Kornimate/medical-research-clean huggingface dataset:
covered vs. uncovered sems for occluded biliary metal stents

Conditions: Biliary Tract Neoplasms; Jaundice, Obstructive

Summary: endoscopic retrograde biliary drainage (erbd) is now widely accepted as the standard intervention for the relief of obstructive jaundice in patients with unresectable malignant biliary obstruction. although plastic stents (pss) were developed earlier, self-expandable metal stents (semss) are now used widely as the initial choice for erbd in this setting, as semss offer longer patency.however, semss do become occluded in some patients. there are a limited number of reports on the management of occluded sems with various results. the aim of this study is to compare the efficacy of comvi stents semss with uncovered sems in subsequent erbd after the occlusion of initial semss.

endoscopic placement of self-expandable metallic stents (semss) is the mainstay of palliative measures for alleviating obstructive jaundice secondary to advanced cholangiocarcinoma. previous meta-analysis showed no significant difference in stent patency between covered and uncovered sems, which are currently available. however, information on secondary sems insertion is still scarce, and there has been no prospective trial comparing efficacy of secondary stenting between covered and uncovered sems for the management of occluded metal stent in malignant biliary obstruction. previously, only two small retrospective studies addressed this issue. given the absence of prospective trial on re-intervention for occluded sems in malignant biliary obstruction, we aimed to prospectively compare the efficacies and complication rates of secondary comvi stent (csems) and usems for the management of such condition.

Eligibility criteria:
inclusion criteria: * patients with sems occlusion, which was inserted either endoscopically or percutaneously, for the relief of malignant nonhilar biliary obstruction * patients in whom the above sems had been inserted for no less than 7 days * patients with one of the following: 1. cholangitis (as defined by fever, tenderness in the right upper quadrant or epigastrium, and/or a ≥ twofold increase in the serum bilirubin level above the baseline after initial sems insertion) 2. a ≥ twofold increase in the serum bilirubin level above the baseline after initial sems insertion * patients in whom the cause of initial erbd occlusion was identified, such as tumor overgrowth, ingrowth, and/or sludge * age ≥ 20 years exclusion criteria: * unable to give informed consent * patients with sepsis and/or shock not responding to medical treatment or eastern cooperative oncology group (ecog) performance status 4 * patients with estimated survival \< 4 weeks * patients who had undergone curative or palliative surgical intervention * hilar or perihilar biliary obstruction * patients who had undergone endoscopic nasobiliary drainage,plastic stent insertion, or percutaneous transhepatic biliary drainage prior to second sems insertion * covered sems as initial sems * migration or food impaction as the cause of initial sems occlusion

Keywords: stents endoscopy cholangiopancreatography endoscopic retrograde
robotic rehabilitation and dual-task exercises in hemiplegic patients

Conditions: Cognitive Coping; Hemiplegia

Summary: the aim of this study was to investigate the effectiveness of dual-task exercises combined with robotic rehabilitation applied to post-stroke hemiplegia patients.

this research is designed as a randomized controlled experimental study. the study will be conducted on 50 hemiplegic patients. participants will be randomly divided into two groups. patients in the exercise group will be subjected to dual-task exercises together with robotic rehabilitation. patients in the control group will be subjected to only the robotic rehabilitation treatment program. both groups will be treated with 30-45 minute sessions, 3 days a week for 12 weeks. the exercises will be explained to the patients in detail one-on-one and repeated.

Eligibility criteria:
inclusion criteria: * diagnosis of post-stroke hemiplegia (hemiplegia onset must be between 3 months and 1 year). * age range: 45-65 years. * voluntariness to participate in rehabilitation. * patients with a motor function loss of 30-70% according to fugl-meyer motor assessment results. * literacy exclusion criteria: * history of active psychiatric disease. * severe joint deformities or other neurological diseases. * having had a recent stroke during rehabilitation.
danlou tablets to prevent left ventricular remodeling

Conditions: Left Ventricular Remodeling; Acute Myocardial Infarction

Summary: danlou tablets are chinese patent medicine which has been approved in china for the treatment of ischemic heart disease, but the evidence supporting its efficacy on cardiac remodeling remains unclear. this pilot study was designed to determine whether danlou tablets reduced adverse left ventricular (lv) remodeling in patients with acute myocardial infarction (mi). patients following acute mi were enrolled and randomly allocated to danlou tablets (4.5 g q.d. for 90 days) or placebo, superimposed on standard medications for the treatment of mi. major end points were changes in lv volumes and ejection fractions as evaluated by serial echocardiography in addition to clinical outcomes were also determined.

this randomized, prospective, double-blind, placebo-controlled, parallel-group clinical trial was performed in two institutions (guangdong provincial hospital of cm and wuyi hospital of cm). the study was conducted in accordance with the declaration of helsinki and its text revisions and all participants provided written informed consent before enrollment. the clinical research ethical committee at guangdong provincial hospital of chinese medicine approved the research protocol (b2011-41-01). once eligible candidates had undergone pci, they were admitted to the coronary intensive care unit and received standard treatment according to the institutional protocol based on american college of cardiology/ american heart association and european society of cardiology guidelines.20 simultaneously, patients were randomized assigned in a 1:1 ratio to receive danlou tablets (4.5 g oral dose taken once daily) or matching placebo for 90 days according to a computer-generated site-stratified, block randomization schedule. danlou tablets were approved by china food and drug administration for the treatment of ischemic heart disease in 2005 (z20050244).

Eligibility criteria:
inclusion criteria: * acute myocardial infarction * successfully underwent revascularization exclusion criteria: * previous myocardial infarction within 30 days * malignant arrhythmia * congenital heart disease * cardiac shock * documented or suspected history of heart failure or depressed lv ejection fraction \<15% * planned coronary artery bypass grafting * a life expectancy of \<1 year * hepatic impairment * glomerular filtration rate ≤30 ml/min per 1.73 m2 * autoimmune or connective tissue disease * chronic substance abuse or psychiatric illness * unable to complete 3 month clinical follow-up
transfusion-induced alterations of pulmonary and immune function in mechanically ventilated patients

Conditions: Pulmonary Edemas; Blood Protein Disorders

Summary: specific aim: to test whether transfusion of leukoreduced red cells of lesser storage time (versus conventional storage time) reduces mild alterations in pulmonary function and immune activation in critically ill patients with mechanically ventilated lungs. we propose to perform a prospective, randomized, double-blind clinical trial in critically ill patients whose lungs are mechanically ventilated, and who have orders to receive transfusion of at least one unit of packed red cells, comparing pulmonary function between patients randomly allocated to receive a unit of red cells stored for 5 days or less, with similar patients randomly allocated to receive a unit of red cells stored conventionally (median 21 days). we will test the hypothesis that transfusion of red cells of lesser storage age, (5 days or less) will produce the less changes of pulmonary function and immune activation than will transfusion of red cells of conventional storage age (median 21 days).

specific aim: to test whether transfusion of leukoreduced red cells of lesser storage time (versus conventional storage time) reduces mild alterations in pulmonary function and immune activation in critically ill patients with mechanically ventilated lungs.

Eligibility criteria:
inclusion criteria: * patients, male or female, any race or ethnicity, age 18 years or older, in one of the seven adult critical care units of the mayo clinic, rochester, with mechanically ventilated lungs, requiring elective transfusion of at least one unit of red cells exclusion criteria: * transfusion of any blood component within the previous 2 hours, emergency transfusion or hemodynamic instability defined by other than a stable dose of vasoactive medications.

Keywords: pulmonary protein
creative arts program to reduce burnout in healthcare professionals

Conditions: Burn-Out Syndrome; Post-Traumatic Stress Disorder; Depression, Anxiety

Summary: this study plans to learn if creative arts programs that include visual, musical, written, or physical expression can reduce symptoms of burnout syndrome, post traumatic stress disorder (ptsd), depression, and anxiety in critical care healthcare professionals. this study also explores if creative arts can enhance the connection to the purpose of work, the development of adequate coping skills, while providing time to connect with peers.


Eligibility criteria:
inclusion criteria: * employed as a healthcare provider, practicing primarily in a hospital setting for at least 20 hours per week. * positive symptoms of burnout measured via the maslach burnout inventory (mbi): * emotional exhaustion score of \>17, or * depersonalization score of \>7, or * personal accomplishment score of \< 31. exclusion criteria: • unwillingness to participate in any of the four creative arts interventions.
tracheobronchitis in respiratory involvement on the lung spect/ct images of coronavirus disease (covid-19) patients

Conditions: Infectious Disease of Lung

Summary: tracheobronchitis signs may be observed on ventilation lung scintigraphy during coronavirus disease (covid-19) infection. this case report study aimed to analyze the rates and associated factors of such tracheobronchitis in covid-19 patients referred to ventilation/perfusion lung scintigraphy with shortness of breath, suspected of pulmonary embolism.

it was a retrospective study

Eligibility criteria:
inclusion criteria: * patient with tracheobronchitis signs * patient with lung scintigraphy exam exclusion criteria: * none

Keywords: coronavirus disease (covid-19) lung ventilation perfusion scintigraphy tracheobronchitis shortness of breath cadmium-zinc-telluride (czt)-spect computer tomography (ct)
laparoscopic value in the management of acute abdomen during pregnancy

Conditions: Acute Abdomen; Pregnancy Related

Summary: the term "acute abdomen" is often used to describe the manifestations of any serious intraperitoneal disease, which may indicates surgical intervention. acute abdomen in pregnancy accounts for approximately 7-10% of all abdominal emergencies. several pathologies could contribute acute abdominal pain during pregnancy. they include obstetric and non-obstetric causes. as for the non-obstetric causes , any gastrointestinal or urological disorders could be presented by an acute abdominal pain. in pregnancy, several factors overlap and making the diagnosis challenging. these factors include the distorted anatomy by the growing uterus that displaces intraperitoneal structures. additionally, nausea, vomiting, and abdominal pain are considered the normal course during pregnancy especially at the first trimester. moreover, sure diagnosis must be achieved to operate in a pregnant woman with more possible morbidity and mortality for the mother and\\or fetus.

laparoscopy can be safely performed during any trimester of pregnancy. historical recommendations were to limit surgery to the second trimester only, but these recommendations were based on experience with open surgical procedures during pregnancy. these recommendations were thought to minimize the spontaneous abortion rate of surgical intervention during the first trimester, which was reported to be as high as 12%, and to avoid preterm labor, reported in up to 40%, when surgery occurred during the third trimester. however, studies limited to laparoscopy have shown improved outcomes and demonstrated that pregnant patients may undergo laparoscopic surgery safely during any trimester without any appreciated increase in risk to the mother or fetus.

Eligibility criteria:
inclusion criteria: * all pregnant women having acute abdomen and underwent surgical intervention will be included in this study. exclusion criteria: * non-pregnant women with acute abdomen are excluded.
exosome-based detection of molecular residual disease in stage ii-iii colorectal cancer

Conditions: Colo-rectal Cancer; Colorectal Cancer Recurrent

Summary: this study aims to establish an exosome-based liquid biopsy signature to detect molecular residual disease (mrd) in stage ii-iii colorectal cancer (crc) patients. identifying patients with mrd after surgery is crucial for selecting appropriate candidates for adjuvant chemotherapy (act), allowing for more personalized treatment approaches and potentially improving patient outcomes.

the current standard for treating stage ii-iii colorectal cancer involves surgical resection, often followed by adjuvant chemotherapy (act) for high-risk patients. however, identifying patients who would benefit most from act remains challenging. molecular residual disease (mrd) in these patients is a critical factor in determining the likelihood of recurrence. this study aims to develop an exosome-based liquid biopsy assay using circulating exosomal micrornas (exo-mirnas) to predict the presence of mrd in postoperative patients. by analyzing exo-mirnas from blood samples collected after surgery, the goal is to identify high-risk patients who may benefit from act while sparing low-risk patients from unnecessary treatment. a risk-stratification model, termed the exosome-based molecular residual disease prediction for adjuvant chemotherapy induction (emrati) score, will be developed to improve act decision-making and enhance clinical outcomes for stage ii-iii crc patients.

Eligibility criteria:
inclusion criteria: 1. patients with pathologically confirmed stage ii or iii colorectal cancer. 2. patients who have undergone curative-intent surgery. 3. patients with no evidence of distant metastasis (stage iv). 4. patients aged 18 years or older. 5. patients who provided written informed consent. exclusion criteria: 1. patients with stage iv cancer or those receiving neoadjuvant therapy. 2. patients with non-curative resection or requiring urgent surgery. 3. patients with a follow-up period of fewer than 3 years. 4. patients with severe comorbidities or who are unable to participate in follow-up assessments.

Keywords: colorectal cancer molecular residual disease adjuvant chemotherapy stage ii-iii crc exosomal mirna
neuromodulation effects in older adults

Conditions: Cognitive Impairment; Cognitive Decline

Summary: the current study is a mechanistic study to evaluate working memory gains from application of transcranial direct current stimulation (tdcs) in older adults with mild cognitive impairments (mci) compared to cognitively healthy control

the current study is a mechanistic study to evaluate working memory gains with transcranial direct current stimulation (tdcs) in older adults with mild cognitive impairments (mci) compared to cognitively healthy control. the proposed study investigates the effects of acute (one-time) tdcs application on working memory gains (i.e., behavior and functional) by evaluating brain structure and cognitive function relationships. tdcs is a method of non-invasive brain stimulation that directly stimulates brain regions involved in active cognitive function and enhances neural plasticity when paired with a training task. a mechanistic, in-scanner, crossover design tdcs study (active and sham stimulation) with 2milliamps (ma) fixed dosing application will enroll 110 participants comprising 55 cognitively normal/healthy older adults and 55 older adults with mci. the study will employ multi-modal neuroimaging (structural and functional data), person-specific computational models, and machine learning to elucidate acute tdcs effects on working memory. change in cognitive function (i.e., working memory performance) will be quantified using working memory tasks and magnetic resonance imaging (mri). the investigators will compare changes in working memory performance resulting from active tdcs versus sham tdcs during 2-back task compared to 0-back task. the investigators will test the following hypotheses: 1. acute tdcs will increase working memory performance during active tdcs and larger degree of brain atrophy seen in mci patients will significantly decrease current intensity in stimulated brain regions. 2. acute tdcs will significantly increase functional connectivity within the working memory network during active tdcs but not sham. the present study will provide insight into mechanisms underlying tdcs application in mci population for combating cognitive decline in a rapidly aging population in the united states. information gathered from this study may guide future intervention strategies to combat cognitive decline and improve the quality of life of aging population.

Eligibility criteria:
inclusion criteria: * age 60-95 years * montreal cognitive assessment (moca) score 18 and above (scores will be adjusted for education) * able to receive electrical stimulation * adequate motor capacity to participate in intervention and training sessions exclusion criteria: * contraindications to mri recording * left-handed * inability to communicate in english * history of neurological/psychiatric disorders and traumatic brain injury * incidence of stroke * severe visual and hearing impairment precluding completion of study assessments

Keywords: cognitive aging brain stimulation functional mri computational modeling finite element method (fem)
effect study of an eccentric training program and stretching for patients with chronical rotator cuff tendinopathy

Conditions: Chronical Rotator Cuff Tendinopathy

Summary: in the first part of the the study two new outcome measurements (force reproducibility and subacromial space) will be tested for reproducibility. therefore 30 healthy people will be assessed. in a second part of the study 60 patients will be randomly allocated to two groups. group a (n=30) will perform a traditional training program and group b (n=30) will perform an eccentric training program. before the onset of the training programs, pain, function, maximal force, range of motion, subacromial space and force reproducibility will be assessed. both training programs will be accomplished at home. the first six weeks there will be an appointment with the therapist once a week to explain, correct and when necessary, aggravate the exercises. the next six weeks these appointments will be diminished to once every two weeks. after 6 and after 12 weeks of training the patients will be reassessed for all the parameters.


Eligibility criteria:
inclusion criteria: * global tendon thinning * inhomogeneous echo partitioning * calcifications at the insertion * symptoms present for at least 3 months: painful resisted isometric abduction, painful palpation of the supraspinatus tendon, impingement tests positive exclusion criteria: * documented full thickness rotator cuff rupture * other lesions than crct at the moment of the study * echographic criteria for ruptures (focal thinning, fluid-filled gap,compressibility)
antioxidant status during burn rehabilitation

Conditions: Burns

Summary: it is believed that children with a prior history of significant burn injury continue to manifest low levels of antioxidants well into their convalescence.the purpose of this study is to examine malondialdehyde (an oxidative lipid marker) and vitamins e, c and beta carotene status in reconstructive burn patients.


Eligibility criteria:
inclusion criteria: * greater than 3 but less than 19 years * reconstructive or followup outpatient care at least 1 year postburn * initial burn size \> 40% * written informed consent and hipaa authorization exclusion criteria: * history of multivitamin or steroid use, liver disease, preburn malnutrition

Keywords: rehabilitation pediatrics
paclitaxel-coated peripheral stents used in the treatment of femoropopliteal stenoses

Conditions: Peripheral Arterial Disease (PAD)

Summary: this randomized multi-center study is intended to compare different coatings on stents for treatment of lesions of the above-the-knee femoropopliteal artery.


Eligibility criteria:
inclusion criteria: * one de novo or restenosed artherosclerotic lesion with ≥ 50% diameter stenosis * symptoms of peripheral arterial disease (rutherford 2-4) exclusion criteria: * pregnant, breastfeeding, or planning to become pregnant in the next 5 years * less than 18 years old * medical condition or disorder that would limit life expectancy to less than 12 months or that may cause noncompliance with the protocol or confound the data analysis * previous stent in the study vessel
evaluating ida selection ability. the visa study.

Conditions: IVF; Infertility

Summary: a non-inferiority, prospective parallel group, multi-center, randomized controlled trial to investigate whether selection of a single blastocyst for transfer using the deep learning tool, ida, results in non-inferior clinical pregnancy rate compared to trained embryologists using standard morphology criteria.


Eligibility criteria:
inclusion criteria: 1. women undergoing ivf or icsi with controlled ovarian stimulation with gonadotrophins and the intention to treat by either transfer of a single fresh embryo on day 5 or in case of a freeze all cycle, the first rewarmed embryo. 2. age: up to and including the 42nd completed birthday on the day of randomization. 3. has at least two early blastocysts on day 5. exclusion criteria: 1. treatment involving donated eggs 2. intention to perform any form of preimplantation genetic testing 3. the use of imsi or polarized light in the icsi process 4. the use of assisted hatching prior to randomization 5. previous participation in this rct 6. where the cycle is carried out for fertility preservation 7. if a day 2-4 transfer is planned 8. has a reduced likelihood of obtaining two early blastocysts on day 5 as evidenced by either: an amh level of \<3pmol/l or afc \<5 (if available)

Keywords: embryo embryo scoring blastocyst selection pregnancy rate live birth rate
assessment in patients after thoracic surgery

Conditions: Thoracic Surgery

Summary: lung cancer is the leading cause of death in men and the second in women with a 5 year survival in europe of less than 15%. one of the methods most used for its treatment is pulmonary resection. the objective of this study is to analyze the clinical profile presented to patients after pulmonary resection.

one of the most widely used methods for the treatment of lung cancer is pulmonary resection. the morbidity and mortality of pulmonary resection surgery is conditioned by both the type of intervention and the patient's condition. functional deterioration is a risk associated with hospitalization in the elderly, with a high prevalence (35-70%) and serious consequences, since in the majority it can lead to the appearance of complications not related to the reason for admission or the specific treatment. it is very important to evaluate the clinical profile of patients after pulmonary resection in order to stablish a more specific repercussion.

Eligibility criteria:
inclusion criteria: * patient admitted for lung resection and who sign the informed consent exclusion criteria: * patients who did not agree to sign informed consent and those who presented other types of problems to be able to adequately carry out the assessment, such as not handling the language.