Kornimate/medical-research-clean huggingface dataset:
evaluation of a protocol for multidisciplinary management of acute cholecystitis.

Conditions: Acute Cholecystitis

Summary: acute cholecystitis is a complex disease and its management is sometimes controversial. two main factors contribute to its complexity: the patient's surgical risk and the possibility of concomitant choledocholithiasis. the design of a multidisciplinary protocol between the services of gastroenterology and surgery aims to harmonize its management and to adapt it to the most recent guidelines. as it concerns more than one department, it is crucial to analyze its compliance and effectiveness.

adult patients attending the emergency department and diagnosed with acute cholecystitis will be asked to participate. those considered not suitable for surgery will be admitted in a medical department and assigned to conservative treatment or cholecystostomy, according to their acute cholecystitis severity. in patients suitable for surgery, risk of concomitant choledocholithiasis will be assessed and patients will be assigned to low risk or intermediate-high risk. the latter will be admitted in a medical department, and choledocholithiasis will be ruled out and treated if present. the former will be offered cholecystectomy or cholecystostomy according to their surgical risk and acute cholecystitis severity. a flowchart with extended information is attached. primary objectives • to harmonize the management of acute cholecystitis with a multidisciplinary protocol based on the most recent guidelines. secondary objectives * to analyze the compliance with this protocol. * to evaluate the validity of the criteria used in the decision-making process. * to assess the morbidity and mortality of different groups of patients according to the selected treatment, severity of cholecystitis and baseline characteristics of the patient. * to estimate the resource use in each group of patients. * to compare current data with a previous period. * to adapt and modify the protocol according the study results. inclusion criteria * patients aged 18 or older who agree to participate (an informed consent signature is required) * patients attended in the emergency department of our hospital and diagnosed with acute cholecystitis according to the tokyo criteria. exclusion criteria * patients under 18 years or patients who refuse to participate in the study * patients diagnosed with acute cholangitis during admission for other causes.

Eligibility criteria:
inclusion criteria: * patients aged 18 or older who agree to participate (an informed consent signature is required) * patients attended in the emergency department of our hospital and diagnosed with acute cholecystitis according to the tokyo criteria. exclusion criteria: * patients under 18 years or patients who refuse to participate in the study * patients diagnosed with acute cholangitis during admission for other causes.

Keywords: acute cholecystitis eus-guided cholecystostomy percutaneous cholecystostomy laparoscopic cholecystectomy
the research of the evaluation of clinical procedures in gastroesophageal varices in patients with liver cirrhosis

Conditions: Gastroesophageal Varice

Summary: the purpose of this study is to evaluate the efficacy of two different endoscopic treatment in gastroesophageal varices in patients with liver cirrhosis: ligation versus ligation plus sclerotherapy in addition to cyanoacrylates

gastroesophageal variceal bleeding, which often results from portal hypertention, is known as one of the most frequent death causes of patients with liver cirrhosis. when a patient has bleeding episode, it's very likely that he/she will develop another one in the future. endoscopic treatments such as ligation, sclerotherapy or cyanocrylates are proved to decrease the risk of re-bleeding. the purpose of this study is to evaluate the efficacy of two different endoscopic treatments in patients who have both gastric and esophageal varices with liver cirrhosis: in addition to cyanoacrylates, ligation versus ligation plus sclerotherapy.

Eligibility criteria:
inclusion criteria: * patients with portal hypertension caused by liver cirrhosis who presented with an acute or recent episode of gastroesophageal variceal bleeding and have previously received endoscopic treatments of ligation and cyanoacrylate. diagnosis of liver cirrhosis or mixed cirrhosis was based on results of liver biopsy or biochemical tests and liver imaging by ultrasonography. * the extent of the varices range from moderate to severe. * the age of the patients range from 18 to 72 years old. exclusion criteria: * patients who had other causes for portal hypertention(ctpv,budd-chiari syndrome,etc.) * patients with severe systemic disease (renal failure, heart failure,carcinoma other than liver cancer,etc.) * patients who had contraindications for ligation,sclerotherapy or cyanoacrylate. * patients who have previously received shunt or devascularization operation,tips. * patients who had portosystemic shunt according to the results of ct scan.

Keywords: gastroesophgeal variceal bleeding liver cirrhosis portal hypertension
role of color doppler ultrasonography in assessment of vascular access surveillance in hemodialysis patients.

Conditions: Arteriovenous Fistula

Summary: the aim of this study is to provide an overview of the possible applications of dus during the maturation and postoperative follow-up of vascular access, with particular emphasis to establish a relationship between doppler ultrasound parameters including: 1. flow volume. 2. outflow vein diameter. 3. outflow vein depth. 4. resistive index.


Eligibility criteria:
inclusion criteria: * esrd patients on dialysis with heamodialysis vascular access with adult age group (18 years and above). exclusion criteria: * patients with chronically occluded vascular access with failed surgical or interventional attempts.
study of bomedemstat in participants with essential thrombocythemia (img-7289-ctp-201/mk-3543-003)

Conditions: Essential Thrombocythemia

Summary: this is a phase 2b open label study of an orally administered lsd1 inhibitor, bomedemstat (mk-3543, formerly called img-7289), in patients with essential thrombocythemia. this study investigates the following: * the safety and tolerability of bomedemstat * the pharmacodynamic effect of bomedemstat

this is a phase 2 multi-center, open-label study evaluating the safety, efficacy and pharmacodynamics of bomedemstat administered orally once daily in patients with essential thrombocythemia (et). patients will be dosed with bomedemstat for 169 consecutive days in the initial treatment period (itp). qualifying patients may continue to receive bomedemstat in the additional treatment period (atp). safety will be evaluated by clinical assessments of safety parameters i.e., safety laboratory testing, adverse event reporting, physical examination and vital sign assessments. pharmacodynamics will be evaluated by hematology assessment, patient reported symptom burden, change in spleen size by palpation and other measures. to ensure safety, a safety advisory board will perform periodic reviews of safety parameters and pharmacodynamic markers.

Eligibility criteria:
inclusion criteria: * diagnosis of essential thrombocythemia per world health organization (who) diagnostic criteria for myeloproliferative neoplasms. * requires treatment in order to lower platelet count based on patient age over 60 or history of thrombosis. * have failed at least one standard therapy * must have discontinued et therapy at least 1 week (4 weeks for interferon) prior to study drug initiation. exclusion criteria: * has undergone major surgery ≤4 weeks prior to starting study drug or has not recovered from side effects of such surgery. * unresolved treatment related toxicities from prior therapies (unless resolved to ≤ grade 1). * uncontrolled active infection. * current use of prohibited medications * known hiv infection or active hepatitis b or hepatitis c virus infection * other hematologic/biochemistry requirements, as per protocol * use of investigational agent within last 14 days * pregnant or lactating females
how to differentiate and treat cystic laesions in the anterior mediastinum (detection)

Conditions: Cysts

Summary: multicenter trial about anterior mediastinal cysts


Eligibility criteria:
inclusion criteria: cysts in the anterior mediastinum * thymic cysts * bronchogenic cysts * pericardial cysts * cystic thymoma * cystic teratoma exclusion criteria: * patients \<18 years old * patients without radiological imaging * patients without approval for follow-up
cryoprobe versus forceps for transbronchial biopsy

Conditions: Lung Diseases

Summary: the purpose of this study is to compare the effectiveness of transbronchial biopsy done by a 1.1mm cryoprobe versus the standard 2.0mm forceps.

a smaller (1.1mm), flexible, single-use cryoprobe with an oversheath has been developed that can be used for transbronchial biopsies. this device has the potential to gather larger and higher quality tissue samples than the standard method using forceps, and with potentially fewer complications than older, larger versions of the cryoprobe. for this study, patients will be randomized in a 1:1 fashion to transbronchial biopsy using a 1.1 mm cryoprobe versus 2.0 mm forceps, stratified by indication (evaluation of lung transplant allograft, diffuse parenchymal lung disease or pulmonary parenchymal lesion). blinding of the proceduralist is not possible due to the nature of the procedure. pathologists interpreting the biopsy samples will be blinded to the biopsy device used. patients enrolled in this study will have data collected by research staff for up to 30 days after the bronchoscopic biopsy procedure is performed. this 30-day follow-up period is the standard of care following bronchoscopic biopsy procedures.

Eligibility criteria:
inclusion criteria: * male or female, ≥ 18-years-old * scheduled to undergo bronchoscopy with transbronchial biopsy per standard of care exclusion criteria: * pregnant or nursing woman or woman of child-bearing potential who refuse to take a pregnancy test prior to enrollment * severe pulmonary hypertension (rvsp \> 60 mmhg) * stroke within the last 6 months or myocardial infarction within the last 3 months * presence of bleeding disorder * platelet count \< 50,000 per ml at time of enrollment * use of systemic anticoagulation or antiplatelet therapy without the ability to hold therapy for the recommended time prior to invasive procedure (aspirin monotherapy is acceptable) * do not resuscitate (dnr) status * do not intubate (dni) status

Keywords: lung cryoprobe bronchoscopic biopsy
effectiveness of a cervical cancer stigma reduction intervention program on cancer stigma score and cervical cancer screening uptake in nepal

Conditions: Cervical Cancer; Stigma; Screening

Summary: it is a cluster randomized control trial to assess the effectiveness of the cervical cancer stigma reduction intervention on cancer stigma score and cervical cancer screening uptake in nepal

despite the presence of ample evidence, that stigma is one of the major reasons for low screening coverage, nepal does not have a single stigma reduction intervention targeted among women to increase cervical cancer screening coverage. therefore, we aim to assess the effectiveness of a stigma reduction education program on stigma score and cervical cancer screening uptake in nepal. we will conduct a two-arm open-label cluster-interventional study in budanilkhantha municipality. a computer-based program will randomly allocate the 12 wards of budanilkhantha municipality with an allocation ratio 1:1; 6 wards in intervention group and 6 wards in control group. we will conduct a "stigma reduction education program" in the intervention group. after that we will follow up the participants for2 months to see the effectiveness of a stigma reduction education program on stigma score and cervical cancer screening uptake in nepal. we will analyze data using stata 14. we will use independent tests to find the mean difference between cervical cancer screening uptake and cervical cancer stigma score. the difference in mean among the two groups will actually be the difference due to intervention given. findings from this study will help managers and stakeholders to formulate and improve strategies on screening programs and develop programs to reduce stigma on cervical cancer among women in nepal.

Eligibility criteria:
inclusion criteria: * women aged 30-60 years (the age range recommended for via screening in nepal * married women * residents of budanilkantha municipality exclusion criteria: * women who have already undergone screening within 5 years. * women with hearing or mental disorders * pregnant women * less than 6 weeks postpartum * mothers who had lived in the community for less than 6 months to perform seasonal work (e.g. in brick kilns) or visitors in the family. * women who are already diagnosed with cervical pre-cancer and cancer and have undergone hysterectomy.
pediatric intensive care and covid-19

Conditions: Covid19; Pediatric ALL; Infection; Critical Illness; SARS-CoV Infection

Summary: in this prospective longitudinal cohort the investigators reported the clinical, and biological characteristics of all critically ill patients admitted in the pediatric intensive care unit (picu) of bicêtre hospital during the 2019 coronavirus disease (covid-19) pandemics. patients were older than 37 weeks of gestational age. no upper limit was set as the unit was transiently converted into a pediatric "adult covid-19" intensive care unit.

all patients will be monitored during their picu stay. clinical characteristics include: age, gender, co-morbidities, organ support therapies (mechanical ventilation, renal replacement therapy, extracorporeal membrane oxygenation, vasopressors), organ complications (pulmonary embolism, acute respiratory distress syndrome, renal failure, heart failure) and function, infective complications (ventilator associated pneumonia, central line associated bloodstream infection, pulmonary access, sepsis, septic shock), microbiologic and viral identification, 7-day and 28-day mortality. biological characteristics include: * admission workup: qualitative and quantitative ig, ferritin, creatinine kinase, complement study (c3,c4,ch50), * daily workup: blood cells count, arterial blood gas analysis, lactate, electrolytes, albumin, blood urea nitrogen, creatinine, hemostasis (fibrinogen, factor v, ii+vii, factor x, prothrombin time, antixa activity, activated cephalin time, d-dimer), c-reactive protein, procalcitonin. * twice weekly workup: circulating cells phenotyping (t cell and subclass including treg, b cell, natural killer cell, myeloid derived suppressor cell, neutrophils), interleukin 6. * bone marrow analysis when indicated by attending staff.

Eligibility criteria:
inclusion criteria: * patients suspected or confirmed of severe acute respiratory syndrome coronavirus 2 infection * no opposition from patients or legal representatives after study information * patients admitted to the pediatric intensive care unit of bicêtre hospital, assistance publique hôpitaux de paris - paris saclay university * between march 15, 2020 to june 31, 2021 exclusion criteria: * patient or legal representative refusal to participate

Keywords: children monitoring immunodepression hla-dr myeloid derived suppressor cell neutrophil phenotype
study assessing the effect of medications to prevent fever on prevenar 13®

Conditions: Pneumococcal Vaccines

Summary: the purposes of this study are assess the immunological response (measure the amount of antibodies, i.e. proteins that fight off germs) produced by children after they have been given the 13-valent pneumococcal vaccine (13vpnc) and infanrix hexa at 2, 3, 4 and 12 months of age when medications to prevent fever are given on the same day as the vaccination. also to evaluate the safety of 13-valent pneumococcal conjugate vaccine (13vpnc) in children who receive medications to prevent fever on the day of vaccination.


Eligibility criteria:
inclusion criteria: * aged 2 months (56 to 98 days) at time of enrollment. * healthy infant as determined by medical history, physical examination, and judgment of the investigator. exclusion criteria: * previous vaccination with licensed or investigational pneumococcal, diphtheria, tetanus, pertussis, polio, or hib conjugate vaccines. * a previous anaphylactic reaction to any vaccine or vaccine-related component. * allergy or contraindication to paracetamol or ibuprofen administration. * contraindication to vaccination with pneumococcal conjugate, diphtheria, tetanus, pertussis, polio, hib, or hbv vaccines.

Keywords: prevenar 13 13vpnc antipyretic medication healthy subjects
acute impact of different foods and beverages on exercise induced oxidative stress and inflammation

Conditions: Inflammatory Response; Oxidative Stress; Oxidative Stress Induction

Summary: the aim of this research project is to explore the acute impact of specific foods and beverages, which have been shown to be associated with inflammatory processes, mainly in epidemiological studies, on inflammatory and oxidative stress parameters in healthy humans following a high intensity physical workout.

the aim of this research project is to explore the acute impact of specific foods and beverages, which have been shown to be associated with inflammatory processes, mainly in epidemiological studies, on inflammatory and oxidative stress parameters in healthy humans following a high intensity physical workout. the choice of food will mainly be based on the food groups from the empirical dietary inflammatory index. for that purpose, seventy-two healthy volunteers will be recruited to perform several interventions in order to assess the impact of different nutrient groups or single- foods on oxidative and inflammatory markers. they will be divided into the three groups beverage consumption, plantbased foods and protein sources. the intense physical activity serves to induce a physiological stress response in the body, known to be accompanied by an increase in oxidative and inflammatory stress parameters. the idea is that anti- inflammatory or antioxidant nutrients could potentially attenuate this stress response in dependence on their anti- inflammatory or antioxidant potential. the operability of this concept has already been tested. the main benefit of this approach is to get a deeper insight into short term effects of single foods or beverages on inflammatory and prooxidative processes in humans by using short term intense physical activity as a stress model. one major practical aspect of this approach is to assess dietary components with respect to their pro- or anti-inflammatory-/oxidative stress potential regarding e.g. non-communicable diseases such as type 2 diabetes, coronary heart disease or the metabolic syndrome. furthermore, it could help to reduce inflammation or oxidative stress during or following high intense physical exercise in order to reduce the stress response during training or competition in order to enhance regeneration and to foster the training gain in sports.

Eligibility criteria:
inclusion criteria: * female human subjects * aged 18-40 years * no chronical diseases * not more than 120 minutes of physical activity per week * no regular resistance training within the past 6 months * bmi 18.5 - 24.99 kg/m² * body fat percentage of at least 20% * exclusion criteria: * contraindications against physical activity * anemia * fructose or lactose intolerance * smoking * medications with influence on ros levels or inflammation * allergy or intolerance against intervention food/beverages.
use of endobronchial valves in non-upper lobe heterogeneous emphysema

Conditions: Heterogeneous Emphysema

Summary: hypothesis: patients with advanced emphysema with predominance of the disease in areas other than the upper lobes, as determined by high resolution computed tomography (hrct), could have a positive response to valve treatment.


Eligibility criteria:
inclusion criteria: * age 18-80 years * ex-smoker with smoking cessation confirmed by exhaled carbon monoxide (co) levels * moderate to severe airflow obstruction fev1 \<50% predicted * severe dyspnoea - mmrc ≥2 * hyperinflation - total lung capacity (tlc) ≥100% predicted, rv ≥150% predicted * swt ≥75m * optimum copd treatment for at least 6 weeks * no copd exacerbation for at least 6 weeks * less than 4 admissions for exacerbation in the preceding 12 months exclusion criteria: * patient unable to provide informed consent * patient without clear targets for airflow re-distribution * total lung co uptake (tlco) \<15% predicted and fev1 \<15% predicted * po2 on air \<6.0kpa * pco2 on air \>8.0kpa * neurological, rheumatological or other cause of exercise limitation * other major medical illness, e.g. lung cancer that will limit participation * production of purulent sputum more often than not (more than 50% of days) * clinically significant bronchiectasis * large bulla - more than 1/3 of hemithorax volume (i.e. where bullectomy would be more suitable) on ct scan * arrhythmia or cardiovascular disease that poses a risk during procedure or exercise * prednisolone dose greater than 15mg a day * significant pulmonary hypertension - rvsp ≥45mmhg * left ventricular failure - left ventricular ejection fraction \<45% or left ventricular fraction shortening \<23% * prior lvrs or lobectomy * lung nodule requiring surgery * subject completed or is participating in a standard pulmonary rehabilitation program within 3 months of enrolment * female of childbearing age with positive pregnancy test * subject participated in a research study of investigational drug or device in prior 30 days * subject taking clopidogrel, warfarin, or other anticoagulants and unable to abstain for 5 days pre-procedure

Keywords: intrabronchial valve heterogeneous emphysema non-upper lobe
comparison study of narrow band imaging versus white light resection in patients with bladder tumors/cancer

Conditions: Bladder Cancer

Summary: the purpose of this study is to compare the recurrence rate at 1 year following narrow band imaging and trans-urethral resection of bladder tumor with white light and turb in patients with non-muscle invasive bladder cancer.

currently bladder tumors are diagnosed visually with standard cystoscopy that uses white light, or light that is generated encompassing the entire visual spectrum. some tumors such as carcinoma in situ may not be visible using white light and require patients to undergo random bladder biopsies in order to find the cancer. recently the development of photodynamic agents have been shown to enhance these procedures to accomplish better resection and identify over-looked tumors. however, these methods often require the instillation of dyes into the bladder as well as specialized cystoscopes. narrow band imaging (nbi) is now available which uses a special filter to limit the light to only certain wavelengths which allows the identification of areas of increased vascularity or abnormalities without the need for dyes. nbi has been investigated in gastro-intestinal disease and found to be beneficial. early reports in urology suggest that this technology may reduce the number of tumors that are missed which could impact the recurrence rate of bladder tumors, but this is not known at this time.

Eligibility criteria:
inclusion criteria: * patients scheduled for treatment of primary or recurrent non-muscle invasive bladder cancer * patients greater than 18 years of age * no tumors in the upper tract (kidneys or ureters) * no previous pelvic radiation exclusion criteria: * gross hematuria at the time of resection making visualization with nbi not possible * participation in other clinical studies with investigations drugs concurrently or within 30 days. * pregnancy * conditions associated with a risk of poor compliance or unwilling to follow up

Keywords: bladder cancer urothelial carcinoma stage pta or pt1 nmibc ta/t1 narrow band imaging white light cystoscopy transurethral resection superficial bladder tumor positive urine cytology