Kornimate/medical-research-clean huggingface dataset:
randomized study evaluating the role of surgeon-performed ultrasound in the management of the acute abdomen

Conditions: Abdominal Pain

Summary: the purpose of this study is to evaluate whether surgeon-performed ultrasound as a supplement to clinical investigation when a patient presents with abdominal pain in the emergency department can improve the management of the patient.

surgeon-performed ultrasound bedside in the emergency department when a patient presents with abdominal pain is quite common in continental europe and usa. it is considered to be implemented at emergency departments all over sweden. this is the first randomized study performed to evaluate the method. in our study we compare diagnostic accuracy and further management of patients admitted to the emergency department for abdominal pain, with or without examination with surgeon-performed ultrasound bedside.

Eligibility criteria:
inclusion criteria: * admitted to emergency ward for abdominal pain * 18 years or older exclusion criteria: * pregnancy * condition that has to be taken care of immediately * inability to communicate with the investigator * previously diagnosed abdominal condition * severe drug or alcohol addiction * dementia

Keywords: abdominal pain ultrasound surgery emergency department diagnostic accuracy
a retrospective study of patients with leukemia relapse in the cns treated with car t cells

Conditions: Acute Lymphoblastic Leukemia

Summary: car t cells targeting cd19 have been approved for patients with relapsed or refractory all, failing two or more prior protocols. several institutional-based studies with other car t cells targeting cd19 have demonstrated outstanding response rates in patients with refractory disease, and the ability of car t cells to clear cns leukemia. nevertheless, these cases are sparse and have never been reported collectively. here, we aim to retrospectively assess toxicity and long term outcome of patients treated with car t cells for cns relapse of all.


Eligibility criteria:
inclusion criteria: * prior diagnosis of b-cell acute lymphoblastic leukemia involving the central nervous system * treatment with car t cells (either on a clinical trial or commercial use) due to this indication

Keywords: car t cells cns leukemia
study of streptococcus pneumoniae in nose and throats of infants with acute otitis media

Conditions: Otitis Media; Otitis Media With Effusion; Pneumococcal Infections

Summary: the aim of this study is to assess in france the impact of prevenar on the possible evolution of the pneumococcal serotypes distribution and antibiotic resistance in np samples of children with aom.


Eligibility criteria:
inclusion criteria: * infants aged from 6 to 24 months * presenting with aom (ear infection) * patients must not have received any antibiotic therapy within the past 7 days. other inclusion applies. exclusion criteria:

Keywords: middle ear infection
near infrared spectroscopy for detection of cerebral desaturation after positioning for neurosurgical procedures

Conditions: Cognitive Dysfunction; Patient Positioning

Summary: the occurrence of postoperative cognitive dysfunction (pocd) might be related to intraoperative cerebral desaturation. positioning for neurosurgical procedures are associated with head rotation, elevation, flexion or extention that may affect blood brain inflow and outflow. anatomical variations of willis circle could affect the cerebral blood flow in extreme head position with the development of cerebral ischemia or functional changes of brain. investigators suppose that detection of cerebral tissue desaturation and its prompt correction could modify the occurence of pocd after these procedures.

standardized anesthesia and perioperative care will be provided to all patiens with positioning for neurosurgical or spinal procedures, where the head is elevated, extended. flected or rotated. in group a before the start of general anesthesia, the baseline level of cerebral tissue oxygenation (rsco2) will be measured using the near-infrared spectroscopy nirs (invivo medtronic) . continuous measurement of rsco2 will be used for detection of cerebral tissue desaturation. each desaturation episode will be managed according to a standardized protocol - correction of extreme head position will be followed by optimalisation of mean arterial pressure (map), arterial hemoglobin oxygen saturation, end tidal carbon dioxide concentration and a level of hemoglobine concentration. in group b neither measurement of rsco2 nor interventions are provided. cognitive dysfunction will be assessed by adenbrooke test before operation and on the fifth postoperative day.

Eligibility criteria:
inclusion criteria: * glasgow coma scale 15, american society of anaesthesiologists (asa) physical status classification system grade i-iii, patient positioning with elevation, rotation, flexion or extention of head exclusion criteria: * inability to past the addenbrooke test, postoperative ventilation, awake phase during surgery, lung disease with retention of carbon dioxide, neurological disease before surgery (aphasia, paresis, blindness, deafness)

Keywords: near-infrared spectroscopy neurosurgical procedures cognitive dysfunction
icu mortality predictors of trauma patients

Conditions: İntensive Care Unit

Summary: in this study, the data of the patients who were hospitalized due to trauma in intensive care unit (icu) were examined in their first development. the mortality rate and the factors affecting mortality in these patients were determined

in this study, 107 trauma patients were examined. patients were divided into two groups according to icu results: survivors (group 1) and deceased patients (group2). patients were rated in terms of age, neutrophil lymphocyte ratio (nlr) , mean platelet volüme (mpv), lactat value, intensive care unit stay, apache 2 soring systems. mortality rate and the factors affecting this rate were examined. 83 of the patients were male (77.58%) and 24 were female (22.42%). the mean age was 46 years. the mean value of lactate level was 3.25. mpv mean value was 10.34. nlr mean value was 8.23 and apache 2 score mean value was 22.8. the average length of stay in hospital was 11.33 days. when the intergroup mortality was evaluated in terms of the relationship between continuous variables, there was a statistically significant difference in apache 2 score. no statistically significant difference was found between age, lactate, mpv, nrl and length of hospital stay. nrl, mpv, lactate levels were not suitable for evaluation of trauma patients as a early prognostic factor in the first day icu admission. the investigators think that the use of trauma scoring systems such as apache 2 related to mortality during first hospitalization in icu is more appropriate.

Eligibility criteria:
inclusion criteria: * trauvma patients exclusion criteria: * systemic inflammatory diseases * cancer * renal failure * cardiac failure * serebro vascular diseases

Keywords: trauma, mortality
regulatory post marketing surveillance study on nexavar®

Conditions: Carcinoma, Hepatocellular; Carcinoma, Renal Cell

Summary: this surveillance are to identify problems/questions regarding adverse events, factors that are considered to affect on safety and efficacy in the clinical practice of using nexavar

the objectives of this surveillance are to identify problems/questions regarding the followings in the clinical practice of using nexavar®. 1. unknown adverse events (in particular, serious adverse events) 2. identification of adverse events occurred in the real practice. 3. factors that are considered to affect on safety. 4. factors that are considered to affect on effectiveness

Eligibility criteria:
inclusion criteria: * patients with diagnosis of advanced rcc or hcc and decision taken by the physician to prescribe nexavar. exclusion criteria: * exclusion criteria must be read in conjunction with the local product information but patients who are participating in other interventional studies currently will be excluded.

Keywords: carcinoma, hepatocellular carcinoma, renal cell
driving pressure during general anesthesia for minimally invasive abdominal surgery (generator)

Conditions: Postoperative Complications; Surgery

Summary: the purpose of this international multicenter, patient and outcome-assessor blinded randomized controlled trial is to determine whether the application of an individualized high positive end expiratory pressure (peep) strategy with recruitment maneuvers, aiming at avoiding an increase in the driving pressure during intraoperative ventilation, protects against the development of postoperative pulmonary complications in patients undergoing minimally invasive abdominal surgery.


Eligibility criteria:
inclusion criteria: 1. age \> 18 years; and 2. scheduled for minimally invasive abdominal surgery; and 3. at increased (i.e., intermediate or high) risk of ppcs according to the 'assess respiratory risk in surgical patients in catalonia' (ariscat) risk score (≥ 26 points, see appendix i); or at increased risk of ppcs based on the combination of age \> 40 years, scheduled surgery lasting \> 2 hours and planned to receive an intra-arterial catheter for blood pressure monitoring during the surgery; and 4. signed written informed consent exclusion criteria: 1. planned for open abdominal surgery; 2. planned for surgery in lateral or prone position; 3. planned for combined abdominal and intra-thoracic surgery 4. confirmed pregnancy; 5. consent for another interventional trial during anesthesia; 6. having received invasive ventilation \> 30 minutes within the last five days; 7. any previous lung surgery; 8. history of previous severe chronic obstructive pulmonary disease (copd) with (noninvasive) ventilation or oxygen therapy at home or repeated systemic corticosteroid therapy for acute exacerbations of copd; 9. history of acute respiratory distress syndrome (ards); 10. expected to require postoperative ventilation; 11. expected hemodynamic instability or intractable shock; 12. severe cardiac disease (new york heart association class iii or iv, acute coronary syndrome or persistent ventricular tachyarrhythmia's).

Keywords: minimally invasive abdominal surgery mechanical ventilation positive end-expiratory pressure driving pressure postoperative pulmonary complications recruitment maneuver
development of a novel asian mediterranean diet and its acceptability in nafld

Conditions: Fatty Liver, Nonalcoholic

Summary: the goal of this pre-intervention study is test the acceptability of asian version of the mediterranean diet to nafld patients. the main question\[s\] it aims to answer are: 1. whether asian version of the mediterranean diet that retains the nutritional composition and can be developed by mapping the components of the mediterranean diet and finding substitute ingredients commonly eaten in southeast asia. 2. whether the 4-week menu cycle of newly developed novel asian mediterranean diet is acceptable among singaporean local population. participants will participate in taste test sessions to find out if the asian mediterranean diet meals are acceptable to people with nafld.

numerous studies have shown that mediterranean diet decrease the risk of cardiovascular disease, metabolic syndrome, cancer and overall mortality characterized by being low in saturated fats and animal protein, high in antioxidants, fibre and monounsaturated fatty acids, and with an adequate omega-3 to omega-6 fatty acid balance. recent studies have proved that adherence to a mediterranean diet is beneficial for non-alcoholic fatty liver disease (nafld) as it provides antioxidants and anti-inflammatory nutrients that slows the development of hepatic steatosis. however, adhering to the mediterranean diet can be difficult for people of southeast asian cultural backgrounds to follow, as food items used in traditional mediterranean diets may not be readily available or frequently used in local cuisines. it is therefore the aim of this study to first map out the nutritional composition of the traditional mediterranean diet, derive substitute ingredients, and then develop an asian version of the mediterranean diet that can be accepted and easily adopted by the asian population while retaining the beneficial nutritional characteristics. following this, nafld patients will be recruited for the sensory evaluation of the asian mediterranean diet. specifically for this study, the researchers are keen to focus on a clinical condition (i.e. nafld) that has been demonstrated to reap positive effects from adopting a mediterranean diet. as such, this is a pre-intervention study with a focus on development and evaluating its acceptability among nafld patients.

Eligibility criteria:
inclusion criteria: * diagnosis of nafld, as determined clinically by imaging evidence of hepatic steatosis on ultrasound/ct/mri exclusion criteria: * secondary causes of nafld (e.g. medication-induced) * unstable body weight (variation \>5% within the preceding 3 months) * current use of weight loss medications * other liver diseases (viral hepatitis, auto-immune or cholestatic liver disease, wilson's disease, hemochromatosis, alpha-1 anti-trypsin deficiency) * unstable diabetes (hba1c \>8.5%) * renal failure * inability to provide informed consent * pregnancy and lactation * problems with tasting and smelling * food allergy/intolerances/restrictions

Keywords: mediterranean diet
early placental insufficiency screening

Conditions: Pre-eclampsia

Summary: to assess the role of uterine artery and maternal serum plgf and sflt-1 and their combination in screening for pre-eclampsia and small -for-gestational age (sga) fetuses at 12-14 weeks of gestation

pre-eclampsia (pe) and intrauterine growth restriction (iugr) are known as major factors in perinatal morbidity and mortality. routine antenatal care is focused on the detection of women at increased risk to apply this population a program of careful monitoring and appropriate intervention. uterine artery doppler during anomaly scan at 12 to 14 weeks in selected women at increased risk, has proved to be accurate to detect those who will develop pe or iugr during the second half of pregnancy. a variety of angiogenic proteins have been studied as potential markers for pre-eclampsia. among these protein plgf and sflt-1 have respectively demonstrated higher and lower levels in pregnant women who will subsequently develop pre-eclampsia. our study is aimed to evaluate the performance of serum plgf and sflt-1 measurement in association with uterine artery doppler as a screening for placental insufficiency.

Eligibility criteria:
inclusion criteria: * chronic hypertension under medication * insulin or not insulin dependant preexisting diabetes * previous history of pre-eclampsia * previous history of unexplained stillbirth * previous history of placental abruption * previous history of sga (\< 10th centile) * history of pre-eclampsia or chronic hypertension before 45 years in the mother or a sister * history of vascular pathology before 50 years in the father * obesity (bmi\>26) * nulliparous after 38 years * assisted conception with donor * primipaternity after 38 years old or before 20 years old exclusion criteria: * multiple pregnancy * pregnancy requiring termination * unability to understand the study * thrombophilia * treatment with heparin

Keywords: pre-eclampsia
reducing isolation and feeling of loneliness during critical illness

Conditions: Critical Illness; Social Isolation; Anxiety; Depression; Post Intensive Care Unit Syndrome

Summary: the trial is a pilot-randomized trial testing feasibility and limited-efficacy of delivering social engagement using technologic strategies to reduce periods of social isolation.

patients with critical illnesses such as sepsis and acute respiratory failure (arf) who require an icu stay are at high risk of developing anxiety, depression, post-traumatic stress disorder, and cognitive deficits. risk factors for emotional and cognitive impairments after icu include underlying systematic illness, as well as consequences of life-saving therapies. in brief, patients are frequently restricted and even restrained to the bed, provided high dosages of sedatives, develop delirium, and are isolated from family and staff for extended periods of time. moreover, the icu environment including lights, noises, and the social isolation have a serious negative impact on cognitive function and emotional health status. prospective data from the icu demonstrate that critically ill patients in icu spend two-thirds of their time completely alone. patients who have survived describe their icu experience as a traumatic event similar to war, and testimonials for the icu recovery clinic frequently resemble: "i felt like i was being held captive in an unknown basement." periods of social isolation in daily life as well as in the hospital have a significant negative impact on patient-centered outcomes including increased risk of disability, frailty, and mortality. our study will examine the feasibility of delivering social engagement interventions using technology such as virtual reality (vr) to reduce feelings of isolation and loneliness. there have been a handful of projects to reduce anxiety and depression using a myriad of delivery techniques including journaling in a diary, emotional-behavioral therapy, face-to-face social engagement and family engagement using face-time and vr. these projects, however, have not examined the impact of social engagement on reducing periods of isolation and loneliness. we hypothesize that social engagement delivered using vr technologies will reduce periods of social isolation and thus improve anxiety, depression, and post-traumatic stress disorder (ptsd).

Eligibility criteria:
inclusion criteria: * adult * admitted to icu with acute respiratory failure (ventilation via tube or mask or hfnc) exclusion criteria: * previous cognitive or emotional health condition * inability to follow commands

Keywords: critical illness post intensive care unit syndrome social isolation
effects of progressive muscle relaxation training applied in addition to aerobic exercise training in individuals with migraine diagnosis

Conditions: Migraine; Migraine Disease

Summary: aim: the purpose of this study is to evaluate the effects of progressive muscle relaxation training, in addition to aerobic exercise training, on pain, disability, quality of life, psychological status, and functional capacity in individuals diagnosed with migraine. methods: the study population comprises migraine patients who presented to the neurology clinic of mardin training and research hospital. participants meeting the inclusion criteria will be randomized into two groups: an exercise group and a control group. the exercise group will receive both aerobic exercise and progressive muscle relaxation training, while the control group will receive only aerobic exercise. participants' physical and demographic characteristics, as well as migraine-associated symptoms, will be assessed and recorded. pain characteristics will be evaluated using a pain diary and pressure pain threshold measurements of the head and neck muscles. disability will be assessed with the migraine disability assessment scale (midas). quality of life will be measured using the headache impact test (hit-6). psychological status will be evaluated with the hospital anxiety and depression scale (hads). functional capacity will be assessed clinically using the 6-minute walk test.

participants in both groups will receive sessions under the supervision of a physiotherapist, three sessions per week for 12 weeks. the aerobic exercise program will consist of a warm-up, a main exercise phase (loading program), and a cool-down period. progressive muscle relaxation training will be implemented as part of the relaxation training protocol.

Eligibility criteria:
the inclusion criteria are listed as follows: * having been diagnosed with migraine by a specialist neurologist. * experiencing at least 3 migraine attacks per month. * being between the ages of 18 and 65. * volunteering to participate in the study. exclusion criteria listed as follows: * being pregnant. * having any neurological disease other than migraine. * having other secondary headaches in addition to migraine. * having a recent history of head or neck trauma. * participating in a regular exercise program in the last 6 months. * having a history of malignancy. * having a disease or disability that may prevent aerobic exercise.

Keywords: aerobic exercise physical therapy therapy migraine relaxation
tissue characterisation by endoscopic gi-elastography

Conditions: Disorder of Upper Gastrointestinal Tract; Pancreatic Nodule; Secondary and Unspecified Malignant Neoplasm of Retroperitoneal Lymph Nodes; Secondary Malignant Neoplasm of Lymph Node

Summary: in this single centre study we study the use of endoscopic ultrasonography (eus) combined with elastography in order to separate malignant tissue from benign tissue in and adjacent to the upper gastrointestinal tract.

the purpose of this study is to use endoscopic ultrasonography (eus) with strain based elastography to identify strain traits separating malignant from benign lesions. we are registering feasibility of endoscopic strain imaging and compare diagnostic accuracy of eus + elastography with previous data on eus alone. inclusion criteria: * group 1: focal subepithelial lesions in esophageal, ventricular or duodenal wall discovered by endoscopy or other imaging modality. * group 2: pancreatic lesion discovered by other imaging modality. * group 3: mediastinal or retroperitoneal lymph node or tumor discovered by other imaging modality. histology of lesions should not be known at the time of examination. eus elastography findings are evaluated shortly after the examination and categorised by different methods; categorical score, vas, strain ratio. the result is then compared to histology or cytology results. patients who do not undergo tissue sampling are followed up to discover disease progress.

Eligibility criteria:
inclusion criteria: * solid focal lesions in pancreas or pancreatitis * intramural lesions in esophagus, ventricle or duodenum * lymph nodes or tumour \> 1 cm in mediastinum or retroperitoneum accessible by eus exclusion criteria: * cystic pancreatic lesions * patients where the histology or cytology of the lesion in question is known at the time of examination

Keywords: elastography strain ratio pancreas gi wall lesions lymph nodes