 hour postoperatively, presence of postoperative pain, chronic analgesic use history(more than 3 uses per week), presence of fibromyalgia, frequent urinary tract infections, diagnosed with central sensitization disorders, bruxism, depression-panic attacks, allergic asthma, irritable bowel syndrome, and migraines will be recorded. the effects of these factors on nrs scores at 1 hour, 3 months, and 1 year postoperatively will be examined.

Eligibility criteria:
inclusion criteria: -patients aged 18-90 years, * asa i-iv, * undergoing elective nephrectomy under general anesthesia will be included in the study. exclusion criteria: * patients who cannot be reached by phone and hose who die within the 1-year postoperative period will be excluded from the study.

Keywords: chronic pain nephrectomy surgery pain risk factors acute pain postoperative pain
a multimodal enhanced recovery program in anorectal surgery

Conditions: Colorectal Disorders; Anorectal Disorder; Patient Satisfaction; Pain, Postoperative; Opioid Use; Opioid Abuse; Opioid Dependence

Summary: the goal of this study is to establish whether an opioid-sparing enhanced recovery after surgery (eras) program in ambulatory anorectal surgery can be safely introduced at a single tertiary referral center without an increase in postoperative pain or negative impact on the patient experience. a single-center, single-blinded randomized control trial is proposed, where patients will be assigned in a 1:1 ratio to either usual care, which includes extended opioids (control group) or the enhanced recovery group (experimental), which includes preemptive pain control, targeted education, and multimodal opioid-sparing pain management during the intraoperative and postoperative periods. the expected outcome is that the enhanced recovery program will significantly reduce opioid utilization with comparable pain scores and patient satisfaction after anorectal surgery.

there is an opioid epidemic in the united states, and the epidemic continues to worsen. the rate of opioids prescribed, distributed, and deaths from opioid overdoses continue to increase steadily. opioids also have the costs of abuse, dependence, diversion of unused medication, and can serve as a gateway to other illegal substances. opioid use often begins with treatment of acute postoperative pain, and the surgical episode can be a 'gateway' to the opioid crisis. opioids remain ubiquitous in patients undergoing surgical procedures. among opioid-naïve patients, persistent use after surgery occurs in 6-10%. ambulatory surgery cases are rarely mentioned in the context of this public health crisis, but are a major contributor to the problem. opioids are ubiquitous after ambulatory anorectal surgery and prescribed in large quantities, often several times more than what is needed or taken by patients. as patients take a fraction of the opioids prescribed, this adds to issues of opioid diversion. in colorectal surgery, ambulatory anorectal procedures are common and frequent procedures, with the potential to impact a large number of patients when implementing quality improvement. thus, study into eras and ways to reduce opioids after ambulatory anorectal surgery is warranted. this application challenges the notion that inpatient surgery should be the only target for enhanced recovery and opioid interventions. it seeks to shift the clinical practice paradigm that extended opioids are necessary after ambulatory anorectal surgery. this new application of eras to ambulatory anorectal surgery could address a critical barrier to progress in reducing opioids in procedures that are common but underrepresented in current research.

Eligibility criteria:
inclusion criteria: * patients in whom surgery is planned via an anorectal approach for hemorrhoids, fissures, or fistula disease. exclusion criteria: * patients are not eligible if currently or chronically (more than 7 days prior to presentation) on opioid medication or opioid-receptor antagonist medication.