Kornimate/medical-research-clean huggingface dataset:
levothyroxine treatment in thyroid benign nodular goiter

Conditions: Thyroid Nodule

Summary: we will study the effect of taking eltroxin at different time, i.e. fasting or postprandial periods. we will also study the effect of levothyroxin treatment in chinese people

objective - current treatment of benign thyroid is oral levothyroxin by suppression of thyrotropin secretion and so that tumor growth. although current consensus is taking thyroxin one hour before meal because the ph value of gastrointestinal tract will affect drug absorption, some patient suffered from epigastric discomfort when taking thyroxin with empty stomach, and wish to take it postprandial. however, there is no direct evidence showing if taking thyroxin at different time point significantly affects treatment outcome. besides, the response to thyroxin therapy differs among people. the purposes of this study are to evaluate the clinical significance of different time points of thyroxine intake and to search factors relating to thyroxin response of benign thyroid tumors. research design and methods - we will include patients who have benign thyroid tumors diagnosed with fine needle aspiration cytology and have normal thyroid function into our study. after informed consent, patients will be randomly assigned into two groups. patients in the first group will take thyroxin one hour before breakfast until thyrotropin level stabilized between 0.5 and 1.0 mu/l for 3 months. then thyroxin will be discontinued. patients will restart thyroxin therapy three months later but after breakfast. patients in another group will take thyroxin postprandial, discontinue thyroxin and then one hour before breakfast. questionnaire interviews about diet and life style, blood samples and fine needle aspiration cytology samples will be obtained. changes of thyroid nodules will be evaluated with thyroid echo. statistic analysis - descriptive data will be described as means and sds for continuous variables, and analysis of variance and chi-square tests were used for assessing the significances. a p-value below 0.05 was considered significant. keywords: benign thyroid tumor, thyroxin, preprandial, postprandial.

Eligibility criteria:
inclusion criteria: 1. age between 20 to 90 years old 2. benign nodular goiter diagnosed with thyroid echo and fine-needle - aspiration cytology exclusion criteria: 1. age younger than 20 or older than 90 years old 2. pregnancy 3. allergy to eltroxin 4. taking other drugs which will have drug interaction with eltroxin 5. patients with cardiovascular disease, hypertension, gastrointestinal disease
application of 3d printing guide plate in percutaneous disc decompression

Conditions: Lumbar Disc Herniation; Radiculopathy; Percutaneous Disc Decompression; 3D Printing Guide Plate; Radicular Pain; Low Back Pain; Discogenic Pain

Summary: application of 3d printing guide plate in percutaneous disc decompression

this study applies 3d-printed customized guide plate in assisting the accurate puncture in percutaneous disc decompression, in patients with low back pain, lumbosacral radicular pain, disogenic pain, lumbar disc herniation, disc degeneration, etc. this technique can shorten reduce the intra-operative radiation, and do not affect the surgical outcome. this study involved diseases such as lumbar disc herniation (ldh), disc degeneration, etc. percutaneous disc decompression surgeries are effective treatments for these disease. needle puncture is the key technology in percutaneous disc decompression surgeries. in the past when there were no customized guides, the surgeons would place the needle according to his/her previous experience under the guidance of c-arm fluoroscopy or ct. if the position of the needles is not satisfactory, repeated procedure will be performed. this would lead to an increase in the duration of surgery and intra-operative radiation, which is detrimental to both the surgeon and the patient. this problem could be well solved by applying the 3d printing guide plate. the key processes for the 3d printing guide plate procedure: the model of the spine or bone is established according to the patient's ct scan data to prepare the customized guide plate, then sterilize them for future use. the final position of needle is confirmed by c-arm fluoroscopy or ct or evoked pain.

Eligibility criteria:
inclusion criteria: 1. age ≥18 years old; 2. pain lasting ≥12 weeks; 3. the previous failure of conservative management such as physiotherapy, exercise therapy, or analgesic medications; 4. pain intensity≥4 out of 10 on the numerical rating scale (nrs); 5. availability of computed tomography/magnetic resonance imaging findings of pathology concordant with the side and level of their clinical features; 6. agree with percutaneous disc decompression. exclusion criteria: 1. patient refusal to participate in the study; 2. pregnant or nursing; 3. allergies to local anesthetics, contrast dyes or steroids; 4. significant anatomic deformity (either congenital or acquired) making it difficult to access the target as evidenced by computed tomography/magnetic resonance imaging; 5. patients with platelet dysfunction, bleeding disorder or continuing anticoagulant treatment; 6. systemic infection; 7. injection site infection; 8. unstable medical or psychiatric condition; 9. unable to tolerate the surgeries.
assessing supported employment with veterans with felony convictions and mental illness or substance abuse

Conditions: Employment

Summary: this study continues to develop and refine best practices in the delivery of vocational services to veterans with histories of felony convictions and mental health/substance abuse difficulties. there are currently over 225,000 incarcerated veterans and it is estimated 64,000 veterans are released from prisons annually. these veterans encounter significant difficulties in finding employment due to stigma, intrapersonal difficulties, and out-dated work skills. additionally these veterans are more likely to be homeless than other population., previous work has found that manual based, vocational groups led by trained vocational staff led to quicker employment compared to traditional vocational services and manual based self studies. to attempt to improve on previous results, this study adds principles and components of supported employment including ongoing follow-up, treatment team coordination, and community based assistance.


Eligibility criteria:
inclusion criteria: * history of at least one felony conviction * diagnosis of a mental illness including substance use disorders exclusion criteria: * dementia * active psychosis
stochastic modulated vibrations on autonomic nervous system of breast cancer patients during radiotherapy

Conditions: Autonomic Nervous System Imbalance; Psychological Distress; Cancer-related Pain; Breast Cancer Lymphedema; Quality of Life

Summary: the aim of this research is to study the influence of stochastic modulated vibrations on the autonomic nervous system of breast cancer patients during radiation therapy

since it is well known that breast cancer patients experience an important load of stress from diagnosis through treatment and throughout cancer survivorship (fear of cancer recurrence), this study focusses on activation the parasympathetic nervous system and making patients as comfortable as possible during treatment. the scope of this study is based on previous research, that has shown that controlling physical and psychological complications during treatment may have a positive (preventive) effect on late term and long-term quality of life and survival outcomes. breast cancer patients will receive andullation during their irradiation period. the primary outcome measure of the autonomic nervous system is vagal nerve activity, a modulator of the parasympathetic nervous system. secondary outcome measures are stress, pain and lymphedema.

Eligibility criteria:
inclusion criteria: * histological proven breast cancer, following breast cancer surgery * starting with adjuvant radiation therapy for 3 weeks * minimum 18 years * medical record available and complete * supine lying on mattress for 20 minutes is possible * dutch, french or english exclusion criteria: * severe neurological, orthopaedic or rheumatic disorders * cardiac disorders * early or synchronous malignancy * pregnancy or lactation * persons suffering from depression or illnesses which influence the mental health or wellbeing
mitigation of emergence agitation through implementation of masimo bridge therapy

Conditions: Emergence Delirium; Agitation, Emergence

Summary: this is a randomized, prospective, double-blinded (patient and outcome-assessor) trial. our goal is to assess efficacy of bridge therapy (versus sham bridge therapy) to prevent emergence agitation following general anesthesia. primary objective: activation of bridge therapy from the time of the pre incision "time out" until 24 hours after admission to the pacu (post anesthesia care unit) is associated with reduced frequency and intensity of emergence agitation. secondary objective: bridge therapy activation will also result in a lower incidence of rescue pharmacologic treatment of agitation. tertiary objective: activation of bridge therapy during a stable anesthetic state is associated with a reduced patient state index as measured on sedline


Eligibility criteria:
inclusion criteria: 1. age 18-90 2. english speaking 3. asa physical status between i-iv 4. undergoing a surgical procedure at hmc 5. patient answers "yes" to one of the following below: 1. do you drink 7 or more alcoholic beverages per week? 2. do you use (smoke or eat) cannabis (or other recreational drugs) on a weekly basis? 3. have you felt disoriented, aggressive, angry, or delirious after waking up from a previous surgery? 4. have you been told by a care provider or friend/family member that you woke up from surgery in the past disoriented, confused, or aggressive/angry? 5. have you been diagnosed with post-traumatic stress disorder (ptsd)? exclusion criteria: 1. \ 90 years old 2. intubated patients 3. pregnant by hmc lab test 4. non-english speaking 5. has a cardiac pacemaker 6. hx of bleeding condition 7. skin issues where the device would be applied, this includes: dermatitis, psoriasis vulgaris, skin breakdown, skin integrity compromised. 8. plan to use dexmedetomidine as part of the anesthetic technique 9. plan to use sedline for clinical anesthetic management during operating procedure. 10. patients with previous history of sensitivity to compound benzoin tincture.
differential effects of various anesthetic agents on cognitive function in patients with alzheimer's disease

Conditions: Alzheimer Disease

Summary: the objective of the study is to determine the effects of different anesthetic agents on cognitive function in patients with alzheimer's disease (ad). the investigators will test the hypothesis that anesthesia with desflurane or propofol, compared to isoflurane or sevoflurane, will have less of an effect on post-operative cognitive dysfunction in patients with ad.

patients with mild-to-moderate alzheimer's disease who are scheduled to have elective noncardiac, nonneurologic, nonvascular surgery will be recruited at the massachusetts general hospital (mgh). the study will first be introduced to patients at their preoperative surgical clinic appointment by his/her surgeon. if patients are interested in participating, they will notify their surgeons, and subsequent recruitment will take place at the mgh pre-admission testing area (pata), a clinic for preoperative evaluation and medical optimization. patient contact and recruitment, however, will only proceed with permission from (1) the patient him/herself and (2) the patient's surgeon. per the partners human research committees-approved criteria, if patients do not have capacity for clinical-decision making but express a willingness to participate in the study, a surrogate (i.e. healthcare proxy and/or family member) co-signature will be required on the consent form. on the day of the subject's surgery, the anesthesia team will be allowed to choose one of four anesthetic options (i.e. propofol anesthesia, isoflurane anesthesia, sevoflurane anesthesia, or desflurane anesthesia) based on clinical preference and appropriateness. the research team will be blinded to the anesthetic to which subjects are assigned. finally, patients will be followed for one year post-operatively with a battery of cognitive tests to determine differences in cognitive trajectory.

Eligibility criteria:
inclusion criteria: * patients diagnosed with alzheimer's disease (ad) per diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv) criteria. * patient recruitment permission granted by his/her surgeon * requires general anesthesia for elective noncardiac, nonneurologic, nonvascular surgery. exclusion criteria: * history of neurologic or psychiatric disease (i.e. stroke, psychosis, etc.) * non-native english speaker * severe visual or auditory disorder * sensitivity to sulfites (some propofol formulations at mgh may contain sodium metasulfite). * asthma (sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people).

Keywords: alzheimer disease dementia postoperative care cognitive reserve
signatures of n-ac for non-suicidal self-injury in adolescents

Conditions: Self-Harm; Depression; Suicide

Summary: to measure nac-induced changes to concentrations of glutathione (gsh) in the anterior cingulate cortex (acc) as measured by magnetic resonance spectroscopy (mrs) in 36 adolescents and young adults with nssi (12 in each group: high, low, and placebo).

this study is a double-blind, placebo controlled, 4-week course of two-tiered n-acetylcysteine (nac) dosing focused on identifying the optimal dose to achieve meaningful change in measurable biomarkers (glutathione and glutamate). this design will allow us to confirm acute biological changes, select the optimal dose for achieving biological effects, and examine dose/concentration-response relationships with respect to biological markers and pharmacokinetics. brief schedule of activities: subjects will be recruited through community and clinical settings and screened over the phone. there will be a total of 4 in-person visits and two sets of on-line study activities. eligible participants will be assigned to one of 3 groups (double-blinded): a low-dose nac group (3600 mg/day), a high-dose nac group (5400mg/day), and placebo (pbo). the study intervention period is 4 weeks. total participation is up to 8 weeks, depending on the length of time between day 0 and day 1. the investigators will recruit 36 adolescents and young adults aged 16-24 years. there will be 12 participants in each group (pbo, 3600mg/day, 5400mg/day). the investigators will use a minimization procedure to ensure that the participants in these 3 groups will have similar age, clinical severity and medication status.

Eligibility criteria:
inclusion criteria: * current frequency of at least one nssi episode in the past 2 months * ≥ 5 past episodes of nssi with significant tissue damage (e.g. scars present) * psychotropic medications are dose-stable for 1 month * ability to understand study procedures and to comply with them for the entire length of the study exclusion criteria: * any mri contraindications (e.g. metal plates, claustrophobia, braces, implanted devices) * any current serious medical illness as defined by medical history * current substance use disorder (except tobacco use disorder) * primary psychotic disorder (e.g. schizophrenia, schizoaffective disorder, schizophreniform disorder) * neurodevelopmental disorder such as mental retardation or autism * changes in psychotropic medications in past 1 month * taken nac or glutathione on a regular basis in the past 6 months * currently pregnant, planning to become pregnant, currently breastfeeding, or unwillingness to use contraception throughout the study. * allergy/sensitivity to n-acetylcysteine. * inability or unwillingness of individual or legal guardian/representative to give written informed consent.
phase ii clinical study of plm60 for the treatment of cutaneous t cell lymphomas

Conditions: Relapsed Cutaneous T Cell Lymphom

Summary: to study efficacy and safety of mitoxantrone hcl liposome injection in patients with relapsed cutaneous t cell lymphomasell


Eligibility criteria:
inclusion criteria: * the subjects are voluntary and sign the informed consent form; * ecog score 0 to 2; * the expected survival time ≥3 months; * patients with cutaneous t-cell lymphoma confirmed by histopathology, with measurable lesions, with or without systemic lymph node involvement; clinical stage ib-iva; * the patients previously receive at least once of systemic therapy (including systemic electron beam irradiation or chemotherapy, stem cell transplantation) and do not achieve remission (including remission period shorter than 30 days after the treatment; * an interval of at least four weeks after the target tumor was treated with chemotherapy, radiotherapy, biological therapy, stem cell transplantation or other study drugs; * subjects at childbearing age agree to take effective contraceptive measures during the study; blood pregnancy test result is negative (except infertility due to menopause or operation); * laboratory tests (blood routine, liver and kidney function) meet the following requirements: 1. anc≥ 1.5×109/l; b) plt ≥ 75×109/l; c) hb ≥ 9 g/dl; d) cr) ≤ 1.5x uln ; e) tbil ≤ 1.5x uln; f) ast or alt ≤2.5 x uln. exclusion criteria: * pregnant or lactating women; * an allergic history to anthracyclines or liposome drugs; * disease progression or recurrence after anthracycline treatment within six months before the enrollment;" * patients who once used mitoxantrone injection; * patients who have used doxorubicin (or pirarubicin) with the total cumulative dose\> 360mg/m2, or epirubicin with the total cumulative dose \> 600mg/m2; * left ventricular ejection fraction is \ 450ms in male, \>470ms in female); a past history of cardiac disease caused by anthracyclines; a history of severe heart disease; * concomitant treatment as other anticancer drugs are needed; * with internal organ involvement (including bone marrow, central nervous system; * clinically active infection that can significantly affect the clinical trial; * within 6 weeks after organ transplantation or major organ surgery; * those who are inappropriate to be enrolled as evaluated by the researchers.
zinc supplementation to improve prognosis in patients with compensated advanced chronic liver disease.

Conditions: Advanced Chronic Liver Disease; Portal Hypertension; Hepatocellular Carcinoma

Summary: zinc homeostasis could play a role in advanced chronic liver disease (cacld) and its supplementation has been linked with improvement in liver function, decrease of hepatic complications and reduction in hepatocellular carcinoma (hcc) incidence. cacld encompasses a heterogeneous group of patients with a variable risk of clinically significant portal hypertension (csph) and clinical events. the anticipate model is a validated model for stratifying these risks. our aim is to demonstrate that the administration of zinc can reduce the rate and risk of presenting clinical events (first decompensation, hcc, death and liver transplantation). this study protocol describes an ongoing phase iii, national, multicentre, randomized, double-blind clinical trial that will enroll 300 patients to receive either the trial treatment (zinc acexamate) or placebo. an inclusion period of 42 months is planned, with a minimal duration of follow up of 2 years. our principal hypothesis is that zinc could modify the natural history of cacld patients, with an overall improvement in prognosis


Eligibility criteria:
inclusion criteria: * patients of both sexes with diagnosed compensated advanced chronic liver disease (cacld) determined by hepatic stiffness on transient elastography \>15 kpa. * age between 18 and 80 years, inclusive. * absence of prior or current decompensation. * for women of childbearing age, a possible pregnancy will be ruled out by a pregnancy test prior to the start of the study. following the test, the woman must use an effective contraceptive method during sexual intercourse (see appendix i) in the days leading up to the start of treatment, and continue to use it throughout the treatment period, as well as for several days after its completion. * signing of informed consent. exclusion criteria: * history or current presence of hepatocellular carcinoma. * concomitant systemic disease with a short-term poor prognosis. * pregnancy, breastfeeding, or refusal to use contraceptive measures during participation in the study. * patients with compensated advanced chronic liver disease (cacld) due to hepatitis b virus (hbv) under antiviral treatment, and those with cacld due to hepatitis c virus (hcv) cured with antiviral treatment.
tch versus ec-th as neoadjuvant treatment for her2-positive breast cancer

Conditions: HER2-Positive Breast Cancer

Summary: both tch (docetaxel/carboplatin/trastuzumab) and ec followed by th(epirubicin/cyclophosphamide followed by docetaxe plus trastuzumab) regimens as neoadjuvant treatment for her2-positive breast cancer have been recommended by nccn guideline. it is unknown which regimen is better. this study is to evaluate the efficacy and safety of tch (docetaxel/carboplatin/trastuzumab) and ec followed by th(epirubicin/cyclophosphamide followed by docetaxe plus trastuzumab) regimens as neoadjuvant treatment in her2-positive breast cancer. the endpoint of pathologic complete response is used as a surrogate marker for survival. safety and tolerability assessed by number of grade 4 toxicities and hospitalizations.


Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed her2 positive invasive breast carcinoma * clinical stage ⅱ-ⅲc * eastern cooperative oncology group(ecog) performance status 0 to 1 within 14 days of study entry * normal (greater than 50%) left ventricular ejection fraction (lvef) by echocardiography * signed informed consent * adequate organ function within 2 weeks of study entry: absolute neutrophil count \>1500/mm3, hgb \>9.0 g/dl and platelet count \>100,000/mm3 total bilirubin \ 50ml/min using the cockcroft gault equation serum glutamate oxaloacetate transaminase(sgot)(ast) or serum glutamic oxaloacetic transaminase(sgpt)(alt) and alkaline phosphatase must be within the range allowing for eligibility * patients must be over 18 years old. * women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment * women of childbearing potential and men must agree to use adequate contraception (barrier method of birth control) prior to study entry and for the duration of study participation. exclusion criteria: * metastatic disease * prior chemotherapy, hormonal therapy, biologic therapy, investigational agent, targeted therapy or radiation therapy for current breast cancer. patients with history of breast cancer greater than 5 years from initial diagnosis are eligible for the study. patients may not have received anthracycline-based chemotherapy in the past. patients with history of ductal carcinoma in situ(dcis) are eligible if there were treated with surgery alone. * history of previous or current malignancy at other sites with the exception of adequately treated carcinoma in-situ of the cervix or basal or squamous cell carcinoma of the skin. patients with a history of other malignancies, who remain disease free for greater than five years are eligible.

Keywords: neoadjuvant treatment her2-positive breast cancer