Kornimate/medical-research-clean huggingface dataset:
discontinuation of maintenance her-2 directed therapy in long-term survivors of metastatic her-2 positive breast cancer

Conditions: HER2-positive Metastatic Breast Cancer; Stage IV Breast Cancer

Summary: the purpose of this preliminary research study is to see if patients discontinuing maintenance herceptin and/or other anti-her-2 treatments with monitoring in addition to radiologic imaging and routine blood work will stay in complete radiological remission and to determine how long patients are able to stay in complete radiological remission without treatment.


Eligibility criteria:
inclusion criteria: 1. patients with a diagnosis of her-2 positive metastatic (stage iv) breast cancer. 2. patients in complete radiological remission (crr), including a stable bone scan, as determined by computed tomography (ct), positron-emission tomography (pet), or pet-ct. a. patients with brain metastasis are allowed to participate as long as their disease has been treated and radiologically stable for at least 36 months. 3. patients must be on the same or current anti-her-2 directed therapy for at least 36 months. 4. archived tumor biopsy available. 5. patients with no evidence of circulating tumor deoxyribonucleic acid (ctdna) as determined by the signatera assay. 6. patients willing to stop maintenance anti-her-2 directed therapy with close monitoring. 7. patients with an eastern cooperative oncology group (ecog) performance score from 0 to 2. 8. patients ≥ 18 years of age. 9. ability to understand and the willingness to sign a written informed consent document. exclusion criteria: 1. patients with uncontrolled metastatic disease. 2. patients whose disease has been controlled for less than 36 months on the same or current anti-her-2 therapy. 3. patients who are currently receiving or have received treatment for a secondary cancer other than resected non-melanoma skin cancer lesions or in situ cancer within the past 24 months. 4. patients positive for ctdna (which occurs when a patient's blood sample contains ≥2 target markers) with the signatera assay. 5. use of investigational drugs ≤ 28 days prior to study enrollment and during the study. 6. history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the patient's participation for the full duration of the trial, or that makes participation in the trial to be not in the best interest of the patient in the opinion of the investigator. 7. patients with impaired decision-making capacity. patients who are found to be ctdna+ at study entry will be recorded as a screen failure (section 5.4). their signatera testing results will be provided to their treating physician to aid in clinical decision-making for disease management and treatment.
a review of low-dose ct lung cancer screenings in a community-based healthcare system with high incidence

Conditions: Non-small Cell Lung Cancer

Summary: an analysis of low-dose cat scan(ldct) screenings for lung cancer completed within the st. elizabeth system from january 2015 until december 2019. the study investigator, or designee(s), will retrospectively review patient encounters, collecting data related to ldct referrals and completions. data analysis will focus on the subsequent imaging, procedures, reviews at the nodule review board and lung cancers diagnosed as a result of the ldct.

this study is a single center, minimal risk, physician initiated retrospective chart review. potential subjects will be identified using records provided by the st. elizabeth healthcare thoracic oncology and radiology department. potential subjects will be screened for eligibility. study investigator and designees will review patient electronic medical records, extracting data related to the ordering/completion of a ldct and interventions that occurs thereafter. collected data will focus on dates of encounters, diagnostic imaging/procedures, and treatments. please see appendix a for a complete list of data points. all of the data that will be collected for study purposes will be kept confidential. this will be attained by the following: first, each enrolled subject will be assigned a study specific serial number for the database. all study documents and data collection tools will be maintained with the investigative site file in a locked cabinet in a secure location maintained by the investigator. the database will not include the patient's name or hospital medical record number. no one will have access to the database but the study principal investigator and study staff designated by the principal investigator. however, study data may be reviewed by the institutional review board of record, an appointed study monitor, an internal auditor for st. elizabeth healthcare, and necessary regulatory authorities. the security of the database will be maintained under the direction of the principal investigator. fourth, when the study is completed, the manuscript is published, and irb storage document requirements have been met, the file will be permanently deleted and destroyed

Eligibility criteria:
inclusion criteria: * patients within st elizabeth healthcare who are referred for and/or have completed a ldct from january 2015-february 2018 * \>=18 years of age exclusion criteria: • patient undergoes subsequent imaging, procedures and/or treatment at a facility outside of st. elizabeth where records are not available through epic
a preliminary study of 18f-av-45 in alzheimer's disease and healthy elderly volunteers

Conditions: Alzheimer Disease

Summary: a preliminary study to test how florbetapir f 18 (18f-av-45) acts in the brains and bodies of healthy elderly people and patients with alzheimer's disease (ad) by using a positron emission tomography (pet) scanner.


Eligibility criteria:
inclusion criteria (ad group): * probable ad according to the national institute of neurological and communication disorders and stroke-alzheimer's disease and related disorders association (nincds-adrda) criteria * mild/moderate dementia as evidenced by a mini mental state exam (mmse) score ranging from 10 to 24, boundaries included, at screening * history of cognitive decline had been gradual in onset and progressive over a period of at least 6 months inclusion criteria (healthy volunteer group): * no evidence of significant cognitive impairment by history and psychometric testing * mmse of 29 or higher exclusion criteria (both groups): * neurodegenerative disorders other than ad * cognitive impairment resulting from trauma, hypoxic damage, vitamin deficiency, brain infection, brain cancer, endocrine disease, or mental retardation * clinically significant infarct or possible multi-infarct dementia as defined by the nincds criteria * evidence on screening mri or other biomarker that suggests alternate etiology for cognitive deficit (for healthy controls, evidence suggesting the presence of ad pathology) * clinically significant psychiatric disease * history of epilepsy or convulsions * clinically significant hepatic, renal, pulmonary, metabolic, or endocrine disturbances * current clinically significant cardiovascular disease * received investigational medication within the last 30 days

Keywords: amyloid imaging positron emission tomography 18f-av-45 florbetapir f 18 diagnostic imaging
clinical aspect of erosive pustular dermatosis of the leg

Conditions: Erosive Pustular Dermatosis of the Leg

Summary: erosive pustular dermatosis of the leg is a fairlyrecent clinical entity that was described the first time in 1987. diagnosis of erosive pustular dermatosis of the leg is made on clinical grounds. it presents as non-follicular pustules of variable size and numbers that rapidly give way to erosions and crusts on one or both legs, and which are found in particular on the anterior aspect of the middle third of the leg (. the lesions are of chronic progression, despite topical therapy. erosive pustular dermatosis of the leg is seen in elderly patients, mainly female, and may be associated with chronic venous insufficiency or cutaneous atrophy. in the absence of specific criteria and because of the existence of misleading clinical forms, diagnosis is based upon exclusion.

the primary objective of this investigation was to describe the different clinical aspects of cases of erosive pustular dermatosis of the leg.

Eligibility criteria:
inclusion criteria: - non-follicular pustules and multiple erosions on one or both legs showing no evidence of improvement after application of compression in the event of clinical signs of chronic venous insufficiency and showing no improvement following treatment with local and/or systemic antibacterial therapy, fungal samples from the pustules negative on direct examination, negative direct immunofluorescence results for biopsy samples (taken from around the lesion) exclusion criteria: - age \< 18 years old

Keywords: erosive pustular dermatosis of the leg erosive pustular dermatosis of the scalp venous insufficiency
ceramide level as apredictor of outcomes in patients of anterior myocardial infarction undergoing primary coronary intervention

Conditions: Anterior STEMI

Summary: ceramide level as a predictor of outcomes in patients of anterior myocardial infarction undergoing primary coronary intervention

ceramides are a family of lipid molecules that are found in high concentrations within cell membranes and play a key role in a variety of physiological functions including apoptosis, cell growth, cell adhesion and plasma membrane integrity maintenance.(1) all tissues can synthesize ceramides de novo from saturated fats and sphingosine.(2) the ( ldl ) present in atherosclerotic plaque is rich in ceramide and contain 10 - 50 fold higher content of ceramide when compared with plasma ldl .(3) ceramide (d18:1/16:0) is associated with the fraction of necrotic core tissue and lipid core burden in coronary atherosclerosis.(4) previous clinical research found that circulating ceramides are elevated in patients with hypertension,(5) obesity (6 - 7) and type ii diabetes mellitus. previous clinical research found that elevated ceramide plasma concentrations are associated with coronary plaque vulnerability evaluated by intravascular ultrasound . virtual recent studies showed targeted profiling of ceramides predicted short-term and long-term major adverse cardiac events. plasma ceramide level is also positively associated with the levels of total cholesterol. \[8 - 9\] the plasma ceramides that have been studied as high-risk factors are cer (d18:1/16:0), cer (d18:1/18:0) and cer (d18:1/24:1) and the ratios of these ceramides to cer (d18:1/24:0) \[10 - 11\]. however, it is tempting to speculate that ceramides are associated with plaque vulnerability as they are known to fuel many central atherosclerosis processes including lipoprotein aggregation and uptake, inflammation, superoxide anion production, andapoptosis 12 - 13 - 14

Eligibility criteria:
inclusion criteria: * 1- subjects with anterior stemi according to esc guidelines 2017 . 2. subjects undergoing ppci exclusion criteria: * patients with previous pci. patients with previous cabg. patients with timi flow less than ii. patients with residual stenosis more than 70 % in major artery. cardiogenic shock.
initial effects of kinesiotaping in non surgical treatment of hallux valgus

Conditions: Hallux Valgus; Pain

Summary: the main aim of this study was to find the initial effects of kinesiotaping on pain and joint alignment used in the conservative treatment of hallux valgus. 22 female patients diagnosed with hallux valgus participated in this study. kinesiotaping was implemented after the first assessment and renewed in the 3rd, 7th and 10th days. the main outcome measures were the pain hallux adduction angle. kinesiotaping may be an effective treatment option in decreasing pain and deformity in hallux valgus deformity who are conservatively treated. in future studies this method might be shown in larger sample groups at longer periods of treatment comparing with alternative treatment approaches like exercise or orthotics.

hallux valgus is a common pathologic entity affecting the great toe. taping is an alternative method used to treat hallux valgus. the main aim of this study was to find the initial effects of kinesiotaping on pain and joint alignment used in the conservative treatment of hallux valgus. 22 female patients diagnosed with 13 bilateral, 7 right, 2 left totally 35 with hallux valgus participated in this study. kinesiotaping was implemented after the first assessment and renewed in the 3rd, 7th and 10th days. the main outcome measures were the change in pain was assessed by using visual analogue scale (vas) and hallux adduction angle was measured by the universal goniometry. secondary outcome measures were patients' functional status was measured by foot function index (ffi) and aofas. the plain radiographic results were also measured before and after 1-month of treatment. pain and disability was controlled by kinesiotape® implementation in patients with hallux valgus. kinesiotaping may be an effective treatment option in decreasing pain and deformity in hallux valgus deformity who are conservatively treated. in future studies this method might be shown in larger sample groups at longer periods of treatment comparing with alternative treatment approaches like exercise or orthotics.

Eligibility criteria:
inclusion criteria: * hallux adduction angle between 15-40º * pain intensity higher than 5 according to vas * 20- 45 years age female * no trauma, surgery history * surgery is indicated but the patient is willing to try conservative treatment options exclusion criteria: * fracture, surgery history on the great toe * systematic disease (rheumatoid arthritis, systematic lupus erythematosus diabetes) * using nsaid, analgesic drug * hallux rigidus diagnosis

Keywords: hallux valgus pain conservative treatment
patient navigation for her2+ metastatic breast cancer patients treated with tucatinib

Conditions: HER2+ Metastatic Breast Cancer (MBC)

Summary: the goal of this study is to test a novel nurse-delivered patient navigation program for women with her2+ metastatic breast cancer (mbc) receiving tucatinib, trastuzumab, and capecitabine. the program will focus on enhancing understanding of the treatment regimen, managing symptoms and adherence, and improving coping and self-management skills. if successful, the program could be integrated into clinical care to better support mbc patients. the main question the study aims to answer is: is the patient navigation program feasible and acceptable for mbc patients? participants will receive patient navigation sessions over about 12 weeks. participants will also complete study assessments via electronic survey at baseline and at about 3, 6, 9, and 12 weeks after enrollment, with the last assessment occurring after completion of the patient navigation program sessions. participants will also complete a post-program exit interview.


Eligibility criteria:
inclusion criteria: * female (sex assigned at birth); * ≥18 years of age at enrollment; * diagnosed with her2+ metastatic breast cancer (mbc); * receiving treatment with tucatinib combined with capecitabine and trastuzumab; * able to speak and read english exclusion criteria: * visual or hearing impairment; * severe cognitive impairment; * severe mental illness interfering with ability to participate

Keywords: patient navigation
a study of the use of fat flap reconstruction to reduce neck injury after cancer treatment

Conditions: Head and Neck Squamous Cell Carcinoma

Summary: the purpose of this study is to find out whether the fat alt flap procedure is a safe and practical option for reducing neck morbidity in hnscc patients following cancer treatment of the neck. neck morbidity after radiation therapy and surgery includes difficulty swallowing, neck or shoulder pain, stiffness, swelling, or changes to the appearance of the treated area. in addition, the researchers will find out whether the study procedure is effective at reducing neck morbidity and improving quality of life after cancer treatment. the researchers will measure quality of life by having participants answer questionnaires.


Eligibility criteria:
inclusion criteria: * patients 18 years or older * diagnosed with hnscc (e.g., oropharyngeal, hypo/laryngeal scc) * primary treatment is with radiotherapy with or without chemotherapy * salvage neck dissection is subsequently indicated for persistent or recurrent, nonmucosal disease in cervical lymph nodes * at the time of salvage neck dissection additional flap coverage is indicated to improve carotid coverage or replace missing skin exclusion criteria: * patients with primary site mucosal recurrence in addition to neck disease

Keywords: free fat flap reconstruction quality of life 23-102
an observational study of integrated chronic pain management in a community health center

Conditions: Chronic Pain; Spine Disease

Summary: this was a prospective observational study with the primary objective of quantifying a change in pain scores after 6-12 months of two separate interventions within the study site (pain team and chiropractic team). target enrollment was 30 participants for each intervention. the primary outcome was a change from baseline of the pain disability questionnaire (pdq), the study tool. secondary outcomes were reduction of opioid dose by morphine equivalent daily dose, and its effect on pdq scores.

data collection after participants were enrolled, they completed a baseline pdq while waiting for their appointment. participants continued to see the intervention group, pcp, and other medical providers as determined by their health providers independent of this study's protocol. another pdq was collected at an intended 6 - 12 months later. demographic information was collected by manual chart review in the electronic medical record nextgen (nextgen ehr, nextgen healthcare, inc. irvine, ca, usa). variables collected included age, sex, race, bmi, insurance type, preferred language, presence of another pain diagnosis (e.g. knee pain), active mental health diagnosis (including substance abuse), diagnosis of hypertension or diabetes, and morphine equivalent dose (med); one post-hoc variable was recorded: timing of follow-up survey in relation to the 2019 coronavirus (covid-19) pandemic, defined as before/after march 1, 2020. intervention type was analyzed as an independent variable since the study was not designed as a comparison of interventions. all data was stored in an encrypted excel database on a password-protected laptop. consent forms were stored in a locked cabinet accessible only to the pi. stata 16.0 (statacorp, llc, college station, tx, usa) was used for statistical analysis. pdq scores at baseline and follow-up were tested for statistical significance using paired t-tests. univariate analysis was performed on individual categorical variables and change in pdq using two-sample t-tests. multivariate linear regression was used to determine associations of these factors to the outcome. variables were excluded from regression models if there was a subgroup size of six or less.

Eligibility criteria:
inclusion criteria: * referred by pcp to either intervention at study site exclusion criteria: * active cancer diagnosis

Keywords: community health center integrated pain team
surfactant protein genetic variants in covid-19 infection

Conditions: Coronavirus Infection

Summary: surfactant protein plays important role in innate immunity against respiratory viral infections. however, investigators have shown that the surfactant protein polymorphisms are associated with severity of various pulmonary diseases such as respiratory syncytial virus (rsv), tuberculosis, pediatric acute lung injury. covid-19 virus gains entry through the respiratory system and responsible for death due to acute respiratory failure. there is a considerable heterogeneity in presentation of covid-19 infection from asymptomatic patients to severe infection requiring intensive care and some may die. considering reports of covid-19 related deaths/severe disease in the same family, it is possible that genetics play an important role in severity of covid-19 infection. investigators propose to study the association of surfactant proteins in covid-19 patients. key objectives: a) characterize genetic markers within the surfactant protein genes in covid-19 positive patients, b) to determine if there is a correlation between certain genetic markers and the severity of covid-19 infection which may be used as a prognostic marker, c) to correlate genetic markers with immune studies.


Eligibility criteria:
inclusion criteria: the major inclusion criteria is a confirmed diagnosis of covid-19 infection performed on nasopharyngeal secretions by enzyme immunoassay or culture in patients. exclusion criteria: patients unable to sign informed consent will be excluded.
phase 3b study of metvix ndl-pdt versus metvix c-pdt in subjects with actinic keratoses

Conditions: Actinic Keratoses

Summary: this study was to be conducted as a multi-centre, randomized, investigator-blinded, active and vehicle-controlled, intra-individual (split-face/scalp) non-inferiority (regarding efficacy) and superiority (regarding pain) study. the primary purpose of this study is to demonstrate the non-inferiority of ndl-pdt compared to c-pdt in terms of lesion complete response rate.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of mild (grade 1) and/or moderate (grade 2) aks on the face or the scalp on treated areas * subject with two symmetrical treated areas half scalps or two half faces excluding ears, chin, bridge of the nose, eyelids and lips inside the vermillion border): no more than a twofold difference in terms of total number of lesions between the two tas exclusion criteria: * subject with clinical diagnosis of at least one severe (grade 3) ak on treated areas * subject with pigmented ak on the treated areas * immuno-compromised subject for idiopathic, disease specific or therapeutic reasons * subject with porphyria,

Keywords: actinic keratoses photodynamic therapy natural daylight
mehri turki surgical technique of the webbed neck

Conditions: Congenital Webbing of Neck

Summary: the webbed neck is one of the conspicuous deformities of turner syndrome that presents a surgical challenge. despite the availability of surgical techniques, surgical outcomes are not always acceptable and recurrence occurs. mehri turki performed a surgical technique based on a latéral cervical approach allowing direct visual control to manage the fibrotic band. it provides a high level of visual control so that vulnerable anatomic structures are easily protected.

five girls between 17 and 19 years old, with turner syndrome, had a webbed neck (pterygium colli) with low and laterally displaced nuchal hairline. the surgical technique aims to correct neck contour and hairline placement while concealing cervical scars. thus, preoperative drawing delimitated the harmful triangular hairy skin next to the fibrous band extending from the mastoid to the acromion. besides, the predefined design drawings provide the exact placement of the future hairline. choosing a prone position for bilateral and symmetrical repair, the surgical technique was as follows: the incision was made at the junction of the hairless skin and the hairy skin from the mastoid up to the lower end of the webbing skin, in front of the acromion and completed by z plasty to avoid scar contracture. the subcutaneous skin was undermined in the anterolateral direction, exposing the fibrous fascial band which must be excised to prevent recurrence. the harmful skin having a triangular shape was excised considering the future hairline. skin closure was done after the superior traction of the posterior cervical advancement.

Eligibility criteria:
inclusion criteria: * webbed neck with abnormal hairline exclusion criteria: * surgical contraindication for any health concern * puberty age

Keywords: congenital abnormalities webbed neck surgical technique turner syndrome fetal cystic hygroma nuchal fold