Kornimate/medical-research-clean huggingface dataset:
real-time diagnosis of colorectal polyps using narrow-band imaging

Conditions: Colon Polyps

Summary: accurate optical diagnosis of colorectal polyps could allow a "resect and discard" strategy with surveillance intervals determined based on the results of the optical biopsy. the investigators perform education to characterize the histology of diminutive and small colorectal polyps by using narrow band imaging (nbi). after education program, the investigators prospectively evaluate real-time optical biopsy analysis of polyps with nbi by 15 gastroenterologists at a medical check up center.

this study is an extension of quality assurance program in seoul national university hospital healthcare system gangnam center. this study is composed of four periods. first, a computer based education program on the accuracy of predicting polyp histology with nbi (nice and wasp classification) will be performed by 15 endoscopists (less experienced in nbi) during septepber 2015. in the second period from october 2015 till deceber 2015, 1st phase real- time optical diagnosis for diminutive and small colorectal polyps will be activated. all endoscopists will have weekly feedback on their accuracy of optical diagnosis for polyps, and discuss the nbi findings that mismatched by histologic diagnosis all together per one month. third, the result of 1st phase real-time optical diagnosis will be analyzed from january 2016 till april 2016. in this period, endoscopists with low accuracy of 1st phase real-time optical diagnosis will be re-educated. the last period from may 2016 till september 2016, 2nd phase real-time optical diagnosis for polyps will be activated. performance will be evaluated by comparing optically predicted diagnosis with actual histologic diagnosis. cumulative sum analysis will be used to determine the learning curve for each endoscopist. negative predictive value for the prediction of nonneoplastic polyp and concordance of surveillance intervals for diminutive polyps diagnosed optically with high confidence will also be measured.

Eligibility criteria:
inclusion criteria: * customers who received screening and surveillance colonoscopy in seoul national university hospital healthcare system gangnam center from october 2015 to september 2016. exclusion criteria: * age \<18 years * customers who refused to offer their health check up data * history of inflammatory bowel disease * history of familial adenomatous polyposis * customers who received incomplete colonoscopy * history of previous colorectal resection * incomplete data collection on optical diagnosis

Keywords: optical diagnosis narrow band image
reducing emergency department utilization with an after visit summary nudge toward alternative care options

Conditions: Behavior, Health

Summary: decreasing utilization of the emergency department (ed) is a priority for the system. often, ed visits can be avoided if patients contact geisinger first to get appropriate direction for their concern or are otherwise better informed about reasons to visit the ed vs. urgent care or primary care facilities. the study team is working to reduce ed utilization by including additional information in adult outpatient after visit summaries (avss). the study will involve will involve a/b testing different avs versions, including 1) a version that encourages patients to contact geisinger via different contact methods, 2) a version that includes a map to the patient's closest convenientcare location and accompanying information about convenientcare, and 3) a version that includes a self-triage guide. a control group will receive the current standard avs. analysis results will be assessed to determine which version is most effective at reducing ed use.


Eligibility criteria:
inclusion criteria: * age 18+ * has a geisinger primary care physician assigned * completes an outpatient office visit or telemedicine appointment at geisinger exclusion criteria: * the avs was not printed according to the ehr, and the patient does not have an active mygeisinger patient portal account, so they do not have a way to view the avs

Keywords: emergency department use urgent care use
evaluation of bioresorbable sheet to prevent intra-abdominal adhesions in colorectal surgeries

Conditions: Adhesions

Summary: study to investigate and determine the difference between the extent and severity of intra-abdominal adhesions in patients where surgiwrap film was placed compared to patients with no adhesion barrier inserted. hypothesis: due to the preclinical safety data and clinical case reports in various indications it is anticipated that the surgical sites where the resorbable anti-adhesion barrier surgiwrap was placed, there will be a reduction of adhesions compared to the control group with no treatment.


Eligibility criteria:
inclusion criteria: * patients with rectal cancer, ulcerative colitis or other pathologies requiring a second surgery for ileostomy closure. * age between 18 and 78 years. * patient or his/her legal representative has read and signed the approved informed consent form before randomization. exclusion criteria: * previous abdominal operation through a midline approach * use of hernia mesh * use of any antiadhesive irrigants or irrigants containing corticosteroids, heparin, salicylates, nonsteroidal anti-inflammatory drugs. * pregnancy

Keywords: surgery colectomy proctocolectomy adhesions
a health promotion campaign targeting caregivers of young children

Conditions: Childhood Obesity

Summary: this project will evaluate the effectiveness of the take time health promotion campaign. the take time (tobacco free, injury free, moving daily, eating healthy) campaign will target parents and caregivers of children up to 8 years of age. the study will help answer the following research questions 1. are community organizations able and willing to deliver a health-promotion campaign targeting young children? 2. what impact does the take time campaign have on the readiness of the community to support healthy childhoods? 3. what impact does the take time campaign have on awareness and achievement of healthier lifestyles for young children? 4. can health promotion initiatives be "institutionalized" within the municipality and community organizations so that the campaign will continue beyond the study period? 5. are changes in awareness and/or behaviour related to exposure to the take time campaign?

the take time initiative will be developed and delivered in conjunction with the township of uxbridge and the heart and stroke foundation of ontario. the durham region health department, the ministry of health promotion and sport, and 35 schools and community organizations have also agreed to collaborate on project activities. the health promotion campaign will occur from october 15, 2010 until may 31, 2011. the campaign activities were developed from the input of parents and programme/care providers gathered during the planning phase of this research. the impact of the take time campaign will be evaluated in two ways. the overall readiness of the community to support healthy childhoods will be evaluated using the community readiness model, which relies on a series of interviews with key individuals in leadership positions. awareness and current behaviour among community members will be assessed through the completion of telephone surveys of randomly selected households. each of these evaluations will be completed twice, before and after delivery of the take time campaign. the pre-campaign evaluations will be completed in september 2010. the post-campaign evaluations, using the same procedures, will be completed in june 2011.

Eligibility criteria:
inclusion criteria: * parent(s) or caregiver(s) of young children (8 years of age and younger) will be eligible for the pre- and post- intervention telephone surveys. * intervention activities will target parents and caregivers of young children and children 8 years of age and younger, although the events, information and policies may also influence other residents of the community. exclusion criteria: * children and adults who are not parents or caregivers for young children 8 years of age or younger are not eligible to complete the random telephone survey.

Keywords: pediatrics health promotion campaign community events
study on the reduction of catheter-related infections by use of self-disinfecting venous and arterial access caps

Conditions: CLABSI - Central Line Associated Bloodstream Infection; Catheter-Related Blood Stream Infection

Summary: observational study on the reduction of catheter-related infections by use of self-disinfecting venous and arterial access caps (curos caps ;3m, saint paul, mn, usa)


Eligibility criteria:
inclusion criteria: * every patient in the hemato-oncological department who received at least one cvc was included in the study exclusion criteria: * none

Keywords: clabsi crbsi blood stream infection
a study of caspofungin acetate (mk0991) for the treatment of esophageal candidiasis or invasive candidiasis in chinese adults (mk-0991-066)

Conditions: Fungal Infection

Summary: to evaluate the safety, tolerability, and efficacy of caspofungin for the treatment of esophageal candidiasis and invasive candidiasis to support the registration of caspofungin for these indications in china.


Eligibility criteria:
inclusion criteria: * participant has a confirmed diagnosis of esophageal candidiasis or invasive candidiasis for whom iv antifungal therapy is appropriate * for esophageal candidiasis * participant has endoscopic evidence of esophageal candidiasis * participant has disease documented by symptoms consistent with esophageal candidiasis and positive stain or wetmount koh of brushing or biopsy from endoscopy followed by positive culture for candida or positive histopathologic evidence of candida infection * for invasive candidiasis * participant has at least 1 positive culture of a candida species from blood or other normally sterile body site obtained within 96 hours of study entry * participant has clinical evidence of infection within 96 hours before study entry * temperature \>100\^◦f (37.8\^◦f) on 2 occasions at least 4 hours apart or 1 determination of \>101\^◦f (38.3\^◦f) or clinically significant hypothermia \<96.8\^◦f (36.0\^◦c) * systolic blood pressure \<90 or ≥30 mm hg decrease in systolic blood pressure from the participant's normal baseline * signs of inflammation at a site infected with candida exclusion criteria: * participant has any of the following abnormal laboratory values: international normalization ratio (inr) \>1.6 or, if participant is receiving anticoagulants, inr \>4.0; bilirubin \>5 times the upper limit of normal range; aspartate aminotransferase (ast, or serum glutamic oxaloacetic transaminase \[sgot\]) or alanine aminotransferase (alt, or serum glutamic pyruvic transaminase \[sgpt\]) \>5 times the upper limit of normal range * for esophageal candidiasis * participant has candida disease limited to the oropharynx * participant has another cause of esophagitis or has clearly defined ulcers on endoscopy with high likelihood of another non-candida pathogen * participant has other esophageal pathology on endoscopy that is unrelated to acute esophageal candidiasis * for invasive candidiasis * participant has evidence of infection limited to a positive culture for candida from urine, sputum, catheter tip, indwelling drain, or mucosal or superficial skin surface * participant has suspected candida endocarditis, osteomyelitis, or meningitis
gallium (68ga) edotreotide pet/ct for imaging patients with gastrointestinal pancreatic neuroendocrine tumors

Conditions: Advanced Gastroenteropancreatic Neuroendocrine Tumor

Summary: this is a single-arm imaging study using dotatoc peptide, labelled with the gallium (68ga) tracer.


Eligibility criteria:
inclusion criteria: 1. able and willing to provide a written informed consent; 2. 18\~75 years old,male or female； 3. ecog performance status 0 or 1; 4. confirmed or suspicion of gep-net. exclusion criteria: 1. unable to lie flat for the entire imaging duration (e.g. persistent cough, claustrophobia, severe arthritis, etc.), unable to enter the pet/ct device; 2. individuals planning to be pregnant, and lactating women; 3. individuals with concurrent active infections or with unexplained fever \>38.5°c for more than 1 hour during the screening period or prior to administration of investigational medication.
epidural pca related adverse effects in young and elderly

Conditions: Pain, Postoperative

Summary: in this retrospective study, postoperative pain score, epidural patient controlled analgesia (epi-pca) related complications, the risk factors for requirement of rescue analgesics and antiemetics will be evaluated in young and elderly patients, respectively, using fentanyl and ropivacaine-based epi-pca during postoperative 48 hours after various surgeries.

since 2010, a pca service team in the investigators' hospital have collected multidisciplinary clinical data from all the patients who used epidural-patient controlled analgesia (epi-pca) postoperatively in aim of the assessment of clinical outcome. the investigators reviewed the collected data from the patients who had used epi-pca for pain control after an elective surgery under general or spinal anesthesia between sep. 2010 and nov. 2015. the need for informed consent was waived for this study. for the epi-pca, fentanyl and ropivacaine was diluted and administered to the patients according to the clinician's determination. the data of the pca regimen which has been decided were recorded and analyzed. demographic variables including age, sex, body mass index, american society of anesthesiologists (asa) physical status and history of smoking, motion sickness, postoperative nausea/vomiting, hypertension and diabetes mellitus will be analyzed. anesthesia and surgery-related variables including the duration of anesthesia, the type of anesthesia (general or spinal), laparoscopy and the operation site (categorized in abdominal, thoracic, upper \& lower extremities, head \& neck, spine and others) will be also analyzed. pca-related variables including total dose of fentanyl for two days (µg/kg), use of mixed additional analgesics and antiemetics in pca and discontinuation of pca will be analyzed. postoperative variables including the numeric rating scale (nrs, 0-10, 0 = no symptom; 10= unthinkable worst pain) for pain, requirements of rescue analgesics and antiemetics will be analyzed. in addition, the postoperative complications including nausea, vomiting, headache, dizziness, and sedation will be analyzed. all the recorded postoperative variables at post-anesthesia care unit, 6-12, 12-18, 18-24 and 24-48 hrs after anesthesia will be analyzed.

Eligibility criteria:
inclusion criteria: * patients who had used epi-pca for pain control after an elective surgery under general or spinal anesthesia between sep. 2010 and nov. 2015. exclusion criteria: * age \< 20 years old, * age 40 to 69, * routine use of analgesics/antiemetics * imperfect data

Keywords: epi-pca patient controlled analgesia epidural patient controlled analgesia elderly patient side effect postoperative pain
study evaluating amg 386 in adult patients with advanced solid tumors

Conditions: Tumors

Summary: the purpose of this study is to test the safety, tolerability and pharmacokinetic (pk) profile of amg 386 after intravenous administration in adult subjects with advanced solid tumors.


Eligibility criteria:
inclusion criteria: - have evaluable disease - must be able to undergo mri evaluation: 1. must not have cardiac pacemakers or neurostimulators not specifically approved for use in the mri environment; 2. must not have metal implants, other than those approved as safe for use in mri; 3. must not be claustrophobic or have physical characteristics that will preclude undergoing mri; - subjects enrolling to the dose expansion cohort must have at least one tumor that is amenable to dce-mri evaluation (e.g., greater than or equal to 3 cm lesion outside the thoracic cavity) - have eastern cooperative oncology group (ecog) performance status of less than or equal to 2 - adequate hematologic, renal and hepatic function exclusion criteria: - presence of untreated cns metastasis or symptoms of brain metastases - presence of leukemia or myelodysplastic syndrome - history of high-dose chemotherapy requiring bone marrow or peripheral stem cell support - unstable or uncontrolled disease or condition related to or impacting cardiac function (e.g., unstable angina, congestive heart failure \[nyha greater than class ii\], uncontrolled hypertension \[diastolic greater than 85 mmhg; systolic greater than 145 mmhg\] or cardiac arrhythmia) - history of arterial thrombosis (i.e., stroke, transient ischemic attack or myocardial infarction) within 6 months of study day 1 - history of bleeding diathesis or hypercoagulopathy within 6 months of study day 1 - active peptic ulcer disease or gastritis - unresolved toxicities from prior anti-cancer therapy, excluding alopecia - anti-tumor treatment within 3 weeks of study day 1. if anti-tumor treatment was an antibody therapy, the interval must be 6 weeks - anticoagulation therapy, except a low dose of coumadin™ (less than 2 mg) for prophylaxis against central catheter-related thrombosis - major surgery within 4 weeks of study day 1 - history of allergic reaction to bacterially produced proteins - known positive test for human immunodeficiency virus (hiv) infection, hepatitis c virus or chronic hepatitis b infection - pregnant or breastfeeding - not using adequate contraceptive precautions, in the judgment of the investigator

Keywords: solid tumor metastatic cancer advanced solid tumors
nitrites, exercise, and peripheral arterial disease

Conditions: Peripheral Arterial Disease

Summary: the hypothesis of this proposal is that in subjects with pad, regular consumption of a high nitrate supplement which raises plasma nitrite, in conjunction with 12 weeks of supervised exercise training at the limb ischemic threshold (set) will produce a greater clinical benefit (increases in cot and pwt) than placebo plus supervised exercise at the limb ischemic threshold (pet).


Eligibility criteria:
inclusion criteria: * peripheral arterial disease (abi of less than 0.9) * intermittent claudication for 3 or more months exclusion criteria: * individuals with known alcohol or drug abuse problems * individuals who have suffered a heart attack or stroke, or have changes on a resting ecg, in the last 3 months * those classified as american heart association class d * gangrene, impending limb loss or osteomyelitis * lower extremity vascular surgery, angioplasty or lumbar sympathectomy within 3 months of enrollment * severe peripheral neuropathy * any condition other than pad that limits walking * chest pain during treadmill exercise which appears before the onset of claudication, or \>3mm st depression during exercise * subjects taking nitrates or nitroglycerin products * must not be taking protein pump inhibitor medications

Keywords: cardiovascular diseases vascular diseases arterial occlusive diseases exercise functional capacity
clinical nutrition concept for hospitalized patients with malnutrition

Conditions: Malnutrition

Summary: the purpose of this study is to determine whether there is a positive correlation between an evidence based clinical nutrition concept and relevant clinical outcomes in malnourished hospitalised patients when severity of disease is adjusted.

patients have been consecutively screened at admission by sga (subjective-global-assessment)-score and nrs 2002 (nutritional-risk-screening)-score in the departments of surgery and internal medicine. the nutrition status of each patient is combined with clinical data, utilization data and direct costs on the basis of clinical homogenous patient clusters. risk-adjustment was provided by the disease-staging-scale (medstat/thomson healthcare, ann arbor mi), which allows patient classification by diagnosis and co morbidities including age and gender. the risk adjustment scales run by routine data sets from german inpatient g-drg system. in the control period the effects of usual nutrition care are documented. during the intervention period an implementation of an interdisciplinary evidence-based guideline for screening and clinical nutrition was introduced in each participating hospital. the issue is to describe the relation between risk-adjusted malnutrition status and clinical outcomes and costs.

Eligibility criteria:
inclusion criteria: * at least 18 years of age * internal or operative admission diagnosis in participating hospitals exclusion criteria: * patients with demand for emergency care * patients with demand for intensive care * patients with hospital day-care * patients unwilling to participate or unable to comply with the protocol in the control group

Keywords: hospital malnutrition nutritional status nutrition assessment enteral nutrition parenteral nutrition severity of illness index cost analysis
blood flow restriction training in multiple sclerosis

Conditions: MS

Summary: traditional physical therapy resisted training for people with ms have been shown to be beneﬁcial; however, their usefulness has been limited by fatigue. the effect of blood flow restriction on strength and other measures of physical function was demonstrated in healthy populations and those with chronic disease. this study may add missing information to the existing literature and suggests directions for research on the effectiveness of bfr training on individuals with relapsing and remitting ms.

multiple sclerosis patients are characterized by impaired functional capacity which is related to reduce muscle strength affecting predominantly the lower extremity. resistance training (rt) has proven to be one of the interventions in ms patients showing a consistent and positive effect on muscle strength and on parameters directly related to lower extremity physical function (eg, walking performance and stair negotiation). training with blood flow restriction (bfr), is an increasingly common clinical intervention among physical therapists over the past decade and consistent with the evidence. it has been investigated in people with neurological disorders including stroke and incomplete spinal cord injuries. research is limited on the use of bfr for individuals with ms.

Eligibility criteria:
inclusion criteria: 1. patients were diagnosed with ms by a neurologist according to mcdonald's criteria 2010 2. expanded disability status scale (edss) scores ranging from 2.5 to 5.5 . 3. patient able to walk 100 meters or more. 4. no change within ms specific medication three months from the study. 5. last ms attack from more than two months. exclusion criteria: 1. multiple sclerosis patients with other neurological or orthopedic problems. 2. multiple sclerosis patients with systemic problems (cardiovascular or pulmonary diseases...). 3. patients with cognitive impairment. 4. pregnant female patients. 5. patients in acute relapse stage. -