Kornimate/medical-research-clean huggingface dataset:
biliary anastomosis using surgical loupe versus microscope in living donor liver transplantation

Conditions: Liver Failure; Liver Diseases; Liver Cancer; Liver Neoplasms; Liver Dysfunction

Summary: comparison of biliary complications in right lobe living donor liver transplantation patients undergoing biliary reconstructions using microscope versus surgical loupes .

liver transplantation (lt) is the most effective treatment modality in patients with end-stage liver disease and it is also established as a viable treatment option in the field of oncology. living donor liver transplantation (ldlt) using the right lobe (rl) is a major achievement despite its technical challenges, which has created a significant increase in graft supply. while a secure bile duct anastomosis is one of the basic principles of a successful liver transplant procedure, biliary reconstruction remains the achilles' heel of ldlt because of the high incidence of posttransplant biliary complications associated with significant recipient morbidity and mortality. some of these complications are related to technical difficulties due to multiple small biliary orifices, particularly in right lobe grafts. in our center, we have been using microsurgical reconstruction technique for duct-to-duct biliary anastomosis in such grafts. the routine use of this technique has been shown to significantly decrease biliary complications in single-center retrospective studies. however, prospective controlled studies comparing microsurgical and standard biliary reconstruction techniques are lacking. in this study, our objective is to compare posttransplant complications of the two techniques of biliary reconstruction in rl ldlt. 40 patients will be included in the study. they will be randomly allocated in the equal groups.i̇n group 1 biliary anastomosis will be performed using surgical loupes and i̇n group 2 biliary anastomosis will be performed using microscope. the patients will be followed for one year after the transplant to compare biliary complications.

Eligibility criteria:
inclusion criteria: * 1.primary adult living donor liver transplant 2.right lobe grafts with a single biliary orifice exclusion criteria: * 1.bile duct diameter \< 3mm 2.biliary costructions with a hepaticojejunostomy 3.right lobe grafts with multipl biliary orifice

Keywords: liver transplantation living donor liver transplantation biliary anastomosis
a study of taspoglutide versus placebo for the treatment of obese patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy

Conditions: Diabetes Mellitus Type 2

Summary: this 2 arm study will assess the efficacy, safety and tolerability of taspoglutide compared to placebo in obese patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy. patients will be randomized to receive taspoglutide (10mg sc once weekly for 4 weeks followed by 20mg once weekly) or placebo sc, in addition to their prescribed, pre-existing metformin therapy.after the first 24 weeks, patients on placebo will be switched to taspoglutide 20mg once weekly (after 4 weeks on taspoglutide 10mg once weekly) the anticipated time on study treatment is 12 months, and the target sample size is 100-500 individuals.


Eligibility criteria:
inclusion criteria: * adult patients, 18-75 years of age; * type 2 diabetes mellitus, receiving metformin at a stable dose of \>=1500mg/day for at least 12 weeks; * hba1c \>=6.5% and \<=9.5% at screening; * bmi \>=30 and \<=50 kg/m2 at screening; * stable weight +/-5% for at least 12 weeks prior to screening. exclusion criteria: * history of type 1 diabetes or acute metabolic diabetic complications such as ketoacidosis or hyperosmolar coma within the past 6 months; * evidence of clinically significant diabetic complications; * myocardial infarction, coronary artery bypass surgery, post-transplantation cardiomyopathy or stroke within the past 6 months.
analgesic effect of intra-articular bupivacaine fentanyl for postoperative pain relief in knee arthroscopic surgery

Conditions: Knee Arthroscopic Surgery

Summary: however, local anesthetic agents can produce analgesia for a limited time when used as a single injection. bupivacaine is a local anesthetic that has an immediate action on pain by blocking peripheral afferents. however, as the ideal analgesic, the drug must cover the whole postoperative period (≥ 24 hours); therefore, bupivacaine is usually combined with many adjutants to provide long-lasting post-arthroscopy analgesia.

intr-articular drug administration has gained popularity because of its simplicity and efficacy in achieving anesthesia for diagnostic and operative arthroscopy and for providing postoperative analgesia .although the knee joint has been examined most commonly, arthroscopy of other joints such as shoulder, ankle, wrist, metatarsophalangeal and temporomandibular joints is being increasingly used. intra-articular installation of local anesthesia during arthroscopic procedures has been used by many orthopedic surgeons to provide pain relief after surgery.the aim of this study was to evaluate the analgesic efficacy of intra-articular dexamethasone versus fentanyl added as an adjuvant to bupivacaine in patients undergoing knee arthroscopic surgery

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists physical status (asa) i or ii exclusion criteria: * contraindication to spinal anesthesia. * allergy to the study drugs. * refusal of the patients.
sphenopalatine ganglion blockade in migraine

Conditions: Episodic Migraine

Summary: migraine is a fairly common disease that is a leading cause of disability worldwide. 15% of the general population suffer from migraine headaches. although there are currently many options for the treatment of acute migraine, these treatment options, such as acetaminophen, nonsteroidal anti-inflammatory drugs (nsaids), triptans, combinations analgesics and antiemetics, have insufficient efficacy and significant side effects. therefore, there is a need for new treatment modalities in migraine. sphenopalatine ganglion (spg) block is gaining interest as an effective treatment for migraine, other headaches and facial pain syndromes. in our study, we aimed to block the sphenopalatine ganglion with a local anesthetic drug and compare it with the placebo control group.

between 1 may and 1 december 2021, 50 patients aged 18-50 years, who were diagnosed with episodic migraine according to icd iii criteria, who applied to the headache outpatient clinic of afyonkarahisar health sciences university medical faculty hospital, are planned to be included in the study. patients with similar age, gender and disease duration will be randomly divided into 2 groups using the closed envelope method. demographic information of the patients, chronic disease history, medications used, and duration of disease will be questioned. before the treatment, the frequency of pain, the number of attacks, the severity of pain (vas), and the duration of pain will be questioned. vas (visual analog scale) is a scale that evaluates the severity of pain. this scale consists of numerical values between 0 and 10. 0 is considered no pain, and 10 is considered the most severe pain. routine attack treatment of the patients will continue. injection into the sphenopalatine ganglion of the patients in both groups will be made by entering the arcus zygomaticum and oriented at a 45 degree angle towards the opposite tooth. injections will be made with a dental injector. the first group will be injected with 4ml of 1% lidocaine, and the second group will be injected with 4ml of 0.9% saline. injections will be repeated weekly for the first 4 weeks, then monthly. at the end of the 1st and 3rd months of the treatment, the patients will be evaluated in the routine outpatient clinic control, and the two groups will be compared statistically by questioning the frequency of pain, the number of attacks, the severity of pain (vas), and the duration of pain.

Eligibility criteria:
inclusion criteria: * having a diagnosis of episodic migraine (according to icd-iii) * receiving any prophylaxis treatment in the last 3 months, exclusion criteria: * being pregnant and lactating * neurological and psychiatric conditions ( * contraindications to the use of local anesthetics * other chronic painful conditions, * having a history of malignancy
comvi and d-type stent in malignant goo

Conditions: Gastric Outlet Obstruction

Summary: covered self-expandable metallic stents (sems) have been used to prevent tumor ingrowth, a common complication of uncovered semss. however, they have revealed a high incidence of stent migration in patients with unresectable malignant gastric outlet obstruction (goo). a conformable covered sems was introduced to overcome both stent migration and tumor ingrowth. the aims of this study were to evaluate the clinical outcomes of newly designed conformable covered and uncovered sems for palliation of malignant goo.


Eligibility criteria:
inclusion criteria: * adults 18 years of age or older * obstructive symptoms due to unresectable malignant goo * a karnofsky performance score of more than 30 (13) exclusion criteria: * history of a previous sems insertion * the presence of obstruction in the gastrointestinal tract excluding the gastric outlet * severe comorbidities precluding the endoscopic procedure, such as cardiopulmonary disease, sepsis, and bleeding disorders * a life expectancy of less than 1 month after sems insertion * history of gastric surgery

Keywords: gastric outlet obstruction palliative treatment stent
a randomized prospective trial comparing polyethylene glycol and sodium picosulphate with magnesium citrate

Conditions: Colorectal Cancer; Colon Adenoma

Summary: adequate bowel cleansing is important for a completeness of colonoscopy and detection of colon polyps. inadequate bowel preparation leads to longer duration of colonoscopy and obscured mucosal visualization resulting in missed lesions. bowel cleansing agents are simply classified into the large volume, iso-osmotic polyethylene glycol (peg) based solutions or the small volume osmotically active agents, such as sodium picosulphate with magnesium citrate (spmc). there are rare reports that compare directly conventional polyethylene glycol (peg) solution and sodium picosulphate with magnesium citrate (spmc) for bowel preparation in korea. the aim of this study is to compare the efficacy, safety, and tolerability of different regimens of spmc and peg solution.

1. study design: endoscopist-blinded, prospective, randomized controlled trial 2. subjects 1. entry criteria: male or female patients, aged between18 and 75 years undergoing elective outpatient colonoscopy were eligible for the study. 2. exclusion criteria: gastrointestinal obstruction or perforation, toxic megacolon, severe uncontrolled inflammatory bowel disease, previous colorectal resection, congestive heart failure, recent acute myocardial infarction or unstable angina, uncontrolled arterial hypertension, renal insufficiency with glomerular filtration rate \< 60 ml/minute/1.73 m2, liver cirrhosis or ascites, pregnancy, lactation, and history of hypersensitivity to any bowel cleansing agents. 3. sampling design: consecutive recruitment of consenting patients 4. variables predictor 1. group 1 (same day peg) received 4 l of peg at 6 hours before procedure on the day of the colonoscopy 2. group 2 (split peg) received 2 l of peg at 6:00 p.m the evening before colonoscopy and 2 l of peg at 4-6 hours before procedure 3. group 3 (spmc 2) received one sachet of spmc at 6 p.m the evening before colonoscopy and another sachet of spmc at 4-6 hours before procedure; 4. group 4 (spmc 3) received one sachet of spmc at 6 p.m and the other sachet at 9 p.m the evening before colonoscopy and another sachet at 4-6 hours before procedure. 5. primary outcome: quality of bowel preparation (ottawa scale) 6. secondary outcome: tolerability, palatability, side effect of the cleansing agents

Eligibility criteria:
inclusion criteria: * male or female patients, aged between18 and 75 years undergoing elective outpatient colonoscopy were eligible for the study exclusion criteria: * gastrointestinal obstruction or perforation, toxic megacolon, severe uncontrolled inflammatory bowel disease, previous colorectal resection, congestive heart failure, recent acute myocardial infarction or unstable angina, uncontrolled arterial hypertension, renal insufficiency with glomerular filtration rate \< 60 ml/minute/1.73 m2, liver cirrhosis or ascites, pregnancy, lactation, and history of hypersensitivity to any bowel cleansing agents.

Keywords: bowel preparation polyethylene glycol sodium picosulphate
retinal neuro-vascular coupling in patients with non-arteritic anterior ischemic optic neuropathy

Conditions: Anterior Ischemic Optic Neuropathy

Summary: ischemic optic neuropathy is among the most common causes of serious impaired vision in the middle-aged and elderly population in the western world. the current study focuses on a subgroup of ischemic optic neuropathy, the so-called non-arteritic ischemic optic neuropathy (naion). although the exact pathogenesis of naion has not been fully clarified it is known that patients with cardio-vascular risk factors such as hypertension, diabetes mellitus and dyslipidemia have also an increased risk to develop naion. along this line of thought it has been shown that patients with a history of naion in one eye have an increased risk to develop naion also on the contralateral eye. however, clinical studies investigating ocular perfusion abnormalities in patients with naion are sparse and even contradicting. thus, the current study seeks to measure ocular blood flow parameters in patients with a history of naion and compare it to healthy age-matched subjects.


Eligibility criteria:
inclusion criteria for healthy subjects: * men and women aged over 18 years * non-smokers * normal findings in the medical history unless the investigator considers an abnormality to be clinically irrelevant * normal ophthalmic findings, ametropy \< 6 dpt. inclusion criteria for patients with naion: * men and women aged over 18 years * history of naion in one eye * normal ophthalmic findings, ametropy \< 6 dpt. * adequate visual acuity to allow participation in the ocular blood flow measurements * a potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history for at least 30 days prior inclusion, if considered relevant by the investigator. any of the following will exclude a healthy subject from the study: * current ocular disease or history of naion * presence or history of a severe medical condition as judged by the clinical investigator * untreated arterial hypertension * history or family history of epilepsy * presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator * best corrected visual acuity \< 0.5 snellen * ametropy ≥ 6 dpt * pregnancy or planned pregnancy * alcoholism or substance abuse any of the following will exclude a patient from the study: * presence or history of a severe medical condition other naion as judged by the clinical investigator * untreated arterial hypertension * history or family history of epilepsy * presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator * best corrected visual acuity \< 0.5 snellen in the non-affected eye * ametropy ≥ 6 dpt * pregnancy, planned pregnancy * alcoholism or substance abuse
post-bariatric weight regain behavioral intervention

Conditions: Obesity

Summary: this project aims to evaluate a newly developed internet-delivered (via e-learning modules) acceptance-based behavioral intervention (abti) for individuals who are experiencing weight regain after bariatric surgery. specifically, the investigators aim to assess abti's efficacy on stopping and/or reversing weight by comparing it to a wait-list control (wlc) condition. the investigators also aim to evaluate its effect on targeted weight control behaviors and acceptance-based skills. finally, the investigators will examine the relationship between weight outcomes and changes in process variables through exploratory analyses. treatment outcomes (i.e., weight, maladaptive behaviors, physical activity, acceptance-based skills) will be measured at assessments pre-, mid-, and post-treatment, as well as at 3 months after treatment has ended. primary aims. 1. to test the hypothesis that participants randomly assigned to abti will display greater weight loss from pre- to post-treatment than those assigned to wlc. 2. to test the hypothesis those receiving abti, compared to wlc, will display decreased maladaptive eating behaviors (i.e., loss of control episodes, grazing, emotional eating, disinhibition), increased physical activity, and greater improvements in acceptance-based skills (i.e., mindfulness, defusion, food-related acceptance). exploratory aim. (1) to assess if changes in acceptance-based skills, maladaptive eating behaviors, and physical activity are associated with pre- to post-treatment weight outcomes.


Eligibility criteria:
inclusion criteria: * has undergone any type of weight loss surgery at least 1.5 years ago * demonstrate ≥ 10% weight regain of maximum weight loss or 5% of their minimum weight post-surgery, with weight regain lasting for at least 3 months prior to enrollment. * ability to give consent and speak, write, and understand english. exclusion criteria: * currently enrolled in structured weight loss program * currently pregnant/plan to become pregnant within 6 months of enrollment * have a serious medical condition that has the potential of affecting weight or that would prevent engagement in dietary changes and/or an exercise regimen * exhibit psychiatric symptoms that would interfere with the ability to benefit from the intervention, or report acute suicidality * non-ambulatory (i.e., unable to walk at least one city block without a cane or walker at the time of screening * use of medications known to affect body weight, such as chronic systemic steroids or psychiatric medications including lithium, tricyclic antidepressants, and antipsychotic agents
digital meditation for postoperative pain control after abdominal surgery for cancer

Conditions: Hematopoietic and Lymphoid System Neoplasm; Malignant Solid Neoplasm

Summary: this phase i trial tests a digital meditation for postoperative pain control after abdominal surgery for cancer. mindfulness interventions such as guided meditation may improve pain control and decrease stress. including a brief mindfulness intervention administered via test messages as part of postoperative care may improve pain severity, decrease opioid use, and improve patient responses to non-surgical treatments.

primary objectives: i. to investigate and define anticipated and unanticipated adverse events (aes) related to a daily virtual mindfulness intervention delivered via short message service (sms) text messaging and to test its safety in the postoperative period amongst patients with cancer. ii. to determine the feasibility and acceptability of a novel, brief mindfulness intervention delivered via sms text messaging in the postoperative period amongst patients undergoing surgery for cancer. iii. to determine the feasibility and acceptability of an artificial intelligence platform to deliver and receive sms text messages for the purpose of delivering pain assessment tools and collecting and storing pain-specific and patient reported outcomes. outline: patients are assigned to 1 of 2 arms. arm i: patients complete pain survey via text message daily for 10 days after surgery. patients also complete telephone interview 2 weeks after surgery. arm ii: patients complete mindfulness intervention via text message daily for 10 days after surgery. patients also complete telephone interview 2 weeks after surgery.

Eligibility criteria:
inclusion criteria: * patients \>= 18 years of age * open abdominal surgery for cancer * ownership of smartphone (ios or android operating systems) with sms texting capabilities * ability to read * ability to understand the purposes and risk of the study and willingly give standard written informed consent for treatment established by each participating institution. exclusion criteria: * patients with contraindications to abdominal surgery and/or general anesthesia
a prospective study to evaluate long-term clinical outcomes of the gts cementless femoral stem

Conditions: Osteoarthritis, Hip

Summary: this is a multicenter, non-controlled, prospective study. 303 subjects (gts standard and lateralized) have been recruited. study will be conducted in centers across europe.

the objective of this prospective clinical study is to obtain multi-center, long-term (10-year) clinical data on the new gts® femoral stem in its standard and lateralized versions as part of post market surveillance requirements. the initial study assessment period will be 12 years; 24 months recruitment and the follow-up clinical reviews for all patients will be at 3 months, 1 year, 2 years, 3 years, 5 years, 7 years and 10 years.

Eligibility criteria:
inclusion criteria: patients inclusion criteria for this evaluation are be in accordance with the indications of the gts® stem and specifically * primary osteoarthritis or secondary coxarthritis * inflammation of the hip: rheumatoid arthritis, etc. * femoral neck fracture * avascular necroses of the femoral head * sequelae from previous operations on the hip, osteotomies, etc. * congenital hip dysplasia additional inclusion criteria include: * 18 years of age or older * subjects willing to return for follow-up evaluations * subjects who read, understood study information and provided an informed written consent (specific local regulatory requirements) exclusion criteria: exclusion criteria are in accordance with absolute and relative contraindications for use for gts® stem absolute contraindications include: * local or systemic infections. * severe muscular, neurological or vascular deficiencies of the extremity involved * bone destruction or poor bone quality that is likely to affect implant stability(paget's disease, osteoporosis, etc.) * concomitant disease likely to affect implant function * allergy to any of the components of the implant * patients weighing more than 110 kg additional exclusion criteria: * subjects unable to co-operate with and complete the study * dementia and/or inability to understand and follow instructions * neurological conditions affecting movement * patient over 18 under law supervision