Kornimate/medical-research-clean huggingface dataset:
the hemodynamic effect between two types of anesthesia in esophageal surgery

Conditions: Epidural Block; Oesophageal Cancer; Oesophagectomy

Summary: continuous paravertebral block (pvb) was reported to provide less episodes of hypotension than continuous thoracic epidural block (teb). the maintenance of optimal tissue perfusion is essential for esophageal anastomosis in patients undergoing oesophagectomy. the aim of this study is to compare hemodynamic effect of continous pvb compared to teb , in patient undergoing oesophagectomy with laparoscopy and thoracotomy.


Eligibility criteria:
inclusion criteria: * asa score 1 to 3 * oesophagectomy : abdominal time with laparoscopy ans thoracic time with thoracotomy exclusion criteria: * pregnancy * uncooperative patient * patient refusal * coagulopathy * allergy to local anesthetic * psychological disorders * failure to install the epidural or paravertebral catheter. the patient will therefore be excluded secondarily but will be able to benefit from an alternative technique for the management of his pain. * sepsis * skin infection at the puncture site * allergy to local anesthetics * esophagectomy with cervical surgical time * patient with chronic pain eva\> 4 before surgery.

Keywords: hemodynamic effect para vertebral block
a web-based dyadic intervention for colorectal cancer

Conditions: Colorectal Carcinoma

Summary: this clinical trial studies how well a web-based dyadic intervention works to manage psychoneurological symptoms for patients with colorectal cancer and their caregivers. patients with colorectal cancer receiving chemotherapy experience severe and distressing psychoneurological symptoms that include fatigue, depression, sleep disturbance, pain, and cognitive dysfunction. when these co-occurring symptoms are undertreated, they negatively affect functional status, survival rates, and quality of life of patients as well as decrease health outcomes of their family caregiver. a critical need exists to develop an effective and novel intervention that focuses on patients with colorectal cancer receiving chemotherapy and their caregivers. a web-based dyadic intervention holds great promise to reduce psychoneurological symptoms burden and improve quality of life for patients with colorectal cancer receiving chemotherapy and advance intervention development and implementation in cancer supportive care and health equity.

primary objectives: i. to develop a web-based dyadic intervention for patients with colorectal cancer receiving chemotherapy and their caregivers (crcweb). ia. determine tailored contents by identifying needs and supports for a web-based dyadic intervention using interviews with patient-caregiver dyads (n=8); ib. develop a prototype of a web-based dyadic intervention program (crcweb); ic. test the usability (e.g., design, navigation, structure, language) of crcweb prototype using interviews with 4 dyads (in aim ia). ii. evaluate the feasibility and acceptability of crcweb for patients with colorectal cancer receiving chemotherapy and their caregivers in 20 dyads in a pilot clinical trial. iii. evaluate the preliminary effects of crcweb on the primary outcome (i.e., attrition, adherence, acceptability, fatigue, depression, sleep disturbance, pain, and cognitive dysfunction) and secondary outcomes (i.e., quality of life) for patients with colorectal cancer receiving chemotherapy and their caregivers in 20 dyads in a pilot clinical trial. outline: patients and caregivers attend a crcweb intervention over 8 weeks. patients and caregivers complete interviews and surveys throughout the trial.

Eligibility criteria:
inclusion criteria patients: * age \>= 18 years * diagnosed with colorectal cancer * life expectancy \> 12 months * receiving active chemotherapy * self-reported at least two psychoneurological symptoms (based on the symptom measures' cutoff scores) * identified primary caregiver (i.e., family members or significant others identified by the patients as their primary source of emotional and physical support) * access to the internet * fluent in english caregivers: * age \>= 18 years * primary caregiver * access to the internet * fluent in english exclusion criteria patients: • karnofsky performance scale \< 50 caregivers: • have severe diseases (e.g., cancer, heart disease)
18f-fdg and 68ga-fapi pet/ct in crohn's disease

Conditions: Crohn Disease

Summary: intestinal stricture is a complication of crohn's disease (cd), which is thought to be the result of chronic transmural inflammation combined with a dysregulated wound-healing process. while inflammatory strictures may respond to anti-inflammatory treatment, fibrotic strictures are usually anti-inflammation resistant, requiring further endoscopic balloon dilation or surgical intervention. therefore, to determinate the inflammatory or fibrotic nature of intestinal stricture is a key step in the treatment of cd. 18f-fdg is a radiotracer reflecting the glucose metabolism of disease and is usually accumulated in inflammatory disease. 68ga-fapi is a novel radiotracer that specifically targets fibroblast activation protein (fap). fap is a membrane glycoprotein expressed on activated fibroblasts, which are key cells in the process of fibrotic intestinal stricture of cd. in this study, we hypothesis that the inflammatory or fibrotic nature of intestinal stricture can be non-invasively evaluated by 18f-fdg and 68ga-fapi pet/ct in patients with cd.

patients with intestinal stricture will undergo 18f-fdg and 68ga-fapi pet/ct on two consectutive days. the accumulation of 18f-fdg and 68ga-fapi at the site of stricture will be determined by standard uptake value (suv), molecular volume (mv), and total molecular index (tmi). in patients with a planned surgical resection of one or more stricture (s), the image results will be compared with histological findings.

Eligibility criteria:
inclusion criteria: * written informed consent signed * crohn's disease patients with proofs of intestine stricture by other modalities, e.g. mri, ct, ultrasound, and/or endoscopy. exclusion criteria: * known hypersensitivity to any of the excipients of 18f-fdg and 68ga-fapi. * if the patients are on metformin, discontinuation of 48 hours is required before 18f-fdg injection to minimize the bowel uptake. * pregnant or breast-feeding women. * any mental condition rendering the patient unable to understand the nature, scope, and possible consequences of the study, and/or evidence of an uncooperative attitude.
the effect of an evidence-based physiotherapy regimen for patients with rotator cuff tendinopathy

Conditions: Tendinopathy; Shoulder Impingement Syndrome; Shoulder Pain; Subacromial Impingement

Summary: primary aim of this study is to investigate wether an evidence-based physiotherapy regimen is more effective than standard care in patients referred for arthroscopic surgery of the shoulder. it is hypothesized that a multimodal physiotherapy regimen will relieve pain, improve shoulder function and reduce the need for subacromial decompression surgery of the shoulder compared to standard care/wait and see controls.

there has been a fourfold increase in surgery rates for non-traumatic shoulder disorders , despite increasing evidence demonstrating that there is no difference in effect between physiotherapy based- and surgical interventions. the target population for this study is patients suffering from rotator cuff tendinopathy waiting for subacromial decompression surgery at a university hospital in norway. during this waiting period , study participants will be randomly assigned to standard follow up or a physiotherapy regimen in primary care. we want to compare the effect of a structured physiotherapy regimen consisting of heavy slow resistance exercises, stretching, manual mobilization and low level laser therapy to standard follow up.

Eligibility criteria:
inclusion criteria: patients on need for surgery ( placed at surgical waiting list at hospital or referred to surgery by their gp ) 1. typical history with difficulties working with arms elevated over the head, and pain located in the upper segment of c5 dermatome. 2. symptom duration of minimum 3 months. 3. three or more reproducible signs of rotator cuff tendinopathy / subacromial impingement: * positive isometric abduction and/or lateral rotation (ombregt, bisschop \& veer, 2003) * painful arc during active abduction (ombregt, bisschop \& veer, 2003) * positive neers sign (neer, 1972 ; tennent, beach \& meyers, 2003) * positive jobes test (jobe \& moynes, 1982 ; tennent, beach \& meyers, 2003) * positive hawkins-kennedy impingement test (hawkins \& kennedy, 1980) exclusion criteria: 1. shoulder pain due to trauma, e.g. fall. 2. reduced rom consistent with adhesive capsulitis/frozen shoulder 3. history in combination with examination and tests (apprehension/relocation), giving reason to suspect pathological instability 4. full thickness rupture of rotator cuff tendon 5. oa of the glenohumeral joint, os acromiale with decreased space of the subacromial space, previous fractures in the shoulder complex or shoulder surgery on the symptomatic side. 6. subjects with other comorbidity: rheumatological or neurological disease, fibromyalgia or symptoms from the cervical spine 7. subjects suffering from serious psychiatric illness. 8. subjects unable to understand english or norwegian. 9. less than 3 positive reproducible sings of rotator cuff pathology / subacromial disease.

Keywords: shoulder tendinopathy subacromial impingement syndrome rotator cuff tendinopathy supraspinatus tendinopathy
dose escalation trial of dalotuzumab (mk-0646) in advanced solid tumors and multiple myeloma (mk-0646-001)

Conditions: Solid Tumor; Multiple Myeloma

Summary: this study will look for the highest tolerated dose of dalotuzumab (mk-0646) given as weekly, every other week. or a every three week infusion. the hypothesis of this study is that administration of dalotuzumab as a one- to two-hour weekly, every other week, or every three week infusion in participants with advanced cancer will be generally safe and tolerated at a dose which achieves a trough concentration ≥3 μg/ml.

trial duration of treatment: participants can be treated for up to two years if their disease has not progressed and they are not having unmanageable side effects.

Eligibility criteria:
inclusion criteria: * participant has metastatic or locally advanced solid tumor or multiple myeloma * tumor specimen has igf-1r expression * participant agrees to use birth control throughout study exclusion criteria: * participant must not be recovering from antineoplastic therapy in the last 4 weeks * participant has participated in a clinical trial in the last 4 weeks * participant has a history of heart problems such as congestive heart failure, angina, heart attack or stroke in the last 3 months * participant is taking growth hormone or growth hormone inhibitors * if female, participant is pregnant or breastfeeding * participant is human immunodeficiency virus (hiv) positive * participant has a history of hepatitis b or c
uric acid and the endothelium in ckd

Conditions: Kidney Disease

Summary: this study will test the hypothesis that uric acid impairs the function of vessels in patients with kidney disease

the purpose of the study is to understand the effect of lowering serum uric acid levels on vascular function in individuals with chronic kidney disease by comparing the effects of: 1) allopurinol therapy and 2) placebo. patients will receive: 3 month study drug (either allopurinol or placebo), with assessment of serum uric acid levels and vascular function.

Eligibility criteria:
inclusion criteria: * individuals with moderate chronic kidney disease (ckd stage iii) with estimated glomerular filtration rates between 30-60 ml/min/ 1.73m2 * elevated uric acid levels * age range: more than 18 years old * ability to give informed consent * albumin \> 3.0 g/dl * bmi \< 40 kg/m2 exclusion criteria: * life expectancy \< 1.0 years * expected to undergo living related kidney transplant in 6 months * pregnant, breast feeding, or unwilling to use adequate birth control * history of severe liver disease * history of severe congestive heart failure * history of hospitalizations within 3 months * active infection, on antibiotics * history of warfarin use or other medications that are contraindicated with allopurinol * uncontrolled hypertension * history of acute gout on allopurinol * history of adverse reaction to allopurinol * immunosuppressive therapy within the last 1 yr

Keywords: uric acid kidney disease endothelial dysfunction
evaluation of bema® buprenorphine nx for buprenorphine induction of opioid dependent subjects

Conditions: Opioid Dependence

Summary: this is a randomized, double blind, placebo controlled study in opioid dependent subjects. subjects meeting entry criteria will be treated with multiple doses of b-bnx or b-placebo, with non-responders rescued within 6 hours. open treatment b-bnx will be administered as follow-up therapy. clinical efficacy assessments include the clinical opioid withdrawal scale (cows), subject-rated assessments, and a urine drug screen.


Eligibility criteria:
inclusion criteria: * signed informed consent obtained prior to any study procedure being performed * subject is a male or non-lactating female with a negative urine pregnancy test * subject is aged 18 to 65 years, inclusive * current diagnosis of opioid dependence or addiction per the diagnostic and statistical manual of mental disorders - 4th edition (text revision) (dsm-iv-tr) criteria including physical dependence on opioids * daily short-acting opiate use of at least 60 mg morphine equivalent no opioid use for at least 12 hours prior to screening with positive opiate result on urine drug screen * clinical opioid withdrawal scale (cows) score ≥9 * subject is in good general health in the judgment of the investigator as determined from the physical and oral examination findings. exclusion criteria: * use of a long-acting opioid within the last 72 hours * use of an investigational drug or device within the last 30 days * history of hypersensitivity, allergy, or intolerance to buprenorphine, naloxone, or related drugs * immediate suicidal risk, as determined by meeting any of the following: 1. history of suicidal ideation ≤ 3 months prior to baseline with a score of 4 (intent to act) or 5 (specific plan and intent) on the ec-ssrs 2. history of suicidal behavior ≤1 year prior to baseline (actual attempt, interrupted attempt, aborted attempt and/or preparatory acts/behavior) on the ec-ssrs * a history or current evidence of any clinically significant disorder or any other condition which in the opinion of the investigator, would jeopardize the safety of the subject or impact the validity of the study results
transthoracic echocardiography of ventricular function of parturients in labor

Conditions: Obstetric Labor Complications; Cardiovascular Diseases in Pregnancy; Cardiovascular Risk Factor

Summary: this echocardiography study will characterize heart structure and function during labor. imaging of the heart during the stress of labor could increase detection of subclinical cardiovascular disease using advanced imaging techniques. cardiac serum biomarkers and complication rates will also be measured and compared between patients with and without evidence of cardiovascular disease on echocardiography.


Eligibility criteria:
inclusion criteria: * all healthy parturients 18 years of age or older with estimated gestation greater than or equal to 37 weeks who are expected to deliver during their hospitalization. * during the echocardiographic exam, the patient must be in active labor with cervical dilation between 6-10 cm and contractions that are spaced less than 5 minutes apart. exclusion criteria: * known functional or structural heart disease * previously diagnosed pulmonary hypertension. * comorbid disease other than diet controlled gestational diabetes, uncomplicated obesity, mild asthma and euthyroid patients with a history of hypo or hyperthyroidism. * parturients endorsing active use of non-prescription mind-altering drugs including cocaine, methamphetamine, or ketamine. * other non-inclusion criteria include inability to tolerate left lateral positioning either symptomatically or by fetal heart rate monitoring, suspected hypo-or hypercoagulable states that was not previously diagnosed, hemodynamic instability requiring \>2 l crystalloid administration within 1 hour time frame after epidural placement or vasopressor administration of \>15 mg ephedrine or \>300 mcg phenylephrine administration within 1 hour after epidural placement.
renal resistive index post-operative complications in major surgery?

Conditions: Major High Risk Operations; Renal Resistive Index; Outcome

Summary: an observational trial aiming to verify whether does any relationship exist between renal resistive index and postoperative outcome in major high risk surgery

renal resistive index was measured just after major high risk operations and then patients were observed searching for any surgical and medical-related complications during the first post-operative week

Eligibility criteria:
inclusion criteria: * age \> 18 years * major surgical operations exclusion criteria: * age \< 18 years
the heartrunner trial

Conditions: Out-Of-Hospital Cardiac Arrest

Summary: the study will assess 30-day survival for cases where volunteer citizen responders ('heart runners') were activated through a smartphone app to retrieve an aed in case of suspected out-of-hospital cardiac arrest (ohca) versus standard emergency medical services care. the study will randomize emergency medical dispatch center incoming calls which are suspected out-of-hospital cardiac arrest, such that half will be randomized to activation of heart runners and half to no activation of heart runners (standard care). the study will also assess physical or psychological risks involved for the activated heart runners.

chances of survival after out-of-hospital cardiac arrest decrease 10% per minute from collapse until defibrillation. activating volunteer citizens through the emergency medical dispatch center can potentially increase rates of bystander defibrillation and survival. the heartrunner trial will investigage the effect of activating registered volunteer citizens through a mobile app integrated with the emergency medical services on 30-day survival following out-of-hospital cardiac arrest. both arms will receive standard care by the emergency medical services. the intervention arm will additionally receive the activation of volunteer citizen responders. the randomization will take place independently in 3 different strata according to heart runner distance to ohca (\ 9 min). the trial will also assess whether it is safe, both physically and psychologically, to activate volunteer citizen responders to respond to out-of-hospital cardiac arrests.

Eligibility criteria:
inclusion criteria: * all out-of-hospital cardiac arrests recognized by emergency medical dispatcher and where the heartrunner system is activated. * non-traumatic etiology, this excludes intoxication, drowning or suicide. * age \> 7 years exclusion criteria: * caller is not in direct contact with the patient * if emergency medical dispatcher deems aed is not indicated, e.g., in nursing homes where trained personal is present. * ohcas not treated by the ems due to ethical reasons or obvious signs of death * ohcas with no heart runners within 1800 meters * not true cardiac arrest (suspected, but not verified) * ems-witnessed ohcas emergency medical dispatchers are instructed not to activate heart runners in case any of the exclusion criteria above. however, since it can be challenging for emergency medical dispatchers to gather sufficient information about the patient within the first few minutes, heart runners will admittedly be activated even though they should not have been. since randomization will occur for all cases in which a heart runner is activated, cases with any of the exclusion criteria will be secondarily excluded. these cases will be accounted for but not included in analyses of outcome. our pilot study showed approximately 60% of suspected cardiac arrests were true cardiac arrests. therefore, we expect 40% of cases for which heart runners were dispatched not to be true cardiac arrests.
isolating and testing circulating tumor dna and soluble immune markers during the course of treatment for lung cancer

Conditions: Lung Cancer; Lung Neoplasms; Cancer of Lung; Cancer of the Lung; Neoplasms, Lung; Neoplasms, Pulmonary; Pulmonary Cancer; Pulmonary Neoplasms; Carcinoma, Non-small-cell Lung; Adenocarcinoma; Squamous Cell Carcinoma

Summary: the purpose of this study is to explore the detection of circulating tumor dna, soluble immune markers, and the evaluation of peripheral blood mononuclear cells (pbmc).

our plan is to collect blood from patients with advanced stage lung cancer who are scheduled to undergo systemic therapy. in this study we will utilize a novel technology for circulating tumor dna detection in order to evaluate their presence in patients with lung cancer by comparing blood samples at six time points. we will obtain baseline blood and then collect blood at five time points during the course of the patient's chemotherapy treatments and at the end of treatment. these same blood collections will be used for the detection of soluble immune markers and evaluation of pbmcs.

Eligibility criteria:
inclusion criteria: * advanced (non-resectable) malignancy in the thorax * age \>18 years old * willing and able to provide consent * no prior history of neoadjuvant therapy exclusion criteria: * age \<18 years old * unable to provide consent * patients with hemoglobin less than 10 g/dl (to minimize the impact of potential iatrogenic anemia)

Keywords: chemotherapy