Kornimate/medical-research-clean huggingface dataset:
pancrea: risk factors and outcomes of infected pancreatic necrosis

Conditions: Acute Necrotizing Pancreatitis; Infection; Pancreatitis

Summary: severe acute pancreatitis is a common reason for intensive care unit (icu) admission and is associated with prolonged hospital stays and high morbidity and mortality rates. the atlanta classification differentiates mild, moderate, and severe acute pancreatitis, and each of these categories correlates with morbidity and mortality. mortality remains high, between 10% and 39%, in severe and moderately severe acute pancreatitis. after the first week, about 30% of patients with necrotizing pancreatitis develop infected pancreatic necrosis (ipn). ipn is a risk factor for mortality.the treatment of ipn combines antibiotics with interventions to remove the infected intra-abdominal material, preferably using minimally invasive techniques such as percutaneous and endoscopic drainage, which have been proven beneficial. in several studies biological markers such as procalcitonin and interleukin 8 were effective in predicting ipn. however, few clinical risk factors for ipn have been reported. identifying risk factors may help to improve standardized strategies for early diagnosis and treatment, and then patients outcome. our primary objective was to identify risk factors for ipn in patients admitted to the icu for acute pancreatitis. our secondary objective was to describe the management and outcomes of ipn

using electronic patient data monitoring systems, the investigators reviewed all patients with a diagnosis of acute necrotizing pancreatitis admitted to digestive liver disease unity or icus at the nantes university hospital, from january 1, 2012, to december 31, 2015. for enrolled patients, general clinical characteristics were collected. patients were categorized into two groups according to the development of an infected pancreatic necrosis (highly suspected or proven), and the differences of these characteristics between two groups were evaluated. potential risk factors were collected and studied by using multiple logistic regression analysis.

Eligibility criteria:
inclusion criteria: * adult patients (age \>18 years) with acute necrotizing pancreatitis admitted in an icu between january 2012 and december 2015 for moderately severe or severe acute pancreatitis were included. * organ failure that resolves within 48 h (transient organ failure) and/or local or systemic complications without persistent organ failure or persistent organ failure (\>48 h) exclusion criteria: * mild acute pancreatitis, defined as no organ failure or local complication (no necrosis or peri-pancreatic collection)

Keywords: acute necrotizing pancreatitis acute pancreatitis sepsis/complications infection organ dysfunction scores drainage catheters antibiotics multiresistant organism pancreatitis/complications pancreatitis/diagnosis pancreatitis/surgery pancreatitis/therapy pancreatitis, acute necrotizing/complications pancreatitis, acute necrotizing/surgery pancreatitis, acute necrotizing/therapy
safe generations plus: swaziland pmtct ltf study

Conditions: HIV (Human Immunodeficiency Virus)

Summary: this study is to understand how to improve retention in care and treatment services to hiv positive pregnant women and their babies in swaziland. the investigators will evaluate outcomes of patients who are lost-to-follow-up (ltf) under a new approach for prevention of mother-to-child (pmtct) called option b+, where all hiv positive pregnant women initiate lifelong antiretroviral therapy (art) regardless of their disease stage. the goal is to understand the outcomes of patients who are ltf from care, and the reasons for disengagement from care in the context of pmtct in order to inform efforts to improve retention in care among patients under option b+.

the study will be conducted among approximately 1,600 women and their infants who received option b+ pmtct services at ten facilities in swaziland. these facilities were included in another study on option b+ called safe generations in which routinely collected patient-level data was abstracted from medical registers. this study has three parts: the first is a review of alternative patient medical records among women and their infants who were documented as ltf in the safe generations study. the second component consists of tracing women who are ltf on the phone or in the community to administer a questionnaire. lastly, an in-depth interview will be conducted among a sub-group of women to explore patterns of care.

Eligibility criteria:
inclusion criteria: * mothers and their infants who were enrolled in pmtct at safe generations study sites after the sites transitioned to option b+. * determined to be ltf per the safe generations study protocol (i.e., have not attended a clinic visit in the 90 days prior to their 6-month postpartum appointment and are not known to be dead or transferred out, according to clinical visit data abstracted to the safe generations study database). exclusion criteria: * mothers that are not a pmtct client.

Keywords: pmtct (prevention of mother-to-child transmission) hiv (human immunodeficiency virus) loss to follow-up (ltf) option b+ (b+) art (antiretroviral therapy)
prevention of conversion in posterior retroperitoneal adrenalectomy by measuring preoperative anatomical conditions

Conditions: Adrenal Tumor; Adrenal Mass; Pheochromocytoma; Conn Adenoma; Adrenal Metastases; Adrenal Hyperplasia

Summary: with our retrospective study the investigators show the limitations of the posterior retroperitoneal adrenalectomy by analyzing anatomical parameters. the investigators compared the data from one patient who underwent a conversion with 13 patients without a conversion. furthermore, they explored the influence of these parameters on the operation time and excluded the patient who had a conversion from this analysis. the investigators hypothesize that by determining anatomical characteristics on cross-sectional imaging (ct or mri), they can show the limitations of the posterior retroperitoneal adrenalectomy to prevent patients from being converted to lateral transperitoneal adrenalectomy.

minimally invasive adrenalectomy has become the gold standard for the surgical treatment of small, benign adrenal lesions. in addition to the common laparoscopic lateral transperitoneal adrenalectomy, the posterior retroperitoneal adrenalectomy is becoming increasingly important. to date, there is no consensus regarding the preferred approach in the resection of benign adrenal tumors. a comprehensive adrenal tumor program should be able to offer both options, however, patient selection criteria for a given approach have not yet been defined. the choice between lateral transperitoneal adrenalectomy and posterior retroperitoneal adrenalectomy is relevant for patients with unilateral tumors \< 6-7 cm and without previous abdominal surgery. the aim of this study was to determine the limits of posterior retroperitoneal adrenalectomy using anatomical parameters to enable the preferred access to be chosen preoperatively to prevent conversion. in addition, the investigators describe the relationship between these parameters and the operation time to find a measure of the degree of technical difficulty.

Eligibility criteria:
inclusion criteria: * patients whose adrenal gland was removed with retroperitoneal access * operation was between 01.07.2016 and 31.12.2018 * operation was at the kantonsspital aarau exclusion criteria: * patients with multivisceral resection

Keywords: adrenalectomy minimally invasive surgery posterior retroperitoneoscopic adrenalectomy retroperitoneal fat mass
use of neural functional electrical stimulation for the recovery of grasping movements for patient with quadriplegia.

Conditions: Spinal Cord Injuries

Summary: functional electrical stimulation (fes) has been used for decades in rehabilitation centers. having demonstrated efficacy for prevention of muscle atrophy following spinal cord injury (sci), fes can also be considered for functional restoration of hand movements in the patients with complete tetraplegia belonging to group 0 or 1 of the classification of giens. however, the majority of the systems using the fes directly stimulates the muscles (surface electrodes, intramuscular or epimysial), which increases the number of components and requires more electrical energy for the muscle activation. nerve stimulation would activate more muscles through a reduced number of electrodes, limiting the number of internal components, reduces the risk of spreading infections and require less electrical energy for its operation.


Eligibility criteria:
inclusion criteria: 1. neurological level ≥ c7 2. 18 years old min and max 65 years old, 3. complete traumatic injury: defined by a or b score on the ais scale. 4. patient belonging to group 0 or 1 of the giens classification. 5. neurological stability (no change in muscle testing)\> 6 months, 6. post-injury duration\> 6 months 7. patients undergoing surgery to restore elbow extension. 8. threshold of stimulation and diffusion of the studied muscles below 50 ma of intensity for a pulse width of 300 μs and a frequency of 25 hz. 9. positive electrical mapping of muscles with a minimum score of 4 mrc for at least one of the extensors (triceps, ecrl, ecrb, edc, epl) and / or flexor (fpl, fds, fdp). exclusion criteria: * 1. strong spasticity and contractures in flexion or extension of the upper limbs. 2. unstable epilepsy. 3. unstable cardiovascular pathology (coronary heart disease, major hypertension, heart failure etc.). 4. wearing a pacemaker. 5. dermatological problems contraindicate the application of surface electrodes. 6. body weight\> 100kg

Keywords: neural stimulation quadriplegia grasping
predicting outcomes from tdcs intervention in parkinson' disease using electroencephalographic biomarkers and machine learning approach: the predict study protocol

Conditions: Parkinson Disease; Electroencephalogram; Transcranial Direct Current Stimulation

Summary: parkinson's disease (pd) is a progressive and disabling neurodegenerative disease, clinically characterized by motor and non-motor symptoms. the potential of the "transcranial direct current stimulation" (tdcs) for symptomatic improvement in these patients has been demonstrated, but the factors associated with the best therapeutic response are not known. the electroencephalogram (eeg) is considered as a diagnostic and prognostic biomarker of pd, and has been used in recent studies associated with machine-learning methods to identify predictors of responses in neurological and psychiatric conditions. using connectivity-based prediction and machine-learning, the investigators intend to identify and compare characteristics related to baseline resting eeg between pd responders and non-responders to tdcs treatment. the recruited participants will be randomized to treatment with active tdcs associated with dual-task motor therapy or motor therapy with visual cues. a resting-state electroencephalography (eeg) will be recorded prior to the start of the treatment. the investigators will determine clinical improvement labels used for machine learning classification, in baseline and posttreatment assessments and will use three different methods to categorize the data into two classes (low or high improvement): support vector machine (svm), linear discriminant analysis (lda) and extreme learning machine (elm). the functional label will be based on the timed up and go test recorded at baseline and posttreament of tdcs treatment.


Eligibility criteria:
inclusion criteria: * diagnosis of idiopathic parkinson's disease by a neurologist based on parkinson's disease society brain bank (pdsbb) criteria (hughes et al.,1992) * disease staging between 1.5 and 3, according to the modified hoehn and yahr scale (hoehn and yahr, 1967) * regular pharmacological treatment with levodopa (equivalent dose \> 300mg) or taking antiparkinsonian medication such as anticholinergics, selegiline, dopamine agonists (amantadine) and comt (catechol-o-methyl transferase) inhibitors * score of more than 24 points on the mini-mental state examination (folstein et al., 1975) exclusion criteria: * associated neurological, musculoskeletal and/or cardiorespiratory diseases that could compromise gait; * alcohol or substance abuse disorders; * deep brain stimulation implant; * history of brain trauma or neurological disease that would interfere with study procedures.
use of computer-based patient-reported data to assess long term and late effects of head and neck cancer at the point-of-care

Conditions: Head and Neck Cancer Patients; Late Effects

Summary: patient-reported information on outcomes such as symptom-burden and health-related quality of life (qol) is regarded as a useful tool to improve quality of care in clinical cancer research. however, integrating patient-reported information in the routine clinical practice is often difficult due to excessive time use and practical barriers. electronic data acquisitions, where the treating physician has immediately access to the patient-reported data in the subsequent consultation, have been shown to be beneficial in the everyday clinical decision making. the aim of this study is to develop and test a computer-based patient-reported assessment tool that will assist the clinicians in tracking long term and late effects in head and neck cancer patients and investigate if the tool leads to improved symptom assessment of a range of head and neck cancer specific symptoms, which again may lead to improved symptom control and enhanced quality of life in the patients. patients with a diagnosis of head and neck cancer attending the oncology outpatient clinics at herlev hospital and physicians and nurses who work at the clinic will be invited to participate. the assessment tool will be developed with inspiration from prior international studies of symptom assessment in head and neck cancer patients and tailored so that it will fit into a danish context. the tool will be tested in a controlled intervention study. in the intervention group, patients will complete the assessment tool in the patients waiting area prior to every scheduled consultation. the result will then be printed and provided to the treating physician. in the control group, the patients will complete the assessment tool prior to consultations. however, the data will not be provided to the physicians at any time. to assess the impact of the tool on number of symptoms addressed during consultations and patients' overall quality of life, medical records will be reviewed for before start of intervention and again at 6 and 12 months follow-up. the patients will also complete the eortc qlq-c30 and the eortc qlq-h\&n35 at baseline and at 6 and 12 months follow-up. furthermore, we will conduct a qualitative evaluation (semi structured interview and participant observations) of attitudes among clinicians and patients regarding the use of tool at the point of care.


Eligibility criteria:
inclusion criteria: * prevalent recurrence free patients with cancers in the tongue, oral cavity, pharynx and larynx attending the oncology clinic at herlev hospital, herlev, denmark. 9 months to 5 years after end of treatment exclusion criteria: * patients with recurrence of their cancers and patients still in treatment.

Keywords: head and neck cancer quality of life symptom-burden late effects
effects of spinal cord stimulation

Conditions: Chronic Pain

Summary: the goal of this interventional study is to test effects of spinal cord stimulation in patients receiving treatment for their chronic pain. the main question of the study is: • what is the effect of spinal cord stimulation when compared to placebo? participants will rate their pain with their usual spinal cord stimulation on and off.


Eligibility criteria:
inclusion criteria: * patients (\>18 years of age) with scs implanted to treat chronic pain. * patients who consent to participation and can cooperate in the study. * use of continuous paresthesia-free scs for minimum 6 months prior to participation in the study. * pain score of 7 or less on a 0-10 scale in the most painful area treated with scs, rated upon inclusion. * patients not receiving other neuromodulation treatment. * patients who have not undergone changes in their (pain relevant) medication during the last 30 days (pro necessitate medication allowed).
paraneoplastic neurological syndromes and autoimmune encephalitis collection

Conditions: Paraneoplastic Neurological Syndromes or Autoimmune Encephalitis

Summary: numerous neurological disorders affecting the central and peripheral nervous system can be attributed to the immune system through multiple effector mechanisms. however, current treatments could be drastically improved by faster and more accurate diagnosis. the sample collection will benefit to patients with rare neuroimmune syndromes such as autoimmune encephalitis (ae) and paraneoplastic neurological syndromes (pns) leading to a better and early diagnosis, as well as treatment improvement.


Eligibility criteria:
inclusion criteria: * patient with consent * patient with well-characterized antibodies in serum or cerebrospinal fluid or not * patient with neurological disorder compatible with pns or auto-immune encephalitis exclusion criteria: * refusal of consent * patient under guardianship

Keywords: paraneoplastic neurological syndromes autoimmune encephalitis biological collection
an open label ph comparison of esomeprazole and lansoprazole in barrett's esophagus patients

Conditions: Barrett's Esophagus

Summary: the purpose of the study is to compare the treatment of esomeprazole 40 mg once daily and lansoprazole 30 mg once daily in controlling intragastric ph in barrett's esophagus patients


Eligibility criteria:
inclusion criteria: * documented history (within 2 yrs of histologically proven be; * aged 18-70 (inclusive); * willing and able to comply with all study procedures exclusion criteria: * signs of clinically significant gi bleeding within 3 days prior to randomization; * history of gastric or esophageal surgery; * clinically significant illness within 2 weeks prior to first dose of study drug or during study

Keywords: barrett's esophagus
hyponatremia and hypoalbuminemia is morbimortality predictors in coronary artery bypass graft surgery

Conditions: Coronary Artery Disease; Hyponatremia; Hypoalbuminemia

Summary: coronary artery disease is a common medical disease in many populations. the pathogenesis of this disease is very complex. surgery is one of the treatment choices. assessing the risk factors will improve the surgical outcome. in this study some biochemical parameters were evaluated to find out the relationship between these parameters (electrolytes and albumin vs)


Eligibility criteria:
inclusion criteria: * patients who underwent coronary artery bypass graft surgery * elective surgery exclusion criteria: * pediatric patients * off-pump surgery * emergent surgery
breast cancer tumor heterogeneity

Conditions: Breast Cancer

Summary: breast cancer biomarkers are usually performed on core needle biopsy (cnb) specimens and are not routinely repeated on surgical specimens (ss). however, preliminary data suggests that testing these biomarkers, on ss when compared to cnb samples can lead to different results. our hypothesis is that the aim of this study is to identify a group of women with invasive breast cancer who may benefit from additional her2 testing on their ss to ensure that areas of her2 amplification are not missed. another aim is to determine whether further her2 testing on the ss in select patients would lead to changes in breast cancer treatment options.


Eligibility criteria:
inclusion criteria: 1. women \> age 18 with capacity to consent 2. invasive breast cancer identified on cnb at aamc within 45 days of study consent 3. ihc biomarkers performed on original cnb (including her2) 4. tumors with greater than 2cm of invasive disease (measured radiographically prior to resection or microscopically after resection), or 5. multifocal or multicentric tumors exclusion criteria: 1. men 2. women with her2 positive tumors detected on cnb specimens 3. women receiving neoadjuvant chemotherapy 4. women whose cnb or surgical resection was performed at a hospital other than aamc. if the cnb prior to resection was repeated at aamc and new tumor biomarkers were performed, then the patient is eligible for enrollment 5. women whose ihc marker results were inconclusive on cnb or not performed -

Keywords: breast cancer heterogeneity her2
immune response evaluation to curative conventional therapy

Conditions: Head and Neck Squamous Cell Carcinoma

Summary: the irect trial is a non-interventional, prospective clinical trial using modern immune monitoring techniques over the course of the standard of care for hnscc. the dynamics of host/tumor immune interactions during the conventional standard treatment will be analyzed to find the most promising target antigen and to develop a strategy how and when specific immunotherapy should be added to the current treatment schedule. the results from this trial will help to understand how state of the art treatment can be complemented using cancer-testis antigen specific vaccines and immune-modulating drugs to improve the outcome of head and neck cancer patients.


Eligibility criteria:
inclusion criteria: * newly diagnosed patients with stage iii-iva/b head and neck squamous cell carcinoma * fit for treatment with curative intent * conventional primary treatment * primary surgical treatment * primary radiotherapeutic treatment * informed consent * \>18 years of age * sufficient contraception exclusion criteria: * distant metastasis at baseline * severe concomitant disease compromising curative treatment * previously diagnosed other malignant diseases * active immunosuppressive therapy * known immune defect * pregnancy * anemia requiring treatment at study entry (\<9g/dl)

Keywords: head and neck squamous cell carcinoma cancer-specific immunity cancer immunology cancer-testis antigens human papilloma virus immune modulatory cells
a prospective trial of elective extubation in brain injured patients.

Conditions: Brain Injury

Summary: identifying the optimal time of extubation in a brain injured population should improve patient outcome. brain injured patients usually remain intubated due to concerns of airway maintenance. current practice argues that unconscious patients need to remain intubated to protect their airways. more recent data however suggests that delaying extubation in this population increases pneumonias and worsens patient outcomes. we designed a safety and feasibility study of randomizing brain injured patients into early or delayed extubation. the purpose was to gain insight into patient safety concerns and to obtain estimates of sample size needed for a larger study.


Eligibility criteria:
inclusion criteria: 1. resolution or improvement of any pulmonary process requiring mechanical ventilation. 2. adequate gas exchange. 3. adequate ventilation. 4. respiratory rate to tidal volume ratio \<105. 5. core body temperature \< 38 degrees celsius. 6. hemoglobin \> 8 grams per deciliter. 7. no sedative medications for 2 hours. neurological requirements included: 1. gcs ≤ 8. 2. intracranial pressure (icp) \ 60 mm hg for patients with intracranial pressure monitors. exclusion criteria: 1. age \< 18 years. 2. lack of informed consent by the patients' surrogate. 3. dependence on mechanical ventilation for at least two weeks prior to enrollment. 4. patients with tracheostomies. 5. intubation instituted for therapeutic hyperventilation. 6. planned surgical or radiological intervention within the next 72 hours. 7. anticipated neurological or medically worsening conditions (i.e develop cerebral edema or vasospasm). 8. patients intubated for airway preservation due to airway edema (cervical neck injuries or surgery) as opposed to airway protection.

Keywords: mechanical ventilation extubation outcomes brain injury