Kornimate/medical-research-clean huggingface dataset:
evaluation of diabetic foot wound healing using hydrogel/nano silver-based dressing vs. traditional dressing

Conditions: Diabetes Mellitus

Summary: background: the wound dressings perform a crucial role in the cutaneous wounds' management due to their ability to protect wounds and promote dermal and epidermal tissue regeneration. objective: the aim of the present study to evaluate the effectiveness of using hydrogel/nano silver-based dressing vs. traditional dressing on diabetic foot wound healing. approach: sixty patients with type-2 diabetes hospitalized for diabetic foot wound treatment were recruited from selected surgical departments at kasr al-aini university hospital.

data collection: the patients of group-i wounds were cleaned using normal saline; then, the wounds were closed firmly with hyderogel\\nano silver dressing. the dressing was changed every two days according to dressing manufacture instruction. when the dressing was opened after three days, the wound was assessed for granulation tissue, wound, and discharge size. the patients of group ii wounds were dresses using a traditional method, cleaned by normal saline, use of betadine antiseptic; then they were secured with clean linen gauze. the dressing was changed once daily. the wound healing process of the two groups was then assessed for three consecutive weeks.

Eligibility criteria:
inclusion criteria: diabetes type i and type ii patient with diabetic foot ulcer age ranged 35-55 years old willing to participate exclusion criteria: unwilling to participate.

Keywords: diabetic foot ulcer
plasma rich fibrin epidural injection by racz catheter versus epidural blood patch in postdural puncture headache

Conditions: Plasma Rich Fibrin; Epidural; Racz Catheter; Epidural Blood Patch; Postdural Puncture Headache

Summary: this study aims to evaluate plasma-rich fibrin epidural injection by racz catheter and epidural blood patch in post dural puncture headache.

post-dural puncture headache (pdph) is also known as post-lumbar puncture (lp). pdph is a major complication of neuraxial anesthesia that can occur following spinal anesthesia and with inadvertent dural puncture during epidural anesthesia. traditional management strategies include conservative measures such as oral analgesia, bed rest, oral or intravenous hydration, oral or intravenous caffeine, and administration of epidural crystalloid before catheter removal, but in refractory cases, more invasive techniques may be necessary. an epidural blood patch (ebp) has been the most favorable treatment for pdph after an accidental dural puncture. one innovative approach is the use of plasma-rich fibrin (prf) derived from autologous whole blood, which contains and releases several different growth factors and cytokines to stimulate the healing of bone and soft tissue via degranulation. this approach has recently gained popularity in pain management. another is the racz catheter, a thin and flexible catheter used for targeted delivery of therapeutic agents.

Eligibility criteria:
inclusion criteria: * age from 18 to 65 years. * both sexes. * patients suffering from post-dural puncture headache. exclusion criteria: * uncooperative patients. * severe comorbid conditions. * pregnancy. * anticoagulant therapy. * known allergies to plasma-rich fibrin or epidural blood patch components. * body mass index (bmi) ≥35 kg/m2.
depression, stress and vulnerability factors in drug resistant focal epilepsies

Conditions: Depression and Epilepsy

Summary: psychiatric disturbances, notably depression, occur frequently as co-morbid conditions with epilepsy. a complex, probably bidirectional relationship between epilepsy and depression has been postulated. both epilepsy and depression also interact with stressful life events, but only some patients develop these disorders after a stressful event, indicating the possibility of a "vulnerable" population. animal and human studies have looked at the role of brain derived neurotrophic factor (bdnf) in this context. low serum and/or csf levels of bdnf are associated with higher incidence of depression, and thus indicate the vulnerable population. animal studies of bdnf have looked specifically at the relation between epilepsy and depression using a novel "double hit" design. after chronic stress exposure, measurement of bdnf levels allowed identification of 2 sub-groups: a vulnerable population and non-vulnerable population. a "second hit" of kainic acid induced status epilepticus (se) was then applied to both the vulnerable and non-vulnerable populations. only the vulnerable population exposed to se developed a depression-like profile. in a proof of concept approach we propose studying the relation between epilepsy, depression, anxiety and stressful life events, using serum bdnf levels in patients with pharmacoresistant epilepsy. evaluation of epilepsy type and co-morbid psychiatric profile will be performed in 150 subjects. by comparing bdnf levels for different epilepsy subgroups to bdnf levels for healthy subjects and for depressed subjects without epilepsy, we hope to identify whether risk of co-morbid depression and/or anxiety in epilepsy may be predicted using bdnf levels. in addition, in a subgroup of 25 patients, we propose a pilot study in which cortisol and c-reactive protein will be measured in addition to bdnf.


Eligibility criteria:
inclusion criteria: * definite diagnosis of epilepsy, of any type (partial or generalised) and at any stage from diagnosis onwards * known or unknown etiology (symptomatic or cryptogenic epilepsy) exclusion criteria: * psychogenic non-epileptic seizures * psychotic disorders and bipolar disorders
total neoadjuvant 6 cycles of chemotherapy versus 3 cycles in partial responder patients diagnosed with epithelial ovarian cancer

Conditions: Stage III and IV Ovarian Cancer

Summary: neoadjuvant chemotherapy in stage iii and iv ovarian cancer is given in 3-4 cycles with patients who r0 surgical resection is less likely to occur, in this study will assess total neoadjuvant chemotherapy 6 cycles then interval debulking surgery (experimental arm) versus 4 cycles then interval debulking surgery (control arm) in patients who achieve partial response or stationary disease by imaging after 3- 4 cycles of neoadjuvant chemotherapy, investigators'' primary end points will be event free survival, safety and tolerability and time to relapse, our secondary end points will be overall survival and surgical morbidity and mortality


Eligibility criteria:
inclusion criteria: 1. \> 18 years of age 2. recently diagnosed with stage iii and iv oc 3. patients eligible for platinum-based cth 4. patients have pr or sd after 3-4 cycles of nact exclusion criteria: 1. relapsed ovarian cancer 2. patients ineligible for platinum-based cth 3. patient not candidate for ids 4. stage i, ii oc 5. patients progressed after 3 cycles 7-patients do not tolerate cth
immune checkpoint receptors in aml-leukemic initiating cells

Conditions: Acute Myeloid Leukemia

Summary: this project aim at deciphering immune mechanisms that allow the immunoescape of aml initiating cells.

leukemic initiating cells (lic) were shown to play a key role in aml relapses, and are characterized by resistance to treatment and a high capacity to escape to immune system. immune checkpoints (icp) maintain self-tolerance and physiological amplitude of the immune response. we decided to focus our work on icp receptors and ligand that could be expressed by aml lic and lymphocytes subsets. the tumor cells are able to express these ligands to exploit the icp to overcome the anti-cancer immune response. few studies are published in aml in the field of icp, some studied limited cohort and others analyzed the expression of these ligands in total leukemic population, with a limited interest since the lic fraction represents a small subset but mainly contributes to relapse. these cells are rare and their profile of expression could be highly different but not detectable in these studies because of technical limits. we aim at analyzing icp ligands and receptors expression at diagnosis and relapse, the phenotype of bm cells will be analyzed by flow cytometry according to different panels of monoclonal antibodies using standard immunostaining protocols.

Eligibility criteria:
inclusion criteria: * ≥ 18 years of age * newly diagnosed aml exclusion criteria: * isolated extramedullary aml * mixed phenotype acute leukemia

Keywords: acute myeloid leukemia immune checkpoint ligand flow cytometry
artificial intelligence system in medical regulation

Conditions: Emergency Medical Communication Centres; Call Management

Summary: population health needs are increasing. information and communication technologies are changing. the digital shift offers new opportunities for the exploration and analysis of mass health data. it is possible to rely on these new technologies to modernize, optimize patient management at the level of emergency medical communication centres. our project aims to integrate the methods and tools of artificial intelligence for emergency medical communication centres. the system aims to help regulate emergency calls at crra 15 in france, or centrale 144 in switzerland, to assess the severity of calls, identify care pathways, and improve efficiency when committing resources. the development of such a system is aimed at securing and optimising the information system and the means of telecommunication used in the emergency medical communication centres, and provide an individualized response to the patient management.


Eligibility criteria:
inclusion criteria: * all patient which call the emergency medical communication centres exclusion criteria: * patient opposed to the study
hypertonic saline for fluid resuscitation after cardiac surgery

Conditions: Cardiovascular Diseases; Valvular Heart Disease

Summary: background: volume replacement strategies and type of fluid used in patients undergoing cardiac surgery have changed during the last years. currently used crystalloid solutes have a variable composition and a major impact on organ function and outcome. additionally critically ill patients are prone to fluid overload, which is despite common perception, not a benign occurrence as it is associated with prolonged icu- and hospital length of stay and increased mortality rates. fluid resuscitation using bolus or continuous infusion of hypertonic saline was used for more than thirty years. only a few studies have been conducted so far, but they showed that infusion of hypertonic saline results in less volume administered, increased renal function less weight gain in critically ill patients when compared to other crystalloids. aim: this preliminary randomized controlled double-blind study aims to identify whether fluid resuscitation using hypertonic saline (hs) when used in addition to lactated ringers solution results in less total fluid amount administered in patients following cardiac surgery. additionally we want to evaluate whether the use of hypertonic saline results less need for pharmacological cardiocirculatory support, increased renal function, less postoperative volume overload shortened post-cardiac bypass immune suppression and increased postoperative outcomes. study intervention: at admission to the icu patients will receive 5ml/kg body weight of 7.3% nacl or 0.9% nacl by infusion pump over 60 minutes. if necessary, fluid resuscitation will thereafter be performed with ringer's lactate to normalize peripheral perfusion and to allow weaning of vasopressors.


Eligibility criteria:
inclusion criteria: * adult patients undergoing cardiac surgery for ischemic or valvular heart disease exclusion criteria: * patients unable to give informed consent * patients with age \<18 years * pregnancy or breastfeeding * left-ventricular ejection fraction (lvef) \< 30% preoperatively * preexisting renal insufficiency with an egfr \<30 ml/min/1.73m2 * patients with postoperative circulatory support devices such as lvad, iabp, impella, ecmo * preexisting serum sodium of \>145mmol/l or \<135 mmol/l * preexisting serum chloremia \>107mmol/l or \< 98 mmol/l * systemic steroid therapy (at any dose at time of inclusion) * chronic liver disease (bilirubin \>3 mg.dl) * any signs of infection or sepsis defined as clear clinical evidence for active infection or current antibiotic therapy
uric acid and surgical prognosis

Conditions: Uric Acid

Summary: preoperative serum uric acid significantly impacted mortality and morbidity in non-cardiac surgery.

preoperative sua levels demonstrate a nonlinear, sex-specific relationship with postoperative outcomes in non-cardiac surgery.

Eligibility criteria:
inclusion criteria: * patients aged 18 years or older * patients who underwent non-cardiac surgery exclusion criteria: * emergency surgery * pregnancy * cadavers * patients with missing preoperative sua values or no follow-up after surgery

Keywords: uric acid mortality surgical prognosis acute kidney injury
the effects of vitamin d plus omega-3 polyunsaturated fatty acids in patients with episodic migraine

Conditions: Episodic Migraine

Summary: first, the aims of this study are to explore the effect of vitamin d versus placebo in the prevention of episodic migraine. second, we would like to compare and evaluate the effect of vitamin d plus omega-3 fatty acids versus placebo plus omega-3 fatty acids in terms of migraine frequency, symptom severity, and associated complications.

the purpose of this study is to investigate the effects of supplementing with omega-3 fatty acids and vitamin d on the prevention of muscle atrophy and lifestyle performance in migraine patients. furthermore, it aims to understand the biological mechanisms of action of omega-3 fatty acids and vitamin d in decreasing migraine attacks, the severity of headaches, and associated complications, as well as inflammatory markers.

Eligibility criteria:
inclusion criteria: 1. aged 20-65 years 2. episodic migraine diagnosis with ichd-3 3. baseline migraine days between 4 and 15 days per month 4. episodic migraine without or without aura 5. blood vit d\< 30ng/ml at baseline 6. with completed informed consent exclusion criteria: 1. non-migraine (ex: tension-type headache or secondary headache) 2. having major head trauma in the past 3. alcoholism within 1 year 4. patients with abnormal liver and kidney function and patients with other serious diseases such as infection with any inflammation 5. pregnant women or women who are still breastfeeding 6. those who are unable to cooperate with the progress of the trial and who have participated in other clinical studies. 7. patients with abnormal coagulation function or taking anticoagulant drugs 8. weight \ 80 kg 9. abnormal parathyroid function, intestinal dysfunction, hypercalcemia (total calcium ion concentration in blood\> 2.6 mmol/l) 10. conditions with high risk of hypercalcemia, such as: metastatic cancer, sarcoidosis, multiple myeloma, primary hyperparathyroidism 11. those who are allergic to fish or fish oil 12. vegetarian 13. taking beta-blockers, antiepileptic drugs, calcium ion blockers, antidepressants or hormonal preparations in the past month 14. using vitamin d (\> 3000 iu/day), calcium tablets, estrogen drugs, bisphosphonates, and other drugs to treat bone diseases.

Keywords: episodic migraine prevention vitd fish oil
combined treatment of arterial hypertension and atrial fibrillation

Conditions: Arterial Hypertension; Atrial Fibrillation

Summary: the purpose of this study is the comparative evaluation of systolic blood pressure (sbp) lowering, atrial fibrillation (af) recurrence and clinical data in patients with paroxysmal/persistent af and resistant/non-resistant hypertension, undergoing af ablation alone or combined with percutaneous renal denervation.

on the basis of the eligibility criteria, patients is assigned by the enrolling physician to one of two strata. the first stratum includes patients with moderate drug-resistant hypertension, defined by the joint national committee vii and esh/esc guidelines as office bp ≥ 140/90 mm hg and \<160/100 mm hg. the second stratum includes patients with drug-resistant hypertension, defined by office bp ≥ 160/100 mm hg.

Eligibility criteria:
inclusion criteria: * symptomatic drug-refractory af (with history of failure of ≥2 class i or iii antiarrhythmic drugs) in patients referred for catheter ablation of af * paf with ≥1 monthly episodes or persaf in patients who had already undergone ≥3 electrical cardioversions. paf was defined as episodes lasting less than 7 days with spontaneous termination. persaf was defined as lasting more than 7 days before being terminated pharmacologically or by electrical cardioversion. * office-based systolic blood pressure of ≥140/90 mm hg, despite treatment with 3 antihypertensive drugs (including 1 diuretic) * a glomerular filtration rate ≥45 ml/min/1⋅73 m2, with modification of diet using a renal disease formula exclusion criteria: * secondary causes of hypertension * severe renal artery stenosis or dual renal arteries * congestive heart failure with nyha ii-iv symptoms * left ventricular ejection fraction \<35% * transverse left atrial diameter \> 60 mm on transthoracic echocardiography 1. previous af ablation procedure 2. treatment with amiodarone * previous renal artery stenting or angioplasty * type 1 diabetes mellitus

Keywords: arterial hypertension atrial fibrillation percutaneous renal denervation
9 minutes for colonoscopy withdrawal

Conditions: Colon Polyps; Colorectal Adenomas

Summary: a withdrawal time of at least 6 minutes has been considered to be necessary to guarantee the adenoma detection rate and the critical quality criterion of colonoscopy. however, several large observational investigations demonstrated that 9 minutes will be in favor of higher adenoma detection rate and lower risk of interval colorectal cancer, when compared with 6-minute withdrawal. meanwhile, a few studies also indicated that no significant benefit were observed in longer withdrawal time. up to now, no randomized controlled trials have been conducted to give a definitive conclusion. therefore, we performed a multicenter, prospective, randomized controlled trial to compare adenoma detection rate of 6-minute and 9-minute withdrawal in colonoscopy.


Eligibility criteria:
inclusion criteria: * patients whose age is between 40-85. * patients who have indications for screening, surveillance and diagnostic colonoscopy. * patients who have signed inform consent form exclusion criteria: * patients who have undergone colonic resection * patients with intracranial and/or central nervous system disease, including cerebral infarction and cerebral hemorrhage. * patients with severe chronic cardiopulmonary and renal disease. * patients who are unwilling or unable to consent. * patients who are not suitable for colonoscopy * patients who received urgent or therapeutic colonoscopy * patients with pregnancy, inflammatory bowel disease, polyposis of colon, colorectal cancer, or intestinal obstruction * patients who are taking aspirin, clopidogrel or other anticoagulants * patients with aronchick score \> 3
efficacy of a non-invasive pelvic floor muscle trainer for treatment of stress urinary incontinence

Conditions: Stress Urinary Incontinence; Urinary Incontinence; Pelvic Floor Disorders

Summary: the goal of this clinical trial is to assess the efficacy and usability of the electromyography component of the company's pelvic health product in a patient population with stress urinary incontinence. the main questions it aims to answer are: does treatment with the device under study improve symptoms of stress urinary incontinence as measured by the iciq? participants will be given one of the devices under study, in addition to educational materials on use of the device, and a treatment schedule. participants will perform a standardized biofeedback-mediated pelvic floor muscle training program with the study device 10 minutes a day, five times a week for 4 weeks. there will be a mid-study check in to assure all devices are functioning appropriately. at the end of the study, participants will complete a post-treatment urinary incontinence symptom questionnaire(iciq).

this will be a prospective cohort study of women \> 18 years of age with symptoms of stress urinary incontinence, recruited via an online recruitment tool. after screening, patients meeting inclusion criteria will be given a study brochure, and then given instructions on how to indicate desire to participate in the study. the patient will then be contacted for study participation, including explanation of study and details and completion of informed consent. participants will then complete a pre-treatment urinary incontinence symptom questionnaire(iciq). after completion of the above, the participants will then be given one of the devices under study, in addition to educational materials on use of the device, and a treatment schedule. participants will perform a standardized biofeedback-mediated pelvic floor muscle training program with the study device 10 minutes a day, five times a week for 4 weeks. there will be a mid-study check in to assure all devices are functioning appropriately. at the end of the study, participants will complete a post-treatment urinary incontinence symptom questionnaire(iciq). endpoint of the study will be change in stress urinary incontinence symptoms as measured by the iciq. the iciq will be collected at 2 time points: before study entry, and at study close.

Eligibility criteria:
inclusion criteria: * female * 18 years of age or older * documented symptoms of predominantly stress urinary incontinence as determined by the iciq questionnaire exclusion criteria: * history of pelvic or lower back surgery pregnancy or less than 12 months post partum history of physician-supervised pfmt history of kegel exercises greater than once a month history of prior operative delivery self-reported history of pelvic organ prolapse stage ii or greater

Keywords: stress urinary incontinence pelvic floor disorders