Kornimate/medical-research-clean huggingface dataset:
hepatic histology and metabolism following total pancreatectomy and pancreaticoduodenectomy

Conditions: Total Pancreatectomy; Pancreaticoduodenectomy; Pancreatic Diabetes; Non-Alcoholic Fatty Liver Disease; Metabolic Complication; Diabetes Mellitus

Summary: the objective of the study is to investigate the development of nafld following total pancreatectomy and pancreaticoduodenectomy and to explore the histological and metabolic changes following the procedures.

after total pancreatectomy patients are treated with exogenous insulin and pancreatic enzyme supplementation in order to treat the endocrine and exocrine insufficiencies inherently occurring postoperatively. in addition to secondary diabetes and insufficient digestive capacity, totally pancreatectomised patients face a high risk of developing non-alcoholic hepatic steatosis. under normal circumstances non-alcoholic fatty liver disease is regarded as the hepatic manifestation of metabolic syndrome and pathophysiologically related to excess energy intake and insulin resistance resulting in fat accumulation in adipose tissue as well as in the liver. thus, the high incidence of hepatic steatosis following total pancreatectomy is surprising as patients typically are lean, peripherally insulin sensitive and properly insulinised.interestingly, the pancreatic hormone glucagon has been implicated in lipid metabolism and recent human data from studies investigating the effect of glucagon receptor antagonism suggest that glucagon signalling may be essential for maintaining a fat-free liver. this makes the investigators speculate that the decreased glucagon levels following pancreatic surgery may play a hitherto unrecognised role in the development of hepatic steatosis after the operation. the study will include 33 patients scheduled for pancreatectomy (total or pancreaticoduodenectomy). they will be followed for one year. a liver biopsy will be collected during the operation on all patients. after 12 months, participants will undergo magnetic resonance spectroscopy and those who have hepatic lipid content ≥2% will undergo an ultrasound-guided percutaneous liver biopsy. furthermore, all participants will undergo a metabolic evaulation after one year.

Eligibility criteria:
inclusion criteria: * subject scheduled for total pancreatectomy or pancreaticoduodenectomy * informed consent signed prior to any study-related procedure exclusion criteria: * known liver disease before total pancreatectomy or pancreaticoduodenectomy (excluding nafld) * severe co-morbid disease (besides from the indication for the pancreas surgery) * pregnancy * any condition that the investigator feels would interfere with the safety of the trial participation or the safety of the subject * metastatic disease percutaneous liver biopsy exclusion criteria (to be evaluated before last visit) * mr spectroscopy demonstrating lipid content \<2% * haemoglobin \<6 mmol/l * inr \>1.5 * trombocytes \<40 × 109/l * skin infection in area where biopsy will be sampled

Keywords: liver biopsy lipid metabolism glucose metabolism postoperative complications pancreatic surgery
l-citrulline supplementation pilot study for overweight late onset asthmatics

Conditions: Asthma

Summary: in people who develop asthma after the age of 12 and who are also overweigh, there can be an increased burden of asthma symptoms, more flare-ups, and poorly-controlled asthma when compared to normal weight asthmatics. certain factors are more abundant in the blood of individuals who are obese. one such factor is derived from the metabolism of an amino acid found in your diet, which is known as l-arginine (amino acids are most commonly known as the building blocks of proteins, the same as the proteins found in food). this factor is called asymmetric dimethylarginine or adma. the balance of l-arginine to adma may be important to the health of subjects with asthma. the balance between l-arginine and adma plays an important role in producing nitric oxide (no) in the airways. no is normally produced in the lung and plays a major role in maintaining airways open and functioning normally. our research has shown that in subjects with asthma who are overweight and developed asthma later in life, the combination of low l-arginine and high adma, may lead to lower no levels. we are asking participants in this study to take l-citrulline, which is converted to l-arginine by your body, as a supplement for a period of one week. we anticipate that l-citrulline will restore no levels in the airways, by increasing the ratio of l-arginine to adma


Eligibility criteria:
inclusion criteria: * male and female patients, 18-75 yrs old, from all racial/ethnic backgrounds * diagnosis of asthma for \>1 yr * bmi ≥ 30 * baseline pre-bronchodilator fev1 between 60 and 90% predicted with a 12% or greater bronchodilator response to 4 puffs of albuterol * smoking history \<20 pack years and no smoking in the last year * able to identify age of asthma onset exclusion criteria: * respiratory tract infection within the last 4 weeks; * oral cs burst within the last 4 weeks or regular systemic cs use * hospitalization within the last 3 months * er visit within the 4 weeks * significant or uncontrolled concomitant medical illness including (but not limited to) heart disease, cancer, diabetes * current smoking or within the previous 12 months * current use of statins for the past 30 days (statins lower adma levels) * pregnancy * intolerance or allergy to l-arginine or l-citrulline * phosphodiesterase inhibitors * taking oral nitrates

Keywords: l-citrulline adma asthma obesity
evaluation of polygenic risk score for epithelial ovarian cancer risk prediction: the prove study

Conditions: Ovarian Cancer

Summary: the goal of this observational study is to evaluate whether polygenic risk score (prs) assessment can help predict the onset of epithelial ovarian cancer in women aged over 18, comparing those with a histologically confirmed diagnosis of epithelial ovarian or fallopian tube cancer (cases) to women with no personal history of ovarian cancer (controls). the main questions it aims to answer are: * is there an association between prs and the presence of epithelial ovarian cancer? * can prs improve the prediction of ovarian cancer risk when adjusted for other clinical factors? researchers will compare prs values between cases and controls to see if higher prs percentiles are associated with an increased risk of ovarian cancer. participants will: * complete a questionnaire on socio-economic status, lifestyle, and dietary habits. * undergo blood sampling, for the analysis of brca1-2, palb2, rad51c, rad51d pathogenic variants. * undergo prs analysis.


Eligibility criteria:
inclusion criteria: * for cases: women with a first-time diagnosis of histologically confirmed epithelial ovarian or fallopian tube cancer. * for controls women with no concomitant or past oc diagnosis. exclusion criteria: * for both cases and controls: the presence of concurrent malignancies other from oc.

Keywords: polygenic risk score ovarian cancer case-control
maintenance targeted therapy with or without stereotactic body radiation therapy for stage iv non-small cell lung cancer

Conditions: Stage IV Non-small Cell Lung Cancer

Summary: this is a prospective, multicenter, randomized controlled study to evaluate stereotactic body radiation therapy (sbrt) as a potential treatment for stage iv non-small cell lung cancer (nsclc) that has a mutated epidermal growth factor receptor (egfr) and has been receiving treatment with a targeted agent such as gefitinib, erlotinib and icotinib.


Eligibility criteria:
inclusion criteria: 1. patients must have biopsy proven metastatic nsclc (stage iv). 2. patients must have received first line chemotherapy, from 4-6 cycles, and achieved stable disease or a partial response. 3. patients receiving first-line erlotinib, gefitinib, or icotinib for egfr mutant-positive for 3 months and achieved stable disease, partial response or completely response. 4. age 18 to 75 years old. 5. patients must have measurable disease at baseline. 6. the amount of metastatic focus \<5. 7. ecog score 0-2 8. adequate normal organ and marrow function for tki treatment and radiotherapy. 9. patients must has sensitizing egfr mutation (e.g. exon 19 deletion or exon 21 l858r) 10. patients must provide written informed consent to participate in the study. exclusion criteria: 1. patients who previously received radiotherapy to the primary site. 2. patient can't tolerate radiotherapy or targeted therapy; 3. pregnant or nursing women
combined effects of nutritional and exercise countermeasures

Conditions: Muscular Atrophy; Muscle Weakness

Summary: the purpose of this study is to see if a combination of resistance exercises and amino acid capsules can reduce muscle loss and maintain muscle function during bedrest. this experiment will imitate many of the physical conditions experienced by astronauts during space flight by examining the effects of resistance exercise or nutrition on muscle during 2 days of bedrest. the diet of astronauts will also be imitated by providing diets in the general clinic research center.


Eligibility criteria:
inclusion criteria: * 18-50 years of age * availability of transport and ability to report to research center at appointed times exclusion criteria: * subjects with limiting or unstable angina or a cardiology confirmed ecg which demonstrates cardiac abnormalities such as \> 0.2 mv horizontal or downsloping st segment depression, frequent arrhythmia's (\>10 pvc/min), or valvular disease. * subjects with vascular disease as determined by a combination of risk factors of peripheral atherosclerosis, namely hypertension, obesity, diabetes, hypercholesterolemia and/or evidence of venous or arterial insufficiency upon palpitation of femoral, popliteal, and pedal arteries. * any history of hypo- or hyper-coagulation disorders including subjects taking coumadin or with a history of dvt or pe at any point in their lifetime. * any subject that has a chronically elevated systolic pressure \>170 or a diastolic blood pressure \> 100 will be excluded. subjects may be included if they are taking blood pressure medication and have a blood pressure below these criteria. * any subject with an uncontrolled metabolic disease including liver or renal disease. * fasting blood glucose of \>126 mg/dl on two separate occasions * presence of acute illness or metabolically unstable chronic illness. * any subject currently on weight-loss diet. * inability to abstain from smoking for duration of study. * recent ingestion of anabolic steroids (within 6 months). * subjects with atrial fibrillation, history of syncope, angina or congestive heart failure. * subjects with a recently (6 months) treated cancer other than basal cell carcinoma. * pregnancy/lactation. * any other condition or event considered exclusionary by the pi and covering faculty

Keywords: muscle loss and maintenance of muscle function
powered assist to improve ambulation in severe lung disease

Conditions: Lung Disease Chronic

Summary: chronic respiratory disease (crd) is among the most prevalent and growing diseases worldwide with disabling consequences. many with a compromised respiratory system cannot support the metabolic energy demands of walking causing them to walk slowly and stop often. those with crd could receive substantial benefit from a powered wearable exoskeleton device that assumes part of the energy of walking. assisting the legs will lower the metabolic energy demands, and therefore the ventilation required for exercise, thereby allowing them to walk faster and further. proposed is a series of single-case experiments comparing walking endurance with and without a powered exoskeleton assist. the aim of this study is to determine the efficacy of an exoskeleton on walking endurance in ventilatory limited patients with crd. an exoskeleton could be a novel immediate and long term strategy to augment walking as part of the spectrum of pulmonary rehabilitation and community reintegration.


Eligibility criteria:
inclusion criteria: * stable chronic respiratory disease * modified medical research council dyspnoea score (mmrc) ≥ 2 exclusion criteria: * evidence of cardiac rhythm or circulatory compromise * myocardial infarct within the previous three months * moderate-severe aortic stenosis * uncontrolled hypertension * sustained cardiac arrhythmias * untreated neoplasia * lung surgery within the previous three months * any other predominant co-morbidities or treatments that might influence walk testing * body size outside of exoskeleton fit specifications * skin sores or skin breakdown in the area where the device is worn * a high risk of fracture

Keywords: walking exoskeleton device
low-dose nedaplatin (cdgp:cis-diammine-glycolatoplatinum)/5-fu combined with radiation for esophageal cancer

Conditions: Esophageal Cancer; Squamous Cell Carcinoma

Summary: the purpose of this study is to clarify efficacy and toxicity of daily low-dose nedaplatin (cdgp) and continuous infusion of 5-fu combined with radiation in patients with esophageal squamous cell carcinoma.

the tumor stages and disease grades were classified according to the tnm classification (sixth edition) of the international union against cancer (uicc). these were determined conventionally by computed tomography (ct) of the neck, chest and abdomen, bone scan, endoscopic ultrasonography (eus), endoscopy and esophagography. low-dose of nedaplatin (cdgp) 10 mg/body/day was daily administered on day 1-5, 8-13, 15-19, 22-26 and 5-fu 500 mg/body/day was continuously administered on day 1-5, 8-13, 15-19, 22-26. fractionated radiotherapy was performed from day 1 and a total dose of 50-60 gy was delivered at the rate of 1.8-2.0 gy per fraction. serotonin receptor antagonist was preventively given as an antinauseant just before the administration of nedaplatin. tumor response was assessed according to the response evaluation criteria in solid tumors (uicc, 2002). toxicities were graded according to the common terminology criteria for adverse events v3.0 (ctcae). survival was calculated from the start of chemoradiotherapy.

Eligibility criteria:
inclusion criteria: * newly diagnosed cases histologically as squamous cell carcinoma, * a performance status 0 to 2, * white blood cells \>3,000/microl, * platelets \>100,000/microl, * serum total bilirubin \<2.0 mg/dl, * serum transaminase \<3 times the upper normal limit, * serum creatinine \<1.5 mg/dl, * creatinine clearance \>60 ml/min exclusion criteria: * serious cardiac disease * prior chemotherapy and radiotherapy

Keywords: esophageal cancer nedaplatin 5-fu chemotherapy radiation chemoradiotherapy
evaluation of usefulness of contrast enhanced mri in evaluation of spine trauma: prospective study

Conditions: Trauma

Summary: non-contrast mri with t2 fat suppression has been a useful imaging modality in evaluation spinal trauma. however, the role of contrast enhancement has not investigated in patients with spinal trauma. therefore, this prospective study aims to evaluate the usefulness of contrast enhanced mri for spinal trauma w/u clinically. the study hypothesis is that there is no additional gain in addition of contrast enhanced study to routine non-contrast mri.


Eligibility criteria:
inclusion criteria: 1. patients who provided the informed consent 2. patients with spinal trauma 3. patients with age of 19 years or more exclusion criteria: 1. relative contraindication of mr contrast * previous history of any adverse event after injection of magnetic resonance contrast * pregnant or breast-feeding state * within 2 weeks after liver transplantation * epileptic disorder 2. patients impossible with follow-up period of at least 2 months clinically 3. patients with severely impaired renal function of estimated glomerular filtration rate (gfr) \< 30 ml/min/1.73m2 and/or on dialysis 4. patients with age less than 19 years

Keywords: spine trauma mri contrast
psychosocial intervention for women with mood disorders seeking treatment for obesity

Conditions: Obesity; Mood Disorders

Summary: women with mood disorders are vulnerable to the negative consequences associated with obesity, and face considerable challenges with adherence to behavioral weight management interventions. strategies are needed to support the psychological well-being of this population, and improve adherence to weight-related treatment. the goal of this preliminary study is to determine the acceptability of a group-based compassion-focused psychoeducational intervention among women with mood disorders who are attending a behavioral weight management program.

pilot feasibility trial to examine the acceptability and efficacy of compassion-based intervention in reducing indices of psychopathology (i.e., internalized weight stigma, mood symptoms), and improving weight management outcomes (i.e., physical activity behaviour, dieting behaviour, weight loss) among women with mood disorders undergoing lifestyle weight management. in this proof of concept study, adult females with a diagnosis of major depressive disorder of bipolar disorder will be randomized into two arms: weight management treatment as usual + psychoeducation group; weight management as usual + control.

Eligibility criteria:
inclusion criteria: * informed of the nature of the study and have agreed to and are able to read, review, and sign the informed consent form. the informed consent document will be written in english, therefore the volunteer must have the ability to read and communicate in english. * female participants 18 - 65 years of age, inclusive, at the time of screening. * available and able to attend weekly group meeting on assigned dates. * diagnosis of major depressive disorder or bipolar disorder by a physician within the past 12 months, as indicated in wmc medical records and confirmed by mini. * actively pursuing lifestyle weight management at wmc, with evidence of booked follow-up appointment. * weight status of at least 25kg/m2, as indicated by data from last appointment at wmc. * access to a computer and email account in order to complete online questionnaires exclusion criteria: * enrolled in surgical management of obesity at wmc. * active substance abuse/dependence disorder, current suicidality, or active episode of psychosis. * presence of a hearing or visual impairment that will prevent completing the online surveys and from participating in a group discussion weekly meeting

Keywords: weight management compassion-focused treatment internalized weight bias depressive symptoms
clinical research on acute intermittent porphyria and the use of carbohydrate-rich diet as a treatment

Conditions: Porphyria, Acute Intermittent

Summary: the main aim of this clinical trial is to learn about the effect of carbohydrate-rich diet as a treatment for aip (acute intermittent porphyria). aim: investigate the diet's impact on tissue and serum glucose, plasma insulin, cytokine levels, amino acids, and gut microbiota in aip, and their correlation with pbg (porphobilinogen). aim: assess the diet's effect on aip symptoms and health status in aip. aim: measure the effect of a high-carbohydrate diet on mitochondrial activity in aip aim: map and detect potential mutations in mitochondrial genomic dna in aip aim: discover new markers in aip through rna sequencing and machine learning. participants will follow two diet plans, a 4-week intervention with 60-65 e% carbohydrates and a 4 week intervention with 40-45 e% carbohydrates.

acute intermittent porphyria (aip) is an inherited disease that leads to the accumulation of porphobilinogen (pbg), resulting in severe abdominal pain, paralysis, fatigue, low-grade inflammation, and an increased risk of kidney failure and liver cancer. studies at the cellular level and in mice have shown that elevated levels of glucose and insulin can affect heme synthesis, potentially reducing pbg levels. the investigators have previously demonstrated that individuals with aip consume less carbohydrate (e% 40) than recommended. the investigators aim to conduct a crossover study involving 50 participants with aip, where 50% will be subjected to a 4-week intervention with 60-65 e% carbohydrates, while the other half will consume 40-45 e% carbohydrates for 4 weeks. after a 4-week intervention-free period, the two groups will switch to the respective carbohydrate percentages. symptoms, pbg levels, continuous tissue glucose, plasma/serum insulin, glucose, cytokines, amino acid levels, microbiota in the gut, body composition, and physical activity measured using accelerometers will be assessed before and after each intervention and compared. mitochondrial activity will be assessed at the cellular level as oxidative activity. mutations in mitochondrial dna and rna will also be examined since defects in oxidative energy metabolism are known to be associated with inflammation and cancer. the work will be carried out at nordland hospital and at the university of oslo. the study will be coordinated and conducted by the postdoc and partners at nordland hospital, the university of oslo, the arctic university of tromsø, and nord university. clinical nutritionists will create dietary plans, and bioengineers will perform analyses. stay abroad for postdoc, and research cooperation, with porphyria researchers at utmb, texas and mgh, boston, us.

Eligibility criteria:
inclusion criteria: * diagnosis of aip exclusion criteria: * not having diagnosis of aip * undergoing treatment as part of other clinical research on aip * pregnancy * diabetes * below 18 years of age
palliative care consultation to improve communication for patients considering surgery for a pancreatic neoplasm

Conditions: Pancreatic Neoplasm

Summary: this clinical trial evaluates a palliative care consultation for improving communication between providers and patients considering surgery for a pancreatic neoplasm. pancreatic operations have known complications that can affect quality of life. palliative care has been shown to improve patient reported quality of life and functional outcomes. receiving a palliative care consultation may improve communication and decision making for patients considering surgery for a pancreatic neoplasm.

outline: patients are randomized to 1 of 2 arms. arm i: patients receive usual care and undergo evaluation by a tumor board within 14 days of baseline. arm ii: patients attend a palliative care visit over 60 minutes to discuss their illness, quality of life, fears and concerns and communication preferences within 7 days of baseline. patients also undergo evaluation by a tumor board within 14 days of baseline. after completion of study intervention, patients are followed up 7 days after the tumor board visit and 90 days after initiation of treatment.

Eligibility criteria:
inclusion criteria: * adults (18 years or older) * pancreatic neoplasm pathology * ability to read, write, and speak in english * has decisional capacity * expected to be seen and discussed at pcsc and seeing a surgeon as part of their tumor board evaluation exclusion criteria: * metastatic pancreatic neoplasm * currently incarcerated * currently is or previously has received palliative care, or are unwilling to forego palliative care for the first 90 days post randomization * evidence of any behavior, condition, or circumstance (including, but not limited to: blindness, deafness, serious behavior or mental health conditions, discontinuing curative treatment, lack of access to technology, etc) that would interfere with their ability to complete study procedures as noted within the chart