Kornimate/medical-research-clean huggingface dataset:
sorafenib vs.transarterial chemoembolization plus radiotherapy in hepatocellular carcinoma with macrovascular invasion

Conditions: Hepatocellular Carcinoma

Summary: to evaluate and compare the efficacy and safety of sorafenib versus trans-arterial chemoembolization plus external beam radiation therapy in patients with hepatocellular carcinoma invading major intrahepatic vessels

current practice guidelines recommend only sorafenib for patients with hepatocellular carcinoma invading major intrahepatic vessels. however, recent data from observational studies suggest that the combination of transarterial chemoembolization and external beam radiotherapy would be as effective as sorafenib.

Eligibility criteria:
inclusion criteria: * age \>19 years * child-pugh class a liver function * performance status: eastern cooperative oncology group (ecog) score 0 or 1 * hepatocellular carcinoma (hcc) confirmed by dynamic ct or mri, or by biopsy * hcc invasion of first or second branch portal vein or hepatic vein or inferior vena cava * reserved unilateral portal blood flow at least in partial * hcc size larger than 1 cm and less than 50% of total liver volume * no confirmed extrahepatic metastasis * adequate hematopoietic function hemoglobin ≥ 8.5 g/dl absolute neutrophil count ≥ 750/mm3 platelet count ≥ 30,000/mm3 * creatinine \< 1.5mg/dl * no plan for pregnancy or breast feeding. active contraception. * willing to give informed consent exclusion criteria: * prior history to or exposure of transarterial chemoembolization, external beam radiation to liver, or sorafenib * complete obstruction of hepatic outflow * confirmed extrahepatic metastasis of hcc * hcc occupying more than 50% of liver volume * uncontrolled ascites of hepatic encephalopathy * prior liver transplantation * positive for human immunodeficiency virus (hiv) * active gastric or duodenal ulcer * other uncontrolled comorbidities or malignancy * inability to give informed consent

Keywords: liver cancer first-line tumor thrombus vascular invasion
perioperative erector spinae plane block in thoracoscopic surgery

Conditions: Pain, Postoperative; Regional Block

Summary: the erector spinae plane block (espb) is a novel myofascial plane block. the espb is targeted at anterior surface of the erector spinae plane, which is oriented cephalocaudally to the spinal transverse process. local anaesthetic injected in this plane can block the dorsal rami and ventral rami and intercostal nerves. the aim of this study was to evaluate the effect of espb on postoperative pain in thoracic surgery.

the erector spinae plane block (espb) is a newly defined regional anesthesia technique for thoracic analgesia. the blocks were performed at the t5 level of the spine using an in-plane approach.previous studies were not designed as randomized controlled trial. in this study, the efficacy of espb is to confirm with randomized controlled trial design. espb will be performed in video assisted thoracoscopy preoperatively. after the surgery, the efficacy of espb will be assessed.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists patients with physical class 1, 2 * patients undergoing video assisted thoracoscopic surgery exclusion criteria: * patients who experienced side effects on local anesthetics * patients with abnormal blood coagulation tests (inr\> 1.5) * pregnant or lactating patients
effect of neuromuscular electrical stimulation in patients with chronic low back pain

Conditions: Low Back Pain; Paraspinal Muscles

Summary: this study evaluates the effect of a 10-week long intervention with the stimawell 120mtrs system on multifidus morphology and function in individuals with chronic low back pain. half the participants will receive muscle therapy at the device's phasic setting, while half will receive muscle therapy at the device's combined setting. this study also evaluates the acute effect of a single treatment with the stimawell 120mtrs on multifidus stiffness in individuals with chronic low back pain.


Eligibility criteria:
inclusion criteria: * chronic non-specific lbp (\>3 months), defined as pain in the region between the lower ribs and gluteal folds, with or without leg pain. * aged between 18 to 60 years old. * english or french speakers * at least a 4/10 score on an 11-point numerical pain rating scale (nprs) for pain intensity. the score will be the average of current pain, and best and worst pain over the previous week. * at least a 'moderate' modified oswestry disability index (odi) score. * able to undergo mri exam. exclusion criteria: * currently undergoing or having received physical therapy treatment in the previous month * consistent motor control training for the low back and / or consistent weightlifting, power-lifting, bodybuilding, or strongman training in the previous 6 weeks * history of lumbar surgery * presence of positive lumbosacral dermatomes or myotomes * presence of disease which could affect the stiffness of muscle tissue (collagen tissue disease, hemiplegia, multiple sclerosis, blood clots) * presence of systemic disease (cancer, metabolic syndrome) * presence of rheumatoid arthritis * presence of spinal stenosis, fracture, infection, or tumor * presence of lumbar scoliosis greater than 10 degrees * presence of cardiac arrhythmia * pregnant and breastfeeding women * individuals with epilepsy * individuals at risk for serious bleeding * individuals with pacemakers or metal implants * individuals with aneurysms or heart valve clips * individuals with tattoos or piercings in the lumbar spine * individuals who have taken prescribed muscle relaxants more than once a week over the past month * bmi \> 30

Keywords: diagnostic imaging electrical stimulation therapy low back pain paraspinal muscles
proximal lower limb intramuscular block : effects on hemiparetic gait

Conditions: Neurologic Disorder; Spastic Hemiplegia; Gait, Hemiplegic; Block

Summary: to assess feasability, tolerance of anesthesic intramuscular motor block. to study immediate effects on differents muscles : gluteus maximus, rectus femoris in a hemiparetic population (over 15 days) to precise the role of the muscles which could be rehabilitatoin targets.

spastic paresis comprises both muscular and neurological disorders affecting movement through mostly the antagonist muscles compared to the agonist : muscular : spastic myopathy, shortening, stretch-sensitive paresis and neurogenic : spastic dystonia and cocontraction. about gait, most of the litterature focuses on distal muscles targets. there are no studies about proxmial muscles role (gluteus maximus). anesthesic perineural block have the disavantage to induce sensitive block as intramuscular block do not.

Eligibility criteria:
inclusion criteria: * able to consent * avoiding ground swing phase gait disorder exclusion criteria: * severe cognitive disorder * inr \> 3.5 * local cutaneous affection on injection sites * acute medical affection * seizure * hypersensitivity to anesthesics * brugada syndrome * porphyria * severe cardiac disorder * polyradiculopathy * botulinum toxin injection \< 2 months
the comparison of sympathetic blockade of stellate ganglion block and thoracic paravertebral block

Conditions: Complex Regional Pain Syndromes; Postherpetic Neuralgia; Phantom Limb Pain; Chronic Post Surgical Pain; Post-Traumatic Neuralgia; Neuropathic Pain

Summary: the purpose of this study is to investigate the effect of ultrasound-guided thoracic paravertebral block (tpvb) when performing sympathetic block for upper limb pain control.

well-trained pain physicians performs all us-guided stellate ganglion block(sgb)s or us-guided thoracic paravertebrl block(tpvb)s, who is not involved in evaluating study variables. electrocardiography, noninvasive blood pressure, heart rate, and peripheral oxygen saturation were monitored for all patients before, while, and after conducting procedure. for us-guided sgb, patients are supine positioned, and skin preparation on injection site is done with chlorohexidine. procedure is conducted under ultrasound guidance at c6 level. 5 ml of 1% mepivacaine is injected for the sgb group. syringes are prepared by one nurse who do not involved in other steps of this study. for us-guided tpvb, patients are prone positioned, and skin preparation on injection site is done with chlorohexidine. procedure is conducted under ultrasound guidance at t2 paravertebral space. 10 ml of 1% mepivacaine is injected for the tpvb group. syringes are prepared by one nurse who do not involved in other steps of this study. temperature measurement is conducted 2 times (before us-guided sgb or tpvb and after 20 minutes) at both hands by one person who's not involved in other measuring in the study.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of complex regional pain syndrome * clinical diagnosis of postherpetic neuralgia * clinical diagnosis of phantom limb pain * clinical diagnosis of chronic post-surgical pain * clinical diagnosis of post-traumatic pain syndrome * upper extremity pain lasting more than 3 months patients with a new or known diagnosis of chronic neuropathic pain lasting more than 3 months in the upper extremity exclusion criteria: * refusal of a patient * any vascular disease in the upper extremities * previous history of thoracic sympathetic or stellate ganglion neurolysis (e.g. -thermocoagulation, radiofrequency neuromodulation, and/or chemical neurolysis) * coagulopathy * systemic infection or local infection at the needle injection site * major deformation at the level of the neck (radiotherapy, surgery, etc.) * known allergy to local anesthetics of amide type * inability to understand a numeric rating pain scale (cognitive dysfunction) * patients whose palm temperature on the ipsilateral side is ≥ 36.5℃ in the thermography before the procedure
co2 absorption during laparoscopy

Conditions: Pneumoperitoneum

Summary: co2 absorption from the pneumoperitoneum increases over time during laparoscopic procedures. adding 4% of oxygen to the carbon dioxide was shown in rabbits to decrease co2 resorbtion through prevention of mesothelial hypoxia. we want to prove this concept in human and expand it to the use of full conditioning.

in order to confirm the animal data in the human, a first rct was performed in which 20 women undergoing a laparoscopy for at least 60 minutes were randomised to a pneumoperitoneum with either 100% carbon dioxide or 96% carbon dioxide plus 4% of oxygen. insufflation pressure and trendelenburg were standardised at 15 mm hg and 30° respectively. in a second trial women were randomized to either 100% carbon dioxide or 86% carbon dioxide plus 4% of oxygen + 10% nitrous oxide + humidification and set temperature of 32°c of the peritoneal cavity.

Eligibility criteria:
inclusion criteria: * women/men planned to undergo a laparoscopic intervention for at least 1 hour and having signed the informed consent exclusion criteria: * pregnancy * immunodeficiency * refuse or unable to sign informed consent * chronic disease (i.e. copd, crohn, cardiac...)

Keywords: women undergoing laparoscopic surgery for: hysterectomy, colpopexy, endometriosis, adhesions or myomas
minimal residual disease quantification by next-generation sequencing in pediatric b-all children patients treated with blinatumomab consolidation

Conditions: Acute Lymphoblastic Leukemia, Pediatric

Summary: a retrospective analysis to investigate pediatric b-cell acute lymphoblastic leukemia patients who were treated with blinatumomab for consolidation, and who were detected as minimal residual disease (mrd) positive by next generation sequencing (ngs). the efficacy of blinatumomab clearing mrd detected by ngs will be analyzed, in order to see the potential of using ngs to guide mrd eradication by blinatumomab.


Eligibility criteria:
inclusion criteria: * patients diagnosed with b cell precursor acute lymphoblastic leukemia * patients who received blinatumomab for consolidation * patients who were detected mrd positive by ngs before initiation of blinatumomab treatment exclusion criteria: * patients without data of ngs detection after receiving blinatumomab treatment
pregabalin add-on for neuropathic pain in cervical myelopathy

Conditions: Pain, Neuropathic

Summary: there is no information on the effect of pregabalin in patients with neuropathic pain in cervical myelopathy under routine clinical practice. the investigators will conduct this prospective, randomized trial to determine the efficacy of pregabalin for neuropathic pain in cervical myelopathic patients in order to validate or refute this popular practice. the primary aim of this study was to compare leeds assessment of neuropathic symptoms and signs scale (lanss) scores of neuropathic pain in cervical myelopathy patients.

neuropathic pain is a well-recognized clinical entity. it is defined as pain caused by the lesion or dysfunction of the peripheral or central nervous system, and it can be diagnosed by well-established clinical criteria. neuropathic pain is caused by lesions or dysfunction of the nervous system and is initiated by several cellular and molecular mechanisms. compression of neural and neurovascular structures may result in neuropathic pain. although a number of therapies are available for neuropathic pain, including antidepressants, tramadol, opioids, and different antiepileptic drugs, the results of a recent systematic review suggest that, in view of their balance between efficacy and tolerability, pregabalin can be regarded as first line treatments for peripheral pain with a neuropathic component. pregabalin is one of antiepileptic drugs (aeds) that have been studied in the treatment of a wide variety of disorders, such as neuropathic pain, epilepsy, spasticity, and anxiety. the use of aeds in the treatment of neuropathic pain is based on a number of similarities in the pathophysiologic and biochemical mechanisms underlying neuropathic pain and epilepsy. its use for the treatment of several neuropathic pain syndromes is common, and it is approved by the food and drug administration (fda) for the treatment of diabetic neuropathy, post-herpetic neuralgia, fibromyalgia and spinal cord injury, a model of central neuropathic pain. the off-label use of pregabalin for the various pain syndromes in general, and for neuropathic pain in particular, is ubiquitous. however, minimal support for this practice exists in the literature and its cost is perhaps exorbitant. there is no information on the effect of pregabalin in patients with neuropathic pain in cervical myelopathy under routine clinical practice.

Eligibility criteria:
inclusion criteria: 1. between the ages of 18 to 80 years 2. among patients with cervical myelopathy, patients with neuropathic pain (lanss pain scale ≥ 12) 3. completing 8-week drug trial exclusion criteria: 1. current or prior gabapentin or pregabalin use 2. chronic use of narcotic pain medications 3. chronic depression or the use of anti-depressants 4. history of addiction and/or substance abuse 5. presence of significant motor deficits, and /or bowel and/or bladder dysfunction 6. known renal insufciency, diabetes, congestive heart failure, cardiac conduction abnormalities, and thrombocytopenia
efficacy study of altabax to clear methicillin-resistant staphylococcus aureus (mrsa) nasal colonization

Conditions: Methicillin-resistant Staphylococcus Aureus

Summary: the purpose of the study is to determine whether altabax (retapamulin ointment, 1%) is effective in the treatment of methicillin-resistant staphylococcus aureus (mrsa) nasal colonization. the hypothesis is that the prevalence of mrsa increases as a function of increasing clinical exposure and that the topical antibiotic altabax is efficacious in clearing mrsa nasal colonization. the prevalence of mrsa nasal colonization among tulane university medical students and residents and physicians of tulane medical center and ochsner medical center will be investigated. a total of 300 subjects will be recruited for the study. after giving informed consent, subjects will be swabbed to obtain specimens for culture and asked to complete a short survey to assess risk factors. swabs will be used to directly inoculate three types of plates: chromagar mrsa plates, spectra mrsa plates, and tsa with sheep blood plates. after appropriate incubation, staph latex slide tests will be done and then results confirmed with cefoxitin disk susceptibility testing. mrsa positive subjects will be offered a treatment protocol with the topical antibiotic altabax (retapamulin ointment, 1%) to be applied as a thin layer to the anterior nares twice daily for 5 days. after the 5-day treatment is complete, subjects will be retested for the presence of mrsa at day 7, day 12, day 30, and day 90. for this portion of the study, all cultures will additionally undergo disk susceptibility testing for retapamulin, erythromycin, clindamycin (including d-test), trimethoprim sulfa, and mupirocin (5 mcg and 20 mcg disks). in addition, etests for retapamulin and mupirocin will be done. genetic isolates will be characterized by rep-pcr pre-treatment and post-treatment. data will be analyzed for mrsa prevalence and risk factor associations with mrsa colonization. of those subjects found to be mrsa positive, data from the follow-up cultures will be used to assess the efficacy of altabax in clearing mrsa nasal colonization.


Eligibility criteria:
inclusion criteria: * subjects must be either a student, resident, or physician at tulane university or be a resident or physician at ochsner medical center. exclusion criteria: * subjects who are pregnant or who are presently taking antibiotics or require treatment with systemic antibiotics at anytime during the course of the study.
psychobiological mechanisms of placebo and nocebo effects in the treatment of chronic back pain

Conditions: Chronic Lower Back Pain; Healthy Control Subjects

Summary: placebo and nocebo responses have mainly been studied in healthy humans for pharmacological rather than psychological interventions. moreover, only few studies examined patients or tested how previous experience and attitudes affect placebo and nocebo responses. on the psychological level expectancy and classical conditioning have been identified as two primary mechanisms. both seem to be important with classical conditioning potentially having more long-term effects and expectancy being more important in nocebo effects. there is some initial evidence from the investigators own research that patients may be more prone to these effects and the investigators have also shown that placebo effects may last up to several years after treatment. the investigators therefore examine previous attitudes to pharmacological interventions for chronic pain in patients with chronic back pain and subdivide them into groups with high of low belief in the respective treatment modality. the investigators then apply a pharmacological placebo and study the interaction between the prevailing attitude (implicit and explicit) and the placebo effect with respect to pain perception but also to neurobiological mechanisms using functional magnetic resonance imaging. in addition to expectancy, conditioning of placebo will be examined and the long-term effects of the intervention will be determined.


Eligibility criteria:
inclusion criteria: * male and female human subjects with chronic back pain (chronic persistent and recurrent pain \> 6 months) * age between 18 and 65 * voluntary participation. exclusion criteria: * acute or chronic somatic diseases and inflammatory, neuropathic or tumor-related pain * acute and chronic mental disorders according to dsm-iv (except for comorbid anxiety or depression, which are frequent in chronic pain) * insufficient german language skills * cognitive limitations * intake of opioid medication or tranquilizers * metal implants or electric implants that cannot be removed * pregnancy * claustrophobia * history of epilepsy, brain trauma, or brain tumor
degenerative achilles tendon rupture repair with regeneten augmentation

Conditions: Achilles Tendon Rupture; Achilles Tendinopathy

Summary: retrospective case series to investigate the effect a bovine collagen patch to augmented repair in acute achilles tendon rupture with pre-existing tendinopathy

retrospective case series. investigate the effect a bovine collagen patch to augmented repair in acute achilles tendon rupture with pre-existing tendinopathy. acute achilles tendon rupture patients all underwent pre-operative ultrasound; those with tendinopathy enrolled into study. standard achilles tendon repair performed; augmented with a bioinductive collagen patch (regeneten)

Eligibility criteria:
inclusion criteria: * pre-operative ultrasound confirmation of tendinopathy exclusion criteria: * underwent lower limb intervention with past 3 months * physical or psychological condition impairing ability to consent * physical or psychological condition impairing ability to adhere to rehabilitation protocol * allergy to bovine material * pregnant individuals

Keywords: achilles regeneten tendinopathy
spironolactone to decrease potassium wasting in hypercalciurics on thiazides diuretics

Conditions: Idiopathic Hypercalciuria; Hypokalemia Caused by Thiazide Diuretics

Summary: kidney stone formation due to an excess of calcium in the urine is a common problem. it is treated with thiazide diuretics. these drugs often cause excessively low blood potassium levels that in turn require large doses of potassium supplements. these supplements are often large, unpleasant and easy to forget. we are trying the addition of spironolactone to these patients' medications to see if it allows them to take a lower dose of potassium.

see rationale above ten patients who have had multiple kidney stones primarily due to hypercalciuria and who are currently on stable dose of thiazide or thiazide plus amiloride will be enrolled in the study. in addition, pts have to require at least 60meq of k supplementation a day or be on 40meq and be hypokalemic and unable to tolerate increased k supplements. we will then give them 50mg a day of spironolactone for four weeks. a complete 24-hour urine stone profile will be obtained before and after the drug is administered. after four weeks the patients' serum potassium will be rechecked, and their dose will be lowered according to a nomogram. primary end point is the mean change in serum k before and after spironolactone. secondary endpoints are the change in urine calcium on and off the drug and the mean reduction in k dose on the drug.

Eligibility criteria:
inclusion criteria: * age 18-65 * history of idiopathic hypercalciuria (\>200mg per 24 hours or a ca/cr ratio of \>140) felt to be the primary etiology of patient's kidney stones * history of at least three kidney stone events * on same dose of thiazide diuretic for at least three months * on stable dose of k 60meq or more a day to maintain serum k \>3.5 or unable to tolerate an increase in k supplement with dose at least 40meq a day exclusion criteria: * use of ace inhibitor, ace receptor blocker or other medication known to effect serum potassium levels * gfr \<80 by mdrd equation * serious cardiac disease, diabetes, ckd , current or planned pregnancy or breastfeeding * history of hypertension

Keywords: nephrolithiasis hypercalciuria hypokalemia thiazide diuretics