Kornimate/medical-research-clean huggingface dataset:
ultrasound- guided continuous retro laminar block versus continuous erector spinae plane block in multiple rib fractures

Conditions: Retrolaminar Block; Erector Spinae Plane Block; Spirometry; Pain; Multiple Rib Fractures

Summary: the aim of this study is to compare the incentive spirometry volume and analgesic efficacy of ultrasound guided continuous retrolaminar block and continuous erector spinae plain block in patients with multiple rib fractures.

thoracic epidural analgesia (tea) and thoracic paravertebral block (tpvb) are strongly recommended techniques for managing thoracic neuropathic pain however, they can be technically challenging to perform and are associated with up to 15% failure rate in thoracic epidural analgesia (tea)and potential risk of pneumothorax in thoracic paravertebral block (tpvb).newer approaches have been the focus of many studies in recent years; these approaches include retrolaminar block and erector spinae plane block. retrolaminar block (rlb) is a new thoracic truncal block for controlling somatic pain in both the thoracic and abdominal walls. the erector spinae plane block (espb) has been used successfully to manage severe neuropathic pain arising from ribs .the basis to use espb is its likely site of action which is the dorsal and ventral rami of the thoracic spinal nerves.

Eligibility criteria:
inclusion criteria: * age from 18 to 65 years old. * both sexes. * patients with unilateral multiple traumatic rib fractures (≥ 3 ribs). exclusion criteria: * 1st ken refusal. * patients with any contraindication for regional block as: * bleeding disorders. * infection at the injection site. * patients with hemodynamic instability. * patients with known hypersensitivity to the study drugs * unconscious patients * patients with significant trauma outside the chest wall e.g., acute spine or pelvic fracture, severe traumatic brain or spinal cord injury, or abdominal visceral injuries * patients with significant lung contusions, pneumothorax, flail chest * chronic opioid users. * uncooperative patients and patients with psychiatric illness
the pre-operative pathway in pancreatic head malignancy-assessment of the diagnostic accuracy of staging ct scan

Conditions: Cancer of Pancreas

Summary: our aim is to assess the ability of scans to distinguish the organ of origin of pancreatic head malignant tumours and to predict the resectability based on the preoperative imaging. to achieve this, a retrospective review of the preoperative ct scans will be conducted for all patients with pancreatic head malignancy treated at the peninsula hepato-pancreatico-biliary (hpb) cancer unit between january 2006 till january 2014.

pancreatic cancer arises from the glandular part of the pancreas and is the fifth most common cause for cancer related death in the uk. it. ampullary carcinoma arises from the epithelium of the ampulla of vater into which the common bile duct and pancreatic duct drain. cholangiocarcinoma arises from the bile duct epithelium, and may occur within the intra-pancreatic portion of the distal common bile duct mimicking a pancreatic malignancy. cancers arising from these origins often cause obstructive jaundice and are hard to distinguish. surgery is indicated for the treatment of these types of malignant tumours, and the definitive final diagnosis is usually not known until the specimen is examined. this situation does not allow specific treatment to be given pre-operatively, so-called 'neo-adjuvant therapy'. the rationale for this approach is that in a proportion of patients the tumour will be made smaller by this treatment, which may facilitate surgical resection.

Eligibility criteria:
inclusion criteria: * all patients who have undergone surgery for presumed pancreatic malignancy in derriford hospital between jan 2006 and jan 14 will be included. exclusion criteria: * not applicable

Keywords: computerised tomography (ct) scan diagnostic accuracy pancreatic head malignancy
ast combined with 0.05% cyclosporin eye drop improve corneal nerve density in patients with ss dry eye

Conditions: Sjogren's Syndrome; Dry Eye; Ocular Surface Disease

Summary: the objective of the present study was to evaluate the efficacy of autologous serum tears combined with 0.05% cyclosporin eye drop in treating sjögren's syndrome dry eye and their effect on corneal nerves. we assessed the impact of 12-week ast combined with 0.05% cyclosporin eye drop treatment on signs, symptoms, and sub-basal nerve density (snd) in patients with dry eyes related to sjogren's syndrome.

objective: to describe the clinical efficacy and safety of the treatment of sjögren's syndrome dry eye using autologous serum tears combined with 0.05% cyclosporin eye drop and to evaluate their effect on corneal nerves. design: singal-center, prospective, observational study. patients and methods: thirty eyes of fifteen patients with dry eye related to sjögren syndrome were enrolled in this study. following a 4-week washout period, the treatment was inverted for each patient for the same duration and treatment. ocular surface disease index (osdi), tear film, break-up time, corneal staining with the use of fluorescein, schirmer's test and corneal confocal microscopy were investigated.

Eligibility criteria:
inclusion criteria: * patients were diagnosed with ss according to the classification criteria defined by the american-european consensus group for the diagnosis of ss and also diagnosed with severe ded based on the consensus of chinese dry eye experts. * age 18-65 years old. * controlled collagen disease by the same rheumatologists at least 3 months prior to the initiation of the trial. * at least one eye that failed to respond to previous treatments including lartificial tears, topical ocular nsaids or corticosteroids. exclusion criteria: * patients with ded related to meibomian gland dysfunction, blepharitis, abnormal blinking, conjunctival relaxation or any other diseases besides ss. * diagnosed with allergic conjunctivitis, uveitis, ocular hypertension, retinopathy and other eye diseases. * those who have a history of previous ocular oprations, eye injuries or contact lenses usage. * known hypersensitivity to experimental drugs or any of its ingredients. * necessity to modify the systemic treatment of previous diseases during the trial. * pregnancy or lactation. * severe systemic disease.

Keywords: autologous serum tears 0.05% cyclosporin eye drop cornea nerves
rct of mushroom based natural product to enhance immune response to covid-19 vaccination

Conditions: COVID-19 Vaccination

Summary: this is a randomized, double-blind, placebo-controlled clinical trial to evaluate the effect of two polypore mushrooms, fomitopsis officinalis and trametes versicolor (fotv), for use as an adjunct to vaccination for covid-19 in a general population at the time of covid-19 vaccination.

this is a randomized, double-blind, placebo-controlled clinical trial to evaluate the effect of two polypore mushrooms, fomitopsis officinalis and trametes versicolor (fotv), for use as an adjunct to vaccination for covid-19 in a general population at the time of covid-19 vaccination. fo and tv have immunomodulatory properties which may increase antibody titers in response to vaccination more than vaccination alone. however, because they are also immunomodulatory - not purely immune-stimulating - they may have the added benefit of simultaneously decreasing vaccine-related side effects following covid-19 vaccination. the study aims to establish the safety and feasibility of the use of fotv vs placebo; evaluate the effect on post-vaccination clinical symptoms, neutralizing antibody, and immune response in 45 total subjects

Eligibility criteria:
inclusion criteria: * scheduled for or planning on scheduling covid-19 vaccination * age 18 years and older * willing to avoid alcohol, cannabis, and dairy products during the study product in-take period. * capable of documenting vitals, symptoms, and study product intake daily and communicating this information to the study team exclusion criteria: * known liver disease (or diagnosis of cirrhosis) * known renal disease or acute nephritis. * pregnant or breastfeeding women
complications of cholecystostomy in acc

Conditions: Cholecystitis

Summary: acute cholecystitis (ac) is the second most frequent pathology in surgical emergencies; laparoscopic cholecystectomy (lc) is the gold standard treatment, but not all patients are fit for surgery at the diagnostic. percutaneous cholecystostomy (pc) is an alternative to lc but has high comorbidity. this study aims to analyse the complications of pc and review its indications in the literature.

it is a single-centre retrospective study of 2000 acute cholecystitis in adults from january 2011 to december 2023, including demographyc characteristics, comorbidy severity defined as charlson comorbidity index (cci), asa score, tokyo guidelines severity classification,the indicatioons for a pc and local complications of pc.

Eligibility criteria:
inclusion criteria: * all patients admited in the hospital del mar with the diagnostic of an acute cholecystitis exclusion criteria: * acute cholangitis * acute pancreatitis * neoplasia * chronic cholecystitis * patients under 18 yearls old * pregnancy

Keywords: acute choleystitis cholecystostomy tokyo guidelines non-surgical treatment mortality high-risk patient
dexketoprofen and ibuprofen in long bone fractures

Conditions: Pain; Bone Fracture

Summary: the aim of this study was to compare the efficacy of ibuprofen and dexketoprofen, two common analgesic drugs used in pain control in patients with long bone fractures.

long bone fractures are the fractures of long bones (tibia, femur, humerus) in the human body. such fractures usually occur as a result of trauma and are manifested by symptoms such as pain, swelling, bruising and limitation of movement. effective control of pain can help the patient relax and facilitate the healing process. ibuprofen and dexketoprofen, which belong to the class of non-steroidal anti-inflammatory drugs (nsaid), are among the analgesics commonly used in the pain management of all fractures. these drugs are thought to be able to relieve pain, reduce inflammation, and help patients move. however, each patient's individual response and tolerance may differ, so the efficacy and side effects of each drug may vary from patient to patient. this makes it difficult to determine which analgesic is more effective and safe in clinical practice. the fact that it is a subject that has not been done much in the literature has led us to do this study.

Eligibility criteria:
inclusion criteria: * over 18 years * patients under 80 years of age * patients who agreed to participate in the study * one of the tibia, femur and humerus bones is broken * patients with a vas score of 50 and above * patients with no other injuries requiring emergency surgery * previously known adverse reactions to the active ingredient of the drugs to be used patients with no history * conscious patients * oriented cooperative patients exclusion criteria: * patients under the age of 18 and over the age of 80 * patients who did not agree to participate in the study * patients with vital signs outside the normal limits * patients with a history of adverse reactions to known nsaids * those who cannot determine the severity of pain on the vas * patients with a vas score of 50 mm or less * those with other orthopedic injuries pregnant women * those with advanced systemic disease * those with malignancy * those with chronic liver and kidney disease * those who use neuro-psychiatric drugs with sedative and analgesic effects * those with a history of psychological and neurological diseases * patients using analgesics 8 hours before the examination

Keywords: long bone fracture ibuprofen dexketoprofen pain
a single-dose pharmacokinetics and safety study of ceftobiprole in pediatric patients =3 months to <18 years of age

Conditions: Staphylococcal Skin Infections; Streptococcal Infections

Summary: this study will assess the pharmacokinetics (how drugs are absorbed, distributed in the body and removed over time) and safety of a single dose of ceftobiprole in pediatric patients undergoing treatment with systemic antibiotics and may be used to guide dosing recommendations for ceftobiprole in children.

this purpose of this study will be to assess the pharmacokinetics (how drugs are absorbed, distributed in the body and removed over time) and safety of a single dose of ceftobiprole in pediatric patients undergoing treatment with systemic antibiotics and may be used to guide dosing recommendations for ceftobiprole in children. this study is an open-label (all patients will know the identity of the drug) single-dose, pharmacokinetic study in infants and children =3 months to \<18 years of age who are medically stable as judged by the clinical investigator and require therapy with antibiotics. patients will be given a 2-hour i.v. infusion (given directly into the vein) of 7, 10, or 15 mg/kg ceftobiprole. the study population will be grouped according to the following 4 age groups: =12 to \<18 years of age; =6 to \<12 years of age; =2 to \<6 years of age; and =3 months to \<2 years of age. every attempt will be made to include patients of both sexes in each age group. safety evaluations will include clinical laboratory tests (hematology, serum chemistry, and urinalysis), pregnancy testing, vital signs, physical examination, monitoring of adverse events, and recording of concomitant medications. patients will be given a single 2-hour i.v. (given directly into the vein) infusion of ceftobiprole. the total duration of the study is approximately 18 days, including screening and posttreatment.

Eligibility criteria:
inclusion criteria: * infants (=3 months to \<2 years of age) must have been born at =36 weeks of gestation * documented or presumed, or be at risk for, bacterial infection(s) and receiving systemic antibiotic therapy * stable medical condition exclusion criteria: * history of drug allergy or hypersensitivity to ß-lactam antibiotics such as penicillins, cephalosporins, or carbapenems * history of clinically significant cardiac arrhythmia, cystic fibrosis, chronic lung disease associated with abnormal pulmonary function, acute or chronic arthritis * history of infection with hepatitis b, hepatitis c, or human immunodeficiency virus (hiv)

Keywords: staphylococcal skin infections skin infections streptococcal infections
yoga-cbt group intervention for adolescents with chronic pain and their caregivers

Conditions: Pediatric Chronic Pain

Summary: clinical symptoms that are often found to be comorbid with pediatric chronic pain include anxiety, depression as well as increased stress, obesity, and decreased physical conditioning. integrative therapies have been increasingly offered at children's hospitals as part of an integrated approach to treatment. limited research exits on the efficacy of mind-body practices (e.g., yoga) utilized in conjunction with evidenced-based non-pharmacological treatments like cognitive behavioral therapy (cbt) to treat pediatric pain. hence, this 7-week interventional pilot study was conducted to evaluate the impact of combining yoga and cbt for both pediatric patients with chronic pain and their caregivers.


Eligibility criteria:
inclusion criteria: * established children's hospital of philadelphia (chop) patients 14-18 years old, of any gender, race, or ethnicity * english speaking * has received a diagnosis related to the primary symptom of chronic pain * for adolescents who are less than 18 y/o, parental or guardian permission (informed consent) and adolescent assent (patient) * parents or legal guardians of adolescents enrolled, who speak english * parents or legal guardians' permission (informed consent) of their own participation exclusion criteria: * current medical status or cognitive functioning precludes completing assessment instruments (e.g., cognitive or intellectual disability such as diagnosis of autism spectrum disorder) * physical limitation, handicap, or injury that would prevent participation or risk further injury or harm (e.g. physical assistance required from a device) * non-english speaking * for adolescents who are less than 18 years of age, parental or guardian permission (informed consent) and/or adolescent (patient) assent declined * patient, who in the opinion of the investigator, may be non-compliant or unable to complete the study procedures * parents or legal guardians of adolescents enrolled, who do not speak english * parents or legal guardians' permission (informed consent) for their own participation or if the adolescent is less than 18 years of age and assent has been declined * parents or legal guardians, who in the opinion of the investigator, may be non-compliant or unable to complete the study procedures (if the dyad or triad includes a primary caregiver who has a developmental delay, intellectual disability, or communication challenge that prohibits completion of questionnaires or participation in study sessions)

Keywords: pediatric pain cognitive behavioral therapy yoga
evaluation of an active surveillance protocol for prostate cancer in the brazilian population

Conditions: Prostate Cancer

Summary: in this study, the investigators aim to form a brazilian national prospective active surveillance cohort of patients with low-risk prostate cancer in the public health system. the investigators aim to demonstrate data on the pathological reclassification rate, treatment-free survival, among others. this cohort aim to evaluate and validate the active surveillance strategy in brazil.

prostate cancer is the most common malignancy in men in brazil. it is estimated that about 80% of patients diagnosed with prostate cancer have localized disease, and many of these cases have low-risk cancer. active surveillance(as) is a treatment strategy mainly for low risk prostate cancer to avoid radical treatment through periodic assessments (psa, digital rectal exam and prostatic biopsies). during this follow-up, the patient will be treated only when necessary and with curative intent. several series of institutional cohorts with long-term follow-up have demonstrated that the as strategy in selected patients is a safe alternative to immediate treatment, with comparable survival. the active surveillance strategy has never been evaluated in the brazilian population. the main outcomes from as derive from international cohorts. the brazilian population is extremely diverse, so validation in this cohort is relevant. the current study aim to form a national multicentric prospective cohort of patients with low-risk prostate cancer following an as protocol in the the public health system to evaluate and validate this strategy in brazil.

Eligibility criteria:
inclusion criteria: * pathological diagnosis of prostate adenocarcinoma; * prostate biopsy with at least 12 cores; * psa less than or equal to 10 ng/ml and clinical stage ct1/ct2a; * gleason score below or equal to 6 (3+3); * prostate multi parametric mri performed or planned * availability of pathological samples exclusion criteria: * clinical contraindication to prostatectomy and/or radiotherapy procedures; * life expectancy below 10 years, according to the charlson comorbidity index (icc); * previous treatment with hormone blockade or radical therapies. * intraductal or cribriform histology on biopsy

Keywords: active surveillance
melatonin studies of totally blind children

Conditions: Sleep Disorder; Blindness

Summary: the purpose of this study is to learn more about abnormal body rhythms in blind boys and girls that keep them from falling asleep at bed-time or cause them difficulty staying alert during the day. the investigators hope to learn if there are any differences between the body rhythms of girls and boys. the investigators also want to investigate whether age or puberty have an effect on body rhythms.

subjects will be asked to collect saliva samples in their home hourly throughout the daytime, approximately every 2 weeks. subjects may be monitored for up to a year, after which they will be discontinued from the study. if subjects are found to be naturally entrained to the 24-hour day, they will be monitored longitudinally for changes. subjects will be discontinued after their monitoring period is over or after an entrained status has been confirmed. while no specific time commitment is required, we hope most subjects will participant for 4 months - 2 years.

Eligibility criteria:
inclusion criteria: * totally blind * between 5-8 yrs or 17-20 yrs of age exclusion criteria: * pregnancy * light perception * low melatonin production * taking melatonin * co-morbid medical disorders (such as seizure disorders)

Keywords: melatonin
stratifying adult diffuse lower-grade gliomas based on their varied metabolic profiles (stradivari project)

Conditions: Lower Grade Glioma

Summary: the goal of this observational study is to better characterise lower-grade gliomas from a molecular and metabolic point of view, so to identify further subgroups of these tumours with different behaviour and, possibly, different treatment susceptibility. participants of prospective metabolic cohort will be subjected to routine treatment, part of the exceeding tutor material will be subjected to advanced molecular-metabolic analyses to desume their metabolic profile to be then correlated with clinical outcome (progression-free survival, overall survival, response to therapy/progression) and diagnosis (astrocytoma/oligodendroglioma and grade). critical enzymes identified from metabolic analyses on the first cohort will be tested on a protein level on a retrospective cohort of patients previously operated and for whom fully available clinical history and pathological material is available in institutional archive (no need for further intervention on these patients) to see if they actually correlate with clinical outcome.


Eligibility criteria:
prospective metabolic cohort: inclusion criteria: * radiological diagnosis of brain tumor compatible with lower grade glioma * full clinical history exclusion criteria: * current pregnancy or lactation * patients not able to provide informed consent retrospective cohort of ffpe samples: inclusion criteria: * confirmed diagnosis of lower grade glioma * full clinical and radiological history

Keywords: lower grade glioma metabolomics tumor heterogeneity patient stratification