Kornimate/medical-research-clean huggingface dataset:
observational aspirin use and cvd in the physicians' health study

Conditions: Cardiovascular Diseases; Coronary Disease; Heart Diseases; Myocardial Infarction; Cerebrovascular Accident

Summary: to analyze existing data from the physicians health study (phs), a randomized primary prevention trial of low-dose aspirin and beta carotene conducted among 22,071 u.s. male physicians, to address questions concerning aspirin and cardiovascular (cv) disease that could not adequately be addressed during the randomized aspirin period.

design narrative: the aspirin component of the trial was terminated on january 25, 1988, due to a demonstrated benefit of aspirin on myocardial infarction. at that time, however, the number of strokes and cv deaths experienced by trial participants was inadequate to definitively evaluate these endpoints. the beta carotene component of the trial continued uninterrupted until its scheduled termination in december, 1996. during this period detailed information continued to be collected on post-trial aspirin use through annual questionnaires. as of october, 1995, the number of deaths, including cardiovascular deaths, had increased fourfold from that in the randomized period, and the number of strokes had increased 3.5 times. the investigators used data from both the randomized aspirin period and the observational period following the trial to assess the impact of aspirin use on cardiovascular and total mortality, and the long-term impact of aspirin use on subsequent stroke and mi. the methods included analyses of both randomized aspirin assignment and of time-varying aspirin use, as assessed on the annual questionnaires. because of the potential for bias, the propensity for aspirin use, particularly during the observational period was taken into account. analyses included use of proportional hazards models allowing for both time-varying effects of aspirin use and controlling for time-varying confounders, as well as more complex procedures using causal modeling. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
no eligibility criteria
a study evaluating the efficacy and safety of abciximab, an anti-platelet therapy, in patients undergoing high-risk coronary angioplasty

Conditions: Angina, Unstable; Angioplasty, Transluminal, Percutaneous Coronary

Summary: the purpose of this study is to evaluate the effectiveness and safety of abciximab (an anti-platelet therapy) versus placebo in patients undergoing high risk coronary angioplasty.

this is a randomized, double-blind, placebo-controlled, multicenter study evaluating the efficacy and safety of abciximab, an anti-platelet therapy, in patients undergoing high risk coronary angioplasty. the primary outcomes of the study include any of the following: the number of deaths from any cause, or myocardial infarctions and recurrent ischemic events requiring urgent intervention (e.g., repeat angioplasty, coronary artery bypass surgery, intracoronary stent placement, or intra-aortic balloon pump). patients receive an abciximab bolus, abciximab bolus plus infusion, or placebo.

Eligibility criteria:
inclusion criteria: * patients referred for elective or urgent coronary balloon angioplasty or atherectomy with an fda-approved device in one of the following settings: unstable angina or non-q wave myocardial infarction, acute q-wave myocardial infarction, or high-risk clinical/morphological characteristics exclusion criteria: * patients with a history of hemorrhagic diathesis - having had major surgery or clinically significant gastrointestinal or genitourinary bleeding within 6 weeks of study enrollment * having had a stroke within 2 years prior to enrollment or any stroke with significant residual neurological deficit * having occlusion of the left main coronary artery greater than 50% or a history of vasculitis * treated with oral anticoagulants within 7 days (unless prothrombin time is =\< 1.2 times control) or intravenous dextran (before or planned for during the treatment angioplasty)

Keywords: abciximab angina, unstable angioplasty, transluminal, percutaneous coronary
clinical, physiological and prognostic implication of microvascular status

Conditions: Coronary Artery Disease

Summary: there are several physiologic parameters in evaluating cardiovascular disease. this study will reveal which parameter is the most proper value in predicting disease severity and risk factors of patients.

fractional flow reserve (ffr), index of microcirculatory resistance (imr), and coronary flow reserve (cfr) will be measured in stable angina patients before coronary intervention. relationship between angiographic characteristics of patients and ffr, imr, cfr will be analyzed. comparison of risk factors and prognosis between parameters will be also analyzed. this study will evaluate that which parameter is correlate with disease severity and risk factors of patients.

Eligibility criteria:
inclusion criteria: * age ≥ 18 * patients with stable angina * ffr, imr, cfr were measured before coronary intervention exclusion criteria: * patients who have severe side effects or contraindication to hyperemic agents (ex. adenosine) * patients with hemodynamic instability * elevation of cardiac enzymes, evidence of acute mi, or a culprit vessel of acute coronary syndrome

Keywords: coronary artery disease angina, stable fractional flow reserve, myocardial coronary angiography
efficacy of combined ultrasound guided steroid injection and splinting in patients with carpal tunnel syndrome

Conditions: Carpal Tunnel Syndrome

Summary: to compare the effectiveness of ultrasound guided-steroid injection plus splinting to that of steroid injection alone using clinical and electrophysiological parameters in patients with carpal tunnel syndrome

this is a prospective, single-blinded randomized controlled study. patient with cts were randomly assigned to group receiving ultrasound guided steroid injection and group receiving ultrasound guided corticosteroid injection and splinting. the steroid injection was using 1ml of 10 mg (10mg/ml) triamcinolone acetonide (shincort) mixed with 1 ml of 2% lidocaine hydrochloride (xylocaine). the inclusion criteria included an age of more than 18 years and typical signs of cts according to american academy of neurology criteria lasting for at least 3 months. the diagnosis of cts was confirmed by electrophysiological tests.the exclusion criteria included the following: presence of thenar atrophy; existence of disorders such as hypothyroidism, diabetes mellitus, chronic renal failure, or rheumatoid arthritis; any accompanying orthopedic or neurologic disorders that could mimic cts such as cervical radiculopathy, polyneuropathy, proximal median nerve entrapment, or thoracic outlet syndrome; prior steroid injection into the affected carpal tunnel or carpal tunnel surgery; history of distal radius fracture; pregnancy or lactation; regular use of systemic nsaids or corticosteroids; and known allergy to corticosteroids and local anesthetics.

Eligibility criteria:
inclusion criteria: 1. clinical diagnosis of cts 2. the diagnosis of cts was confirmed by electrophysiological tests. exclusion criteria: 1. presence of thenar atrophy 2. existence of disorders such as hypothyroidism, diabetes mellitus, chronic renal failure, or rheumatoid arthritis; any accompanying orthopedic or neurologic disorders that could mimic cts such as cervical radiculopathy, polyneuropathy, proximal median nerve entrapment, or thoracic outlet syndrome 3. prior steroid injection into the affected carpal tunnel or carpal tunnel surgery 4. history of distal radius fracture 5. pregnancy or lactation 6. regular use of systemic nsaids or corticosteroids 7. known allergy to corticosteroids and local anesthetics.
cardiorenal syndrome in end-stage kidney disease

Conditions: End-stage Renal Disease; Cardiorenal Syndrome; Heart Disease

Summary: cardiorenal syndrome (crs) is prevalent among end-stage renal disease (esrd) patients. recently, its prevalence is rising. there are several different clinical presentations of this syndrome. it has a high rate of morbidity and mortality. the purpose of this study is to find the connection between the heart pathology and its effect on esrd patients. this will aid in choosing the appropriate medical therapy for these patients, and hopefully, aid in increasing their quality of life, and decrease their morbidity and mortality.


Eligibility criteria:
inclusion criteria: * end-stage renal patients exclusion criteria: * cancer patients
combined and isolated effects of sleep deprivation and alcohol intake on exercise performance in humans.

Conditions: Alcohol Intake; Sleep Deprivation

Summary: although the effects of acute alcohol intake and sleep deprivation on exercise performance lacks evidence in the literature, in many situations, they occur simultaneously. once the alcohol affects physiological processes, the processes that occur during sleep can be impaired, such as: suppression of gh release, action of neurotransmitters and neuromodulators in the cns, changes in the proportion of sleep stages and may lead to suppression of rem sleep. these changes promote a significant functional impairment such as a reduction in alertness and modification in reaction time, which affects the performance of any activity of daily and professional life. however, the combined effects on the physical performance variables, such as aerobic and neuromuscular performance lack of evidence in the literature.

ten subjects were randomized in four situations after familiarization and control situation: (1) alcohol intake combined with sleep normal; (2) alcohol intake combined with sleep deprivation; (3) placebo intake combined with sleep normal and (4) placebo intake combined with sleep deprivation.

Eligibility criteria:
inclusion criteria: - physical active men exclusion criteria: * audit questionnaire above 15 points * nocturnal chronotype * skeletal muscle injuries in upper and lower limb * metabolic and cardiovascular disease
study evaluating the effect of isonatremic dialysis treatment in chronic kidney disease patients on dialysis

Conditions: Chronic Kidney Diseases

Summary: aim of this study is to evaluate, in a population of chronic kidney disease patients on dialysis (stage 5d), the effect of treatment with isonatremic dialysis (vs conventional dialysis), during an observational period of 2 months each, on: * control of interdialytic weight gain * perdialytic tolerance in terms of adverse events occurring during all of the sessions of the study * body composition and thirst measured monthly during the 4 months of follow-up. * tolerance to treatment.


Eligibility criteria:
inclusion criteria: * chronic kidney disease patient on dialysis (stage 5d) * with plasma sodium concentration between 130 and 140 mmol/l * anuric * patient dialysed with dialysis machine allowing isonatremic dialysis treatment exclusion criteria: * patient with plasma sodium concentration below 130 or above 140 mmol/ * pacemaker

Keywords: chronic kidney disease patient on dialysis (stage 5d) extracorporeal purification isonatremic dialysis sodium
robotic versus laparoscopic surgery for middle and low rectal cancer: a target trial emulation

Conditions: Rectal Cancer

Summary: this study aims to compare the effectiveness of robotic surgery versus laparoscopic surgery in treating low rectal cancer. while robotic surgery has gained popularity, there is limited long-term evidence regarding its outcomes. by using real-world data from a specialized multicenter colorectal cancer database in shanghai, china, this retrospective cohort study will emulate the target trial to evaluate whether robotic surgery offers advantages over laparoscopic surgery. key factors such as disease-free survival, locoregional recurrence, circumferential margin positivity, and postoperative complications will be examined. the goal is to provide stronger, evidence-based support for the clinical use of robotic surgery in treating low rectal cancer.


Eligibility criteria:
inclusion criteria: 1. age from 18 years to 80 years; 2. american society of anesthesiologists (asa) class i - iii; 3. histologically proved rectal adenocarcinoma; 4. inferior tumor edge ≤ 10 cm from anal verge, measured by rigid rectoscopy; 5. tumor assessed as ct1-t3 (mesorectal fascia not involved) n0-1, or yct1-t3 nx after preoperative radio- or chemoradiotherapy, measured by pelvic mri; 6. no evidence of distant metastases (including pelvis, peritoneum, liver, lung, brain, bone, distant lymph node, etc), according to ultrasound, ct, mri, pet-ct, etc; 7. no other malignancies in medical history except adequately treated basocellular carcinoma of the skin or in situ carcinoma of the cervix uteri; 8. received either robotic or laparoscopic surgery; 9） surgery with radical intent; 10) informed consent. exclusion criteria 1. emergency surgery for acute intestinal obstruction, bleeding, perforation, etc; 2. synchronous colon surgery for multiple colorectal tumors or other schedules; 3. hereditary colorectal cancer (familial adenomatosis polyposis, lynch syndrome, etc.); 4. co-existent inflammatory bowel disease; 5. pregnancy or lactation; 6. patients received treatment other than preoperative radio- or chemoradiotherapy.
is it fair to use antibiotics after laparoscopic cholecystectomy for the patients with acutely inflamed gallbladder?

Conditions: Acute Cholecystitis

Summary: during the laparoscopic cholecystectomy for acute cholecystitis, most surgeons routinely use the postoperative antibiotics after surgery. however, there is no consensus regarding the actual need of postoperative antibiotics in these cases and the use of postoperative antibiotics remains controversial. investigators will compare the surgical outcomes after laparoscopic cholecystectomy to the patients who has no evidence of systemic infection, according to the usage of postoperative antibiotics or not. the investigators expect that the routine use of postoperative antibiotics after laparoscopic cholecystectomy for acute cholecystitis gallbladder will have no effects on the postoperative morbidity.

primary outcome of this study is the confirmation of safety in the cases of acute cholecystitis without postoperative antibiotics usage after laparoscopic cholecystectomy. for this purpose, the investigators compare the surgical infectious outcomes including the wound infection or abdominal infections according to the usage of postoperative antibiotics after laparoscopic cholecystectomy. secondary outcome of this study is the confirmation of efficacy according to skip the use of postoperative antibiotics after laparoscopic cholecystectomy. the investigators estimate the efficacy using the comparing the outcomes such as duration of hospitalization according to the use of postoperative antibiotics or not.

Eligibility criteria:
inclusion criteria: * grade i tokyo guideline for acute cholecystitis * grade ii tokyo guideline for acute cholecystitis without the evidence of gallbladder perforation exclusion criteria: * chronic cholecystitis * gallbladder polyp or gallbladder cancer * the patient who underwent reduced port surgery * the patient who underwent common bile duct exploration during the operation * the patient who underwent concurrent operation * the patient who had past history of upper abdominal surgery * the patient who had a immunodeficiency state * the case which had a suspicion of delayed bile leakage * the case which had a incomplete cystic duct ligation * the patient who underwent open conversion surgery during the operation * the patient who had a high risk of bleeding
feasibility and safety of single port robot in colorectal procedures

Conditions: Colon Cancer; Colon Polyp; Rectal Cancer; Diverticulitis; Prolapse, Rectal; Rectal Polyp; Inflammatory Bowel Diseases

Summary: the purpose of this study is to evaluate the safety and feasibility of using the single port (sp) robot (davinci, intuitive surgical) to perform single port robotic colon surgery and transanal robotic surgery. the hypothesis of the study is that the sp robot will prove a safe effective modality to perform these procedures.

in the colorectal arena, the robotic approach for benign and malignant disease is well established, with a great deal of literature generated regarding the safety and benefits of a colorectal robotic approach for benign and malignant disease. the section of colorectal surgery at the lankenau medical center has been an active and robust contributor to surgical literature on laparoscopic surgery, robotic colorectal surgery, and single port laparoscopic surgery. its one investigator has been involved in the development of clinical applications to the single port robotic platform where this has been utilized in cadaver work that has been published. recently, the sp robot has gone through fda clearance and is now available for clinical utilization. the fda approval is for urologic surgery. the sp robot will be utilized in the same fashion to perform the same colorectal operations that the investigators have been performing with multiple port placements in the past to accomplish robotic surgery in a single port platform in the colorectal arena. the principal investigator has worked on the sp robot over the past 3 years with extensive cadaver experience to develop its safe application in the colorectal field. this study will entail a collection of demographics, preoperative, perioperative and postoperative outcomes of the patients into a database to follow this, report on the outcomes, and notably answer questions to demonstrate the feasibility and safety of this approach in colorectal patients.

Eligibility criteria:
inclusion criteria: * all patients being considered for minimally invasive colorectal surgery will be evaluated for participation in the study. exclusion criteria: * emergency surgery * inability to offer informed consent * pregnant patients

Keywords: single port robotic surgery minimally invasive colectomy single port robotic colectomy single port robotic tem
tap block with methyl-prednisolone as a pain treatment modality after total abdominal hysterectomy procedures

Conditions: Local Anesthetic; Ultrasound; Pain, Acute

Summary: the aim of this work to compare between the efficacy of ultrasound guided tap block with dexamethasone as an adjuvant versus ultrasound guided tapb with methyl prednisolone as an adjuvant to local anesthetic for postoperative pain management in lower abdominal hysterectomy procedures.

patients will be divided in to two groups; tapb with dexamethasone as an adjuvant to local anesthetic gr a(n=25) and tapb with methyl prednisolone as an adjuvant to local anesthetic gr b(n=25). by the end of surgery and with the patient in supine position and after covering of surgery site, preparing the skin with povidone iodine, a high frequency (5-10 mhz) ultrasound probe (s-nervetm; sonosite inc., bothell, wa, usa) will be placed transversally on abdominal wall between lower costal margin and iliac crest near midline. after identifying the rectus abdominis muscle, we will gradually move the ultrasound probe laterally to identify the transversus abdominis muscle lying posterior to the rectus muscle. a 22 g echogenic needle using the in plane technique will be inserted medially aiming towards the iliac crest, then 30ml total volume of 0.25 plain bupivacaine 1.5mg/kg with lidocaine 1% 3mg/kg with 8mg dexamethasone in group a patients and 30ml total volume of 0.25 plain bupivacaine 1.5mg/kg with lidocaine 1% 3mg/kg with 50 mg methylprednisolone in group b patients. vital signs (h.r and non invasive blood pressure) will be recorded at the onset of the block then every 20 min for an hour then every 4hrs for 12 hrs. post operative postoperative: paracetamol every 8 hours and ketorolac every 12 hours should be given as a part of multimodal analgesia and nalbuphine given as rescue analgesia and included in secondary outcomes post-operative assessment and analgesic regimen post operative pain assessment using v.a.s will be assessed (0-10) (11) (as zero refer to no pain and 10 refer to the worst pain) after 1h of the block then every 4hrs for 12 hrs. then every 8hrs for 48 hrs then after 72hrs . the patient will be given paracetamol every 8 hours and ketorolac every 12 hours the time to the first request of rescue post operative analgesic will be recorded, when the patient complain of pain (v.a.s\> 3) intravenous nalbuphine 5mg will be given, total dose of nalbuphine will be recorded /24hrs.

Eligibility criteria:
inclusion criteria: * asa physical status i-ii. * age 20-45 years. * undergoing lower abdominal hysterectomies. exclusion criteria: * patient refusal * patients with coagulopathy. * hypertensive patients. * diabetic patients. * morbid obesity * allergy to the used drugs

Keywords: ultrasound tap block hystrectomy methyl prednisolone
trocar-site infiltration versus tap-block

Conditions: Laparoscopic Cholecystectomy

Summary: for symptomatic gall bladder disorders (cholelithiasis and cholecystitis), laparoscopic cholecystectomy (lc) has been considered as the gold standard treatment. however, these minimally invasive technique is associated with acute moderate pain during the 24 hours postoperative, which is routinely managed using opioids. the transversus abdominis plane (tap) block has been used as part of a multimodal analgesia strategy. besides, wang et al found that tap block is more effective than a conventional pain control, but not significatively different from another local incisional pain control that is port site infiltration.so, the aim of this study, is to compare the analgesic efficacy and safety of trocar-site infiltration with ropivacaine with ultrasound-guided tap block following laparoscopic cholecystectomy when used as part of multimodal analgesia.


Eligibility criteria:
inclusion criteria: * bmi \< 30 kg/m2 * scheduled for laparoscopic cholecystectomy * asa grade i, ii and iii exclusion criteria: * bile duct exploration, insertion of a t-drain or patients with acute cholecystitis * conversion to open cholecystectomy or if the surgery exceeded 200 minutes * severe systemic disease * patients on analgesics for any reason * history of allergy to local anesthetics * an ongoing pregnancy * patient refusal

Keywords: acute pain management ropivacaine trocar-site infiltration tap-block laparoscopic cholecystectomy