Kornimate/medical-research-clean huggingface dataset:
d2 vs d3 lymph node dissection for left colon cancer

Conditions: Colon Cancer

Summary: the efficiency of the d3 lymph node dissection is still controversial for left colon cancer patients. this study will try find difference in 5-year overall survival between d2 and d3 lymph node dissection. investigation of the functional and short-term outcomes will clarify safety of the d3 lymph node dissection.

discussion about optimal type of lymph node dissection in colorectal cancer continues during last 15 years, when in europe was presented concept of complete mesocolic excision. however, this concepts is very close to japanese d3 lymph node dissection and in the first view it seems the same but principal differences were found. japanese concept is partial resection of the bowel according feeding artery (short bowel specimen, long lymphovascular pedicle), opposite european concept is wide resection of the bowel like hemicolectomy or extended hemicolectomy, sigmoidectomy. in complete mesocolic excision anatomical landmarks are still unclear but in japanese guidelines it has anatomical margins which can standardize this procedure. also nerve sparing technique around root of inferior mesenteric artery was described. one more difference is in histological examination of the specimen. european concept is to pay more attention to the quality of complete mesocolic excision and less - to the number of investigated lymph nodes. in japan lymph node extraction is performed by surgical team from the fresh specimen and send to pathologist separately (each group of lymph nodes). considering the absence of randomized control trials for patients with left colon cancer dilemma trial was started using japanese approach

Eligibility criteria:
inclusion criteria: 1. agreement of the patient to participate in trial 2. colon cancer (only adenocarcinoma ) 3. the tumor located between the splenic flexure and rectosigmoid junction 4. ct3-т4а,b 5. cn0-2 6. cm0 7. tolerance of chemotherapy 8. asa 1-3 exclusion criteria: 1. стis - т2, ст4b (tail of the pancreas, stomach, small bowel, ureter, urinary bladder) 2. preoperative complications of the tumor (perforation and full bowel 3. obstruction) 3. previous radiotherapy or chemotherapy 4. synchronous or metachronous tumors 5. women during pregnancy or breast feeding period

Keywords: d2 d3 lymph node dissection complete mesocolic excision left colon cancer cme
clinical value of microvascular ultrasonography in real-time differential diagnosis of thyrotoxic patients

Conditions: Hyperthyroidism/Thyrotoxicosis

Summary: this study aims to verify the clinical value of thyroid ultrasound with microvascular flow imaging in thyrotoxic patients for differential diagnosis between hyperthyroidism and thyroiditis. we intend to use the rs85 ultrasound device manufactured by samsung medison. graves' disease and painless thyroiditis/subacute thyroiditis are the main cause of thyrotoxicosis. precise discrimination between graves' disease and painless thyroiditis/subacute thyroiditis is clinically very important in determining treatment methods, such as the prescription of antithyroid drugs. primary endpoint was to verify the value of vascularity index, defined by blood pixel in range of image / total pixel in range of image .seondary endpoint was to verify the superiority value of microvascular flow imaging to discriminate thyrotoxicosis patients compared with color doppler/ power doppler ultrasound imaging and conventional ultrasound imaging.

thyrotoxicosis refers to the appearance of various clinical symptoms or signs due to and excessive increase of thyroid hormone in the body. graves' disease, which causes thyrotoxicosis, is one of the most common autoimmune diseases and is known to account for 0.5% of the population. precise discrimination between graves' disease and painless thyroiditis/subacute thyroiditis is clinically very important in determining treatment methods. the microvascular flow imaging technology is expected to show higher sensitivity and accuracy than conventional color doppler images in differentiating patients between graves' disease and painless thyroiditis/subacute thyroiditis. we enrolled thyrotoxicosis patients in their initial presentation and used rs85 ultrasound device manufactured by samsung medison to discriminate graves' disease and painless thyroiditis/subacute thyroiditis. power / color doppler ultrasound imaging and conventional ultrasound imaging were used. tranverse and longitudinal plane of the dominant lobe were selected for imaging. doppler adler's method was used to asscess vascularization. to assess the vascularity index, which is defined by blood pixel in range of image / total pixel in range of image, we selected the total tranverse plane of the thyroid as range of image.

Eligibility criteria:
inclusion criteria: * initial presentation with thyrotoxicosis exclusion criteria: * past history of thyroidectomy * factitious thyrotoxicosis * unable for ultrasound
does simulation scenario execution improve acute care skills and confidence related to maternal and pediatric care emergencies?

Conditions: Maternal, Pediatric Care Emergencies

Summary: in uganda and many countries in sub-saharan africa, health providers have minimal training and intermittent opportunity to maintain skills in managing delivery complications and acute newborn and pediatric conditions. interventions like effective resuscitation assistance at the time of birth are lifesaving. every 30 second delay in establishing effective resuscitation at birth increases the risk of death by 16%. the purpose of this study is to test whether medical simulation can improve acute care skills and confidence related to maternal and pediatric care emergencies.

in uganda and many countries in sub-saharan africa, health providers have minimal training and intermittent opportunity to maintain skills in managing delivery complications and acute newborn and pediatric conditions. interventions like effective resuscitation assistance at the time of birth are lifesaving. every 30 second delay in establishing effective resuscitation at birth increases the risk of death by 16%. the purpose of this study is to test whether medical simulation can improve acute care skills and confidence related to maternal and pediatric care emergencies. a solid body of evidence now supports simulation-based learning as superior to didactic teaching and problem-based learning for the acquisition of critical assessment and management skills, particularly for clinical emergencies. simulation-based training promotes skill acquisition and retention, enhances teamwork, and increases knowledge and understanding of key procedures. simulation-based learning is now the norm in medical, nursing and paramedical training in most high income settings. there remains a critical need to operationalize simulation-based learning in resource-constrained settings

Eligibility criteria:
inclusion criteria: * participants are medical and nursing students in active clinical rotation; third and fifth year medical students and third and fourth year nursing students at mbarara university of science and technology. exclusion criteria: * exclude medical and nursing students in the pre-clinical years and those in non-clinical rotations at the time of the intervention.

Keywords: maternal newborn resuscitation emergencies medical simulation
comparison of intermittent vs. continuous walking in ms

Conditions: Multiple Sclerosis, Endurance

Summary: objective: to compare effects of an intermittent and continuous walking program on walking endurance and fatigue in people with multiple sclerosis (ms).a randomized crossover prospective method was used.the intervention consisted of eight 6-minute-long walks (2x/week for 4 weeks). the continuous condition consisted of 6 continuous minutes of walking. the intermittent condition consisted of three 2-minute bouts with 2-minute rests. after a 4-week detraining period, participants performed the second training condition.


Eligibility criteria:
inclusion criteria: * positive diagnosis of ms * ambulatory for at least 6 minutes with or without an assistive device (e.g. cane, crutches or orthotics) * ability to read, understand, and sign an informed consent form exclusion criteria: * evidence of exacerbation in the prior three months as defined by a treating physician * orthopedic or cardiovascular condition that would interfere with ability to walk for 6 continuous minutes, * currently being on an active physical rehabilitation program
connect cancer survivors with tobacco treatment

Conditions: Tobacco Use; Tobacco Use Cessation; Smoking Cessation; Nicotine Addiction; Tobacco Smoking

Summary: the purpose of this study is to evaluate the comparative effectiveness of two different informatics-enabled implementation strategies on increasing tobacco treatment and improving smoking cessation rates for cancer control and prevention. this will be done via a two-arm pragmatic cluster randomized trial (crt) to test the effectiveness of nudges to change (elevate-s) vs. quit-focused usual care (elevate) in increasing tobacco treatment (use of medication, brief advice, or referral to external counseling) and smoking cessation.


Eligibility criteria:
eligibility criteria: * be receiving care at a participating clinic * report current tobacco use (assessed by the rooming staff during the index visit) * have a completed appointment with a participating clinic * be an adult (at least 18 years old).

Keywords: patient reported outcomes tobacco treatment
a study to compare the glycemic effects, safety, and tolerability of exenatide once weekly to those of sitagliptin and pioglitazone,in subjects with type 2 diabetes treated with metformin (duration - 2)

Conditions: Type 2 Diabetes Mellitus

Summary: this study will compare the benefits of exenatide once weekly treatment to those achieved by the approved antidiabetic therapies sitagliptin and pioglitazone in subjects whose type 2 diabetes is managed with metformin therapy alone. the safety and tolerability of the three treatment regimens will also be compared.


Eligibility criteria:
inclusion criteria: * has been diagnosed with type 2 diabetes mellitus * has a hemoglobin-specific a1c fraction (hba1c) of 7.1% to 11.0%, inclusive, at study start * has a body mass index (bmi)of 25 kg/m2 to 45 kg/m2, inclusive, at study start * has been on a stable treatment regimen of metformin for a minimum of 2 months prior to study start * either is not treated with or has been on a stable treatment regimen with any of the following medications for a minimum of 2 months prior to study start: 1. hormone replacement therapy (female subjects) 2. oral contraceptives (female subjects) 3. antihypertensive agents 4. lipid-lowering agents 5. thyroid replacement therapy 6. antidepressant agents 7. drugs known to affect body weight, including prescription medications (e.g. orlistat \[xenical®\], sibutramine \[meridia®\], topiramate \[topamax®\]) and over-the-counter antiobesity agents exclusion criteria: * has been previously exposed to exenatide once weekly * has donated blood within 60 days of study start or is planning to donate blood during the study * currently being treated, or is expected to require or undergo treatment with any of the following treatment-excluded medications: 1. exenatide (byetta®) or any dipeptidyl peptidase-4 dpp-4)inhibitor, sulfonylurea (su), thiazolidinedione (tzd), or glucagon-like peptide (glp)-1 analog within 3 months prior to study start 2. alpha-glucosidase inhibitor, meglitinide, nateglinide, or pramlintide (symlin®) within 30 days of study start 3. insulin within 2 weeks of study start or for more than 1 week within 3 months of study start 4. systemic corticosteroids by oral, intravenous, or intramuscular route; or potent, inhaled, or intrapulmonary (including advair®) steroids known to have a high rate of systemic absorption 5. drugs interacting with the cyp2c8 enzyme system, including gemfibrozil (lopid®) and rifampin * has received any investigational drug within 1 month (or five half-lives of investigational drug, whichever is greater) of study start * has previously experienced a clinically significant adverse event (e.g., significant edema) related to tzd or dpp-4 inhibitor use

Keywords: diabetes exenatide once weekly byetta sitagliptin januvia thiazolidinedione amylin lilly pioglitazone
ics/laba combination with integrated dose counter and smartphone app to improve asthma control

Conditions: Asthma

Summary: poor adherence to asthma controller medication may link to poor asthma outcome. a metered dose device with built-in dose counter helps physicians to monitor drug compliance in asthma patients. mobile-phone based self management opens a window for better asthma control. the present study aims to investigate the relationship between the adherence to controller medication of combined inhaled corticosteroid/long acting beta2-agonists, assessing by integrated dose counter, and the level of airway inflammation and asthma control. moreover, the investigators also use a new asthma self-management apps to enhance drug compliance. with the application of the new, easily available tools, the investigator expect to increase adherence rates, and hence, to reduce airway inflammation and improve the level of asthma control.

the study will be conducted as a prospective, observational, open labeled, randomized trial in a single center (taipei veterans general hospital). after screening, the enrolled patients will be randomized to either routine care or smartphone self management group. in the routine care group, the patient will be treated as routine practice as a real-world setting. no additional intervention will be done. in the smartphone self management group, an asthma self management apps (my asthma app, glaxosmithkline, chinese version, or line), which provides multiple function, including health information (real-time weather condition, air pollution index) at the point-of-living, personalized health assessments (asthma control test, peak flow rate) and interactive action plans (green, yellow, and red light), and regular reminding for controller administration, will be downloaded to the participant's smartphone. the participant will be educated to operate the apps to improve asthma control. participants in both groups will use identical controller (sal/flu 2 inhalations twice daily plus as-needed rescue ventolin) and will be scheduled to follow up for 24 weeks.

Eligibility criteria:
inclusion criteria: 1. symptomatic asthmatics free of controller medication for at least 3 months 2. aged from 20 to 70 years 3. life-long smoking index \< 10 pack-years exclusion criteria: 1. copd, clinically overt bronchiectasis, lung cancer, active tuberculosis, or other known specific pulmonary disease. 2. a chest x-ray indicating diagnosis other than asthma that might interfere with the study. 3. major disease abnormalities are uncontrolled on therapy. 4. alcohol or medication abuse. 5. patients had lower respiratory tract infections or received systemic steroid in the 4 weeks prior to the commencement of study. 6. unable or unwilling to comply with all protocol 7. unable to use smartphone

Keywords: asthma control adherence asthma self management plan airway inflammation
evaluation of muscle involvement in systemic sclerosis

Conditions: Systemic Sclerosis

Summary: muscle involvement is poorly described in patients with systemic sclerosis (ssc) . the prevalence of muscle damage is evaluated at 5-95 % of ssc patients, particularly due to variable definitions depending on the series in the scientific litterature. muscle clinicobiological and histological presentation an response to immunosuppressive treatments are highly variable. muscle involvement defined by creatinine kinase (ck) elevation, the presence of electromyography (emg) abnormalities and/or muscle magnetic resonance imaging (mri) hyperintensities and/or muscle biopsy inflammation appears to be associated with diffuse ssc, the presence of cardiac damage, and anti-pm-scl antibodies. the main objective is to describe muscular manifestations associated with ssc. secondary objectives are: * to compare characteristics between ssc patients with and without muscle involvement * to determine homogeneous groups of ssc patients with muscle involvement


Eligibility criteria:
inclusion criteria: * patients with systemic sclerosis according to 2013 acr/eular classification criteria
the effect of dexmedetomidine analgesia and sedation in minimally invasive spine surgery under local anesthesia

Conditions: Spinal Diseases; Local Anesthesia

Summary: evaluate safety and efficacy of dexmedetomidine in minimally invasive spine surgery under local anesthesia sedation.explore the appropriate concentration of dexmedetomidine, whether or not can reduce the amount of local anesthetics.


Eligibility criteria:
inclusion criteria: * sign the informed consent； * american society of anesthesiologists (asa)classification:class i\~ii;elective minimally invasive spine surgery； * age ≥18 years old, weighing 45 \~ 80 kg, height 151 \~ 185 cm; * hypertension within ⅱ grade, or controlled with drugs within ⅱ level； * diabetes fasting in 8.3mol/l or less exclusion criteria: * dex allergy; * change anesthesia preoperative or intraoperative ; * metabolic disorders, anemia has not been corrected; * recent patients receiving sedatives and antidepressants; * degenerative diseases of the central nervous elderly persons; * serious central nervous system diseases (acute stroke, uncontrolled epilepsy, severe dementia); * hypovolemia; 8) unstable angina or acute myocardial infarction; * left ventricular ejection fraction less than 30%, heart rate lower than 45bpm; * ii-iii degree heart block; * acute hepatitis or severe liver disease (liver function c level); * patients with renal insufficiency randomly assigned to receive treatment, but if patients need dialysis test is excluded or interruption ;

Keywords: dexmedetomidine prone position spine surgery minimally invasive local anesthesia
mechanism of aphakic and pseudophakic glaucoma in pediatric patients

Conditions: Congenital Cataract; Aphakic or Pseudophakic Glaucoma

Summary: in cell cultures, lens epithelial cells and trabecular meshwork cells will be exposed to aqueous humor from pediatric eyes undergoing cataract removal surgery. cytokine analysis of candidate factors will be performed before and after exposure to lens epithelial.

aqueous from the anterior chamber will be withdrawn before surgery. then the lens capsule will be opened (capsulorhexis) and removed. the lens material will be removed. all 3 components will be sent to the lab. lens epithelial cells will be isolated and will be used in a co-culture setup with trabecular cells to investigate the interactions between lens cells and trabecular cells. understanding the interaction between young and adult lens cells on trabecular cell will shed light on mechanism of infantile aphakic glaucoma. aqueous humor taken out before cataract surgery and before glaucoma operation of aphakic eyes will be used for analysis of growth factor and cytokines in the aphakic eye using proteins membrane arrays. eyes before cataract surgery will be used as controls. such analysis will shed light on the possible factors affecting trabecular cells in aphakic eye.

Eligibility criteria:
inclusion criteria: * children with congenital cataract and are going to do removal surgery * children with aphakic or pseudophakic glaucoma and are going to do glaucoma surgery * both of parents are able to sign the informed consent form exclusion criteria: * patients with other eye diseases apart from congenital cataract(in children with congenital cataract) and aphakic or pseudophakic glaucoma (in children with aphakic or pseudophakic glaucoma)

Keywords: congenital cataract aphakic pseudophakic glaucoma pediatric patients
availability of spine neuronavigation in africa

Conditions: Spine Disease

Summary: in this study, the availability of spine neuronavigation in africa was evaluated. access to surgical equipment is an important goal of global surgery and global neurosurgery. the study findings show that there are regional differences in access to spine neuronavigation techniques and highlight that the major barriers to increased prevalence are cost and lack of trained personnel.


Eligibility criteria:
inclusion criteria: * neurological and orthopedic surgery residents, fellows and consultants working in africa. exclusion criteria: -

Keywords: access africa computer-assisted surgery neuronavigation spine surgery
study of erythromycin in ger-associated apnea of the newborn

Conditions: Gastroesophageal Reflux; Apnea; Bradycardia

Summary: to evaluate the relationship of reflux and apnea and to determine whether the administration of erythromycin improves the incidence of ger and ger-associated apnea, bradycardic and/or desaturation events in a prospective randomized controlled trial.

a randomized placebo-controlled trial to determine whether erythromycin, a drug known to enhance gut motility, will improve the incidence of ger and ger-associated apnea, bradycardiac and/or hypoxic events. the investigators have two aims: 1) to examine the relationship between ger and apnea, bradycardia, and/or desaturation (abd) events by simultaneously employing a unique computer algorithm developed at the university of virginia to measure abd events and an multi-channel intra-luminal impedance (mii) ph monitoring to measure ger episodes. 2) in a randomized placebo-controlled trial, the investigators will study whether erythromycin decreases ger and ger-associated apnea, bradycardia and/or hypoxia in premature infants.

Eligibility criteria:
inclusion criteria:infants admitted to neonatal intensive care unit who are \ 14 days of age, non-intubated, on full feeds for 3 days with one of the following: * any apnea, bradycardia, or desaturation (abd) event, or * documented symptoms of reflux exclusion criteria: * major central nervous system, gastrointestinal, or complex cardiac anomalies

Keywords: neonate apnea preterm reflux gastroesophageal reflux impedance erythromycin desaturation bradycardia hypoxia