Kornimate/medical-research-clean huggingface dataset:
laser en bloc resection of bladder tumor (holerbt) vs. conventional transurethral resection of bladder tumors (cturbt)

Conditions: Bladder Cancer

Summary: randomized clinical trial aiming to assess holmium laser en bloc resection of bladder tumor (holerbt) in comparison with conventional transurethral resection of bladder tumors (cturbt) in tumor histopathological staging quality, detrusor muscle sampling in biopsy, completeness of tumor resection and peri procedure complication.

urothelial carcinoma of the bladder is the 2nd most common urological malignancy and it makes a growing healthcare problem worldwide. the vast majority of newly diagnosed are non-muscle bladder cancers (nmibc) which represents about 75% and can be treated with transurethral resection of bladder tumors (turbt) so, correct initial staging is critical. the quality of turbt strongly determines patient prognosis and overall treatment. conventional transurethral resection of bladder tumors (cturbt) causes fragmentation, artifacts, thermal damages and tangential sections that might hamper histopathological evaluation. the expert meeting at davos of the european association of urology (eau) section of uro-technology (esut) and the section of uro-oncology (esou) identified en bloc resections of bladder tumors (erbt) using various energy sources or modified resection loops as a promising technique. laser therapy for the treatment of non muscle invasive bladder tumor (nmibc) was first reported in the 1970s. neodymium:yag lasers were mainly used for tissue vaporization. afterward, the introductions of en bloc resection methods have laser treatments for bladder cancer regains its popularity. the most commonly used are holmium (ho:yag) and thulium (tm:yag). ebrbt overall complication rate of 0.7%, of which all complications had not been life-threatening. compared conventional turbt to holerbt, a significant reduction of obturator nerve reflex, related bladder perforations, peri- or postoperative bleeding was rare, reduction in bladder irrigation time in comparison with conventional turb. better histopathological results were with laser en bloc resection of bladder cancer by lowering of thermal damage the study will be conducted in a single tertiary centre at urology and nephrology center in mansoura, egypt. eligible patient presented with papillary bladder tumor will be asked to participate in this study and will be provided with an informed consent form in line with good clinical practise and the declaration of helsinki.

Eligibility criteria:
inclusion criteria: * patients diagnosed at the out-patient cystoscopy with papillary bladder tumour will be legible for inclusion exclusion criteria: * tumor criteria * non papillary gross features of the tumor * anteriorly located tumor * patients criteria * poor performance status * history of bcg sepsis * history of bladder irradiation * contracted bladder

Keywords: bladder cancer, laser
normal values in stress echocardiographic parameters in patients after successful mitral valve repair for organic mr

Conditions: Heart Valve Diseases; Mitral Valve Insufficiency; Heart; Dysfunction Postoperative, Cardiac Surgery; Heart; Disease, Mitral(Valve); Diseases of Mitral Valve

Summary: surgical treatment is the only approach with potentially defined clinical success for organic mitral valve (mv) regurgitation. recurrent or persistent complaints after initial successful mv repair is a clinical challenge in current practice. especially when echo parameters at rest are within or near normal ranges and patients presenting disproportionately symptomatic in relation to the observed results. however, while mv regurgitation is a hemodynamic disease, currently used 2-dimensional (2d) transthoracic echocardiography (tte) at rest lacks information about hemodynamic changes. physical stress echocardiography is a promising technique to complement nowadays rest tte in order to improve interpretation of hemodynamic changes. however, normal values for exercise echo are lacking in this postoperative patients cohort. a prospective, observational trial to determine normal values in stress echocardiographic parameters in asymptomatic patients after successful mv repair for organic mv regurgitation, is therefore highly needed. purpose of the sep- study is to determine normal values in stress echocardiographic parameters in asymptomatic patients at least 6 months after successful mv repair for organic mv regurgitation. these normal values for stress echo are of utmost importance to correctly and accurate interpret stress echo results during postoperative follow-up and to improve clinical decision making in patients post mv repair.


Eligibility criteria:
inclusion criteria: * age ≥18 years; * male or female from all ethnicities; * at least 6 months post successful, isolated mv repair. s * asymptomatic exclusion criteria: * pulmonary hypertension \>50 mmhg at rest; * atrial fibrillation (af) at time of study related stress echo test; * known contraindication or incapability to perform peak exercise or inability to perform physical stress testing; * lvef \<45%; * nyha class ii and more. * other heart valve disease of more than mild severity; * concomitant surgery during mv repair, e.g. maze, tvp procedure; * prior heart valve surgery; * congenital heart disease; * disabling comorbidity, e.g. chronic obstructive pulmonary disease (copd); * unable to provide informed consent
us guided erector spinae plane block in breast cancer surgery: analgesia, spread and immunomodulation

Conditions: Analgesia; Breast Cancer

Summary: prospective interventional study

the aim of the present study is to evaluate the effect of us guided unilateral espb using different volumes of local anaesthetics on analgesic efficacy, dermatomal spread and immunomodulation in breast cancer surgery. the primary outcome is the analgesic efficacy of the different local anaesthetic volumes of espb. the secondary outcomes are the dermatomal dye spread and sensory coverage, immunomodulation and complications in breast cancer surgery. immunomodulation will be assessed by measuring natural killer cells cytotoxicity.

Eligibility criteria:
inclusion criteria:asa physical status 1 or 2 scheduled for mastectomy under the effect of general anaesthesia - exclusion criteria: 1. patient refusal. 2. allergy or contraindication to any of the studied medications or anaesthetic agents. 3. chronic opioid analgesic use. 4. pregnancy. 5. morbid obesity (bmi ≥ 40 kg/m2). 6. scoliosis or any vertebral anomalies or previous spinal surgeries. 7. infection at the site of injection or any other contraindication for regional anaesthesia. 8. duration of surgery more than 90 minutes. 9. renal impairment.

Keywords: erector spinae plane block ultrasound guided breast cancer surgery natural killer cells analgesia spread
effect of spinal or sevoflurane anesthesia on neutrophil activation during knee surgery with pneumatic tourniquet

Conditions: Knee Surgery With Tourniquet

Summary: aim of study : assessement of neutrophil activation during ischemia reperfusion associated with tourniquet use for total knee arthroplasty. this activation was compared in a group of patient scheduled for spinal anesthesia and for sevoflurane anesthesia

aim of study : assessement of neutrophil activation during ischemia reperfusion associated with tourniquet use for total knee arthroplasty. this activation was compared in a group of patient scheduled for spinal anesthesia and for sevoflurane anesthesia this activation was assessed by plasma myeloperoxidase and elastase measurements in four consecutive blood samples during and after surgery (before surgical incision and 1, 3, 24 hours following tourniquet release.

Eligibility criteria:
inclusion criteria: * total knee arthroplasty under spinal or sevoflurane anesthesia exclusion criteria: * american society of anesthesiologists class 3 and 4 * vascular disease of the lower limbs * cardiac or respiratory disease * immune disorder

Keywords: total knee arthroplasty tourniquet sevoflurane spinal anesthesia myeloperoxidase elastase neutrophil
herbal tea in the treatment of type 2 diabetes mellitus

Conditions: Type 2 Diabetes Mellitus

Summary: diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. it has become a major healthcare problem in india. high-quality, low-cost solutions adapted to the local context are critical to addressing the current crisis in the management of diabetes. herbal tea consists of tulsi, guava and stevia, which has glucose lowering properties.the aim of this trial is to study the effect of a herbal tea in the glycemic response in the early type 2 diabetes.


Eligibility criteria:
inclusion criteria: adults aged over 18 years and having a diagnosis of diabetes and meeting one of the following criteria 1. fasting plasma glucose ≥126 mg/dl, fasting defined as no caloric intake for at least 8 hours, and 2. 2-h post load glucose ≥140 mg/dl during an ogtt. and 3. glycosylated haemoglobin (a1c) ≥ 6.5 %. exclusion criteria: any one of the following 1. patients on insulin therapy. 2. patients on oral hypoglycemic agents other than metformin 3. any history suggestive of micro vascular or macro vascular disease - coronary artery disease, stroke, peripheral artery disease or diabetes related retinal changes. 4. women in child bearing age unable to practice any form of contraception 5. patients with diagnosis of anaemia (hemoglobin \<11 g/dl in female and \<13 g/dl in male) 6. impaired renal function; estimated glomerular function \<60mls/min/1.73m2. 7. known history of any chronic illness taking regular pharmacological agents. 8. blood pressure fluctuations exceeding 20 mmhg on 2 subsequent clinic visits or known history of hypotension or bradycardia in last 6 months or taking 3 or more antihypertensive medications regularly in the last 6 weeks 9. known history of autonomic dysfunction like diabetic autonomic neural imbalance or neuropathy 10. participating in another clinical trial with an active intervention or drug or device with last dose taken within 60 days.

Keywords: herbal tea diabetes
dose finding study of str-324

Conditions: Pain, Acute

Summary: this study aims to evaluate the analgesic effect and the safety of 4 doses of str-324 administered as an infusion, with or without initial bolus, to patients suffering from post-operative pain. the sensitivity of the pain model used in the trial will be evaluated with a standard group treated with morphine under the usual care conditions.

the first step (single-blind standard group) aims to verify the sensitivity of the study pain model in the proposed surgery to confirm the validity of the surgery according to their pain and enrolment rate. 12 patients are planned to be enrolled. the second step (dose-finding study) is a randomized, double-blind, parallel groups, controlled clinical trial involving a total of 106 patients divided into two groups in which patients will be randomized between str-324 and morphine hcl: * group 1: titration initiated with a bolus * group 2: titration without initial bolus.

Eligibility criteria:
selection criteria: 1. patient aged ≥18 to \<65 years old, at screening; 2. having signed an informed consent prior to any study-related procedure; 3. patients planned to undergo a major laparoscopic abdominal or pelvic surgery; 4. surgery to be performed without local or regional anaesthesia nor infiltration; 5. body mass index (bmi) between 18 and 30 kg/m² inclusive at screening, and with a minimum weight of 50 kg; 6. women of childbearing potential must agree to use at least one effective contraceptive method upon enrolment and for 1 cycle following the last dose of the investigational product. inclusion criteria: the criteria for definitive enrolment must be checked in the post-anaesthesia care unit (pacu) at the inclusion visit: 1. nrs-measured pain intensity ranging from 4 to 8 inclusive at baseline pacu measurement; 2. with a sedation score ≤ s1 (awake or intermittently sleepy) at the time of pain assessment. exclusion criteria: 1. patient contra-indicated for morphine administration; 2. unstable or poorly controlled psychiatric condition (e.g., untreated ptsd, major anxiety, or depression). subjects who take stable doses (same dose \>30 days) of antidepressants and/or anti-anxiety drugs may be included; 3. women who are pregnant or breastfeeding; 4. history of alcohol, opiate or other drug abuse. 5. evidence of any active or chronic disease or condition that could interfere with, or for which the treatment might interfere with the conduct of the study, or that would pose an unacceptable risk to the subject in the opinion of the investigator. minor deviations of values from the normal range may be accepted, if judged by the investigator to have no clinical relevance; 6. clinically significant abnormalities, as judged by the investigator, in laboratory test results; 7. participation in an investigational drug or device study within 1 month prior to dosing.
novel thermal imaging technique for breast screening

Conditions: Breast Cancer

Summary: this trial is to study a new breast imaging tool called thermalytix™. thermalytixtm is a new radiation-free, automated breast cancer screening technique that uses artificial intelligence (ai) over thermal images. thermal images are heat signatures in our body. this new technique will capture heat signatures in the breast and analyze those images with ai software. this study will evaluate the performance of thermalytixtm breast imaging against standard imaging modalities, such as mammography and ultrasound.


Eligibility criteria:
inclusion criteria: * be capable of understanding the investigational nature of the study and all pertinent aspects of the study * be capable of signing and providing written consent in accordance with institutional and federal guidelines * be willing and able to comply with scheduled visits, treatment plan, and follow up with research staff * age ≥ 21 years * cohort specific criteria * cohort 1: be scheduled for biopsy * cohort 2: had a normal screening mammogram within 3 months of study enrollment * cohort 3: be scheduled for diagnostic mammogram * cohort 4: history of breast cancer, s/p lumpectomy and be scheduled for routine mammogram exclusion criteria: * cohort specific criteria * cohort 1: previous biopsies in the same or opposite breast within 3 months of study enrollment, prior history of breast cancer, prior history of breast surgeries including implants * cohort 2: prior history of breast surgeries including implants * cohort 3: already underwent a biopsy in the same or opposite breast within 3 months of study enrollment, prior history of breast cancer, prior history of breast surgeries including implants * cohort 4: surgery \<1 year, h/o mastectomy with reconstruction * unable to complete study related procedures

Keywords: breast cancer thermal imaging artificial intelligence breast imaging
dose-escalation study of bibh 1 in patients with non-small cell lung cancer scheduled for surgical resection

Conditions: Lung Neoplasms

Summary: study to assess the toxicity, pharmacokinetics, biodistribution and imaging characteristics associated with increasing doses of 131i-bibh 1, to compare the uptake of 131i-bibh 1 in tumour to that of normal tissue in patients with non-small cell lung cancer and to measure human anti-human antibody (haha) concentrations.


Eligibility criteria:
inclusion criteria: * histologically confirmed primary or secondary advanced non-small cell lung cancer * eligible for a lung biopsy or scheduled for surgery that would provide biopsy material * karnofsky performance status of ≥ 70 * expected survival of ≥ 3 months * greater than or equal to 18 years of age * absolute granulocyte count ≥ 2.5 x 10\*\*9/l * lymphocyte count \> 0.7 x 10\*\*9/l * platelet count ≥ 100 x 10\*\*9/l * serum creatinine ≤ 2.0 mg/dl (0.20 mmol/l) * alanine aminotransferase/aspartate aminotransferase (alt/ast) ≤ 3x upper limit of normal * total bilirubin \< 2 mg/dl or 34µmol (si unit equivalent) * ability to provide written informed consent exclusion criteria: * active metastatic disease to the central nervous system, exhibited by new or enlarging lesions on ct or mri scan or within 3 months of treatment (i.e., surgery or radiotherapy) for brain metastases * exposure to an investigational agent within four weeks of the bibh 1 infusion * patients that are not fully recovered from surgery. because of the potential binding of bibh 1 to healing scars, patients with incomplete healing at an incision site, as evidenced by incomplete granulation, infection or localized edema are excluded * chemotherapy or immunotherapy within four weeks preceding entry (six weeks for nitrsoureas and/or mitomycin-c.) * previous administration of a murine, chimeric or humanised measurement and/or antibody fragment * serious illness: e.g., active infections requiring antibiotics, bleeding disorders or diseases considered by the investigator to have potential for interfering with obtaining accurate results from this study * women who are breast-feeding or pregnant * men and women of childbearing potential who are unwilling to utilize a medically acceptable method of contraception * previous participation in this study * patients who have autoimmune disease or hypertopic skin conditions that possibly over-express fibroblast activation protein and may be targeted by the antibody. these diseases include active inflammatory arthritis, cirrhosis and keloids. * patients with unstable angina pectoris. patients prescribed medication to control their angina pectoris must be on a fixed dose for at least 1 month prior to screening to be eligible for the trial. * patients who experienced a myocardial infarction within 3 months of screening.
ureteral stent size measurement study

Conditions: Quality of Life

Summary: to examine a patient's quality of life using three methods for measuring stent size: (a) direct measurement, (b) patient height, and (c) a standardized formula. the intent of the study is to show if there is a difference in a patient's quality of life, postoperative symptoms, pain medication and anticholinergic use by using one of these specific methods for stent size determination. no method is interventional in this study.

ureteral stent placement is common in urologic practice and many studies have been done looking at factors to improve stent related symptoms, but few have used a validated questionnaire to assess these symptoms affect on quality of life.we plan to prospectively randomize patients to three separate techniques such as (a) direct measurement,(b) patient height, and (c) a standardized formula for the determination of stent size. using a validated questionnaire, the ureteral stent symptoms questionnaire (ussq), we will assess whether there is a difference in outcome measures such as patient quality of life, need for pain medications and anticholinergics, and in postoperative symptoms based on one of these techniques. the ussq was developed by joshi et al to assess the impact of health-related quality of life issues related to ureteral stents. data from ussq questionnaire will be collected 7-10 days post-operatively as well as 4 weeks post-op and then this will be aggregated for our outcome measures to determine which method of stent size give better outcomes.

Eligibility criteria:
inclusion criteria: * all patients presenting to charleston area medical center between the ages of 18 and 90 years old who will undergo cytoscopy or ureteroscopy with ureteral stent placement will be eligible for the study. exclusion criteria: * patients excluded from this study will be those who are less than 18 years of age, pregnant women, and patients who are septic on presentation, as well as patients who have had lower extremity amputations or are wheelchair bound.

Keywords: ureteric measurement
a prospective study of different digoxin treatment regimens in egyptian hospital

Conditions: Atrial Fibrillation

Summary: digoxin is the primary cardiac glycoside in clinical use. because of the narrow therapeutic index and risk of toxicity, therapeutic drug monitoring is highly recommended. in egypt, most cardiologists give digoxin holiday for both atrial fibrillation and heart failure, it is not clear if the interrupted digoxin regimens are effective since serum digoxin concentrations might fall below the therapeutic range. objective: to evaluate and compare the digoxin serum concentration and patient's quality of life in the continuous versus interrupted digoxin dosing regimens.

digoxin is a cardiac glycoside prescribed in heart failure and certain supraventricular tachyarrhythmias. it exerts a positive inotropic, neurohormonal, and electro physiologic actions on the heart . for heart failure patients, the targeted steady state serum digoxin level is between 0.5 and 0.8 ng/ml . ventricular rate control in atrial fibrillation patients will usually require higher digoxin steady state serum concentrations . however, serum digoxin level higher than 2 ng/ml is associated with increased incidence of adverse drug reactions and should be avoided . because of inter and intra-patient variability, narrow therapeutic index, and risk of toxicity, digoxin doses are calculated based on the patient weight, renal status, indications and drug interactions. due to substantial overlap between therapeutic and toxic levels of digoxin, therapeutic drug monitoring is a must especially in patients with deteriorating renal function and electrolyte disturbance. in egypt, most cardiologists give a digoxin holiday for patients with atrial fibrillation and /or heart failure where patients skip the drug doses on thursday and friday or friday only every week to avoid possible drug accumulation and toxicity. it is not clear if these interrupted digoxin regimens really offer safer alternative over the continuous dosing regimens without compromising the effectiveness. it is anticipated that plasma digoxin levels may fall below the therapeutic range during the holiday which may affect patient clinical status and quality of life.

Eligibility criteria:
inclusion criteria: * patients with atrial fibrillation (af) * with or without congestive heart failure (chf) * taking digoxin tablets with or without holiday regimens exclusion criteria: * taking the following drugs concurrently: amiodarone, verapamil, quinidine and propafenone. * diagnosed with thyroid disorders (hyperthyroidism \& hypothyroidism). * diagnosed with renal failure * pregnant
alfuzosin hydrochloride to promote passage of distal ureteral calculi

Conditions: Kidney Calculi; Ureteral Calculi; Colic

Summary: this study will assess improvement in the percentage of spontaneous stone passage for distal ureteral calculi for alfuzosin compared to placebo, decrease of pain and narcotic/analgesic use associated with stone passage, decrease of the time to spontaneous stone passage, shift in the size distribution of stones passed towards larger sizes.


Eligibility criteria:
inclusion criteria: * age =\>18 * \<8mm ureteral calculus below the pelvic brim identified by non-contrast ct scan and/or intravenous pyelogram exclusion criteria: * subject with know hypersensitivity to alfuzosin hydrochloride or any component of alfuzosin hydrochloride tablets * pregnant/nursing females * solitary kidney * renal insufficiency (creatinine\>1.8) * urinary infection (fever \>101, positive urine culture, many bacteria on urinalysis) * moderate or severe hepatic insufficiency (childs-pugh categories b and c) * potent cyp3a4 inhibitors such as ketoconazole, itraconazole, and ritonavir, since alfuzosin blood levels are increased * other alpha-blockers * phosphodiesterase type 5 inhibitors for erectile dysfunction * any subject for whom the principal investigator feels it would not be in his or her best interest to participate in the study