Kornimate/medical-research-clean huggingface dataset:
pelvic ct with agatston calcium score for peyronie disease

Conditions: Peyronie Disease

Summary: the purpose of this study is to find out how including a ct exam of the penis can help urologists make treatment decisions for patients with calcified peyronie's disease.

peyronie disease (pd) affects up to 10% of men with fibrosing penile plaques causing penile pain and progressing to deformity. calcified plaque develops in up to 20% of these patients, excluding them from medical therapy with collagenase injection and often requiring more extensive surgery for treatment. pddu identifies plaque distribution and characteristics while the doppler exam evaluates for any underlying erectile dysfunction. calcification can make pddu difficult to identify the full extent of plaque since the shadow caused by calcification may prevent accurate measurement and over or underestimate the plaque size. in addition, the ultrasound exam is operator dependent and requires injection of an agent to induce erection. since current clinical practice excludes men with any degree of calcification presumed on physical examination or demonstrated on pddu from receiving injection therapy they may be triaged to surgical management instead. a prior study found the presence of calcifications at ultrasound had odd ratio 1.75 of patient progressing to surgical management, while fibrosis without calcification did not have increased odds of surgical management. noncontrast pelvis ct provides three dimensional detail of calcified plaque including parts of the penis that are difficult to image with pddu, and calcification does not have artifact on ct. by adding non-contrast pelvis ct with agatston calcium scoring to pddu and clinical parameters of penile deformity, patients may be better stratified into the appropriate treatment pathway.

Eligibility criteria:
inclusion criteria: * peyronie disease with stable curvature considered for therapeutic intervention * pddu obtained at clinic visit * able to provide informed consent exclusion criteria: * implanted penile prosthesis or implanted urethral sphincter that would prevent adequate ct images * acute active peyronie disease that would not be managed with injection or surgical therapy
laparoscopic-assisted distal gastrectomy and totally laparoscopic distal gastrectomy for gastric cancer

Conditions: Gastric Cancer

Summary: the aim of this study is comparing the short-term quality of life between laparoscopy-assisted distal gastrectomy and totally laparoscopic distal gastrectomy for gastric cancer.


Eligibility criteria:
inclusion criteria: 1. aged 20-80 years; 2. patients had an eastern cooperative oncology group performance status score of 0 or 1; 3. patients had histologically confirmed gastric adenocarcinoma (tumor size\<5cm) at clinical stage i-iii with t1-4an0-2m0 excluding t4b or n3 tumors, according to the of the american joint committee on cancer classification system, eighth edition; 4. patients were expected to undergo laparoscopic distal gastrectomy with d2 lymphadenectomy. exclusion criteria: 1. patients had bulky regional lymph nodes (larger than 3 cm at the long diameter) or possible distant metastasis in preoperative evaluation 2. patients had history of chemotherapy, radiotherapy, immunotherapy or target therapy; 3. patients had any concurrent or previous malignant tumor; 4. patients had unstable cardiovascular, respiratory, kidney, or liver disease and poorly controlled hypertension, diabetes, mental disorders; history of upper abdominal surgery (except laparoscopic cholecystectomy). 5. patients were histologically proven gastric adenocarcinoma (by preoperative gastrofiberscopy).

Keywords: gastric cancer，laparoscopic distal gastrectomy
is interval appendectomy necessary?

Conditions: Appendicitis

Summary: appendicitis is one of the most common surgical problems in children, with 20-35% of patients having perforated by the time they present to a doctor. in these cases, the patient is often treated non-surgically with antibiotics. once a patient has improved, it is not known whether it is better to perform an interval appendectomy (ia) or to continue a watchful waiting approach. the purpose of this trial is to determine if expectant nonoperative management (watchful waiting) is not inferior compared to ia management after successful conservative treatment of appendiceal mass at admission.


Eligibility criteria:
inclusion criteria: * under 18 years of age * perforated appendicitis where the treating physician chooses to follow the conservative approach rather than performing an immediate appendectomy exclusion criteria: * uncertainty about the diagnosis * the need for laparotomy/laparoscopy for another reason * perforated appendicitis with diffuse abdominal fluid on imaging associated with a clinical picture of severe sepsis * another medical condition that may affect the decision to operate e.g., inflammatory bowel disease * a comorbidity or chronic illness that contraindicates the watchful waiting approach, e.g, diabetes or cardiac problems

Keywords: general surgery
mitoxantrone and g-csf in treating patients with metastatic prostate cancer

Conditions: Prostate Cancer

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. combining chemotherapy with g-csf may make tumor cells more sensitive to the chemotherapy drug and may kill more tumor cells. purpose: phase i/ii trial to study the effectiveness of mitoxantrone plus g-csf in treating patients with metastatic prostate cancer that has not responded to hormone therapy.

objectives: i. study the effectiveness of mitoxantrone in patients with metastatic, hormone refractory prostate cancer. ii. assess the side effects of mitoxantrone in this patient population. iii. determine whether filgrastim (granulocyte colony-stimulating factor; g-csf) treatment can overcome chronic bone marrow suppression and facilitate a dose intensive mitoxantrone chemotherapy regimen in this patient population. outline: this is a dose escalation study. patients receive a 30 minute intravenous infusion of mitoxantrone once a week on day 1. on days 2-6 of each week, patients receive subcutaneous filgrastim (granulocyte colony-stimulating factor; g-csf). treatment continues for patients who respond to therapy and exhibit no disease progression. dose escalation proceeds until the maximum tolerated dose (mtd) of mitoxantrone with g-csf support is determined. the mtd is defined as the dose preceding that at which 2 or more patients experience dose limiting toxicity. after the mtd is determined, an additional 20-40 patients are enrolled at this dose level to examine their response to this therapy. projected accrual: approximately 12-24 patients will be accrued for the phase i portion of this protocol. an additional 20-40 patients may be accrued for the phase ii portion of this study.

Eligibility criteria:
disease characteristics: histologically confirmed hormone refractory adenocarcinoma of the prostate metastatic disease required patient characteristics: age: not specified performance status: swog 0-2 life expectancy: greater than 12 weeks hematopoietic: absolute granulocyte count greater than 1500/mm3 platelet count greater than 100,000/mm3 hepatic: bilirubin less than 2.0 mg/dl sgot less than 2 times normal renal: creatinine less than 1.5 mg/dl cardiovascular: must have adequate cardiac function (lvef at least 40%) other: no other malignancy except skin lesions that have been completely excised no prior hypersensitivity to e. coli derived products prior concurrent therapy: biologic therapy: not specified chemotherapy: no prior chemotherapy endocrine therapy: see disease characteristics at least 1 month since lhrh agonist and/or flutamide radiotherapy: no concurrent radiotherapy no prior extensive radiotherapy (such as whole pelvic irradiation) surgery: not specified

Keywords: adenocarcinoma of the prostate stage iv prostate cancer recurrent prostate cancer
perioperative nutritional status and nutritional support in patients with spinal deformity

Conditions: Spine Deformity

Summary: to investigate the nutritional status, nutritional support and postoperative complications of patients undergoing spinal orthopedic surgery during the perioperative period.

adopting the method of continuous fixed point sampling, the inpatients in the orthopedic ward of our hospital were selected as the objects of investigation. (1) data collection 1. general data: the information of gender, age, ethnicity, height, weight, course of disease, family history, combined diseases, medication etc. 2. nutritional assessment：①nutritional risk screening tool 2002(nrs 2002), an evidence-based nutritional risk screening tool developed by the european society for parenteral and endoenteral nutrition, was recommended by the chinese society for parenteral and endoenteral nutrition as a nutritional risk screening tool for inpatients in china. the total nrs 2002 was divided into three scores, namely disease severity score, impaired nutritional status score and age score. nrs 2002 score ≥3 (accompanied by poor general conditions, such as weight loss, appetite, mental state, etc.) are at nutritional risk and require nutritional support; those with a score less than 3 have no nutritional risk and do not need nutritional support. ②other indicators include height, weight and body mass index, as well as biochemical indicators such as pre-albumin and hemoglobin. nutritional assessment was performed within 24 hours of admission, on the 1d after surgery, on the 7d after surgery, every 7d after surgery, or upon discharge. nrs 2002 was repeated to assess patients' nutritional risk at the first review three months after discharge. 3. nutritional support: the nutritional support received during the hospital was recorded, including the form of nutritional support (enteral or parenteral nutrition), energy ratio, variety selection, duration of administration, etc. 1 g carbohydrate provided 16.74 kj(4 kcal) calories, 1 g fat milk provided 38.93 kj(9.3 kcal) calories and 1 g amino acid provided 16.74 kj(4 kcal) calories to calculate the energy provided by the nutritional support program. the amount of nitrogen provided by the nutritional support program was calculated with about 1 g nitrogen provided by 6.25 g amino acids. 4. complications: postoperative complications, such as sepsis, pneumonia, urinary tract infection, wound infection, and delayed wound healing, were recorded during hospitalization and within 3 months after discharge.

Eligibility criteria:
inclusion criteria: * diagnosis of spine deformity, complete the operation in one time； * age: more than 10 years old ； * patients and their family members agreed to participate in the study and signed the informed consent； * conscious, patient or family members can communicate verbally. exclusion criteria: * emergency surgery； * hospital stay less than 24 hours； * surgery was not performed during the hospital stay； * nutritional metabolic diseases.

Keywords: spine deformity, nutritional support, postoperative complications
dynamic hormone profiling and multimodal data capture in primary aldosteronism

Conditions: Mineralocorticoid Excess; Primary Aldosteronism; Hypercortisolism

Summary: this study is a observational study applying 24-hour microdialysis methodology to perform dynamic multisteroid adrenal hormone profiling of patients with suspected or confirmed pa. simultaneous registration of blood pressure, tissue glucose, sleep pattern, activity level and food intake registration may be performed. the overall objective is to develop a novel, sensitive, fast and user-friendly diagnostic procedure for pa, using multimodal data capture including dynamic multisteroid hormone profiling from microdialysis fluid.

primary aldosteronism is the most common cause of secondary hypertension. primary aldosteronism has increased risk of organ complications compared with primary hypertension if left undiagnosed and without specific treatment. however, the current diagnostic work-up is a cumbersome, multistep process, relying on repeated single time point measurements of aldosterone, not capturing the rhythmic nature of aldosterone and related adrenal hormone secretion. in this study we will apply the u-rhythm microdialysis sampling system for 24-hour measurements from subcutaneous microdialysis fluid, analysed with lc/ms-ms methodology for dynamic multisteroid adrenal hormone profiling. we will further compare multisteroid hormone profiling results with variations in blood pressure and tissue glucose, sleep pattern, activity level and food intake. the overall objective of the study is to develop a novel, sensitive, fast and user-friendly diagnostic procedure for pa, using multimodal data capture including 24-hour dynamic multisteroid hormone profiling from microdialysis tissue. primary objective • assess dynamic multisteroid rhythmicity in microdialysis fluid of aldosterone, precursors and metabolites of the mineralocorticoid and glucocorticoid pathway, compared to standard diagnostic work-up in patients with suspected or confirmed pa. secondary objectives * quantify the influence of salt and volume loading during diagnostic saline infusion test on multisteroid adrenal rhythmicity. * quantify the influence of glucocorticoids/acth suppression on multisteroid rhythmicity. * quantify the influence of cortisol co-secretion on multisteroid rhythmicity in pa. * quantify influence of blood pressure, pulse, sleep, food intake and movement on multisteroid rhythmicity in pa.

Eligibility criteria:
inclusion criteria age 18 to 70 years suspected pa admitted for diagnostic saline infusion testing or confirmed pa diagnosis according to endocrine society criteria.. written informed consent exclusion criteria * age \ 70 years. * pregnancy. * known adrenal failure and/or on steroid therapy (oral, inhaled, parenteral or topical) or other interfering medication.

Keywords: aldosterone
awake thoracic epidural anesthesia versus general anesthesia in thoracotomy

Conditions: Awake; Thoracic Epidural Anesthesia; General Anesthesia; Thoracotomy

Summary: this study aims to compare awake thoracic epidural anesthesia and general anesthesia in thoracotomy.

the severity of acute postoperative pain is a causative factor for chronic postsurgical pain, and it has been observed that the incidence of chronic postsurgical pain is very high after thoracotomy. effective management of acute post-operative pain is a must in these patients. thoracic epidural analgesia (tea) is used as an adjunct to general anesthesia (ga) in thoracic surgery. however, tthe horacic epidural blockade has been rarely utilized as a sole method to provide anesthesia for major thoracic procedures

Eligibility criteria:
inclusion criteria: * age from 18 to 75 years old. * both genders. * american society of anesthesiologists (asa) physical status classification ii or iii. * scheduled for thoracotomy. exclusion criteria: * difficult airway management, * hemodynamically unstable patients, obesity (body mass index \>30). * absolute contraindication to thoracic epidural anesthesia such as (patient refusal, allergy to local anesthetics, coagulopathy, active neurologic disorders, skin infection at insertion site, uncooperative patients, uncontrolled cough, and unfavorable anatomy for thoracic epidural). * neurological disorders: risk of seizure, unable to cooperate, intracranial mass or brain edema, extensive pleural adhesions or previous pulmonary resections, hypoxemia (pao2 \ 50) * poor cardiac function (ejection fraction less than 50%). * patients with bad pulmonary function tests.
smoking cessation and reduction with an electronic nicotine delivery device (endd)

Conditions: Nicotine Dependence; Smoking Cessation

Summary: the study's major aim is to investigate the ability of a commercial electronic nicotine delivery device (endd) to induce long-term smoking reduction/abstinence in smokers unwilling to quit. secondary aims are to monitor adverse events and measure participants' perception and acceptance of the product. this pilot study will evaluate smoking reduction/abstinence effects, product preferences, and adverse events of a currently marketed device in italy ("categoria" electronic cigarette - "original" 7.2 mg nicotine cartridges). the primary hypothesis is that the e-cigarette is a safe device that allows smoking reduction or abstinence in smokers.

cigarette smoking continues to be a very difficult addiction to break. therefore, improved approaches to smoking cessation are necessary. the electronic-cigarette (e-cigarette), a battery-powered electronic nicotine delivery device (endd) resembling a cigarette, may help smokers to remain abstinent during their quit attempt or to reduce cigarette consumption. the efficacy of these devices in smoking cessation and/or smoking reduction studies has never been investigated. in this prospective proof-of-concept study we monitored possible modifications in smoking habits of 40 smokers (unwilling to quit) experimenting the 'categoria' e-cigarette focusing on smoking reduction and smoking abstinence. study participants were invited to attend four study visits: at baseline, week-4, week-8, and week-12. product use, number of cigarettes smoked, and exhaled carbon monoxide (eco) levels were measured at each visit. smoking reduction and abstinence rates were calculated. adverse events and product preferences were also reviewed.

Eligibility criteria:
inclusion criteria: * healthy smokers * unwilling to quit * age 18-60 years * smoking ≥ 15 cig/day for at least 5 years * exhaled co level of ≥ 15 ppm * ftnd ≥ 5 exclusion criteria: * alcohol and illicit drug use * breastfeeding or pregnancy * major depression or other psychiatric conditions * previous experience with endd * recent myocardial infarction * angina pectoris * high blood pressure (bp\>140mm hg systolic and/or 90mmhg diastolic) * diabetes mellitus * severe allergies * poorly controlled asthma or other airways diseases

Keywords: electronic cigarette endd nicotine smoking cessation smoking reduction
brain imaging biomarkers in patients with brain metastasis

Conditions: Brain Metastases, Adult

Summary: a biomarker is a measurable indicator of the severity or presence of some disease state. in this study, brain metastases patients who will be receiving radiation treatment, will undergo ct (computed tomography) and mri (magnetic resonance imaging) scans prior to and after radiation treatment to measure these biomarkers. this is a single-center phase ii study to validate the predictive abilities of biomarkers, in terms of determining how patients will respond to radiation treatment.

advances in medical imaging can provide useful information to guide and look at the response to treatment. previous studies suggest early changes in the tumor after radiation treatment may be detectable using special mri (magnetic resonance imaging), and ct (computed tomography) scans. a biomarker is a measureable indicator of the severity or presence of some disease state. previous studies suggest that the change in several imaging biomarkers can predict who will respond to radiation treatment. in this study, patients will undergo ct and mri scans prior to and after radiation treatment to measure these biomarkers. the purpose of this study is to validate the predictive abilities of biomarkers in terms of determining how patients will respond to radiation treatment. this is a single-center phase ii study, which will be conducted at the princess margaret cancer center. the study will be enrolling up to a total of 90 patients who will be receiving radiation treatment for brain metastases. patients will be asked to participate within this study for 2 years.

Eligibility criteria:
inclusion criteria: * biopsy proven primary malignancy (original biopsy is adequate as long as the brain imaging is consistent with brain metastases) * at least one index lesion with diameter \> 1cm and without imaging evidence of hemorrhage * patients age \> 18 years of age * patients planned for rt to brain metastases * ability to understand and the willingness to sign a written informed consent document. exclusion criteria: * previous whole brain radiotherapy * previous radiosurgery to the index lesion * individuals unable to undergo contrasted mri for whatever reason

Keywords: radiation therapy radiotherapy biomarkers magnetic resonance imaging computed tomography radiosurgery
human papillomavirus in cervical cancer and pre-cancer in switzerland: the cin3+plus study

Conditions: Cervical Cancer

Summary: this study will investigate the types of hpv in samples from women with cervical pre-cancer and cancer and gather information to help investigate the impact of hpv vaccination in switzerland.


Eligibility criteria:
inclusion criteria: * participant is willing and able to give informed consent for participation in the study. * participant is literate in german, french, italian or english. * female, aged 18 years or above. * histologically confirmed cin3+ lesions, i.e. cin3, adenocarcinoma in situ and invasive carcinoma of the cervix. * participant resides in the canton zurich, geneva, basel, baselland, luzern or ticino. exclusion criteria: * none

Keywords: hpv cervical cancer human papillomavirus cervical pre-cancer cervical neoplasia
neurocovid - a study of intensive care-requiring covid-19 patients

Conditions: Covid19

Summary: critically ill patients requiring intensive care suffer to a large extent from cognitive deficits involving higher brain functions that primarily affect memory, learning and the ability to concentrate. while the background to this effect is not fully understood, there are growing evidence to support mechanisms related to neuro inflammation and changes in blood flow with concomitant ischemic brain damage. patients with covid-19 often suffer from severe inflammatory activity with an increased risk of coagulation abnormalities and brain damage. covid-19 patients requiring intensive care develope more severe impairment of neurological and cognitive function than critically ill intensive care patients who have not covid-19. this project therefore aims to map the link between inflammation, immunology and coagulation systems as well as biochemical and structural changes in the brain with cognitive effects in patients in intensive care for covid-19.


Eligibility criteria:
inclusion criteria: * age ≥18 years * need for intensive care * positive pcr test for sars-cov-2 exclusion criteria: * none

Keywords: sars-cov-2 intensive care neurocognitive disorders cognitive dysfunction biochemical and structural brain changes