Kornimate/medical-research-clean huggingface dataset:
surgical correction of moderate ischemic mitral regurgitation

Conditions: Moderate Ischemic Mitral Regurgitation

Summary: the purpose of this study is to try and determine whether repair of moderate ischemic mitral regurgitation at the time of coronary bypass graft surgery (cabg) has an impact on survival.we will compare patients undergoing cabg + mitral repair or cabg only groups. primary endpoints include late survival. secondary endpoints include event free survival, symptoms, and echocardiographic outcomes.


Eligibility criteria:
inclusion criteria: * patients undergoing coronary bypass surgery who have moderate degree of ischemic mr exclusion criteria: * etiology of mitral regurgitation other than ischemic, degree of regurgitation other than moderate.
extended safety study of montelukast in infants and young children with chronic asthma (0476-232)

Conditions: Asthma

Summary: patients were treated with either montelukast 4 mg oral granules or usual care. patients who completed protocol mk0476-176-01 (nct00943683) had the option to enroll in this study. additionally, patients with asthma who were 6 to 11 months of age and who had not participated in protocol mk0476-176-01, could also enroll.


Eligibility criteria:
inclusion criteria: * patient successfully completed visit 5 of mk0476 protocol 176 (nct00943683) or: * patient is in good, stable health * patient has been fed solid foods for at least 1 month * patients had at least 3 episodes of asthma or asthma-like symptoms, all occurring after 8 weeks of age; at least one within 6 months of the prestudy visit * patients had to be in need of a controller therapy according to criteria established in the global initiative for asthma (gina) guidelines exclusion criteria: * patient was hospitalized at the start of the study or had any major surgery 4 weeks prior * patient had an allergy to apples or applesauce
ursodeoxycholic acid in chronic heart failure

Conditions: Heart Failure, Congestive

Summary: this is a double-blind, placebo-controlled, cross-over study evaluating the effects of udca on peripheral blood flow and immune function in patients with stable chronic heart failure (chf). sixteen patients with chf will be recruited from the heart failure clinic at the royal brompton hospital. following baseline evaluation, patients will be randomised to receive either placebo or udca at a dose of 1000 mg/day for a period of four weeks. they will then undergo repeat evaluation (peripheral blood flow and immune function). a four week washout period will then take place before the patients cross-over to receive the respective other therapy for a further four weeks (i.e. those first receiving placebo will go onto receive udca and vice versa). the study will be completed after a total of twelve weeks, with a final assessment (peripheral blood flow and immune function).


Eligibility criteria:
inclusion criteria: * age \>21 years * of either sex * the patient is willing and capable of complying with the requirements of this protocol * the patient has provided written informed consent * the patient has clinical evidence of chronic heart failure: * reduced ejection fraction (≤40%) or left ventricular impairment on echocardiography (lvedd ≥60mm) * stable clinical condition and medication for at least 1 month prior to the study (new york heart association class ii-iv). * the patient is receiving appropriate conventional medical therapy for heart failure (ace inhibitor or angiotensin ii blocker, diuretics, beta-blocker as indicated and tolerated). exclusion criteria: * congenital heart disease * any life-threatening disease, other than heart failure * active malignancy of any type, or history of a malignancy within previous 5 years. patients with a history of other malignancies that have been surgically removed and who have no evidence of recurrence for at least five years prior to study enrolment are acceptable. * previous heart transplant * severe neuro-muscular disease * history of unstable angina, myocardial infarction or stroke within 3 months prior to the study * pregnancy or women of child-bearing age * treatment with immunosuppressive therapy e.g. steroids for rheumatoid arthritis or obstructive lung disease * significant renal dysfunction (serum creatinine \>250mmol/l), severe liver disease (liver function tests \> 3 times normal) * unable to understand and comply with protocol or to give informed consent
hfnc in management of bronchiectasis exacerbation

Conditions: Bronchiectasis

Summary: patients with bronchiectasis experience exacerbations with hypercapnic respiratory failure associated with an increased respiratory workload that may require intensive care unit (icu) admission due to the inability of the respiratory muscles to compensate for increased demand. these exacerbations are frequently treated with noninvasive ventilation (niv).

niv has been shown to unload the respiratory muscles, increase alveolar ventilation and gas exchange and reverse the rapid and shallow breathing pattern commonly adopted by bronchiectasis patients with advanced lung disease. niv is a cornerstone therapy for hypercapnic acute respiratory failure. still, there is also an increasing interest in high-flow nasal cannula (hfnc) as a potential alternative treatment in this indication. hfnc delivers an actively heated and fully humidified gas mixture with flow rates up to 60 l/min and adjustable fio2 from 21 to 100%. the high flow rates generate small amounts of positive end-expiratory pressure (peep) that may help counterbalance the effects of intrinsic peep (peepi) on the work of breathing and might act by washing out of the physiological dead space. furthermore, it could help to facilitate secretion clearance from the humidified gas. studies have demonstrated the benefits of hfnc in acute hypoxemic respiratory failure, after cardiothoracic surgery, and in preventing post-extubation failure among unselected cohorts of critically ill patients during weaning from invasive mechanical ventilation. however, the current evidence of using hfnc in patients with hypercapnic acute respiratory failure is limited. we aime to spotlight this research area.

Eligibility criteria:
inclusion criteria: * patients will be eligible for enrolment if diagnosed with bronchiectasis and admitted to the respiratory intensive care unit (ricu), requiring ventilator support without invasive mechanical ventilation. exclusion criteria: * age: less than 18 years. patients with post-arrest encephalopathy. patient with the previous tracheotomy. patients who received invasive ventilatory support. patients with end-organ failure.
human umbilical cord-mesenchymal stem cells via different transplantation routes in esld

Conditions: End-Stage Liver Diseases

Summary: stem cells are non-terminal cells that can self renew and replicate through symmetric or asymmetric division, with the potential to differentiate into different types of cells and tissues. multiple studies have shown that human umbilical cord mesenchymal stem cell has good safety and effectiveness in improving acute or chronic liver injury. stem cell therapy for end-stage liver disease (esld) can be administered through various routes, among which hepatic artery and peripheral vein infusions are the most commonly used in clinical practice. the efficacy of hepatic artery infusion appears to be greater than that of peripheral vein infusion.

thirty-two participants with end-stage liver disease admitted to the department of gastroenterology of the general hospital of northern theater command are expected to be enrolled over a period of 6 months. they will be randomly assigned to peripheral vein infusion and hepatic arterial infusion of human umbilical cord mesenchymal stem cell groups. the investigators will observe alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, albumin, prothrombin time, international normalized ratio, model for end-stage liver disease score, and child-pugh score at weeks 4, 12, and 24 post-infusion.

Eligibility criteria:
inclusion criteria: 1. 18-80 years old - 2. end-stage liver disease - 3. signed informed consent exclusion criteria: 1. tumours of the liver or other organs - 2. liver transplantation recipients - 3. acute myocardial infarction, acute heart failure, type i and type ii respiratory failure, pulmonary embolism, acute cerebral infarction, acute cerebral haemorrhage and other serious cardiopulmonary diseases - 4. other diseases that may seriously affect the survival - 5. human immunodeficiency syndrome - 6. interferon or glucocorticoid therapy within 1 year - 7. treated for mental illness - 8. participation in other clinical trials within 30 days - 9. pregnant or breastfeeding subjects - 10. allergic asthma, allergic urticaria, eczema, or a history of multiple drug and food allergies - 11. other circumstances that are unsuitable for participation in this study

Keywords: cirrhosis end-stage liver diseases umbilical cord-mesenchymal stem cells randomized controlled trial
outcome, hindsight and implicit bias in emergency medicine and medical disciplinary law.

Conditions: Emergencies; Implicit Bias

Summary: background hindsight bias and outcome bias may play an important role in retrospective law of errors in emergency medicine and may affect judgement. in addition, differences in sex and medical history may affect treatment decisions (implicit bias). aims first, to assess if and to what extent knowledge of an outcome may affect the ability of emergency physicians and physicians with experience in disciplinary law to determine the quality of care given. secondly, to investigate whether a medical history with nonspecific/functional/somatoform complaints and sex differences affect clinical decision making in emergency physicians. study design and analyses a web-based cross-sectional survey using vignettes with six clinical scenarios (four vignettes for outcome/hindsight bias, four vignettes for implicit bias). the survey was sent to all emergency physicians and residents in training in the netherlands. four scenarios were also sent to physicians with experience in disciplinary law. in four vignettes, participants received a scenario without an outcome, or with a positive or negative outcome. they were asked to rate the quality of care provided as sufficient or insufficient and, in more detail, poor/below average/average/good/outstanding and how likely they thought it would be that the patient would have had a negative outcome (in percent). in the other two vignettes, participants received one vignette describing a scenario of a patient presenting to the ed with acute abdominal pain and one vignette describing a scenario with chest pain. the sex and medical history differed among the participants (e.g. male/female, nonspecific medical history/somatic medical history). participants were asked whether they would prescribe pain medication, and whether they would do diagnostic imaging. importance and impact this research may help to understand the impact of knowing the outcome in retrospective laws in dutch emergency physicians and physicians with experience in disciplinary law. if outcome and hindsight bias are present, retrospective judgement may need a different approach in medicine, i.e. blinding judges for the outcome, to prevent wrong justice and adverse effect on clinicians well-being. also, if implicit bias in sex and medical history is present, a training programme is needed to reduce certain bias and to improve equality in the provided care.


Eligibility criteria:
inclusion criteria: * emergency physicians or residents, general practitioners, and physicians with experience in disciplinary law. exclusion criteria: * others
metabolic subtypes of non-alcoholic fatty liver disease

Conditions: Non-Alcoholic Fatty Liver Disease; Machine Learning

Summary: the purpose of this study was to use machine learning to explore a more precise classification of nafld subgroups towards informing individualized therapy.

clinical characteristics of nafld are heterogenous, but current classification for diagnosis is simply based on pathological examination. the conventional pathological classification is insufficient to reflect the complexity and heterogeneity of nafld and can not predict the prognosis. towards precision treatment, a more refined metabolic classification of nafld phenotypes is highly demanded for a personalized diagnosis, aiming to identify patients at elevated risk of cardiovascular disease or cirrhosis. this kind of refined classification can provide a more precise diagnosis and enable more individualized preventive interventions and early treatments. in a cross-sectional cohort, unsupervised machine learning was used to cluster patients with biopsy-proved nafld from drum tower hospital affiliated to nanjing university medical school based on clinical variables. verification of the clustering was performed in a longitudinal cohort.

Eligibility criteria:
inclusion criteria: * biopsy-proved nald cohort: 1. age 18 to 75 years 2. receiving liver biopsy at the time of metabolic surgery 3. relatively complete clinical information, including physical examination, biochemical and haematological assessments * longitudinal cohort 1. age 18 to 75 years 2. receiving abdominal imaging examinations, 3. relatively complete clinical information, including physical examination, biochemical and haematological assessments (4）follow-up time at least more than 12 months exclusion criteria: * (1)consumed excessive alcohol (≥140 g/week for males or ≥ 70 g/week for females) • * (2) with history of other liver diseases including chronic hepatitis, biliary obstructive diseases or autoimmune hepatitis
video images about decisions for ethical outcomes in the emergency department (video-ed)

Conditions: Emergencies

Summary: a randomized controlled trial of a video decision aid in the emergency department setting to improve advance care planning documentation.

a randomized controlled trial of a video decision aid in the emergency department setting shown to patients followed by a brief advance care planning discussion and then relay that discussion to the patient's primary care provider and/or admitting clinical team and look at rates of advance care planning documentation in the electronic health record over time. primary outcome is advance care planning documentation in the ehr at 3 months.

Eligibility criteria:
inclusion criteria: * anyone aged 65 and over or anyone aged over 50-64 with an indicator of serious illness exclusion criteria: * non english or spanish speakers those with a polst legally blind medically non stable requiring icu level care
effect of cervical vagal blockade on cough incidence in non-intubated uniportal video-assisted thoracic surgery

Conditions: Video-assisted Thoracoscopic Surgery

Summary: currently, there is a trend toward non-intubated anesthesia methods for video-assisted thoracic surgery in our hospital. during the surgery, intrathoracic vagus nerve blockade is suggested for inhibit cough reflex in previous paper. however, right and left side of vagus nerves both deep near the aorta or trachea respectively. to achieving the procedure may induce cough reflex by lobar traction even result vital organ damage. this study aims to apply alternative vagus nerve blockade at neck level via ultrasound guidance and test if the procedure real reduce cough reflex then previous method. we also follow up the patient's vital sign, vocal cord and diaphragm movement, horner syndrome and hoarseness to evaluating if cervical vagal blockade has the potential risk involve other surrounding nerves


Eligibility criteria:
inclusion criteria: * adults younger than 80 years old are scheduled for one-port video assisted thoracic surgery exclusion criteria: * anticipated difficult airway, respiratory insufficiency,vocal cord palsy,diaphragm palsy parkinsonism,previous stroke,tachycardia

Keywords: vagus nerve block
iort following breast conserving surgery for early stage breast cancer registry

Conditions: Breast Cancer

Summary: this is a prospective, registry trial which will enroll women aged 65 and above with early stage, low risk breast cancer who will be treated with partial mastectomy and intraoperative radiation therapy (iort). the primary aim is to determine the 5-year risk of in-breast tumor recurrence. secondary aims include identification of acute- and late-toxicity, cosmetic result, disease-free survival and overall survival.


Eligibility criteria:
inclusion criteria: * female * ecog performance status 0-1 * age 65 years or older * ct1 or ct2 (≤3.0 cm) * invasive ductal carcinoma histology * estrogen receptor positive (er+) * grade 1 or grade 2 * clinically negative lymph nodes (cn0) by examination, imaging and/or nodal sampling * suitable for breast conserving surgery and radiation therapy * patient must be able to provide study-specific informed consent exclusion criteria: * multi-centric cancer not amenable to single lumpectomy * prior ipsilateral whole breast radiation * known brca 1 or brca 2 mutation * status post neoadjuvant hormonal or chemotherapy * invasive lobular histology * pure ductal carcinoma in situ (dcis) * grade 3 * diffuse suspicious microcalcifications

Keywords: breast cancer invasive ductal carcinoma intraoperative radiation therapy iort
an efficacy and safety study of abt-slv176 for the treatment of hypogonadal men

Conditions: Hypogonadism; Testosterone Deficiency

Summary: this is an open-study with a 26 week open label treatment period followed by an optional 26 week open label extension. the total treatment period will be 52 weeks.


Eligibility criteria:
inclusion criteria: low testosterone exclusion criteria: * normal testosterone levels * elevated prostatic specific antigen (psa) * history of breast or prostate cancer

Keywords: low testosterone
fet-pet directed simultaneous in-field boost for primary gbm

Conditions: Glioblastoma Multiforme

Summary: the combination of anatomical mri examination with functional examination of tissue metabolic activity such as fet-pet (pet using the radiotracer - 18f-fluoro-ethyl-tyrosine) is a valuable tool to determine the actual tumor infiltration. the fet-pet examination can be performed using the dual-time point aqusition of fet for exact treatment planning. it has also been proven that using the dual fet-pet method, it is possible to obtain a precise image of the glioblastoma infiltration corresponding to the location and shape of the recurrence, and the tumor volumes in dual fet-pet are significantly larger than in mri. moreover, tumor defined in dual fet-pet is different than that of the tumor defined in single fet-pet acquisition. in the dualfetboost trial we plan to assess the safety and preliminary efficacy of hypofractionated irraditon using simultaneous in-field boost directed on dual fet-pet based tumor volumes for treatment of primary glioblastoma multiforme with concomitant temozolomide.

in the case of the treatment of glioblastoma multiforme, as a standard, radiotherapy lasts 6 weeks, and the extension of treatment may adversely affect the tumor cells death, the patient's well-being and treatment costs (prolonged hospitalization). in turn, escalating the dose may increase the toxicity of radiation therapy by increasing dna damage in healthy brain tissue. using of dual fet-pet images for treatment planning allow to reduce volumes of healthy tissue irradiated. dose-intensification proposed in the study using simultaneous in-field boost allows the dose escalation without increasing the overall treatment time. all patient will be treated with moderately hypofractionated radiotherapy (2.6 gy per fraction) directed on pet positive volumes and conventional fractionation (60gy in 30 fractions) on tumor margin.

Eligibility criteria:
inclusion criteria: * histopathological confirmation of glioblastoma (who grade iv) * age between 18-75 years of age * general condition according to the zubrod scale 0 or 2 * the results of the blood counts are normal * liver enzyme parameters normal * the results of the parameters of the patient's functions are normal * informed consent to participate in the category exclusion criteria: * coexistence of another cancer * the location of the tumor in the area of the brain stem or cerebellum * prior brain radiation therapy * no uptake visible in the fet-pet imaging * contraindications for mri * contraindications to radiotherapy or chemotherapy * pregnancy, lack of consent to the use of protection against pregnancy, puerperium * alcohol addiction * mental illness * claustrophobia

Keywords: fet-pet boost glioblastoma dose-intesification dose-escalation
rapid maxillary expansion with low level laser therapy

Conditions: Crossbite; Malocclusion; Cross Bite; Maxillary Constriction

Summary: the posterior crossbite is a common type of malocclusion that might affect the normal growth pattern. early treatment is recommended by rapid maxillary expansion with different appliances. this line of treatment needs a sufficient retention period to decrease the rate of relapse. the low level laser therapy has been used to enhance tissue regeneration. this study aims to compare the effect of rapid maxillary expansion with low level laser versus rapid maxillary expansion in children with posterior cross bite malocclusions.

this study aims to evaluate the effect of rapid maxillary expansion using the bonded hyrax expander combined with low level laser therapy versus rapid maxillary expansion alone. the investigators intend to recruit sixty subjects of both sexes, between the age of 7 and 14 years. patients with posterior crossbites and patent mid-palatal sutures will be randomized into one of the two groups of treatment. full orthodontic records will be collected and the standard orthodontic radiographs will be replaced by cone beam computer tomographic images. the records will be taken before the maxillary expansion and after 6 months of retention. the skeletal, dentoalveolar, and soft tissue effects of the two interventions will be compared.

Eligibility criteria:
inclusion criteria: 1. posterior crossbite 2. patent mid-palatal suture 3. mixed dentition or early permanent teeth 4. subjects who reported no medical conditions or prolonged medications exclusion criteria: 1. poor oral hygiene 2. active periodontal disease 3. craniofacial abnormalities 4. previous orthodontic treatment 5. any systemic disease or medication that might affect bone metabolism.

Keywords: bonded-hyrax hyrax-expander maxillary constriction posterior cross bite rapid maxillary expansion
a study to assess the efficacy and safety of pf-04236921 in subjects with crohn's disease who failed anti-tnf therapy

Conditions: Crohn's Disease

Summary: this is a proof of concept study to determine the efficacy and safety of a monoclonal antibody with three doses versus placebo. subjects will be randomized to a treatment and the dose will be delivered subcutaneously twice, 4 weeks apart. all subjects will have moderate to severe refractory crohn's disease.


Eligibility criteria:
inclusion criteria: * subjects must have failed or are intolerant to anti tnfs * hscrp greater or equal to 5.0 mg/l * ulcerations demonstrated by colonoscopy as defined by ses cd assessment performed within 8 weeks of study entry (screening) and able to retrospectively complete the ses-cd or colonoscopy performed during screening exclusion criteria: * pregnant or breastfeeding women * crohn's disease with active fistulae or abscess * history of diverticulitis or symptomatic diverticulosis * abnormality in hematology or chemistry profiles at screening

Keywords: crohn's disease safety efficacy pharmacokinetics pharmacodynamics crohn's disease activity index (cdai)