Kornimate/medical-research-clean huggingface dataset:
role of probe-based confocal laser endomicroscopy targeted biopsy in the molecular study of undifferentiated gastric cancer

Conditions: Undifferentiated Gastric Cancer

Summary: the purpose of this study is to conduct a study on genetic pathology, obtaining of pure cancer tissues is mandatory. although the endoscopy with biopsy has been a gold standard for diagnosing gastric cancer, percentage of cancer cells in biopsy samples is usually 30% or less. recently, confocal laser endomicroscopy has been introduced for real-time histopathologic diagnosis in various cancers. in previous pilot study in our institution, pcle-targeted biopsy provided superior results in terms of the proportion of cancer cells in biopsy samples compared to wle-targeted biopsy, especially for gastric cancers with undifferentiated histology. however, there was a limitation because of small sample size. therefore, the investigators aim to evaluate that biopsy using probe-based confocal laser endomicroscopy for undifferentiated gastric cancer will increase the percentage of cancer cells and expression ratio of tumor marker in biopsy samples.


Eligibility criteria:
inclusion criteria: a. age, between 20 and 80 b. patients with undifferentiated gastric cancer who will be underwent surgery exclusion criteria: a. previous subtotal gastrectomy b. previous emr/esd history c. significant cardiopulmonary disease d. active hepatitis or severe hepatic dysfunction e. severe renal dysfunction f. severe bone marrow dysfunction g. severe neurologic or psychotic disorder h. pregnancy or breast feeding

Keywords: confocal laser endomicroscopy undifferentiated gastric cancer target biopsy
metoclopramide and the length of first stage of labor , a randomized controlled trial

Conditions: Labour Duration and Metoclopramide

Summary: reducing the length of labor is a highly desirable goal of intrapartum care, both from a perspective of maternal and fetal well-being and for the providers of the birth services. avoiding a long, protracted labor entails shorter exposure to pain anxiety and stress and would translate into a major improvement in maternal satisfaction with the childbirth experience. prolonged labor can lead to increased maternal and neonatal morbidity and mortality such as rupture of the uterus, postpartum hemorrhage, puerperal sepsis, and maternal death. prolonged labor may be due to maternal age, premature rupture of membrane, epidural analgesia and the secretion of high levels of maternal stress hormones.

several studies showed that active management of labor could shorten the duration of labor, and the safety of this method has been demonstrated. metoclopramide binds to dopamine receptors acting as a receptor antagonist, and it is also a mixed serotonin receptor agonist and antagonist. metoclopramide could potentially reduce spasms of the smooth muscle of the cervix that remains richly innervated at birth and thus have a regulatory effect on cervical contractility, an interaction that might be important in aiding maximal tissue compliance, promoting cervical dilatation during labor, and helping to reduce dystocia. dopamine and other catecholamines have been identified in rabbit, rat, guinea-pig, sheep, and human uteri. the purpose of this study is to determine the effectiveness of metoclopramide for reducing the duration of spontaneous labor among nulliparous women managed according to a standard intrapartum protocol.

Eligibility criteria:
inclusion criteria: * primigravida * singleton pregnancy * termgestation (37-42 weeks) * sure reliable dated * vertex presentation , occipito-anterior position * regular uterine contractions at every 5 minutes,each lasting for 20 seconds * cervical dilatation of 5 cm * with or without rupture of membrane * no evidence of maternal or fetal distress exclusion criteria: * chorioamnionitis * scarred uterus e.g. myomectomy * cephalopelvic dispropotion * history of cervical surgery or injury * hypersensitivity to metoclopramide

Keywords: metoclopramide - labor duration-labor pain
comparison of pelvic lymphadenectomy versus isolated sentinel lymph node biopsy procedure for early stages of cervical cancers : a multicenter study with evaluation of medico-economic impacts

Conditions: Uterine Cervical Dysplasia

Summary: patients with early cervical cancer are usually treated with radical hysterectomy + pelvic lymph-node dissection. the study randomizes patients in 2 arms. the control arm is the classical surgical treatment including identification of the sentinel nodes, full pelvic lymph-node dissection and radical hysterectomy. the experimental arm is only sentinel node identification + radical hysterectomy.


Eligibility criteria:
inclusion criteria: * women 18 years of age or older, * absence of contraindication to laparoscopy, * uterine cervical carcinoma (every histological type except neuroendocrine), * stage ia1 with lymphatic tumor space involvement (lvsi) or ia2 diagnosed on cervical conization; or stage ia2, ib1 or iia detected by clinical examination, confirmed by biopsy and measured by the mri, the highest diameter being lower to 4 cm (a preoperative brachytherapy is allowed for tumors 2 to 4 cm in diameter), * negative pregnancy test for women able to procreate, * having the french national social security * signed informed consent exclusion criteria: * neuroendocrine carcinoma, * in situ carcinoma or stage ia1 without lvsi, * maximal tumoral diameter measured by mri more than 4 cm, * stage ib1 by "down-staging", * stage ib2, iib to ivb, including those who had a response to neoadjuvant treatment (chemotherapy or rt + chemotherapy) , * presence of distant metastases, * progression of the cervical cancer or recurrence, * history of pelvic lymphadenectomy, * other cancer diagnosed during the course of treatment, * contraindication to the injected products : allergy known to patent blue or rhenium sulfide, * history of severe allergy (history of quincke's edema, anaphylactic shock), * patient who does not understand, speak or write the french language, * pregnant woman

Keywords: cervical cancer early stage carcinoma figo ia1 ia2 ib1 iia sentinel lymph node biopsy pelvic lymphadenectomy surgery of uterine cervical carcinoma medico economic impact quality of life
self-reported exercise behavior and short-term patient outcomes in women undergoing radiation treatment for operable breast cancer

Conditions: Breast Cancer

Summary: using an observational prospective design, potential subjects will be identified and screened for eligibility via medical record review of breast cancer patients scheduled for radiation therapy at duke radiation oncology clinic. subjects who agree to participate will be asked to complete study questionaires prior to the start of radiation therapy and again during the last week of therapy.

exercise behavior will be defined as patient reported mean total minutes (frequency x duration) of mild, moderate, and vigorous-intensity physical exercise per week over the past month at baseline (prior to enrollment in the study). in addition we will collect patient reported mean total minutes per week of mild, moderate, and vigorous-intensity physical exercise over the course of radiation therapy.baseline characteristics including demographic data (age, education, employment) as well as bmi, waist to hip ratio, and health comorbidities (including smoking status, cardiovascular disease, and diabetes) will also be collected. bmi and health comorbidities will be extracted from the chart. patient-reported outcomes will include qol, fatigue, depression, pain and sleep. qol will be assessed using the functional assessment of cancer therapy (fact) scale developed for the assessment of patient symptoms and qol in cancer patients. fatigue will be assessed using the 13-item fact-fatigue scale for the assessment of fatigue in cancer patients.skin toxicity will be defined as radiation dermatitis, pruritus, and pain. lymphedema will be assessed by measuring limb girth. measurements will be taken by first marking both limbs while patient is lying supine, starting at the ulnar styloid at 5cm intervals on the length of the arms. the diameter of the limb will then be measured at these markings. based on these measurements, the affected limb will be compared to the unaffected limb. range of motion will be defined as reduced abduction compared to the contralateral shoulder . all measurements will be taken with a goniometer.

Eligibility criteria:
inclusion criteria: * women with a biopsy-proven diagnosis of ductal carcinoma in situ or invasive breast carcinoma * definitive radiation treatment planned to the chest and/or regional nodes * 18 years of age or older * signed study-specific informed consent exclusion criteria: * significant mental disorders making informed consent difficult or mental impairment leading to inability to cooperate * karnofsky performance status (kps) \< 70%

Keywords: breast cancer, exercise and quality of life
effectiveness study of santyl ointment to treat pressure ulcers

Conditions: Pressure Ulcer; Soft Tissue Necrosis Lower Limb

Summary: researchers at lsuhsc-s hope to learn the effects of the combination of a medication and a device which by themselves are effective for the treatment of wounds. you are being asked to take part in this study because you have a wound on your body which has not responded to standard treatments. the researchers will be studying whether the combination of two treatments will make wounds heal faster. for those in study, the investigators will treat them with a vacuum device on their wound. also, some of the people in the study will receive a special ointment and researchers will use special tests to determine if the two treatments together are working better than just one treatment alone.

evaluate the effectiveness of collagenase santyl ointment when used in conjunction with npwt for the treatment of chronic pressure ulcers and determine whether the addition of collagenase santyl ointment has a positive effect on wound healing. through volumetric changes and histological evaluation, we wish to test the hypothesis that the application of collagenase santyl ointment in conjunction with npwt facilitates improved wound healing and mitigates some potentially harmful effects of npwt alone (e.g. pain with dressing removal and tissue ingrowth

Eligibility criteria:
inclusion criteria: * 18 to 85 year-old competent adults in inpatient setting (no prisoners, mentally ill, or children) * pressure ulcers to pelvis/abdomen/trunk and or upper extremities which have been refractory to prior treatment interventions and contain less than or equal to 25% necrotic tissue in wound bed (as percentage of total surface area) exclusion criteria: * lower extremity/foot wounds related to arterial insufficiency, incarcerated individuals, patients with untreated osteomyelitis, uncorrected coagulopathy, malignancy, sensitivity to collagenase, wounds with evidence of clinical infection (via swab culture or punch biopsy)

Keywords: collagenase santyl enzymatic debridement maintenance debridement vac npwt
hepatoprotective effect of remote vs local preconditioning of liver

Conditions: Liver Metastases

Summary: the aim of this study is to evaluate hepatoprotective effect from ischemia-reperfusion injury of remote ischemic preconditioning of the liver against local ischemic preconditioning of the liver during human liver resections.

in this randomized control study, a total of 60 patients were randomized into 3 groups: remote ischemic precondition group - ripc (3 intervals of 5 minute right upper limb ischemia with 3 intervals of 5 minute reperfusion), local ischemic precondition group - lipc (15 minutes of inflow liver occlusion followed by 10 minutes of reperfusion before liver transection), control group - cg (group without ischemic preconditioning before liver transection). patients were also stratified according to the extent of the hepatectomy. hepatoprotective effect was evaluated by comparing serum transaminase levels, bilirubin levels, albumin, and protein levels, coagulograms and pathohistological exams. we also measured flow rate by doppler ultrasound of hepatic artery and portal vein before and after preconditioning.

Eligibility criteria:
inclusion criteria: * patients with colorectal cancer liver metastasis all of which signed an informed consent exclusion criteria: * having any other underlying liver disease, or preoperative increased liver transaminase, bilirubin * patients with chronic cardiac, pulmonary or renal disease

Keywords: preconditioning, resection
cost-utility study of continuous positive airway pressure treatment in obstructive sleep apnea syndrome patients

Conditions: Obstructive Sleep Apnea Syndrome

Summary: the purpose of this study is to estimate the cost-utility of continuous positive airway pressure (cpap) therapy in obstructive sleep apnea (osa) patients in sao paulo city, brazil, after 3 years of treatment and to estimate the cost-effectiveness of cpap on the number of medical visits, hospitalizations, medical examinations, used medications, new case incidence and cost of traffic accidents and absence from work. it is also designed to estimate quality-adjusted extended years of life, and to assess cost-effects of the therapy (device, masks, supplies, maintenance/year for membership of professional consulting, electric power) on the cost-effectiveness

osa is highly prevalent in sao paulo city, brazil. it is associated with significant comorbidities. the cost-utility study is important to (1) support decision-making on health policies, (2) to incorporate new technologies, (3) implementation of preventive programs and policy development assistance in the medical field. probably cpap treatment in the long-term, will improve health, physical and mental state, and especially, reduces spending on public health, demonstrating cost-utility.

Eligibility criteria:
inclusion criteria: * both genders * aged 30 to 70 years old * ahi \> 30 events/hour exclusion criteria: * patients residing in other cities and states other than são paulo / sp / brazil * patients with no fixed residence * previous cpap contact

Keywords: osa sleep cpap cost
effect of metoprolol on thalassemia cardiomyopathy

Conditions: B Thalassemia

Summary: effect of b blocker was first evaluated in patient with cardiomyopathy not induced by ischemia and idiopathic which as the most common causes of cardiomyopathy. effect of bb on thalassemia cardiomyopathy was evaluated in this study

in this clinical trial, 45 patients with thalassemia cardiomyopathy were randomized to receive either metoprolol (n = 26) or placebo (n = 19). echocardiography and 6 minute walk test was performed at baseline and repeated after 6 months and the values were compared.

Eligibility criteria:
inclusion criteria: * documented lvef \< 50% by echocardiography * b thalassemia * no decompensated heart failure for at least 4 weeks (hospitalization for chf, worsening lower extremity edema, worsening dyspnea on exertion, , and orthopnea) * have no evidence of acute myocarditis and * hemoglobin level above 7 gr⁄dl. exclusion criteria: * pulse rate below 60/min * systolic blood pressure less than 90 mmhg * evidence of peripheral vascular disease * major depression, history of asthma, pr interval more than 240 msec, second or third degree av block * major medical diseases including diabetes mellitus requiring insulin injection, hypothyroidism, hypoparathyroidism, chronic renal failure (glomerular filtration rate below 30 ml/min), hepatic cirrhosis, hepatitis-b and hepatitis-c, positive tests for human immunodeficiency virus, and other hemoglobinopathies

Keywords: thalassemia cardiomyopathy metoprolol succinate echocardiography six minute walk test
intravenous sodium bicarbonate verifies intravenous position of catheters in spontaneously breathing adult volunteers

Conditions: Infiltration; Extravasation

Summary: vascular access in patients carries a significant risk of accidental extravasation of intravenous (iv) fluids and medications with the potential for tissue injury. this prospective controlled study assessed the diagnostic utility of using intravenous diluted sodium bicarbonate to confirm placement of iv catheters in volunteers . diluted sodium bicarbonate or 0.9% normal saline, will be injected in a randomized order while end-tidal carbon dioxide in the exhaled air will be monitored. the investigators hypothesize that the injected bicarbonate will dissolve into carbon dioxide and water and cause a transient increase in the measured exhaled co2. the effect is unique to bicarbonate and will not appear once normal saline is injected. the safety of the administration of bicarbonate on the metabolic profile of the volunteers will be assessed by measurement of venous blood ph and electrolytes.

vascular access in patients carries a significant risk of accidental extravasation of intravenous (iv) fluids and medications with the potential for tissue injury. this prospective controlled study assessed the diagnostic utility of using intravenous diluted sodium bicarbonate to confirm placement of iv catheters in volunteers . diluted sodium bicarbonate or 0.9% normal saline, will be injected in a randomized order while end-tidal carbon dioxide in the exhaled air will be monitored. the investigators hypothesize that the injected bicarbonate will dissolve into carbon dioxide and water and cause a transient increase in the measured exhaled co2. arbitrary increase of more than 10%in end-tidal carbon dioxide is considered as a positive response. the effect is unique to bicarbonate and will not appear once normal saline is injected. the safety of the administration of bicarbonate on the metabolic profile of the volunteers will be assessed by measurement of venous blood ph and electrolytes.

Eligibility criteria:
inclusion criteria: * asa i,ii * no cardiovascular or respiratory disease exclusion criteria: * asa \> ii * cardiovascular disease * respiratory disease * renal failure * metabolic alkalosis

Keywords: infiltration extravasation
successful treatment of maternal listeria monocytogenes bacteremia in the first trimester

Conditions: Listeria Monocytogenes

Summary: successful treatment of maternal listeria monocytogenes bacteremia in the first trimester of pregnancy

a 34-year-old nulliparous woman with 11 gestational weeks with flu-like illness was proved to be infection by listeria monocytogenes, and then treated by intravenous ampicillin 2 g every 4 hours for 3 weeks. a healthy unaffected male baby was delivered at 41 weeks' gestation.

Eligibility criteria:
inclusion criteria: * one pregnant woman with listeria monocytogenes bacteremia in the first trimester
food pharmacy at oregon health & science university (ohsu) knight cardiovascular institute (kcvi)

Conditions: Hyperlipidemias

Summary: participants in the intervention group of this study will receive weekly home deliveries of fruit \& vegetables for 3 months. the primary objective of this study is to determine if increased access to fruits and vegetables leads to sustained dietary changes, measured through changes in the healthy eating index (hei). secondary objectives are to determine whether increased fruit and vegetable access (increased hei) ultimately leads to improved cardiovascular (cv) health indicators (e.g., body mass index, waist circumference, blood pressure, and levels of blood lipids and hemoglobin a1c).


Eligibility criteria:
inclusion criteria: * age 19 years and older * established patient at ohsu center for preventive cardiology * not requiring changes to medication regimen for the 6-month study duration * must be eligible to register with produce delivery company (reside in portland-metro area; have access to a computer with internet service; able to read english) exclusion criteria: * triglycerides \> 500 mg/dl * heavy alcohol use (\> 3 drinks/day) * uncontrolled hypertension (bp \> 140/90) * ldl-c \> 160 mg/dl * uncontrolled diabetes mellitus (hba1c \> 8%) * failure to provide informed consent * current pregnancy * healthy eating index (hei) score of ≥ 80

Keywords: diet nutrition hyperlipidemia produce
effect of targeted education for atrial fibrillation patients

Conditions: Atrial Fibrillation and Flutter

Summary: the aim of this study is to evaluate the effect of targeted in-person and online education on cardiovascular outcomes of af patients (inpatient and outpatient), compared with standard care. several other parameters (i.e. knowledge level, quality of life, symptom burden, self-care capabilities, adherence to oral anticoagulation, and an evaluation of the educational efforts) will be studied. cost-effectiveness and cost-utility will also be investigated. the main research hypothesis is that individualized education based on the knowledge gaps measured with the jakq (jessa atrial fibrillation knowledge questionnaire) in each individual patient (called 'targeted education') is superior when compared to current af care, both from an efficacy perspective (evaluated by different outcome measures) and from a cost-effectiveness perspective.


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years 2. patients in whom af or atrial flutter is diagnosed with an electrocardiogram (12-lead, holter,...) 3. patients who are capable to sign the informed consent. exclusion criteria: 1. not able to speak and read dutch 2. cognitive impaired (e.g. severe dementia) 3. life expectancy is estimated to be less than 1 year. 4. ongoing participation in another clinical trial. 5. pregnant women

Keywords: education
abdominal aortic aneurysm surgery and thrombosis

Conditions: Abdominal Aortic Aneurysm

Summary: the aim of our study is to evaluate the incidence of post-operative thrombotic complications after abdominal aortic aneurysm surgery in the context of atherosclerosis or infectious aneurysm and its links with preoperative inflammation and hemostasis.

abdominal aortic aneurysm (aaa) develops in the context of atherosclerosis or infection (aortitis or mycotic aneurysm). aaa and its surgery are associated with pro-thrombotic modifications of hemostasis, which persists in the post-operative period. pro-thrombotic reactions occur in the intraluminal thrombus. inflammatory cells recruitment is mediated by adhesion molecules from the activated endothelium, such as "vascular cell adhesion molecule-1" (vcam-1), "intercellular adhesion molecule-1" (icam-1), p-selectin and e-selectin. in the setting of infection, neutrophil death process occurs, the netosis, with the liberation of neutrophil extracellular traps (nets), containing dna and histones. nets are associated with thrombosis and various studies have already quantified netosis biomarkers in plasma from patients with thrombotic disease, such as mpo-dna (dna coupled myeloperoxidase). in the clinical perioperative setting, patients with aortitis scheduled for aaa surgery shwoed exhibit thrombotic events. the hypothesize was that patients with aortitis have an inflammatory and hemostatic activation different from patients who develop aaa in atherosclerotic condition, and that inflammation is a risk factor of postoperative thrombotic events.

Eligibility criteria:
inclusion criteria: * patient \>18 years-old; * patient scheduled for aaa surgery by laparotomy in the vascular surgical unit at bordeaux university hospital; * patient who gave his/her authorization for the use of its medical data and results of blood analyses performed on residual plasma and results of aortic material analyses exclusion criteria: * patient who do not understand the study (not fluently french speaking or unable to give his/her consent); * patient with a pre-existing hemostatic disorder; * patient scheduled for an endovascular surgery and benefiting from a secondary laparotomy

Keywords: abdominal aortic aneurysm netosis thrombosis