Kornimate/medical-research-clean huggingface dataset:
assessing the efficacy of steroid treatment of achalasia

Conditions: Achalasia

Summary: would systemic steroids be an effective treatment in early variants of achalasia?


Eligibility criteria:
inclusion criteria: * adults ages 18-90 with a diagnosis of achalasia confirmed by findings on esophageal manometry and barium esophagogram will be eligible for the study. * eckardt score6 greater or equal to 6 or 2 or greater for dysphagia and/or regurgitation * symptoms less than 2 years exclusion criteria: * medical conditions such as severe heart or lung disease that preclude safe performance of endoscopy and injection; * greater than mild esophageal dilation * type 1 achalasia as defined by the chicago classification scheme7 and/or esophageal diameter \> 3cm; * prior treatment for achalasia * use of medications that might affect les pressure such as anticholinergics or calcium channel antagonists * symptom duration greater than 2 years * inability to read due to: blindness, cognitive dysfunction, or english language illiteracy * disorders which predispose to unreliable responses such as schizophrenia, alzheimer's disease or significant memory loss * pregnant and lactating females will be excluded as steroids are not thought safe for the fetus.

Keywords: trouble swallowing dysphagia disorder of the esophagus
backwards examination of the right colon: a back-to-back study

Conditions: Colon Neoplasms

Summary: the aim of this study is to evaluate the examination of the proximal colon with the retroflexion colonoscopic technique in terms of feasibility and its possible additive contribution in the detection of important lesions, namely polyps and cancers.

the investigators prospectively examined the additional diagnostic yield of right colon examination with colonoscope retroflexion in consecutive, symptomatic and screening - surveillance patients. right colon was examined in forward-view first and thereafter, retroflexion was performed to re-inspect it.

Eligibility criteria:
inclusion criteria: * patients undergoing elective colonoscopy in a attikon university general hospital. exclusion criteria: * patients aged \ 80 years; * right colectomy; * recent abdominalsurgery; * multiple diverticula of the right colon; * american society of anesthesiology (asa) physical status classification grade iv; * inflammatory bowel disease and polyposis syndromes.

Keywords: colonoscopy right colon retroflexion adenoma detection rate feasibility surveillance interval
a prospective,open-label study of anastrozole in post-menopausal women with hormone sensitive advanced breast cancer

Conditions: Breast Cancer

Summary: the overall objective of the clinical study is to assess the tolerability and clinical efficacy of anastrozole in post-menopausal women with hormone sensitive advanced breast cancer in india.


Eligibility criteria:
inclusion criteria: 1. patients must be adult (age ≥ 18 years age) post-menopausal\* women 2. patients must be diagnosed with advanced breast cancer (histologically or cytological confirmation required) i.e. tnm stage iii or iv disease (locally advanced or metastatic breast cancer) or locoregional recurrent disease, not suitable for treatment by local surgery or radiation therapy 3. measurable or evaluable disease 4. patients with er/pr positive tumour or er/pr unknown status 5. patients must be suitable for endocrine treatment with anastrozole 6. prior adjuvant chemotherapy or endocrine therapy for early breast cancer is allowed, provided such treatment was completed at least twelve months prior to study enrollment 7. performance status 0-2 (as per who classification) 8. concurrent use of bisphosphonates is permitted. 9. patients must give their written informed consent for participation in the study exclusion criteria: 1. patients with tumors known to be estrogen and progesterone receptor-negative. 2. estrogen hormone replacement therapy, concurrently or within 6 weeks before randomization 3. extensive visceral involvement (significant hepatic involvement, brain metastasis or pulmonary involvement \> 50% of the lungs); serum liver enzymes sgot and sgpt should be no greater than five times the upper limit of the reference range 4. patients received bone marrow transplantation before randomization 5. any concurrent medical illness (uncontrolled cardiac disease or diabetes mellitus) or laboratory abnormalities that would compromise safety or prevent interpretation of results 6. an estimated survival of less than 3 months from the start of study drug treatment based on clinical judgment. 7. any systemic investigational drug within the thirty days of enrollment into study

Keywords: breast cancer post menopausal women post menopausal women with hormone sensitive advanced breast cancer
immunogenicity of covid-19 vaccine co-administration with influenza vaccine in healthy volunteers

Conditions: Immune Response to SARS-CoV-2

Summary: this study, a pilot randomized controlled trial, single-blind (outcome assessor), evaluating the immune response (both humoral and cell-mediated) against sars-cov-2 and the safety of three different vaccine administration approaches: the sars-cov-2 mrna vaccine alone, the influenza vaccine alone, and the co-administration of both vaccines.


Eligibility criteria:
inclusion criteria: * thai adults aged 18-60 years, who have vaccinated covid-19 and influenza vaccine more than 6 months. * the subjects are able to and willing to comply with the requirements of the clinical trial program and could complete the 1-month follow-up of the study. * individuals who are in good health condition at the time of entry into the trial as determined by medical history, physical examination and clinical judgment of the investigator and meet the requirements of immunization. * the subject can provide with informed consent and sign informed consent form (icf). exclusion criteria: * have history of influenza or covid-19 infection within 6 months. * have the medical history or family history of convulsion, epilepsy, encephalopathy, and psychosis. * be allergic to any component of the research vaccines or used to have a history of hypersensitivity or serious reactions to vaccination. * history of guillain-barré syndrome. * women with positive urine pregnancy test, pregnant or breast-feeding, or have a pregnancy plan within six months of after baseline period. * have infectious diseases, including hiv and sars-cov-2 infection or any symptom of common cold. * have history of sars-cov-2 infection less than 6 months. * having severe chronic diseases or condition in progress cannot be controlled. for example, poor controlled dm and uncontrolled ht. * have the history of urticaria 1 year before receiving the investigational vaccine. * have known underlying diseases of thrombocytopenia or other coagulation disorders (which may cause contraindications for intramuscular injection). * having needle sickness. * have the history of immunosuppressive therapy, cytotoxic therapy, or systemic corticosteroids. * have received blood products within 4 months before injection of investigational vaccines. * under anti-tuberculosis treatment. * not be able to follow the protocol, or not be able to understand the informed consent according to the researcher's judgment, due to various medical, psychological, social, or other conditions.

Keywords: co-administration immunogenicity cell-medicated immune response influenza vaccine covid-19 vaccine sars-cov-2 vaccine
cohort of patients with hepatocellular carcinoma or cholangiocarcinoma

Conditions: Cholangiocarcinoma; Hepatocellular Carcinoma

Summary: the main objective is to describe the evolution of patients treated for a primary malignant hepatobiliary tumor (hepatocellular carcinoma or cholangiocarcinoma) over the long course.

the collection of data from patients with chc and cholangiocarcinomas who are cancers with poor prognosis is a major challenge to improve patients'care (diagnosis, prognosis); facilitate the search for new therapeutic targets and the follow-up of clinical studies; and develop personalized treatments.

Eligibility criteria:
inclusion criteria: inclusion criteria : * age ≥ 18 years olds * medical care in nephrology department since 2015 cholangiocarcinoma: - histologically and cytologically documented cholangiocarcinoma, regardless of the stage of the disease hepatocellular carcinoma: * hepatocellular carcinoma at any stage of the disease, presenting the diagnostic criteria according to the diagnostic criteria of barcelona : tumor of more than 1 cm, developed on cirrhosis liver with arterial phase hyperenhancement and washout in the portal venous or delayed phases on ct and mri * hepatocellular histologically documented exclusion criteria: - lack of patient non-opposition

Keywords: hepatocellular carcinoma cholangiocarcinoma cohort
tapb vs qlbii for kidney transplantation procedure

Conditions: Postoperative Pain

Summary: the main advantage of quadratus lumborum block (qlb) compared to transversus abdominalis plane block (tapb) is the impact on visceral pain due to the spread of the local anaesthetic agent to the paravertebral space. it may produce extensive analgesia and better pain control. previews studies shoved the effectiveness of tapb in kidney transplantation procedure (ktx) by reducing opioids requirements during and after the operation. qlb was not evaluating in ktx procedure yet, but it reduced postoperative morphine requirement after cesarean section under spinal anaesthesia. the aim of this prospective, randomised controlled, multicenter, clinical study is to compare the perioperative analgesic efficacy of qlb and tapb in patients who had ktx under balanced (general and regional) anaesthesia.

after bioethical committee of medical university of warsaw approval, informed written consent will be obtained from all patients. a sample size of 104 patients was calculated to obtain at list 25% reduction of fentanyl usage in qlbii group with 0,05% significance and power of 0,8. consenting patients, scheduled to ktx procedure under general anaesthesia will be randomly assigned (1:1) according to the computer -generated randomization list with permuted blocks (block sizes: 20, 20, 24, 40) to receive 20ml of 0,25% bupivacaine with epinephrine ipsilaterally to the operation side in qlbii or tapb after the general anaesthesia induction and before the surgery starts. all the blocks will be performed in the supine patients position, under ultrasound guidance for both techniques. the correct spread of injectate will be confirmed with ultrasound.

Eligibility criteria:
inclusion criteria: 1. kidney transplantation procedure with anatomical urinary outlet 2. written informed consent exclusion criteria: 1. patients' refusal 2. known allergies to study medication 3. inability to comprehend or participate in pain scoring scale 4. inability to use intravenous patient controlled analgesia system 5. anatomic, posttraumatic and postoperative deformations could possibly affect the spread of local anesthetic in transversus abdominalis plane or quadratus lumborum muscle plane. 6. transversus abdominalis plane or quadratus lumborum muscle plane not seen in ultrasound examination.
pre-mapping networks for brain stimulation 2

Conditions: Depressive Episode; Major Depressive Disorder

Summary: the investigators compare the primary and secondary outcome measures using accelerated intermittent theta burst stimulation (aitbs, 20 sessions active and 20 sessions sham in a counterbalanced crossover design) to treat depressive symptoms with 2 parallel arms of intervention: personalized (stimulation position based on participants' brain networks) vs conventional (stimulation in f3 position of the 10-20 eeg cap) aitbs.


Eligibility criteria:
inclusion criteria: * men and women between the ages of 18 and 60 years * diagnosis of major depressive disorder according to dsm 5 (f32.x according to icd-10) or bipolar disorder (bipolar i or bipolar ii) according to dsm 5 (f31.x according to icd-10) and an acute depressive condition at the time of the initial examination in outpatient or inpatient treatment (e.g. department of psychiatry and psychotherapy, umg) * availability of informed consent to participate in the study, including the examinations and interventions exclusion criteria: * neurological diseases, current or previous * other axis i diagnoses that mimic the affective disorder, current or previous * physical illnesses that could be related to the affective symptoms (so-called organic causes) * illicit drug use in the past month * substance dependence, current or previous * physical illnesses which, depending on their type and severity, could interfere with the planned examinations, influence the parameters to be examined or endanger the test participant during the course of the examination * medical contraindications against performing an mrt examination / rtms application (such as metal parts in the body, e.g. implants, pacemakers, infusion pumps, metal splinters, etc.) * pregnancy * previously known cerebral-morphological abnormalities (e.g. tumor, lesion, etc.) * evidence or history of epilepsy * head trauma with a history of loss of consciousness * unwillingness to be informed of incidental findings * participation in an rtms / ekt application within the last 8 weeks * lack of the ability to provide informed consent
ebus/spectrum analysis

Conditions: Lung Cancer

Summary: to evaluate the clinical benefit of spectrum analysis of endobronchial ultrasound images of lymph nodes during ebus tbna for lymph node staging in patients with lung cancer.


Eligibility criteria:
inclusion criteria: * ages 18 years or older * patients with known or suspected lung cancer who require ebus-tbna for lymph node staging exclusion criteria: * patients who are deemed on clinical grounds not to be medically fit for a bronchoscopy * inability to give informed consent * patients who are pregnant
use of a probiotic in the treatment of fibromyalgia (fibroprob)

Conditions: Fibromyalgia

Summary: this study aims to understand the efficacy of two probiotic interventions as prophylaxes of fibromyalgia symptoms in individuals diagnosed. the primary outcome measure will be the progression and treatment of fibromyalgia, defined as a decrease in the fibromyalgia impact questionnaire (fiq) score, other otucomes will be the effect on the symptoms of anxiety and depression associated with fibromyalgia, defined as a decrease in the hospital anxiety and depression scale (had) score; perception of pain by scoring on a visual analogical pain scale (vas), and differences in the patient's usual medical treatment. finally adverse effects will be evaluated. the study will have two arms: one arm including a probiotic preparation and a placebo arm.


Eligibility criteria:
inclusion criteria: 1. age between 20 - 65 years. 2. signature of informed consent by the patient. 3. patients diagnosed according to the 2010 american college of rheumatology (acr) diagnostic criteria for fibromyalgia exclusion criteria: 11. women who are pregnant, breastfeeding or who do not commit to using an effective method of contraception during the course of the study. 2. known allergy to any of the components of the study product or the placebo. 3. consumption of antibiotics in the 2 weeks prior to the start of the study. 4. consumption of probiotics in the 2 months prior to the start of the study. 5. evidence of neuropsychiatric disorders including: parkinson's disease, psychotic disorder, bipolar depression 6. regular consumption of alcohol in excess of 45 g ethanol/day in the year prior to study inclusion. 7. any concurrent malignant pathology known at the time of inclusion in the study or serious metabolic, cardiovascular, renal, hepatic or gastrointestinal diseases which may lead to non-completion of the study according to the investigator's criteria.

Keywords: probiotic fibromyalgia
prefabricated versus 3d-printing myofunctional appliances

Conditions: Class II Division 1 Malocclusion

Summary: the aim of this clinical study is to evaluate the dentoskeletal effects of class ii division 1 treatment in growing patients with a prefabricated myofunctional appliance versus a 3d-printing myofunctional appliance.

this study aims to investigate the dentoskeletal effects of class ii division 1 treatment in growing patients with a prefabricated myofunctional appliance versus a 3d-printing myofunctional appliance.

Eligibility criteria:
inclusion criteria: * increased overjet \>4 mm * skeletal class ii relationship (anb \> 4 degree) * no previous orthodontic treatment exclusion criteria: -craniofacial syndrome

Keywords: myofunctional treatment 3d-print prefabricated myofunctional appliance class ii division 1 malocclusion orthodontics
cognitive-behavioural and hypnotic treatment of chronic primary insomnia among the elderly

Conditions: Insomnia

Summary: the present study examines the short- and long-term clinical efficacy of cognitive-behavior therapy and pharmacological treatment in patients suffering from late-life primary insomnia. 46 subjects suffering from chronic primary insomnia were randomized into either cognitive-behavior therapy (cbt, n=18), hypnotics (7.5 mg zopiclone, n=16), or placebo treatment (n=12). all active treatments lasted 6 weeks with follow-ups conducted at 6 months. ambulant clinical polysomnography (psg) and sleep diaries were used on all three assessment points.


Eligibility criteria:
inclusion criteria: * age 55 years or older * fulfilment of the dms-iv criteria for insomnia, including difficulties initiating sleep, maintaining sleep, and/or early morning awakenings with no ability of return to sleep * duration of at least 3 months * complaints of impaired daytime functioning. exclusion criteria: * use of hypnotic medication the last 4 weeks before project start * use of antidepressive or antipsychotic medications * signs of dementia or other serious cognitive impairment defined by a score under 25 on the mini-mental state examination * presence of a major depressive disorder or other severe mental disorder as identified by a clinical assessment based on the structured clinical interview for dsm-iv (scid-i) * presence of sleep apnea defined as (a/h index \> 15) or periodic limb movements during sleep (plm index with arousal \> 15), * working nightshifts and unable or unwilling to discontinue this work pattern, * willingness or inability to stop taking sleep medication before start * having a serious somatic conditions preventing further participation
interprofessional group intervention to promote faculty wellbeing and engagement

Conditions: Burnout, Professional

Summary: a randomized trial of an interprofessional intervention to reduce burnout and enhance professional engagement in physicians, certified nurse midwives, and nurse practitioners.

to test the hypothesis that an intervention involving self-facilitated interprofessional group meetings would result in improvement in wellbeing and to determine whether use of a written curriculum provided increased benefit, the following study is conducted: practicing clinical faculty in the department of obstetrics and gynecology at the massachusetts general hospital were recruited to participate in three monthly small groups over dinner. participants were randomized to a control group, which met without any specified guidelines for discussion content, or to receive an intervention which consisted of a one-page discussion guide addressing themes relevant to challenges in the healthcare environment: reframing challenging patient interactions; embracing uncertainty in work; and coping with errors, near misses, and bad outcomes. outcomes included burnout, empowerment and engagement in work, stress from uncertainty assessed using validated metrics, and perception of of collegiality and community. all participants were also offered the option of participating in evaluation of biomarkers. to test the hypothesis that an increased sense of bonding and relational connection, and reduced stress levels would be reflected by changes in hormone levels during the meeting and over the course of the study. faculty who opted into this portion of the study gave the following samples: urine oxytocin before and after the first and third group meetings salivary oxytocin before and after the first and third group meetings salivary cortisol before and after the first and third group meetings hair cortisol at the beginning of the study and at the end of the study (a roughly three month interval). an optional focus group was conducted after the three monthly sessions. all participants signed a consent form prior to participating in the study.

Eligibility criteria:
inclusion criteria: * physican in the department of obstetrics and gynecology at massachusetts general hospital * nurse practitioner in the department of obstetrics and gynecology at massachusetts general hospital * certified nurse midwife in the department of obstetrics and gynecology at massachusetts general hospital exclusion criteria: * none
pilot study of 18f-faza in assessing early functional response in patients with inoperable non small cell lung cancer undergoing radiotherapy or chemo-radiotherapy

Conditions: Lung Neoplasm; Cell Hypoxia

Summary: non-small cell lung cancer (nsclc) has a poor prognosis if not caught early enough. one of the factors that may impact the ability to control nsclc is low oxygen levels (hypoxia) inside the tumour. this study will use 18f-faza pet scans to assess whether patients have hypoxic tumours and to monitor the changes to the hypoxic areas of a tumour during currently available standard treatment. it is hypothesized that 18f-faza pet may predict response to treatment, local control, and/or survival in nsclc.

locally advanced nsclc has a poor prognosis with a 5 year overall survival rate of only 15%. tumour hypoxia may impact the ability to control nsclc. using 18f-faza pet, this study will assess patients for hypoxic treatment. with this information, we can start individualizing patient treatment to target hypoxia. the relationship between areas of hypoxia (18f-faza) and high glucose utilization (18f-fdg) will also be assessed.

Eligibility criteria:
inclusion criteria: 1. patients with histologically-proven, by biopsy or cytology, unresected lung cancer of the following histological types: squamous cell carcinoma; adenocarcinoma; undifferentiated large cell carcinoma, and non-small cell, not otherwise specified (nos, diagnosis on cytology alone) 2. patients with american joint committee on cancer (ajcc) stage i, ii, iiia, or iiib with detectable tumour that can be encompassed by radiation therapy fields, including both primary tumour and the involved regional lymph nodes. 3. patients must be deemed to be suitable to undergo definitive (i.e. potentially curable) chemoradiotherapy or radiotherapy by the treating physician. 4. the prescribed radiotherapy dose must be a minimum of 60 gy in 30 fractions 5. male or female ≥ 18 years of age. if female of child bearing potential and outside the window of 10 days since the first day of the last menstrual period, a negative pregnancy test is required. 6. ecog/zubrod status 0-1 7. patients must have at least one measurable lesion ≥ 1 cm on ct 8. able and willing to follow instructions and comply with the protocol 9. provide written informed consent prior to participation in the study exclusion criteria: 1. patients who have undergone complete or subtotal tumour resection 2. patients with post-resection intrathoracic tumour recurrence 3. patients eligible for definitive surgery (patients who are eligible for surgery, but surgery did not proceed are eligible for this trial) 4. no distant or metastasis, prior chemotherapy, or thoracic neck or radiotherapy 5. evidence of any small cell histology 6. prior or concurrent malignancy (except non-melanomatous skin cancer) unless disease-free for at least 5 years 7. inability to lay in supine position for approximately one hour 8. nursing or pregnant females 9. aged less than 18 years

Keywords: 18f-faza 18f-fdg positron emission tomography