Kornimate/medical-research-clean huggingface dataset:
dmso for prevention of capsular contraction in alloplastic breast reconstruction

Conditions: Breast Capsular Contracture; Dimethyl Sulfoxide

Summary: capsular contraction is the one of the most common complications of both esthetic and reconstructive breast surgery, with high incidence after radiotherapy. the mechanism of the contraction is unclear, but is believed to be similar to the formation of hypertrophic scarring. dimethyl sulfoxide (dmso) has demonstrated its use as an anti-inflammatory, anti-proliferative, and antibacterial agent. the aim of this study is to test the effect of dmso on the incidence and severity if capsular contracture after breast alloplastic reconstruction in irradiated patients. we conduct a prospective randomized-control single-surgeon study in the tertiary academic rabin medical center. 110 female candidates for mastectomy, radiotherapy and immediate two-stage reconstruction will be included. they will be divided into two groups: the dmso treatment group, which will be treated according to our protocol, and the control group, that will be treated with the same protocol but with 0.9% saline instead. several measures will be taken, including: capsular contracture grading by two plastic surgeons, a vas-score of breast pain, maximal capsular thickness (mct) in sonography evaluation, and pathology examination of the capsule (biopsy will be taken during the second stage operation). rates and grades of capsular contracture evident clinically, radiologically and pathologically, will be evaluated and compared.


Eligibility criteria:
inclusion criteria: * female candidates for mastectomy, radiotherapy and immediate two-stage reconstruction exclusion criteria: * autologous reconstruction * single-stage alloplastic reconstruction * intake of steroids, anti-inflammatory, anti-coagulate or immunomodulatory medications on a regular basis * low compliance to home treatment or follow-ups.

Keywords: breast capsular contructure dimethyl sulfoxide radiotherapy breast reconstruction
family and personal history of malignancy in intraductal papillary mucinous neoplasm (ipmn)

Conditions: Pancreatic Cancer; Neoplasm

Summary: this is a retrospective observational study to determine the proportion of patients with a family history of pancreatic cancer and other malignancies among patients who have intraductal papillary mucinous neoplasm (ipmn). the investigators will be reviewing the demographic, clinical, radiologic, pathologic, and follow-up information from the pancres center database. the investigators will also conduct a chart review to collect information recorded by clinicians on each subject's family history of malignancy and personal history of malignancy. results of this database and chart review will be incorporated into a datasheet in which all patient identifiers have been removed. the primary outcome will be the percentage of ipmn patients with at least one first-degree relative with pancreatic cancer or ipmn, or at least two first or second degree relatives with pancreatic cancer, ipmn, or malignancies related to pancreatic cancer syndromes, including colorectal, gastric, breast, ovarian, and melanoma neoplasms. secondary outcomes will be the relative risk of ipmn subtypes of higher malignant potential (main duct or mixed type location), more advanced histology (carcinoma in situ or invasive carcinoma), and recurrence following surgical resection amongst subjects with a family history.

intraductal papillary mucinous neoplasm (ipmn) is a cyst-like cancer of the pancreas that is increasingly being identified in medical practice, including during the screening of individuals at high risk of pancreatic cancer. it has been established that 10 to 20% of pancreatic cancers are familial. in comparison, there has been little research into the importance of genetic risk in ipmn incidence. the investigators will perform a retrospective chart review of patients with ipmn who were evaluated for surgical intervention at our tertiary referral center. the investigators are interested in determining the proportion of ipmn patients with a family history of pancreatic and other cancers. in addition, the investigators will assess if familial cancer risk is associated with increased risk for malignant ipmn and recurrence, relative to those patients without an inherited predisposition.

Eligibility criteria:
inclusion criteria: * tissue-confirmed diagnosis of intraductal papillary mucinous neoplasm or imaging suspicious for ipmn * seen in consultation for ipmn at columbia-presbyterian medical center between 2002 and 2008 exclusion criteria: * not meeting the inclusion criteria.

Keywords: pancreatic cancer family history pre-cancerous lesion intraductal papillary mucinous neoplasm (ipmn) intraductal papillary mucinous neoplasm
endometrial cancer and robotic-assisted versus traditional laparoscopy

Conditions: Endometrium Cancer

Summary: the aim of this study is to compare the robotic-assisted laparoscopic surgery to the traditional laparoscopic surgery in endometrial cancer patients. the study is prospective and the patients are randomised into two groups of 50 patients each. randomisation is done with minim-programme and patients age and body mass index are taken into account. the primary endpoint is the operation time. the number of patients in this study is based on the non-inferiority design. presumption is that the operation time in robotic-assisted laparoscopy will be 25% longer. secondary endpoints include: 1. bleeding 2. complications 3. conversions 4. number of pelvic lymph nodes


Eligibility criteria:
inclusion criteria: * endometrial cancer operations, which means hysterectomy, bilateral salphingo-oophorectomy and pelvic lymphadenectomy * gr 1 and 2 differentiation type exclusion criteria: * the operation cannot be made with an laparoscopy operation * age more than 85 years or young under 30 years patient

Keywords: endometrium cancer robotic-assisted laparoscopy traditional laparoscopy laparoscopic surgery treatment operation time bleeding complications conversions pelvic lymph node
photoacoustic imaging of the ovary

Conditions: Ovarian Cancer

Summary: the purpose of this study is to develop technology to image the ovaries in order to better evaluate ovarian disease and to study how these experimental imaging techniques might work together or separately to improve our ability to detect ovarian cancer.

epithelial ovarian cancer causes the highest mortality of any of the gynecologic cancers although it is the second most common gynecologic malignancy. ovarian cancer is not usually detected earlier than stage iii or iv because it is usually asymptomatic; yet survival is high with early stage disease. in addition, women with a pelvic mass noted on ultrasound that undergo oophorectomy have only a 1-3% risk of malignancy and thus 97-99% will be overtreated because of our inability to reliably differentiate benign from malignant masses with ultrasound. brca1 testing and family history will identify certain high-risk individuals who have a higher risk of malignancy and need a modality that will be more reliable in detecting early cancers to provide more accurate surveillance.we are developing a new transvaginal imaging device optimized for ovarian cancer detection, diagnosis and validated from ex vivo and in vivo clinical studies. this automated system may provide an early diagnostic tool for ovarian cancer in the future.

Eligibility criteria:
inclusion criteria: * all patients, twenty one years or older, referred to the university of connecticut for conditions necessitating oophorectomy. * patients cannot be pregnant or wish to become pregnant. * willingness to participate in the study. exclusion criteria: * all subjects who fail to meet the inclusion criteria are ineligible for the study.

Keywords: ovarian cancer epithelial ovarian cancer
lidocaine spray for pain control in rib fractures

Conditions: Rib Fractures; Analgesia

Summary: in this study, we aimed to compare the analgesic efficacy of lidocaine spray with tramadol hydrochloride and fentanyl citrate in rib fractures.

patients over the age of 18 who came to our emergency department with blunt chest trauma were divided into three groups. groups was created from patients who were given lidocaine 10% spray (local), i.v. 100 mg of tramadol and i.v. fentanyl 50 mcg. a total of 48 patients, each of whom were 16, were included in the study. numerical rating scale (nrs) pain scores of the patients at baseline, 15th, 30th and 60th minutes were compared. these scores and the amount of falls at follow-up were analyzed comparatively between the 3 groups.

Eligibility criteria:
inclusion criteria: * open conscious * oriented and cooperative * blunt thoracic trauma and rib fracture * numerical rating scale (nrs) was 5 or higher exclusion criteria: * patients who refused to participate in the study * detected or suspected pregnancy * known history of allergy or other adverse reaction to the drugs used in the study * history of sedative drug use or drug addiction * analgesic use within 6 hours of admission to the emergency department * needed emergency tube thoracostomy or surgical intervention * hemodynamically unstable * open and/or infected wounds in the fracture area

Keywords: analgesia fentanyl lidocaine spray rib fracture tramadol
repetitive transcranial magnetic stimulation with h-coil in parkinson's disease (rtms-pd)

Conditions: Parkinson Disease

Summary: focal repetitive transcranial magnetic stimulation (rtms) has been applied to improve symptoms in parkinson disease (pd) with conflicting results. however, the stimulation with h-coil has been shown to stimulate a wider cortical area compared with the standard coils, with preliminary results confirming the potential efficacy of the treatment. in this study the investigators aimed to explore the safety and efficacy of excitatory rtms with h-coil on pd motor symptoms.

this was a double-blind, placebo-controlled study, with a 1:1:1 randomization into three groups: group 1 - real rtms over primary motor cortex and prefrontal cortex (m1-pfc): group 2 - real rtms over m1 and sham rtms over pfc; group 3 - sham stimulation over both targets

Eligibility criteria:
inclusion criteria: * male or female subjects aged ≤80 years * diagnosis of parkinson's disease according to uk brain bank criteria * hoehn and yahr (hy) scale ii-iv * stable anti-depressive and anti-parkinsonian therapy for at least two months prior to enrollment * subjects who answered all questions in the tms pre-treatment safety questionnaire in a negative manner. * have given written informed consent exclusion criteria: * presence of an additional neurological or psychiatric pathology * severe personality disorder * uncontrolled hypertension. * history of epilepsy, seizures, febrile convulsions. * history of epilepsy or seizures in first degree relatives. * history of head injury or stroke. * presence of metal prostheses in the head (except dental fillings). * metal implants or known history of any metal particles in the eye, cardiac pacemakers, cochlear implants, use of neurostimulators or medical pumps. * history of migraine within the past six months. * history of drug or alcohol abuse. * impossibility of adequate communication with the examiner. * participation in another clinical study, either concomitant or within the previous 3 months. * inability to sign the consent form.
developing artificial intelligence-based algorism to predict side effects and symptoms from chemotherapy

Conditions: Lung Cancer; Head and Neck Cancer; Esophageal Cancer

Summary: in this study, the investigators obtain wearable disease based biomarkers from patients diagnosed with cancer and undergoing chemotherapy, and simultaneously measure patient self-reported adverse events through an app to evaluate chemotherapy completion rates, emergency room visits, and frequency of ctcae adverse events. the investigators will develop an artificial intelligence-based algorism that can predict patients' side effects based on biomarkers alone.

in this study, patients diagnosed with lung, head and neck, and esophageal cancers and undergoing chemotherapy will be measured for self-reported side effects using a wearable device to collect biomarkers through an app, and the association between patient quality of life and side effects and biomarkers obtained from the wearable device will be analyzed. on the other hand, blood (edta 3cc) for pharmacogenomics testing will be tested once at any point during the study period as an indicator associated with side effects after chemotherapy.

Eligibility criteria:
inclusion criteria: * 20 years of age or older * must have diagnosed with lung, head and neck, or esophageal cancer, 1. scheduled to receive their first treatment in preoperative or postoperative chemotherapy. 2. scheduled for systemic chemotherapy due to recurrence or metastasis. * eastern cooperative oncology (ecog) performance status of 0 to 2. * patients who have access to a smartphone and can use the mobile app on their own. * understand the purpose of the study and agree to participate in the study. exclusion criteria: * patients who, in the judgment of the researcher, have difficulty using the application. * patients who are judged by the medical staff to be unable to participate in the study.
comparison of fluid resuscitation in pediatric burn patients using crystalloids and with albumin on day two.

Conditions: Burns

Summary: the goal of this comparative, interventional randomized controlled trial is to use albumin during resuscitation in pediatric burn patients on day 2, as it can reduce extravasation of fluids and decrease the overall fluid requirements, along with mortality and maintain circulation. participants will be divided into 2 groups. albumin will be administered additionally in group a, while only crystalloids will be used for resuscitation in group b.

the randomized controlled trial will be done at department of pediatric surgery, mayo hospital lahore from january 2022 to december 2022. ninety patients (forty-five patients in each group) will be enrolled using a non probability convenient sampling technique. patients will be randomly divided into 2 groups. albumin solution will be administered in group a and in group b only routine crystalloids will be given. basic demographic information will be noted. effect modifiers (hemoglobin, albumin level, weight and height) will be noted. group a: after first 24 hours, maintenance fluid, n/2+5%dextrose solution will be started according to weight(100ml/kg/day for first 10kg, 50ml/kg/day for next 10kg and 20ml/kg/day for the remainder) and will be increased or decreased by 1/3 to maintain the urinary output to 1-1.5ml/kg/hour. 12, 75 5% albumin solution will be administered @0.5ml/kg/%burn over initial 8 hours of day 2 and it's amount will be subtracted from the 24 hours fluid calculated earlier. group b: after first 24 hours, maintenance fluid, n/2+5%dextrose solution will be started according to weight (100ml/kg/day for first 10kg, 50ml/kg/day for next 10kg and 20ml/kg/day for the remainder) and will be increased or decreased by 1/3 to maintain the urinary output to 1-1.5ml/kg/hour.

Eligibility criteria:
inclusion criteria: * 25-40%, less than 12 hours old, scald or flame burn patients * full thickness exclusion criteria: * burns with inhalational injury. * patients hypersensitive to albumin. * deranged renal or hepatic profile. * patients with known cardiac or debilitating congenital anomalies. * patients with known metabolic disease. * burns associated with trauma including fractures, head injuries, intra-abdominal bleed etc. * albumin level lower than 1.8g/dl at time of admission.

Keywords: albumin resuscitation pediatric burns fluid creep shock crystalloids
optimizing pulsatility during cardiopulmonary bypass to reduce acute kidney injury

Conditions: Acute Kidney Injury; Hemolysis; Thrombocytopenia; Surgery

Summary: the objective is to determine the effectiveness of pulsatile flow during cardiopulmonary bypass to reduce the incidence of acute kidney injury after cardiac surgery. investigators will also evaluate the safety and impact of pulsatile flow on clinical outcomes compared to non-pulsatile flow during cardiopulmonary bypass.

non-pulsatile and pulsatile blood flow during cardiopulmonary bypass for cardiac surgery are both considered standard of care and allow surgeons to operate on the heart without movement. pulsatile cardiopulmonary bypass produces variations in blood flow to produce a pulse similar to a normal beating heart. non-pulsatile and pulsatile blood flow during cardiopulmonary bypass are approved as safe and effective ways to provide perfusion during cardiac surgery, but it is unknown whether there are differences in clinical outcomes after surgery. acute kidney injury is common after cardiac surgery and may be caused by inadequate perfusion during cardiopulmonary bypass. specific aim: the purpose of this study is to determine the effectiveness of pulsatile blood flow during cardiopulmonary bypass to reduce the incidence of acute kidney injury after cardiac surgery compared to non-pulsatile blood flow. hypothesis: pulsatile blood flow during cardiopulmonary bypass will reduce the incidence of acute kidney injury after cardiac surgery compared to non-pulsatile blood flow.

Eligibility criteria:
inclusion criteria: * able to provide informed consent * scheduled for elective cardiac surgery with cardiopulmonary bypass exclusion criteria * emergency procedures * scheduled for heart or lung transplantation * scheduled for ventricular assist device implantation * use of the medtronic elongated once-piece arterial cannula * diagnosed with sepsis * diagnosed with delirium * experiencing hemodynamic instability (heart rate \> 100 and systolic blood pressure \< 90) * requiring mechanical circulatory support * requiring vasoactive medications
deep brain stimulation of nac/alic to prevent treatment-refractory obsessive compulsive disorder

Conditions: Obsessive Compulsive Disorder

Summary: nucleus accumbens/anterior limb of internal capsule play important roles in the process of treatment-refractory obsessive compulsive disorder, deep brain stimulation of nucleus accumbens/anterior limb of internal capsule will inhibit its activity and thus to effectively prevent the disorder.

obsessive-compulsive disorder (ocd) is characterized by obsessions (persistent thoughts) and compulsions (repetitive ritualistic behaviour). core symptoms of ocd cause remarkable distress and often perceived as inappropriate. the prevalence of ocd in the general population is estimated between 1% and 3%. it is a psychiatric illness that can lead to chronic functional impairment. treatment options for ocd include cognitive behavioural therapy (cbt) and/or pharmacotherapy. even when the best treatment options are used, approximately 10% of these patients remain severely affected and are considered therapy-refractory resulting in marked suffering and impairment in self-care, work and social life. more recently, deep brain stimulation (dbs) has been investigated as a therapy for refractory ocd, and the procedure was granted a limited humanitarian device exemption by the fda in 2009. for these patients, deep brain stimulation (dbs), a neurosurgical treatment that involves stereotactic implantation of electrodes in specific deep-seated brain regions, has emerged as a new treatment option.

Eligibility criteria:
inclusion criteria: 1. diagnosis of ocd following the diagnostic and statistical manual of mental disorders-fourth edition (dsm-iv) criteria for ocd; 2. duration of illness: min. 5 year; 3. 18 years old \<age \<60 years old; 4. severe form of ocd, as evidenced by: a score≥25 on the y-bocs, a score \> 4 on the cgi scale, a score≤40 on the gaf ("global assessment of functioning). 5. all patients were lack of response to drug therapy after adequate administration (defined as more than 12 weeks at the maximum tolerated dose) of at least four different medications, lack of response to cbt (cognitive behaviour therapy)over the course of 1 year of therapy or after 20 sessions. 6. normal cognitive status and ability to understand and comply with instructions for multiple therapies. 7. good overall health. exclusion criteria: 1. present or past history of psychotic symptoms. 2. severe personality disorders; 3. any clinically significant neurological disorder or medical illnesses affect ; 4. brain function, other than motor tics or gilles de la tourette syndrome; 5. patient currently treated with anticoagulant or antiplatelet drug; 6. patient with contraindication for surgery or anesthesia; 7. inability to undergo awaked operation; 8. infection, coagulopathy, significant cardiac or other medical risk factors for surgery; 9. patient with contraindication for mri scanning (cardiac pacemaker, pregnancy, metal in body, severe claustrophobia), abnormal brain mri or serious inter current disease

Keywords: obsessive compulsive disorder deep brain stimulation nucleus accumbens
phenol neurolysis of genicular nerves for chronic knee pain

Conditions: Pain, Chronic

Summary: chronic knee pain from osteoarthritis (oa) is commonly treated with total knee arthroplasty (tka) when conservative therapies fail to provide pain relief. more than 600,000 tkas are performed in the u.s. annually, a number that continues to increase. a logistic-regression model suggests that the incidence rate of tka will increase by 143% in the united states by 2050 compared to 2012. although tka is successful in reducing knee pain and joint stiffness in most cases, it can be associated with a 7-35% incidence of persistent refractory post-surgical knee pain. aim: to determine whether chemical neurolysis of the genicular nerves with 6% aqueous phenol is non-inferior in reducing knee pain as compared to corticosteroid injection of the genicular nerves, in patients with refractory chronic knee pain for more than 6 months after total knee replacement. hypothesis: chemical neurolysis of genicular nerves with phenol will provide equal or superior pain relief than corticosteroid genicular nerve injections at 3 months, as measured by the oxford knee score.


Eligibility criteria:
inclusion criteria: * ages 40-95 years * patients with knee pain, on average \> 4 (nrs) persisting more than 6 months after tka * willingness to undergo image guided diagnostic nerve block and the study intervention exclusion criteria: * pain score (nrs) \< 4 at time of study enrollment * conditions that preclude the diagnostic block or the study intervention (e.g., irreversible coagulopathy or bleeding disorder, allergic reaction/contraindication to local anesthetic, contrast dye, steroids, and/or phenol, pregnancy, severe or uncontrolled medical illness). * evidence of indolent infection of the knee prosthesis (elevated c-reactive protein assessed when clinically indicated) * inability to write, speak, or read in english * pregnancy

Keywords: total knee arthroplasty chronic pain