Kornimate/medical-research-clean huggingface dataset:
the potential for oral diindolylmethane (dim) supplementation to increase the production of the brca1 protein in brca1 mutation carriers

Conditions: Breast Cancer

Summary: women with a brca1 mutation face a lifetime risk of breast cancer of approximately 70% and a lifetime risk of ovarian cancer of approximately 40%. a number of potential anti-cancer nutrients have been proposed, however, it is important that diet supplements be evaluated prior to general recommendation. the risk of breast and ovarian cancer in carriers of a brca1 mutation might be lowered by some nutritional supplements. for example, green tea, broccoli and vitamin d are of potential interest. one dietary supplement that is thought to have potential for brca1 carriers is diindolylmethane (dim), which is an active ingredient in broccoli and other green vegetables. dim - is found in vegetables like broccoli and is available as a supplement in health food stores. the investigators think that dim may increase the production of the normal copy of brca1 and offset the effect of the mutation. the purpose of this study is to determine that there is a potential for oral dim supplementation to result in the increased production of the brca1 protein in brca1 mutation carriers. the results of the study will also serve as an evaluation of the current use and success of preventive strategies for brca1 mutation carriers.


Eligibility criteria:
inclusion criteria: * carriers of a mutation in the brca1 gene * non-carriers of a mutation in the brca1 gene who come from a family with a brca1 mutation (a family in which at least one individual has tested positive for a brca1 mutation) * can participate after being free of dim supplementation for one month exclusion criteria: * have a personal history of cancer * currently pregnant or breast-feeding

Keywords: brca1 breast cancer 3,3'-di-indolylmethane dietary intervention estrogen metabolites mrna expression brca1 protein estrogen
detection and management of sinusitis in a single-center prospective cohort of patients with exudative amd (sine)

Conditions: AMD

Summary: an inflammatory component associated with amd has been highlighted by genetic associations of predisposition to amd, as well as by the recently demonstrated link between amd and periodontitis. some patients followed at the fondation adolphe de rothschild hospital for wet amd seemed to show an improvement of neovascular activity (less need for intravitreal injections of anti-vegf) after treatment of their sinusitis. the investigators would therefore like to assess the link between amd and sinusitis, an infection close to the site of amd.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * patient followed and treated for at least 2 years for bilateral neovascular form of age-related macular degeneration (amd) * at least one eye treated with ≥ 6 intravitreal injections during the year preceding preinclusion * express consent to participate in the study * affiliated with or beneficiary of a social security plan exclusion criteria: * persons referred to in articles l1121-5 to l1121-8 of the csp (corresponding to all protected persons: pregnant women, parturients, nursing mothers, persons deprived of liberty by judicial or administrative decision, minors, and persons under legal protection: guardianship or curatorship). * severe myopia (\> 6 diopters) * patient already being treated for acute or chronic sinusitis * history of central serous chorioretinopathy or diffuse retinal epitheliopathy
using group interpersonal psychotherapy to improve the well-being of adolescent girls

Conditions: Mental Depression

Summary: adolescent girls in developing countries face high rates of adversity and are at an elevated risk of depression and other forms of psychological distress. untreated depression can have negative consequences on life outcomes such as early pregnancies, social exclusion and school dropout. these can result in a cycle of poverty for young women and their families. despite this being a very pressing problem there is little evidence on what types of interventions can help break the vicious cycle of poor mental health and poverty. this research program aims to evaluate, through the use of a cluster-randomized control trial (cluster- rct), the effect of group-based interpersonal psychotherapy (ipt-g) and unconditional cash transfers on adolescent girls' mental health and social functioning. working with strong minds uganda in collaboration with brac uganda's empowerment and livelihood for adolescents (ela) clubs, the evidence generated from this research will create a better understanding of whether adolescent mental health improves through this cost-effective approach, and whether improved mental health impacts other outcomes of interest.


Eligibility criteria:
inclusion criteria: * 13-19 year old female who scores 10 or above on phq-8 exclusion criteria: * male * score below 10 on phq-8
endostomal three-dimensional ultrasonography for parastomal hernia

Conditions: Parastomal Hernia

Summary: the intention is to examine the role of ultrasonographic examination inside intestinal stomas in diagnosing parastomal hernia. patients with a stoma since at least one year back who are being scheduled for abdominal surgery will be examined for eligibility according to the selection criteria. included patients will undergo routine clinical examination, endostomal ultrasonography and computerized tomography scan of the abdomen. findings will be correlated to findings during surgery (gold standard). values for sensitivity, specificity, predictive values and likelihood ratio will be calculated.

parastomal hernia (psh) is one of the most common stoma complications, with an incidence of 30-50 % within just a couple of years of stoma creation. surgical parastomal hernia repair is a morbid and complicated procedure, with a 30-day reoperation rate of 13 % and 30-day mortality rate of 6 % in population-based surveys. there is no established gold standard diagnostic modality. routinely, patients are examined clinically in various positions with and without increased intra-abdominal pressure. it has been shown in previous studies that clinical examination has a very low inter-observer reliability. computerized tomography is often performed in addition to clinical examination, but is not ideal in diagnosing psh either, not only beacause of insufficient test characteristics but also since the examinations should ideally be performed with specific protocols, prone position and be reviewed by a dedicated radiologist. the risk of incorrectly diagnosing a psh (false positive) is that patients might subsequently be exposed to complex and dangerous surgical interventions without any health benefit, while incorrectly ruling out a psh (false negative) can cause the patient to have to live with potentially treatable symptoms, life-threatening bowel incarceration being the most severe potential complication. thus, improved diagnostic accuracy is required. a method that has been developed within our research group is endostomal tree-dimensional ultrasonography, which has preliminarily proven to be approximately as sensitive as ct, with a markedly higher specificity. a larger and less selected study needs to be conducted in order to reliably calculate test characteristics, predictive values and likelihood ratio.

Eligibility criteria:
inclusion criteria: * end colostomy or end ileostomy since ≥ 1 year * planned for laparotomy or laparoscopy * age ≥ 18 * speaks and reads swedish language * informed consent exclusion criteria: * known parastomal hernia only indication for laparotomy or laparoscopy

Keywords: parastomal hernia ultrasound ultrasonography endostomal intrastomal colostomy ileostomy
etanercept and celecoxib alone/combined treatment in effectiveness and safety of active ankylosing spondylitis

Conditions: Ankylosing Spondylitis

Summary: this is a multi-center, open label, randomized clinical trial of etanercept and celecoxib alone/combined treatment in effectiveness and safety on active ankylosing spondylitis (as). subjects will be randomly assigned in a 1:1:1 ratio to one of the three groups (celexocib 200mg bid, etanercept 50mg qw, etanercept plus celecoxib group) for 54 weeks. primary endpoints are the magnetic resonance imaging (mri) spondyloarthritis research consortium of canada (sparcc) score of sacroiliac(si) joint and spine, as well as the assessment of spondyloarthritis international society (asas)20 response rate at 52 weeks.

a multi-center, open label, randomized clinical trial evaluating the effectiveness and safety of etanercept and celecoxib alone/combined treatment will be conducted on active ankylosing spondylitis (as) patients. disease activity is defined as fulfilling three aspects below: basdai ≥ 4 or asdas≥ 2.1；crp\>6 mg/l or esr 28 mm/1st hour；more than 2 and less than 16 syndesmophyts between cervical spine and lumber spine detected by x-ray. all patients were randomly assigned in a 1:1:1 ratio to one of the three treatment groups：celecoxib 200mg bid，etanercept 50mg qw and combined therapy for 52 weeks. primary endpoints are the magnetic resonance imaging (mri) spondyloarthritis research consortium of canada (sparcc) score of sacroiliac(si) joint and spine, as well as the assessment of spondyloarthritis international society (asas) 20 response rate at 52 weeks. key secondary endpoints include the modified stoke ankylosing spondylitis spine score (msasss), spondyloarthritis research consortium of canada (spracc) si joint structural score (sss), basdai, asdas, asas40, asas70 and asas5/6 response rate at 52 weeks.

Eligibility criteria:
inclusion criteria: * 18 to 65 years * meet 1984 newyork modified criteria for as * basdai≥4 or asdas score ≥ 2.1 * crp\>6 mg/l or esr\>28 mm/h * syndesmophyte quantity ≥2 and \<16 of spine * sexually active women of childbearing potential must agree and commit to use a medically accepted form of contraception * no active or latent tuberculosis infection. exclusion criteria: * pregnant or breastfeeding women * current or previous history of psoriasis or inflammatory bowel disease. * infection with clinical significance within 24 weeks before screening * receipt any bio-agents treatment within 12 weeks before screening * corticosteroids intra-articular injections in last 3 months before the trial * significant concurrent medical events including: gastrointestinal ulcer, myocardial infarction within 12 months before the screening visit, unstable angina pectoris, congestive heart failure. * alcohol and drug abuse

Keywords: inflammation etanercept celecoxib ankylsoing spondylitis
a study of istradefylline (kw-6002) as monotherapy in parkinson's disease (pd) patients

Conditions: Parkinson's Disease; Movement Disorder Syndrome

Summary: the primary purpose of this study is to evaluate the efficacy, safety, and tolerability of 40 mg per day of istradefylline (kw6002) as monotherapy in patients with parkinson's disease.

parkinson's disease is a progressive disease which results in deterioration of motor function and is the result of dopamine depletion in specific brain structures. current therapeutic approaches include dopamine replacement and the use of dopamine receptor agonist drugs. these therapies are effective but may be associated with unwanted complications like wearing off phenomena and involuntary abnormal movements (dyskinesia). istradefylline may provide a nondopaminergic approach to the treatment of parkinson's disease. this study will compare the efficacy of 40 mg per day of istradefylline in improving the symptoms of parkinson's disease with placebo.

Eligibility criteria:
inclusion criteria: 1. early pd by ukpds criteria 2. mild to moderate difficulty daily activities 3. females: either postmenopausal or willing to use adequate contraception exclusion criteria: 1. unable to discontinue current pd medication 2. exposure to levodopa for more than 1 month 3. symptoms that may suggest a diagnosis other than parkinson's disease 4. medical conditions and/or abnormal laboratory findings which preclude participation including cancer in the last 5 years, a history of drug abuse/dependence, abnormal cognitive status, a history of seizures, neuroleptic malignant syndrome, psychosis, or abnormal liver function tests

Keywords: parkinson's disease movement disorder neurology, clinical trial
early use of prone position in ecmo for severe ards

Conditions: Respiratory Distress Syndrome, Adult

Summary: venovenous extracorporeal membrane oxygenation (vv-ecmo) is widely used in the salvage treatment of critical acute respiratory distress syndrome (ards). however, reducing lung injury, accelerating lung recovery, shortening vv-ecmo support time, and decreasing complications during the treatment need further study. by changing the body position of ards patients, the prone position can increase the lung's dorsal ventilation and improve the lung's ventilation/blood flow ratio to improve oxygenation. previous multicenter studies have proved that the prone position can significantly reduce the mortality of patients with moderate and severe ards. however, patients with severe ards rescue by vv-ecmo rarely combine with a prone position.on the one hand, with the support of ecmo, the patient's oxygenation will be significantly improved, and they will no longer need the assistance of a prone position. in addition, the ecmo cannula brings some challenges to implementing a prone position. only a few cohort studies have reported that vv-ecmo combined with a prone position could improve the oxygenation index and respiratory system compliance during the late treatment period. the initial reason for pp in ards patients was to alleviate severe hypoxemia, as it was an efficient means to improve oxygenation in most patients. however, some patients were categorized as non-responders in the pp regarding oxygenation, which caused vv-ecmo therapy to be initiated. should we decide to perform pp after vv-ecmo therapy no longer? this study evaluates whether early use of pp during vv-ecmo would increase the proportion of patients successfully weaned from vv-ecmo support compared with supine positioning in severe ards patients who received pp before ecmo.


Eligibility criteria:
inclusion criteria: 1. met the diagnostic criteria of berlin's definition for ards; 2. had undergone prone positing before vv-ecmo； 3. receiving vv-ecmo support exclusion criteria: 1. spinal instability； 2. elevated intracranial pressure; 3. facial/neck trauma; 4. recent sternotomy; 5. large ventral surface burn; 6. multiple trauma with unstabilized fractures; 7. severe hemodynamic instability; 8. massive hemoptysis; 9. high risk of requiring cpr or defibrillation;

Keywords: acute respiratory distress syndrome extracorporeal membrane oxygenation prone position
risk factors for postoperative pancreatic fistula following non-traumatic pancreatic surgery. retrospective observational study.

Conditions: Pancreas Neoplasm

Summary: postoperative pancreatic fistula is a potentially fatal sequela with substantial morbidity and mortality. a retrospective observational study was conducted in the surgical unit of zagazig university hospital . three hundred forty-seven patients were admitted with a clinical diagnosis of pancreatic fistula following both open and laparoscopic approaches for pancreatic benign and malignant tumors.

postoperative pancreatic fistula is a potentially fatal sequela with substantial morbidity and mortality. popf incidence and risk factors vary. a retrospective observational study was conducted in the surgical unit of zagazig university hospital . three hundred forty-seven patients were admitted with a clinical diagnosis of pancreatic fistula following both open and laparoscopic approaches for pancreatic benign and malignant tumors.

Eligibility criteria:
inclusion criteria: * \> 18 years, * both sexes, * respectablee pancreaticoduodenal tumors, or chronic pancreatitis exclusion criteria: * \<18 years, * patients who underwent total pancreatectomies, * patients discovered intraoperatively to be fixed to portal vein or superior mesenteric artery, traumatic pancreatic surgeries, postoperative associated gastric or biliary leak, pancreaticoduodenal cancers infiltrating the colon, stomach or liver.
the effects of folic acid on sudanese women with polycystic ovary syndrome

Conditions: Polycystic Ovary Syndrome

Summary: an open clinical trial

the patients with pcos will be recruited to receive folic acid (45 patients) and equal number will receive no folic acid

Eligibility criteria:
inclusion criteria: * patients who will visit this centre suffering from pcos-related subfertility will be invited to be enrolled to this study if met the rotterdam criteria for the diagnosis of pcos exclusion criteria: * the patients whom will be excluded from the study are those comorbid with hyperprolactinemia, congenital adrenal hyperplasia, diabetes mellitus, significant cardiovascular problems, thyroid dysfunctions, unresolved medical conditions, or using medications suspected to affect reproductive or metabolic functions within two months of the study entry.

Keywords: folic acid pcos insulin resistance infertility
colistin intravenous administration in critically ill patients suffering from hospital infections caused by multi-antibiotic-resistant germs.

Conditions: Hospital Infection; Multi-antibiotic Resistance; Critically Ill

Summary: colistin is an antibiotic active against several classes of multi-resistant gram-negative bacteria; the drug should be used in high doses in patients on continuous renal replacement therapy, since the drug is eliminated through the dialysis filter. this is an open-label, phase 4, interventional, prospective, single-center pilot study aimed to analyze the concentrations of colistin in plasma and ultrafiltrate by liquid chromatography/mass spectrometry, in 20 critically ill patients admitted to intensive care and suffering from severe infections by multi-resistant bacteria, who receive continuous renal replacement therapy.


Eligibility criteria:
inclusion criteria: * infection where the involvement of mdr germs is documented or highly probable * continuous renal replacement therapy * acute renal failure, stage iii of the 2012 kdigo classification * half-life of the continuous renal replacement therapy filter less than 48 hours. exclusion criteria: * state of pregnancy or breastfeeding, or patients expecting to conceive children within the projected duration of the study, starting with the screening through 30 days after the last dose of imp treatment * patients with a positive urine pregnancy test within 72 hours prior to study drug treatment. if the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. in the event that 72 hours have elapsed between the screening pregnancy test and the first dose of study treatment, another pregnancy test (urine or serum) must be performed and must be negative in order for subject to start receiving study medication * women of childbearing potential * refusal of informed consent * known hypersensitivity to polymyxins and to excipients * clinical condition with high probability of death, according to symplified acute physiology score (saps ii) * partial maintenance of renal function, defined by stages i and ii of the 2012 kdigo classification. * renal replacement therapy filter other than an69 st 150 * prior systemic treatments with any investigational agents within 4 weeks prior to the inclusion in the trial * any other clinical condition that, in the opinion of the investigator, makes the patient unfit for the trial

Keywords: colistin
rtms for the treatment of primary progressive aphasia: a randomized controlled trial

Conditions: Aphasia, Primary Progressive; Repetitive Transcranical Magnetic Stimulation

Summary: the primary progressive aphasia (ppa) is a neurodegenerative condition characterized by a gradual, irreversible decline of language function (mesulam, 2001). there are no known treatments for ppa so far. the relentless progression of ppa symptoms eventually leads to a profound impairment in communication ability and, ultimately, to more generalized deficits of cognition. some cases and small studies reported that transcranial magnetic stimulation (tms), one of the non-invasive neuromodulation tech, can be employed to facilitate language production and improve the language ability in patients with ppa. herein we will explore the tolerance and efficacy of tms for the treatment of ppa by the randomized controlled trial .meanwhile the functional mri tech will be used to investigate the neural network changing in the procedure


Eligibility criteria:
inclusion criteria: all participants had also been evaluated previously by a behavioral neurologist at the peking union medical college hospital and had been clinically diagnosed with a variant of ppa. exclusion criteria: 1. scored below 15 on the mini-mental state exam (mmse) due to concerns that global cognitive impairment might preclude their ability to follow the directions and interfere with task performance. 2. had a history of seizures or unexplained loss of consciousness, pregnancy, surgical breach of the skull, or any other medical or surgical contraindication to receiving noninvasive brain stimulation. 3. is unable to complete the treatment and evaluations
feasibility study of cbct for igrt in cancer patients

Conditions: Head and Neck Cancers; Breast Cancer; Thoracic Cancers; Liver Cancer; Genito Urinary Cancer; Gastrointestinal Cancers

Summary: cone beam computed tomography (cbct) is an imaging technology that is incorporated into many modern radiation therapy systems. the quality of conventional cbct is good enough to align patients for their daily radiation therapy but cbct images have poor contrast and are susceptible to imaging artefacts that limit their usability for other tasks in the radiation therapy workflow. varian medical systems, the sponsor of this study, has developed new cbct imaging technology called hypersight that so far has demonstrated increased image quality compared with conventional cbct images. this new hypersight cbct imager has previously been built into varian halcyon and ethos treatment machines, where the imager is enclosed in a ring that rotates around the patient. now, hypersight has been built into a varian treatment machine, called truebeam, where the imager is mounted on a c-shaped arm that rotates around you to acquire an image. this study is being done to evaluate the image quality of hypersight cbct compared to conventional cbct images, and to determine whether hypersight cbct can improve the process of delivering radiation treatments. the goal of this study is to collect images from this new hypersight-truebeam cbct imager from a variety of patients and locations in the body. the images will be analyzed to determine whether their quality is high enough to use for tasks other than positioning patients for treatment. for example, the study will determine whether the hypersight images could be used to calculate a radiation plan.


Eligibility criteria:
inclusion criteria: 1. patient age ≥ 18 2. patient is receiving radiation therapy for head and neck, thorax, liver, breast, genitourinary, or gastrointestinal malignancies 3. a cbct acquisition for localization is standard of care for the radiation therapy treatment plan being delivered exclusion criteria: 1. patient has ecog performance status ≥3. 2. patient is wheelchair bound. 3. patient has a life expectancy \<3 months. 4. patient is unwilling or unable to provide informed consent to participate in the study. 5. patient is pregnant or has plans for pregnancy during the period of treatment. 6. patient is part of a vulnerable population (per iso 14155:2020, "individuals who are unable to fully understand all aspects of the investigation that are relevant to the decision to participate, or who could be manipulated or unduly influenced as a result of a compromised position, expectation of benefits or fear of retaliatory response"). this includes prisoners.