Kornimate/medical-research-clean huggingface dataset:
effects of scalp block on postoperative analgesia in craniotomy surgery

Conditions: Analgesia

Summary: patients undergoing craniotomy surgery often experience severe postoperative pain. this pain can affect the patient's hemodynamics, disrupt sleep patterns, and prolong hospital stays. sudden increases in heart rate and blood pressure due to pain may lead to elevated intracranial pressure in patients, potentially causing morbidity and mortality. opioids are commonly used to mitigate hemodynamic fluctuations and reduce postoperative pain; however, they may delay recovery, contribute to excessive sedation, and affect postoperative neurological examinations. additionally, opioids have adverse effects such as nausea, vomiting, and respiratory depression. alleviating hemodynamic instability and postoperative pain are critical concerns for neuro anesthesiologists. regional analgesia techniques are employed in neurosurgery patients because they minimize anesthesia requirements, alleviate pain, and allow for neurological assessment with a lower incidence of systemic complications.the scalp block was developed due to its potential benefits as an effective regional anesthesia technique that supports the advancement of delicate brain surgeries such as functional and microsurgeries.

in this study, we hypothesize that patients who receive a scalp block will have lower postoperative numerical rating scale scores and consume less total analgesia. our primary objective is to evaluate postoperative numerical rating scale scores in patients undergoing craniotomy surgery with a scalp block. our secondary objectives are to assess the total amount of rescue analgesia consumed, the time to first rescue analgesia, patient satisfaction, and any possible complications. the study was planned as a prospective, randomized, controlled, double blind. at each clinic, an anesthesiologist randomly allocated patients to two significant groups using numbered opaque sealed envelopes: group s (patients receiving scalp block) and group c (patients getting just multimodal analgesia). the anesthesiologists responsible for the randomization process were not involved in any other sections of the trial, and the individuals executing the scalp blocks procedure were not engaged in other areas of the research. additionally, the researcher who intervened, the participants, and the analyzer were blinded to the details of the study. after the surgery, two different anesthesia technicians recorded the primary and secondary results of the study.

Eligibility criteria:
inclusion criteria: * 18-65 years * general anesthesia * american society of anesthesiologists physical status i-iii exclusion criteria: * contraindications to regional anesthesia * coagulation disorders * known allergy to local anesthetics * infections at the block site * pregnant patients * emergency cases
durvalumab alone or in combination with novel agents in subjects with nsclc

Conditions: Stage III Non-small Cell Lung Cancer; Unresectable

Summary: the purpose of this study is to compare the clinical activity of durvalumab alone vs durvalumab in combination with novel agents. the overall study goal is early identification of novel durvalumab combinations that are more active than durvalumab alone in the treatment of patients with unresectable, stage iii nsclc who have not progressed after ccrt.

study d9108c00001 (coast) is a phase 2, open-label, multicenter, randomized multidrug platform study assessing the efficacy and safety of durvalumab alone vs durvalumab in combination with novel agents in subjects with locally advanced, unresectable, stage iii non-small cell lung cancer (nsclc).

Eligibility criteria:
main inclusion criteria: 1. written informed consent and any locally required authorization obtained from the subject prior to performing any protocol-related procedures, including screening evaluation 2. age 18 years or older 3. body weight ≥ 35 kg 4. subjects must have histologically or cytologically documented nsclc who present with locally advanced, unresectable, stage iii disease 5. subjects must have completed, without progressing, definitive ccrt within 42 days prior to being randomized into the study 6. provision of tumor tissue sample, when available, from original diagnosis obtained before initiation of chemoradiotherapy 7. life expectancy ≥ 12 weeks 8. eastern cooperative oncology group (ecog) performance status of 0 or 1 9. subjects must have at least one previously irradiated tumor lesion that can be measured by recist v1.1 main exclusion criteria: 1. mixed small cell and non-small cell lung cancer histology 2. current or prior use of immunosuppressive medication within 14 days before the first dose of study drug 3. prior exposure to any anti-pd1, anti-pd-l1, or anti-ctla4 antibody for treatment of nsclc 4. subjects with history of ≥ grade 2 pneumonitis from prior chemoradiation therapy 5. subjects with a history of venous thrombosis within the past 3 months 6. subjects with history of myocardial infarction, transient ischemic attack, or stroke in the past 6 months 7. congestive heart failure 8. active or prior documented autoimmune or inflammatory disorders 9. history of active primary immunodeficiency 10. active infection including tuberculosis, hepatitis b, hepatitis c, or human immunodeficiency virus (hiv) 11. history of allogenic organ transplantation 12. qtcf interval ≥ 470 ms 13. history of another primary malignancy 14. concurrent enrollment in another clinical study \[concurrent enrollment in an observational (non-interventional) clinical study or during the follow-up period of an interventional study is permitted\] 15. females who are pregnant, lactating, or intend to become pregnant during their participation in the study

Keywords: locally advanced nsclc non-small cell lung cancer cancer lung unresectable stage iii
real-world comparative observational study in non-valvular atrial fibrillation patients using oral anticoagulants

Conditions: Atrial Fibrillation

Summary: the purpose of this study is to compare the risk of major bleeding event among nonvalvular atrial fibrillation patients treated with warfarin, apixaban, dabigatran and rivaroxaban.


Eligibility criteria:
inclusion criteria: * patients ≥18 years old as of the index date * at least 1 diagnosis of atrial fibrillation in the 12 months prior to or on index date, identified by any medical claim * at least one year of baseline period and continuous enrollment for at least 12 months prior to index date individuals with nvaf who were using oral anticoagulants (i.e., warfarin, dabigatran, rivaroxaban and apixaban) within the study period beginning jan 1, 2012 through december 31, 2013 or last date of the last data cut available at the time of execution of the study exclusion criteria: * patients with evidence of valvular heart disease, thyrotoxicosis, pericarditis, mitral stenosis, venous thromboembolism(vte), heart surgery, and endocarditis during the baseline period any time prior to or on index date * patients with any evidence of pregnancy at any time during the baseline will be excluded
can hyperoxia be prevented with noninvasive monitoring in on-pump cardiac surgery?

Conditions: Hyperoxia; Oxygen Reserve Index; Cardiac Surgery

Summary: in our study, we aimed to observe the usability of non-invasive monitoring methods in oxygenation management, using non-invasive monitoring techniques, preventing hyperoxia and avoiding oxidative damage-related complications in patients undergoing on-pump cardiac surgery.

in on-pump cardiac surgery; the risk of organ perfusion disorders is high due to the heart-lung pump process they involve. it is essential to avoid hypoxia in such patient groups in order to prevent perfusion disorders. while preventing hypoxia, hyperoxia processes can be observed frequently in patients. in order to avoid complications related to hyperoxia and oxidative damage, oxygenation management should be followed closely. today, non-invasive monitoring methods are being used in this field. in our study, we aimed to observe the usability of this method in oxygenation management and avoidance of hyperoxia by performing oxygenation management over ori (oxygene reserve index) value using the masimo root + radical 7 rainbow set device with sphb finger probe. 30 patients will bi included in our study; and they will be divided into two groups: in one group oxygenation management will be performed by conventional method, such as blood gas analysis. in other group ori values will be used to manage oxygenation. lung ultrasound will be performed in both groups to see if there will be any sign for atelectasis, preoperatively and postoperatively. kidney and liver functions will also be investigated before and after surgery. for cognitive disfunction evaluation; cam-icu scores will be recorded in both groups at 24 hours after the operation.

Eligibility criteria:
inclusion criteria: * patients between the ages of 18 - 75 * patients undergoing on-pump cardiac surgery exclusion criteria: * patients with advanced chf (ef \<40%) * patients with advanced copd (fev1 \<60%) * patients with a history of cvd * patients with advanced carotid lesions (\> 50-70% of stenosis) * patients with renal failure * patients with liver failure * patients with cardiac arrhythmia

Keywords: hyperoxia ori
superb micro-vascular imaging for evaluation of hepatic lesions

Conditions: Hepatic Lesion

Summary: superb micro-vascular imaging (smi) based on the ibeam platform is used to evaluate the blood supply of solid tumors. compared with color doppler technology, the sensitivity, accuracy and consistency of the ability of smi to display blood flow are evaluated. thus, the investigators will use superb-microvascular imaging (smi, toshiba, japan) for diagnosing hepatic lesions, which enable to detect slow micro vascular flow inside the tumor

to evaluate the diagnostic accuracy of smi (primary outcome) when applying on the hepatic lesion. each us findings during exam for patients with hepatic lesion were recorded by radiologist. sample size calculation according to the primary outcome.

Eligibility criteria:
inclusion criteria: 1. visible hepatic lesion on us 2. agree to participate in the study 3. accessible follow-up imaging or pathological results exclusion criteria: 1. pregnant women

Keywords: superb micro-vascular imaging hepatocellular carcinoma
multiple sclerosis rehabilitation study

Conditions: Multiple Sclerosis

Summary: the effects of routine rehabilitation in ms patients versus no rehabilitation.

routine rehabilitation inervention in patients with ms. this comprises of medical and nursing input, physiotherapy, occupational therapy, speech pathology, neuropsychology, compared with a "control" group on the waiting list for rehabilitation intervention. duration of intervention is 6 weeks.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of ms (paty)- community dwelling participants with known neurological and psychological deficits per edss groups.- age 19-64 years.- male and female participants.- residing within 60kms of metropolitan melbourne.- have mobility problem.- adequate cognition (kfs=2). exclusion criteria: * patients residing in nursing home and other residential care.- those with severe cognitive problems kfs\>2.-

Keywords: mulitple sclerosis ms
dispersion of local anesthetic on the erector spinae plane block in cadavers

Conditions: Nerve Block

Summary: this study aims to better understand the dispersion of local anesthetic on the erector spinae block, a new technique developed for analgesia. it consists on injection of local anesthetic around the posterior muscles of the spine. in this study, the investigators will make the injection with coloring solution on cadavers and by dissection will note the dispersion of the solution according to injectate volume. the investigators hypothesize more volume allows bigger spread and will allow new indications of this technique in perioperative analgesia and treatment of chronic pain

the study's methodology will include performing ultrasound guided erector spinae block in cadavers included in the study according to eligibility criteria. after signing of written consent form, the participants will be randomized on the height of the block (vertebral level - t3, t12 and l4) and the volume to be injected (10, 20 and 30ml). the block will be performed by experienced physicians on the technique by ultrasound guidance and fixed pressure measured with an in-line pressure monitor (15 psi) with the cadaver in the lateral position. the cadavers will be submitted to autopsy by standard thoracoabdominal midline incision, with the viscera removed for analysis. the cadavers will have their paraspinal muscles removed (quadratus lumborum and psoas major), the medial parietal pleura opened and the number of levels with colored solution registered, noting the spread to ventral rami of spinal nerves and to the paravertebral space.

Eligibility criteria:
inclusion criteria: * fresh cadavers (not subject to formaldehyde fixation process or frozen \> 24h) * age \> 18 years * written informed consent signed by responsible party * height \> 150cm and \< 190cm exclusion criteria: * previous spinal surgery * severe spinal deformity * bmi \> 35 kg/m2 * absence of a responsible party to sign the written informed consent
level trial: correction of inguinal hernia, endoscopic versus lichtenstein

Conditions: Inguinal Hernia

Summary: the aim of this study is to compare laparoscopic total extraperitoneal and open mesh repair of inguinal hernia, with regard to hospital stay, postoperative pain, quality of life, postoperative recovery and return to daily activities, complications and recurrences


Eligibility criteria:
inclusion criteria: * informed consent * age \> 18 years * inguinal hernia(primary, recurrence or bilateral) * elective procedure exclusion criteria: * scrotal hernia * prostatectomy, pfannenstiehl-incision, pre-peritoneal surgery in history * participation in other trial * pregnancy * communicative or cognitive restrictions

Keywords: groin inguinal hernia lichtenstein tep
myoelectric robot-assisted rehabilitation for the upper limb after stroke

Conditions: Stroke

Summary: the aim of this study is to assess the clinical effectiveness of the rehaarm-robot and to determine the feasibility of including robotic therapy in daily rehabilitation programmes, after stroke. additionally, we aim to investigate the acceptance of this intervention from patients and therapists. a total of 10 patients will be recruited in this study, all the patients will receive 1 hour of standard therapy together with 45 min of robot therapy every day. the robot therapy will last 45 minutes, for 15 consecutive days within a maximum period of four weeks. additional 15 minutes are required for placing surface electrodes on the shoulder and patient preparation. the study will include passive and active shoulder training of four movements: horizontal abduction/adduction, abduction/adduction, internal/external rotation and flexion/extension. the passive part lasts 10 minutes and the active part 35 minutes.


Eligibility criteria:
inclusion criteria: * patients suffering from stroke, ischemic and / or hemorrhagic * stroke in the left hemisphere * score between 1 and 3 in the upper-limb sub-item of the italian version of the national institute of health stroke scale (it-nihss) (pezzella et al. 2009) * score of the functional independence measure (fim) scale (keith et al., 1987) less than 100 out of a total of 126. this scale is used as a reference to indicate the degree of autonomy in carrying out activities of daily living (adls) * score of the upper-limb fugl-meyer scale (fma) (fugl-meyer et al., 1975) less than 60. this scale measures the residual motor function of a person after stroke exclusion criteria: * non-stabilized fractures * diagnosis of depression * traumatic brain injury * pharmacologically uncontrolled epilepsy * ideomotor apraxia * neglect * mini mental state examination (mmse) score \<20/30 * severe impairment of verbal comprehension, defined by a score in the token test (tau points\<58/78) * patients participating in other rehabilitation treatments for the upper-limb (e.g. virtual reality treatment, motor imagery, etc)

Keywords: stroke upper limb robotics electromyography rehabilitation
efficacy and accuracy of combined localization versus single localization in non-palpable breast cancer

Conditions: Breast Cancer; Breast-conserving Surgery

Summary: the standard method for localizing non-palpable breast cancer is currently preoperative wire-guided localization, its positive margin rate still remains around 20-50%. this study aims to compare the accuracy and efficacy of wire vs. combined breast tissue markers in localizing non-palpable breast cancer.

the standard method for localizing non-palpable breast cancer is currently preoperative wire-guided localization. this study aims to compare the accuracy and efficacy of wire vs. combined breast tissue markers in localizing non-palpable breast cancer.

Eligibility criteria:
inclusion criteria: 1. female patients, age≥18 year 2. a score of ≥ 2 on the eastern cooperative oncology group scale 3. patients pathologically diagnosed with untreated breast cancer by core-needle biopsy, with histologically confirmed non-palpable in situ cancer, including pleomorphic lobular carcinoma in situ or invasive non-palpable breast cancer that required localization 4. patients are willing to undergo breast conserving surgery and have no contraindications to breast conserving surgery. exclusion criteria: 1. inflammatory breast cancer or paget's disease 2. breast deformities and other conditions that impact breast conservation success rate 3. patients with contraindications to breast-conserving surgery, as well as those with systemic diseases, mental disorders, or other subjective reasons that may affect their ability to participate in the trial. patients with severe bleeding disorders or coagulation disorders were also excluded 4. pregnancy or lactation 5. patients with hookwire, radioactive 125i seed or other localization techniques in the breast cancer lesions before enrollment 6. patients with stage iv diseases or unresectable lesions in either breast 7. patients combined with other diseases that may affect survival 8. patients with multicentric breast cancer lesions or lesions \> 5 cm in diameter on imaging examinations 9. patients who have previously undergone radical mastectomy for ipsilateral breast cancer or chest wall radiotherapy
investigating the efficacy and safety of the combination treatment of huaier granule and biliary drainage for moj

Conditions: Obstructive Jaundice

Summary: this study is designed to evaluate the efficacy and safety of the combination treatment of huaier granule and biliary drainage for malignant obstructive jaundice.

after sign the informed consent, the, eligible patients are those who have completed the examinations within 2 weeks after the biliary drainage will enter the study and visit the study sites at weeks 12, 24, 36, and 48. the follow-up duration is up to 48 weeks or until the death of patient during the study. the patients will be allocated to two groups based on whether being exposed to huaier granule or not. study data will be collected prospectively, including the patients' baseline characteristics, chemo-/radio-therapy history, previous huaier granule treatment, laboratory tests, imaging examinations, and various clinical endpoints including liver function, quality of life, status of survival, and safety. this is a non-interventional study in patient population in real world. therefore, the patients' treatment regimen will not be interfered, i.e., the patients will independently decide whether to take huaier granule or not based on the recommendation from the clinician after the drainage. the patients will be allocated into different groups completely according to their treatment at clinic in real world. during the study, only the study required data and endpoints will be collected.

Eligibility criteria:
inclusion criteria: 1. male or female, aged between 18\~75 years; 2. naïve patients who were diagnosed as malignant obstructive jaundice that was caused by carcinoma of head of pancreas, cholangiocarcinoma, gallbladder carcinoma, or duodenal papilla carcinoma, or carcinoma metastasis in hilar lymph nodes based on clinical assessments and/or pathological examination; 3. total bilirubin \>80 umol/l; 4. patients who are not indicated for or refused to receive surgical resection; 5. ecog score ≤2 or kps score ≥60; 6. expected survival time ≥12 weeks; 7. has signed and dated the informed consent in volunteer and are willing to comply with the data collection procedures by investigator. exclusion criteria: 1. female patients who are pregnant or breastfeeding; 2. patients who are receiving concomitant intravenous chemotherapy; 3. patients whose malignant obstructive jaundice was caused by liver cancer; 4. patients who have severe coagulation disorders and massive ascites; 5. patients with obstructive jaundice who have concomitant fever; 6. patients who are not applicable for or not willing to receive biliary drainage; 7. patients who are not appropriate to participate in the study at discretion of the investigator.
use of myo-inositol as adjuvant therapy in patients with polycystic ovary syndrome (pcos) in vitro fertilization (ivf)

Conditions: Polycystic Ovary Syndrome

Summary: the original mechanism of action of myo-inositol and preliminary results available in the literature on its use in ivf suggest its value as adjuvant gonadotropin therapy to reduce the risk of ohss in pcos patients. the aim of the study is to demonstrate that administration of myo-inositol decreases the incidence of ovarian hyperstimulation syndrome (ohss) in high-risk infertile with pcos supported in ivf patients.


Eligibility criteria:
inclusion criteria: * patients pcos (rotterdam eshre / asrm criteria) combination of at least two of the following three criteria: * cycle disorder * clinical hyperandrogenism and / or biological * account antral follicles\> 24 * age ≤ 18 ≤ 38 years * bmi \<35 kg / m² * able to understand the protocol and signed informed consent exclusion criteria: * patients not having the rotterdam criteria * patients\> 38 years and / or bmi\> 35 kg / m² * woman enjoying a measure of legal protection * hypersensitivity to any component of the inofolic (myo-inositol, soy, folic acid, glycerol, gelatin, coloring e171) * participation in another interventional biomedical research with treatment administered may disrupt ovarian stimulation

Keywords: in vitro fertilization ovarian hyperstimulation pregnancy