Kornimate/medical-research-clean huggingface dataset:
medical imaging characteristics of patient with unclassified acute cervical pain

Conditions: Carotidynia

Summary: some cases of acute antero-lateral cervical pain cannot be accurately classified by medical imaging (ultrasound and/or magnetic resonance imaging and/or ct-scan) : imaging rules out carotid dissection, carotid occlusion or vasculitis as well as musculoskeletal causes and thus the pain is considered "of unknown origin". the investigators hypothesize that in such cases perivascular inflammation of the carotid may be involved. this study aims at systematically reviewing medical files (including imaging) of patients suffering from acute cervical pain in which carotid dissection, carotid occlusion or vasculitis as well as musculoskeletal causes have been ruled out by ultrasound and/or magnetic resonance imaging and/or ct-scan


Eligibility criteria:
inclusion criteria: * adult patient with acute cervical pain * presence of at least one medical imaging modality of the neck : ultrasound with doppler imaging, magnetic resonance imaging, ct-scan * medical imaging of the neck includes dedicated vessel analysis * absence of definite diagnosis for the cause of the pain after imaging exclusion criteria: * musculoskeletal cause of the pain * carotid dissection * carotid occlusion * carotid vasculitis
early use of polymyxin b hemoperfusion in abdominal sepsis

Conditions: Gram-Negative Bacterial Infections; Sepsis; Septic Shock

Summary: this clinical study designed as a prospective, open labelled, multi-centre, rct will be carried out to evaluate if direct hemoperfusion with polymyxin b immobilized fiber column (pmx) is superior to conventional medical therapy for sepsis, for patients with sepsis arising from abdominal cavity infection, accompanied by the failure of one or more organs. 120 patients (60 treatment/60 control) will be considered in this study. those patients fulfilling inclusion criteria and not having exclusion criteria will be randomly allocated to one of two study groups. one group will be treated with pmx (pmx group) and the other will receive a "standard therapy" for sepsis (control group). all patients will receive full intensive care management, including fluid resuscitation, vasopressors, antimicrobial chemotherapy, ventilatory support, and renal replacement therapy, if required. each patient will be followed up for 28 days after study entry.


Eligibility criteria:
inclusion criteria: * patients with severe sepsis due to intra-abdominal cavity infection after emergency surgery with at least 2 sirs criteria and 1 organ dysfunction (as defined by sccm) exclusion criteria: * less than 18 years of age * females with a positive pregnancy test * treated with another investigational drug or device within the 30 days immediately preceding enrolment in this study * undergone organ transplantation during the past one year * documented history of sensitivity to polymyxin-b, anticoagulant (heparin) * terminally ill, including metastases or hematological malignancy, with a life expectancy less than 30 days (as assessed by the attending physician) or have been classified as "do not resuscitate" * diagnosed with hiv * previous history of end stage chronic organ failure(s) * uncontrolled hemorrhage within the last 24 h * diagnosed with granulocytopenia (leukocyte count of less than 500 cells/mm3) and/or thrombocytopenia (platelet count of less than 30,000 cells/mm3) * more than 4 failed organs at entry * an apache ii score of more than 30 at entry to the study

Keywords: abdominal sepsis abdominal surgery septic shock polymyxin b hemoperfusion endotoxins
intravenous aii for the treatment of severe hypotension in high output shock: a pilot study

Conditions: Septic Shock

Summary: the investigators propose a dose finding study to determine the feasibility of angiotensin ii (aii) to increase mean arterial pressure in high-output shock. if aii can be shown to increase mean arterial pressure, this could lead to future pharmacologic development based on the aii hormonal pathway. the investigators propose a 20 patient, randomized, placebo-controlled, blinded study in the treatment of high-output shock. patients with high-output shock and a cardiovascular sofa (sequential organ failure score) score of \> 4 will be eligible. in addition, patients must already be receiving cardiac output monitoring and have a cardiac index \> 2.4 l/min/ 1.73 m2. patients will be randomized to intravenous aii or saline in a blinded fashion. there will be 10 patients in each arm. this is a safety and dose finding feasibility study. the investigators are starting with a small cohort consistent with similar types of studies. the investigators estimate that ten patients in each arm will generate a basis for determining if there is sufficient signal for aii to improve blood pressure at the doses outlined. the primary endpoint in the study will be the effect of aii on the standing dose of norepinephrine which is required to maintain a mean arterial pressure (map) of 65 mmhg. secondary endpoints will be the effect of aii on urine output, serum lactate, and creatinine clearance. 30 day post dose mortality will also be assessed. subjects discharged prior to day 30 will be contacted by telephone for this assessment.


Eligibility criteria:
inclusion criteria: 1. high-output shock 2. cardiovascular sofa score of \> 4 3. cardiac index \> 2.4 liters/min/bsa 1.73m2 4. indwelling arterial line already present as part of standard care 5. age \> 21 years of age 6. signed consent form 7. use of indwelling urinary catheter as standard care expected at least for 12 hours during the study interventions exclusion criteria: 1. patients with acute coronary syndrome 2. patients with a known history of vasospasm 3. patients with a history of asthma 4. patients currently experiencing bronchospasm 5. patients with active bleeding with an anticipated need for \> 4 units of prbc or hemoglobin \< 7g/dl or any other condition that would contraindicate drawing serial blood samples

Keywords: high output shock distributive shock warm shock septic shock pressor angiotensin atii vasopressor
outcomes of expanded autologous bone marrow-derived mesenchymal stem cells therapy in type ii diabetes

Conditions: Type 2 Diabetes Mellitus

Summary: the purpose of this study is to evaluate the safety and effectiveness of autologous bone marrow-derived mesenchymal stem cells transplantation in the treatment of type 2 diabetes mellitus

bone marrow-derived mesenchymal stem cells have the immunosuppressive effect and secrete a variety of cytokines, improve the microenvironment of diabetic patients, targeting insulin resistance tissue, ameliorate the metabolic disorder of islet damage, protect and regeneration of the islet beta cells; reduce high blood sugar.the purpose of this study is to evaluate the safety and effectiveness of autologous bone marrow-derived mesenchymal stem cells transplantation in treatment 30 patients with type 2 diabetes mellitus at vinmec international hospital, hanoi, vietnam

Eligibility criteria:
inclusion criteria: * males and females * age from 18 years and above. * hemoglobin a1c (hba1c) is ranged from 7.5% to 9% at baseline. * type 2 diabetes duration 5 years or more. * before the screening, joint or combined with insulin, oral medications to treat more than 3 months. * who signed the informed consent form. exclusion criteria: * type 1 diabetes. * chronic disease or severe disease, including cancer, severe heart disease, kidney disease, liver disease, etc. * according to the medical doctor's judgement, may endanger the safety of the subjects

Keywords: diabetes bm mesenchymal stem cell
the safety and efficacy of umbilical cord blood mononuclear cells in patients with secondary poor graft function after hematopoietic stem cell transplantation

Conditions: Poor Graft Function

Summary: this study is conducted in a prospective, single-center clinical design and is divided into two stages: dose escalation and dose extension. patients meeting the diagnostic criteria of secondary poor graft function are selected as the study objects. the safety data of umbilical cord blood mononuclear cells in the treatment of secondary poor graft function are obtained through dose escalation stage, and then one dose is selected for dose extension stage to explore the efficacy of umbilical cord blood mononuclear cells in treating secondary poor graft function.


Eligibility criteria:
inclusion criteria: 1. age≥18 years old; gender is not limited. 2. meet the diagnostic criteria for secondary poor graft function: after 28 days of transplantation, patients who had achieved hematopoietic reestablishment (anc ≥ 0.5×10\^9/l for 3 consecutive days without g-csf application, plt ≥ 20×10\^9/l for 7 consecutive days without platelet infusion, hb ≥ 80g/l for 2 consecutive weeks without red blood cell infusion) again developed two or three line cytopenia lasting more than 2 weeks. bone marrow examination revealed low myelodysplasia, remission of primary disease, complete donor chimeric cells, and no severe graft-versus-host disease (gvhd) or disease recurrence. 3. eastern cooperative oncology group (ecog) physical status score ≤ 2 points. 4. subjects sign informed consent. exclusion criteria: 1. serious infection not controlled. 2. active bleeding. 3. patients with cardiac insufficiency (ejection fraction\<50%), or suffering from serious heart disease, including myocardial infarction, cardiac insufficiency, etc. 4. patients with hepatic and renal insufficiency (total bilirubin\>35µmol/l, alt and ast\>2 times of the upper limit of normal; serum creatinine\>130µmol/l). 5. pregnant or lactating women. 6. concurrent malignant tumors of other organs. 7. failure to understand or follow the research protocol. 8. patients participating in other clinical investigations. 9. other conditions that the investigators consider inappropriate to participate in the study.

Keywords: secondary poor graft function umbilical cord blood mononuclear cells
covered stents versus bare-metal stents

Conditions: Gastrointestinal Vascular Conditions; Arteriosclerosis; Lifestyle-related Condition; Stenosis; Vascular Insufficiency; Necrosis

Summary: to compare the outcome of revascularisation the gastrointestinal arteries using covered stents compared to bare-metal stents in patients with cgi.

symptomatic chronic atherosclerotic gastrointestinal ischemia (cgi) is an uncommon, potentially underdiagnosed condition caused by fixed stenosis or occlusion of in most conditions at least one of the three gastrointestinal arteries. atherosclerosis is a predisposing factor for cgi. clinical symptoms can vary widely. typical symptoms are postprandial abdominal pain, unintended weight loss and food avoidance. but atypical abdominal pain such as exercise related pain, diarrhoea and nausea can also indicate cgi. the use of endovascular techniques for revascularization of chronic stenosis and occlusions of the gastrointestinal arteries has rapidly increased and endovascular therapy with stenting has become the most common method chosen for revascularization, having replaced open surgery with its associated morbidity and mortality. nowadays standard care in significant chronic gastrointestinal ischemia is the use of bare metal stents although the patency of these stents is not very high. according retrospective data the patency of covered stents is significantly higher compared to bare metal stents. one likely explanation for these lower restenosis and re-intervention rates observed with covered stents is the established barrier to tissue ingrowth. only recent retrospective data about this topic is available but the expectancy in this prospective study is that the patency of covered stents is indeed higher compared to metal stents.

Eligibility criteria:
inclusion criteria: * patients with consensus diagnostic of cgi based on a clinical meeting with a gastroenterologist, a vascular surgeon and an interventional radiologist. * diagnostic consensus of cgi is based on. * presence of postprandial pain * unexplained weight loss (\>5% of normal body weight). * significant stenosis of \>50% of at least one of the gastrointestinal arteries on a recent cta (computer tomographic angiography) not older than one year, with maximum slice thickness 1 mm and enhancement in aorta of 300hu (hounsfields units) * mucosal ischemia detected by vls (visible light spectroscopy) or tonometry * patients over the age of 18 years. * patients who gave informed consent. * patients have sustained atherosclerosis. exclusion criteria: * patients who don't give informed consent. * age \< 18 years * no stenosis detected during arteriography. * renal insufficiency (gfr below 30 ml/min or gfr below 60 ml/min when comorbidities relevant to kidney function present). * previous stent placement in the to be treated gastrointestinal artery. * pregnancy * celiac artery compression syndrome. * vasculitis

Keywords: endovascular treatment arterial occlusive disease bare metal stent polytetrafluoroethylene covered stent
accuscreen equipment evaluation for newborn hearing screening

Conditions: Hearing Loss

Summary: an evaluation and comparison of results between the 'accuscreen new' currently in use and an 'accuscreen new' with different settings to see if the new settings reduce unnecessary referrals for babies from newborn hearing screening. babies will be tested with the standard and modified equipment. referrals for diagnostic testing will be based on the standard equipment. a comparison in referrals between the standard and modified equipment will be made.

all newborn babies undergo hearing screening, usually within the first few days of life and some are tested with the automated auditory brainstem response test (aabr). this involves recording activity from the hearing nerve and parts of the brainstem from three small sensors placed on the baby's head and neck when a series of clicking sounds are played in to the ear. in march 2015 we started using an 'accuscreen new' to record the aabr, which is approved by the newborn hearing screening programme (nhsp) and used widely across the uk. however, since introducing the new equipment the 'screen refer' rate increased significantly in very young babies (less than 48 hours old) and diagnostic testing showed they had satisfactory hearing. the impact of the increased referral rate caused increased delays on diagnostic testing and also lead to unnecessarily increased parental anxiety in relation to the hearing of their new born baby. the equipment suppliers (gn otometrics) and the nhsp programme centre have agreed to an evaluation and comparison of results between the 'accuscreen new' currently in use and an 'accuscreen new' with different settings which we believe will reduce unnecessary referrals of so many young babies to audiology (the modified equipment will test for up to 10 minutes to see if a response is present, instead of stopping after one or two minutes). babies will be tested with the standard and modified equipment. referrals for diagnostic testing will be based on the standard equipment. a comparison in referrals between the standard and modified equipment will be made.

Eligibility criteria:
inclusion criteria: * babies requiring aabr testing through newborn hearing screening exclusion criteria: -

Keywords: newborn hearing screening hearing loss hearing screening equipment
lucentis versus mitomycin c during glaucoma surgery

Conditions: Glaucoma

Summary: does a new add on (or adjunctive) therapy used in glaucoma surgery improve the success of trabeculectomy? ranibizumab may offer benefit similar to mitomycin c in preventing epi-scleral fibrosis while avoiding the well known complications of mytomycin c which include late bleb leaks, hypotony and infection.

this is an open-label, single center trial with two arms for patients who underwent guarded filtration surgery to control glaucoma. the control will consist of patients randomly assigned to receive inter-operative mitomycin c 0.4 mg/ml which is applied in a standard fashion with a soaked pledget inserted in the sub-tenon's space during surgery. the study arm will consist of patients randomly assigned to receive a sub-tenon injection of ranibizumab 0.5 mg/0.05ml with a 30 gauge needle on a tuberculin syringe at the termination of the surgery. no mitomycin c will be applied. post operative follow-up will consist of a minimum of 6 visits during a one year period.

Eligibility criteria:
inclusion criteria: * 18 yrs or older * patients requiring first time glaucoma filtering surgery * phakic or pseudophakic * must provide written informed consent and comply with study assignments exclusion criteria: * pregnant, lactation or premenopausal women not using adequate contraception. * previous glaucoma surgery, tube shunt surgery, pars plana vitrectomy, scleral buckle, penetrating keratoplasty. * abnormality preventing reliable applanation tonometry in each eye. * current infection or inflammation in either eye. * enrolled in another investigational study.

Keywords: glaucoma glucoma filtering surgery ranibizumab mitomycin c patients requiring first time glaucoma filtering surgery
breakfast on postprandial hyperglycemia

Conditions: Type 2 Diabetes

Summary: reduction of postprandial hyperglycemia (pphg) is a major target in the treatment of type 2 diabetes (t2d). skipping breakfast has been consistently associated with higher hba1c and overall pphg in subjects with type 2 diabetes (t2d). our aim was to explore the effect of skipping vs eating breakfast on pphg after subsequent isocaloric (700kcal) lunch and dinner

in type 2 diabetic individuals the omission of breakfast is associated with significant increase in hba1c and all-day postprandial hyperglycemia even without overeating in the evening. in contrast, high-energy breakfast and low-energy dinner result in a significant reduction of all-day postprandial glycaemia similarly, 3 months of high-energy breakfast led to a 5% reduction in hba1c levels in type 2 diabetes participants despite the growing evidence showing the beneficial effects of breakfast consumption on overall postprandial hyperglycemia and hba1c levels, very little is known regarding the relationship between breakfast skipping and all-day glycemic excursions in type 2 diabetes patients. therefore, to test whether breakfast skipping influences metabolic responses to the following meals in type 2 diabetes patients during the same day, we explored the postprandial glycemic response to identical lunch and dinner meal tests with or without breakfast.

Eligibility criteria:
inclusion criteria: * bmi: 26-34 kg/m2. * hba1c \> 7 % * t2d since \< 10 yrs, * . only non treated or treated with oral antidiabetic drugs * those treated with insulin or glp-1 analogs will be excluded. exclusion criteria: * type 1 diabetes * serum creatinine level \> 1.5 mg/dl * pulmonary disease, psychiatric, immunological, neoplastic diseases or severe diabetic complications,such as cardiovascular disease, cerebrovascular disease, proliferative diabetic retinopathy, gastroparesis or anemia (hg \> 10g/dl) or underwent bariatric surgery. * abnormal liver function tests * participating in dietary program or using of weight-loss medications * history (within one year) of illicit drug abuse or alcoholism. * use of psychotropic or anoretic medication during the month immediately prior to study onset
pulsed radiofrequency versus pulse dose pulsed radiofrequency of the pudendal nerve in patients with pudendal neuralgia

Conditions: Pain, Chronic

Summary: the relatively complex anatomical structure of the pelvis has been a focus of study in the medical field. the diagnosis of the causes of chronic pelvic pain is usually a complicated process. pudendal neuralgia is a syndrome that is characterized by pelvic pain, including bowel, bladder regional pain or discomfort, sexual dysfunction, severe burning sensations and needle-like pain, which are aggravated when seated and relieved after standing. pudendal neuralgias are induced by pudendal nerve damage the mechanism of prf has been studied repeatedly. it has been verified that prf has definite safe treatment range, but during the prf treatment, the tissue surrounding the electrode may have some degree of change and so it is difficult to assess any actual damage.7 based on electric field intensity, prf can actually produce tissue changes observable as in vitro changes to ultrastructure in early-phase histologic study. these biological changes were converted to biological effect to alleviate neuropathic pain in animal models.


Eligibility criteria:
inclusion criteria: * pain located in the pudendal nerve distribution area * pain intensity increases in the sitting position; * no nocturnal pain symptoms; * pain with no objective sensory impairment * pain is relieved by diagnostic pudendal * the pain symptom is associated with sexual dysfunction, with the elimination of obstetrical and gynaecologic, urological and anorectal diseases in the related departments and absence of any physical and mental disorders; * treatment by other departments is invalid; * patients should be older than 18 years * patients should be able to sign an informed consent form exclusion criteria: * patients have simple tailbone, gluteus muscle or lower abdominal pain, or only paroxysmal pain, or only pruritic symptoms, and/or have imaging anomalies that may explain the symptoms; * female patients who are pregnant; * patients who take anticoagulant drugs or have any coagulation disorder; * patients who are unable to complete the questionnaire; * patients with pain, which is caused by malignant or autoimmune diseases and * patients who are hypersensitive to metals.
self-acupressure and zhan zhuang for symptom cluster management

Conditions: Breast Cancer Female; Survivorship

Summary: the proposed study will be a 3-arm, parallel-group randomized controlled trial on the effects of self-acupressure and zhan-zhuang for alleviating pain, fatigue, and sleep disturbance in breast cancer survivors. subjects will include 54 breast cancer survivors who have experienced a moderate level of pain, fatigue and sleep disturbance. all eligible subjects will be randomized into one of the three groups in a 1:1:1 ratio: zhan zhuang group, or self-acupressure group, or wait list control group. subjects in the zhan-zhuang group will receive up to 8 weeks of the intervention consisting of a training course over two weeks followed by self-practice for 6 weeks. those in the self-acupressure group will attend an acupressure training course for two weeks and then, will be asked to practice self-acupressure for 6 weeks. the wait list control group will be provided with delayed self-acupressure or zhan zhuang at the end of the study. outcome assessment will be conducted at baseline, week 8 (post-intervention) and week 12 (4 week follow-up). primary outcomes include pain, fatigue and sleep disturbance. secondary outcomes include psychological distress and health-related quality of life. qualitative data will be collected from selected participants who have received the intervention.


Eligibility criteria:
inclusion criteria: * a female adult aged 18 and older; * a diagnosis of early-stage (stage i, ii, or iii) breast cancer; * completion of surgery, and/or chemotherapy and/or radiotherapy; * have at least a moderate level of pain, fatigue and sleep disturbance as measured on 0-10 numerical rating scales, with a score of ≥ 3 for each symptom during the past one month; * willing to use whatsapp messenger for follow-ups; * being able to communicate in chinese exclusion criteria: * prior use of acupuncture, acupressure, zhan zhuang, or other types of zhan zhuang within the past three months; * currently receiving progressive muscle relaxation, mindfulness-based stress reduction, and other body mind exercise (e.g. yoga) for the treatment of pain, fatigue, and sleep disturbance; * mentally incapable of participating in the study as indicated by the hong kong version of montreal cognitive assessment score; * inability to perform self-care as indicated by the karnofsky performance scale score\<70