Kornimate/medical-research-clean huggingface dataset:
usefulness of the artery first approach in pancreatic cancer surgery

Conditions: Pancreatic Cancer, Adult; Margin, Tumor-Free; Surgery Site Fistula; Recurrence Tumor

Summary: this study is aimed to evaluate difference of the 2 year recurrence free survival after pancreaticoduodenectomy for pancreatic cancer between artery-first approach and conventional procedure groups.

the patients will be divided into 2 groups conventional group: the patients who included this group will undergo conventional pancreaticoduodenectomy (pd) or pylorus preserving pancreaticoduodenectomy (pppd). we will identify and isolate superior mesenteric vein (smv) before pancreatic resection. the surgeon will dissect tissue around superior mesenteric artery (sma) and uncinate process of pancreas along the sma. experimental group: the patients who included this group will undergo pd or pppd including total pancreatic mesopancreas excision and superior mesenteric artery approach. before pancreatic transection, the surgeon will isolate superior mesenteric vein (smv) and superior mesenteric artery (sma). and the surgeon will dissect nerve plexus and lymph node around sma. inferior pancreaticoduodenal artery (ipda) and first jejunal artery will be identified and the surgeon will ligate according to surgical margin. anastomosis will be performed as usual manners. postoperative manage is same in two groups. the investigators will compared 2 years recurrence free survival rate between conventional and experimental groups.

Eligibility criteria:
inclusion criteria: * resectable pancreatic head cancer * no systemic metastasis * age \> 20 years * the patients who understand informed consent and is able to agree with study exclusion criteria: * the patients who have systemic metastasis * the patients who need neoadjuvant therapy in borderline resectable and locally advanced pancreatic cancer * those with active or uncontrolled infections * those with severe psychiatric / neurological disorders * alcohol or other drug addicts * patients with moderate or severe comorbidities who are thought to have an impact on quality of life or nutritional status (cirrhosis, chronic kidney failure, heart failure, etc.)
single agent lenalidomide in adult patients with relapsed/refractory acute lymphoblastic leukemia

Conditions: Leukemia; Relapsed Adult Acute Lymphocytic Leukemia

Summary: time-to-progression (ttp)

determine the time-to-progression (ttp) for subjects with relapsed/refractory acute lymphoblastic leukemia (all) receiving single agent lenalidomide 50 mg/day for 28 days/cycle.

Eligibility criteria:
inclusion criteria: * relapsed or refractory acute lymphoblastic leukemia (all) with \> 10% bone marrow or peripheral blood blasts per who-criteria. refractory define as failure to achieve cr after prior therapy. * previously untreated patients \> 60, if not candidates for standard induction * age ≥ 18 * not a candidate for curative treatment regimens * unwilling or unable to receive conventional chemotherapy * ecog performance status ≤ 2 * life expectancy \> 2 months * registered to in revassist restricted distribution program, and willing and able to comply with the program requirement * females of childbearing potential (fcbp): * must have a negative serum or urine pregnancy test (sensitivity of at least 50 miu/ml) 10 to 14 days prior to study enrollment and within 24 hours prior to prescribing lenalidomide * must either commit to continued abstinence from heterosexual intercourse or begin two acceptable methods of birth control * agree to ongoing pregnancy testing * men must agree to use a latex condom during sexual contact with a fcbp * able to adhere to the study visit schedule and other protocol requirements * willing and able to understand and voluntarily sign a written informed consent exclusion criteria: * prior therapy with lenalidomide * history of intolerance to thalidomide including development of erythema nodosum while taking thalidomide or similar drugs * advanced malignant hepatic tumors. * concomitant treatment with other anti-neoplastic agents (exception hydroxyurea) * anti-neoplastic treatment less than 4 weeks prior to enrollment (exception hydroxyurea) * use of any other experimental drug or therapy within 14 days of baseline * inability to swallow or absorb drug * active opportunistic infection or treatment for opportunistic infection within 4 weeks of first dose of study drug * new york heart association class iii or iv heart failure * unstable angina pectoris * cardiac arrhythmias with rapid ventricular response (heart rate \> 100 beats/minute) * uncontrolled psychiatric illness that would limit compliance with requirements * known hiv infection * known active hepatitis b virus (hbv) (exception seropositivity due to hbv vaccine not considered active hbv) * known hepatitis c virus (hcv) infection * pregnant * lactating females must agree not to breastfeed while taking lenalidomide * other medical or psychiatric illness or organ dysfunction or laboratory abnormality which in the opinion of the investigator would compromise the patient's safety or interfere with data interpretation * creatinine ≥ 1.5 mg/dl * creatinine clearance ≤ 60 ml/min. * total bilirubin \> 1.5 x institutional upper limit of normal (uln) (exception documented gilbert's syndrome) * ast and alt \> 3 x institutional uln
prognostic value of measuring dsaz by mri in cirrhotic patients on prophylactic treatment with β blocker (azymr)

Conditions: Bleeding Esophageal Varices; Cirrhosis

Summary: portal hypertension (pht) that leads to esophageal varices is clinically present, at the time of diagnosis, in 60% of cirrhotic patients (groszmann nejm 2005). variceal bleeding is a life-threatening complication. the yearly incidence of the first variceal bleeding in cirrhotic patients is estimated to 4%. this risk increases to 15% when medium or large varices are initially present, (d'amico baillieres clin gastroenterol 1997); therefore, for patient with medium or large varices a primary prophylaxis treatment with nonselective beta-blockers must be instituted decreasing risk of bleeding approximately by half (d'amico hepatology 2005). the method to evaluate the efficacy of beta blockers treatment is the hepatic venous pressure gradient (hvpg). hvpg \ 20%) to beta blockers was observed only in almost 30 % of patients. in non responder patients, the variceal bleeding incidence is estimated to 24 % at 2 years. in this situation, alternative treatments to beta-blockers have been suggested: endoscopic ligation, which was shown to be as effective as beta blockers in primary prevention, and more recently carvedilol (reiberger, gut 2012). so, hvpg monitoring may provide critical information for patients. however, because of its technical requirement and its invasivity, hvpg measurement is not feasible in clinical practice . so, there is a general consensus to continue indefinitely beta blockers treatment without control of hemodynamic efficiency (merkel j. hepatology 2009). previous studies have suggested the interest of azygos blood flow measurements for evaluating hemodynamic changes in the esophageal collateral vessels of patients with portal hypertension (bosch j. hepatology 1985 ). more recently magnetic resonance imaging (mri) has been reported to be an efficient technique to assess azygos blood flow (gouya radiology 2011) in cirrhotic patients. its feasibility is obviously higher than hvpg measurement. however, in the same way that hvpg, a large-scale implementation in clinical practice of azygos blood flow measurement by mri requires to specify minimal absolute threshold, or relative post-therapeutic decrease, related with no variceal bleeding.


Eligibility criteria:
inclusion criteria: cirrhotic patients requiring β blocker in primary prophylaxis of bleeding esophageal varices exclusion criteria: * patients under 18 year's old * life expectancy of less than one month * patient already has a vasoactive treatment * patient with chc or portal vein thrombosis * patient without social security or deprived of freedom * contraindication to mri * contraindication to beta-blockers * mental state does not allow the signing of an informed consent

Keywords: measurement of azygos blood flow
study of the effect of serelaxin on high-sensitivity cardiac troponin i (hs-ctni) release in patients with chronic heart failure

Conditions: Chronic Heart Failure

Summary: this was a multicenter, randomized, double-blind, crossover, placebo-controlled, phase ii clinical study that evaluated the effect of serelaxin versus placebo (both in addition to soc) on the release of hs-ctni, in patients with chf after an exercise testing session.


Eligibility criteria:
key inclusion criteria: * male or female ≥ 18 years of age, with body weight ≤ 160 kg * diagnosis of stable chf: * new york heart association (nyha) functional class ii/iii. * receiving guideline-recommended treatment for chf. * left ventricular ejection fraction \< 45%, obtained within the last 3 months prior to screening. * nt-probnp \> 300 ng/l in sinus rhythm or \> 900 ng/l if not in sinus rhythm (determined locally). * ability to exercise for at least 10 to 12 minutes based on investigator's judgment. * systolic bp ≥ 125 mmhg at randomization * renal function defined as an egfr of ≥ 25 ml/min/1.73 m\^2 at screening (smdrd formula). key exclusion criteria: * dyspnea primarily due to non-cardiac causes. * increased risk of developing hypotension during vasodilator therapy according to investigators judgement. * any contraindication for exercise testing and spirometry. * stopping of the spiroergometry at screening according to the stopping rules, unless the patient has reached maximum exercise capacity defined as carbon dioxide production/oxygen consumption (vco2/vo2) \> 1.05. * change in guideline-recommended chf treatment within 1 month prior to screening.

Keywords: serelaxin, chronic heart failure, spiroergometry, troponin, new york heart association (nyha) functional class ii/iii, left ventricular ejection fraction,
metformin and lactoferrin in sepsis in icu

Conditions: Sepsis

Summary: sepsis is a life-threatening organ dysfunction triggered by an unregulated response of a host to infection. sepsis is a reason for substantial mortality and morbidity among intensive care unit (icu) patients. 1 therefore, the aim of our study is to compare the safety and efficacy of metformin and lactoferrin in icu patients with sepsis.

sepsis is a life-threatening organ dysfunction triggered by an unregulated response of a host to infection. sepsis is a reason for substantial mortality and morbidity among intensive care unit (icu) patients. 1 the pathophysiology of sepsis has changed spectacularly over the last several decades. significant comprehension into the components of the inflammatory response has been achieved. inflammation contributes to endothelial injury and initiates coagulation pathways.2 the inflammatory reaction is mediated by the release of cytokines (tumor necrosis factor-alpha, interleukins, and prostaglandins) from neutrophils and macrophages. the cytokines trigger the extrinsic coagulation cascade and inhibit fibrinolysis. these overlapping processes end with organ dysfunction.3 the sequential organ failure assessment or sofa score was developed to assess the acute morbidity of critical illness at a population level and has been extensively validated as a tool for this purpose across a range of healthcare settings and environments.4 metformin is oral anti-diabetic agent that has positive effects such as antioxidant and anti-inflammatory properties which are considered potentially beneficial properties for management of septic patients. previous studies showed that preadmission metformin use may reduce mortality in adult patients with sepsis and diabetes mellitus. therefore, our study aims to test the potential efficacy of metformin in all subsets of patient with sepsis.5,6 lactoferrin is a cationic glycoprotein and associated with many activities including the relevant anti-inflammatory one, especially associated to the downregulation of pro-inflammatory cytokines besides its anti-microbial and immunomodulatory effect.7 a previous study suggested that lactoferrin supplementation to enteral feeds with or without probiotics decreases late-onset sepsis in preterm infants without adverse effects and this encourage us to test its role in adult patients with sepsis.8 therefore, the aim of our study is to compare the safety and efficacy of metformin and lactoferrin in icu patients with sepsis.

Eligibility criteria:
inclusion criteria: * inclusion criteria: 1. age more than 18 years old. 2. a diagnosis of sepsis according to the latest sepsis definition.11 3. estimated gfr \&gt;45 ml/minute. exclusion criteria: exclusion criteria: 1. pregnancy and breast feeding. 2. end stage hepatic disease. 3. end stage renal disease -

Keywords: sepsis metformin lactoferrin
economic and clinical outcomes of (whole exome) sequencing in tapestry

Conditions: Health Care Utilization

Summary: the purpose of this research is to learn more about the impact of genetic testing on healthcare costs, clinical care, and quality of life.


Eligibility criteria:
inclusion criteria: * tapestry patients who have received genetic results, regardless of positive or negative testing results. * age of 18 and older. * patients with an established mayo clinic provider prior to their enrollment in tapestry. exclusion criteria: * individuals less than 18 years old. * patients without capacity to consent (i.e., needing legal authorized representatives). * prisoners. * subjects eligible for chart review, without a minnesota research authorization on record.

Keywords: tapestry quality of life - adjusted life years ecost
women health cohort for breast, bone and coronary artery disease

Conditions: Coronary Artery Disease

Summary: a single center cohort which enrolled women who performed mammography, bone densitometry (dexa), and coronary ct angiography in seoul national university bundang hospital from march 2011 to february 2013.

to evaluate whether bone mineral density and breast arterial calcification can predict coronary artery disease in women older than 40 years

Eligibility criteria:
inclusion criteria: * women (≥ 40 years) who performed mammography, bone dexa, and coronary ct angiography at health promotion center of seoul national university bundang hospital. exclusion criteria: * women who have history of breast surgery or intervention * women who have history of myocardial infarction or revascularization * too poor image quality of coronary ct angiography for interpretation * renal dysfunction with serum creatinine ≥ 1.4mg/dl
information about a doctor or a possibility of choosing doctor's gender and attendance to screening colonoscopy

Conditions: Colorectal Cancer; Screening

Summary: the purpose of the study is to investigate whether the information about a doctor or possibility to choose doctor's gender included in invitation letter is associated with attendance rate to screening colonoscopy.

study is performed as a part of nordicc (clinical trials nct 00883792) trial, which is intended to investigate the effect of screening colonoscopy on colorectal cancer incidence and mortality. nordicc trial is a multicenter, randomized study conducted in norway, sweden, netherlands and poland. this study is designed to assess two factors potentially influencing patients attendance. these two factors are: identification of particular doctor performing examination and the possibility of choosing doctor's gender.

Eligibility criteria:
inclusion criteria: * individuals 55-64 years of age randomized to the screening arm of the nordicc trial in poland exclusion criteria: * previous open colorectal surgery * need for long term attention and nursing services (somatic or psychosocial reasons, mental retardation) * ongoing cytotoxic treatment or radiotherapy for malignant disease * severe chronic cardiac or pulmonary disease (nyha iii and iv) * lifelong anticoagulant treatment * coronary or cerebrovascular incident requiring hospitalization during the last three months * residence abroad * return of unopened letter of invitation and/or reminder, or message of death of the subject (not updated in population registry) * failure to provide written informed consent * screening colonoscopy within 10 years

Keywords: attendance colorectal cancer screening invitation letter
a study of avastin (bevacizumab) with xelox or folfox in patients with metastatic colorectal cancer and disease progression under first-line folfiri and avastin

Conditions: Colorectal Cancer

Summary: this open-label single arm study will evaluate the efficacy and safety of avastin added to xelox or folfox in patients with metastatic colorectal cancer and disease progression on 1st line therapy with folfiri plus avastin. patients will receive either avastin (7.5mg/kg iv infusion every 3 weeks) and standard xelox (xeloda \[capecitabine\] plus oxaliplatin) chemotherapy or avastin (5 mg/kg iv infusion every 2 weeks) and standard folfox (5-fu and leucovorin plus oxaliplatin) chemotherapy. the anticipated time on study treatment is until disease progression, and the target sample size is 100 individuals.


Eligibility criteria:
inclusion criteria: * adult patients \>/=18 years of age * metastatic colorectal cancer * at least 1 measurable lesion according to recist v. 1.1 * patients with disease progression with prior folfiri + avastin therapy who are not candidates for primary metastasectomy * disease progression \</= 8 weeks after last dose of avastin * ecog \</=2 * no more than 8 weeks between 1st-line treatment with folfiri + avastin and 2nd-line treatment with xelox or folfox + avastin exclusion criteria: * disease progression \> 8 weeks after last avastin administration * clinically significant cardiovascular disease * cns disease except for treated brain metastasis * history of other malignancies within 2 years prior to start of study treatment (with the exception of curatively treated basal and squamous cell carcinoma of the skin or in situ carcinoma of the cervix) * major surgery, open biopsy, or significant traumatic injury within 28 days prior to start of study treatment
a smoking cessation treatment for adult women

Conditions: Nicotine Dependence

Summary: the purpose of this study is to develop and pilot test a smoking cessation counseling that focuses on the perceived risks of quitting smoking (e.g., weight gain, managing cravings and negative affect, loss of enjoyment). aim 1: to develop the risk-based smoking cessation intervention. aim 2: to examine whether manualized smoking cessation counseling about the perceived risks of quitting is feasible to administer and acceptable to adult women who want to quit smoking. aim 3: to examine smoking cessation outcomes for women who receive the risk-based treatment in comparison to standard smoking counseling. it is expected that women who receive risk-based counseling will show better quit rates and a longer time to relapse than women who receive standard treatment.

the purpose of this treatment development study is to design and pilot test a smoking cessation intervention in which counseling sessions are tailored to individual smokers' perceived risks of quitting. the feasibility, acceptability, and efficacy of the novel treatment will be examined through a pilot study in which female smokers will be randomly assigned to receive either the tailored treatment or a standard treatment. it is expected that participants receiving the tailored treatment will show higher rates of smoking abstinence than participants receiving the standard smoking cessation treatment at the end of the 8-week treatment and at one month follow-up.

Eligibility criteria:
inclusion criteria: * between the ages of 18 and 64 years old * meet diagnostic and statistical manual-iv (dsm-iv) criteria for nicotine dependence with fagerström test for nicotine dependence (ftnd) score ≥4 * smoke at least 15 cigarettes (3/4 pack) daily (averaged over 1 week, in the past 1 month) and have an expired breath carbon monoxide (co) level ≥10 * at the time of initial evaluation, are motivated to quit smoking in the next 30 days. * have the capacity to give informed consent, and are english-speaking. exclusion criteria: * have a positive urine drug screen or urine pregnancy test at baseline evaluation * meet dsm-iv criteria for alcohol or other drug abuse or dependence in the previous 6 months * meet dsm-iv criteria for a current diagnosis of major depressive disorder, panic disorder or post-traumatic stress disorder * meet dsm-iv criteria for a current or past diagnosis of bipolar disorder or schizophrenia * are currently receiving treatment for nicotine dependence (e.g., nicotine replacement therapy, bupropion, chantix)

Keywords: smoking treatment perceived risks
effectiveness of respiratory muscle training by spirotiger in chronic patients

Conditions: Chronic Obstructive Pulmonary Disease; Congestive Heart Failure

Summary: the reduction in effort tolerance as result of a decreased efficiency in ventilation is common both in patients affected by copd (mckenzie) and chronic heart failure (chf) (ribeiro, frankenstein). one of the most common cause is the reduced respiratory muscle strength and endurance. some studies have evaluated the effect of a specific training on the muscular strength both in pulmonary (battaglia, powell) and cardiac patients (winkelmann, chiappa). moreover, only few studies investigated a specific training for such patients (koppers, sherer) because of the complicated equipment needed to prevent hypocapnia. up to date, portable and economic systems for isocapnic hyperpnea have been developed for respiratory muscle training. primary aim of the study was to evaluate the effectiveness of the respiratory muscle training -by the technique of the isocapnic hyperpnea- on the effort tolerance and endurance in patients with copd and chf secondary aims were: a.to quantify the number of patients with deficit of respiratory muscles endurance and b.to verify different response of training between copd and chf patients

all consecutive stable patients with diagnosis of copd or chf and normal mmse, admitted in foundation s. maugeri in lumezzane (brescia, italy) for routinary rehabilitation at respiratory and cardiac rehabilitative divisions are enrolled. all patients who met the inclusion criteria (see above)are informed about the aim of the project, sign an informed consent and are enrolled in the study. 40 patients are enrolled. they are divided in two groups of 20 each (10 cardiac and 10 respiratory patients) named: 1. spirotiger group: these patients perform 20 sessions of usual training (cyclette and calisthenic exercises) and specific training (further 20 sessions) for respiratory muscles with spirotiger 2. control group: these patients perform 20 sessions of usual training (cyclette and calisthenic exercises) and additional 20 sessions with a placebo device (threshold)

Eligibility criteria:
inclusion criteria: * ability to perform 6-min walking test. * emogas analysis at rest (with pao2\>60mmhg and pco2\<45 mmhg) * mini mental state examination (mmse) \> 25 * absence of major events in the last month (i.e. respiratory exacerbation treated with antibiotic therapy, chf unstabilization with administration of vasopressor drugs to support the cardiac pump). * maximum voluntary ventilation (mvv) as evaluation of endurance \<90%. exclusion criteria: * haemodynamic instability

Keywords: endurance exercise training 6-min walking test