Kornimate/medical-research-clean huggingface dataset:
scap vs hifu for recurrent prostate cancer after radiation therapy

Conditions: Cryotherapy; High Intensity Focused Ultrasounds; Recurrent Prostate Cancer

Summary: the evidence base relating to the use of scap and hifu is poor, with significant uncertainties relating to long-term oncological outcomes. one of the main limitations when the few studies reported are analyzed is the lack of information about the histopathology both before starting treatment and at the time of recurrence after cryotherapy. the vast majority of studies refer only to bcr-free survival as end point, thus limiting interpretation of real oncological performance of this technique. furthermore, side effects vary widely from study to study and there are uncertainties about the real morbidity associated to cryotherapy in the salvage setting. another important hot issue in this scenario is the potential benefit that new imaging and diagnosis techniques (mri, targeted biopsy, psma) may add for a more accurate indication. this could provide the possibility of better results for scap. the clinical value of this new diagnostic tools is unknown in this scenario and needs to be explored.


Eligibility criteria:
inclusion criteria: * patients with local recurrence (with histological confirmation) after treatment with radiotherapy or brachytherapy without evidence of distant involvement evaluated preferably with pet/psma (if not available then fluciclovine pet/ct or choline pet/ct must be performed). * life expectancy \>10 years * prostate volume \< 100cc * psa\<10 ng/ml * mpmri + fusion/systematic biopsy (template suppl 1) o mpmri ≤ct3a without affecting the bladder neck or the membranous urethra so that the continence mechanisms of the sphincter are not compromised. exclusion criteria: * patients with clinically confirmed distant metastasis * any previous major rectal surgery * clinically significant lower urinary tract or rectal anomalies * existing urethral, rectal, or bladder fistulae
effectiveness of small phlebotomy tubes in reducing blood transfusions in adult medical intensive care unit and intermediate care unit patients with anemia

Conditions: Anemia

Summary: the purpose of this study is to evaluate the effectiveness of small phlebotomy tubes to reduce rbc transfusions in medical intensive care unit (icu) and intermediate care unit (imu) patients with low hemoglobin compared with standard size tubes, to compare the intervention and the control groups in regards to: icu length of stay (los), icu mortality, hospital los, and hospital mortality and to assess the acceptability of small phlebotomy tubes in adult icu and imu patients.


Eligibility criteria:
inclusion criteria: * admission to the medical icu or imu. * hemoglobin less than 10 g/dl. exclusion criteria: * clinical bleeding. defined as any bleeding needing an intervention. an intervention could be an increase in the frequency of hemoglobin monitoring, a transfusion, a procedure, or a consultation intended to prevent or treat bleeding. * hemolytic disorder (e.g. sickle cell disease, hereditary spherocytosis, autoimmune hemolytic anemia). * bone marrow disorder (e.g. aplastic anemia, leukemia, marrow infiltration disorder, chemotherapy within the last 8 weeks). * jehovah's witnesses. * patient is comfort care measures only. * refractory shock: mean arterial blood pressure below 65 mmhg despite maximal doses of 3 vasopressors. maximal dose of vasopressors are as follows: norepinephrine 70 mcg/min; vasopressin 0.03 units/min; epinephrine 35 mcg/min; dopamine 20 mcg/kg/min; phenylephrine 350 mcg/min. * severe acidosis: ph below 7 in more than one arterial blood gas in the past 24 hours, in the absence of diabetic ketoacidosis. * surgical admission diagnosis. * pregnancy. * current prisoner

Keywords: blood transfusion
outcome and complications assessment in the surgical treatment of distal fibular fractures

Conditions: Ankle Fractures

Summary: from the archives of the irccs rizzoli orthopedic institute (sir2020) all cases of patients undergoing surgical interventions for the reduction and synthesis of fractures of the distal fibula will be retrieved ankle-fract version 2.0 8/08/2024 7 isolated or associated with other lesions, treated surgically with placement of anatomical fibula plates and any accessory procedures from 01/01/2019 to 1/1/2024. an overall electronic database will be created and all medical records of these cases will be reviewed. the pre- and post-operative data of the patients will be analyzed by analyzing the medical records and the post-operative x-rays (x-ray performed as per common clinical practice, present at the institute (irccs istituto ortopedico rizzoli) which highlight consolidation of the fracture. the radiological reports will be read, analyzing when the bony consolidation of the fracture is reported in relation to the time elapsed since the operation. the questionnaires will be submitted to all patients who have completed the course at 1 year. all patients who sign the informed consent will be asked to complete the questionnaires either at the time of the follow-up visit by common clinical practice or by telephone, in the event that the patients have exceeded the 1-year follow-up.


Eligibility criteria:
inclusion criteria: * patients suffering from fibula fracture treated surgically through reduction and synthesis with an anatomical fibula plate; * patients of both sexes aged between 18-90 years; * patients who have given their written informed consent to participate in the study patients in possession of a post-operative control x-ray examination to evaluate consolidation and alignment (x-ray performed as per common clinical practice). exclusion criteria: * patients with severe postural instability; * patients incapable of understanding or wanting; * patients with concomitant neurological pathologies that prevent walking and standing * bedridden patients. * lack of written informed consent to participate in the study * written form to participate in the study * physiotherapy not performed

Keywords: ankle injuries ankle fractures foot surgery
the multiple sclerosis continuous quality improvement (mscqi) collaborative

Conditions: Multiple Sclerosis

Summary: to establish the first systems level continuous quality improvement (cqi) collaborative for multiple sclerosis (ms) in the united states, to conduct benchmarking analyses and assessments of geographic variation in ms care quality and value, and study the effect of cqi interventions on improvement of selected performance (quality) indicators.

this is a three year study which employed a step-wedge randomized design which exposed three of four participating centers to a healthcare qi intervention during the 3 year period. each of the centers exposed to an intervention served as its own control during a baseline pre-intervention period during the first year of the study. the fourth site served as a longitudinal control for comparison to the other three centers exposed to a qi intervention.

Eligibility criteria:
inclusion criteria: * adults aged 18 years or older with documented clinically confirmed ms who are followed by one of the participating ms centers. exclusion criteria: * candidates will be excluded from study entry if they are unable or unwilling to provide informed consent.
immediate anterior chamber paracentesis with a 30-gauge needle for acute primary angle - closure

Conditions: Glaucoma, Angle-closure

Summary: this study was to evaluate the efficacy and safety of immediate anterior chamber paracentesis (acp) with a 30-gauge needle as an initial treatment for acute primary angle closure (apac).

this is a prospective study from patients with apac presenting at the faculty of medicine siriraj hospital, bangkok, thailand in 2005. at presentation, patients received immediate acp with a 30-gauge needle. the iop, best corrected visual acuity (bcva), corneal edema grading, pupil size and symptoms were recorded at immediately, 15 and 30 minutes, and then 1, 24 and 48 hours after paracentesis. all affected eyes received antiglaucomatous medications 60 minutes after acp and underwent peripheral iridotomy within 24 hours.

Eligibility criteria:
inclusion criteria: * patients aged more than 18 year old with the first attack of apac * iop of more than or equal to 40 mmhg. exclusion criteria: * patient unable to cooperate for paracentesis * patients with apac in the only remaining eye * patients received any glaucoma treatments prior to the study * patients with secondary causes of acute angle closure * patients with intraocular inflammation or infection; (6) patients with apac in the eye with a history of previous intraocular surgery * patients known hypersensitive to tetracaine hydrochloride or tobramycin.

Keywords: paracentesis primary acute angle closure iridotomy filtration glaucoma
effectivity of bilateral transversus thoracis muscle plane block after open heart surgery

Conditions: Interleukin-6; Cortisol

Summary: this study aimed to assess the effectivity of bilateral transversus thoracis muscle plane block to reduce pain and stress response after open heart surgery

this is a double blind randomized controlled trial. thirty-two subject will be recruited with non-probability consecutive sampling method. subjects who meet all inclusion criteria and do not have exclusion criteria will be asked to sign the informed consent form before included in this study. subjects will be randomized into two groups. the first group is the treatment group who will get bilateral transversus thoracis muscle plane block after induction of anesthesia and the second group will be the control group who will not get any regional block during surgery. after surgery, time to first morphine dose, total morphine consumption in 24 hours, extubation time, and adverse events will be recorded for both group.

Eligibility criteria:
inclusion criteria: 1. age 19-75 years old 2. patients who will undergo elective open heart surgery with median sternotomy approach exclusion criteria: 1. patient who does not agree to be included in this study 2. weight \ 75 kg 3. patient with chronic obstructive pulmonary disease 4. patient with chronic kidney disease who needs regular hemodialysis. 5. patient with local infection in the injection area for transversus thoracis muscle plane block 6. patient with chronic pain 7. patient with history of chronic analgetics drugs usage 8. patient who is contraindicated for local anesthetics 9. patient with communication disability 10. patient with cognitive disorders 11. patient with severe psychiatrics disorders, such as schizophrenia and bipolar disorder
treatment of peri-implant mucositis on incongruous dental prostheses versus congruous

Conditions: Bleeding of Subgingival Space

Summary: the aim of the present study was to test the hypothesis that non-surgical periodontal therapy on peri-implant mucositis resolution results in a greater clinical improvement in patients with congruous versus non-congruous single dental implant restoration.

the aim of the present study was to test the hypothesis that non-surgical periodontal therapy on peri-implant mucositis resolution results in a greater clinical improvement in patients with congruous versus non-congruous single dental implant restoration by comparing two groups of patients with peri-implant mucositis.

Eligibility criteria:
inclusion criteria: * peri-implant mucositis * bleeding on probing and/or a gingival index \<1 at least at one site at baseline * absence of peri-implant bone loss during the last 2 years before baseline exclusion criteria: * periodontal disease * systemic diseases
broken-swedeheart- optimized pharmacological treatment for broken heart (takotsubo) syndrome.

Conditions: Takotsubo Syndrome

Summary: the aim of this study is to document an optimized pharmacologic treatment for patients with takotsubo syndrome. there is currently no published documentation in a large number of patients. the study is a randomized registry clinical trial and in total 1000 patients registered in swedeheart will be included.


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years. 2. a clinical diagnosis of ts (see definition 2.1), including an ejection fraction (ef) ˂ 50 % at baseline 3. written informed consent obtained exclusion criteria: 1. previous randomization in the trial 2. any concomitant condition resulting in a life expectancy of less than one month 3. previously diagnosed left ventricular ejection fraction \<50% 4. known cardiomyopathy (except previous takotsubo syndrome) 5. known hemodynamically significant valve disease (moderate or severe aortic/mitral regurgitation) or stenosis 6. heart transplant or left ventricular assist device recipient 7. most recent (within the most recent 3 months) haemoglobin ˂10 g/dl 8. systolic blood pressure \<80 mm hg at screening 9. estimated glomerular filtration rate \<30 ml/min/1.73m2 10. current dialysis 11. pregnancy or of childbearing potential who is not sterilized or is not using a medically accepted form of contraception 12. not suitable in the opinion of the investigator due to severe or terminal comorbidity with poor prognosis, or characteristics that may interfere with adherence to the trial protocol specific exclusion criteria for randomization 1 13. any contra-indication for treatment with adenosine or dipyridamole (including av-block ii and iii, sick-sinus syndrome in subjects who don´t have a functioning pacemaker, unstable angina, ongoing treatment with dipyridamole) 14. severe asthma (defined as asthma requiring medium or high-dose inhaled corticosteroids combined with other long-acting medications) and severe chronic obstructive pulmonary disease (copd), (defined as fev-1 ˂ 50 %) 15. ongoing treatment with dipyridamole 16. declined participation in study 1 specific exclusion criteria for randomization 2 1. any contra-indication for anticoagulant treatment. 2. current indication for treatment with, anticoagulant or dual antiplatelet therapy 3. declined participation in study 2
infiltrations of onabotulinum toxin a in resistant depression: comparison of two facial injection sites.

Conditions: Major Depression

Summary: the aim of the study is to evaluate in adult subjects with resistant depression the effect of an injection of botulinum toxin in the corrugator and procerus muscles, in comparison to the infiltration of the crow's feet area, in addition to the current antidepressant treatment.

three randomized, double-blind, placebo-controlled studies have shown that a single injection of onabotulinum toxin a (onaa) into the corrugator and procerus (frowning muscles) allows for a significant decrease in patients with a depressive episode characterized resistant. however, the effectiveness of this method of treating depression can not currently be considered established. the main objective of our study is therefore to evaluate the efficacy of onaa injections in the glabellar zone with a different methodology, using lateral muscle injection orbicularis oculi (involved in crow's feet wrinkles). ) as another injection zone in comparison. the efficacy will correspond to the number of responders at 6 weeks in the two groups of injection. this evaluation will be done at 6 weeks, then at 3 months (s12).

Eligibility criteria:
inclusion criteria: * male or female from 18 to 80 years old included * inpatient or ambulatory patients treated for resistant depressive episode, that is to say by an absence of symptomatic remission (nonresponse or partial response) after the use of two successive trials of antidepressants of different pharmacological class, well conducted in terms of dosage and duration, while ensuring quality adherence (at least 80% of the treatment taken during the period considered) * diagnosis according to dsm-5 depressive episode characterized with madrs score\> 20 * women of childbearing potential must have an effective method of contraception (failure rate \<1% per year with correct use): iud, pill, ... (participant statement) * patient able to adhere to the restrictions and prohibitions of the protocol * patient agreeing to sign an informed consent exclusion criteria: * current psychiatric comorbidity * severe intellectual disability * known hypersensitivity to botulinum toxin type a or any of the excipients * myasthenia gravis * presence of infection at the injection site (s) * participation in an interventional clinical study. * pregnant woman, breastfeeding, or who plans to be pregnant during the study or within 6 weeks after the last administration of the treatment. * any patient already receiving aesthetic treatment
tdcs combined with therapeutic exercise in fibromyalgia patients

Conditions: Fibromyalgia

Summary: the purpose of this study is to assess the effects on pain of transcranial direct current stimulation combined with therapeutic exercise in fibromyalgia patients.

fibromyalgia is one of the rheumatic diseases with the greatest impact on the quality of life, whose etiology and pathophysiology is not yet fully demonstrated. perhaps this is why its therapeutic approach is refractory to current treatments. based on the theory that fibromyalgia is characterized by a sensitization at the level of the central nervous system that leads to an increase in the perception of pain, any therapeutic approach aimed at modulating the central nervous system may be beneficial. electrical stimulation with transcranial direct current (tdcs) is among these techniques. in the same way, therapeutic exercise has shown to have, like the tdcs, a beneficial effect on pain in different chronic pathologies. the present study aims to investigate the effect on pain of a combination therapy of tdcs and therapeutic exercise in patients with fibromyalgia.

Eligibility criteria:
inclusion criteria: * age between 18 and 65 years. * fulfilled the 2010 american colleague of rheumatology criteria for fibromyalgia. * normal pain intensity of 4 or more points on a visual analog scale. * able to participated in a therapeutic exercise program. * understanding of spoken and written spanish. exclusion criteria: * pregnancy or breastfeeding. * metallic implants in the head. * tumor, trauma or surgery in the brain. * epilepsy or stroke. * history of substance abuse in the last 6 months. * use of carbamazepine in the last 6 months. * severe depression (beck depression index ii of 29 or more). * diagnosed psychiatric pathology. * rheumatic pathology not medically controlled. * coexisting autoimmune pathology. * chronic inflammatory disease (rheumatoid arthritis, erythematosus systemic lupus, inflammatory bowel disease).

Keywords: tdcs therapeutic exercise referred pain central sensitization
an observational study to investigate clinical usefulness of oros hydromorphone in korean cancer patients

Conditions: Pain

Summary: this study aims to collect clinical information and to examine the usefulness and safety of oral osmotic system hydromorphone in korean cancer patients. the decision to treat patients with drug is as per physician discretion and that doses are determined based upon approved labeling recommendations and physician discretion.

the primary purpose of this observational study is to collect clinical data on cancer pain control using oros (oral osmotic active system) hydromorphone and to investigate the clinical usefulness of oros hydromorphone for korean cancer patients. information on the effectiveness of cancer pain control and any adverse events reported by those patients using oros hydromorphone will be reported. in addition, clinical usefulness of oros hydromorphone will be evaluated through assessing sleep disturbance due to pain, breakthrough pain, and end-of-dose failure before and after the study drug administration and examining the patient's satisfaction with study drug and the investigator's global assessment. this is a multi-center, open-label, prospective, exploratory, and observational study with approximately 770 patients. efficacy endpoints will be analyzed to examine the difference between before and after the treatment. since this is an observational study under the condition of routine practice, oros hydromorphone dosage should be adjusted at the discretion of the investigator, based on patient response. it is recommended that the dosage be conservative at first and adjusted appropriately considering the adverse events and analgesic effect for all the patients.

Eligibility criteria:
inclusion criteria: * patients who are in need oros hydromorphone to relieve cancer pain exclusion criteria: * patients with serious gastrointestinal diseases that may interfere with oral analgesic effects, such as dysphagia, vomiting, absence of periastalsis, intestinal obstruction, and/or severe strangulation, in which case the absorption and passage of orally-administered medication may be unduly influenced

Keywords: open-label non-interventional oros hydromorphone korean cancer patients
cognitive behavioral stress management (cbsm) & prostate cancer

Conditions: Stress

Summary: the purpose of this study is to test a stress management program for men with early-stage prostate cancer.


Eligibility criteria:
inclusion criteria: * men who had undergone either a radical prostatectomy or radiation therapy (i.e., external beam or seed implant) for stage i or ii prostate cancer in the preceding 18-months * 50 years of age or older * ability to speak, read, and write in english * having a ninth grade reading level or greater * being free of cognitive impairment that would interfere with the study * no active psychiatric symptoms in the previous three months. exclusion criteria: * previous history of non-skin cancer * have received adjuvant treatment, including hormone treatment, for prostate cancer

Keywords: group therapy
ali (acute lung injury) /ards (acute respiratory distress syndrome) in oncologic pediatric patients

Conditions: Acute Lung Injury; Acute Respiratory Distress Syndrome; Neoplasms

Summary: identify pediatric oncologic patients with ali/ards at graacc (grupo de apoio ao adolescente e a criança com câncer) /iop's (instituto de oncologia pediátrica) pediatric intensive care unit and evaluate the mechanical ventilation practice in these subjects for a 48mo period.

evaluate adequate mechanical ventilation based on protective ventilation protocols for children available so far. evaluate and describe the subjects. evaluate the necessity and outcome of rescue therapies (surfactant, prone position, corticosteroids, alveolar recruitment) obtain data about ali/ards' etiology, mortality rates and predictive factors related to the outcomes (picu/ hospital discharge or death)

Eligibility criteria:
inclusion criteria: * patients admitted at the intensive care unit with diagnosis of acute lung injury or acute respiratory distress syndrome and submitted to mechanical ventilation for over 24h exclusion criteria: * mechanical ventilation less than 24h * absence of ali/ards criteria * no neoplasm diagnosis

Keywords: acute lung injury respiratory distress syndrome neoplasms child