Kornimate/medical-research-clean huggingface dataset:
pituitary histopathology and hyperprolactinaemia and risk of glucose metabolic disturbances in acromegaly.

Conditions: Acromegaly; Surgery

Summary: acromegaly is frequently associated with impaired glucose tolerance and diabetes. we hypothesise that pituitary histopathology and plasma hyperprolactinaemia could have prognostic value in predicting the risk of glucose metabolic disturbances in acromegalic patients. the aim of this study is to examine glucose metabolic outcome in acromegalic patients with and without histologically verified prolactin and growth hormone (gh) co-secreting adenomas. the study population include 79 patients who have all undergone surgical treatment for acromegaly.

acromegaly is frequently associated with impaired glucose tolerance and diabetes. we hypothesise that pituitary histopathology and plasma hyperprolactinaemia could have prognostic value in predicting the risk of glucose metabolic disturbances in acromegalic patients. the aim of this study is to examine glucose metabolic outcome in acromegalic patients with and without histologically verified prolactin and growth hormone (gh) co-secreting adenomas. 79 patients who have all undergone surgical treatment for acromegaly are included. clinical and biochemical baseline data are collected from medical records. patients are divided into two groups based on histopathological evaluation of pituitary adenomas; 1. pure gh secreting adenomas or 2. gh and prolactin co-secreting adenomas.

Eligibility criteria:
inclusion criteria: * diagnosis of acromegaly, and treated at the department of endocrinology, copenhagen university hospital, rigshospitalet, denmark (tertiary referral hospital), surgical treatment of acromegaly exclusion criteria: * no surgical treatment performed

Keywords: acromegaly, surgery, histopathology, hyperprolactinaemia,
genetic polymorphisms associated with vertebral osteochondrosis

Conditions: Spinal Osteochondrosis

Summary: the present study is proposed for the identification of phenotype, biochemical and genetic markers in adult symptomatic spinal osteochondrosis to promote the early diagnosis of this pathological condition and to establish possible therapeutic targets that favor a conservative approach aimed at treating patients.

the primary outcome is to determine the association between specific phenotypic characteristics of osteochondrosis, in particular linked to osteo-cartilaginous degeneration, with the identified vitamin d receptor genotypes. the secondary outcomes are to evaluate the circulating levels of the osteo-cartilage degradation markers, of the vitamin d and to evaluate the association of the osteochondrosis phenotype with variants in genes involved in inflammatory processes.

Eligibility criteria:
inclusion criteria * males and females * 18≤age ≤ 65 years old * patients with adult spinal osteochondrosis exclusion criteria * age \ 65 years old * chronic major diseases such as diabetes, autoimmune diseases, cardiovascular diseases, malignancies
serial daily diaphragm ultrasounds in ventilated patients

Conditions: Muscle Atrophy or Weakness; Ventilator-associated Lung Injury

Summary: when a person is put on a breathing machine the investigators think that the breathing muscles can get weaker. the investigators are not sure how quickly this happens but in some people this leads to problems when they try to breathe on their own without the breathing machine. the diaphragm is at the bottom of a person's chest separating their lungs from what is in their belly and it is a very strong muscle. in fact, it is main muscle that one uses for breathing. an ultrasound machine is a painless way to see what is happening beneath the skin. it is safe and easy to do. using an ultrasound the investigators are planning to measure how thick the diaphragm is and how much it changes while a person is on a breathing machine in the icu. getting a better understanding of this condition could lead to improved treatments that might help support patients who require a ventilator for breathing. the investigators hypothesis is that patients for whom the breathing machine is doing all of the work of breathing, will have their diaphragm thickness gradually decrease and changing to a breathing modem mode where they have to put in more effort the diaphragm thickness will start increasing again.

the investigators propose to expand the investigators single-centre longitudinal pilot study into a complete study in which the investigators will use b-mode ultrasonography to evaluate daily changes in diaphragm thickness in all critically ill patients on mechanical ventilation (mv) until successful weaned from mv. the impact of patient age, co-morbidities, and the use of various modes of ventilation on diaphragm thickness will be assessed. diaphragmatic thickness and its change from baseline will be evaluated as predictors of the need for a prolonged wean (\>7days). the investigators hypothesize that in patients on mandatory mode ventilation, diaphragmatic thickness will progressively decrease. switching from mandatory to assisted breathing modes will correlate with increases in diaphragmatic thickness.

Eligibility criteria:
inclusion criteria: * all patients age ≥19 years in the icu on ventilation exclusion criteria: * history of diaphragmatic or neuromuscular disease * on a home ventilator * history of diaphragm surgery * absence of adequate initial us images (3 consecutive days with at least 2 operators) * bmi greater than 40

Keywords: atrophy ventilator induced diaphragm dysfunction
brain maturation in children with localization related epilepsy

Conditions: Benign Childhood Epilepsy With Centro-temporal Spikes (BCECTS); Focal Cryptogenic Epilepsy of Childhood; Cryptogenic Epilepsy of Childhood

Summary: this project intends to investigate children with idiopathic and cryptogenic localization related epilepsies, using a longitudinal assessment of structural and functional mri data, in relation to neuropsychological evaluation. the rationale is primarily based on: 1) the frequent observation of selective cognitive dysfunctions in such children, the pathophysiology of which remains largely uncertain; 2) the recent major advances in the mri investigation of brain maturation showing striking age and region dependant patterns. the primary hypothesis is that some children with localization related epilepsies suffer from altered maturation in the epileptic brain regions, and that this abnormal maturation affects their cognitive abilities. 100 children with localization related epilepsies and 100 matched controls will be prospectively enrolled during the first two years of the disease (for patients) and benefit from a comprehensive phenotypic and neuropsychological evaluation once a year for 5 years. the brain maturation of these children will be longitudinally assessed using structural and functional mri, and correlated with neuropsychological data. investigators hope to demonstrate that children with localization related epilepsies and cognitive dysfunctions suffer from an abnormal brain maturation in regions underlying the epileptic activity and the altered cognitive processes. the finding could partly bridge the gap between these two abnormalities and help better understand their interaction and respective dynamic. once validated, the study of regional brain maturation in children with epilepsy might be further used as a reliable surrogate marker or predictor of associated cognitive dysfunction.


Eligibility criteria:
inclusion criteria: * motivation to participate in the study for 5 years * for patients - one of the following diagnostics - bcects (benign childhood epilepsy with centro-temporal spikes), focal cryptogenic epilepsy of childhood, panayiotopoulos syndrome, diagnosis established according to the current diagnostic criteria (ilae, 1989) * for patients - no anti-epileptic drug for 24 months * normal mri if available before inclusion * signed consent by on of the parents exclusion criteria: * associated neurological and psychiatric diseases * other epileptic syndromes * other chronic severe disease * contra-indication for performing an mri examination * claustrophobia

Keywords: benign childhood epilepsy with centro-temporal spikes rolandic epilepsy brain development dti functional mri structural mri idiopathic focal epilepsy cryptogenic epilepsy of childhood
aprepitant for nause and vomiting induced by chemoradiotherapy in hnscc

Conditions: Vomiting; Nausea Post Chemotherapy; Head Neck Cancer

Summary: to evaluate the safety and efficacy of aprepitant combined with ondansetron and dexamethasone to prevent nausea and vomiting induced by intensity-modulated radiotherapy (imrt) cisplatin-chemotherapy regimen in locally advanced squamous cell carcinoma of head and neck

to evaluate the complete response rate, nause-free rate, vomiting-free rate, and the quality of life of aprepitant combined with ondansetron and dexamethasone for the nausea and vomiting induced by chemoradiotherapy in hnscc.

Eligibility criteria:
inclusion criteria: pathology confirmed squamous cell carcinoma. the primary sites included nasopharynx, mouth, oropharynx, hypopharynx, larynx, nasal cavity and paranasal sinuses; aged 18 to 70 years old; stage iii-ivb diseases; eastern cooperative oncology group performance status 0-1; normally functioning of liver, kidney, bone marrow; concurrent chemoradiotherapy is recommended after multi-disciplinary team discussion; must be able to swallow tablets; at least 12 weeks lifetime was expected; fertile male or female patients volunteered to use effective contraception within 90 days of the study period and at the end of study. exclusion criteria: nausea and vomiting occurred 24 hours before the start of the chemotherapy; corticosteroid or benzodiazepines used; combination medicine which metabolism through drug-metabolizing enzyme cpy3a4 and cyp2d6; serious cardiovascular, pulmonary, diabetes, mental and other diseases; perinatal women or refused to take contraception during treatment; other induced vomiting factors. (the transfer of the central nervous system, intestinal obstruction or hypocalcemia, and so on)
implications for treatment of the metabolic syndrome

Conditions: Metabolic Syndrome

Summary: to characterize features of metabolic syndrome in volunteers. to undertake a randomised trial to determine whether treatment with a statin improves muscle microvascular blood flow.

to characterise features of the metabolic syndrome, including body fat, insulin sensitivity, and liver fat together with muscle micorvascular blood flow. to undertake a randomised controlled trial of atorvastatin 40 mg. o.d for 6 months to determine whether any of the above measures change with treatment.

Eligibility criteria:
inclusion criteria body mass index (bmi) 20-35 kg/m\^2" and "\> 3 criteria for the metabolic syndrome (ncep iii atp criteria - see below) , one of which will be hypertriglyceridaemia, i.e. fasting plasma triglycerides \>2.0 mmol/l - a cardinal lipid abnormality of the syndrome ncep iii atp metabolic syndrome criteria are: waist greater than or equal to 102 cm bp greater than 130 / 85 mmhg tg greater than or equal to 1.7mmol/l glucose greater than or equal to 6.1 mmol/l hdl less than 1.0 mmol/l exclusion criteria: aged \ 75 years known diabetes; renal, liver, or uncontrolled thyroid disease; uncontrolled hypertension; treatment with lipid-modifying drugs; antihypertensive medication; corticosteroid therapy; or hormone replacement therapy.

Keywords: metabolic syndrome volunteers recruited from the community
psychosocial and functional factors in axspa

Conditions: Spondyloarthropathies; Ankylosing Spondylitis (AS)

Summary: this observational, cross-sectional study aims to characterize patients with axial spondyloarthritis (axspa) from a biopsychosocial perspective. the study examines the relationships between psychosocial factors (such as pain catastrophizing, kinesiophobia, and fear-avoidance beliefs) and clinical indicators of disease progression, including functional limitations and disease activity. the primary objective is to identify psychosocial predictors of functionality and disease activity in axspa patients, which may guide more personalized therapeutic interventions. findings could provide insights into the combined effects of physical and psychological aspects on disease management, promoting a holistic approach to axspa care.


Eligibility criteria:
inclusion criteria: * adults (18 years and older) diagnosed with axial spondyloarthritis (axspa) based on the assessment of spondyloarthritis international society (asas) criteria. * experiencing symptoms of axial or peripheral involvement. * a minimum score of 3/10 on the numeric pain rating scale (nprs) during the initial assessment. exclusion criteria: * individuals with other rheumatic or musculoskeletal conditions affecting the spine or joints (e.g., rheumatoid arthritis or osteoarthritis). * history of spinal surgery or joint replacement surgery. * receipt of corticosteroid injections or other pharmacological treatments targeting inflammation within six weeks prior to data collection. * any ongoing medico-legal conflicts that could interfere with study participation.
oral care with 3% hydrogen peroxide (oroxid®) in icu - effects on the lower airway microbial colonisation

Conditions: VAP - Ventilator Associated Pneumonia

Summary: hypermicrobe is a single-centre, controlled, randomised, prospective, superiority clinical trial to compare the efficacy of daily oral care with 3% hydrogen peroxide (oroxid®) versus standard of care (0.2% chlorhexidine digluconate) on the cumulative incidence of lower respiratory tract microbial colonisation in mechanically ventilated adult critically ill patients.

rationale: ventilator-associated pneumonia (vap) is the most common hospital-acquired infection (hai) in the intensive care unit (icu), and its impact is very high in terms of morbidity, length of hospital stay and overall costs. chlorhexidine for oral care in critically ill has no clear impact on vap rates and may cause harm. 3% hydrogen peroxide (oroxid) could be a promising substitute. aim: to test effectivity and safety of 3% hydrogen peroxide solution on ventilator-associated complications design: prospective, single center, parallel group randomised controlled trial. subjects: icu patients (general icu) treatment in the intervention group: daily oral care with 3% hydrogen peroxide control group: standard-of-care protocolised daily oral care with 0,2% chlorhexidine primary outcome: cumulative incidence of lower respiratory tract microbial colonisation analysed by kaplan-maier method, censored in the case of icu discharge or extubation \> 24h. secondary and exploratory outcomes: differences in the relative risk of infection related ventilator-associated complications, antibiotic (atb) consumption analysis, intraoral complications, reported using the bedside oral exam (boe) score, validated and adopted for icu, length of icu stay in days (time frame: at 3 months), number of ventilator-free days (time frame: at 28 days); that is, number of days, out of 28 days after admission, that patient has not been supported by mechanical ventilation

Eligibility criteria:
inclusion criteria: 1. age ≥18 years 2. in-patient of icu and expected to stay \> 5 days 3. mechanical ventilation or imminent need of it; predicted length of mechanical ventilation (mv) ≥ 72h 4. clinical pulmonary infection score (cpis) less than 6 at the baseline 5. no history and symptoms of aspiration at the baseline exclusion criteria: 1. atb therapy of respiratory infection on admission 2. suspected pulmonary infection on admission and in the first 48h of mechanical ventilation 3. pregnancy 4. oral ulcers or injuries 5. patient with a history of hydrogen peroxide allergy

Keywords: pneumonia hydrogen peroxide chlorhexidine respiratory tract microbiome
study on precision treatment of diabetic retinopathy macular edema guided by real-time oct during operation

Conditions: Diabetic Retinopathy

Summary: select proliferative proliferative diabetic retinopathy(pdr) patients who are planning to undergo vitrectomy for informed notification. after obtaining informed consent, vitrectomy will be performed. after hemorrhage is removed, the macular shape can be obtained through intraoperative optical coherence tomography (ioct) real-time scanning. if the central macular thickness (cmt) of the patient is ≥250μm, random enter the anti-vascular endothelial growth factor (anti-vegf) treatment group, the internal limiting membrane stripping group and the glucocorticoid treatment group for treatment, and compare the patients' visual acuity (1 day, 7 days, 1 month, 3 months, 6 months) and the thickness of the center of the macula, compare and observe its treatment effect.

1. test method: * include suitable cases of diabetic retinopathy and macular edema inclusion criteria: a. pdr patients with severe vitreous hemorrhage who cannot collect oct images and require vitrectomy b. type 2 diabetes, aged 18\~80 years old c. good blood sugar control (glycated hemoglobin \<8.3%) d. sign the informed consent form voluntarily, and are willing and able to follow the outpatient visits and research procedures within the time specified in the trial exclusion criteria: a. exclude severe infections of conjunctiva, cornea, and sclera b. combined with other retinal vascular diseases such as retinal vein occlusion c. cardiorenal insufficiency d. myocardial infarction or stroke occurred within 6 months ②intraoperative real-time operation all patients underwent 25gauge(25g) transplanter three-channel vitrectomy to remove cloudy vitreous or vitreous hemorrhage and posterior vitreous cortex. through intraoperative oct, the macular area was observed in real time and the central macular thickness was measured. if central macular thickness (cmt) ≥ 250 μm, anti-vegf, glucocorticoid, or internal limiting membrane peeling was randomly selected to treat macular edema. * re-examine the effect of surgery after operation the visual acuity and the thickness of the center of the macula were reviewed at 1 day, 7 days, 1 month, 3 months, and 6 months after the operation to compare the effect of the operation, and observe the cornea, anterior chamber, vitreous cavity, and intraocular pressure.

Eligibility criteria:
inclusion criteria: * pdr patients with severe vitreous hemorrhage who cannot collect oct images and need vitrectomy * type 2 diabetes, aged 18\~80 years old * good blood sugar control (glycated hemoglobin \<8.3%) * sign the informed consent form voluntarily, and are willing and able to follow the outpatient visits and research procedures within the time specified in the trial exclusion criteria: * exclude severe infections of conjunctiva, cornea, and sclera * combined with other retinal vascular diseases such as retinal vein occlusion * cardiorenal insufficiency * myocardial infarction or stroke occurred within 6 months.
efficacy of inspiratory muscle training on respiratory performance in patients with esophageal cancer receiving combined modality therapy

Conditions: Esophageal Cancer

Summary: the purpose of this study is to investigate the effectiveness of inspiratory muscle training (imt) on respiratory performance in patients with esophageal cancer during combined modality therapy.

background and purpose: incidence rates of esophageal cancer remain high in eastern asia. in 2012, esophageal cancer was the 9th leading cause of cancer deaths in taiwan. whether surgical resection is possible, combined modality therapy is usually required for the treatment of esophageal cancer. in clinical observation, patients underwent combined modality therapy usually demonstrated respiratory muscle dysfunction which might further impair physical activity and quality of life. the purpose of this study is to investigate the effectiveness of inspiratory muscle training (imt) on respiratory performance in patients with esophageal cancer during combined modality therapy. methods: this is a prospective interventional study design. a total of 45 patients with newly diagnosed esophageal cancer will be recruited from the mackay memorial hospital. all tests will be performed at baseline (prior to cancer treatment), weekly during treatment, prior to surgery, and one month after surgery. tests will include demographic data collection, respiratory muscle performance (maximal inspiratory and expiratory pressure tests combined with diaphragmatic surface electromyography, and pulmonary functional test), dyspnea, and the functional exercise test (6-min walk test). imt will start with an intensity of 30% of maximal inspiratory pressure, 15 times/set, 3 sets/day, 7 days/week and training will continue until surgery is scheduled or 2 weeks after the completion of treatment if surgery is not suitable. repeated measure anova will be used for analyzing difference of parameters among various time points. clinical relevance: the results of this study will help to better understand the clinical beneficial effects (e.g., better functional capacity) of an added inspiratory muscle training during combined modality therapy in patients with esophageal cancer.

Eligibility criteria:
inclusion criteria: * newly diagnosed primary esophageal cancer, aged more than 20 years, communicate without difficulty. exclusion criteria: * inability to perform inspiratory muscle training, the presence of unstable angina or myocardial infarction in recently one month, cannot cooperate with training protocols, and pregnancy.

Keywords: inspiratory muscle training diaphragmatic surface electromyography respiratory muscle strength functional capacity
autologous fat in peripheral nerve injury

Conditions: Nerve Injury

Summary: the aim of this study is to assess the efficacy of autologous fat graft in enhancing peripheral nerve regeneration. the investigators hypothesize that fat grafting will allow for faster and greater recovery of motor and sensory function following surgical repair of injured peripheral nerves.

traumatic injuries to peripheral nerves are a frequent finding after hand trauma. high morbidity after nerve injuries mainly affects the younger and working population, with consequent decrease in life quality and productivity . even in direct nerve repair and microsurgical nerve coaptation, regeneration is often suboptimal with incomplete target reinnervation. suboptimal outcome is attributed to axonal degeneration, fibrotic scar formation, and neuromas at the site of injury. the use of adipose tissue has become very popular in tissue engineering and reconstructive surgery in recent years. it is proposed as a "regenerative tool" for various tissues, including peripheral nerves, because it offers an effective and minimally invasive procedure for obtaining stem cells. unprocessed fat grafting can provide a simple approach to improve peripheral nerve regeneration by means of neoangiogenesis \& inflammatory response modulation. furthermore, it serves as a good protective barrier in peripheral nerve surgery, reducing fibrosis and adhesions. a recent study advocated by tuncel et al, concluded that combined use of autologous fat graft with surgical repair methods induced significantly better regeneration in rats \[3\]. in another study by kilic et al, using adipose tissue flap in a crush injury model in rats was found to be superior to other groups in myelin thickness, nerve fiber density, axon count, and functional recovery at 4 weeks. they concluded that fat tissue seems to promote nerve regeneration because of its stem cell content. to our knowledge, no prior studies have examined the use of fat graft in peripheral nerve repair in humans. so, the investigators proposed this clinical study to evaluate the outcomes of primary nerve repair combined with autologous fat graft in peripheral nerve injuries.

Eligibility criteria:
inclusion criteria: - acute median or ulnar nerve lacerations below elbow exclusion criteria: * old nerve lacerations \> 48 hours * nerve gap which requires nerve grafting * psychosocial issues that would limit participation and compliance

Keywords: fat graft autologous fat peripheral nerve injury