Kornimate/medical-research-clean huggingface dataset:
neoadjuvant chemotherapy versus surgery alone for esophageal squamous cell carcinoma

Conditions: Esophageal Neoplasm

Summary: the effect of neo-adjuvant chemotherapy on survival of patients with thoracic esophageal squamous cell carcinomas remains the most controversial part of neo-adjuvant therapy for esophageal carcinomas. one of our objectives is to evaluate whether the neo-adjuvant therapy with cisplatin and paclitaxel followed by right thoracic approach esophagectomy with total 2-field lymph node dissection improves the overall survival of thoracic esophageal cancer patients.

the effect of neo-adjuvant chemotherapy on survival of patients with thoracic esophageal squamous cell carcinomas remains the most controversial part of neo-adjuvant therapy for esophageal carcinomas. therefore, the optimal management of resectable esophageal squamous cell carcinomas differs widely among different areas based on local randomized controlled trials. the neo-adjuvant chemotherapy might be a good strategy if sufficient local control is achieved by surgical treatment. this study defined the detail of surgery procedure and the region of lymphadenectomy and adopted cisplatin and paclitaxel as neoadjuvant chemotherapy regimens. we try to evaluate the efficacy and safety of this neo-adjuvant strategy.

Eligibility criteria:
inclusion criteria: 1. histologic diagnosis of squamous cell thoracic esophageal carcinoma of stage iia to iiib, (7th union for international cancer control, uicc-tnm). 2. patients must not have received any prior anticancer therapy of esophageal carcinoma. 3. age ranges from 18 to 75 years. 4. without operative contraindication. 5. absolute white blood cells count ≥4.0×109/l, neutrophil ≥1.5×109/l, platelets ≥100.0×109/l, hemoglobin ≥90g/l, and normal functions of liver and kidney, total bilirubin（tbil）≤1.5n, aspartate aminotransferase (ast)≤2.5n, alanine aminotransferase(alt)≤2.5n, prothrombin time(pt)≤1.5n, and activated partial thromboplastin time(aptt) is in normal range, endogenous creatinine clearance rate(cre)≤1.5n. 6. patients must not have diagnosed with other cancer and must not received any prior anticancer therapy except prostatic cancer with more than 5 years disease-free survival(dfs). 7. expected r0 resection. 8. ecog 0～2. 9. signed informed consent document on file. 10.no metastatic lymph node in cervical by color doppler sonography. exclusion criteria: 1. multiple primary cancer. 2. the subject cannot understand and sign the informed consent form(icf). 3. patients with concomitant hemorrhagic disease. 4. any un expected reason for patients can't get operation. 5. inability to use gastric conduit after esophagectomy because of a prior surgery. 6. pregnant or breast feeding. 7. patients are diagnosed or suspected to be allergic to cisplatin or paclitaxel.
oral cancer awareness in egypt

Conditions: Oral Cancer

Summary: oral cancer is a fatal disease with high prevalence and poor survival rate. most oral cancer cases can be detected by the patients themselves. so, when a patient is aware of oral caner, the patient would realize its signs and symptom and seek early medical care; therefore, improving the prognosis. to our knowledge, the level of awareness of oral cancer has not been investigated in egyptian population. therefore, this study is planned to be a pilot study as a first study in egypt.

cancer of the oral cavity is considered a global health burden. according to globocan report of 2012, the incidence of oral cancer in egypt was 1,687 per 10,000 per annum; while the mortality was 659 per 10,000 per annum. statistically, the rates are expected to increase as to reach 2,658 per 10,000 incidence and 1,069 per 10,000 mortality by the year 2030. fortunately, 85% of head and neck cancers are visible. therefore, the patient does not always need to visit a specialist for a special test to check for oral cancer. instead, if the patients have basic knowledge about oral cancer, its signs and symptoms and its risk factors, they can detect the change themselves. as a first step to reach this amazing goal, the level of awareness of the general population needs to be detected. to the best of our knowledge, the awareness of oral cancer has not been assessed in the general population of egypt before. as awareness of oral cancer is mandatory for dental practitioners, our study targets the general population other than those working in the dentistry field.

Eligibility criteria:
inclusion criteria: * adult individuals (age\>18 years). exclusion criteria: * dental students or dental practitioners; as awareness of the disease is an integral part of their profession. * oral cancer patients: individuals who experience currently or previously having oral cancer. * individuals with mental or communication disabilities.
study of calcium plus vitamin d supplementation in prevention of colorectal adenomas recurrence

Conditions: Colorectal Adenoma

Summary: calcium plus vitamin d may be effective in the prevention of colorectal adenoma recurrence. the aim of this study is to investigate the effect of supplementation with calcium plus vitamin d on the recurrence of colorectal adenomas.

colorectal adenomas are well-known to be precancerous lesions that develop into colorectal cancers on the basis of the adenoma-carcinoma sequence. the effects of screening for colorectal adenomas and removing precancerous lesions on the prevention of colorectal cancer have been established. because of the high recurrence rates of colorectal adenomas in patients who have undergone polypectomy, the potential chemopreventive agents that may reduce the risk of colorectal adenoma recurrence need to be investigated. since laboratory and epidemiologic evidence suggests that calcium or vitamin d may help prevent colorectal adenomas, we conduct a randomized, placebo-controlled, prospective clinical trial to study the effect and safety of calcium plus vitamin d supplementation in prevention of colorectal adenomas recurrence.

Eligibility criteria:
inclusion criteria: * individuals aged 18-65years * individuals who had at least one histologically confirmed colorectal adenoma removed within three months before recruitment * individuals without a history of familial polyposis * those who voluntarily sign the consent form after being fully informed and understanding the purpose and procedures of the study , characters of the disease, effect of medications, methods of related examinations, and potential risk/benefits of the study exclusion criteria: * patients who are hypersensitive or intolerant to the drugs * patients who are intolerant to another colonoscopy examination * patients with hypercalcemia or urolithiasis * pregnant women, women during breast-feeding period, or women with expect pregnancy * patients with diabetes mellitus, severe heart or renal disease, or cancer history * patients with a history of subtotal gastrectomy or partial bowel resection * patients who are not able to cooperate * individual who are involved in designing, planning or performing this clinical trial * patients with medical conditions who are not appropriate to participate the study * patients who are taking aspirin, nsaids or cox2 inhibitors * patients who are taking folic acid or butyrate. * patients with ibd
progressive relaxation exercise on dyspnea, pain and sleep quality

Conditions: Cancer

Summary: this study was planned to examine the effect of progressive relaxation exercises applied to lung cancer patients receiving chemotherapy on dyspnea, pain and sleep quality.

it is thought that relaxation exercises reduce respiratory distress and improve sleep quality in lung cancer patients.

Eligibility criteria:
inclusion criteria: * be between the ages of 18-65 * ability to communicate adequately * absence of psychiatric problems * those who are determined by the physician that they do not have a physical disability in exercising * volunteering to participate in the research * individuals who have the ability to use technological tools * patients with at least 3 cures exclusion criteria: * individuals with phones that do not have voice recording capabilities * individuals with phones that do not have the ability to install whatsapp

Keywords: cancer patients pain sleep quality progressive relaxation exercise
pilot to examine risk and feasibility of remote management of bp from ckd through esrd

Conditions: Chronic Kidney Disease; Bloodpressure; Hypertension

Summary: the transition from chronic kidney disease (ckd) to end-stage renal disease esrd is a vulnerable and challenging period of time for patients and providers. suboptimal control of blood pressure is known to be common in patients with the advanced stages of ckd, and may contribute to their elevated risk of progression to esrd, cardiovascular morbidity, and mortality. this proposal is a pilot randomized controlled trial designed to test whether intensive home blood pressure lowering is feasible and safe in patients with advanced ckd as they transition to esrd.

the transition from advanced chronic kidney disease (ckd), when estimated glomerular filtration rate (egfr) is \<=30 ml/min/1.73m2, to end-stage renal disease (esrd) represents a vulnerable period, when multiple physiologic and psychosocial changes occur as patients prepare for either dialysis or kidney transplant. this study is a pilot randomized controlled trial to test the safety and feasibility of studying strict versus usual bp control in a population of patients with advanced ckd (egfr \<=30 ml/min/1.73m2), including those with diabetes. for this pilot study, we will randomize 120 patients with advanced ckd who have elevated bp to either a home sbp target of \<120 mm hg (intervention group) versus usual care (130-140 mmhg).

Eligibility criteria:
inclusion criteria: adults ≥16 years of age who meet the egfr eligibility criteria, which will be determined based on whether participants have 1. at least two egfr in the last three months that are \<=30 ml/min/1.73m2 or 2. prior diagnosis of ckd (per electronic chart review) and at least one egfr \<=30 ml/min/1.73m2 3. history of hypertension 4. mid-arm circumference between 22-37cm (bp cuff size limitation) and be able to provide consent to participate in our study. exclusion criteria those who: * are or are planning to become pregnant, due to inability to take multiple classes of anti-hypertensive agents * are marginally housed, due to concerns regarding routine follow-up * are actively participating in a different interventional trial that may affect blood pressure * are unwilling to consent to participate * institutionalized individuals or prisoners * are actively abusing illicit drugs or alcohol * have a history of poor or doubtful compliance (e.g., frequently missed appointments) * have office sbp \>170 mmhg * are already taking \>5 anti-hypertensive medications (any classes, including diuretics) have cognitive impairment prohibiting participation in the study.
laparoscopic vs ultrasound-guided transversus abdominis plane block vs laparoscopic intraperitoneal instillation of local anesthetic in pediatrics

Conditions: Laparoscopic; Ultrasound; Transversus Abdominis Plane Block; Laparoscopic Intraperitoneal Instillation; Pediatrics; Inguinal Hernia Repair

Summary: the aim of this study is to compare laparoscopic -assisted, ultrasound-guided transversus abdominis plane block and laparoscopic intraperitoneal instillation of local anesthetic in pediatrics undergoing inguinal hernia repair.

inguinal hernia is one of the most common pediatric surgeries. effective and safe pain management causes fewer side effects and enables faster hospital discharge. it is also important in overcoming chronic pain in the late postoperative period. transversus abdominis plane block (tapb) has emerged as a safe, simple, and inexpensive modality incorporated into many enhanced recovery pathways to achieve narcotic-sparing analgesia after bariatric surgery. tapb was first performed through the lumbar triangle of petit in 2001. since that time, both ultrasound-guided (us) and laparoscopic (lap) tapbs have been developed to aid in proper identification of the correct plane and minimize peritoneal penetration.

Eligibility criteria:
inclusion criteria: * age: 2 months to 7 years old * both sexes. * american society of anesthesiologists (asa) i-ii. * schedule for elective unilateral inguinal hernia repair. exclusion criteria: * patients with history of allergy. * hepatic and renal failure. * previous inguinal surgery. * block contraindications (e.g., infection at the site of block, bleeding disorder, or abnormalities of the sacrum).
micardis® in patients with essential hypertension

Conditions: Hypertension

Summary: the aim of this observational study was to supplement the data on efficacy, safety, and tolerability of telmisartan under daily conditions in hospitals


Eligibility criteria:
inclusion criteria: * patients with essential hypertension * minimum age of 18 years exclusion criteria: not applicable
study describing cognitive processing speed changes in relapsing multiple sclerosis subjects treated with ozanimod (rpc-1063)

Conditions: Multiple Sclerosis

Summary: this is a multicenter, longitudinal, single-arm, open-label study to describe the change from baseline in cognitive processing speed, measured by the sdmt, in subjects with rms treated with ozanimod hcl 1 mg at 3 years. all subjects will receive orally administered ozanimod hcl 1 mg. the primary efficacy endpoint is the proportion of subjects with a clinically meaningful increase in raw score of ≥ 4 points or 10% from baseline (improved). the treatment period is 36 months. for all subjects who finish the subject and for those who discontinue, there will be a 30-day (± 15 days) and a 90-day (± 10 days) safety follow-up visit. there is no planned protocol extension following the end of the study. approximately 250 subjects with rms will be recruited for this study. subjects with rms will be enrolled in this study if they have received ≤ 1 dmt, have an edss ≤ 3.5, and have been diagnosed with rms within 5 years of study entry. the investigator will be responsible for the overall conduct of the study at the site, confirmation of subject eligibility, routine study subject clinical management including for ms relapses, and management of aes.


Eligibility criteria:
inclusion criteria: below are some criteria for inclusion. additional inclusion criteria apply. 1. subject must understand and voluntarily sign an informed consent form (icf) prior to any study-related assessments/procedures being conducted. 2. subject is willing and able to adhere to the study visit schedule and other protocol requirements. 3. subject is male or female 18 to 65 years of age (inclusive) at the time of signing of the icf. 4. subject has a diagnosis of ms according to the 2010 or 2017 revised mcdonald criteria. 5. subjects has ≤ 5 years since time of rms diagnosis. 6. subject has ≤ 1 approved rms dmt at time of study entry. exclusion criteria: following are some criteria that would exclude the subject from participation. additional exclusion criteria apply. exclusions related to general health 1. subject has any clinically relevant hepatic, neurological, pulmonary, ophthalmological, endocrine, psychiatric, or other major systemic disease making implementation of the protocol or interpretation of the study difficult or that would put the subject at risk by participating in the study. subjects with mild or moderate asthma, and subjects with other mild pulmonary disease (eg, chronic obstructive pulmonary disease \[copd\]) may be included in the study. 2. subject has a presence of other neurologic disorders to explain the progressive neurologic disability (as defined in the key inclusion criteria) or that might affect cognition. 3. subject has a visual or other sensorimotor impairment likely to confound test performance. 4. subject has a presence of \> 10 gde lesions on the baseline brain mri scan. 5. subject has a history of developmental disorder (eg, attention-deficit/hyperactivity disorder \[adhd\], learning disability).

Keywords: multiple sclerosis rpc-1063 ozanimod phase 3b
integrated traditional chinese and clinical medicine for chronic hepatitis b and its complication

Conditions: Hepatic Encephalopathy; Cirrhosis, Liver; Portosystemic Shunt

Summary: hepatic encephalopathy is the most common complication after tips, and hepatic encephalopathy occurs in almost all portosystemic shunts. for patients with severe upper gastrointestinal bleeding or refractory ascites in the decompensated chronic hepatitis b, transjugular intrahepatic portosystemic shunt (tips) is a very effective treatment. however, due to the severe complications such as hepatic encephalopathy after tips, the clinical application of tips is limited. literature studies have shown that the incidence of encephalopathy after tips is about 35%. tips reduces the portal vena blood flow into the liver by establishing a new channel. but at the same time, the toxic substances from the gastrointestinal tract and other organs do not enter the liver to detoxify, and are more likely to enter the brain, leading to hepatic encephalopathy. moreover, studies have found that the liver and the intestine originate from the same germ layer and are closely related to each other in anatomy and function. there are a large number of microorganisms living in the intestinal tract. normally, the intestinal tract, as the first defense of the human body, can effectively prevent bacteria and their products from entering the bloodstream. in cirrhosis and portal hypertension, blood return disorder causes intestinal damage. a series of microbes and product endotoxins such as gram-negative bacteria will enter the blood through the injury, and the toxins in the peripheral blood will enter the brain and cause hepatic encephalopathy happened. the research team's early treatment plan with integrated traditional chinese and western medicine proved that it greatly reduced the incidence of hepatic encephalopathy after tips. and improve the clinical symptoms and signs of patients with liver cirrhosis, and improve the quality of life and survival of patients.


Eligibility criteria:
inclusion criteria: * tips treatment criteria in line with the 2017 edition of the "expert consensus on transjugular intrahepatic portosystemic shunt" were selected to include patients with hepatitis b cirrhosis and child-pugh grade a and b after tips surgery. * patients with liver cirrhosis, portal hypertension, bleeding from esophagus and gastric varices; refractory pleural and ascites due to liver cirrhosis; incomplete portal vein/localized thrombosis in liver cirrhosis or primary and secondary prevention of cirrhosis, portal hypertension, esophagus and gastric varices bleeding. exclusion criteria: * severe blood coagulation disorder (pta≤20%) or platelets lower than 30×109/l; * child-pugh classification of liver function c; * those with respiratory and circulatory dysfunction; * those whose systemic or focal infections have not been effectively controlled; * patients with moderate to severe malnutrition; * extensive primary or metastatic liver malignant tumors; * those who are highly allergic to the products and drugs used in the treatment process.
shock wave therapy plus exercise in gtps

Conditions: Greater Trochanteric Pain Syndrome of Both Lower Limbs

Summary: the aim of this randomized controlled study is to investigate if the sequential administration of focused shock wave therapy and of a rehabilitation program based on the strengthening of gluteal muscles is more effective than a standard shock wave treatment for greater trochanteric pain syndrome


Eligibility criteria:
inclusion criteria: * unilateral hip pain of four weeks or longer duration * pain to palpation in the greater trochanteric area at physical examination * pain in hip end-range abduction/rotation/adduction at physical examination * gluteal tendinopathy, in absence of full thickness tears at a sonographic examination of the gluteal tendons * adult age and written informed consent exclusion criteria: * no hip osteoarthritis, diagnosed according to altman's criteria * no history of knee osteoarthritis * no history of rheumatologic diseases * no previous fractures or surgery in the affected limb * no clinical signs of lumbar radiculopathy at physical examination * no corticosteroid injections, since the onset of the current pain episode * no general contraindication to shock wave therapy (pregnancy, bleeding disorders or anticoagulant drug usage, cancer in the focal area)
levosimendan versus dobutamine for renal function in heart failure

Conditions: Cardiorenal Syndrome

Summary: although inotropes have a favorable effect on central hemodynamics in patients with heart failure, their effect on renal hemodynamics is incompletely defined. the purpose of this study is to evaluate the efficacy of a 75 min intravenous infusion of levosimendan compared to a 75 min infusion of dobutamine on renal hemodynamics and function in patients with chronic heart failure and signs of cardiorenal syndrome. the investigators hypothesis is that patients treated with levosimendan will show greater increases in renal blood flow and glomerular filtration rate (gfr) than those treated with dobutamine.


Eligibility criteria:
inclusion criteria: * written, signed and dated informed consent * male and female subjects ≥18 years of age * chronic congestive heart failure scheduled for right sided cardiac catheterization * left ventricular ejection fraction ≤ 40% determined by echocardiography * elevation of n terminal-probnp ≥ 500 ng/l * cardiorenal syndrome (30ml/min ≤ estimated gfr ≤ 80 ml/min (mdrd) exclusion criteria: * acute heart failure, untreated * systolic blood pressure \< 80 mmhg * tachycardia above 100 bpm * angina canadian cardiovascular society (ccs) class iii or higher * aortic stenosis * hypertrophic cardiomyopathy * restrictive cardiomyopathy * the presence of kidney disease diagnosed before heart failure * administration of radiographic contrast \< 1 week * radiographic contrast allergy * in the investigator's opinion, the patient has a clinically significant disease that could be adversely affected by study participation

Keywords: heart failure renal failure inotropic drugs levosimendan dobutamine