Kornimate/medical-research-clean huggingface dataset:
stereotactic radiosurgery for patients with hepatic metastases.

Conditions: Metastatic Cancer; Unspecified Adult Solid Tumor, Protocol Specific

Summary: rationale: stereotactic radiosurgery may be able to send x-rays directly to the tumor and cause less damage to normal tissue. purpose: this phase i trial is studying the side effects and best dose of stereotactic radiosurgery in treating patients with liver metastases.

objectives: * to determine the maximum tolerated dose of fractionated stereotactic radiosurgery in patients with hepatic metastases. * to determine the dose-limiting toxicity of stereotactic radiosurgery in these patients. * to assess the tumor response in these patients. outline: this is a multicenter study. patients receive 3-5 fractions of stereotactic radiosurgery over 14 days in the absence of disease progression or unacceptable toxicity. cohorts of 9-13 patients receive escalating doses of stereotactic radiosurgery until 60 gy is reached or the maximum tolerated dose (mtd) is determined. the mtd is defined as the dose preceding that at which \> 33% of patients experience dose-limiting toxicity. after completion of study therapy, patients are followed at 6 weeks, every 3 months for 1 year, every 6 months for 2 years, and then annually for 2 years.

Eligibility criteria:
disease characteristics: * histologically confirmed primary cancer * stage iv primary disease with up to five liver metastases that are visualized on ct scan, mri of the abdomen, or positron-emission tomography * no liver metastases secondary to germ cell tumor or hematologic malignancy * other sites of metastases allowed * no malignant ascites * the cumulative total dose of radiotherapy to ≥ 2/3 of the liver and surrounding normal tissues, including the esophagus, stomach, and small bowel, must be ≤ 15 gy * percutaneous or laparoscopic biopsy of the metastasis and placement of 3-5 fiducials required if undergoing cyberknife for treatment delivery patient characteristics: * karnofsky performance status 60-100% * life expectancy ≥ 3 months * albumin ≥ 3 g/dl * alkaline phosphatase \< 1.5 times upper limit of normal (uln) * ast and alt \< 1.5 times uln * total bilirubin \< 1.5 times uln * prothrombin time \< 1.5 times uln * hemoglobin \> 10 g/dl * platelet count \> 100,000/mm³ * anc \> 1,000/mm³ * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception * no history of diagnosed inflammatory bowel disease, such as ulcerative colitis or crohn's disease * no active peptic ulcer disease * no hepato-renal syndrome prior concurrent therapy: * prior systemic therapy allowed provided complete blood cell counts have recovered * no other concurrent antineoplastic treatment

Keywords: liver metastases unspecified adult solid tumor, protocol specific
personalized hemodynamic therapy in patients undergoing high-risk surgery

Conditions: Postoperative Complications

Summary: the purpose of this study is to evaluate the effectiveness of using the personal preoperatively assessed cardiac output in high-risk patients to guide perioperative administration of fluids and vasoactive drugs on predefined postoperative complications.


Eligibility criteria:
inclusion criteria: * patients ≥ 18 years undergoing a major abdominal procedure (including general, urological, gynaecological, and vascular) with an expected duration of surgery ≥ 90 min or presumed blood loss exceeding 1,000 ml (e.g., intrabdominal vascular surgery) and ≥ 1 of the following high-risk criteria: * acute or chronic renal impairment (serum creatinine ≥ 1.3 mg/dl) * predefined risk factors for cardiac or respiratory complications * immunodeficiency due to a therapy (e.g., immunosuppressants, chemotherapy, radiation, long-term or high-dose steroids) * immunodeficiency due to specific diseases (e.g., leukaemia, lymphoma, aids) * severe liver impairment (biopsy proven liver cirrhosis plus 1 of the following: portal hypertension or history of upper gastrointestinal bleeding due to portal hypertension or previous episodes of hepatic insufficiency/hepatic encephalopathy/hepatic coma * age ≥ 80 years exclusion criteria: * age \<18 years * pregnancy * surgery for palliative treatment * emergency procedure * refusal of consent * participation in another randomized controlled trial * failure to meet inclusion criteria

Keywords: cardiac output hemodynamics perioperative care
emotional freedom technique (eft) effect on nurses

Conditions: Stress; Anxiety; Burnout, Caregiver

Summary: background: infectious disease outbreaks have a psychological effect on the general population, and especially on health workers. nurses who care for covid-19 patients feel negative emotions, fear, and anxiety due to fatigue, discomfort, and helplessness due to high-intensity work. objective: the study aims to evaluate the effect of eft in the prevention of stress, anxiety, and burnout of nurses who have an important position in the fight against covid-19. design: randomized controlled trial. setting: covid-19 department of a university hospital in istanbul province, turkey. participants: the sample of the study consisted of nurses working on 80 covid-19 cases. methods: the investigators will recruit nurses who care for the patient infected with covid-19 randomly allocated them to the intervention (n = 40) and control (n = 40) groups. eft will apply to the experimental group with online access. data will collect using the introductory characteristics form, the subjective discomfort unit scale, the state-trait anxiety inventory, and the burnout scale.

with the onset of the covid-19 epidemic, healthcare workers have assumed important responsibilities in the control, prevention, care, and treatment of its spread. in this period, they provided the necessary health practices for suspicious or confirmed covid-19 patients in the front lines and under harsh conditions, which are generally long and tiring. it is clear that infectious disease outbreaks have a psychological effect on the general population, and especially on health workers. the social distance required to prevent outbreaks is a key factor in disease management while causing social and psychological effects. 2.1. design a randomized controlled experimental research design. the study complied with the guidelines of the consolidated standards of reporting trials (consort) checklist. 2.2. participants this study will conduct with nurses working in a university hospital located in istanbul between may 2020 and june 2020, working in the care of covid-19 patients. 2.5. measures the data will be collected with the introductory characteristics form, the positive units of distress scale, the state-trait anxiety inventory, and the burnout inventory. the investigators created our data collection forms using survey monkey, which provides electronic self-access and prevents data from multiple entries from the same person, making it easier to collect and track data. confidentiality will be guaranteed by completely disabling electronic and ip address records to obtain anonymous replies.

Eligibility criteria:
inclusion criteria: * not taking any courses about coping with anxiety and stress, * volunteering to participate in the study. exclusion criteria: * having any psychiatric diagnoses

Keywords: covid-19 emotional freedom technique
study of south african dialysis patients

Conditions: Chronic Kidney Disease, Receiving Dialysis

Summary: an observational study to describe the treatment of anaemia in patients with chronic kidney disease, who are receiving dialysis treatment at selected study centres in south africa.

this multicentre, prospective, observational study will describe the treatment and clinical outcomes of of dialysis patients in south africa. no formal hypothesis will be tested in this descriptive study. eligible subjects will be receiving either peritoneal or haemodialysis, will have received aranesp therapy between 3 and 6 months prior to enrolment into the study, do not need to be receiving aranesp at the time of enrolment and will be followed for up to 12 months after commencement of aranesp. data to be collected includes esa therapies, iron usage, relevant concomitant therapies, haemoglobin concentrations, other relevant clinical laboratory parameters and red cell transfusions.

Eligibility criteria:
inclusion criteria: * adult patients undergoing chronic haemodialysis or peritoneal dialysis * commenced aranesp therapy 3-6 months prior to enrolment * erythropoiesis stimulating agent (esa) naive or treated with another esa prior to commencing aranesp * informed consent obtained exclusion criteria: * received aranesp in an interventional study within 6 months prior to start of observation period * receive investigational product during the observation period

Keywords: chronic kidney disease dialysis erythropoiesis stimulating agent south africa
paracetamol for cancer pain

Conditions: Advanced Cancer; Opioid Use, Unspecified

Summary: randomised, double-blind placebo controlled cross-over trial main goal: optimize the medical pain treatment for patients with advanced cancer disease study goal: measure paracetamol's additional analgesic effect in a situation where the patient is concomitantly treated with oral opioids eqv. morphine \> 100 mg/d.

national multicenter study with an intention to include 50 patients. 6 days treatment, 3d in each arm. mean pain score last 24 h: nrs =/\> 4 all drug treatment constant during the study period. the participants are allowed to take as much rescue opioids as necessary to have adequate relief. paracetamol/ placebo given orally 1000 mg x 4 daily, three days in each arm, direct crossover. daily scoring of pain relief, esas, overall satisfaction and rescue medication.

Eligibility criteria:
inclusion criteria: * adults (\> 18 years) of both sexes * diagnosed with advanced cancer disease * ongoing medicinal pain relief treatment in stable dosing with oral opiates equivalent to \> 100 mg oral morphine daily * nrs median pain score last 24 hrs \> 4 * able to take tablets (paracetamol) orally exclusion criteria: * mental or physical deficiency precluding data collection. * reduced liver function judged with bilirubin, inr and transaminases * anticoagulation with warfarin * ongoing use of nsaids or 5-ht3 antagonists, or use of such drugs last week * ongoing palliative radiation treatment or radiation treatment during the last 4 weeks.

Keywords: paracetamol opioids cancer pain
effectiveness and safety of percutaneous adhesiolysis using rac'z catheter versus navi catheter in management of failed back surgery syndrome

Conditions: Failed Back Surgery Syndrome

Summary: in the past decade, spine surgery rates have dramatically increased in parallel to those of other procedural interventions. persistent pain is a common occurrence after spine surgery, with the most commonly quoted prevalence rates ranging from 10% to 40%. this pain can be classified into failure to alleviate baseline pain, pain resulting from complications (e.g., arachnoiditis and epidural adhesions), and pain that ensues several years later as a sequele to alterations in spinal architecture and biomechanics (e.g., adjacent segment discogenic or facetogenic pain) which is called failed back surgery syndrome ( fbss )

by observing adhesions directly, the lysis of scar tissue can be carried out mechanically using some percutaneous techniques as insertion of catheters as rac'z catheter (thin in calibre) which will be inserted through the skin under fluoroscopy guidance or using navi catheter (large in calibre) either fluoroscopy guided or using thin epiduroscopy. adhesions can be disintegrated and their evaluation scores may improve.

Eligibility criteria:
inclusion criteria: * patients with history of lumbar surgery of at least 6 months duration in the past. * patients over the 18 years of age. * history of persistent function-limiting lower extremity pain aggravated by "dural tug" (observed when the patient, sitting on the exam table with legs stretched out, bends forward, bringing on the back pain) with or without low back pain of at least 6 months duration after failure of conventional conservative management in most patients including nsaids, muscle relaxants (tizanidine, magnesium sulphate) and pregabalin. * patients who are competent to understand the study protocol and provide voluntary, written informed consent and participate in outcome measurements. exclusion criteria: * unstable or heavy opioid use. * uncontrolled psychiatric disorders. * uncontrolled medical illness. * any conditions that could interfere with the interpretation of the outcome assessments. * pregnant or lactating women. * patients with a history or potential for adverse reaction(s) to local anaesthetics or steroid.
mindfulness for cognition in early-stage alzheimer's disease

Conditions: Mild Cognitive Impairment (MCI); Mild Cognitive Impairment (MCI) Due to Alzheimer's Disease; TBI (Traumatic Brain Injury); Aging; Healthy Elderly; Alzheimer&Amp;Amp;#39;s Dementia (AD)

Summary: the goal of this clinical trial is to learn if mindfulness meditation can improve outcomes in older adults with and without cognitive impairment. the main questions it aims to answer are: 1. how does mindfulness impact thinking and memory? 2. how does mindfulness influence brain function and structure? 3. how does mindfulness affect daily function and quality of life? researchers will compare all outcomes to one other groups. in one group, individuals will participate in a mindfulness class intervention; in the other group, individuals will not engage in any active interventions immediately, but will be placed on a waitlist for the mindfulness intervention. researchers will compare all outcomes between the groups groups to determine whether the mindfulness interventions leads to greater improvement compared to no intervention (waitlist group). participants will: * be randomly assigned to participate in the mindfulness intervention, or no immediate intervention (waitlist) * complete paper-and-pencil cognitive testing, surveys, computerized tasks, and neuroimaging measures (eeg and mri) before and after the intervention outcomes will be assess at baseline, 2 months, 4 months and 6 months.


Eligibility criteria:
inclusion criteria: * healthy older adults will show cognitive performance within 1.0 sd for age \& education adjusted norms on a neuropsychological test battery * mild cognitive impairment (mci) participants will show performance on delayed recall or one more or more other cognitive domains worse than 1.5 sd for age \& education adjusted norms, an mmse score between 25-30, and a moca score between 20-30. exclusion criteria: * participants without a computer, smart phone and internet access will be excluded * if they cannot understand the informed consent form or have moderate dementia. * mood disorders (e.g., ptsd, depression, anxiety) or alcohol and drug use that either interferes with day-to-day life or required hospitalization within the past 5 years * cerebrovascular disease * any medical condition whose severity could significantly impair cognition (e.g., stroke, frontotermporal dementia, parkinson's disease) are exclusionary

Keywords: mindfulness aging mild cognitive impairment (mci) cognition memory alzheimers disease social group
digital photographs to evaluate blepharoptosis

Conditions: Blepharoptosis

Summary: to compare measurements made by a computer software (imagej) made on photographs to the traditional clinical measures with a ruler in the evaluation of blepharoptosis


Eligibility criteria:
inclusion criteria: * patients 18 years old or older * patients presenting for evaluation of blepharoptosis of any kind except the one mentioned in the exclusion criteria exclusion criteria: * myasthenia gravis * thyroid eye disease

Keywords: photo
apatinib and etoposide as the maintenance therapy in extensive-stage small cell lung cancer after first-line chemotherapy

Conditions: Extensive-stage Small Cell Lung Cancer; Lung Cancer

Summary: although fist-line therapy with cisplatin and etoposide(ep)or carboplatin and etoposide(ce) has been given, patients with extensive small cell lung cancer(ed-sclc) still relapse and the 2-year survival is extremely low. there is no standard maintenance treatment recommendation for ed-sclc patients after the first-line therapy.apatinib has been approved as a second-line treatment for advanced gastric cancer. several phase iii clinical studies of non small cell lung cancer, liver cancer, colorectal cancer and other tumors also showed apatinib has less toxic side effects and better patient tolerance. however, the clinical application of apatinib in small cell lung cancer is still lack of evidence-based medicine,so this clinical trial is designed to investigate the efficacy and safety of apatinib combine with etoposide as maintenance therapy in ed-sclc patients after first-line chemotherapy in our center.


Eligibility criteria:
inclusion criteria: * histologic or cytologic diagnosis of extensive-stagesmall cell lung caner(sclc) ,after first-line therapy * performance status of 0～2 on the ecog criteria * expected survival is above three months * adequate hematologic (neutrophil count\>=1.5×109/l, hemoglobin\>=80g/l, platelets\>=80×109/l), hepatic function (aspartate transaminase (ast) \& alanine transaminase(alt) =\<upper normal limit(unl) x2, bilirubin level =\< unl x 1.5) * patients have the ability to understand and voluntarily sign the informed consent, and allow adequate follow-up. exclusion criteria: * suffered from other tumor within 5 years( except: cervical carcinoma in situ, cured basal cell carcinoma, cured bladder epithelial tumor). * difficulties in taking pills (inability to swallow tablets,gi tract resection, chronic bacillary diarrhea and intestinal obstruction). * bleeding tendency or coagulation disorders. * uncontrolled hypertension (systolic pressure\>150 mmhg , or diastolic pressure\> 90 mmhg). * urine protein≥++, or urine protein in 24 hours≥2.0g. * severe uncured wounds, ulcers or fracture. * pregnant or breast-feeding. * patients with epilepsy who need to take medicine (such as steroids or anti epilepsy agents). * the researcher believe that the patient is not suitable to participate in the study.
high flow oxygen versus non invasive ventilation associated to automated flow oxygen titration after patient extubation

Conditions: Respiratory Disease

Summary: extubation stay at high risk of reintubation even scheduled and in the best condition of hematosis. re-intubation's rate in main studies in chronic obstructive diseases reach to 20% and it is associated to a higher mortality, higher pneumonia under mechanic ventilation, and higher duration of hospitalization especially in intensive care units. place of niv in this situation is still on evaluation. a recent meta-analysis demonstrates that use of niv in post-extubation in copd seems to decrease re-intubation rate. hfo, thanks to its properties (oxygen, humidification and heat with high flow) could be useful in this population in ventilatory weaning. compared to oxygen conventional therapy with high-concentration mask, hfo seems to be as efficient and better tolerated. a recent study shows that hfo is non-inferior to nvi in post-extubation in patient with high risk of re-intubation. furthermore, oxygenation in post-extubation should be optimized to avoid hypoxemia and hypercapnia in this patient at risk of hypoventilation. place of afot could improve hematosis by providing adapted flow of oxygen to each patient. the investigator choose the hypothesis for this study that hfo is as effective and tolerated in post-extubation than niv with afot.

a recent meta-analysis demonstrates that use of niv in post-extubation in obstructive chronic bronchopathies seems to decrease re-intubation rate. high flow oxygen, thanks to its properties (oxygen, humidification and heat with high flow) could be useful in this population in ventilatory weaning. compared to oxygen conventional therapy with high-concentration mask, high flow oxygen seems to be as efficient and better tolerated . a recent study shows that high flow oxygen is non-inferior to non invasive ventilation in post-extubation in patient with high risk of re-intubation. furthermore, oxygenation in post-extubation should be optimized to avoid hypoxemia and hypercapnia in this patient at risk of hypoventilation.

Eligibility criteria:
inclusion criteria: * patient with respiratory disease suspected or proved (copd, asthma, bronchiectasis, cystic fibrosis, interstitial pneumonia, obstructive insufficient respiratory, restrictive insufficient respiratory) when an extubation is scheduled. * patient who signed the informed consent * patient affiliated to social insurance exclusion criteria: * pregnant woman * terminal extubation * niv at home before intubation (non-exclusion of continue positive airway pressure: cpap) * tracheotomy * patient under trusteeship, guardianship or safeguard of justice

Keywords: high flow oxygen non invasive ventilation automated flow oxygen titration respiratory risk
pilot study with gft505 (80mg) in patients with insulin resistance and abdominal obesity

Conditions: Insulin Resistance; Abdominal Obesity

Summary: the purpose of this study is to demonstrate the efficacy on insulin sensitivity of gft505 at 80mg/d in male patients with insulin resistance and abdominal obesity. evaluation will be made using a glucose clamp technique.

the study period per patient is 26 weeks: a selection period will precede a 8-week treatment period, a 6-week wash out period, a second 8-week treatment period in the second arm of treatment and a 2- week follow-up period. schedule: * selection visit prior to treatment period (d-14 and d-1) * d0 : randomisation visit * period t1: first period of treatment with gft505 80mg or placebo for 8 weeks (d1 to d56) * wash out period for 6 weeks (d57 to d98) * period t2: second period of treatment with gft505 80mg or placebo for 8 weeks (d99 to d154) * follow up period for 2 weeks (d155 to d169)

Eligibility criteria:
inclusion criteria: * waist circumference ≥94cm. * body mass index ≤ 45kg/m2. * homeostasis model assessment of insulin resistance (homa-ir) \> 3. exclusion criteria: * blood pressure \> 160 / 95 mmhg. * diabetes mellitus 1 or 2. * historical of bariatric surgery. * patient treated with a lipid-decreasing medication. * a fasting plasma triglycerides concentration \> 400mg/dl or a plasma low density lipoprotein cholesterol (ldl-c)concentration \> 220mg/dl.

Keywords: pre-diabetes clamp technique ppars insulin resistance
oc000459 dose finding study in patients with mild to moderate persistent asthma

Conditions: Mild to Moderate Persistent Asthma

Summary: this will be a double blind, randomised, 4 arm, parallel group, placebo controlled study of three dose levels of oc000459 tablets in patients with asthma controlled by beta agonist drugs alone. this study will compare the patients on oc000459 at three different dose levels (25mg once daily, 100mg twice daily and 200mg once daily) with patients on placebo after dosing for 17 weeks. the trial will be undertaken in an outpatient population. each treatment arm will consist of at least 110 subjects. the objective is to assess the efficacy of these dose levels on the patients asthma.


Eligibility criteria:
inclusion criteria: * male or female asthmatics, any racial group. females of childbearing potential must practise two forms of contraception * aged 18 to 55 years inclusive. * non smokers for at least the past 12 months with a pack history of less than 10 pack years. * mild to moderate persistent asthma according to gina4 guidelines for at least 12 months exclusion criteria: * receipt of prescribed or over the counter medication within 14 days prior to the first study day

Keywords: asthma treatment placebo efficacy safety