Kornimate/medical-research-clean huggingface dataset:
evaluation of aspen spinous process fixation system and plif technique for the treatment of low back pain

Conditions: Low Back Pain; Spondylolisthesis; Spondylosis; Spinal Instability; Spinal Stenosis

Summary: lumbar spinal fusion was introduced approximately 70 years ago and has evolved as a treatment option for symptomatic spinal instability, spinal stenosis, spondylolisthesis, and degenerative scoliosis. many techniques evolved since then, from wiring, rods, pedicle screws, and recently inter-spinous fixation devices like the aspen. along its evolutionary trail, various methods for achieving circumferential fusion have arisen. distinct from staged anterior/posterior fusion techniques, two methods of achieving an interbody fusion from a posterior approach have emerged: posterior lumbar interbody fusion (plif) and transforaminal lumbar interbody fusion (tlif). recently, the lateral approach for interbody fusion (xlif) has became a more common technique, requiring in some cases, complemental posterior fixation with pedicle screws, facet screws or interspinous fixation devices like the aspen device. in this study, we address the clinical and radiological outcome of a novel technique using standard plif interbody fusion and insertion of the aspen device via posterior lumbar approach.


Eligibility criteria:
inclusion criteria: * oswestry disability index score \>30% * diagnosis of low back pain and/or radicular pain associated to spinal instability * diagnosis of low back pain and/or radicular pain associated to degenerative disc disease * elective single level surgery * signed informed consent form exclusion criteria: * previous surgery with complete laminectomy, pars defect, etc * patients that during the surgery requires complete laminectomy at level of the surgery * structural lesion to facet joints * osteoporosis * systemic or local infection * pregnant or planning to become pregnant

Keywords: spine aspen device plif low back pain
tangential radiation therapy without axillary dissection in breast cancer

Conditions: Early-Stage Breast Cancer

Summary: the purpose of this study is to evaluate whether treatment to the axilla (area under the arm) can be safely minimized by omitting axillary surgery and full axillary radiation therapy and replacing it with radiation therapy to the breast and lower axilla.

* patients will have undergone conservative breast surgery without axillary dissection prior to enrollment in this study. * patients will receive radiation therapy to the breast, including the lowest axillary lymph nodes, over a period of 6 1/2 weeks. * no radiation will be specifically directed toward the upper axilla or supraclavicular lymph nodes. * patients will also receive 5 years of tamoxifen or another type of hormone therapy determined by the medical oncologist. * follow-up visits will occur every 6 months and mammograms every 12 months.

Eligibility criteria:
inclusion criteria: * patients must have clinical stage i or ii breast cancer, clinically uninvolved axillary nodes. * patients must be 55 years or older. * patients must undergo total excision of the primary invasive tumor * final pathologic margin status must be negative * only estrogen receptor (er) or progesterone receptor (pr) positive tumors will be permitted exclusion criteria: * prior history of malignancy, except for non-melanoma skin cancers and carcinoma in situ fo the cervix

Keywords: axillary dissection tangential radiation breast cancer
optimized radiological diagnosis of hepatic candidiasis during the treatment of acute leukemias

Conditions: Leukemia; Infection

Summary: hepatic candidiasis is a frequent complication in patients receiving intensive chemotherapy for acute leukemia. hepatic lesions may be detected by computerized tomographic (ct) scans, but there is no standardized ct protocol for the diagnosis and follow-up of hepatic candidiasis. the investigators compared the size of the fungal lesions in the chest and abdomen ct. the current analysis aimed to increase the value of ct for the diagnosis and the follow-up of hepatic candidiasis in daily routine.


Eligibility criteria:
inclusion criteria: * chest and abdomen ct with fungal lesion in patients with leukemia exclusion criteria: * other liver pathologies

Keywords: computed tomography
neoadjuvant chemotherapy combined with cetuximab for egfr wild type locally advanced rectal cancer

Conditions: Rectal Cancer Stage III

Summary: a number of pilot studies had shown high rate of complete resection after neoadjuvant chemotherapy alone for local advanced rectal cancer(larc), but they did not increase the ratio of pathological complete response (pcr) which was associated with improvement of overall survival (os). on the other hand,some clinical trials show that triple active cytotoxic agents (fluorouracil, oxaliplatin, irinotecan, folfoxiri) combined with cetuximab for egfr wild type metastatic colorectal cancer had more effective than double agents.therefore,a hypothesis is the folfoxiri+cetuximab as the neoadjuvant chemotherapy regimen might improve the patient's ratio of pcr.

this is a multicenter, phase ii trial to assess the efficacy and safety of triplet regimen (folfoxiri) combined with cetuximab for patients with egfr wild type larc. after 4 cycles of folfoxiri+cetuximab and 2 weeks later, the patients will be evaluated by senior radiologist, oncologist and surgeon through pelvic mri, ct and positron emission computed tomography (pet-ct). the patients will go to surgery (tme) if the tumor response is good enough to have complete resection under the decision of the multidisciplinary team (mdt),otherwise, the patients will receive pelvic radiotherapy(45grey/25fraction and 5.4grey/3fraction boost to the tumor bed) combined with capecitabine(625 mg/m²,bid po,d1-5,qw), and additional four cycles of modified folfox6 (mfolfox6) or oxaliplatin 135mg/m²plus capecitabine 1.0/m², bid po(xelox) of each 3 weeks cycle for 2 cycles chemotherapy before tme. all patients will receive 6-8 cycles of mfolfox6 or 4-5 cycles xelox as adjuvant chemotherapy after tme. folfoxiri+cetuximab irinotecan 165 mg/m² + oxaliplatin 85 mg/m² + leucovorin 200 mg/m² + 5-fu 2800 mg/m² cont. inf. 46h + cetuximab 500 mg/m²,all on day 1 of each 2 weeks cycle for 4-6 cycles, other names: cpt11，campto eloxatin xelod erbitux

Eligibility criteria:
inclusion criteria: 1. age ≥ 18 to 75 years at diagnosis 2. diagnosis of rectal adenocarcinoma 3. ecog status: 0～1 4. clinical stage ii (t3-4, n0) or stage iii (t1-4, n1-2) 5. adequate bone marrow, hepatic and renal function as assessed by the following laboratory requirements conducted within 7 days of starting study treatment: 1),leukocytes ≥ 3.0 x109/ l, 2),absolute neutrophil count (anc) ≥ 1.5 x109/ l 3),platelet count ≥ 100 x109/ l, 4),hemoglobin (hb) ≥ 9g/ dl. 5),total bilirubin ≤1.5 x the upper limit of normal (uln). 6),alanine aminotransferase (alt)/aspartate aminotransferase (ast) ≤ 3 x uln. 7),serum creatinine ≤ 1.5 x the uln. 8),signed informed consent; exclusion criteria: 1. patient had received pelvic radiotherapy; 2. patient had received systemic chemotherapy 3. pregnant and nursing women 4. had metastatic disease 5. uncontrolled co-morbid illnesses or other concurrent disease 6. patient had second malignant disease within 5 years 7. patients refused to signed informed consent.

Keywords: local advanced rectal cancer neoadjuvant chemotherapy folfoxiri cetuximab egfr wild type
the seniors covid-19 pandemic and exercise study

Conditions: Well-Being (Psychological Flourishing); Depression; Quality of Life; Loneliness; Physical Activity; Social Identification; Physical Health

Summary: the purpose of this study is to evaluate different types of exercise programs (virtual group-based exercise program; personal exercise program; wait-list control) across 12-weeks on the physical and mental health of older adults during the current covid-19 pandemic.


Eligibility criteria:
inclusion criteria: * 65+ years old * be able to speak and read english * one participant in the study per household (spouses, significant others, or family members can take part in the exercise programs with the study participant; however, they will not be able to provide data and won't be remunerated for participating) * not experience any contraindication which might prevent that person from participating in moderate-intensity physical activity. * participants must be able to access the internet at home via a personal smartphone, tablet (e.g., ipad), or computer (device used must have camera capabilities) * low active individuals (i.e., less than 150 minutes of moderate-to-vigorous physical activity per week) * currently living in canada exclusion criteria: * age of less than 65 years * unable to read and speak in english * inability to participate in moderate-to-vigorous physical activity (including a lack of ability to receive doctor's clearance for participating in physical activity) * lack of internet access which does not allow them to access online materials * device used to access the internet does not have a camera/video capabilities * active individuals (e.g., participate in greater than 150 minutes of moderate-to-vigorous physical activity each week) * living outside canada * not the first person from a household to enroll in the study
effect of acupuncture on hemodialysis patients

Conditions: Acupuncture Therapy; Hemodialysis Patients; Quality of Life; Activities of Daily Living

Summary: the proposed randomized controlled trial (rct) evaluated the effect of acupuncture treatment on the functional capacity (fc) and health-related quality of life (hrqol) in stage 5 chronic kidney disease (ckd) patients receiving maintenance dialysis. a total of 60 end-stage renal disease (esrd) patients undergoing hemodialysis (hd) from a dialysis centre (portugal), were randomly assigned to acupuncture, sham and control group.

end-stage renal disease (esrd) patients undergoing hemodialysis (hd) experience multiple physical and emotional problems, undergo a complex and demanding treatment regimen, face a disruptive chronic disease with a significant decrease in functional capacity and a high impact on their hrqol. traditional chinese medicine (tcm) has been progressively more accepted as an effective therapeutic approach. the fundamental questions guiding our entire research project were: what is the effect of tcm therapeutic strategies in the improvement of symptoms resulting from renal replacement therapy, in esrd patients undergoing hd? does acupuncture have a positive effect on fc and hrqol of hemodialysis patient? if so, are the results maintained over the long term? and what is the effectiveness of short-term intensive interventions when compared to less frequent and prolonged interventions over time? is it possible to integrate acupuncture into the dialysis care routine? based on previous research questions and the complexity of ckd, the objectives of our study were: 1) to assess the effect of acupuncture on fc and hrqol of esrd patients undergoing hemodialysis; 2) evaluate the specific effects of acupuncture as compared to sham; 3) evaluate short and long term effects of acupuncture; 4) determine the difference between short-term intensive and ongoing but less-frequent acupuncture treatments; 5) to assess the feasibility of integrating acupuncture on dialysis care.

Eligibility criteria:
inclusion criteria: * male and female patients, age 18 years or older, receiving regular hemodialysis (hd) treatment for more than 3 months, 3-times a week session, 4h per session, with medically stable condition. exclusion criteria: * patients that refuse to participate in the study, who have a clinical indication that prevents their participation in the study and patients with other comorbidities as poorly controlled malignant hypertension, unstable angina, uncontrolled diabetes mellitus, cerebrovascular failure with recurrent syncope, uncontrolled heart failure, severe mental illness or cognitive impairment will be excluded. other conditions such as inability to practice physical exercise, have had acupuncture treatment in the past two weeks, known hypersensitivity reaction and/or other side effects after acupuncture treatment, inability to cooperate with the procedures inherent to the application of the procedure, will be also excluded from study.

Keywords: chronic kidney disease hemodialysis acupuncture activities of daily living health-related quality of life.
the effectiveness of tdcs on internet game addiction

Conditions: Addiction; Internet Gaming Disorder

Summary: in this study, the investigators aimed to investigate the effect of transcranial direct current stimulation (tdcs) on clinical status of internet game addiction. the clinical status of internet game addiction includes severity of addiction symptom, subjective craving for gaming, response inhibition and cue reactivity. the investigators hypothesized that real stimulation with tdcs on the dorsolateral prefrontal cortex will have higher effectiveness on severity of addiction symptom, subjective craving for gaming, response inhibition and cue reactivity rather than sham stimulation with tdcs.


Eligibility criteria:
inclusion criteria: * diagnosis of internet gaming disorder based on diagnostic criteria of diagnostic and statistical manual of mental disorders (dsm)-5. exclusion criteria: * history of seizure * history of significant head injury * mental retardation * schizophrenia * history of stroke

Keywords: internet game addiction internet gaming disorder transcranial direct current stimulation response inhibition craving cue reactivity
endoscopic ultrasound-guided versus surgical gastroenterostomy for malignant gastric outlet obstruction

Conditions: Malignant Gastric Outlet Obstruction

Summary: gastric outlet obstruction (goo), defined by a mechanical obstruction of the duodenum, pylorus, or antrum, may result from various diseases. goo was caused by underlying malignancy in up to 85% of patients, most of which could be attributed to pancreatic cancer. malignant goo may increase morbidity, reducing quality of life, and significantly influencing tolerability and efficacy of oncologic treatments. before the advent of eus-guided gastroenterostomy (eus-ge), placement of enteral self-expandable metallic stents (sems) or surgical gastroenterostomy (sge) are the standard of care for many years. the main shortcoming of enteral sems placement is recurrent goo due to tumor ingrowth/overgrowth, which occurs in the majority of patients who survive longer than 6 months. on the other hand, the main limitation of sge is its invasive nature, especially in such patients with advanced malignancies and poor nutritional status. in addition, sge is associated with frequent complications, such as perioperative infections and gastroparesis. eus-guided gastroenterostomy (eus-ge) is a novel procedure for palliation of malignant goo. several systematic reviews and meta-analysis demonstrated the feasibility, efficacy and safety of eus-ge. compared with laparoscopic ge (lge), eus-ge not only had almost identical technical and clinical success but also reduced time to oral intake, shorter median hospital stay, and lower rate of adverse events. however, data directly comparing eus-ge to lge are limited. we aimed to compare clinical outcomes between eus-ge and lge in the palliation of malignant goo under a randomized setting.


Eligibility criteria:
inclusion criteria: 1. consecutive patients ≥ 20 years old 2. confirmed unresectable distal gastric or duodenal or pancreatico-biliary malignancies 3. suffering from gastric outlet obstruction with a gastric outlet obstruction score of ≤ 1 4. performance status ecog ≤3 exclusion criteria: 1. unable to give informed consent 2. prior duodenal metallic stent placement 3. severe comorbidities precluding the endoscopic procedure or operation 4. life expectancy of less than 1 month 5. history of gastric surgery 6. linitus plastic 7. multiple-level bowel obstruction confirmed on radiographic studies such as small bowel series or abdominal computed tomography 8. coagulation disorders 9. pregnancy
impact of real-time notification of colonoscopic optical diagnosis on patients' anxiety and depression after polypectomy

Conditions: Colorectal Neoplasms; Colonic Polyp; Anxiety; Depression; Colonoscopy

Summary: the accuracy of endoscopic optical diagnosis for colorectal polyps has been approaching histological diagnosis after implementation of image enhancement endoscopic technologies. the real-time notification of possible nature of resected polyp after colonoscopy is expected to reduce the anxiety and depression level of the patients before the availability of histological diagnosis and improve their quality of life. we designed and conducted a randomized control trial to confirm this hypothesis.

this is a single center, open-label, prospective and parallel randomized controlled trial. this study planning to recruit outpatients from the age of 40 to 79 who are scheduled to undergo sedated colonoscopy. once eligible subjects were diagnosed of colorectal polyps during colonoscopy and received polypectomy, they will be randomized into "ordinary care group (explained at next scheduled clinic)" and "real-time notification group (explained immediately after colonoscopy)". the level of anxiety, depression of the two groups will be measured by using the taiwan version questionnaire of hospital anxiety and depression scale (hads) right before the next scheduled clinic for histological results and compared the difference between the two groups.this study is expected to determine the impact of real-time notification of colonoscopic optical diagnosis on patients' anxiety and depression after polypectomy, and provide evidence to improve post-polypectomy care.

Eligibility criteria:
inclusion criteria: * age of ≥ 40 years and \< 80 years * outpatients who prepare receiving sedated colonoscopy * subjects who have signed informed consent form of this study * informed consensus has been obtained that endoscopic resection should be performed if a colorectal polyp is found * eastern cooperative oncology group (ecog) performance status scale among 0 to 2 exclusion criteria: * subjects with any of the following prior history or current conditions: * (a) contraindications to colonoscopy * (b) major mental illnesses, e.g. major depressive disorder, schizophrenia, generalized anxiety disorder ... * (c) inflammatory bowel disease * (d) hereditary or non-hereditary polyposis syndrome, hereditary non-polyposis colorectal cancer * (e) uncured colorectal cancer * (f) active gastrointestinal bleeding * (g) pregnancy * subjects who do not received polypectomy during colonoscopy.

Keywords: colonoscopy polypectomy image enhanced endoscopy endoscopic optical diagnosis
efficacy verification in early diagnosis and management of lymphedema through home body water analyzer

Conditions: Breast Cancer

Summary: breast cancer is the second most common cancer in women. one in five women who have been treated for breast cancer develop lymphedema. lymphedema is a very common result of breast cancer and its treatment. lymphedema is the build-up of fluid in tissues, which results in tissue swelling. the lymph system is a network of lymph vessels, tissues, and organs that carry extra fluid from your cells/tissues throughout the body. if this lymph fluid is not able to flow in the body how it should, there will be swelling which can lead to lymphedema. it can be classified into stages 0 to 3 depending on the severity of the condition. stages 0 and 1 are reversible, and through early diagnosis and treatment, the recovery to the normal volume and normal skin status of arms can be possible. on the other hand, stage 2 or higher is irreversible, and tissue fibrosis progresses and cannot return to normal skin; therefore, it is important to detect early and start treatment. this is an observational longitudinal study. potential participants will be recruited for follow-up after breast cancer surgery. only patients who fit the inclusion criteria will be considered for participation in the study and contacted by the healthcare provider. standard of care will be used to guide any treatment needed by participants while they are part of the study.


Eligibility criteria:
inclusion criteria: * adults 18 and over who are diagnosed with unilateral breast cancer. * unilateral lumpectomy, unilateral mastectomy, or simultaneous contralateral prophylatic mastectomy within 12 months of enrollment * axillary lymph node dissection or sentinel node biopsy within 12 months of enrollment * adjuvant or neoadjuvant chemotherapy and/or radiation therapy are allowed * breast cancer reconstruction completed or planned is allowed * study participants must own or have access to a smartphone, iphone (ios version 9.0 or above) or android phone (android 8.1 or above). exclusion criteria: * bilateral breast cancer * previous history of breast cancer prior to current diagnosis. * existing diagnosis of lymphedema at the time of enrollment * cellulitis or other active infection at the time of enrollment * adults who are unable to consent. * pregnant women * prisoners * individuals under the age of 18 years old * individuals who are illiterate * individuals who lack the capacity to consent * non-english speakers * individuals with medical implant devices such as pacemakers, or essential support devices such as patient monitoring systems.
modified interactive screening program plus mindbodystrong: a mental health resiliency intervention for nurses

Conditions: Suicide Threat; Burnout, Professional; Depression

Summary: the overall purpose of this study is to evaluate the efficacy of an intervention designed to prevent nurse suicide. this randomized controlled trial will test the modified interactive screening program (misp) alone and the misp combined with a program called mindbodystrong. the misp is a method of screening to detect clinicians at moderate to high risk for suicide and referring them for treatment through an encrypted anonymous on-line platform. mindbodystrong© is an adaptation of a well-tested cognitive-behavioral skills building intervention (also known as cope in the literature) that provides a cognitive-behavior theory-based approach to decrease depression, anxiety and suicidal ideation and improve healthy lifestyle beliefs and behaviors in at-risk populations. mindbodystrong© will involve eight self-paced computerized sessions designed specifically for nurses and clinicians. nurses will be recruited nationally through the professional nursing organizations and health systems.

the study will be the first to test the combination of the misp with a new on-line digitalized version of the previously tested manualized version of the cbsb program (i.e., mindbodystrong©) for nurses. if found to be effective, the combined program will be able to be easily scaled to prevent suicide in nurses and potentially other high-risk populations of clinicians. although cbt is gold standard evidence-based treatment for depression, only a small percentage of affected individuals receive it due to a shortage of mental health providers, which contributes to high depression relapse rates of 50 to 70%. a scalable digitalized intervention could be one key solution to bringing cbt skills to nurses at risk for suicide who could so benefit from them. this randomized controlled trial (rct) will determine the effects of the misp, this adaptation of the american foundation for suicide prevention's (afsp) interactive screening program (isp), combined with the on-line version of the mindbodystrong© program versus the hear program alone on depression, suicidal ideation, burnout, anxiety, post-traumatic stress, healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in u.s. nurses.

Eligibility criteria:
inclusion criteria: * self-identify as a registered nurse * identified as moderate to high risk of suicide by the misp-specific interactive screening program assignment exclusion criteria: * low risk of suicide by the misp-specific interactive screening program assignment * under the age of 18 years * prior participation in mindbodystrong * prior participation in this study

Keywords: nurse suicide depression burnout trauma computerized cbt intervention depression screening