Kornimate/medical-research-clean huggingface dataset:
microembolisation after carotid revascularisation

Conditions: Carotid Stenosis

Summary: microembolisation identified on diffusion-weighted magnetic resonance imaging (dw-mri) is recognized as an important outcome measure for carotid revascularization procedures such as carotid stenting (cas) or carotid endarterectomy (cea). in fact, cerebral microembolisation occurring during revascularization procedures is associated with an increased risk of peri- and post-procedural stroke, transient ischemic attack as well as neurocognitive decline. carotid artery stenting is a less invasive alternative to endarterectomy to treat symptomatic or asymptomatic carotid stenosis. large randomized clinical trials showed a higher periprocedural risk of non-disabling stroke with cas and a higher periprocedural risk of myocardial infarction, cranial nerve palsy, and access site hematoma with cea. however little is known regarding the correlation between the morphological characteristics of the carotid plaque and the occurrence of microembolisation during the procedure and between microembolisation and midterm cognitive impairment. a few studies suggest that plaque morphology may be an important determinant for the increased risk of microembolisation. these studies however have mainly investigated microembolisation occurring during cas and exploratory studies comparing the two procedures are still lacking. the purpose of the present study is to determine the correlation between the morphological characteristics of the carotid plaque and cerebral microembolisation either after carotid stenting or after carotid endarterectomy in patients with symptomatic or asymptomatic carotid disease.


Eligibility criteria:
inclusion criteria: * patients presenting a symptomatic (ipsilateral ischemic stroke, tia located in the carotid artery territory or retinal ischemia) carotid stenosis between 50% and 99% (according to nascet and ecst criteria) * patients presenting an asymptomatic carotid stenosis between 60% and 99% (according to nascet and ecst criteria) patients who accept the informed consent exclusion criteria: * important neurological deficit with nihss \>7 (or severe aphasia) at time of inclusion * previous known cognitive impairment * pregnancy * presence of contraindication based on ground of multidisciplinary team decision: * for surgery: high bifurcation intracranial extension of the carotid stenosis patients with tandem lesions high suspicion of severe siphon stenosis patients with previous irradiation of the cervical region patients with restenosis after endarterectomy * for stenting; excessive arch vessel or carotid artery tortuosity and in particular presence tortuosity ≤90 degrees in the cervical segment excessive aortic arch plaque burden patients older than 70 years unfavourable anatomic disposition as described above co-morbidities that may preclude the use of a periprocedural dual antiplatelet regime. * for ct-scan iodine allergy renal insufficiency * for mri pacemaker any other metallic implants claustrophobia * for ultrasound bad quality ultrasound (patient morphology or equipments

Keywords: cerebral microembolisation plaque characteristics
stand-on ride-on power mobility devices for children with cerebral palsy

Conditions: Cerebral Palsy

Summary: the goal of this interventional study is to learn about the biomechanical factors underlying the beneficial changes in children with cerebral palsy after using individually-adapted stand-on ride-on power mobility devices (pmd). the main questions we aim to answer are: * how does the use of stand-on pmds affect static balance in children with cerebral palsy? * how does the use of stand-on pmds affect dynamic balance and mobility function in children with cerebral palsy? children ages 4-6 years old with cerebral palsy (gmfcs levels ii and iii) will: * use individually-adapted stand-on pmds for three months. * undergo tests to measure static balance, dynamic balance, and mobility function before and after the intervention. * receive a full biomechanical assessment (kinematics, kinetics, muscle activity, gait spatiotemporal characteristics). researchers will compare pre-intervention and post-intervention measurements to quantify improvements in balance, muscle activation, and mobility.


Eligibility criteria:
inclusion criteria: 1. diagnosis of spastic diplegia cp, gmfcs level iii; 2. between 4 and 6 years old (age band selected based on the benefits of early intervention and the age-limitation imposed from the size constraints of the pmds (toy cars) selected for the intervention); 3. able to stand and to walk short distances (at least 10 meters) with or without external assistance; 4. physician medical clearance to participate; and 5. exhibit sufficient cooperation and attention so that simple verbal instructions can be followed. exclusion criteria: 1. have notable orthopedic conditions (e.g., lower extremity amputation; recent hip surgeries or soft tissue lengthening); 2. inadequate vision to complete study's procedures safely; 3. serious/unstable cardiac conditions that prevent engagement in the evaluation sessions; and 4. any other factor that might hinder full participation in the study or confound interpretation of the results.

Keywords: cerebral palsy power mobility device balance muscle activity mobility
custom needle preparation for suprachoroidal steroid injection (one year results)

Conditions: Diabetic Macular Edema; Vogt Koyanagi Harada Disease; Retinal Vein Occlusion

Summary: suprachoroidal drug delivery is a recent route for managing various ocular conditions. safety and long term results are still under investigations.

in this study, we aim to analyze the long term results of suprachoroidal injection in treating various retinal diseases to focus on its efficacy, safety and long term ocular effects as ocular hypertension, cataract progression and macular edema resolution.

Eligibility criteria:
inclusion criteria: * cases with central macular thickness more than 250 microns measured by optical coherence tomography due to one of the following conditions: * diabetic macular edema * vogt-koyanagi harada disease * retinal vein occlusion. exclusion criteria: * other causes of increased macular thickness as age related macular degeneration and myopic choroidal new vascularization. * cases with confirmed diagnosis of glaucoma.
a study conducted about a new mode of ventilation in laparoscopic surgeries

Conditions: Lung Injury, Acute

Summary: carbon dioxide insufflations of abdomen are integral part of laparoscopic operations in minimally invasive surgery era. it does cause splinting effect on diaphragm movement and set it high inside thoracic cavity too. in turn it will be associated with increase in peak and plateau airway pressure during positive pressure ventilation. inverse ratio ventilation has been shown to improve lung compliance and restrict the peak and plateau airway pressure and should be useful as one of the lung protective ventilation method to improve respiratory outcome in laparoscopy surgery.

anaesthesiologists have been ventilating patients in the perioperative period with relatively large tidal volumes (10-15 ml/kg ideal body weight) to prevent intraoperative atelectasis. ventilating patient with large tidal volumes may be a risk factor for development of lung injury.during surgical procedures, both general anesthesia and high tidal volumes may strain non injured lungs and trigger inflammation. high tidal volumes that cause alveolar overstretching can contribute to extra pulmonary organ dysfunction through systemic release of inflammatory mediators. recently protective lung ventilation strategies has been reported to be useful to reduce the respiratory complications in postoperative period. the use of small tidal volume (vt), positive end-expiratory pressure (peep) and restricting peak airway pressure have shown reduced incidence of ventilation induced lung injury. it has been shown that a small tidal volume (vt) and peep can reduce the incidence of postoperative lung dysfunction and improve intraoperative oxygenation. restricting peak airway pressure can be achieved by inverse ratio ventilation. minimizing the risk of ventilator-induced lung injury (vili), improving oxygenation and alveolar recruitment are all advantages of inverse ratio ventilation. however, the potential utility of pressure controlled inverse ratio ventilation (pcirv) has not been studied in patients undergoing general anaesthesia. investigators hypothesized that in patients with normal lungs scheduled for general anesthesia, piv might prevent lung function deterioration and lung morphological alterations. investiagators aim was to compare the intraoperative protective ventilation strategies on oxygenation/ ventilation and postoperative lung dysfunction and lung injury among patients undergoing laparoscopic upper abdominal surgery.

Eligibility criteria:
inclusion criteria: * age 18-60 years * asa- i and ii * patients undergoing laparoscopic upper abdominal surgery exclusion criteria: * significant pulmonary disease * significant cardiac dysfunction * bmi\>30 kg/m2
using micro-filaments to detect "fast ripples" and improve the identification of the epileptogenic zone

Conditions: Epilepsy, Refractory

Summary: record fast ripples with novel intracranial electrodes with micro-tetrodes to improve the identification of epileptogenic zone (ez) and investigate the neuronal circuits underlying brain dynamics associated with epilepsy

this study would improve the localization of the epileptogenic zone and reduce the overall duration of monitoring, especially in patients who do not experience a sufficient number of seizures during the implantation period. in addition, it would be possible to use micro-electrodes and propose a better surgical treatment to some patients whose preliminary assessment with macro-electrodes has not provided significant results. finally, the data collected during this study will help us to further understand pathological brain activity and to describe the neuronal circuitry that gives rise to cortical signals and the relationships between them (from spindles to high frequency oscillations).

Eligibility criteria:
inclusion criteria: * inclusion criteria is determined based on the clinical diagnosis of the refractory epilepsy and the admissibility of the patient for the stereoelectroencephalography (seeg) procedure exclusion criteria: * severe psychiatric disorders, * severe agitation during their crisis * contraindication for performing an mri: claustrophobia, a cardiac or neural stimulator, ferromagnetic surgical clips, cochlear implants, intraocular metallic foreign body or in the nervous system, * contraindication to intracerebral investigation (macro-electrodes): ongoing infection, severe associated pathology (cardiac, pulmonary, renal, hepatic), pregnant or nursing women, * anti thrombotic ongoing treatment.
budesonide foam versus placebo for prevention of acute radiation proctitis

Conditions: Radiation Proctitis

Summary: to proof the superiority of an 8-week rectal treatment with once-daily 2 mg budesonide versus placebo for the prevention of acute radiation proctitis, and to evaluate the occurrence of chronic radiation proctitis 1 year after start of radiation therapy.


Eligibility criteria:
inclusion criteria: * signed informed consent, * men aged at least 18 years, * patients with ecog performance status \ = 70%, * estimated life expectancy more than 3 years, * diagnosis of prostate carcinoma, * indication for local rt in patients with prostatic cancer. exclusion criteria: * crohn's disease, indeterminate colitis, ulcerative colitis, microscopic colitis (i.e., collagenous colitis and lymphocytic colitis), * severe or symptomatic ischaemic colitis at baseline, * grade iii internal haemorrhoids at baseline, * high risk patients needing extended radiation therapy, * acute eortc/rtog lower gi toxicity score of \>=1 at baseline, * bacterial, amoebic, fungal, or viral infections of the gut, * tuberculosis, hypertension, infection, diabetes mellitus (included familiarly predisposition), active peptic ulcer, osteoporosis, glaucoma, or cataract, if careful medical monitoring is not ensured, * portal hypertension or liver cirrhosis, * abnormal hepatic function (alt, ast or ap \> 2.5 x uln), * known intolerance/hypersensitivity/resistance to study drug or drugs of similar chemical structure or pharmacological profile, or to any of the other constituents of the study drug, * participation in another clinical trial within the last 30 days, simultaneous participation in another clinical trial, or previous participation in this trial

Keywords: budesonide placebo acute radiation proctitis late radiation proctitis prevention of acute radiation proctitis prevention of late radiation proctitis
evaluate alln-177 in patients with enteric hyperoxaluria

Conditions: Enteric Hyperoxaluria

Summary: the purpose of this study is to determine the efficacy and safety of alln-177 in patients with enteric hyperoxaluria.

this is a phase 3, multicenter, randomized, double-blind, placebo-controlled study. this study is designed to determine whether treatment with alln-177 for 28 days can reduce urinary oxalate excretion in patients with enteric hyperoxaluria and to evaluate the safety of alln-177 in this patient population compared to placebo.

Eligibility criteria:
inclusion criteria: 1. provided informed consent 2. age 18 or older 3. history of hyperoxaluria secondary to a known underlying enteric disorder associated with malabsorption (e.g., bariatric surgery, crohn's disease, short bowel syndrome, or other malabsorption syndrome) 4. urinary oxalate ≥ 50mg/24h exclusion criteria: 1. acute renal failure or estimated glomerular filtration rate (egfr) \< 30ml/min/1.73 m2 2. unable or unwilling to discontinue vitamin c supplementation

Keywords: kidney stones hyperoxaluria enteric hyperoxaluria oxalate
long-term safety of tafamidis in subjects with transthyretin cardiomyopathy

Conditions: Transthyretin (TTR) Amyloid Cardiomyopathy

Summary: open label study to evaluate tafamidis for the treatment of transthyretin cardiomyopathy

global phase 3, open label long term extension safety study designed to obtain additional safety data for tafamidis meglumine 20 mg and 80 mg (or tafamidis 61 mg where available), and to continue to provide enrolled subjects with tafamidis for up to 60 months, or until subject has access to tafamidis for attr cm via prescription, whichever occurs first.

Eligibility criteria:
inclusion criteria: cohort a: completion of 30 months of study treatment on pfizer protocol b3461028 cohort b: patients in specific countries diagnosed with attr-cm who did not previously participate in pfizer study b3461028 exclusion criteria: -liver and/or heart transplant, or implanted cardiac mechanical assist device

Keywords: amyloidosis amyloid transthyretin ttr attr-cm
combined screening for gastrointestinal tumors

Conditions: Gastrointestinal Tumors

Summary: all participants are required to complete a questionnaire, a helicobacter pylori (h. pylori) test, and a fecal immunochemical test (fit). the questionnaire covers nine aspects: basic information of the participants, symptoms and previous examinations, medical history and surgical history, medication history, smoking history, alcohol consumption history, dietary habits, physical exercise, and family history. after quality control, the data is entered by staff into the zhejiang province cancer screening information platform. risk assessments are performed based on the data collected and high-risk individuals are recommended for clinical screening. additionally, tongue image, stool, urine, blood, tongue coating, saliva, gastric juice, and fresh tissue (gastric mucosa tissue and/or intestinal polyp tissue) samples are collected from all participants undergoing clinical screening. participants are required to complete at least one passive follow-up annually. active follow-ups are conducted for those with positive screening results to ensure timely completion of endoscopic examinations. for those who have not undergone endoscopic examinations despite positive screening results, health education is provided, and they are mobilized at least four times within one month to complete endoscopic examinations. for participants diagnosed and treated for precancerous lesions and tumors, diagnostic and treatment data must be collected, and they are encouraged to follow up as per medical advice. both active and passive follow-up results must be recorded in the screening follow-up information record form and reported to the zhejiang province cancer screening information platform. this is a government collaboration project. all subjects will also be followed by record linkage to cancer register and population register.


Eligibility criteria:
inclusion criteria: * subject residents from zhejiang province. * subject is able to comprehend, sign, and date the written informed consent document to participate in the study. * subject has psychical condition and well consciousness, and also accept and cooperate with the follow-up of this study. exclusion criteria: * subject has heavy cardiovascular, liver or kidney disease. * subject is already suffering from malignant tumors of the digestive tract. * subject has severe intellectual disabilities or language communication barriers. * subject has had gastrointestinal endoscopy in the past year.
evaluation and importance of the pd-1/pd-l1 and the il-10/il-10r axis in malignant and benign pleural effusions - a pilot study

Conditions: Pleural Effusion

Summary: the aim of this study is to evaluate the concentrations of interleukin-2, interleukin-10, interferon-gamma, pd1+ lymphocytes, and the interleukin-10 receptor expression in malignant and benign effusions.

in this prospective trial, 80 patients with pleural effusions and indication for thoracocentesis, drainage, indwelling pleural catheter (ipc) management and/or video-assisted thoracoscopic surgery are enrolled. the pleural effusion will be examined for different cytokines, cytokine-receptors, pd1-lymphocytes and cd4+/cd25+/foxp3+ regulatory t cell.

Eligibility criteria:
inclusion criteria: * age \>18 years * radiologically confirmed pleural effusion with an indication for puncture, pleural drain insertion, or video-assisted thoracoscopy for diagnostic and/or therapeutic reasons * signed declaration of consent exclusion criteria: * withdrawal or cessation of participation
determining the minimal effective volume (meav95) for interscalene brachial plexus block for surgical anesthesia

Conditions: Shoulder Pain

Summary: interscalene block (isb) consistently demonstrates superior pain relief after shoulder surgery. however, patients can experience complications such as blurred vision, hoarseness and shortness of breath with the standard volumes of local anesthetic used in contemporary practice. patients with respiratory diseases are precluded because of the potential effects on respiration. however, they are then exposed to the risks of general anesthesia and opioid medications which can also have detrimental effects on respiration. ultrasound guided isb can reduce the local anesthetic volume required to produce anesthesia for shoulder surgery; this may reduce the complications from isb to allow patients previously unable to benefit to have this technique, such as patients with obesity and respiratory disease. in order to do so the investigators will use an up-down methodology to find the minimum volume of local anesthetic to provide sufficient anesthesia for shoulder surgery.


Eligibility criteria:
inclusion criteria: * patients undergoing elective arthroscopic shoulder surgery in the sitting position * patients aged \>=18 and \<=75 years * asa i-iii exclusion criteria: * patient refusal for surgery under isbpb with sedation * lack of capacity to provide informed consent * pre-existing copd, unstable asthma or diaphragmatic dysfunction * coagulopathy * infection at injection site * allergy to local anesthetics * opioid tolerance (\>30mg oral morphine or equivalent/day for \>1 week) * bmi\>40 * inability to complete questionnaires and assessments (consent, follow-up phone call) due to language barrier * pregnancy or lactation

Keywords: ispb brachial plexus block anesthesia pain management surgery
evaluating the effectiveness of piscean derived collagen dressing on neuropathic diabetic foot ulcer in t2dm patients

Conditions: Diabetic Foot Ulcer Neuropathic; Diabetic Foot Ulcer

Summary: diabetic foot ulcers (dfu) are challenging to treat with complicated healing processes and require advanced wound care. piscean collagen has the potential to promote the regenerative process while remaining cost-effective and with minimal side effects. in this study, the efficacy of a piscean collagen matrix dressing was compared with a standard dressing of saline-moistened gauze for wound healing in patients with neuropathic dfu. this is a double-blinded, randomised clinical trial.

diabetic foot ulcers (dfu) are challenging to treat with complicated healing processes and require advanced wound care. piscean collagen has the potential to promote the regenerative process while remaining cost-effective and with minimal side effects. in this study, the efficacy of a piscean collagen matrix dressing was compared with a standard dressing of saline-moistened gauze for wound healing in patients with neuropathic dfu. this is a double-blinded, randomised clinical trial. after conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a piscean matrix dressing (the study group) or a saline-moistened gauze dressing (control group) for wound care. the reduction in dfu size and the number of patients with complete healing were measured throughout the treatment and in follow-up.

Eligibility criteria:
inclusion criteria: * patients with neuropathic dfus at grades i or ii for a period of at least 12 weeks, based on the wagner classification; * be able to understand simple instructions and provided voluntary, signed informed consent. exclusion criteria: * active infection which might lead to hospitalisation, gangrene, * systemic inflammatory or autoimmune disease * renal failure * presence of ischaemia or osteomyelitis