Kornimate/medical-research-clean huggingface dataset:
clinical comparative study of systematic therapy combined with mwa and systematic therapy for pancreatic cancer

Conditions: Pancreatic Neoplasms; Ablation

Summary: pancreatic carcinoma (pc) is the deadliest malignant tumors worldwide. surgical resection is one of the most effective methods for the treatment of pc, but the resectable rate is less than 20% among the patients with pcs, and the recurrent and metastatic rate is more than 80% in two years after resection. ablation has been confirmed one of the most effective methods for solid tumors by recent twenty years and proven to be a radical treatment similar to the surgical resection for the clinical applications of hepatic and renal tumors at early clinical staging in the internationally guidelines. the purpose is to explore the efficacy and safety of microwave ablation in the treatment of pancreatic cancer in combination with systematic therapy.

pancreatic carcinoma (pc) is the deadliest malignant tumors worldwide. surgical resection is one of the most effective methods for the treatment of pc, but the resectable rate is less than 20% among the patients with pcs, and the recurrent and metastatic rate is more than 80% in two years after resection. furthermore, it is difficult to achieve tumoral complete responses by traditional therapies including chemotherapy, radiotherapy and transarterial embolization. ablation has been confirmed one of the most effective methods for solid tumors by recent twenty years and proven to be a radical treatment similar to the surgical resection for the clinical applications of hepatic and renal tumors at early clinical staging in the internationally guidelines. however, the published clinical practices on the thermal ablation of pcs with large-scale cases are rare. one of the most important reasons for this originates from the extreme complexity and difficult regulation of the temperature distribution in tumors during thermal ablation because of the own characteristics of pcs, including highly invasive growth without tumoral capsules, high proportion of the interstitial fiber tissue, and the unusual blood perfusion because of extremely chaotic microvascular structures. the purpose is to explore the efficacy and safety of microwave ablation in the treatment of pancreatic cancer in combination with systematic therapy.

Eligibility criteria:
inclusion criteria: * inoperable pancreatic cancer * age from 18 to 80 * ps score from 0 to 3 * clear pathological diagnosis exclusion criteria: * severe coagulation dysfunction * individuals with severe heart, lung, liver, and kidney dysfunction * individuals with acute or active infectious lesions in any part of the body * researchers believe that there are any other factors that are not suitable for inclusion or that affect the participation of participants in the study * psychological health issues that hinder this experiment
postoperative pain and polyamines-poor diet (dolamine)

Conditions: Postoperative Pain

Summary: animal studies have shown that the level of pain sensitivity is highly dependent on the amount of polyamines in food. this fundamental observation of a nutritional approach to pain led the authors to develop diets completely depleted in polyamines whose anti-nociceptive properties have been confirmed in animals. postoperative pain after foot surgery are currently fairly well controlled but at the cost of a high consumption of grade ii analgesics which is associated with a high rate of side effects (nausea, vomiting ...). the investigators' hypothesis is that a diet low in polyamines may have an additive effect on pain control and reduce the consumption of level 2 analgesics. the objective of this study is to show the efficacy of a polyamines-poor diet on postoperative pain in ambulatory surgery of the foot.


Eligibility criteria:
inclusion criteria: * foot ambulatory orthopedic surgery * surgery scheduled at least 10 days after the inclusion consultation exclusion criteria: * other diet susceptible to interfere with the poor or high-polyamines diets (e.g. diabetic patients) * contraindication to tramadol or to nsaids * pregnant or breastfeeding woman * patient under legal protection * patient's opposition to participate in the study * poor understanding of french * absence of affiliation to social security * participation to another study
screening for al amyloidosis in smoldering multiple myeloma

Conditions: Smoldering Multiple Myeloma

Summary: in this multicenter study, we will recruit 400 patients 40 years of age or older at 15 centers with a diagnosis of smoldering multiple myeloma (smm), a group of patients for whom standard of care is observation not treatment. the main goal of this study is to screen for the diagnosis of light-chain amyloidosis (al) before the onset of symptomatic disease and to develop a training set for a likelihood algorithm.

this study is based on results from two prior studies in which 4 of 36 patients with smm and none of 14 patients with mgus were found to have al. the hypothesis that we test with this protocol is that patients with (1) a pre-existing diagnosis of smm, (2) free light chain (flc) abnormalities, (3) iglv genes associated with al,(4) t(11;14) or gain 1q, and (5) nt-probnp \> 332pg/ml will have undiagnosed al or risk of progression to al. we will study the potential for smm, the flc screen, al-related iglv gene use, t(11;14) or gain 1q cytogenetic abnormalities, and nt-probnp \> 332pg/ml to be the variables in a likelihood algorithm for al.

Eligibility criteria:
inclusion criteria: * patients 40 years of age and older * diagnosed with smoldering multiple myeloma * dflc greater than 23 mg/l * abnormal flc ratio * if the patient has an egfr less than 50 ml/min/1.73m2, the flc ratio is inconsequential. the patient only needs to meet the age and dflc criterion. exclusion criteria: * patients younger than 40 years of age are not eligible * patients with a previous finding of amyloid in other biopsies will not be included * adults unable to consent are not eligible, including the cognitively impaired pregnant women, pregnant minors, minors (i.e., individuals who are not yet adults), wards of the state, non-viable neonates, neonates of uncertain viability, and prisoners are not eligible

Keywords: smm al amyloidosis
pathogenic mechanisms involved in the initiation and progression of systemic sclerosis

Conditions: Scleroderma (Limited and Diffuse)

Summary: identify rare variants in candidate genes and pathways identified in familial ssc, in patients with sporadic ssc. perform (spatial) transcriptomic and proteomic analyses of affected skin from patients with and without cutaneous fibrosis, for the patterns and levels of expression/activation of candidate genes and pathways. test for dysregulation of expression/activation of candidate genes and pathways in live cells isolated from the blood and skin biopsy of patients, and for the impact of these dysregulations on cell appearance, behavior and function.


Eligibility criteria:
inclusion criteria: * patients diagnosed with one of the following: * limited ssc * limited cutaneous ssc * diffuse cutaneous ssc * patients followed regularly in consultations at cusl. * patients between ages 18-80. exclusion criteria: * other (co-occurring) autoimmune/autoinflammatory disease * pregnancy * participants with temporary or definitive disabilities to give consent * participants unable to sign or read the inform consent form
multicenter retrospective study on patients treated with stereotactic radiosurgery/radiotherapy for single brain lesions: evaluation of treatment efficacy and safety, also through radiomic analysis methods.

Conditions: Brain Metastases; Radiotherapy Side Effect

Summary: the study design concerns all patients diagnosed witha singular brain metastasis who underwent stereotactic radiosurgery/radiotherapy between january 2010 and december 2022

the study will include patients of both sexes diagnosed with single brain metastases who underwent radiosurgical/stereotactic treatment. attention will be paid to data related to local control, potential recurrence, and/or radionecrosis. once a sufficient number of treated patients is reached, the feasibility of a radiomic feature analysis will be assessed in order to identify potential correlations and/or predictive values for treatment response or radionecrosis. if the sample size is adequate, participating centers will be asked to share pre- and post-rt mri (brain mri with contrast using thin slices) and treatment volumes for radiomic evaluation.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * treatment with srs/srt techniques for a single secondary brain lesion * availability of pre-rt brain mri with contrast (1mm slice thickness) * availability of ct simulation imaging for treatment * availability of relevant clinical data in the medical record for the study's objectives * follow-up of at least 6 months after the completion of srs or srt * follow-up evaluation through brain mri exclusion criteria: * age under 18 years * lack of clinical/radiological data for the patient * unavailability of the required imaging * previous whole-brain radiotherapy treatment

Keywords: brain metastases radiotherapy stereotactic body radiotherapy radiosurgery radionecrosis local control safety profile radiomics
pediatric cervical spine clearance: a multicenter prospective observational study

Conditions: Cervical Spine Fracture

Summary: a prospective multicenter observational study, led by dr. katie russell of intermountain primary children's hospital, that will examine the sensitivity, specificity, negative, and positive predictive values of ct scan and plain films in diagnosing cervical spine injury that requires treatment. this study is funded by the primary children's hospital foundation.


Eligibility criteria:
inclusion criteria: * any participant less than 18 years old after blunt trauma * seen by trauma service * with cervical spine imaging (xr, ct, or mri) exclusion criteria: * ct scan from outside facility is poor quality and not repeated (\ 3mm, no reformats, motion artifact) * no radiology over reads by participating institution
the diagnostic performance of tilt test in athletes

Conditions: Syncope

Summary: in the present study the investigators evaluate the sensitivity and specificity of passive tilt test in athletes, as well as their haemodynamic responses and autonomic nervous system activity during head-up tilt. moreover, the investigators try to apply a novel algorithm for the improvement of diagnostic yield of tilt test in athletes.

we examine athletes with a history of reflex syncope and athletes without history of reflex syncope.all subjects undergo a tilt test, for the evaluation of haemodynamics, heart rate variability (hrv) and baroreflex sensitivity.

Eligibility criteria:
inclusion criteria: * 14-40 years old, * more than 5 years of exercise training experience and competition at a regional level at different sports exclusion criteria: * smoking, * recent alcohol consumption, * presence of any chronic disease and use of drugs
multimodal sleep pathway for shoulder arthroplasty

Conditions: Sleep Disturbance; Shoulder Arthritis; Arthroplasty Complications; Perioperative/Postoperative Complications

Summary: the purpose of the study is to investigate the efficacy of sleep medicine in the recovery of orthopaedic shoulder arthroplasty patients. the investigators hypothesize that a multimodal sleep pathway including non-pharmacological sleep hygiene interventions and the use of zolpidem can improve patient sleep, pain control, and subsequent recovery after undergoing total shoulder arthroplasty.

shoulder pain at night is a common symptom of shoulder arthritis and contributes to sleep disturbances. many patients also have difficulty sleeping after shoulder surgery due to the constraints of sling immobilization. while in the hospital, sleep is also disrupted due to pain, nursing staff, other patients, and bathroom use. while poor sleep may appear trivial, sleep deprivation in animal models has identified significant adverse effects on bone metabolism, bone mass, and recovery from post surgical pain. recent evidence has shown that non-pharmacological sleep interventions that improve sleep hygiene and duration can optimize athletic peak performance, fatigue, and recovery. furthermore, pharmacological sleep aid use with zolpidem in orthopaedic postoperative patients has suggested safe administration, improved pain control, reduced pain medication use, and higher patient satisfaction in the settings of total knee and hip arthroplasty, rotator cuff repairs, and acl reconstruction. the purpose of the study is to investigate the efficacy of sleep medicine in the recovery of orthopaedic shoulder arthroplasty patients. the investigators hypothesize that a multimodal sleep pathway including non-pharmacological sleep hygiene interventions and the use of zolpidem can improve patient sleep, pain control, and subsequent recovery after undergoing total shoulder arthroplasty.

Eligibility criteria:
inclusion criteria: all consenting adults undergoing elective total shoulder replacement - exclusion criteria: * allergies to zolpidem or refusal to participate in study
perineal massage and pelvic floor exercise in the antenatal period

Conditions: Urinary Incontinence; Fecal Incontinence; Sexual Dysfunction; Sexuality

Summary: this study aimed to determine the effect of perineal massage and pelvic floor exercise in the antenatal period on sexuality and urinary and fecal incontinence in the postpartum period. this study will be conducted in a pregnant school at a state hospital in turkey. an active control group will be formed as the control group. the control group will be given the "pelvic floor dysfunction prevention training" booklet prepared by the researchers. experimental 1 group will receive perineal massage training in addition to the "pelvic floor dysfunction prevention training" booklet given to the control group. experimental 2 group will receive pelvic floor exercises in addition to perineal massage training and the "pelvic floor dysfunction prevention training" booklet given to the control group.

the research was conducted as a randomized controlled trial. the simple randomization method will be used for the assignment to groups. the data of the research; will be collected using the preliminary evaluation form, personal information form, female sexual function index, the international consultation on incontinence questionnaire-iciq-sf (turkish version), and fecal incontinence severity index. the research will start at the 34th week of pregnancy and the questionnaires will be administered in the 3rd month after delivery. there will be 3 groups in the research.an active control group will be formed as the control group. the control group will be given the "pelvic floor dysfunction prevention training" booklet prepared by the researchers. experimental 1 group will receive perineal massage training in addition to the "pelvic floor dysfunction prevention training" booklet given to the control group. experimental 2 group will receive pelvic floor exercises in addition to perineal massage training and the "pelvic floor dysfunction prevention training" booklet given to the control group.

Eligibility criteria:
inclusion criteria: * being over 18 years old, * being 32-34th pregnancy weeks, * being not experiencing any complications in the mother and fetus during pregnancy (gestational diabetes, hypertension, preeclampsia, intrauterine growth retardation, congenital anomaly, etc.), * having a singleton pregnancy, * being primiparous * being volunteer to participate in the study exclusion criteria: * elective cesarean section planning, * having a history of chronic constipation, * having a previous history of urinary or anal incontinence, * having genital infection with lesions (hsv, hpv, syphilis, candida albicans, chancroid)
the safety of a novel acellular dermal template as treatment for burns and scars

Conditions: Full Thickness Skin Defects

Summary: in this study the safety and feasibility of an acellular dermal template (novomaix), combined with split thickness skin grafts, for use in patients with full thickness skin defects, is tested. results will be compared intra-patient with those obtained after conventional treatment with split thickness skin grafts. we expect this treatment to be safe, and to provide better outcome regarding scar quality.

using dermal substitutes in combination with a split-thickness skin graft (stsg) is a well acknowledged therapy in burns and reconstructive surgery. nevertheless, the ideal substitute is not available yet. we therefore want to investigate the use of an acellular dermal template (novomaix), in combination with stsg, to treat these defects. adult patients with acute (burn) wounds (group 1) and scars (group 2) will be included in this study. this phase i study aims to investigate the safety and feasibility of the use of this dermal matrix, with regard to graft take, epithelialisation and complications after transplantation. moreover, scar quality will be evaluated.

Eligibility criteria:
inclusion criteria: * age ≥18 years 1. with acute burns/trauma wounds that require skin grafting (group 1) or 2. with scar problems requiring surgical treatment (group 2) * full thickness skin defects of 50 cm2 or more, but \<50% tbsa * skin defects must be configured in such a way that two areas of 25 cm2 can be grafted * informed consent by the patient exclusion criteria: * patients with infected wounds * pregnant or breast feeding females * patients with known concomitant medical conditions that may interfere with normal wound healing (e.g. immune deficiency, hiv, diabetes, collagenoses, cancer) * known allergy against porcine collagen or elastin * patients who are expected (according to the responsible medical doctor) to be noncompliant to the study protocol. (this includes patients with severe cognitive dysfunction/impairment and severe psychiatric disorders) * previous enrolment of the patient into the current study

Keywords: burns dermal substitute scar quality reconstruction wound healing wound closure
glycemic control based on serum fructosamine concentration vs. hemoglobina1c (hba1c) in diabetic patients

Conditions: Diabetes

Summary: diabetes mellitus is associated with negative outcomes in patients undergoing surgery. blood sugar levels are monitored by measuring a values that include but are not limited to hemoglobin a1c, capillary blood glucose, and fructosamine . this study is being done to investigate if there is an associated between these values and postsurgical outcomes.

this study aims to compare the predictive capacity of both fructosamine and hba1c on preoperative basal glucose level, as well as adverse events (cardiovascular events, surgical site infection, and mortality) and length of post-anesthesia care unit (pacu) stay in both type i and type ii diabetic patients. secondary outcomes include length of anesthesia administration, an indicator of intraoperative complications, and perioperative glucose level.

Eligibility criteria:
inclusion criteria: 1. male or female patients able to consent. 2. patients with either type i or type ii diabetes mellitus (dm) 3. patients undergoing non-cardiac surgeries under general anesthesia 4. ≥ 18 years of age exclusion criteria: 1. inability to read, understand or sign the consent form 2. end-stage renal disease 3. special populations (incarcerated individuals, pregnant female patients)

Keywords: hemoglobina1c serum fructosamine glycemic control
retrospective chart review screening algorithm to assess the prevalence of pnh-clones

Conditions: PNH; Thrombosis

Summary: the present study is a non-interventional retrospective chart review study assessing the prevalence of pnh-clones in patients with pnh risk-factors aged ≥14 years and treated at our hospital. the objective of this study is to develop a pnh screening tool on the hospital electronic health record (ehr) system. an algorithm defining pnh risk groups is developed.

paroxysmal nocturnal hemoglobinuria (pnh) is a life-threatening hematological disorder, but with an effective therapy. prevalence is estimated between 1-5 per million people, often manifested by cardiovascular, gastrointestinal, neurological or haematological symptoms. referral is therefore typically to several specialists, resulting in pnh underdiagnosis. this chart review study consists primarily of developing an algorithm to identify a high-risk cohort of potential pnh patients who need treatment from all registered patients, with maximum ability to find relevant cases. secondly, this cohort will be manually reviewed by clinicians for final screening. the challenge hence is maximizing the ability to find all relevant pnh patients yet limiting the number to ensure manual review is possible.

Eligibility criteria:
inclusion criteria: * patient ≥14 years of age * at least 1 record encoded in the general hospital delta (az delta) patient database (hix) between 20 april 2018 and 1 march 2022 * a history or presence of at least one pnh risk factors identified following retrospective screening of electronic patient records exclusion criteria: * none

Keywords: pnh thrombosis anemia aplastic anemia myelodysplastic syndrome (mds)
comparison of two fine needle biopsy needles for solid pancreatic masses

Conditions: Pancreatic Neoplasm

Summary: this is a randomized prospective clinical study comparing the acquire biopsy device to sharkcore biopsy device.

at eus, once the pancreatic mass is identified, patients will be randomized to undergo sampling using one of the two fnb needle. all patients will undergo sampling of pancreatic masses using both needles but the needle to be used first will be based on randomization. subsequent passes will be performed by alternate needles and once onsite diagnosis is established using either needle type, more passes will not be performed for onsite diagnostic adequacy. however, a minimum of at least one pass and a maximum of 8 passes will be performed using both needle types. the number of passes needed to achieve diagnostic adequacy using both needles will documented. four dedicated passes will then be performed using the initial randomization sequence for cell block. two passes will be performed using each needle type and the specimen will be preserved in formalin and sent for cell block processing. if the doctor cannot obtain enough tissue with the study needles, another needle with a different gauge (19 or 25) will be used. this will also be a maximum of 8 passes. information about the number of needles used, how many passes were performed, any problems with the needles will be collected. if there is not enough tissue available from these passes to establish a diagnosis, the subject will be asked to come back at another time for a repeat procedure.

Eligibility criteria:
inclusion criteria: * scheduled to undergo eus * patients with solid pancreatic masses on cross-sectional imaging or with jaundice secondary to biliary obstruction * able and willing to provide written or verbal consent exclusion criteria: * unable to safely undergo eus for any reason * coagulopathy (prothrombin time \> 18 secs, platelet count \< 80,000/ml) * active alcohol or other drug use or significant psychiatric illness * pregnancy * unable or unwilling to provide consent

Keywords: fine needle biopsy eus solid pancreatic mass