Kornimate/medical-research-clean huggingface dataset:
establishment of clinical staging of chronic pancreatitis based on histopathology of pancreatic duct biopsy

Conditions: Chronic Pancreatitis

Summary: this study intends to establish the clinical staging of chronic pancreatitis based on histopathology through pancreatic duct biopsy technology.

chronic pancreatitis (cp) is an inflammatory disease that can causes progressive fibrosis of pancreatic tissue and eventually leads to damage of pancreatic exocrine and endocrine. according to statistics, the prevalence of cp in china is 13/10 million, which is still increasing. pancreatic duct stones are the most important pathological changes of cp. more than 50% of patients with cp are accompanied by pancreatic duct stones, which can lead to pancreatic duct obstruction, hypertension and tissue ischemia. removal of pancreatic duct stones under endoscopic retrograde cholangiopancreatography (ercp) are the first choice. pathological features of cp include pancreatic parenchymal atrophy and interstitial fibrosis resulting from chronic inflammatory damage. although there are numerous criteria for clinical staging and severity grading of cp, they all have their own limitations, and none of them have been validated by randomized controlled trials. there is also no clear definition of the clinical stage and severity of cp in the guidelines for the diagnosis and treatment of cp. according to the "clinical guideline: chronic pancreatitis" issued by the american college of gastroenterology in 2020, histopathology is the "gold standard" for the diagnosis of cp. in the past ten years, the technology of mother-daughter scope has developed rapidly. the duodenoscope is used as the mother scope, and the cholangiopancreatoscope is used as the daughter scope. the optical fiber or digital imaging system carried by the daughter scope can directly observe the internal situation of the pancreatic and bile ducts. the channel allows the endoscopist to precisely biopsy the wall of the main pancreatic duct with a biopsy forceps. this technology improves the predicament of pancreatic tissue biopsy in the past, allowing ercp treatment in patients with cp and pancreatic tissue biopsy to be carried out simultaneously.

Eligibility criteria:
inclusion criteria: * patients with chronic pancreatitis or idiopathic recurrent acute pancreatitis; * in line with the indications for ercp treatment. exclusion criteria: * suspected to have malignant tumors; * history of pancreatic surgery or gastrojejunostomy (billroth ii); * bile duct stricture secondary to cholangitis or chronic pancreatitis; * acute pancreatitis exacerbation or acute exacerbation of chronic pancreatitis; * coagulation dysfunction (inr≥1.5 or platelet count≤50×10\^9/l); * pregnant or breastfeeding women; * patients who refused to participate in the study.

Keywords: endoscopic retrograde cholangiopancreatography histology
canadian assessment of patient outcomes and effectiveness of etanercept (enbrel) in psoriasis

Conditions: Psoriasis

Summary: the purpose of this study is to evaluate the use of etanercept (enbrel®) in the treatment of psoriasis in patients for a period of up to 1 year.


Eligibility criteria:
inclusion criteria: * 18 years of age or older at baseline * moderate to severe plaque psoriasis at baseline with a rating of moderate, marked or severe on the physician global assessment (score of 3, 4 or 5) * able to start enbrel (etanercept) therapy per the approved product monograph exclusion criteria * active infections at the initiation of enbrel therapy. * evidence of skin conditions (i.e. eczema) other than psoriasis that would interfere with evaluations of the effect of study medication on psoriasis. * psoralen plus ultraviolet a radiation (puva) within 4 weeks or ultraviolet light b (uvb) therapy within 2 weeks of study drug initiation. * oral retinoids, cyclosporine, methotrexate, or any other systemic anti-psoriasis therapy within 4 weeks or efalizumab (raptiva®) within 8 weeks of study drug initiation and during the study period. * topical vitamin a or d analog preparations, or anthralin within 2 weeks of study drug initiation and during the study period. * have received remicade® (infliximab), humira® (adalimumab) or amevive®(alefacept) within 3 months before the initiation of study medication or during the study period.

Keywords: phase iv psoriasis inflammation
is the efficacy of epidural steroid injections related to the different volume injections?

Conditions: Pain

Summary: this study was aimed to investigate the impact of using different epidural volumes. patients with acute discogenic pain were included in the study.

objectives: this study was aimed to investigate the impact of using different epidural volumes. methods: seventy five patients with acute discogenic pain were included in the study.the patients were randomly assigned to three groups. all patients received a single epidural dose of triamcinolone \[80 mg\] and 12.5 mg bupivacaine combination. the patients in group 1, group 2 and group 3 received a volume of 10 ml, 15 ml, and 20 ml by epidural injections, respectively. the efficacy of treatment was assessed with vas (visual analog scale) \[o= no pain, 10 = unbearable pain\], slet(straight leg elevation test) \[0° = worst, 85° = best\], and oswestry disability index; odi \[0% to 20%:minimal disability , 80% to 100%:bed bound patients\] before and 2 weeks after the epsi.

Eligibility criteria:
inclusion criteria: * acute discogenic pain with less than three months duration not responding to other modalities of conservative management \[nsaids, physiotherapy, bracing, etc.\], * radiological disc bulging accompanying unilateral root impingement symptoms, * an oswestry daily activity score more than 20 percent, and * resistance to treatment. exclusion criteria: * patients with bilateral root impingement symptoms, neurological deficits, and/or history of previous lumbar disc surgery, severe cardiac, pulmonary, gastrointestinal, renal diseases, glaucoma, urinary retention, and/or known allergy to the drugs used in the study were excluded from the study.

Keywords: anesthesia adverse effect spinal epidural
self- and family-management intervention in hiv+ chinese women

Conditions: Hiv

Summary: this project is to develop a culturally sensitive and feasible self- and family-management intervention that will assist hiv+ chinese women and their families to manage the illness and improve quality of life and clinical outcomes.

the study will be conducted in 3 phases. phase 1: the pi conducted a secondary qualitative analysis of in-depth interviews to further illuminate the sociocultural and family context of hiv+ chinese women. the data were obtained from three previous projects conducted in china from 2005 to 2011. phase 2: the pi developed and adapted a theory-driven, culturally sensitive and feasible intervention to improve the quality of life and clinical outcomes of hiv+ chinese women and their families. phase 3: the pi conducted a feasibility, compliance, and acceptability study for a self- and family-management intervention with hiv+ women and of their family members.

Eligibility criteria:
inclusion criteria: inclusion criteria for hiv+ women. * be at least 18 years of age, * be able to give informed consent for the study and to cognitively participate, * be receiving clinical care at ditan hospital and sphcc, * have been diagnosed with hiv within the past 12 months, * have disclosed their status to at least one family member and willing to invite that family member to the intervention, * be well enough to attend counseling sessions at the hospital, and * be able to attend follow-up visits at the hospital. inclusion criteria for family members. * be 18 years of age, * be able to give informed consent for the study and to cognitively participate, * have a female family member who is hiv+, and is currently receiving clinical care at ditan hospital and sphcc, * be a family member who are taking care of the female hiv+ family member, * be well enough to attend counseling sessions at the hospital, and * be able to attend follow-up visits at the hospital. exclusion criteria: exclusion criteria for hiv+ women * history of an affective illness such as depression or bipolar disease, * are under age 18, or * are unwilling or unable to bring a family member to participate in the study. exclusion criteria for family members. * have a history of an affective illness such as depression or bipolar disease, * are under age 18, * or are unwilling or unable to come with their hiv+ family member to participate the study.

Keywords: quality of life
effectiveness of virtual reality training in gait improvement of post stroke patients

Conditions: Stroke

Summary: this single group quasi-experimental study was conducted at rafsan neuro rehab center, peshawar from october 2021 to february 2022. the sample size of study was 40 post stroke patients who were diagnosed on physical findings and other investigation like ct and mri. the inclusion criteria were set as post-stroke patients for more than 3 months with 20 and above score on mas scale and age of 55 to 65 years, while the exclusion criteria were defined as participants having traumatic brain injuries, degenerative brain diseases, post craniotomy tumor patients leading to hemiplegia, patients having recurrent episodes of stroke, stroke patient with dementia and score on mas scale below 20.


Eligibility criteria:
inclusion criteria: * the inclusion criteria were set as post-stroke patients for more than 3 months * 20 and above score on mas scale * age of 55 to 65 years exclusion criteria: * the exclusion criteria were defined as * participants having traumatic brain injuries, degenerative brain diseases, post craniotomy tumor patients leading to hemiplegia, * patients having recurrent episodes of stroke, * stroke patient with dementia * score on mas scale below 20.
evaluation of the pupil dilation reflex in response to noxious stimulation in anaesthetized children. a proof of concept trial

Conditions: Pain; Monitoring, Intraoperative

Summary: after conduction a pilot study, pupillary dilation reflex (pdr) is measured in response to nociceptive stimulation perioperatively in infants, children and adolescents.

an infrared camera of the video pupillometer measures the pupillary dilation reflex (pdr) in response to incremental nociceptive stimuli. the pdr is a robust reflex, even in patients under general anesthesia, and may provide a potential evaluation of the autonomous nociceptive circuit. american society of anesthesiologists (asa) classification i or ii patients from the age of 28 days till 18 years undergoing elective surgery under general anesthesia are recruited. enrolled patients perioperative undergo pdr measurement at 2 different standardized times (before and after opioid administration) generated by an inbuilt pupillary pain index (ppi) protocol. ppi, as a surrogate for nociception includes noxious stimulations from 10 up to 60 milli ampere (ma) until pupil dilation is larger than 13% from baseline diameter. therefore, no inappropriate high stimulation is executed.

Eligibility criteria:
inclusion criteria: * scheduled abdominal, urological or otorhinolaryngology surgery under general anaesthesia * asa i-ii exclusion criteria: * history of eye deformity, invasive ophthalmologic surgery * known cranial nerve(s) deficit * infection of the eye * predicted difficult airway management (paediatric difficult airway guidelines - difficult airway society) * chronic opioid use (\>3 months) * ongoing treatment with beta-blockers, dopamine antagonists, topical atropine * preoperatively administrated benzodiazepins or antiemetics
a study of hemodynamic changes using near infra-red spectrometry (nirs) in infantile epilepsy spasms

Conditions: Epilepsy

Summary: this study will included 20 children presenting with epilepsy with spasms. it aims to offer these children, non invasively and without supplementary examinations, a recording of local and cerebral hemodynamic changes concomitant with an electroencephalographic recording during epileptic episodes. this will be carried out by combining optical imaging using near infra-red spectroscopy (nirs) with electroencephalography (eeg), in a simultaneous high-resolution (hr) recording. this study is among those based on multimodal analyses of epilepsy, combining methods of analysis of electrical activity (electrical imaging) and hemodynamics (optical imaging). surface electroencephalography (eeg) is a precious tool enabling the study of neuronal dysfunction from a functional point view. it is used in the routine follow-up of children with epilepsy. optical imaging is a promising medical imaging technique. it uses light in the spectral regions of near infra-red as a source of radiation. it is quantitative, rapid, non invasive, and inoffensive which could easily be used at the child's bedside or in a clinical setting and can provide metabolic information about cerebral function. this study is multidisciplinary, which calls upon the skills of neurophysiologists, biophysicists, and clinicians


Eligibility criteria:
inclusion criteria: * children between 3 and 6 years old presenting infantile spasms according to the classification of the international league against epilepsy exclusion criteria: * children younger than 3 months and older than 6 years of age, refusal of one of the parents, and dermatosis of the scalp

Keywords: children spasms
clinical and mri cardiac biomarkers on peripheral arterial disease in patients with long term dm

Conditions: Peripheral Arterial Disease

Summary: the aim of this study is to establish a clinically feasible simultaneous evaluation of heart and lower limb using mri and to assess the combined benefit of clinical and cardiac mri imaging markers in the evaluation of pad and prediction of treatment outcome.

we expect to enroll about 60 long-term dm patients (\>10 years) from main study. patient will receive evaluation of the perfusion in the lower limb by using blood oxygenation-level dependent (bold) sequence with measurement of the extracellular volume fraction (ecv) as an indicator of fibrosis severity in calf muscles. all patients will receive cardiac mri (cardiac function, ischemia and fibrosis) and mr angiography (severity of pad). the baseline studies will be completed within 2 years and 3 additional follow-up studies will be performed by the end of 4th year.

Eligibility criteria:
the inclusion criteria include: 1. able to understand and provide signed informed consent 2. dm history of 10 years and above 3. willing to receive 3 mri follow-up and serum hematocrit examinations within 2 years, if applicable 4. willing to receive standard therapy such as surgery or medication 5. age between 18-80 years old the exclusion criteria include: 1. pregnant or breast-feeding women 2. allergic mri contrast medium 3. absolute contraindications to contrast mri (e.g., metallic hazards, hemodynamic instability, pregnancy, known allergy to contrast medium). 4. contraindicated to mri study: cardiac pacemaker, cochlear implantation, metallic object within eyeball 5. patients that refuse to, or has poor ability of understanding and comply study conditions, such as severe dementia or difficulty in mobility 6. patients having dialysis

Keywords: magnetic resonance imaging extracellular volume matrix fraction peripheral artery disease blood-oxygen level dependent cardiac function
comparison of drug eluting stent and covered metal stent in malignant biliary obstruction (mira iii)

Conditions: Biliary Neoplasms; Biliary Obstruction; Pancreatic Neoplasms

Summary: the purpose of this study is to compare the effectiveness and safety of niti-s mira-cover iii biliary stent with comvi biliary covered stent for the treatment of malignant biliary obstruction.

in patients with malignant biliary obstruction, endoscopic placement of biliary stents offers similar technical success rates. endoscopic retrograde cholangiography (ercp)-guided stent placement has become the preferred approach to palliate malignant biliary obstruction. the major mechanisms of self-expandable metallic stent (sems) occlusion are tumor ingrowth, tumor overgrowth, and epithelial hyperplasia. these mechanisms provide the rationale for developing a drug-eluting stent in order to improve stent patency. limited data exist regarding outcomes of paclitaxel-eluting stents in malignant biliary obstruction. this study is to prospectively compare the effectiveness and safety of paclitaxel-eluting covered metal stent and covered metal stent for the treatment of malignant biliary obstruction.

Eligibility criteria:
inclusion criteria: * age greater than or equal to 19 years of age * malignant mid or distal biliary obstruction * unresectable cancer * estimated survival greater than or equal to 3 months (karnofsky score ≥ 60) * patient willing to provide written informed consent and comply with follow-up requirements exclusion criteria: * patients who had undergone surgical biliary drainage * severe bleeding disorder (e.g. coagulopathy) * polypoid lesion or intra-abdominal abscess * female of child-bearing potential who are unable to take adequate contraceptive precautions, are known to be pregnant, or are currently breastfeeding an infant.

Keywords: drug-eluting biliary stent covered metalic stent
a retrospective study of prognostic factors and survival of breast cancer patients with brain metastesis

Conditions: Breast Cancer

Summary: the aim of the study is to to describe the pattern of bm in breast cancer patients, assess the prognostic significance of patient related-factors and to evaluate the efficacy of various treatment modalities. clinicopathological factors and prognostic factors that affect the occurrence of brain metastases and which factors affect the survival after the occurrence of brain metastases remain to be identified . this may help identify patients at high risk for brain metastases and patients with poor prognosis after brain metastases, thus providing them with some preventive or therapeutic measures.

breast cancer (bc) has become the malignancy with the highest morbidity rate in women. despite significant advances in the diagnosis and treatment of breast cancer, metastasis is still an important factor that seriously affects patients' quality of life and prognosis. it has been reported that distant metastases have been found at the initial diagnosis of breast cancer in about 6-10% of patients the bones, lungs, liver and brain are the four most common distant metastatic sites of breast cancer compared with bone metastases and visceral metastases, patients with brain metastases have significantly worse prognosis the median time from diagnosis of breast cancer to cns metastasis has been reported to be 33 month the survival of these patients may be affected by factors including molecular subtypes, performance status, ressectability of bm and visceral metastasis burden. when detected, its treatment is usually difficult and unfortunately has reverse effects on life expectancy multi-disciplinary therapy (mdt) is the first choice for the treatment of brain metastases in breast cancer mdt for breast cancer brain metastasis includes surgery, whole brain radiation therapy (wbrt), stereotactic radiosurgery (srs), chemotherapy, endocrine therapy, targeted therapy, etc. for patients with multiple brain metastases and neurological symptoms, wbrt combined with palliative care is the preferred option in general, patients with brain metastases of 3 or less were recommended to receive surgical resection. patients with 4 to 5 brain metastases but less 3cm in diameter can undergo srs .

Eligibility criteria:
inclusion criteria: * -age \>18 * histological proven breast cancer * radiological documentation of bm by computed tomography (ct) or magnetic resonance imaging (mri) * patients who had been followed up for at least 6 months. exclusion criteria: * -not histologically proven breast cancer * patient without full medical data * those with previous or concurrent diagnosis of second primary malignancy * patients with leptomeningeal or dural metastases without co-existent parenchymal metastatic lesions

Keywords: prognostic factors
nonopioid analgesia after anterior cruciate ligament reconstruction

Conditions: Anterior Cruciate Ligament Injury

Summary: this is a randomized, single blinded, standard of care controlled clinical trial. this project aims to compare postoperative pain control in patients in two treatment arms of anterior cruciate ligament reconstruction: a treatment group given a nonopioid pain control regimen, and a standard of care control group given standard opioid pain control regimen

study design: this is a randomized, single blinded, standard of care-controlled clinical trial. all adult patients over eighteen desiring anterior cruciate ligament reconstruction will be eligible. nonnarcotic postoperative pain control regimen described below were chosen based on previous studies in fracture care and joint arthroplasty. patients will be consented and recruited. once participation has been determined and consent obtained, the names of participating patients will be provided to the research pharmacy. patients will be randomized with a computer-generated table in 2 patient blocks by the research pharmacy. patients postoperative analgesia will be divided into one of the following 2 treatment arms: 1) a novel nonopioid pain protocol or 2) traditional narcotic pain analgesia primary endpoints is reduction in pain as measured by visual analogue scale and patient-reported outcomes measurement information system. the endpoints will be collected at each post-operative day using a journal. moreover, endpoints will be collected at the patient's first post-operative appointment. these appointments are scheduled within one-week of the index procedure. statistical analysis: all continuous data will be analyzed using independent 2-group t tests and reported as means ± standard deviations. categorical data will be compared between the 2 groups using chi-square tests and reported as counts and percentages. a preliminary test to confirm the quality of variances will be conducted prior to utilizing the t test to confirm the appropriate statistical analysis. nonparametric equivalents wilcoxon rank-sum and fisher exact tests will be used as needed for nonnormal distributions and low variable numbers, respectively. a multivariable regression analysis was performed to assess for potential confounding demographic variables.

Eligibility criteria:
eligibility criteria: inclusion criteria: * all adult patients over age 18 and scheduled for a primary or revision anterior cruciate ligament reconstruction exclusion criteria: * exclusion criteria will include patients with a medical history of known allergies or intolerance to allergies or intolerance to celebrex, tylenol, neurontin, dexamethasone, tramadol, substantial alcohol or drug abuse, and pregnancy, history of narcotics within 6 months of surgery, renal impairment, peptic ulcer disease, gi bleeding. secondary exclusion criterion is an intact anterior cruciate ligament reconstruction