Kornimate/medical-research-clean huggingface dataset:
anorectal application of 5% lidocaine cream reduces pain prior to periprostatic nerve block during transrectal ultrasound guided biopsy

Conditions: Pain; Prostate Cancer; Rectal/Anal

Summary: transrectal ultrasound guided prostate biopsy is performed with a periprostatic nerve block to the neurovascular bundle bilaterally. this does not reduce the pain due to probe insertion and manipulation prior to nerve blockage. our study goal is to assess whether topical analgesia would reduce pain during the early stages of the procedure.

prospective, randomized controlled study. patients signed an informed consent form. exclusion criteria were lidocaine allergy or pre-planned general anesthesia. patients were randomized into 6 groups: (1) nerve block with 5 ml 1% lidocaine for each neurovascular bundle + perianal topical application of 10 ml 5% lidocaine cream; (2) as in (1) plus application of 10 ml 5% lidocaine cream evenly on rectal walls. for each approach exposure times of 5, 10 and 20 minutes were allowed, all together 6 groups plus a control group of patients who received periprostatic nerve block only. a 0-10 visual analogue scale (vas) was filled by the patients at 5 time points: immediately after probe insertion, during probe manipulation and prostate assessment, immediately following neurovascular bundle nerve blockage, after prostate biopsies and a global pain estimation of the procedure.

Eligibility criteria:
inclusion criteria: * males referred to trusgbx due to elevated prostate specific antigen (psa) * abnormal findings on digital rectal examination (dre) * repeat biopsies as part of active surveillance (as) * continuously elevated psa levels despite prior negative for malignancy biopsies * previous histological findings of significant hgpin were enrolled exclusion criteria: * known sensitivity to lidocaine * pre-planned biopsy under general anesthesia
viral and host factors in the transmission and pathogenesis of hiv

Conditions: HIV Infections

Summary: to study the collection of blood from individuals known to be at high risk for hiv-infection or who have been recently infected with hiv. the data collected are used for diagnostic, prognostic and management decisions as outlined by current hiv-1 treatment guidelines.

this phlebotomy protocol permits the collection of blood from individuals known to be at high risk for hiv-infection or who have been recently infected with hiv. participants will have from 10 to 60 ml (approximately 1 to 4 tablespoons) of blood drawn for one or all of the following tests: * t cell subset enumeration * serologic reactivity with hiv antigens * viral load assays by bdna, pcr, or rt-pcr * routine laboratory assessments (chemistries, liver function tests, hepatitis serology, rpr) * hiv-1 resistance testing these data are used for diagnostic, prognostic and management decisions as outlined by current hiv-1 treatment guidelines

Eligibility criteria:
inclusion criteria: recently infected with hiv-1 hiv-1 negative, and at high risk for infection exclusion criteria: none

Keywords: hiv infection acute hiv infection primary hiv infection acute seroconversion syndrome
prone positioning in covid-19 patients

Conditions: Coronavirus Disease 2019; ARDS; Mechanical Ventilation Pressure High

Summary: prone positioning improves oxygenation in patients with ards (1-3). patients with severe ards due to covid-19 are candidates for prone position. it should be started within 36-48 h and maintained 1, 3). prone ventilationards based on a randomized trial that showed a mortality benefit (proseva) (3). the improvement of oxygenation occurs by making ventilation more homogeneous, limiting ventilator-associated lung injury (4-6). prone positioning was as effective in improving oxygenation, static respiratory system compliance (crs) (7). higher peep should be applied when there is a high recruitability potential of the lung. this study aimed to investigate whether prone positioning changes the recruitability position of the lung.in covid-ards.

prone positioning improves oxygenation in patients with ards (1-3). patients with severe ards due to covid-19 are candidates for prone position. it should be started within 36-48 h and maintained 1, 3). prone ventilationards based on a randomized trial that showed a mortality benefit (proseva) (3). the improvement of oxygenation occurs by making ventilation more homogeneous, limiting ventilator-associated lung injury (4-6). prone positioning was as effective in improving oxygenation, static respiratory system compliance (crs) (7).higher peep should be applied when there is a high recruitability potential of the lung. this study aimed to investigate whether prone positioning changes the oxygenation, respiratory mechanics and recruitability position of the lung in covid-ards.

Eligibility criteria:
inclusion criteria: * adult patients with laboratory-confirmed covid-19 admitted to the icu * the patients receive invasive mechanical ventilation and meet the criteria for ards (berlin definition) (8), with under continuous infusion of sedatives, exclusion criteria: * pregnancy * pneumothorax and or chest tube * chronic obstructive lung disease * interstitial lung disease * intraabdominal hypertension * increase in intracranial blood pressure * haemodynamic unstability requiring vasopressors
evaluation of an oral care programme for head and neck cancer patients

Conditions: Head and Neck Cancer

Summary: this study will evaluate the effect of an intensified oral care programme on prevalence, severity and duration of mucositis in patients undergoing treatment for cancer in the head and neck region. patients in the control group get professional oral care once a week.

this study will evaluate the effect of an oral care programme on prevalence, severity and duration of mucositis in patients undergoing treatment for cancer in the head and neck region. the oral care programme consists of professional oral care and swabbing of the mucosal membranes with a saline/bicarbonate solution once a week. the patients are instructed to rinse with a saline/bicarbonate solution 5 times per day. they are given an oral care diary to help them keep track of their daily oral hygiene measures and rinses. repeated oral hygiene instructions are given if needed. patients in the control group get professional oral care once a week.

Eligibility criteria:
inclusion criteria: * patients scheduled to receive full dose of curative rt including major salivary glands in the radiation field exclusion criteria: * patients with recurrent cancer * patients with severe cognitive impairment.
forevr peds vr pilot

Conditions: Pain, Postoperative; Pain; Anxiety

Summary: to determine the feasibility and acceptability of using immersive virtual reality technologies to impact clinical outcomes (e.g., pain and anxiety) and medication utilization (e.g., narcotics) in pediatric patients with acute and chronic pain.


Eligibility criteria:
inclusion criteria: * ages 7to 21 years * able to read, understand, and speak english * patients in the immediate postoperative period with significant pain being followed by the acute pain service (acute postoperative pain cohort); patients presenting in same day surgery for peripheral iv placement or patients in the cbdi clinic presenting for peripheral iv placement or port accessing (vascular access cohort); or patients admitted to cchmc on the medical pain service (chronic pain cohort), or sickle cell patients not on the mps list. * patients who have undergone bone marrow transplantation or receiving chemotherapy experiencing pain from mucositis exclusion criteria: * outside the age range (\ 21 years) * history of developmental delays, uncontrolled psychiatric conditions, or neurological conditions (especially epilepsy and/or significant motion sickness/nausea/vomiting) * history of vertigo, dizziness, and/or seizure disorder * conditions that would preclude the application of the vr glasses, such as surgeries of the head and neck
loop diuretic dosage in patients with acute heart failure and renal failure: conventional versus carbohydrate antigen 125-guided therapy (improve-hf)

Conditions: Heart Failure

Summary: worsening renal function (wrf) is a frequent finding in patients with decompensated acute heart failure (ahf) and it is associated to increased length of hospitalization and higher morbidity and mortality. traditionally, wrf in ahf setting has been attributed to low cardiac output, but recent evidence also suggests venous congestion play a crucial role. loop diuretics are the mainstay treatment of ahf, but their use traditionally has been associated to wrf, but also renal function improvement in patients with unequivocal signs of congestion. nevertheless, traditional symptoms or signs of patients with ahf have shown a limited accuracy to neither identify nor quantify the degree of venous congestion. recent authors have reported that plasma levels of antigen carbohydrate 125 (ca125) are closely related to the degree of venous congestion. the investigators hypothesize that ca125 may have a role for identifying the hyperhydrated (high ca125) patients that need high loop diuretic doses, and those with normal ca125 values needing low loop diuretic doses. in this randomized study (1:1) the investigators seek to evaluate whether a ca125 loop diuretic guided management therapy is superior to a standard strategy. the primary endpoint is the magnitude of changes of renal function at 24 and 72 hours after initiation of intravenous diuretic in an acute worsening of heart failure


Eligibility criteria:
inclusion criteria: patients with the diagnosis of acute heart failure (ahf) and the concurrence of the following conditions: 1. presence of symptoms (dyspnea at rest or minimal exertion) and signs attributable to congestion (signs of congestion on chest radiography, or presence of peripheral edema or ascites, or jugular venous distension at 45 degrees or presence of crackles on auscultation). 2. elevated natriuretic peptide (nt-probnp\> 1000 pg/ml or bnp\> 100 mg/dl). 3. creatinine ≥1,4 mg/dl on admission, provided that the estimated glomerular filtration rate less than 60 ml / min / m2. 4. intent to be treated with loop diuretics intravenously. exclusion criteria: 1. life expectancy less than 6 months of life due to other comorbid conditions. 2. cardiogenic shock. 3. diagnosis of acute coronary syndrome in the previous 30 days. 4. pregnancy at the time of inclusion. 5. restrictive or obstructive pulmonary disease or severe degree. 6. chronic renal insufficiency in stage v (estimated glomerular filtration rate \<15 ml / min / m2) or patient previously included in known dialysis program. 7. participation in another clinical trial randomized at the time of inclusion. 8. temperature ≥38 ° c or diagnosis of pneumonia.

Keywords: heart failure renal failure biomarker guided-therapy loop diuretics carbohydrate antigen 125
open label trial of fluoxetine for the treatment of depression in patients with end stage renal disease

Conditions: Depression

Summary: the purpose of this study is to test whether once-weekly prozac therapy leads to reduction in depression in patients requiring kidney dialysis.

once-weekly prozac is a psychiatric medicine, approved by the fda for the use in treatment of psychiatric disorders. this study will test whether once-weekly prozac leads to reduced symptoms of depression. patients requiring dialysis often report symptoms of depression either due to the presence of major depression, a relatively common psychiatric disorder, or due to depression secondary to kidney failure.

Eligibility criteria:
inclusion criteria: * diagnosis of chronic renal failure and end stage renal disease * ongoing need for regular dialysis treatment * diagnosis of depression based on dsmiv * age tween 19-65 years exclusion criteria: * inability to provide informed consent * medically or psychiatrically unstable, as defined by requiring inpatient treatment * pregnancy, nursing or refusal to use a reliable method of birth control in women * patients with known allergy to fluoxetine, or previous treatment failure of fluoxetine

Keywords: depression chronic renal failures end stage renal disease
effects of eldoa versus meckenzie exercise on non-specific low back pain patients

Conditions: Low Back Pain

Summary: to determine the effects of eldoa and mckenzie exercises in posture. to determine the effects of eldoa and mckenzie exercises in rom.

to determine the effects of eldoa and mckenzie exercises in pain. to determine the effects of eldoa and mckenzie exercises in quality of life.

Eligibility criteria:
inclusion criteria: * gender (female) * age (40-69) * nprs (grade \<3) * chronic pain (more than or equal to 3 months) * restricted rom * lumbar straightening exclusion criteria: * any other orthopedic or neurological condition of hip or lumbar spine. * sign and symptoms of lower motor neuron disease. * current use of medication prescribed for pain. * radiculopathy. * malignancy. * fracture. * lumbar trauma. * disc pathology
comparison of bone morphogenetic protein-4 (bmp-4) and 7 levels between control and polycystic ovarian syndrome (pcos) patients.

Conditions: Polycystic Ovarian Syndrome

Summary: the investigators aim to compare the levels of bone morphogenetic protein-4 and -7 (bmp-4 and 7) in blood, follicular fluid and ovarian organ culture supernatant obtained from healthy subjects and polycystic ovarian syndrome (pcos) patients.

female patients at ages 20-35 diagnosed with polycystic ovarian syndrome and age-matched healthy control subjects will be enrolled in this study. blood samples will be obtained at early follicular phase during doctor's visit from pcos patients and control subjects.if the patient is amenorrheic at the time of visit, both random blood samples and another sample at early follicular phase after induction of withdrawal bleeding with progesterone. follicular fluids will be retrieved during oocyte pick-up procedure in patients undergoing assisted reproduction for pcos and control ivf patients whose infertility is not pco related. samples from ovaries will be collected at operation from pcos patients and control subjects if they already undergo any gynecologic laparotomi operations. collected samples will be cultured for 7 days and bmp-4 and -7 levels will be measured in the culture fluid of the samples using elisa method.

Eligibility criteria:
inclusion criteria: * healthy subjects and pcos patients at ages 20-35 will be recruited for the study. exclusion criteria: * those with any metabolic or endocrine problems other than pcos will be excluded from the study.

Keywords: bmp- 4 and 7, polycystic ovarian syndrome
the efficacy and safety of precision repetitive transcranial magnetic stimulation in alleviating motor symptom in parkinson's disease

Conditions: Parkinson Disease; Transcranial Magenetic Stimualtion; Supplementary Motor Area

Summary: repetitive transcranial magnetic stimulation (rtms) is a non-invasive and widely used neuromodulation technology. small sample studies have shown that rtms treatment can significantly improve the symptoms of parkinson's disease(pd) and delay the progression of the disease. in order to further explore the effectiveness of rtms in the treatment of pd and lay the foundation for its clinical promotion, our research team plans to conduct a randomized double-blind controlled study of rtms in the treatment of pd in multiple centers across the country.

this is a multi-center, double-blind, randomized controlled study that will be implemented in multiple hospital centers in china. in this study, the supplementary motor area (sma) of the dominant hemisphere was selected as the stimulation target, and continuous theta burst stimulation (ctbs) sequence contact stimulation was used for a course of continuous stimulation for 7 days to observe the changes in clinical symptoms before and after the intervention.

Eligibility criteria:
inclusion criteria: 1. age ≥ 40 years old; 2. meet the diagnostic criteria for idiopathic parkinson's disease (mds diagnostic criteria for parkinson's disease (2015 edition))\[1\]; 3. have no history of drug adjustment within 4 weeks before treatment and the entire study period; 4. the mds-updrs ⅲ score ≥8, and the hoehn-yahr rating is 1-4; 5. mmse ≥22，able to cooperate with the completion of behavioral tests and transcranial magnetic stimulation therapy. exclusion criteria: 1. previously head mri/ct was focal brain injury or severe leukoencephalopathy (fazekas grade 3 and above); 2. various secondary parkinsonism syndromes (vascular parkinsonism, parkinsonism combined with parkinsonism, drug parkinsonism, etc.); 3. severe craniocerebral trauma, received craniocerebral surgery or deep brain stimulation treatment; 4. there are ferromagnetic implants in the body, such as cochlear implants, cardiac pacemakers, etc. 5. the person has a history of epilepsy, unexplained loss of consciousness, or are taking anticonvulsant drugs to treat epileptic seizures; 6. diagnosed with a neuropsychiatric disorder other than pd 7. have a history of drug abuse or drug use; 8. participants in any clinical trial within the previous 6 month; 9. pregnant/lactating women or subjects (including men) who have a birth plan within 6 months; 10. other conditions deemed unsuitable for inclusion by the investigator.

Keywords: parkinson disease transcranial magenetic stimualtion supplementary motor area
interest of the addition of docetaxel to standard treatment in first-line advanced her2 positive gastroesophageal adenocarcinoma in selective patients

Conditions: HER2-positive Gastric Cancer; Metastatic Cancer; Docetaxel; Trastuzumab

Summary: the purpose of this retrospective study is to evaluate the efficacy and the safety of trastuzumab + chemotherapies with or without taxanes among her2-positive advanced gastroesophageal adenocarcinoma patients.

studies have reported a beneficial role of trastuzumab combined to platin-5-fu based chemotherapy in first-line advanced her2 positive gastroesophageal adenocarcinoma. however, the effect of taxanes combined with platin-5fu + trastuzumab (tpft) is understudied. in this context, the aim of this study is to evaluate the efficacy and the safety of trastuzumab + chemotherapies with or without taxanes among her2-positive advanced gastroesophageal adenocarcinoma patients.

Eligibility criteria:
inclusion criteria: * histologically confirmed non-resectable locally advanced, recurrent, or metastatic adenocarcinoma of the stomach or gastro-esophageal junction; * tumor samples scored as 3+ on immunohistochemistry or fish (fluorescence in situ hybridization) positive (her2:cep17 ratio ≥2); * measurable disease; * treated by trastuzumab, platin (cisplatine or oxaliplatine), fluoropyrimidine (5-fu or capecitabine) +/- taxanes (docetaxel or paclitaxel), * as first-line therapy for advanced gastric cancer. exclusion criteria: * previous chemotherapy by taxane for metastatic disease, * previous anti-her2 therapy.

Keywords: docetaxel trastuzumab advanced her2 positive gastroesophageal adenocarcinoma
soy and isoflavones effect on bone

Conditions: Osteoporosis

Summary: the purpose of this study is to test the effect of 1 year of added dietary soy protein and/or soy isoflavones on bone mineral density in late postmenopausal women.

although soy foods contain several components (isoflavones and amino acids) that could potentially have positive effects on bone health, there are few long term, large, clinical trials using soy as a means of improving bone mineral density. the objective of this study is to provide daily soy protein and isoflavones to healthy older women in order to answer three major questions: 1. does soy protein alone affect bone metabolism? 2. do isoflavones, given with soy protein, affect bone metabolism? 3. what dose of isoflavones affects bone in older women? we hypothesize that soy protein will have a beneficial effect on bone in older women compared to control protein. further, we hypothesize that there will be an additional benefit to bone in women who receive soy protein plus isoflavones (at both doses) compared to soy protein alone. both control and soy proteins used in the study were isolates, meaning they were the highest concentration of protein (85-90% by weight) in order to minimize the volume of protein supplement that each woman was asked to ingest on a daily basis. the soy protein was an alcohol-washed, soy protein isolate containing 90% protein and negligible isoflavone (0.2 mg/g product). the control protein was a mix consisting of 50% protein from sodium caseinate, 25% protein from whey protein and 25% from egg white protein. the use of a mix of proteins as a control provides a more balanced level of amino acids, mimics the real life mix of proteins that humans typically consume, and avoids the unique characteristics of one source of protein. in order to maintain the dietary protein intake constant, the participant was counseled to decrease her intake of other sources of protein from primarily animal sources by approximately 3 ounces per day (the approximate equivalent of the protein powders). the isoflavones tablets each contained 57 mg of total isoflavone from primarily genistein, glycitein, and daidzein and their beta-glycosides.

Eligibility criteria:
inclusion criteria: * postmenopausal women 65 years old or older * able to travel to the clinical sites for follow-up visits exclusion criteria: * history of disease that may affect bone metabolism (including paget's disease, primary hyperparathyroidism, osteomalacia, untreated hyperthyroidism, or multiple myeloma) * cancer of any kind (except basal or squamous cell of skin) in past 5 years * use of any of the following medications within the past 2 years: calcitonin, calcitriol, heparin, phenytoin, phenobarbital * use at any time of bisphosphonates, long-term corticosteroids (over 6 months), methotrexate, or fluoride * estimated creatinine clearance less than 50 ml/min * history of chronic liver disease or evidence of liver disease on screening * history of hip fracture * known vertebral fracture within the past year * vegans

Keywords: bone density bone loss postmenopausal
single centre prospective evaluation of 68gallium-fapi pet/mri in hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma

Summary: single centre prospective evaluation of 68gallium(ga68)-fapi-46 pet/mri in patients diagnosed with hepatocellular carcinoma (hcc). 68gallium-fapi-46 pet/mri and standard contrasted multiphasic mri imaging will be acquired in patients with radiological or histological diagnosis of hcc. the pet scan results will be compared to standard imaging to evaluate its role in lesion detection, characterisation and staging in patients with hcc.


Eligibility criteria:
inclusion criteria: * age 21-99 years * diagnosis of hcc based on histological assessment, or meeting consensus radiological criteria for diagnosis of hcc based on american association for the study of liver diseases practice guidelines(18) * no prior locoregional therapy for hcc * creatinine clearance \> 30ml/min based on cockcroft gault formula * able to provide informed signed consent exclusion criteria: * allergy to 68ga-fapi contrast agents * contraindication to mri, including but not limited to mri incompatible metallic implants, cardiac pacemaker, claustrophobia * weight \> 150kg * known active malignancy other than hcc * hepatic surgery within the last 30 days. * active inflammatory conditions that may affect fapi imaging in opinion of investigator. including but not limited to active infection, igg4-related disease, inflammatory bowel disease, * pregnancy (all women of childbearing age are required to undertake a urine pregnancy test)

Keywords: hepatocellular carcinoma 68ga-fapi-46 pet/mri