Kornimate/medical-research-clean huggingface dataset:
placing trust in endoscopic ultrasonography: impact on planning conformal radiotherapy of cancer of the esophagus and rectum

Conditions: Oesophageal Cancer; Rectal Cancer

Summary: the purpose of this study is to estimate the rate of patients in whom a significant change in the area to be irradiated will be observed between the assessment before and after laying the evaluation of trustees.

the centering of radiotherapy is done with the pre-radiation scanner for tracking the implementation of target skin markers. on this scanner, it is often difficult for the radiation therapist to pinpoint the target volume. to improve the definition of the target volume, image fusion techniques with other imaging tests were developed. to improve the pre-radiotherapy identification, setting up markers echo-endoscopy has been described without major complications. the impact on targeting radiotherapy was mainly described for the prostate. the marking of digestive tumors was described by the establishment of trustees, radiopaque markers in the lymph nodes, esophagus, stomach, pancreas, and bile ducts.

Eligibility criteria:
inclusion criteria: * male or female over the age of 18 * rectal cancer diagnosis or esophagus * radiotherapy indication * signed consent to participate * patient affiliated to a social security system or benefiting from such a system exclusion criteria: * pregnant women, of child-bearing potential, or lactating women * patient deprived of liberty or under supervision of a guardian * impossibility to undergo medical examinations of the study for geographical, social or psychological reasons * contra-indication for procedure study (infeasible eus) * contra-indication for general anesthesia * patient (e) with disorders of hemostasis * patient (e) with portal hypertension

Keywords: laying of medical devices (radio opaque markers)
intravenous vitamin c in the treatment of viral infection, especially in the treatment of shingles

Conditions: Virus Diseases; Herpes Zoster

Summary: chronic viral infections induce oxidative stress that can cause a number of concomitant diseases, e.g. cardio-vascular diseases or metabolic disorders. therefore, a sufficient treatment of oxidative stress may be of benefit for the patient to prevent further diseases. shingles (herpes zoster infection) have been successfully treated with antioxidative substances like high-dose vitamin c for ages. not only the acute symptoms can be diminished by high-dose vitamin c. even long-term sequelae, like painful post-herpetic neuropathy, may be mitigated or even fully avoided.


Eligibility criteria:
due to the design of an observational cohort study, no inclusion or exclusion criteria are named. the included patient group is described under "cohort / group". observational criteria: * adult patients * acute viral infection (especially herpes zoster) * primary care patient * eligible for add-on therapy with vitamin c * willingness to provide pseudonymized data to the sponsor

Keywords: herpes shingles virus disease vitamin c ascorbic acid antioxidant oxidative stress
pilot study using echocardiography to evaluate patients with heart failure and dyssynchrony who have a crt-d device

Conditions: Systolic Heart Failure

Summary: out of all the patients that receive a crt-d ( a dual chamber pacemaker with defibrillator ) for cardiac resynchronization therapy there is approximately one-third that do not respond. we believe that by using a simple technique that includes routine echocardiography that are normally performed in these patients could help us better understand how to program their device to reach better optimization.


Eligibility criteria:
inclusion criteria: 1. adults age 18-110 years 2. must have a crt-d (a biventricular pacemaker with defibrillator) 3. last optimization of their device (crt-d) must not have been done in the past 3 months 4. must be optimal heart failure medical regimen. this includes target dose of beta-blocker and angiotensin converting enzyme inhibitor (ace-i) (or equivalent; i.e angiotensin receptor blocker (arb); or balanced preload and afterload reducers with hydralazine and nitrates.) exclusion criteria: 1. less than 18 years of age or greater than 110 years old. 2. does not have a crt-d 3. optimization of their device has occurred in the past 3 months 4. not on optimal medical therapy for heart failure as listed in the inclusion criteria.

Keywords: dyssynchrony cardiac resynchronization therapy
comparing pressure versus simple adhesive dressing after mohs reconstruction

Conditions: Non-melanoma Skin Cancer

Summary: the purpose of this study is to determine whether using a pressure- vs. simple adhesive dressing affects the postoperative course and wound healing outcomes following mohs surgery.

the investigators will randomize patients undergoing mohs surgery to receive either a pressure or a simple adhesive dressing following their procedure. the hypothesis is that patients with the simple adhesive dressings will be more satisfied and comfortable with their wound care on follow-up. these patients are also expected to cite greater convenience managing the simple dressing at home. finally, the investigators anticipate no difference in the number of postoperative complications between the two groups and expect that there will be a lower cost associated with the simple adhesive dressing as compared to the pressure dressing.

Eligibility criteria:
inclusion criteria: * patients will be considered for enrollment if they have been referred to a mohs surgeon for consideration of mohs surgery for non-melanoma skin cancer. exclusion criteria: * lack of indication for mohs * significant comorbidities * case of a high-risk location or tumor size which necessitates consultation with other specialties in advance.

Keywords: pressure dressing post-operative care simple adhesive dressing mohs
evaluation of a lifestyle medicine practice

Conditions: Chronic Lifestyle Related Disease; Diabetes; Overweight and Obesity; Dyslipidemias; Hypertension; Cardiovascular Diseases

Summary: this project will evaluate the success of the pi's lifestyle medicine practice.

the main objective of the study is to evaluate the effectiveness of the pi's lifestyle medicine practice over time. sub-objectives are: 1. understand variables that affect success in application of lifestyle medicine to lead to improved patient outcomes. 2. develop a model for practice evaluation that can be utilized for board certification of providers and practices that utilize lifestyle medicine. 3. evaluate the reimbursement success of lifestyle medicine services as a factor of billing codes and insurance providers.

Eligibility criteria:
inclusion criteria: * adult patients who are seen by the pi in his lifestyle medicine practice at muntean health care. exclusion criteria: * none
effect of costal harvesting technique on postoperative donor-site morbidity: does muscle sparing technique cause less postoperative pain ? a clinical trial

Conditions: Nasal Deformity; Revision Rhinoplasty; Autogenous Rib Graft; Costal Cartilage; Harvesting

Summary: the purpose of this study was to investigate the effect of 'muscle sparing technique' while harvesting costal/rib cartilage on postoperative donor-site morbidity -namely postoperative pain. although authors report 'muscle sparing technique' cause less pain its not investigated in an evidence-based-medicine perspective. therefore the investigators are planning a controlled, prospective clinical trial to compare the conventional method and 'muscle sparing technique'. effect of costal harvesting technique on postoperative donor-site morbidity: does muscle sparing technique cause less postoperative pain ? a clinical trial

revision rhinoplasty patients requiring costal cartilage were enrolled in the study. all costal cartilage harvestings were full-thickness and they were carried out by a single-surgeon (berke ozucer). patients were randomly assigned either to 'conservative muscle-cuttingharvesting technique' or 'muscle-sparing harvesting technique'. surgical technique costal cartilage harvesting in both groups were identical expect this: m-cutting group : following skin incision with no.15 blade; all layers including the subcutaneous fat, muscle fascia and muscles covering the cartilage were cut with monopolar electrocautery at (25 watts). m-sparing group: : following skin incision with no.15 blade; all layers including the subcutaneous fat, muscle fascia and muscles covering the cartilage were passed with blunt dissection. muscle fibers were dissected parallel to their positioning. postoperative pain was evaluated with a visual analogue scale. participants were questioned regarding their donor-site pain and asked to score their pain 0 (minimum and 10 (maximum). passive state and pain while active was evaluated separately. this evaluation was carried out at 6th postoperative hour, first, second, third postoperative-days, first postoperative week, on 15th ,30th and 45th day postoperatively. also postoperative need for analgesics were also noted for the first three days. muscle-cutting and muscle-sparing groups were analysed for mean ± standard deviation values. these values were compared statistically to assess whether muscle-sparing technique has a significant effect on reduced postoperative pain.

Eligibility criteria:
inclusion criteria: * revision rhinoplasty * when costal cartilage is harvested full-thickness exclusion criteria: * fibromyalgia * no consent * when patient does not comply with follow-up
ambulatory and blood pressure variability responses to exercise in normotensive and hypertensive women

Conditions: Menopause; Exercise; Blood Pressure, High

Summary: this study evaluated the differences between normotensive and hypertensive menopausal women in ambulatory and blood pressure variability responses to combined aerobic and resistance exercise.

the differences in hypotensive and cardioprotective responses of exercise among menopausal hypertensive and normotensive women are still not very clear, mainly the responses of blood pressure variability. in this way, were evaluated 6 indices related to the variability of 24 hour ambulatory pressure measurements in these women before and after 12 weeks of combined exercise training.

Eligibility criteria:
inclusion criteria: * amenorrhea for at least 12 months; body mass index ≤30 kg/m2; ability to engage in treadmill and resistance exercises; hypertension nom-medicated with beta-blockers exclusion criteria: * history of diabetes, cancer or cardiovascular disease (except for hypertension in hypertensive group); doing hormone therapy or soy derived supplementation; smokers

Keywords: blood pressure variability ambulatorial blood pressure monitoring combined exercise
effect of itopride on gastric emptying and accommodation in patients with functional dyspepsia

Conditions: Functional Dyspepsia; Gastric Emptying; Gastric Accommodation

Summary: pathogenesis of functional dyspepsia is poorly understood. gastrointestinal motor abnormalities, helicobacter pylori infection, impaired gastric accommodation to a meal, hypersensitivity of the afferent nerves of the gut, psychological disturbances and central nervous system dysfunction have been proposed. pharmacological treatments for patients with functional dyspepsia remain unsatisfactory. only small benefits relative to placebo have been found with histamine h2 receptor antagonists, proton pump inhibitor and helicobacter pylori eradication. itopride is a dopamine antagonist with acetylcholinesterase inhibitory actions. this agent is currently indicated for patients with various upper gi symptoms. this study is aimed to evaluate the effect of itopride on gastric emptying(by 13-c octanoic acid breath test), accommodation (by gastric scintigraphy spect and slow nutrient drinking test)and symptoms in fd patients

phase3 clinical trial

Eligibility criteria:
inclusion criteria: 1. all adult male or non-pregnant female patients who are diagnosed as functional dyspepsia and fulfilling rome iii criteria (1) will be considered 2. patients should be negative for h. pylori on gastric biopsy and urea breath test. 3. duodenal biopsy in these patients should be negative for giardiasis or celiac disease or any other established organic pathology 4. a normal upper abdominal ultrasound 5. willing to participate and give consent for participation in the study. exclusion criteria: 1. age \<18 years 2. helicobacter pylori positive on gastric biopsy and / or ubt. 3. taking other medications that alter gastric motility like macrolide * anti-emetics and antibiotics . 4. pregnant or breast-feeding females.

Keywords: functional dyspepsia itopride gastric emptying gastric accommodation dyspeptic symptoms
study evaluating vaccine in adults with hiv

Conditions: HIV Infections

Summary: the purpose of this study is to learn whether the study vaccine and adjuvants (drugs that are used to help improve immune responses) have an acceptable safety profile in treating individuals with hiv. a second purpose of this study is to understand how the immune system responds to the study vaccine and adjuvants.


Eligibility criteria:
inclusion criteria: * 18 years of age diagnosed with hiv and on stable haart for a minimum of six months * cd4 t-cell count greater than and equal to 350/mm3 at screening * no reported cd4 t-cell count less than 350/mm3 at any time before screening * viral load less than 50 copies/ml at screening and no viral load greater than 400 copies/ml for a minimum of six months prior to screening exclusion criteria: * any chronic symptomatic infection other than hiv * use of any prior hiv vaccine (prophylactic and/or therapeutic) within one year before or during screening * any malignancy that may require systemic therapy * use of any investigational treatment within six months before screening or planned during study enrollment, except for investigational retrovirals obtained through actg

Keywords: hiv treatment experienced
relationship between high-density lipoprotein subtypes and coronary heart disease prognosis.

Conditions: HDL; Coronary Heart Disease

Summary: cardiovascular disease (cvd) is the leading cause of human mortality worldwide, imposing substantial societal and economic burdens. traditionally, high-density lipoprotein (hdl) has been branded as the "beneficial" lipoprotein. the framingham study found that for every 1mg/dl increase in hdl, the risk of coronary heart disease (chd) was reduced by 2% in men and 3% in women. subsequent studies further affirmed the inverse correlation between hdl and the risk of chd. however, these findings were first challenged by mendelian randomization studies which failed to identify a causal relationship between hdl and chd. moreover, randomized controlled trials demonstrated that therapeutically increasing plasma hdl concentrations did not reduce the risk of chd events, prompting doubts about hdl's status as "good cholesterol." the relationship between hdl and chd might be more intricate than previously believed, possibly not just mediated by the quantity of hdl but also intimately linked with its function. several cross-sectional studies have confirmed the relationship between hdl subtypes and the severity of disease in chd patients, yet findings are inconsistent. conventional testing methods lack a universally accepted standard for defining or describing hdl subfractions, with issues like expensive equipment, poor repeatability, cumbersome operation, slow analysis, and low throughput. microfluidic electrophoresis technology combines the merits of electrophoresis with microfluidic chip technology. this method facilitates efficient separation of substances in microchannels on a substrate, providing rapid and consistent results. utilizing the latest microfluidic chip technology for hdl subfraction detection offers quick, accurate, and straightforward analysis with minimal sample volume and automation. it precisely reflects the serum concentrations of hdl subfractions hdl2b and hdl3, addressing the current pitfalls of clinical hdl subfraction analysis methods. this approach is poised to become the standard method for hdl subfraction testing. in conclusion, existing studies on the association between hdl subtypes and chd remain inconsistent, with most having a small sample size. our study, leveraging microfluidic chip technology for hdl subfraction detection, aims to further investigate: the prognostic value of hdl subtypes for the long-term outcomes of chd patients, building a risk prediction model for adverse cardiovascular events that includes hdl subtypes.


Eligibility criteria:
inclusion criteria: 1. the age of the patients is over 18 years old; 2. coronary artery disease was confirmed by coronary angiography. exclusion criteria: 1. severe valvular disease, severe myocarditis, severe hepatic and renal insufficiency, thyroid insufficiency, severe infectious or systemic inflammatory diseases, severe blood diseases, malignant tumors. 2. lack of data on hdl subtypes.

Keywords: high-density lipoprotein subtypes coronary heart disease
sertraline in addition to standard of care treatment for coccidioidomycosis

Conditions: Coccidioidomycosis

Summary: in this study patients will be randomized 1:2 to receive either standard of care treatment or standard of care + sertraline 200mg/day for 2 weeks, then 400 mg/day for 50 weeks for treatment of disseminated and meningeal coccidioidomycosis.

sertraline has been demonstrated to have in-vitro activity against coccidioides, and in-vivo activity against cryptococcal meningitis in clinical trials. disseminated and meningeal coccidiodes infections require lifelong treatment, have poor outcomes, and new treatment options are needed. in this study the investigators will determine safety and tolerability of adjunctive sertraline (grade 4-5 adverse reactions) compared to standard coccidioidomycosis therapy alone.

Eligibility criteria:
inclusion criteria: * severe coccidioidomycosis infection, manifest as by one of: * coccidioidal meningitis; * severe pulmonary infection requiring intensive care unit level of care; * disseminated infection (in clinical opinion of the investigator); or * clinical progression after \>2 months of high dose fluconazole. * laboratory confirmation of coccidioides infection by culture, histopathology, coccidioides polymerase chain reaction, positive complement fixation titer, or coccidioides antigen exclusion criteria: * age \< 18 years * cannot or unlikely to attend regular clinic visits * presence of jaundice or known liver cirrhosis * pregnancy * if there is a concern of pregnancy, a negative urine (or serum) pregnancy test before study entry is required. * women of childbearing potential will have pregnancy test at enrollment and will be recommended to use contraception and referred to family planning services as necessary. (refer to informed consent document.) * currently breastfeeding * active drug use (amphetamine or cocaine) or requirement for concomitant medications that raise the risk of serotonin syndrome * prolonged corrected qt interval or left bundle branch block on baseline electrocardiogram
full occlusal rehabilitation for patients with severe tooth wear using indirect composite restorations

Conditions: Tooth Wear; Dental Restoration Failure; Dental Restoration Wear

Summary: lava ultimate composite restorations will be used as restorative material to reconstruct severely worn dentitions.

standard dental treatment will be provided to the patients with severely worn dentitions. treatment is based on the principles of 'minimally invasive treatment techniques'. main difference with the 'standard' treatment protocol and the standard procedure of placing composite restorations is the fully digital workflow. in the traditional workflow a silicon impression is made, after which the dental technician produces the (indirect) composite restorations in by hand. these restorations are then adhesively cemented on the teeth by the dentist. in the fully digital workflow, digital 3d-scans are made using the 3d lava scanner (3m espe). based on these digital 3d-images a digital wax-up is made by the dental technician after which all composite restorations (uplays and backings) are designed digitally before being milled and finally adhesively cemented on the teeth by the dentists. an important benefit for the patients is the rehabilitation of their worn dentitions. functionality (teeth are less sensitive, improved chewing ability, a better occlusal stability, etc) and aesthetics will be improved immediately after finishing the treatment. moreover, the estimated treatment time will be less (estimated treatment time approx. 12hours) than the traditional methods when using the standard treatment protocol (estimated treatment time approx. 18hours). another potential benefit is a better control and more predictable results by using 3d-images with the pre-designed computer simulation. a risk of these indirect composite resin restorations is the unknown survival rate compared to other indirect as well as to direct application technique

Eligibility criteria:
inclusion criteria: * generalized severe tooth wear * presence of functional problems * necessary increase of vertical dimension of occlusion (vdo) of ≥3 mm at location of first molars * no edentulous space in need for treatment in the anterior region in upper and lower jaw * a minimum of three posterior teeth (premolars and molars) per quadrant exclusion criteria: * asa 4 * functional problems (mouth opening \< 5cm, severe tempero mandibular dysfunction) * severe periodontitis (dpsi = 4)

Keywords: vertical dimension of occlusion direct composite restorations indirect composite restorations tooth wear failure quality of life
identifying challenges to healthy aging in persons with human immunodeficiency virus (hiv) age 50 and older

Conditions: HIV; Aging

Summary: the primary objective of this study is to identify and characterize frailty and pre-frailty in persons age 50 and older living with human immunodeficiency virus (hiv) followed by the atrium health wake forest baptist infectious diseases specialty clinics (idsc).

the study will implement electronic medical record-based screening for frailty (efi), further characterize frailty using comprehensive geriatric screening, and offer a customized activity and nutrition plan to a subset of participants. participation in phlebotomy for research biomarkers of aging is optional. the study also seeks to validate the electronic medical record embedded electronic frailty index (efi) for the prediction of adverse outcomes in aging persons with hiv, characterize the symptoms of pre-frailty and frailty in persons followed in the idsc, and assess the acceptability and efficacy of a customized activity and nutrition intervention targeting frailty. the study will also correlate research biomarkers of aging with aging symptoms in a subset of participants.

Eligibility criteria:
inclusion criteria: * person living with human immunodeficiency virus (hiv) * age ≥50 years * followed by the atrium health wake forest baptist infectious diseases specialty clinic (idsc) * eligible for ryan white program * able to provide informed consent * pre-frail or frail by electronic frailty index (efi) exclusion criteria: * age \<50 years (study designed to characterize frailty in aging persons with hiv) * unable to complete the required assessments or questionnaires

Keywords: human immunodeficiency virus frailty biomarkers of aging