Kornimate/medical-research-clean huggingface dataset:
spatially fractionated radiation treatment for gynaecological cancers

Conditions: Cervical Cancer; Gynecologic Cancer; Recurrent Cancer

Summary: this is a prospective study to evaluate in-field disease control, survival and late toxicity in patients with cervical cancer or pelvic recurrence treated with spatially fractionated rt. the study will include patients with primary cervical cancer or pelvic recurrence not suitable for brachytherapy in view of anticipated or actual suboptimal target coverage due to aberrant anatomy or large residual disease at the time of brachytherapy.

patients will be treated with spatially fractionated radiation therapy (sfrt) after ebrt completion to a dose of 25-30 gy in 5-6 fractions in the primary setting. for patients receiving re-irradiation, 20-25 gy in 4-5 fractions will be delivered with sfrt, which however may be individualised to match with clinical practice in the re-rt setting. total eqd2 gy for organs at risk will be matched to brachytherapy. the study will be conducted at tata memorial hospital, mumbai and advanced centre for treatment, research and education in cancer (actrec), navi mumbai.

Eligibility criteria:
inclusion criteria: 1. patients with cervical cancer post ebrt, with expected suboptimal brachytherapy dose coverage due to- 1. aberrant uterine or pelvic anatomy leading to difficulty in localization of the cervical os or negotiation of the uterine canal accurately by two independent clinicians in up to two procedures. 2. large residual disease at the time of brachytherapy with anticipated suboptimal target coverage either determined in clinic based on pre-brachytherapy imaging or at dose planning (e.g. figure 2). 3. very narrow vaginal canal not accommodating even the smallest intracavitary or vaginal cylinder applicators. 2. patients with inoperable endometrial cancer not suitable for anaesthesia or have anticipated suboptimal coverage of target volume at brachytherapy as identified on pre-brachytherapy imaging obtained after ebrt. 3. patients with large pelvic recurrences after surgery and/or (chemo) radiation, not amenable to surgical salvage or brachytherapy after salvage ebrt due to reasons specified in item 1. 4. patients with contraindications to anaesthesia for brachytherapy with sufficient risk of on-table or post procedure adverse events. exclusion criteria: 1. any pre-existing fistula in bladder or rectum. 2. pelvic prosthesis. 3. refusal to provide consent.

Keywords: cervical cancer cancer recurrence spatially fractionated radiotherapy rapid rod
intraoperative electromyographic monitoring of the recurrent laryngeal nerve in thyroid surgery

Conditions: Thyroid Surgery; Recurrent Laryngeal Nerve; Electromyographic Monitoring

Summary: the purpose of this study will explore the advantages of electrodes used for monitoring of the recurrent laryngeal nerve (rln) in thyroid surgery

objectives/hypothesis: the purpose of this study will explore the advantages and applications of electrodes used for monitoring of the recurrent laryngeal nerve (rln) in thyroid surgery. we want to know that if the monitoring system will decrease the rate of recurrent laryngeal nerve palsy. study design: one hundred patients who undergoing thyroid surgery will be collected in this study. patients will be intubated for general anesthesia with a medtronic xomed nerve integrity monitor (nim) emg endotracheal tube (jacksonville, fla) that had 2 electrodes imbedded in the wall of the endotracheal tube. these wires were placed up against each vocal cord. two grounding wires(needle no. 26) were placed up in the subcutaneous tissues of both shoulders. the electrode wires, grounding wires, and nerve stimulator were connected to a monitoring device (medtronic nim-response) that recoded a visual evoked potential and audible beep to each muscle contraction of a vocal cord. a medtronic xomed prass monopolar nerve stimulator wand was used to test the rln intraoperatively and was set at 0.5ma. direct physical touching of the rln with nerve stimulator using pulsed current would produce an audible "beep-beep-beep". conclusion: this study will be conducted in cooperation with department of anesthesiology. the following subjects will be collected and elucidated: 1. if the muscle relaxant used during surgery will affect the operation of rln monitoring system. 2. can rln monitoring system accurately identify the rln 3. can rln monitoring system accurately predict the function of rln 4. can rln monitoring system decrease the rln palsy rate after thyroidectomy 5. application of rln monitoring to determine the safety and the benefit of vagal stimulation at the beginning and the end of thyroid operation 6. application of rln monitoring to determine whether extensive dissection of rln increases the risk of nerve injury. at least four papers will be written after this study with the topics as followings: 1. influence of muscle relaxation on neuromonitoring of the recurrent laryngeal nerve during thyroid surgery 2. intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid surgery: plaudits and pitfalls 3. vagal stimulation during intraoperative neuromonitoring of the recurrent laryngeal nerve in thyroid operation. 4. does extensive dissection of recurrent laryngeal nerve during thyroid operation increase the risk of nerve injury? our experience with the application of intraoperative neuromonitoring

Eligibility criteria:
inclusion criteria: * thyroid disease for operation exclusion criteria: * n/a

Keywords: thyroid rln emg
the effect on anxiolytics with type of antiemetic agents on postoperative nausea and vomiting in high risk patients

Conditions: Postoperative Nausea and Vomiting

Summary: nausea and vomiting after surgery are one of the complications that occur after general anesthesia, and the frequency is reported to range from 10% to 80% in the high-risk group. several studies have introduced drugs and methods to prevent nausea and vomiting after surgery. among them, midazolam administered before surgery is known to have anti-anxiolytic and sedative effects on the prevention of nausea and vomiting after surgery. it has also been reported to increase its effectiveness when administered with other antiemetic agents. the purpose of this study is to compare the effects of administration of combination with midazolam and different antiemetic agents on the prevention of postoperative nausea and vomiting in high-risk patients.

this prospective study evaluates female, nonsmoking patients undergoing laparoscopic cholecystectomy. the patients are divided into those with and without postoperative nausea and vomiting. the purpose of this study is to compare and observe the effect of administration of midazolam and two different antiemetics on prevention of postoperative nausea and vomiting. 0.05mg/kg of midazolam is administered intravenously 10 minutes before surgery as a pretreatment. 0.3mg ramosetron is administered intravenously right before the end of surgery and 0.075mg palonosetron is administered intravenously immediately after induction of anesthesia. the incidence of ponv, severity of nausea, use of rescue antiemetics, and pain severity was evaluated at 2 hours, 24hours, and 48 hours after surgery.

Eligibility criteria:
inclusion criteria: * 20-65 years old with american society of anesthesiologists (asa) physical status 1-2 and scheduled for laparoscopic cholecystectomy. exclusion criteria: * pregnant or breast feeding patients * smokers * patients with history of chronic opioid abuse * hypersensitivity to 5-ht3 receptor antagonists or analgesics * those who were antiemetic or opioid treatment within 24 hours prior to surgery
umbilical cord derived mesenchymal stromal cells for the treatment of severe steroid-resistant graft versus host disease

Conditions: Hematologic Malignancies

Summary: mesenchymal stromal cells (msc) have shown promising albeit not always consistent therapeutic effects in the treatment of severe steroid-resistant acute graf versus host disease. remarkably, in all reported clinical studies the toxicity of mesenchymal stromal cells administration has been found consistently negligible. the investigators believe that umbilical cord (uc) derived mesenchymal stromal cells may represent a stronger immunosuppressive tool for such clinical emergency and no data suggest any change in the safety profile of these cells. for this reason, and in the best interest of the patient, the investigators plan to test the safety and activity of umbilical cord mesenchymal stromal cells when given sequentially to another partially effective treatment of steroid resistant acute graf versus host disease such as pentostatin.


Eligibility criteria:
inclusion criteria: patients are required to meet the following inclusion criteria: 1. patients with steroid refractory grade iii-iv classic acute graft versus host disease (gvhd)occurring within 100 days after transplant or induced by donor lymphocyte infusions (dli) or t-cell add back. steroid refractory graft versus host disease (gvhd)is defined according to pidala and anasetti10 as follows: a) progression of at least 1 overall grade within 3 days of optimal steroid treatment; b) failure to demonstrate any overall grade improvement over 5 to 7 days; c) incomplete response by 14 days of 2 mg/kg/day of steroid therapy. 2. patients with persistent, recurrent, or late acute graft versus host disease (gvhd) (features of acute graft versus host disease occurring beyond 100 days, often during withdrawal of immune suppression). 3. patients with an overlap syndrome in which diagnostic or distinctive features of chronic graft versus host disease (gvhd) and acute graft versus host disease (gvhd) appear together79. exclusion criteria: 1. inability to obtain written informed consent
stereotaxic irradiation of hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma

Summary: stereotaxic radiation by cyberknife : 3 x 15 gy over 8 to 10 days for a total of 45 gy.

stereotaxic radiation by cyberknife : 3 x 15 gy over 8 to 10 days for a total of 45 gy

Eligibility criteria:
inclusion criteria: * primitive liver cancer (hepatocellular carcinoma), proved by histology or diagnostic according to bclc criteria * t1-3 n0 m0 * with only one intra hepatic lesion and dimensions between 1 cm and 6 cm (irm or hepatic scanner) * stereotaxic radiotherapy treatment approved in multidisciplinary consultation, the patient being rejected for standard therapeutic * age \>= 18 ans * previous anti tumoral treatment allowed but suspended since at least 15 days before the inclusion * oms =\< 2 * portal thrombosis allowed * portal high blood pressure allowed * no contraindication of fiducials implantation, hemostasis disorders must be treated before the implantation * in case of underlying cirrhosis, only the child-pugh a is allowed * life expectancy \>= 12 weeks * women must have an active contraception during all the study * patient affiliated to health insurance * patient must sign the consent exclusion criteria: * t4 * cirrhosis child b and c * hepatic lesion \ 6 cm * 2 hepatic lesions or more * recurrent or metastatic disease * patient already included in another therapeutic trial with an experimental molecule * allergy to gold * pregnant women or susceptible to be pregnant or breastfeeding * unable for medical follow-up (geographic, social or mental reasons)

Keywords: liver cancer hepatocellular carcinoma
bonsai: biomarkers of nonsteroidal anti-inflammatories

Conditions: Alzheimer's Disease

Summary: the purpose of this study is to test the effect of ibuprofen on the levels of a number of different proteins (called biomarkers) in cerebrospinal fluid (csf), blood, and urine to see whether ibuprofen can influence certain biomarkers associated with the progression of alzheimer's disease.

the hypothesis to be tested is that the possible role of ibuprofen in preventing ad can be detected in changes in biomarkers of ad. eligible participants will complete an enrollment visit to include: a physical exam, a neurological exam, neuropsychological testing, and a minor blood draw. at the second visit, approximately 2 weeks later, participants will undergo a baseline lumbar puncture, and will be issued either ibuprofen or placebo to take once daily for 6-12 weeks. both the participants and the clinicians will be masked to treatment assignment. after 6-12 weeks, the participants will undergo a second, and final, lumbar puncture. this will complete participant involvement in the study.

Eligibility criteria:
inclusion criteria: * age 59 years or older at time of the first visit * family history of one or more first-degree relatives with alzheimer-like dementia * fluency in written and spoken english * willingness to limit use of vitamin e (\<600 iu per day), non-aspirin nsaids, aspirin (\<81mg per day), histamine h2 receptor antagonists, and gingko biloba extract for the duration of the study * ability and intention to participate in regular study visits * provision of informed consent exclusion criteria: * history of peptic ulcer disease complicated by perforation, hemorrhage or obstruction * history of uncomplicated peptic ulcer with symptoms in the 28 days prior to the first visit * clinically significant hypertension, anemia, liver disease, or kidney disease * hypersensitivity to aspirin or other nsaids * concurrent use of warfarin, ticlopidine, or any other type of anti-coagulant * concurrent use of systemic corticosteroids * use of ≥ 4 doses per week of either of the following in the 14 days prior to the first visit: non-aspirin nsaids, aspirin (\>81mg per day), or histamine h2 receptor antagonists * current plasma creatinine ≥1.5mg/dl * enrollment in any trial that is likely to interfere with bonsai procedures or affect treatment outcomes * cognitive impairment or dementia

Keywords: nonsteroidal anti-inflammatories nsaids
footwear minimalism study

Conditions: Healthy Runners

Summary: the following study proposes to investigate the injury risk associated with the use of a new category of running footwear: the minimalist shoe. a group of experienced adult male and female runners with neutral foot types will take part in this study. all participants will be randomized to receive one of three different shoes: a full minimalist shoe (vibram 5-fingers), a partial minimalist shoe (nike free 3.0) and a conventional neutral supportive running shoe (nike pegasus), while training for a 10k event over a 14-week period. outcomes to be investigated are pain, footwear perception, and number of injury events. the hypothesizes is that participants using the minimalist footwear during their running program will experience a reduction in running related pain. a greater degree of footwear minimalism will result in a greater reduction in pain (compared to the partial minimalist shoe, nike free).


Eligibility criteria:
inclusion criteria: * minimum of 5 years experience running * have been running on a regular basis (minimum once per week) over the past 6 months * able to run for 60 minutes continuously * can tolerate 20-40km per week in training * neutral foot posture according to the foot posture index. exclusion criteria: * have not experienced a running related injury requiring a stoppage of 2-weeks or more in the past 6 months * history of surgery to their plantar fascia or achilles tendon * have already been running in a minimalist shoe * have a diagnosis of osteoarthritis - or other degenerative musculoskeletal disorder - affecting the lower extremity * are currently taking analgesic medication.

Keywords: running footwear injury incidence injury risk pain
liraglutide efficacy on glucocorticoid induced hyperglycemia in patients high risk for diabetes

Conditions: Glucocorticoid Induced Hyperglycemia

Summary: glucocorticoids therapy exposes the patient to an increased risk for diabetes morbidity. however, there is no proven preventive therapy. glp-1-ra has shown to improve glucose metabolism in healthy volunteers treated with glucocorticoids. we assume that glp-1-ra will improve glucose metabolism in patients with high risk for diabetes morbidity, treated with glucocorticoids.


Eligibility criteria:
inclusion criteria: * planned treatment with t. prednisone in dosage \>0.5 mg/kg for two weeks or more. * age \>18 years * body mass index \>27 kg/m2 or 1st degree relative with type 2 diabetes mellitus or hypertension or hyperlipidemia or gestational diabetes in the past or diagnosis of polycystic ovary syndrome. exclusion criteria: * glycosylated hemoglobin a1c \>6.5% * diagnosis of diabetes mellitus or treatment with anti-glycemic drug * pancreatitis (acute or chronic) in the past * active malignancy * medullary thyroid carcinoma or multiple endocrine neoplasm type 2 of the patient or of 1st degree relative * pregnancy
passive leg raising test to predict hypotension during induction of anesthesia in patients undergoing cardiac surgery

Conditions: Ischemic Heart Disease; Cardiac Valve Disease

Summary: hypotension frequently occurs during anesthesia induction. preload decrease by anesthetics was often considered as one of main causes for this hypotension. however, the studies on this topic have been lacking. dynamic preload indices are more suitable than static preload indices to predict the effect of preload changes. and, recently, passive leg raising test showed successful results to predict fluid responsiveness in patient with spontaneous ventilation. the investigators hypothesized that hypotension after induction of anesthesia is caused by decrease of preload by anesthetics and passive leg raising test could predict this hypotension. in this study, the investigators will try to evaluate whether passive leg raising induced hemodynamic changes could predict hypotension during anesthesia induction.

in this randomized controlled clinical trial, the investigators hypothesized that passive leg raising induced changes in hemodynamic parameters could predict the hypotension during anesthesia induction. to evaluate this, before anesthesia, the investigators will conduct passive leg raising test. at first, the patient's trunk was elevated 45 degrees for the first set of measurements. then, the lower limbs were raised to a 45° angle while the patient's trunk was lowered to a supine position to measure peak co (usually within 1-2 min). hemodynamic profiles planned to be measured are mean arterial pressure, heart rate, cardiac index, stoke volume and stroke volume variation. after this, the occurrence of hypotension (systolic blood pressure \ 30% of baseline) will be recorded during the time from anesthesia induction to surgical skin incision. hypotension will be treated by a standardized method. if heart rate (hr) is less than 70 beats/min, 5mg of ephedrine will be administered and if hr is greater than 70 beats/min, 30 mcg of phenylephrine will be administered. this will repeated until hypotension subsided. refractory hypotension will be defined as continuous hypotension despite the total infused dose of ephedrine \> 0.5 mg/kg or phenylephrine \> 4 mcg/kg. the ability to predict hypotension and refractory hypotension during anesthesia induction by passive leg raising test will be evaluated by receiver operating characteristic curve analysis.

Eligibility criteria:
inclusion criteria: * adult patients undergoing elective cardiac surgery exclusion criteria: * arrhythmias * documented peripheral artery disease * severe pulmonary disease * heart failure * unstable angina * preoperative use of inotropics or mechanical assist device * use of angiotensin converting enzyme inhibitors * expected intubation difficulty or gastric reflux disease

Keywords: passive leg raising flotrac/vigileo anesthesia hypotension
the diagnosis of occult deep vein thrombosis of the lower extremities in patients presenting with hypoxia

Conditions: Hypoxia

Summary: the purpose of this study is to prove that bedside ultrasound compression is a useful screening tool for the diagnosis of occult deep vein thrombosis in patients presenting to the emergency room with hypoxia.

it is known that 30% of deep vein thrombosis of the extremities is belived to be the precedend of pulmonary emboli; an often fatal disease. it is known that dvt (deep vein thrombosis is often occult. it is also known that pulmonary embolism is often difficult to diagnose and is often missed especialy in patients with chronic illnesses such as copd and chf. venous compression ultrsound is an exam that can be preformed bedside. it is preformed by placing a vascular ultrasound transducer on the femoral vein and popliteal and checking its compressibility. if dvt is present in the femoral or popliteal veins the veins will be noncompressible. it has been shown that us compression for dvt can be preformed by physicians in the er with accuracy and speed. presently us compression is not a tool used for detection of occult dvt in the er. i wish to explore the usefullness of compression us of the lower extremities as a screening tool for dvt in the hypoxic patient.

Eligibility criteria:
inclusion criteria: * patients presenting to the emergency room * 18 years or older, saturation 94% and under on room air. exclusion criteria: * none

Keywords: dvt ultrasound compression hypoxia pulmonary emboli occult dvt in hypoxic patients
multi-site eating disorder prevention program for type 1 diabetes

Conditions: Type 1 Diabetes; Eating Disorders

Summary: this study aims to test the effectiveness of an evidence-based eating-disorder prevention program specifically targeted for individuals with type 1 diabetes (t1d) compared to an educational control group. the diabetes body project (dbp), is an adaptation of the body project which is the only eating disorder prevention program to have repeatedly produced effects when evaluated by independent researchers, produced stronger effects than credible alternative interventions, and affected objective outcomes. dbp has been adapted slightly for individuals with t1d who are at ultra-high risk for eating disorders. the study aims to test the effectiveness of the dbp of reducing body image concerns and reducing eating pathology and improving glycemic control.


Eligibility criteria:
inclusion criteria: 1. between the ages of 14-35 2. diagnosis of type 1 diabetes of at least 1 year 3. using insulin 4. experiencing at least some level of body image concerns exclusion criteria: 1. not between the ages of 14-35 2. does not have access to wifi (will need for the virtual groups) 3. type 1 diabetes diagnosis of less than 1 year 4. does not live in the same time zone of stanford (helps in coordinating groups) 5. hospitalized for eating disorder treatment in the past year 6. had eating-disorder related diabetic ketoacidosis (dka) in the past year 7. not using insulin 8. not experiencing any level of body image concerns 9. unwilling to be video-recorded if assigned to diabetes body project 10. restricted proficiency in language that groups will be conducted in (dependent on location), and pervasive developmental, cognitive, or psychiatric limitations that compromise participation in the intervention sessions and study.
oxytocin infusion and abdominal myomectomy

Conditions: Oxytocin and Abdominal Myomectomy

Summary: objective:to compare oxytocin infusion with control, in patients undergoing abdominal myomectomy in terms of mean blood loss. design: single blinded randomized control trial setting: obstetrics and gynecology department, military hospital, rawalpindi population: 60 women of asa class i-ii, with intramural fibroids, candidate for elective abdominal myomectomy. methods: women were divided into two groups randomly. in the study group 30 units of oxytocin in 1000 ml normal saline were given during surgery, at the rate of 15units/hour. in control group, pure normal saline was given. main outcome measure: intra-operative blood loss


Eligibility criteria:
inclusion criteria: 1. women of asa class i-ii with intramural fibroids, 2. women planned to undergo elective abdominal myomectomy exclusion criteria: 1. women with hemoglobin (hb) \< 10g/dl 2. women with any respiratory or cardiovascular disease.