Kornimate/medical-research-clean huggingface dataset:
a prospective cohort study of combined subinguinal varicocele ligation and sclerotherapy

Conditions: Varicocele

Summary: traditional surgical ligation of the spermatic cord veins is effective in reducing the size of the varicocele and improving fertility outcomes. however, this procedure can be associated with complications such as hydrocele formation and recurrence . antegrade sclerotherapy offers a minimally invasive alternative, involving the injection of a sclerosing agent directly into the dilated veins to achieve occlusion and reduce reflux . this study aims to optimize treatment outcomes for varicocele by combining the benefits of surgical ligation with the sclerosing effects of sclerotherapy .the primary goal is to evaluate the efficacy and safety of combining antegrade sclerotherapy and surgical ligation in the treatment of varicocele .

varicocele (vc) is a vascular condition characterized by the abnormal development or blockage of veins in the scrotum, resulting in dilation, elongation, and twisting of the veins in the spermatic cord. clinically, vc can cause scrotal pain, discomfort, and progressive testicular dysfunction. the prevalence of clinically diagnosed varicocele is approximately 8-16% in adolescents and 15% in adults. vc is a common and correctable cause of male infertility, responsible for around 44% of primary infertility cases . other reports suggest that the prevalence in childhood and adolescence is similar to that in adulthood. a recent european study of 7,000 young men (median age: 19 years) reported a 15.7% prevalence of varicocele . severe and prolonged vc can lead to significant damage to the testes and accessory structures, causing 45-81% of secondary infertility cases. vc most commonly occurs on the left side (77-92% of cases) due to the anatomy of the left internal spermatic vein. bilateral vc is observed in 10% of cases, while isolated right-sided vc is rare (1%). the diagnosis of vc is primarily based on physical examination, often supplemented by imaging . the american society for reproductive medicine and the society for male reproduction and urology recommend treating vc favorably, even in the absence of severe symptoms, if it poses a risk for infertility or decreased semen quality. treatment options for vc include general management (lifestyle modifications, physiotherapy), medication (for varicose symptoms, pain relief, and improvement in semen quality), and various surgical approaches (ligation of the internal spermatic vein via inguinal, retroperitoneal, or subinguinal routes) . minimally invasive techniques, such as laparoscopy, surgical microscopy, and percutaneous embolization, have been developed to improve visualization and reduce surgical trauma.

Eligibility criteria:
inclusion criteria: * 1- clinically and doppler confirmed grades ii or iii varicocele. 2- all left, right or bilateral side varicocele. 3- testicular pain or testicular atrophy. 4- presence of at least one impaired semen parameter. 5- age more than 18years exclusion criteria: * 1- pre-existing hydrocele. 2- concomitant hernia 3- previous inguinal surgery

Keywords: ligation sclerotherapy
study to evaluate effect of pandel cream 0.1% on hpa axis in pediatric and adult population

Conditions: Psoriasis; Atopic Dermatitis

Summary: the purpose of this study is to determine the effect of pandel® (hydrocortisone probutate cream) cream 0.1% on the hypothalamic pituitary adrenal (hpa) axis in pediatric and adult subjects with either psoriasis or atopic dermatitis involving greater than 20% body surface area.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of psoriasis or atopic dermatitis involving more than 20% of body surface area * good health with the exception of psoriasis or atopic dermatitis exclusion criteria: * any disease affecting the hpa-axis * subjects who are pregnant, nursing, or planning a pregnancy within the study participation period

Keywords: psoriasis atopic dermatitis
water iv prostate cancer

Conditions: Localized Prostate Cancer

Summary: this is a multicenter, prospective, randomized clinical trial that aims to assess the safety and efficacy of aquablation therapy in men with low-risk to intermediate to high-risk localized prostate cancer who are candidates for, or have opted for, prostatectomy. participants will be randomized to either aquablation therapy or radical prostatectomy and followed up to 10 years.


Eligibility criteria:
inclusion criteria: 1. biological male with age ≥ 45 years at the time of consent 2. biopsy positive grade group 1-3 prostate cancer 3. are candidates for prostatectomy or, in the case of gg1 disease, have already selected a radical therapy as their treatment. 4. clinical stage ≤ t2c 5. psa ≤ 20 ng/ml 6. prostate volume ≥25 ml exclusion criteria: 1. any prior or current local or systemic treatment for prostate cancer, including but not limited to surgery, radiation therapy (external or brachytherapy), tissue ablation, hormone therapy or chemotherapy. 2. patients with previous surgical or minimally invasive treatment of benign prostatic hyperplasia within the prior 3 months of study treatment. 3. evidence of lymph node, bone metastasis, extracapsular extension or seminal vesicle invasion. 4. patient is unwilling to accept a blood transfusion if required. 5. any condition or history of illness or surgery that may pose an additional risk to patients undergoing the aquablation or radical prostatectomy procedure such as: 5a. medical conditions that preclude the use of anesthesia; 5b. any condition or history of active rectal inflammatory bowel disease or other factors which might increase the risk of rectal injury (i.e. fistula formation); 5c. patient is unable to stop anticoagulants or antiplatelet agents prior to study treatment per standard of care; 5d. any other condition or history of infection, illness or surgery that in the opinion of the investigator might affect the outcome of the study procedure, study conduct, and study results; or pose additional risks to the patient (e.g., other cancer, active urethral stricture disease). 6. patients who are unable to provide informed consent due to cognitive impairment, legal status (such as incarceration), or other factors limiting autonomy or unwilling or unable to follow study instructions including randomization and complete all required study visits through 10 years. this includes individuals with severe cognitive disabilities, those under legal guardianship, or those currently incarcerated. 7. patient currently participating in other studies unless approved by sponsor in writing.

Keywords: aquablation therapy aquablation prostate cancer aquabeam radical prostatectomy hydros
antenatal and intrapartum risk factors associated with neonatal hypoxic ischemic encephalopathy

Conditions: Neonatal Hypoxic Ischemic Encephalopathy

Summary: perinatal asphyxia is a major cause of hypoxic ischemic encephalopathy (hie), perinatal death and long term neurodisability. this can be devastating for the individual and their family; the healthcare and litigation costs notwithstanding. in recent years have attempted to quantify the effect, and wider impact of intrapartum compromise, as well as the underlying mechanisms for it. after a poor outcome related to intrapartum care parents and healthcare practitioners often strive to understand whether the event could have been predicted and/or prevented. this can be difficult to answer, at least partly related to the heterogeneous fetal response to perinatal asphyxia. mothers and the maternity service are increasingly encouraged to personalize care and their choices around the birth process, however the information required to guide these choices is most often missing. this makes it difficult for women and professionals to make an informed choice about their care, including the safest mode of birth for them and their baby. aim of the study: identifying antenatal and intrapartum risk factors associated with neonatal hypoxic ischemic encephalopathy.

antenatal, perinatal and postpartum data will be documented from the medical notes and from parental reports including; * booking factors (maternal age, smoking, parity, previous lower segment caesarean section (lscs), multiple births) * antenatal factors (preeclampsia, gestational diabetes, prelabor abruption, placenta previa, oligohydramnios, polyhydramnios, threatened preterm labor, gender, concerns of iugr infant) * labor factors (induction of labor, pre-labor rupture of membranes, planned lscs, gestation at birth, presentation, prelabor breech, breech delivery, duration of ruptured membranes). * infant characteristics included ga, gender, birth weight (bw), head circumference, and multiplicity. * clinical signs, examination findings and laboratory data also will be included. most covariates will be extracted from patient's notes, routine data collection or as part of a routine clinical database. data will be processed and analyzed using spss software and the results will be processed in tables and figures.

Eligibility criteria:
inclusion criteria: * clinical signs of neonatal encephalopathy(e.g. irritability, decreased responsiveness, coma, seizures, hypotonia, abnormal primitive reflexes, apnea, feeding disturbance, and abnormal cry), nicu admission, full-term infant with poor condition at birth (5-minute apgar score \<7) and/or need for major resuscitation. exclusion criteria: * preterm infant, full term infants with birth asphyxia but with congenital malformations or chromosomal abnormalities, infant of diabetic mother and cns infections are excluded from the study.
effects of cla supplements on body weight and fat oxidation

Conditions: Obesity

Summary: conjugated linoleic acid (cla) is form of fat found in dairy foods, beef and other natural sources. when given to small animals, decreases of body fat have been noted.. although weight loss is the best treatment for overweight and obesity, it is difficult to maintain the loss in the long term. because of this, treatment emphasis has turned to small weight losses obtained through non-restrictive diets and prevention of weight regain. this is a study to determine if 6 months of consumption a purified form of cla will result in greater loss of body fat than control and to determine whether cla consumption increases total fat oxidation, which would help explain why the weight loss occurs.

subjects were screened and then underwent baseline evaluation. the substudy evaluation measured 24-h energy expenditure and substrate utilization by using a whole-room indirect calorimeter. dietary fat oxidation was measured by mixing \[1-13c\]oleate and d31-palmitate into a breakfast meal and then collecting breath carbon dioxide and urine to measure the end products of oxidation. subjects were then provided either 4 g/d of 78% active cla isomers (3.2 g/d: 39.2% cis-9,trans-11 and 38.5% trans-10,cis-12) or 4 g/d of safflower oil placebo as 1-g gel capsule supplements. the baseline evaluations were repeated 6 mo later.

Eligibility criteria:
inclusion criteria: * bmi 25-29.9 kg/m2 * absence of a weight change of greater than 3 kg in the previous 6 months exclusion criteria: * presence of a physical limitation to walking exercise * current or recent (6 months) enrollment in a commercial or self-prescribed weight loss program * a history of metabolic disease-ie. renal, endocrine, hepatic or gastrointestinal disease that would impact the outcome of the study * a history of a psychiatric or eating disorders ÿ presence of metal implants that would interfere with body composition analysis * fasting plasma cholesterol \>300mg/dl or triglycerides above 500 mg/dl. * abnormal ekg
plin1 variants in precocious acs (scaplin)

Conditions: Acute Coronary Syndrome

Summary: this study aims to identify a genetic predisposition factor of precocious acute coronary syndrome occurrence (acs). acs is a major public health problem and the first cause of mortality in the world. it can be due to several risk factor such as heredity. the investigators make the hypothesis that occurrence of early acs (defined as \<50yo for men and \<55yo for women) could be the initiatory event of a mild form of genetic lipodystrophy . our previous study shown an occurrence risk of acs about 8.3 in patients carrying a mutation in the plin1 gene versus patients without a mutation. the plin1 gene encode for perilipin 1 protein localized on the lipid droplet surface. this protein phosphorylation activates the triglycerides lipolysis. our goals in this study are multiple: to validate the high frequency of mutations in this gene in patients with early acs, to determine differences in triglycerides metabolism and also relapse rate between carrier and non-carrier patients of mutation in plin1. our first aim will be to carry out the inclusion of 200 patients with precocious acs. this will allow us to obtain around 15 patients carrying a mutation in the plin1 gene based on our previous study. the investigators will reprogramme patients' cells (carrying or not a plin1 mutation) in human induce pluripotent stem cells (hipsc). these hipsc will be differentiated in cell types of interest as adipocytes or macrophages. the investigators will then study triglycerides metabolism (lipid droplet formation, localization and phosphorylation of perlipin 1) in these cells and atheroma plaque formation. finally, the investigators will study clinical data such as relapse rate and searching for correlation with plin1 mutation.


Eligibility criteria:
inclusion criteria: * age of the patient when acs occurs (between 18 and 50yo for men, between 18 and 55yo for women) * written informed consent exclusion criteria: * men \ 50yo * women \ 55yo * acs causes (toxic, coronary dissection) * congenital cardiac malformations * familial hypercholesterolaemia * pregnancy, breast-feeding women or vulnerable profile. * patient refusal to participate or previously included in a clinical research trial.
a study of a new local anesthesia method for transperineal prostate biopsy

Conditions: Prostate Biopsy; Local Anesthesia

Summary: in comparison with transrectal prostate biopsy, transperineal prostate biopsy has the advantage of better sampling from the anterior area, low risk of infection, and no rectal bleeding. the main problems associated with the transperineal method are pain control and additional general or spinal anesthesia. three types of anesthesia have been reported for transperineal prostate biopsy: (1) spinal anesthesia; (2) general anesthesia; and (3) local anesthesia. from the viewpoint of patient selection (general anesthesia is contraindicated in some patients) and medical cost, local anesthesia is the most suitable choice for prostate biopsy. periprostatic block is the standard method of local anesthesia for this procedure. however, periprostatic block is insufficient for transperineal prostate biopsy due to high pain sensitivity in this region. a number of new methods to eliminate pain have been reported, including (1) periapical triangle (pat) block, (2) paraprostatic plus sexual nerve block, and (3) periprostatic block plus pudendal block.however, there is no anatomical basis for some of these methods, and there have been no randomized controlled trials to evaluate their effectiveness, and some methods are technically difficult to learn. in the previous perineal nerve autopsy, we found that there are two branches leading into the prostate and anterior lateral prostatic tissue, which is the main site of puncture pain. there is a fixed position where the two branches appear. therefore, this anatomical position block may be a useful site for local anesthesia. we named this location the 'transperineal prostate biopsy local anesthesia switch' (abbreviated as tpa switch). in order to validate its effect, we organized this clinical trail.

ninety patients scheduled for prostate biopsy will include in this study. the clinical trial validation process will be as follows: (1) all patients are randomly divided into three groups (figure 1): group 1, subcutaneous local anesthesia+periprostatic block; group 2, subcutaneous local anesthesia+periapical triangle (pat) block; group 3, subcutaneous local anesthesia+tpa switch (transperineal prostate biopsy local anesthesia switch) block; vas scores for each puncture and complications will be recorded.

Eligibility criteria:
inclusion criteria: * 1. ready to be performed transperineal prostate biopsy; 2. fully understand the protocol and aggree to undergo prostate biopsy with local anesthesia which might be elder methods or new experimental method. exclusion criteria: * 1.do not have the history of anaphylaxis or local anesthetic intoxation； 2. cardiac dysfunction or coagulation dysfunction; 3. rectal disease which can not allowed to plug the ultrasound probe in; 4.do not fully understand our protocol; 5. do not aggree our protocol.

Keywords: transperineal prostate biopsy local anesthesia prostate cancer diagnosis
transfusion in gastrointestinal bleeding

Conditions: Gastrointestinal Hemorrhage

Summary: aim: to evaluate the feasibility and safety of a restrictive versus liberal red blood cell (rbc) transfusion policy in adult patients admitted with acute upper gastrointestinal bleeding (augib) in order to inform the design of a definitive phase iii randomised controlled trial.

trial overview: trigger is a pragmatic trial aiming to recruit adult patients admitted with all cause augib (non-variceal and variceal). the study will take place in six united kingdon hospitals and they will be randomly allocated to a transfusion policy at the cluster level; three sites will be allocated to a restrictive transfusion policy and three to a liberal transfusion policy. given the challenges that will be involved in early recruitment and cross-speciality care, a feasibility study is essential to determine whether a sufficient proportion of eligible patients can be recruited into the trial and that clinicians can adhere to the allocated transfusion policy. recruitment will operate for 6 months in total. the investigators will compare recruitment rate, protocol adherence, clinical characteristics of patients recruited, exposure to rbc transfusions and the difference in hb concentrations between the restrictive and liberal transfusion policies. the investigators will collect important clinical outcomes which the investigators anticipate being central to the phase iii trial, including 28-day mortality, further bleeding rates and serious adverse events between the restrictive and liberal transfusion policies. the investigators will also collect data to enable us to plan a health economic evaluation and quality of life assessment for the phase iii trial.

Eligibility criteria:
inclusion criteria: * adults aged 18 or over years presenting with augib, defined by haematemesis or melaena. exclusion criteria: * patients with whom the responsible clinician considers there is a need for immediate rbc transfusion prior to obtaining or regardless of the initial hb result due to severity of bleeding. * existing hospital in-patients who develop augib.

Keywords: transfusion in gastrointestinal bleeding
intraosseous morphine administration during anterior cruciate ligament reconstruction

Conditions: Anterior Cruciate Ligament Tear; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Rupture

Summary: the purpose of this study is to determine if intraosseous (io) morphine decreases pain and post-operative opioid use in patients undergoing anterior cruciate ligament (acl) reconstruction.


Eligibility criteria:
inclusion criteria: * patients of the irb approved surgeon(s) undergoing acl reconstruction with bone-to-bone (btb) autograft * patients aged between 18-40 years old at the time of surgery exclusion criteria: * patients undergoing acl reconstruction with any other type of autograft or allograft other than btb * patients younger than 18 years old or older than 40 years old * patients undergoing meniscal root repair or any other repair that changes their weight-bearing status * patients with a history of substance abuse * vulnerable populations * patients on chronic pain medication within the last 6 months * bmi \>/= 35 * allergy to morphine * unwilling to participate * any additional reason the pi deems reasonable
vitamin d and screening colonoscopy or polyp surveillance

Conditions: Colon Cancer

Summary: the investigators will recruit dod beneficiaries 18 years or older, that have been referred for a screening colonoscopy or polyp surveillance (or had one in the last 2 weeks), and have no previous diagnosis of colorectal cancer. they will have a 25 oh vitamin d level drawn to determine if there is an association between the level obtained and findings on colonoscopy, or previous findings (if repeating).

dod beneficiaries age 18 or older will be recruited from the clinics at the mike o'callaghan federal medical center (mofmc). subjects meeting the inclusion/exclusion criteria will be offered an opportunity to participate: screening visit: * obtain signed informed consent document and hipaa authorization (research-driven). * record: date of birth, age, gender, race, ethnicity, current email address, height (in inches), weight (in pounds), waist circumference (in inches) measurement, blood pressure, and whether subject is taking or has taken any vitamin d supplement or derivative, and if so, note the dosage, frequency, and duration of therapy. * subjects will be told to fast for at least 10 hours prior to visit 1 visit 1 (within two weeks of their screening colonoscopy): -subjects will have the following research-driven blood test drawn which include: serum 25-oh vitamin d via 1 venipuncture (5-10 mls, approximately 1-2 teaspoons of blood will be drawn)

Eligibility criteria:
this study is being conducted at a military installation. you must have military insurance in order to participate in this study. inclusion: * dod beneficiaries 18 years or older * referred for a screening colonoscopy or polyp surveillance or had one in the last 2 weeks exclusion: * previous diagnosis of colorectal cancer, adenomatous polyps, and/or cancer * military trainees * pregnant women