Kornimate/medical-research-clean huggingface dataset:
single versus multiple injection ultrasound guided paravertebral blocks

Conditions: Breast Neoplasms; Anesthesia

Summary: paravertebral block (pvb) has been shown to provide excellent analgesia for major breast surgeries resulting in reduced narcotic consumption, reduced nausea, improved quality of recovery, reduced chronic pain and possibly reduced metastasis with breast cancer. traditionally, pvb is done by multiple injections below t1-t5 transverse processes. with multiple injections, the risk is increased for a pleural, an intraneural, and/or an intravascular injection. recently, ultrasonography is being used to facilitate pvb. the use of ultrasound imaging enables real-time needle visualization during the procedure. this may improve efficacy and reduce the chances of complication like pneumothorax. currently, there are no data comparing ultrasound-guided single injection technique with multiple injections technique with regards to extent of spread for pvb. our objective is to investigate the extent of dermatomal spread of pvb when equal volumes of local anesthetic are injected at one versus five paravertebral sites for patients undergoing major breast surgery. in addition, the investigators wish to compare the performance time and duration of analgesia. methodology: after local reb approval, 72 patients undergoing a unilateral mastectomy with or without axillary node dissection will be randomized to receive either single or multiple injections pvb. the pvb will be performed in prone position under real-time ultrasound guidance using a para-sagittal approach.the patients in single injection group will receive single injection pvb at t3-t4 level with 25 ml of 0.5% ropivacaine and four subcutaneous sham injections. patients in the multiple injection group will receive five injections of pvb from t1 to t5 level. 5 ml of 0.5% ropivacaine will be injected at each level. pleural drift will be used as a sign of correct needle tip location and local anaesthetic spread. the pinprick method will be used to assess the extent of dermatomal blockade, 20 minutes following the completion of procedure. all patients will receive a standardized general anesthesia for the surgery. any adverse events including pneumothorax, epidural spread, la toxicity/seizure, total spinal, will be recorded.


Eligibility criteria:
inclusion criteria: * females, age 18 to 80 years, scheduled to receive unilateral mastectomy surgery, with or without axillary node dissection * able to give informed consent * able to cooperate with study process * availability of home telephone. exclusion criteria: * patient refusal or lack of informed consent * allergy to local anesthetic and other medications used in the study * bilateral mastectomies * coexisting hematological disorder or with deranged coagulation parameters * pre-existing major organ dysfunction such as hepatic and renal failure * significant thoracic kyphoscoliosis * history of previous thoracic surgery.
eating disorders: online self-help & usual treatment (tau) vs tau only

Conditions: Anorexia Nervosa; Bulimia Nervosa; Binge Eating Disorder; Other Specified Feeding or Eating Disorder

Summary: a pilot study exploring whether individuals receiving usual treatment (cbt) from the specialist nhs tayside eating disorders service and accessing the online self-help "smart eating" programme have improved treatment outcomes compared to those receiving usual treatment only. the study will also explore acceptability of the "smart eating" self-help programme via a feedback questionnaire.

this controlled-comparison pilot study will explore whether individuals receiving usual treatment (cbt) from the specialist nhs tayside eating disorders service and accessing the online self-help "smart eating" programme have improved treatment outcomes compared to those receiving usual treatment only. all participants would be involved in the trial for 6 months, capturing their motivation for change, eating disorder psychopathology and quality of life at four time-points (pre-treatment, mid-treatment, end of treatment, 3-month follow-up). some participants may continue to receive usual treatment after study end, which will be detailed in the study analysis. following trial completion, all participants will be able to access the "smart eating" programme. the study will also explore acceptability of the "smart eating" self-help programme via a feedback questionnaire to inform programme adaptations and a possible pragmatic randomised controlled trial planned for the future. currently, no other uk study is piloting the use of the "smart eating" programme as an adjunct to specialist nhs eating disorder treatment.

Eligibility criteria:
inclusion criteria: * aged 16-65 years * meet diagnostic criteria for an eating disorder * commencing treatment under the nhs tayside eating disorders service * fluent in english * provide written consent * literate to the extent of understanding self-report questionnaires \& following verbal instructions * access to a computer exclusion criteria: * deemed too emotionally or physically frail to participate by clinical staff; * currently presenting with active suicidal intent; * unable to read english or follow verbal english instructions.
study on laparoscopic spleen-preserving no. 10 lymph node dissection for advanced middle or upper third gastric cancer

Conditions: Stomach Neoplasms

Summary: the purpose of this study is to explore the short-term, long-term and oncological outcomes of laparoscopic spleen-preserving no. 10 lymph node dissection in a left-sided approach for advanced middle or upper third gastric cancer not invading greater curvature.

a prospective randomized comparison of laparoscopic spleen-preserving no. 10 lymph node dissection for gastric cancer will be performed, to evaluate the short-term, long-term and oncological outcomes. the evaluation parameters are perioperative clinical efficacy, postoperative life quality, immune function and 3-year survival and recurrence rates.

Eligibility criteria:
inclusion criteria: * age from 18 to 75 years * primary proximal gastric adenocarcinoma not invading greater curvature (papillary, tubular, mucinous, signet ring cell, or poorly differentiated) confirmed pathologically by endoscopic biopsy * ct2-4a, n0-3, m0 at preoperative evaluation according to the american joint committee on cancer (ajcc) cancer staging manual seventh edition * no distant metastasis is observed. and the spleen, pancreas or other adjacent organs are not involved by the tumor. * performance status of 0 or 1 on eastern cooperative oncology group scale (ecog) * american society of anesthesiology score (asa) class i, ii, or iii * written informed consent exclusion criteria: * women during pregnancy or breast-feeding * severe mental disorder * history of previous upper abdominal surgery (except laparoscopic cholecystectomy) * history of previous gastrectomy, endoscopic mucosal resection or endoscopic submucosal dissection * enlarged or bulky regional lymph node diameter over 3cm by preoperative imaging * history of other malignant disease within past five years * history of previous neoadjuvant chemotherapy or radiotherapy * history of unstable angina or myocardial infarction within past six months * history of cerebrovascular accident within past six months * history of continuous systematic administration of corticosteroids within one month * requirement of simultaneous surgery for other disease * emergency surgery due to complication (bleeding, obstruction or perforation) caused by gastric cancer * fev1\<50% of predicted values

Keywords: stomach neoplasms laparoscopy
a study of ag-013736 (axitinib) or bevacizumab (avastin) in combination with paclitaxel and carboplatin in patients with advanced lung cancer.

Conditions: Non-Small-Cell Lung Carcinoma; Adenocarcinoma

Summary: to determine if the addition of ag-013736 to chemotherapy is beneficial in patients with advanced lung cancer who have not been previously treated.


Eligibility criteria:
inclusion criteria: * advanced non squamous cell, lung cancer * no prior treatment for lung cancer except prior adjuvant therapy if last dose was \>12 months prior to enrollment exclusion criteria: * prior therapy for advanced lung cancer * the need for blood-thinners * coughing up blood
school-home program for mexican children with attention and behavioral concerns

Conditions: ADHD

Summary: a school-based behavioral intervention for mexican youth with attention/behavior concerns (the collaborative life skills program for latinos/familias unidades empezando retos y tareas para el éxito \[cls-fuerte\]:) will be pilot-tested in a mixed-method investigation with four mexican elementary schools.

a school-based behavioral intervention for mexican youth with attention/behavior concerns (the collaborative life skills program for latinos/familias unidades empezando retos y tareas para el éxito \[cls-fuerte\]:) will be pilot-tested in a mixed-method investigation with four mexican elementary schools. participants will include 24-32 students (n = 6-8 per 4 schools) in participating schools. school personnel will help identify students with and at-risk for attention-deficit/hyperactivity disorder (adhd) with at least one caretaker and teacher able to participate in the intervention. students must be in 1st-6th grade at a participating school and must demonstrate clinically significant attention/behavioral concerns and related impairment as rated by caretakers and teachers. caretakers and teachers must be able to attend program sessions held at the child's school over an approximately 6-week period. through a school-clustered random assignment design, two schools will be selected to receive cls-fuerte during the fall of the 2016-2017 school year and two schools will be selected to receive school services as usual while waiting to receive cls-fuerte the spring of the 2016-2017 school year. caregivers and teachers of students will complete questionnaires about child behavior and family functioning and caregivers will participate in focus groups at 4 time points regardless of treatment assignment: pre (prior to random assignment), post 1 (following cls-fuerte in the fall cohort), post 2 (following cls-fuerte for in spring cohort), and follow-up (at the end of the school year). feasibility and acceptability of cls-fuerte will be examined via participation enrollment, attendance, and engagement ratings and focus group feedback. improvement in satisfaction with school services and youth outcomes will be examined and estimates of effect sizes will be used to support future scaled-up investigation.

Eligibility criteria:
inclusion criteria: * caretakers and teachers of children must each describe at least 3 symptoms of adhd as occurring "often" or "very often," as well as 1 impairment domain of adhd as affecting the child "quite a bit" or "a lot" on a symptom screening interview. exclusion criteria: * inability of caretakers or teachers to attend groups and meetings.
a randomized, placebo-controlled trial of bms-275291 given daily for 12 months to women with stage 1c-iiia breast cancer receiving adjuvant chemotherapy and/or hormonal therapy

Conditions: Breast Cancer

Summary: this clinical trial will assess whether bms-275291 can be administered safely in combination with standard adjuvant therapy for early breast cancer and whether plasma concentrations at trough exceed a target minimum.


Eligibility criteria:
inclusion criteria: 1. histologically confirmed pathologic stage 1c-iiia adenocarcinoma of the breast which has been completely resected. 2. systemic therapy is planned according to one of the following three regimens: * tamoxifen (20mg) given orally once per day * adriamycin (60 mg/m2 iv on day 1) plus cyclophosphamide (600mg/m2 iv on day 1), repeated every 21 days for four courses (to begin within 8 weeks after definitive surgery) * adriamycin (60mg/m2 iv on day 1) plus cyclophosphamide (600mg/m2 iv on day 1), repeated every 21 days for four courses, followed by taxol (175mg/m2 iv on day 85) repeated every 21 days for four courses (to begin within 8 weeks after definitive surgery). 3. ecog performance status 0 or 1. 4. adequate organ function as evidenced by: * anc \> 1500/mm3 * platelets \> 100,000/mm3 * serum creatine \< 1.5 uln * total bilirubin \< 1.5 x uln * ast \< 2 x uln 5. patients to receive adriamycin must have lvef \> 50% or acceptable function per the institutional practice as assessed by muga. 6. signed informed consent. 7. women age =/\> 18 years 8. patients must have recovered from reversible adverse events of prior surgery and any radiation therapy. 9. women of childbearing potential must have a serum or urine pregnancy test within 72 hours prior to the start of study medication. exclusion criteria: 1. patients in whom breast cancer is present at the margin or surgical resection are not eligible in this study. patients suspicious for residual disease following resection are not eligible. 2. prior chemotherapy or immunotherapy for breast cancer. 3. documented metastatic breast cancer. 4. other malignancy (except carcinoma in situ of the cervix or surgically treated non-melanoma skin cancer) within 5 years of study entry. 5. pregnant or breastfeeding females. 6. women of child bearing potential not employing adequate contraception. 7. history of autoimmune diseases such as systemic lupus, rheumatoid arthritis, scleroderma. 8. any serious underlying medical conditions which would impair the ability ot the patient to receive the planned treatment or which may interfere with the completion of this trial. 9. planned chemotherapy, hormonal therapy or biological therapy other than those described above. patients should not be enrolled in any other clinical trials. use of other investigational agents is not permitted. 10. any condition that does not permit compliance with the protocol.
atrial imaging and cardiac rhythm in embolic stroke

Conditions: Cryptogenic Stroke; Atrial Fibrillation; Atrial Dilatation; Stroke, Ischemic

Summary: the aries study is an observational study in which patients with a recent acute ischemic stroke of cryptogenic aetiology are consecutively enrolled in order to perform a extensive cardiologic work-up. the main objective is to study parameters that could predict arrythmias on prolonged monitoring and also echocardiographic parameters of left atrial disfunction that could predict the presence of a hidden atrial fibrilation and recurrent ischemic events in patients with cryptogenic stroke.

cerebrovascular diseases are the second most frequent cause of death in the general population, representing a 10% of global death. in order to prevent recurrent strokes, it is crucial to identify the underlying cause to administrate the best treatment in secondary prevention. cryptogenic strokes are those in which the etiology remains unknown despite performing an extensive work-up; they represent between 20-62% of strokes. occult atrial fibrilation is thought underlie up to 40% of cryptogenic strokes; it has also reciently been postulated that other left atrial arrythmias (parafibrilatory status) and left atrial markers of disfunction could represent a cardiac source of emboli. tha hypothesis of the aries study is that an extensive cardiologic work-up (advanced echocardiography measuring strain /stain rate and 3d echo and a 30 day continuos ecg monitoring) would detect atrial disfunction, parafibrilatory status and atrial fibrilation in patients with cryptogenic stroke, and that patients with these findings could have more stroke recurrences. this study is designed as a prospective observational unicentric study that includes patients with cryptogenic stroke in a consecutive matter in la paz university hospital.

Eligibility criteria:
inclusion criteria: * patients addmitted to the neurology service at la paz university hospital with a recent diagnosis of cryptogenic stroke considered non-lacunar and where no other reasonable diagnosis is suspected. * signed informed consent. exclusion criteria: * presence of large vessel atheromatosis with \>50% estenosis, or \ 50 years old, hipertension, diabetes mellitus, dyslipidemia, smoker). * patients with a un favorable clinical situation or dependance who will not benefit from the study or those that could not fullfill study visits and procedures. * patients in which an embolic arrythmia has already been demonstrated
brain mechanisms underlying the effect of the motilin receptor agonist erythromycin on hunger in normal weight subjects

Conditions: Healthy Volunteers

Summary: the purpose of this study is to investigate the role of erythromycin, a prokinetic agent, on hunger, and the brain mechanism lying behind it.


Eligibility criteria:
inclusion criteria: * female only. * age \> 18 and \< 60. * body mass index (bmi) of 19-25 kg/m2 (no weight change of more than 5 kg in the past three months). * not known to have any chronic medical illness or illnesses affecting the gastrointestinal, cardiovascular, or nervous systems, chronic pain or psychiatric disorder. * if female not known to be pregnant. * not known to have any past upper gastrointestinal surgery. exclusion criteria: * alcohol consumption \> 7 drinks / week * major depression and chronic health conditions except controlled hypertension
impact of vitamin d supplementation on fetomaternal outcomes in ltbi pregnant females

Conditions: Maternal and Child Health

Summary: the goal of this randomized controlled trial is to see the effect of vitamin d supplementation on fetomaternal outcomes in pregnant females with latent tuberculosis infection the main question\[s\] it aims to answer are: if vitamin d supplementation has any impact on maternal outcomes. if vitamin d supplementation has any impact on fetal outcomes.

this study aims to see the impact of vitamin d supplementation on fetomaternal outcomes in pregnant females with latent tuberculosis infection. a three-arm (parallel) randomized controlled trial (rct) will be conducted in a high-burden setting. a calculated sample of 99 (33 in each group) pregnant females with ltbi will be enrolled based on predefined inclusion criteria. vitamin d supplementation will be given as per study protocols. group-a (no intervention), group-b (2000iu/day), group-c (4000iu/day). to maintain the safety measures throughout the study all the study participants will be monitored for hypervitaminosis d. informed consent will be obtained from all participants. the study will be conducted after approval by the ethical review board(s). the final analysis will be based on the effect of vitamin d supplementation on pre-defined fetomaternal outcomes.

Eligibility criteria:
inclusion criteria: - pregnant females aged 18-35 years, already enrolled for delivery in the specified setting coming regularly for prenatal checkups with positive tuberculin skin test exclusion criteria: * history of active t.b * use of any dietary supplement containing more than 400 iu/day (10 mcg/day) of vitamin d within the month before enrolment; * presence of any confounders;
correlation of respiratory rate level and trend evaluation in heart failure patients

Conditions: Heart Failure

Summary: the objective of the study is to determine if there is any relationship between respiratory rate and heart failure events.

the purpose of the correlate-hf study is to collect rrt data in heart failure patients to gain a better understanding of how respiratory rate changes in relation to all cause clinical events as well as other diagnostic features, including but not limited to, activity level, heart rate, and lead impedance.

Eligibility criteria:
inclusion criteria: * implanted cognis device or future commercially available boston scientific crt-d, that contains the sensor trend for respiratory rate, with a right ventricular lead and left ventricular lead actively implanted * respiratory sensor programmed "on" * classified as having nyha class iii heart failure documented, in the past 12 months * age 18 or above, or of legal age to give informed consent specific to state and national law * willing and capable of providing informed consent, participating in all testing associated with this clinical investigation at an approved clinical investigational center and at the intervals defined by this protocol exclusion criteria: * inability or refusal to sign the patient informed consent * inability or refusal to comply with the follow-up schedule * patients that have received routinely scheduled intravenous inotropic therapy as part of their drug regimen within the past 90 days * patients prescribed to positive airway pressure therapy * a life expectancy of less than 180 days, per physician discretion * enrolled in any concurrent study without prior written approval from boston scientific crm * women who are pregnant or plan to become pregnant in the next twelve months
muscle oxygenation in chronic obstructive pulmonary disease

Conditions: Chronic Obstructive Pulmonary Disease; Chronic Obstructive Pulmonary Disease Exacerbation; Muscle Oxygenation

Summary: the aim of our study is to examine the peripheral muscle oxygenations at rest and in motion on the 2nd day of hospitalized patients and before discharge in severe acute exacerbation of chronic obstructive pulmonary disease and to compare the results in the hospital periods by repeating the tests in the stable periods of the patients 1 month after discharge.


Eligibility criteria:
inclusion criteria: * being a copd patient hospitalized with severe acute exacerbation * be between 40-80 years old * having a body mass index below 35 exclusion criteria: * patients who do not want to participate in the study * patients requiring intensive care follow-up during their hospitalization arthritis, neurological disease, deep vein thrombosis, peripheral arterial disease, muscle weakness, broken etc. patients with the condition * extensive parenchyma such as malignancy, pulmonary embolism, vasculitis, collagen tissue diseases, interstitial fibrosis, severe pneumonia patients with damage * patients with severe dyspnea and hemodynamic instability who cannot perform the sit-up test

Keywords: chronic obstructive pulmonary disease muscle oxygenation chronic obstructive pulmonary disease exacerbation
therapeutic touch for wrist fractures in postmenopausal women

Conditions: Osteoporosis; Fractures

Summary: this study will evaluate the effectiveness of therapeutic touch in treating wrist fractures in women past menopause.

in the united states, the use of complementary and alternative medicine (cam) increased by approximately 25% between 1990 and 1997. the number of visits to cam practitioners exceeded visits to primary care physicians by about 250 million in 1997. energy medicine modalities, including therapeutic touch, healing touch, and reiki, are commonly utilized for conditions ranging from headache to cancer, yet understanding of the human energy field and how it may be used in healing is limited. this study will examine the effect of therapeutic touch on fracture healing in postmenopausal women. women will be enrolled in the study within one week of a wrist fracture and will receive either therapeutic touch or a sham (placebo) treatment daily for 3 weeks. assessments will include blood and urine analysis and measures of pain and function in the affected wrist.

Eligibility criteria:
inclusion criertia: * postmenopausal * wrist fracture within 1 week of study entry * able to travel to research center for daily treatment

Keywords: bone metabolism therapeutic touch