Kornimate/medical-research-clean huggingface dataset:
use of virtual reality game playing during venipuncture

Conditions: Autism; Development Delay; Typical Development

Summary: to evaluate the impact of using virtual reality, vr, game playing on successful completion and reduction of distress and pain in pediatric venipuncture, and to increase adherence in obtaining the desired blood volume.

participants will be randomly assigned using a random number generator to either the virtual reality condition, or to the standard procedure that includes using books and/or watching movies as a standard method of distraction. participants will take part in the study during their scheduled research venipuncture. the venipuncture lasts approximately 15-30 minutes. pre and post venipuncture questionnaires for both participant and parent will take 15 minutes to complete. total study time is between 30 and 45 minutes. questionnaires completed by research personal will take 15 minutes to complete.

Eligibility criteria:
inclusion criteria: 1. participants aged 8-19 years old that are receiving a blood draw as part of their recharge evaluation 2. history of distress or refusal of blood draws or similar medical procedures or 3. parent or child endorsement of fear, anxiety, concern or adherence in past blood draw during the recruitment phone call, consent or child evaluation will be offered the potential of the vr intervention or 4. endorsement of anxiety or concerns with medical procedures on an in house phlebotomist blood draw screening form will also be used as inclusion criteria. exclusion criteria: 1. history of seizures. 2. vision loss or significant visual impairment to the degree that the participant is unable to see the activity and features of the vr game.
olanzapine treatment of patients with bipolar i disorder

Conditions: Depression, Bipolar

Summary: the purpose of this study is to assess whether olanzapine is superior to placebo in patients with bipolar depression.

1. dose range and administration mode: oral olanzapine 5mg - 20mg/day 2. duration: 1. screening phase is 2-28 days. 2. double-blind treatment phase is 6 weeks 3. open-label extension phase is 18 weeks

Eligibility criteria:
inclusion criteria: * each patient must be reliable, have a level of understanding sufficient to perform all tests and examinations required by the protocol, and must understand the nature of the study and have provided informed consent * all female patients must test negative for pregnancy and females of breast-feeding potential must agree not to breastfeed an infant during the study and for 1 month following the last dose of study drug * patients must fulfill the criteria for a major depressive episode according to the diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv-tr) as well as criteria for bipolar i disorder, depressed, as defined in the dsm-iv-tr, based on clinical assessment and confirmed by the structured diagnostic interview, the mini international neuropsychiatric interview (mini), at study entry * patients must have a current 17-item hamilton depression rating scale (hamd-17) score greater than or equal to 18 at visit 1 and visit 2 * patients must have a current young mania rating scale (ymrs) total score less than or equal to 8 at visit 2. exclusion criteria: * has received treatment within the past 30 days with a drug (not including study drug) that has not received regulatory approval for any indication at the time of study entry * has participated in a clinical trial of another investigational drug, including olanzapine, within 1 month (30 days) before study entry * was previously treated with olanzapine and had bipolar depression considered to be treatment-resistant to olanzapine or to olanzapine in combination with an available selective serotonin reuptake inhibitor (ssri) * is experiencing (at the time of study entry) a current episode of bipolar depression that is greater than 90 days in duration * has been treatment-resistant to any therapy prescribed for bipolar depression when olanzapine alone or with an ssri prescribed at an appropriate dose and duration
pde5-inhibition with sildenafil in chronic heart failure

Conditions: Heart Failure

Summary: to test the hypothesis that long-term pde5-inhibition by overexpressing the nitric oxide pathway is beneficial in chronic heart failure patients. double-blind and placebo-controlled trial. primary end-points: quality of life and exercise performance

in chronic heart failure (chf), endothelial function (ef) deterioration and muscle underperfusion elicit ergoreflex exercise oversignaling, hyperventilation and breathlessness. pde5 inhibition, by improving ef, might be beneficial. we tested this hypothesis in a long-term therapeutic trial. chf patients were randomly assigned to placebo (23 cases, group 1) or sildenafil (23 cases, group 2) in addition to their current antifailure therapy, for 6 months. in group 2 and not in group 1, assessments at 3 and 6 months showed the following changes: reduction of systolic pulmonary artery pressure (-25.2 and -29.0 %), ergoreflex effect on ventilation (-66.6 and -72.5%), ventilation to co2 production slope (ve/vco2, -14.0 and -16.0%) and breathlessness (-29.6 and -27.1%); increase of brachial artery flow-mediated dilatation (fmd, +57.6 and +67.0%), peak exercise o2 uptake (peak vo2, +25.0 and +26.3%) and ratio of vo2 to work rate changes (vo2wr, +20.7 and +22.0%). these changes were significant at p\<0.01. in group 2 and not in group 1, a significant correlation was found, at 3 and 6 months, between changes in fmd and those in ergoreflex ve. changes in ergoreflex correlated with those in peak vo2 and ve/vco2 slope. no remarkable side effects were noted, but flushing in 3 patients. in chf, benefits of sildenafil are sustained and consist of improvement in ef, modulation in ergoreflex signaling, attenuation in exercise hyperventilation and breathlessness, increase in aerobic efficiency and exercise performance. thus, sildenafil can affect peripheral mechanisms of breathlessness and may be viewed as an effective and safe adjunct to the therapeutic armamentarium of chf.

Eligibility criteria:
inclusion criteria: * eligibility criteria were: consent to participate in the study after detailed information about procedures, possible clinical benefits and risks; ability to complete a maximal exercise test; forced expiratory volume in 1 sec/forced vital capacity ratio\>70%; left ventricular ejection fraction  45%, determined by echocardiography. exclusion criteria: * patients were not recruited if they had systolic blood pressure \> 140 and \<110 mmhg, diabetes mellitus, therapy with nitrate preparations, history of sildenafil intolerance, significant lung or valvular diseases, neuromuscular disorders, exercise-induced myocardial ischemia, atrial fibrillation (6), claudication, peripheral vascular disease.

Keywords: pde5 inhibition chronic heart failure endothelial function exercise ventilation
treatment of immature permanent teeth with three different pulp capping materials with partial pulpotomy

Conditions: Caries, Dental

Summary: the aim of this randomized controlled trial is to compare partial pulpotomy treatments with biodentine®, calcium hydroxide (ch) and mineral trioxide aggregate (mta) in cariously exposed asymptomatic young permanent teeth clinically and radiographically for 1 year and evaluate root developments with image j software program. the null hypothesis of this study is biodentine® will promote healing with high success rates and induce root development more than ch and mta.

the purpose of this study was to evaluate clinical and radiographical success of three different materials in partial pulpotomy treatment. 50 patients with 54 asymptomatic, cariously exposed young permanent mandibular molar teeth were included to the study. the teeth were randomly divided into three main groups which were; calcium hydroxide, mta and biodentine® and finally restorated with stainless steel crowns. pain, percussion sensitivity, palpation sensitivity of soft tissue around the tooth, root development, presence of lesion, integrity of lamina dura were evaluated clinically and radiographically during 12 months and recorded for each. also, image j program with turbo-reg plug in was used for standardization of the radiographs and to determine the increase in root length.

Eligibility criteria:
inclusion criteria: * deep dentine caries with pulp exposure exclusion criteria: * pulp exposure without hemorrhage control

Keywords: biodentine cariously exposed pulp mta partial pulpotomy image j software
efficacy of dextrose prolotherapy compare with eswt in the treatment of chronic rotator cuff tendinopathy

Conditions: Chronic Rotator Cuff Tendinopathy

Summary: to compare the efficacy of dextrose solution injection with eswt for pain reduction in rotator cuff tendinopathy. additionally, secondary objective is to evaluate dash and active range of motion of shoulder joint


Eligibility criteria:
inclusion criteria: * chronic shoulder pain for at least 3 months * unilateral affected side * history of unsuccessful conservative treatment * age 18 years or older exclusion criteria: * rotator cuff complete tear * local or generalized arthritis * previous shoulder surgery * previous history allergy to local anesthesia * pregnancy * current infectious or tumorous disease * dysfunction in the neck or thoracic region of both * coagulation disturbance
efficacy and safety of deb-bace combined with serplulimab in first-line treatment of sclc

Conditions: Carcinoma; Small Cell Lung Cancer

Summary: this project aims to conduct a prospective, single-center, randomized, open-label, two-arm study to compare the clinical efficacy and safety of bronchial arterial chemoembolization with drug-eluting beads (deb-bace) combined with serplulimab versus conventional intravenous chemotherapy combined with serplulimab as first-line treatment for sclc patients. the objective is to provide evidence-based support for clinical practice.


Eligibility criteria:
inclusion criteria: * age more than 18 years old, regardless of gender; * sclc diagnosis based on histopathology according to the primary lung cancer diagnosis and treatment guidelines (2018 edition); * tnm stage ii-iv; * ecog ps score ≤2; * predicted survival time more than 3 months; * provision of signed informed consent. exclusion criteria: * previous interventional therapies such as iodine seed implantation (within the past six months), ablation, bace, or immunotherapy; * concurrent presence of other incurable malignant tumors; * white blood cell count less than 3×10\^9/l, neutrophil absolute count less than 1.5×10\^9/l, neutrophil/lymphocyte ratio equal to or greater than 3, platelet count less than 50×10\^9/l, hemoglobin concentration less than 90 g/l; * hepatic and renal insufficiency (creatinine level exceeding 176.8μmol/l); aspartate aminotransferase (ast) and/or alanine aminotransferase (alt) levels more than twice the upper limit of normal; * uncorrectable coagulopathy or concurrent active hemoptysis; * complicated with active infection requiring antibiotic treatment; * uncontrolled hypertension, diabetes, or cardiovascular disease; * allergy to contrast agents; * women who are pregnant or lactating.

Keywords: small cell lung cancer programmed cell death protein 1 inhibitor serplulimab drug-eluting beads bronchial arterial chemoembolization
pain in patients with crohn disease (paincd)

Conditions: Crohn Disease; Pain; Depression, Anxiety

Summary: abdominal pain is a common symptom in patients with crohn disease (cd). pain is multifactorial, may result from inflammation but persists in many patients during remission. the aim of our study is to determine the epidemiology of pain in cd patients and define the characteristics of pain : localisation, temporal and sensorial characteristics, neuropathic component, impact on quality of life and mood.

abdominal pain is a common symptom in patients with inflammatory bowel disease (ibd) that alters quality of life and can lead to increased healthcare utilization. in addition to abdominal pain, pain can result from extra-intestinal manifestation of ibd. 40% of ibd patients suffer from extra-intestinal manifestations. although abdominal pain has been traditionally attributed to inflammation, functional abdominal pain exists in patients with ibd, associated with a variety of potential causes. about 20-40% of patients in complete clinical and endoscopic remission continue to experience chronic pain. thus, when examining an ibd patient with abdominal pain, in addition to ibd-related complications (e.g., inflammation, stricture), it is important to screen for other contributors, including peripheral factors (visceral hypersensitivity, bacterial overgrowth, and bowel dysmotility) and centrally mediated neurobiological and psychosocial underpinnings. these central factors include psychological symptoms, sleep disturbance, and stress. opioid-induced hyperalgesia (e.g., narcotic bowel syndrome) is also growing in recognition as a potential central source of abdominal pain. pronounced severe pain impacts health related quality of life (qol). longstanding pain leads to decreased qol, increase in pain medication intake, and co-morbidities including depression, anxiety and even addiction. furthermore, pain attacks severely interfere with social and professional life. knowledge of these potential aetiologies should be used to individualize treatment of abdominal pain in patients with ibd. accurate assessment of the source of pain can help guide appropriate diagnosis workup and use of modifying therapy. the aim of the study is to determine the epidemiology of pain in patients with crohn disease (cd) and to characterize their pain (localisation, temporal characteristics, acute vs. chronic, sensorial characteristics, existence of neuropathic component, existence of hyperalgesia), and their impact of qol, depression and anxiety

Eligibility criteria:
inclusion criteria: * any patient with crohn disease in remission or relapse period age ≥ 18 yo. exclusion criteria: * no exclusion criteria beside no informed consent and inadequate french language skills

Keywords: crohn disease pain
cell-surface plectin in the diagnosis of cholangiocarcinoma from ercp-directed biliary samples

Conditions: Cholangiocarcinoma

Summary: cholangiocarcinoma is a malignancy that is most-often diagnosed with ercp-directed cytology brushings of the biliary tree, but the yield on this cytology has been previously shown to only be 5%-40%. additionally, the vast majority (approximately 80%) of patients are not diagnosed until they are surgically unresectable (due to late stage at time of diagnosis), at which point there is no chance for cure and their only options are palliative. therefore, better diagnostic modalities are needed. plectin is a structural protein located inside of most cells, but it has been shown to be expressed on the cell surface of malignant cells in the pancreaticobiliary tract. the investigators hypothesize that ercp-guided biliary samples can provide cells and immunohistochemical staining can detect cell surface plectin in patients with cholangiocarcinoma. this would be a novel diagnostic tool which could greatly reduce the time to diagnosis. a previously performed study pilot study at the university of virginia (unpublished) showed that ercp-directed biliary biopsies in patients with known cholangiocarcinoma had positive plectin immunohistochemistry, thus showing this is possible. in this current study, patients with a biliary stricture or tumor who are already undergoing ercp as part of their routine clinical care (i.e. no procedures will be done exclusively for this research study) will undergo an additional biopsy and/or brushing to be assessed for cell-surface plectin expression via immunohistochemistry. the investigators hypothesize that plectin immunohistochemistry will have a higher sensitivity for cholangiocarcinoma than biopsies and/or brushings (cytology) alone.


Eligibility criteria:
inclusion criteria: * biliary stricture or mass seen on imaging; already undergoing ercp as part of their routine clinical care exclusion criteria: * age \< 18 years old; inability to consent

Keywords: ercp cytology
patient re-education vs. background morphine to iv-pca in patient with unsatisfactory analgesia post laparotomy

Conditions: Post-operative Pain

Summary: the purpose of this study is to improve iv-patient controlled analgesia (iv-pca) technique for postoperative analgesia. investigators are comparing between patient re-education and the background morphine infusion among patients who fail to achieve satisfactory analgesia using iv-pca morphine after laparotomy.

in this study, investigators have a second inclusion criteria for subject recruitment. for subjects who meet this criteria meaning their dynamic pain (when blowing incentive spirometer) is ≥ 4/10 after starting on iv-pca morphine will be randomized in to 2 groups. one group will receive patient re--education with an additional background morphine infusion and the other group will receive re--education only. the second highlight for this study is regarding the background morphine calculation. the background morphine is calculated according to this formula: total morphine requirement in the first 24 hours post surgery (mg) = 100 - age (year) so, the background morphine infusion will be calculated based on subject's age and half of their 24 hours requirement will be infused over 24 hours. this formula was published by pamela macintyre in her paper titled " age is the best predictor of postoperative morphine requirement".

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa)physical status classification class i and ii * elective laparotomy * able to understand either malaysia, mandarin, english language or local dialect * patient with dynamic pain score 4/10 and more within the first 4-hour after initiation of iv-pca exclusion criteria: * patient refusal * laparotomy with pfannenstiel incision * patients with a history of allergy to opioids * patients who required post-operative ventilation support * patients asa iii and above * patients unable to use pca due to insufficient comprehension * morbid obesity/ obstructive sleep apnea * chronic opioid or alcohol abuse

Keywords: iv-patient controlled analgesia (iv-pca) background morphine infusion patient re-education
acupuncture augmentation for inpatients with major depression disorder

Conditions: Depression

Summary: acupuncture practice is based on traditional chinese medicine (tcm) principles of harmonization and balance, and the need to maintain unobstructed flow of energy (qi) to attain efficient body functioning and metabolism so as to attain good mental and physical state of health. while increasing numbers of patients are seeking acupuncture treatment for depression in recent years, there is limited evidence of the effectiveness of acupuncture for in-hospital patients with severe depressive conditions and comorbid cognitive dysfunction, who need intensive antidepression care. in this study, we propose a randomized clinical trial to test the clinical efficacy of acupuncture treatment for in-hospital patients who are suffering from major depressive disorder. a total of 84 patients will be 1:1 randomly assigned to 1 of 2 groups in a single-blind randomized controlled trial. the specific intervention arm involved daily augmentation tcm-style acupuncture with manual stimulation for total 10 sessions; the control arm is consisted of patients with treatment as usual (tau), i. e. waitlist condition who will receive standard antidepressant medication with or without psychotherapies. patients in tau arm will be offered one free course (total 10 sessions) of acupuncture treatment in tcm outpatient clinic after they have been discharged from the ward. all patients' depressive symptoms, cognitive function, quality of life and functioning will be assessed and compared at pre-treatment (baseline), immediately after in-hospital acupuncture treatment, one-month post-treatment and 3-month post-treatment. in addition, we will analyze the association of sociodemographic and clinical characteristics with the treatment effect of acupuncture. this study will be the first study to examine whether acupuncture is a viable augmentation treatment for in-hospital patients with depression. expected outcomes will include determining the relative short and medium-term clinical effects from the most commonly used acupuncture treatment modalities in a local and multiethnic population.


Eligibility criteria:
inclusion criteria: 1. age ≥21 years. 2. dsm-v diagnosis of current major depressive episode. 3. montgomery-asberg depression rating scale score of 20 or more. 4. able to give informed consent. exclusion criteria: 1. history of psychosis or mania 2. with current ect or neurostimulation treatment. 3. with severe heart or renal condition 4. currently taking blood thinning drug including aspirin etc. 5. endocrine abnormalities (e.g., hypothyroidism, unstable diabetes); 6. history of central nervous system involvement (e.g., seizures, brain injury, neurologic ill- ness); 7. pregnancy.

Keywords: acupuncture