Kornimate/medical-research-clean huggingface dataset:
medical marijuana and its effects on motor function in people with multiple sclerosis

Conditions: Multiple Sclerosis

Summary: medical marijuana is commonly prescribed people with multiple sclerosis (ms) for symptom, e.g. spasticity and pain, management. unfortunately not much is known about its effects outside the treatment for these 2 symptoms. several previous studies have suggested people with ms using medical marijuana have lower levels of physical disability and improved walking abilities. a major limitation of these previous studies is that the investigators used subjective measures of motor function. in this proposed observational case-control study the investigators plan to objectively measure multiple domains of motor function, such as: fatigue, strength, and walking ability. no marijuana will be brought on to campus or given to participants.

to investigate the effects of medical marijuana usage on physical function the investigators will employ an observational case-control design. cases (ms medical marijuana users) will be compared to age, sex, and disease duration matched controls (ms non-cannabis users).

Eligibility criteria:
inclusion criteria: * medically diagnosed with ms, * 30-60 years of age, * moderate disability (patient determined disease steps score 2-6). exclusion criteria: * relapse with the last 60 days, * high risk for cardiovascular disease (american college of sports medicine risk classification), * changes in disease modifying medications within the last 45 days, * concurrent neurological/neuromuscular disease, * hospitalization within the last 90 days, * inability to understand/sign informed consent.
effects of morphine added to bupivacaine in transversus abdominis plane block for inguinal hernia repair

Conditions: Inguinal Hernia

Summary: this study is conducted to determine whether morphine added to bupivacaine in ultrasound guided (usg) transversus abdominis plane (tap) block has beneficial effects than bupivacaine alone in providing postoperative analgesia for inguinal hernia surgery.

total of forty adult patients of american society of anaesthesiologists (asa) physical status ( ps) i - ii scheduled for elective inguinal hernia surgery under spinal anaesthesia were recruited in this study after getting written informed consent. they were randomized to undergo ipsilateral usg tap block with 20 ml of 0.25 % bupivacaine (group b) versus 20 ml of 0.25 % bupivacaine with 3 mg morphine (group bm). patients were followed postoperatively for the 24 hours by a blinded investigator for monitoring of number of rescue analgesic consumed, duration of analgesia, numerical rating scale (nrs) at rest and on cough and any adverse effects.

Eligibility criteria:
inclusion criteria: asa i to iii elective surgery exclusion criteria: * patient's refusal * bmi \> 35 kg/m2 or \< 18 kg/m2 * allergic or contraindication to drugs used in study * coagulopathy * local site infection * spine deformity * uncooperative or psychological illness * inability to comprehend pain scale * drugs not injected in target area

Keywords: tap block, morphine, inguinal hernia
improving the treatment of acute relapses in multiple sclerosis through intranasal methylprednisolone administration

Conditions: Multiple Sclerosis Relapsing Remitting; Treatment

Summary: this clinical trial evaluates the nasal administration of methylprednisolone as a treatment strategy for acute relapses in multiple sclerosis

this is a prospective, comparative, randomized, double-blind study adhered to the principles established by the helsinki declaration, including informed consent. patients with a diagnosis of relapsing-remitting multiple sclerosis (rrms) from the national institute of neurology and neurosurgery (innn) that are coursing with acute recurrency will be included. the recruited patients will be organized into two paired groups of 40 patients each, of which group 1 will receive 1g iv methylprednisolone, and group 2 will receive the intranasal dose equivalent to 1g of iv methylprednisolone. clinical symptoms will be measured with the expanded disability status scale (edss) and data will be complemented with results of clinical tests, general laboratories and serum concentration of mp and inflammatory markers. adverse effects in each group will also be identified and quantified. statistical analysis: descriptive, assumption of normality, bivariate comparison of means and multivariate, in addition to intention to treat.

Eligibility criteria:
inclusion criteria: * age between 18 and 65 years. * diagnosis of rrms with an evolution from diagnosis of 3 months to 10 years. * kurtzke expanded disability status scale (edss) from 1 to 6 (grade 6 includes patients with unilateral aid to ambulate) * no contraindication for the administration of mp. * agree to participate in the study by means of a signed informed consent exclusion criteria: * intake of anti-inflammatory steroids in the last 3 days. * patients with active bacterial, viral or fungal infections or undergoing treatment. * patients with hypertension. * patients with diabetes mellitus. * patients with hypo or hyperthyroidism. * patients with glaucoma. * patients with neoplasms. * diagnosis of systemic diseases such as: cardiovascular, pulmonary, hepatic, endocrine, gastrointestinal, etc. * patients with suspected or confirmed pregnancy by means of serum or urinary laboratory tests. * breastfeeding patients. * patients with a history of resistance to glucocorticoids. * patients with a history of severe adverse reactions to glucocorticoids. * patients with a history of hyposmia or anosmia. * patients diagnosed with active sinusitis. * patients with allergic rhinitis. * patients with upper respiratory tract infections. * deviated septum * history of nasal surgery.

Keywords: methylprednisolone intranasal administration multiple sclerosis relapsing remitting
descriptive study of pain, anxiety and depression

Conditions: Pain

Summary: the purpose of the study is to investigate pain, anxiety and depression in chronic pain patients with and without neuropathic pain compared with healthy volunteers

primary outcome measures: * symptom checklist 92 secondary outcome measures: * hamilton depression and anxiety rating scale * major depression inventory * gad-10 anxiety scale * health survey sf-36 * mcgill pain questionnaire * sweat test * heart rate variability testing * coping strategy questionnare * quantitative sensory testing * pain catastrophizing scale * pain rating (vas) * interview

Eligibility criteria:
inclusion criteria: * neuropathic pain patient or patient with fibromyalgia * daily pain in more than 6 months * weekly average pain score 4 or more (vas) exclusion criteria: * treatment with antidepressants, anticonvulsants or any other pain medication except paracetamol * serious or unstable medical disease * prior or present diagnosis of mania, bipolar or psychotic disorder, delirium, suicidal, drug and alcohol dependence, severe agitation * patients who cannot cooperate and do not understand danish

Keywords: neuropathic pain chronic pain depression anxiety
improving heart failure care in minority communities

Conditions: Congestive Heart Failure (CHF); Systolic Dysfunction

Summary: for congestive heart failure (chf) patients with systolic dysfunction, a randomized controlled trial compared nurse-based disease management to address problems in patient and clinician management with usual care for effects on hospitalization and functioning among ethnically-diverse patients in ambulatory practices.

congestive heart failure (chf) disproportionately afflicts black and elderly people, and is a leading cause of hospitalization \> 65 years. although effective therapies can improve functioning and survival in patients with systolic dysfunction, many may not be receiving the full benefit of existing knowledge, including counseling on self-management and appropriate doses of medications. patients play a critical role in managing a chronic condition such as chf, but may not have the skills to do so. clinicians may not provide counseling or medications consistent with evidence-based guidelines. systematic reviews of clinical-behavior change have suggested that interventions targeted to specific problems are more likely to be successful. based on shortfalls identified in patient self-management and clinical care in harlem, a predominately non-white area in northern manhattan, we tailored a nurse-management intervention to address the problems documented, and evaluated its effectiveness in a randomized controlled trial. this trial among primarily-minority patients addresses important gaps in this literature: the study targeted problems documented among chf patients in harlem, enrolled patients from ambulatory practices, randomly assigned patients between nurse-management and usual care, and evaluated their subsequent health-related outcomes. hypothesis: the nurse-management program would result in nurse patients' having fewer hospitalizations and reporting better functioning.

Eligibility criteria:
inclusion criteria: * • adults \>18 years, * systolic dysfunction documented on a cardiac test (echocardiography, radionuclide ventriculography, myocardial stress sestamibi/thallium testing, or left-heart catheterization), * english- or spanish-speaking, * community-dwelling at enrollment, and * current patient in a general medicine, geriatrics, or cardiology clinic or office at a participating site. exclusion criteria: * • medical conditions that prevented a patient's interacting with the nurse, including blindness, deafness, and cognitive impairment; * medical conditions that required individualized management that might differ from standard protocol, namely pregnancy, renal dialysis, and terminal illness; and * procedures that corrected systolic dysfunction, such as heart transplantation.

Keywords: congestive heart failure nurse management effectiveness trial quality improvement minority communities disease management
metastatic left colon and rectal cancer treatment with anti_egfr targeted therapy

Conditions: Metastatic Colorectal Adenocarcinoma

Summary: colorectal cancer ranks the second lethal cancer and third prevalent malignant tumour worldwide, despite of different odern modalities for diagnosis,large number of cases diagnosed at metastatic advanced stage . new treatment approach has been discovered habe been discovered making a huge revolution in metastatic colorectal cancer represented by targeted therapy including anti_egfr ,anti_angiogenic and kinase inhibitors .

retrospective study aims to evaluate the effect of egfr expression in metastatic colorectal cancer and the outcome of treatment with anti_egfr targeted therapy between left colon and rectal cancer

Eligibility criteria:
inclusion criteria: 1. age above 18 2. both sex 3. performance status zero to one according to ecog scale system 4. histo-pathologial diagnosis adenocarcinoma of left colon or rectum. 5. patients diagnosed with left colon and rectal cancer. 6. patients eligible to receive chemotherapy (with renal and liver chemistry, and normal cbc. 7. patients diagnosed with metastatic stage. 8. k-ras wild type. exclusion criteria: 1. second malignancy 2. histo-pathological types other than adenocarcinoma. 3. right colon cancer patients. 4. patients refused receiving anti_egfr targeted therapy. 5. patients with any abnormalities preventing to receive chemotherapy. 6. early stages of colorectal cancer. 7. k-ras mutant type.

Keywords: egfr, targeted therapy ,metastatic colorectal cancer
methylnaltrexone in patients with opioid-induced bowel dysfunction

Conditions: Bowel Dysfunction

Summary: this is a double-blind, randomized, parallel group, dose ranging study of subcutaneous methylnaltrexone to be conducted in patients with advanced medical illness and poorly controlled opioid induced constipation. patients will be randomized to one of three fixed dose levels of sc mntx.


Eligibility criteria:
inclusion criteria: 1. must have advanced medical illness (cancer, hiv, etc) and be receiving palliative care 2. must be on opioid medication for at least 2 weeks with no expectation of significant change in regimen 3. must have constipation 4. must be 18 yrs or older exclusion criteria: 1. concurrent use of medications other than opioids which might interfere with gastrointestinal motility 2. patients who received any experimental drug in the last 30 days 3. patients with active peritoneal cancer (ovarian, etc.) 4. patients with active diverticulitis or diverticulosis

Keywords: opioid-induced bowel dysfunction
side by side - prediction of couples' adjustment to breast or gynecological cancer

Conditions: Enhancing Couples Coping

Summary: the diagnosis and treatment of cancer leads to emotional distress, and major disruptions in role functioning. traditionally, psychosocial services offer individuals diagnosed with cancer peer group support or individual counseling with only few consideration of type or stage of cancer. besides most cancers significantly impacting not only the individual but also their partners and families, breast and gynecological cancer may be particularly embedded in an interpersonal context, namely in the couple's relationship. breast and gynecological cancer cause additional concerns about the women' body image, sexual functioning and these cancers may be prone to provoke or enhance maladaptive patterns of interaction between women and their partners. thus, not only the individual but also the couple's functioning is threatened by these diagnoses. the aim of the here proposed study is to identify predictors of couple's adjustment and to help couples to improve their ability to support each other during this time. in a multi-site study, we will evaluate the efficacy of a couple-based intervention entitled "side by side: coping with cancer together ("seite an seite: krebs gemeinsam bewältigen"). the intervention teaches couples relationship skills that have been repeatedly validated within the marital field. the aim of the intervention is to improve couples' skills to talk to each other effectively about cancer-related topics, and enhance (or maintain) an affectionate relationship in the face of death. we will randomly assign 303 women recently diagnosed with either breast or gynecological cancer and their partners to one of two conditions: (1) seite an seite, or (2) treatment-as-usual, in which couples receive no active psychosocial intervention. assessment will be conducted pre-, post-, and at 6 and 12 months follow-up. these assessments include for both partners negative and positive self-report measures of individual functioning (such as mood, anxiety and benefit finding) and relationship functioning (such as relationship distress, communication patterns). furthermore, at pre-, post- and 12-month follow-up observational data on mutual supportive behavior when communicating about a cancer-related topic will be collected. the study may enhance our understanding of the significance of relationship skills in the process of adjusting to cancer as a couple and as an individual.


Eligibility criteria:
inclusion criteria: * woman was recently diagnosed with breast cancer (stage i - iii) * no history of other cancers * woman and her male partner were married or have been living in a committed relationship for at least 12 month * both partners are willing to participate and able to speak german

Keywords: breast cancer couples coping
perflutren protein-type a microspheres and contrast-enhanced ultrasound in improving response to radioembolization therapy in patients with liver cancer

Conditions: Hepatocellular Carcinoma

Summary: this phase ii trial studies how well perflutren protein-type a microspheres and contrast-enhanced ultrasound work in improving response to radioembolization therapy in patients with liver cancer. ultrasound contrast agents, such as perflutren protein-type a microspheres, use gas microbubbles to improve image quality. using contrast-enhanced ultrasound imaging will "pop" these microbubbles and cause tumors to become more sensitive to radiation therapies.

primary objective: i. characterize the ability of localized ultrasound contrast agent destruction to improve hepatocellular carcinoma (hcc) response to yttrium y-90 (y90) radioembolization. secondary objective: i. determine if contrast-enhanced ultrasound estimated tumor perfusion can reliably predict hcc response to radioembolization 1-14 days post treatment. outline: patients are randomized to 1 of 2 groups. group i: patients receive perflutren protein-type a microspheres intravenously (iv) over 10 minutes and undergo contrast-enhanced ultrasound (ceus) over 60 minutes at 1-6 hours and at approximately 7 and 14 days after yttrium y-90 radioembolization. group ii: patients undergo standard of care yttrium y-90 radioembolization. after completion of study treatment, patients are followed up at 1 month and at 3-4 months.

Eligibility criteria:
inclusion criteria: * be scheduled for sub-lobar radioembolization therapy of a previously untreated hcc mass \< 6 cm visible on grayscale ultrasound * be medically stable * if a female of child-bearing age, have a negative pregnancy test prior to each ultrasound exam * have signed informed consent to participate in the study exclusion criteria: * females who are pregnant or nursing * patients who are medically unstable, patients who are seriously or terminally ill, and patients whose clinical course is unpredictable; for example: * patients on life support or in a critical care unit * patients with unstable occlusive disease (e.g., crescendo angina) * patients with clinically unstable cardiac arrhythmias, such as recurrent ventricular tachycardia * patients with uncontrolled congestive heart failure (new york heart association \[nyha\] class iv) * patients with recent cerebral hemorrhage * patients with known sensitivities to albumin, blood, or blood products * patients with known hypersensitivity to perflutren * patients with known cardiac shunts * patients with known congenital heart defects * patients with severe emphysema, pulmonary vasculitis, or a history of pulmonary embolism * patients with respiratory distress syndrome * patients with a history of bleeding disorders * patients with bilirubin levels \> 2 mg/dl
circulating tumor cell genome in peripheral blood from hepatocellular carcinoma patients under radiotherapy

Conditions: Circulating Neoplastic Cells; Adverse Effect of Radiation Therapy; Fatal Outcome

Summary: hepatocellular carcinoma (hcc) is a common cause of cancer mortality in asia. most patients were presented with advanced disease. percutaneous ethanol injection, radiofrequency ablation, and transcatheter arterial chemoembolization (tace) are not considered as a curative treatment and have achieved very limited success in eradicating large hcc or tumors causing portal vein thrombosis. with the development of novel radiotherapy (rt) technique, rt can be safely given to patients with larger tumor or portal vein thrombosis. however, rt could achieve a tumor response rate of approximately 50 %. currently, there was a paucity of studies regarding a quantitative biomarker to predict tumor response or forecast the outcome in advance. to optimize the therapeutic index, there is a need to seek effective biomarkers for personal medicine because pretreatment afp is not always useful as a surrogate marker in some of the patients. the present study is to investigate whether circulating tumor cell genome in peripheral blood can be used to predict rt response in hcc. we will use the blood sample from patients with locally advanced hcc receiving rt. by using next generation sequencing, we are going to explore the quantity and quality changes of dnas and rnas in the patient's serum or plasma. by this way, genomic expression in peripheral blood may play a key role in determining the optimal therapeutic strategies for hcc patients by predicting tumor response to rt.

patients with hepatocellular carcinoma requiring radiotherapy

Eligibility criteria:
inclusion criteria: * patients with unresectable hepatoma with transarterial chemoembolization (tace) failure or who are not suitable for tace. a maximal tumor diameter \> 3.0 cm * age \> 20, and \< 80 years * ecog 0 or 1 * life expectancy of at least 12 weeks * child-pugh a * cancer of the liver italian program (clip) score ≦ 3 * pretreatment liver function test and renal function test:total bilirubin \< 1.5 times the upper limit of normal (uln), gop/gpt ≦ 5 x of upper limit of normal range, alkaline phosphatase ≦ 4x of uln, prothrombin time / partial prothrombin time \< 1.5 x of uln, serum creatinine ≦ 1.0 x uln * pretreatment blood count:hemoglobulin ≧ 9 g/dl, absolute neutrophil count ≧ 1500/mm3,platelet count ≧ 100,000/mm3 * subjects with at least one uni-dimensional or bi-dimensional measurable lesion and lesion must be measured by ct scan exclusion criteria: * child-pugh c * clip score ≧ 4 * patients with evidence of extrahepatic or metastatic disease * patients with evidence of massive ascites * patients receiving previous irradiation to liver

Keywords: hepatocellular carcinoma genomic expression radiotherapy
pilot study of non-exposure simple suturing eftr with sentinel lymph node navigation for egc (senorita3-pilot)

Conditions: Early Gastric Cancer

Summary: laparoscopic sentinel lymph node dissection and stomach preserving surgery in early gastric cancer is less invasive method which can increase quality of life. current stomach preserving surgery after sentinel lymph node dissection produce transmural communication and expose the tumor to the peritoneum during operation. an endoscopic full-thickness resection method with a simple suturing technique that does not expose the gastric mucosa to the peritoneum (non-exposure simple suturing, ness) was recently developed. this is the pilot study to prove the feasibility of ness-eftr with sentinel node navigation in early gastric cancer patients.


Eligibility criteria:
inclusion criteria: * single lesion of adenocarcinoma in preoperative endoscopic biopsy * clinical stage t1n0 in the preoperative evaluation of endoscopy and computed tomography * tumor size: less than 3cm in differentiated type, less than 2cm in undifferentiated type * location: 2cm far from the pylorus or cardia * aged 20 to 80 * ecog 0 or 1 * patient who signed the agreement * patient who is suspected to underwent laparoscopy assisted gastrectomy exclusion criteria: * indication of endoscopic submucosal resection * inoperable due to poor cardiac, pulmonary function * pregnant * having allergic reaction, previous upper abdominal surgery except laparoscopic cholecystectomy, previous radiation therapy to upper abdomen * diagnosed as malignancy within 5 years except carcinoma in situ of cervix cancer and thyroid cancer