Kornimate/medical-research-clean huggingface dataset:
stereotactic ablative radiotherapy for oligometastatic hepatocellular carcinoma

Conditions: Oligometastasis Hepatocellular Carcinoma

Summary: oligometastasis is a definition that has been described in the past in the 1990s, and in some patients, metastases are not extensive and are limited to a small number of metastases. the local ablative treatment for oligometastasis is not a new concept. in case of liver metastasis from colorectal cancer, long-term survival can be expected if the liver resection is performed. effectiveness has been demonstrated in studies of adrenal and brain metastasis from lung cancer as well as lung metastasis from sarcoma. a recent non-randomized study reported that patients with oligometastasis improved treatment outcomes with aggressive treatment. this study demonstrated that local ablative treatment for oligometastasis showed better treatment outcomes than expected. also, the long-term outcomes in sabr-comet trial showed that the overall survival were increased by 22 months. so far, the standard treatment for metastatic disease is systemic chemotherapy. however, based on these results from studies, active local treatment for patients with oligometastasis is currently being performed in the clinic. in this study, we aimed to apply this concept to patients with hepatocellular carcinoma. to confirm the efficacy and safety of stereotactic radiotherapy in patients with oligometastasis hepatocellular carcinoma


Eligibility criteria:
inclusion criteria: i. 19 years or older ii. patients who signed the informed consent form iii. the clinical trial protocol can be complied with at the discretion of the investigator iv. performance status (based on ecog) less than 2 (0, 1) v. patients with life expectancy greater than 3 months vi. condition in which primary cancer is controlled • definition: a condition that has not progressed at the time of review of clinical trials after curative treatment of primary cancer 3 months ago vii. number of metastatic lesions up to 5 viii. 3 or less metastatic lesions in one metastatic organ ix. those who are undergoing targeted therapy or chemotherapy can also be included (during radiation therapy, drug treatment is stopped) exclusion criteria: i. serious medical complications that cannot proceed with radiation therapy ii. previous radiation therapy history at the location where radiation therapy is to be performed iii. malignant pleural effusion iv. when the spinal cord and the tumor are close (the tumor is located within 3 mm) v. in case of brain metastasis requiring surgical intervention
the physiologic effects of intranasal oxytocin on sarcopenic obesity

Conditions: Obesity; Sarcopenic Obesity; Sarcopenia; Aging; Sedentary Lifestyle

Summary: obesity is highly prevalent in older adults and is a major cause of sarcopenia and disability in older adults. although exercise can counteract the effects of obesity and sarcopenia, many have difficulty adhering to an exercise program and the benefits of exercise are variable. therefore, there is an urgent need to test novel pharmacologic interventions to prevent disability and loss of independence. oxytocin is a pituitary hormone released during parturition and lactation that is also known to suppress appetite in rodents and humans; and, recent small studies have found that intranasal oxytocin reduces body weight in adults. we propose a pilot study of intranasal oxytocin as a novel approach to promote weight loss and increase muscle mass in older subjects with sarcopenic obesity.

the pilot study will be conducted at 3 sites in 9 visits over a period of 12+ weeks. older sedentary subjects will be screened for sarcopenic obesity using a modified consensus definition and evaluated at baseline for safety labs, glucose tolerance, body composition, cognition and physical performance, as well as systemic inflammatory markers in blood and muscle tissue. eligible subjects self-administer 24 iu intranasal oxytocin four times a day for 8 weeks. the study will examine whether the intervention will promote weight loss and preserve muscle mass, thereby preserving and/or improving physical function in older subjects with sarcopenic obesity. generalized linear mixed effects model will be used to evaluate the effect of oxytocin on the change of each continuous measure. the effect of oxytocin will be assessed by whether the time by oxytocin interaction is significantly different from 0 with a 2-sided p-value\<0.05.

Eligibility criteria:
inclusion criteria: * bmi 30-40 kg/m2 * sedentary (\< 2 strenuous exercise/week) * gait speed \< 1 meter/second exclusion criteria: * diabetes (ada criteria) * heart disease (mi or new york heart classification grade iii-iv) * poorly controlled hypertension (sbp \> 170 or dbp \>95 mm/hg) * anemia (hematocrit \<34%) * renal disease (serum creatinine \>1.4, abnormal serum sodium levels, abnormal urinalysis, or physical exam findings indicative of fluid imbalance; individuals with underlying disorder of sodium/water balance, such as siadh, diabetes insipidus, or psychogenic polydipsia) * liver disease (ast/alt/alkphos \> 2x upper limit of normal) * use of systemic steroid, androgens, or anti-coagulants * active/unstable conditions: inflammatory, thyroid, autoimmune, gastrointestinal (gi), hematologic, or neoplastic disorders * individuals with underlying seizure disorder or underlying neurologic disorder that increases seizure risk * cognitive impairment (minicog \<3), unstable mental illness, substance abuse, or history of eating disorder
medial and lateral combined ligament arthroscopic repair for multidirectional ankle instability: case series

Conditions: Ankle Injuries; Ligament Injury; Joint Instability; Deltoid Ligament; Sprain (Strain) (Ankle); Talofibular Ligament Tear

Summary: abstract introduction: the high prevalence of sprains in the population has provided a substantial number of patients with lateral instability of the ankle. the continuity of this condition can lead to the progressive loosening of the medial containment structures, generating a multidirectional rotational instability. the deltoid approach through the imbrication of its components has been proposed as a solution for these patients. the arthroscopic technique has been described as an alternative. methods: this is a retrospective study with patients diagnosed with multidirectional instability and submitted to an ankle arthroscopy with medial repair (arthroscopic tensioning) and lateral (arthroscopic brostrom) between january 2018 and january 2020. all patients will fill an epidemiological questionnaire and will be evaluated for pain and function according to the visual analogue scale (vas) and the american orthopaedic foot and ankle society score (aofas) at 12 months (6-24 months) average of follow-up. discussion: the combined medial and lateral arthroscopic repair may be an effective and safe alternative in the treatment of multidirectional instability. the inclusion of the deltoid complex and the low invasiveness of this technique can improve the clinical outcomes of these patients. additional studies, with a prospective and comparative methodology are required to sustain this proposal. design: level iv. retrospective case series. keywords: ankle injuries; lateral ligament; collateral ligaments; joint instability


Eligibility criteria:
inclusion criteria: * complaints about ankle loosening for the last six months * clinical findings of lateral and medial instability exclusion criteria: * existence of previous surgery * autoimmune diseases * neuropathy * inflammatory disease * isolated medial instability * flatfoot * previous ankle infiltration * radiographic findings of ankle arthritis * cavovarus deformity * coagulopathies * body mass index over 35 * associated injuries, such as osteochondral lesions * syndesmosis instability * tendon ruptures * fractures
use of iv acetaminophen in the treatment of post operative pain in patients undergoing craniotomy and spine surgery

Conditions: Postoperative Pain

Summary: the purpose of this study is to investigate the effectiveness of intravenous acetaminophen (tylenol) for post operative pain control in patients undergoing craniotomies (brain surgery) and spine surgery. studies have shown that intravenous acetaminophen is useful for post operative pain control in some operations but there have not been studies to evaluate the use of acetaminophen in craniotomies or spine surgery.

the purpose of this study is to investigate the effectiveness of intravenous acetaminophen (tylenol) for post operative pain control in patients undergoing craniotomies (brain surgery) and spine surgery. studies have shown that intravenous acetaminophen is useful for post operative pain control in some operations but there have not been studies to evaluate the use of acetaminophen in craniotomies or spine surgery.

Eligibility criteria:
inclusion criteria: * 18-90 years old * undergoing non-emergent craniotomy or single level lumbar laminectomy * must be able to rate pain on a 0-10 scale post-operatively exclusion criteria: * history of liver disease * allergy to acetaminophen * age less than 18 years * renal failure with creatinine clearance less than 30 * pregnancy * altered mentation with inability to report pain score * patients who have received acetaminophen within 6 hours of surgery * patients in which a neuraxial technique has been performed for surgery * prisoners

Keywords: acetaminophen pain laminectomy craniotomy
evaluation of a cd4/cd8+ interferon gamma release assay for monitoring anti-tuberculosis treatment

Conditions: Tuberculosis

Summary: evaluate the possibility of using an igra (interferon-γ release assay) test for monitoring the response to anti-tuberculosis therapy by studying the correlation between the variation in the interferon-gamma (ifn-γ) response to the qft-plus test in the two tubes containing antigens and the gold standard for monitoring tb therapy (culture conversion) in patients with slide positive/culture positive and slide negative/culture positive ptb. evaluate the level of agreement between the results of the new qft access test and the results of the qft plus and culture in patients diagnosed with active tuberculosis. to evaluate the level of agreement between qft access test results and qft plus results in healthy controls and contacts.


Eligibility criteria:
inclusion criteria: 1. clinical symptoms consistent with a high probability of having pulmonary tb disease (probable case), such that they are receiving or are likely to receive ther-apy for active ptb (therapy must not have been initiated for more than 72 hours before recruitment into the study). 2. positive sputum smear for aar 3. positive culture for mycobacterium tuberculosis (confirmed ptb case). 4. positive nucleic acid amplification (naa) test for mycobacterium tuberculosis. exclusion criteria: 1. taken therapy for active tuberculosis or latent tb infection for more than 72 hours. 2. culture confirmation of m. tuberculosis not obtained. 3. age less than 18 years. 4. immunosuppression: hiv-infection, solid organ transplantation, stem cell transplantation, rheumatoid arthritis.
an innovative master platform for clinical trials in mood disorders

Conditions: Mood Disorders; Depressive Disorder; Bipolar and Related Disorders

Summary: mood disorders such as depression and bipolar disorder affect over 350 million people around the world. while several effective treatments exist, it is often difficult to match the right treatment to an individual person. repeated efforts to find the right treatment contribute to poor functioning, low quality of life, and prolongs the time it takes to get well. most areas of medicine are able to use 'biomarkers' or clinical tests, blood tests, or imaging to help diagnose and treat illness. the search for biomarkers in mood disorders is advancing, but one roadblock to progress is the lack of large, standardized studies of mood disorders that are needed to accurately identify biomarkers. the aim of the enable platform is to provide the canadian neuroscience community a standardized way of collecting biomarker data from individuals with a range of mood disorders symptoms. in addition, this 'master clinical trial platform' framework will provide a pool of participants who can be recruited into biomarker-based clinical trials.

the enable platform offers to the canadian neuroscience community (1) standardized data collection methods with deep clinical and neurobiological phenotyping of individuals across the spectrum of mood disorder symptoms; (2) a recruitment pool for efficient launch of clinical trials; and (3) an open source of clinical and neurobiological data for discovery analyses and/or grant applications. the assessments have been categorized into a tiered system, where participants must consent to complete tier 1 items in order to be enrolled in the platform. tier 2 items will be optional measures, the absence of these measures will not compromise the inclusion in the platform. a separate written informed consent to be contacted regarding participation in future clinical trials associate with the enable platform will also be offered. at tier 1, individuals complete clinical assessments (clinician administered and self-report) and during their tier 2, they provide blood, undergo neuroimaging procedures (mri and eeg); and are given an actigraphy device to wear for two weeks.

Eligibility criteria:
inclusion criteria patients: 1. 16 years of age or older. 2. meet criteria for bipolar or depressive disorders as defined by dsm-5. 3. fluency in english, sufficient to complete the interviews and self-report questionnaires. inclusion criteria healthy comparison (hc) participants: 1. 16 years of age or older. 2. no history of psychiatric disorders (according to dsm-5) or significant unstable medical conditions. 3. fluency in english, sufficient to complete the interviews and self-report questionnaires.
randomized clinical trial aimed at comparing unclamped robotic partial nephrectomy with or without renorrhaphy

Conditions: Kidney Cancer

Summary: intended to minimize ischemia during robotic partial nephrectomy (rpn) procedures "by any means possible". before starting enucleation, the boundaries of the tumor are marked during sl-ocrpn surgery cautery. once the tumor is removed, the resection bed is cauterized by dispensing monopolar energy with "quasi-contact" mode, and hemostasis is progressively improved.

since rr impacts postoperative renal function, we believe the use of cautery instead of suture of the parenchymal breach after tumor enucleation provides at least postoperative functional results not lower, shorten the intervention time and reduce the direct costs associated with the procedure. based on available pilot studies, sl-ocrpn is safe, fast, and both the transfusion rate and duration of the hospital stay are not affected by the lack of renorrhaphy at the end of the enucleation. at the same time, this surgical approach does not require the use of a robotic needle holder and this can result in a reduction of direct costs related to treatment. furthermore, based on the preliminary data available, the rate of positive surgical margins would also not result influenced by the absence of rr and the risk of local recurrence could even be reduced by the extended one coagulation of the tumor bed after enucleation.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * radiological diagnosis of organ-confined renal neoplasm (ct1-2 cn0); * patient who is a candidate, due to personal or tumor characteristics, for ocrpn intervention; * compliant patient, able to follow the procedures/follow-up; * patient who agrees to participate in the clinical study and the planned randomization, by signing the informed consent. exclusion criteria: * preoperative evidence of unilateral/bilateral synchronous renal neoplasms; * personal history of renal surgery for benign or malignant pathology.
effects of nonsteroidal anti-inflammatory drugs in recurrence of spondyloarthritis patients after remission

Conditions: Axial Spondyloarthritis

Summary: the multicenter, randomized controlled trial is to investigate and evaluate the effect of nsaids therapy on recurrence in patients with axial spondyloarthritis;

to investigate the recurrence rate in remission patients who withdraw nsaids therapy in axial spondyloarthritis;

Eligibility criteria:
inclusion criteria: * capable of giving informed consent and complying with the examination program of the protocol; * participants with axial spa fulfilling the assessment of spondyloarthritis international society 2009 (asas) axial spa classification criteria; * participants must fulfill the criteria of maintaining remission of aspa, defined as asdas\<1.3； * participants must fulfill the criteria of remission of aspa defined as asdas\<1.3，then continuous to evaluate every four weeks for three times and asdas\<1.3 each time. * laboratory results must fulfill following requirements: hb≥85g/l；3.5×109/l≤wbc count ≤10×109/l；platelet count ≥ normal lower limit; liver function (alt、tbil) ≤twofold of normal upper limit; renal function (scr) ≤normal upper limit; * the pregnancy test must be negative for women of childbearing age; efficient contraception must be taken for both male and female participants during the trial period and within three months after the end of the trial. exclusion criteria: * participants who previously have experienced allergic reactions to nsaids or sulfa-drugs; * participants who are intolerant of nsaids; * participants who are in active axspa episodes; * participants with previous or currant ulcers and/or gastrointestinal conditions or bleeding in three months * participants who were in acute infection or acute attack of chronic infection during screening period; * at the time of screening, participants who were in the acute stage of acute infection or chronic infection, and if the acute infection had improved, they could be re-screened. * participants who suffer from invasive fungal infections (e.g. histoplasma, coccidiosis's, candida, aspergillus, blastomyces, pneumocystis, etc.) within the first 6 months of screening; or opportunistic bacterial infections (e.g. bacterial, viral or other infections, including legionella and listeria); * participants with other autoimmune diseases which are expected to influence the evaluation of experimental medications, such as inflammatory enteritis, psoriasis, uveitis, etc. * participants with previous or currant congestive heart failure, coronary heart disease, serious arrhythmia; * participants with severe, progressive, uncontrolled vital organ and systematic disorders, and other conditions that are considered inappropriate to participate in this trial; * participants with circumstances that may affect the compliance (e.g. prolonged travel or leave, planned relocation, mental illness, lack of motivation to participate, etc.).

Keywords: axial spondyloarthritis anti-inflammatory drugs flare
evaluation of the use of minced skin grafts for promoting donor site wound healing after split-thickness skin grafting

Conditions: Traumatic Skin Loss, 2nd and 3rd Degree Burn, Post Tumour Excision - Raw Areas Undergoes Split- Thickness Skin Grafts

Summary: split-thickness skin grafting (stsg) is one of the most commonly performed procedures to achieve wound closure. most studies are concerned on improving the appearance of scars and shortening the healing time of the recipient sites. however, the management of the donor site usually takes a second consideration. there is a lack of consensus on the recommended method of donor site management. donor site morbidity of stsg is usually minimal, but that may not always be the case. morbidity may include pigmentary abnormalities, prolonged pain and itching, delayed healing, or unfavorable scarring. so, an effort must be taken to find the optimal solution for donor site healing and minimize morbidity. small portions of the skin graft left at the end of the procedure or the graft pieces obtained after trimming the edges are usually discarded. there have been some studies demonstrating the benefit of the minced residual skin graft on the donor site, possibly resulting in earlier epithelialization and improving the appearance

the aim of this study is to compare the duration of wound healing, scar quality and cosmetic results of donor sites after split-thickness skin grafting with and without the use of residual graft pieces as minced skin grafts.

Eligibility criteria:
inclusion criteria: * all patients undergoing split-thickness skin grafting, between 12 - 60 years of age. exclusion criteria: * patients under the age of 12 years or above 60 years. * patients with a known tendency for hypertrophic scarring/keloids * pregnancy * co-morbid factors such as uncontrolled diabetes, ischemic heart disease, renal failure or collagen vascular disease.

Keywords: split- thickness skin grafting
screening of cardiac arrhythmias with wrist-worn aino ecg cardiac monitor

Conditions: Arrhythmias, Cardiac; Atrial Fibrillation

Summary: the study investigates the performance pf pulseon arrhythmia monitor system that includes a wrist-worn device, which combines continuous optical heartbeat interval monitoring and intermittent ecg measurement, and a data management system used by healthcare professionals for data observation, in the detection of previously undiagnosed cardiac arrhythmias, especially atrial fibrillation.

the study consists of monitoring voluntary subjects with pulseon arrhythmia monitoring system for the period of two weeks. the subjects are recruited mainly through newspaper advertisements. the study is executed in tampere and helsinki areas, finland. during the two week monitoring time, the subjects are instructed to wear the wrist device continuously, except when taking the device off e.g. for going to sauna or swimming, and for charging. the subjects are instructed to perform a 35-second ecg measurement (recording) in three cases: 1. scheduled recording four times a day 2. in case of suspecting arrhythmic event, i.e. feeling symptoms 3. in case the wrist device instructs to perform a recording by vibrating and showing an led light the data collected in the study is analysed post-hoc. in the post-hoc analysis, the cardiac rhythm assessed automatically from the ecg measurements is visually confirmed by a cardiologist.

Eligibility criteria:
inclusion criteria for the main study group: * at least 65 years of age * self-assessed ability to use the study devices * ability to give informed consent * volunteering for the study inclusion criteria for the active endurance athlete group: * minimum of 10 years of active training of endurance sport (e.g. long distance running, skiing, cycling, triathlon...) and currently an average amount of training of at least 10 hours a week. * age: ≥ 50 years * self-assessed ability to use the study devices * ability to give informed consent * volunteering for the study exclusion criteria for both groups: * cardiac pacemaker * earlier diagnosis of atrial fibrillation * inability to give informed consent * denial

Keywords: wearable wrist-worn