Kornimate/medical-research-clean huggingface dataset:
study of gemcitabine and oxaliplatin with radiation therapy in patients with pancreatic cancer

Conditions: Pancreatic Cancer

Summary: this study will examine a sequence of treatments including pre-operative chemotherapy and radiation, surgery and post-operative chemotherapy for resectable pancreatic cancer.

this study will examine a sequence of treatments including pre-operative chemotherapy and radiation, surgery and post-operative chemotherapy for resectable pancreatic cancer. this research treatment will evaluate the combination of two chemotherapy agents, oxaliplatin and gemcitabine with radiation therapy. the researchers have already done studies using oxaliplatin, gemcitabine and radiation therapy together for pancreatic cancer. they want to build on the information they have from this previous research and do the research at multiple sites. they will use this study to determine how well people do who are treated with gemcitabine, oxaliplatin, and radiation therapy prior to having surgery for their pancreatic cancer. the researchers will also gather more information about what type of side effects occur with this treatment.

Eligibility criteria:
inclusion criteria: * patients must have cytologic or histologic confirmation of carcinoma arising in the pancreas. * patients must be deemed resectable or borderline resectable based on criteria in section 4.2 prior to registration. * patients must have an expected life expectancy of at least 12 weeks and a zubrod performance status of \< 2. * patients must have adequate organ function defined as follows: absolute neutrophil count of \> 1500/mm3, platelets \> 100,000/mm3, serum cr \< 1.5 mg/dl, total bilirubin \< 3.0 mg/dl with relief of biliary obstruction if present (ptc tube or endobiliary stent). * patients must be free of other active systemic malignancy, ongoing infection, including hiv infection, or any other serious uncontrolled, concomitant systemic disorders or psychiatric condition that would interfere with the safe delivery of protocol therapy. * patients must be aware of the investigational nature of the therapy and provide written informed consent. * patients must have no history of previous chemotherapy for pancreatic cancer or any abdominal radiation therapy. * patients must not have used any investigational agent in the month before enrollment into the study. exclusion criteria: * patients with neuroendocrine tumors are excluded. * patients with preexisting peripheral neuropathy \> grade 2 are ineligible. * pregnant or nursing women are ineligible and patients of reproductive potential must agree to use an effective contraceptive method during participation in this trial and for 6 months after trial.
a trial of procalcitonin in patients with acute exacerbation of chronic obstructive pulmonary disease

Conditions: Procalcitonin; Chronic Obstructive Pulmonary Disease

Summary: current antibiotic prescription for patients with acute exacerbation of chronic obstructive pulmonary disease (aecopd) is generally based on the anthonisen criteria in the global initiative for chronic obstructive pulmonary disease (gold) guideline, that has a potential risk of antibiotics overuse. the dilemma is to identify patients who are most likely to benefit from antibiotics while avoiding unnecessary antibiotic use. procalcitonin (pct), a more sensitive and specific biomarker of bacterial infection than other conventional laboratory tests, has the potential to determine those patients in whom antibiotics would be beneficial. it is unclear whether pct-guided antibiotic therapy is safe and effective for inpatients with aecopd. the investigators aim to conduct a 2-arm, multicenter randomized controlled trial in china to determine whether pct-guided antibiotic therapy will reduce the antibiotic prescription rate for aecopd without negatively impacting the treatment success rate, compared with the gold guideline antibiotic recommendations.

this trial will recruit 500 hopitalized patients with aecopd. the eligible participants will be randomly assigned to either pct group or guideline group.the investigators aim to compare the efficacy and safety between pct-gudied antibiotic therapy and guideline-guided antibiotic recommendations. the primary hypothesis is that pct-guided antibiotic therapy will reduce the antibiotic prescription rate for aecopd without negatively impacting the treatment success rate, compared with the gold guideline antibiotic recommendations.

Eligibility criteria:
inclusion criteria: * hospitalized patients with aecopd * ≥40 years of age * able to understand and communicate to ensure the completion of the trial * voluntary participation and provide written informed consent exclusion criteria: * fever, axillary temperature≥38°c * pneumonia identified by x-ray or ct of the chest * severe respiratory failure requiring admittance to icu * concurrent infection at another site (e.g. urinary tract infection) * immunosuppression secondary to chemotherapy, aids or malignant tumor of blood system * comorbidities requiring corticosteroids (prednisone 30mg/d or equivalent more than 30 days ) * invasive mechanical ventilation * patients with malignant tumors receiving chemotherapy or radiotherapy * pregnancy * participation in another clinical trial * previously enrollment into the study * refuse to attend
a study of 1 8f-fdht pet/mriscans in women with breast cancer

Conditions: Breast Cancer; Breast Carcinoma; Metastatic Breast Cancer; Metastatic Breast Carcinoma; Female Breast Cancer

Summary: the purpose of this study is to see whether 18f-fdht pet/mri scans are an effective way of identifying ar-positive breast cancer.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * ecog performance score of 0-2 * signed informed consent * histologically confirmed ar+ breast cancer * all participants under consideration for enrollment will have their tumor specimen tested centrally at msk; nuclear ar staining ≥ 1% will be considered positive. * progressive metastatic breast cancer manifested as increase in evaluable disease or the appearance of new sites of disease since the date of the last imaging study performed and under consideration for ar-targeted therapy * planning to undergo treatment with agents targeting the antiandrogen signaling pathway on a clinical trial exclusion criteria: * life expectancy \< 3 months * pregnancy or lactation * participants who cannot undergo scanning because of * weight limits * devices or implants that are not mri safe * allergies to contrast materials * cns only disease on recent imaging

Keywords: breast cancer breast carcinoma metastatic breast cancer metastatic breast carcinoma ar+ breast cancer progressive metastatic breast cancer 21-299 memorial sloan kettering cancer center female breast cancer
ketamine infusion therapy for the treatment of ptsd in paramedics

Conditions: Stress Disorders, Post-Traumatic; Anxiety Disorders

Summary: this is an observational study to assess the change in several psychological screening tools before and after a series of six ketamine infusions in paramedics who suffer from post traumatic stress disorder as a result of working in emergency medical services.

working as a paramedic in a prehospital emergency medical services system (ems) has been shown to lead to increased incidence of post traumatic stress disorder (ptsd) and increased risk of suicide in prehospital personnel. in recent years a growing body of literature has shown that ketamine hydrochloride can be an effective treatment for ptsd. this study seeks to look specifically at paramedic level emergency medical technicians ("paramedics") with ptsd related to their prehospital work and assess whether ketamine infusion therapy can be an effective treatment for them. this is an observational study where the results of psychological screening tools that are administered before and after a six-infusion series are reported. additionally the same assessment tools will be administered again 30 days after the final treatment to measure the durability of any changes. the participants will receive the periodic health questionnaire-9 (phq-9), the ptsd checklist for diagnostic and statistical manual, dsm-5 (pcl-5), the alcohol use disorders identification test (audit), and the beck anxiety inventory (bai) before the infusions, after the series of six, and thirty days later. additionally, after the series of six infusions, participants will receive the revised mystical experience questionnaire-30 (rmeq-30) and a one question survey to assess the impact of the experiential aspect of ketamine.

Eligibility criteria:
inclusion criteria: * must have worked as a paramedic (emt-p) on a 911 prehospital service for at least five years. * must be diagnosed with post traumatic stress disorder that happened as a result of working as a paramedic * diagnosis must have been made by a mental health professional * the symptoms of ptsd must be having a significant adverse effect on the subject's life * subjects must be able to speak and read english exclusion criteria: * currently participating in another ptsd treatment program and/or research study * diagnosis of psychosis * uncontrolled hypertension or a history of heart failure

Keywords: ketamine ptsd depression prehospital
pilot study of stomach cancer early detection and prevention with endoscopy

Conditions: Gastric Cancer

Summary: screening esophagogastroduodenoscopy (egd )provides three distinct opportunities to decrease gastric cancer (gc) morbidity and mortality. has potential to discover cancer in early stages before the onset of symptoms, leading to higher rates of survival. second, premalignant lesions such as adenomatous polyps, intestinal metaplasia and dysplasia can be discovered and removed with local resection, akin to polypectomies during screening colonoscopies, preventing the development of cancer. third, egd discovery and treatment of active helicobacter pylori (hp) infection of the stomach provides an opportunity for primary prevention of gc.

the primary objective of the study is to evaluate the acceptability and feasibility of egd-sc. the secondary objectives are: 1. estimate median added time needed for egd at the time of routine screening colonoscopy 2. estimate the frequencies of adverse events 3. estimate the percentage of pre-cancer and cancerous lesions including h. pylori infection, chronic atrophic gastritis, im, dysplasia and gc among this high gc risk population 4. investigate whether high-risk racial/ethnicity groups have different likelihood of uptake of egd, and whether the likelihood is associated with patient beliefs, attitudes and knowledge of gc, perceptions of risk, motivators and barriers, and sociocultural factors, as well as patient preference and satisfaction with egd-sc

Eligibility criteria:
inclusion criteria: * have provided signed informed consent for the trial * aged =40 and =80 years at the time of informed consent * not planned to undergo egd and not had egd in the last five years * planned to undergo colonoscopy * half of the recruited subjects will be from high-risk groups * willing and able to comply with all aspects of the protocol exclusion criteria: * persons with total gastrectomy * persons with anatomic alteration that precludes egd * medical conditions that substantially increase risks for egd * had egd in the last five years

Keywords: h.pylori infection chronic atrophic gastritis
comprehensive ultrasound evaluation as a predictor of weaning

Conditions: Mechanical Ventilation Weaning; Weaning Failure

Summary: several studies investigated the role of specific clinical predictors of weaning success, but it is determined by a combination of different aspects that can result in success or failure. indeed, unresolved lung disease, cardiac dysfunction, loss of respiratory and core muscle strength can play a role in a failure weaning to mechanical ventilation (mv). the investigators hypothesized that a combined score that include heart, lung, and respiratory muscle ultrasound (us) evaluation could be able to predict the ability of weaning success. furthermore, it will be described weather the days of mv before weaning trial may affect the relevance of each clinical variable evaluated.

critically ill patients undergone at least 48 hours of mv and ready to spontaneous breathing trial (sbt) will be included in the study. the spontaneous breathing trial is performed in pressure support ventilation with a clinician-set positive end expiratory pressure (peep) ≤ 5 cm h2o and fio2\< 40%. in addition to the parameters traditionally used for the evaluation of weaning (rsbi), the investigators will perform ultrasound evaluation of diaphragm, lung parenchyma, cardiac function, and the strength of the hand grip. investigators will evaluate the diaphragmatic parameters (thickening fraction,tf, and diaphragmatic displacement, dd) and tfmax (tf during forced breathing /tf during tidal respiration) to identify the inspiratory reserve. weaning success is considered as liberation from mv within 72 hours.

Eligibility criteria:
inclusion criteria: * aged between 18 and 90 years * mechanical ventilation\> 48 h * reason for icu admission: medical / surgical / trauma exclusion criteria: * age under 18 * diagnosis of neuromuscular disease * tracheostomy * terminal extubation * pregnancy in progress - * previous paralysis of the diaphragm or of a hemidiaphragm * use of neuromuscular blocking drugs in continuous infusion in the 48 hours preceding the weaning attempt. * refusal to participate in the study

Keywords: weaning mv critically ill patients ultrasound evaluation
effects of tribulus terrestris in women with hypoactive sexual desire disorder

Conditions: Hypoactive Sexual Desire Disfunction

Summary: hypoactive sexual desire disorder (hsdd) is the most prevalent female sexual dysfunction in society and is strongly linked to the quality of life of women. the androgen hormones decline over age in the premenopausal period, which occurs around 20 years. tribulus terrestris is a plant native to india, recommended in the treatment of infertility, low libido and impotence. its main active ingredient is the protodioscin, which has been attributed to an increase in testosterone levels and improved sexual function. the aim of this study is to evaluate the effects of tribulus terrestris in premenopausal women with hsdd.


Eligibility criteria:
inclusion criteria: * regular menstrual cycle * with no use of hormonal contraception within the last 3 months * without any medication, drugs or alcohol. * healthy patients without systemic or psychiatric disease exclusion criteria: * patients with amenorrhea and/or pregnant. * patients who underwent bilateral oophorectomy. * patient smoker (10 cigarettes per day). * patients with blood pressure \> 160/90 mm hg. * patient with breast or endometrial carcinoma. * patients with a history of myocardial infarction. * patient with diabetes. * patient with vaginal bleeding from any source. * patients with hepatic injury. * patients with active thrombophlebitis or thromboembolic disorders recent * patients with interpersonal relationship problems with your relationship or partner * patients with sexual problems from your partner

Keywords: sexual function hypoactive desire androgens
outcome of tamis mucosal resection in patients with ods

Conditions: Constipation, Impaction, and Bowel Obstruction; TAMIS Mucosectomy; Obstructed Defecation Syndrome

Summary: patients, aged 18 - 90 years, undergoing tamis mucosectomy at the department of general surgery at the medical university of vienna are enrolled into our study. primary endpoint is the outcome (improvement of ods symptoms), defined by ods score.

various surgical approaches for the treatment of obstructed defecation syndrome (ods) commonly associated with rectocele and rectal intussusception have been investigated in the literature. methods such as stapled transanal resection of the rectum (starr) and ventral prosthesis rectopexy (vpr) show promising results at least in the short term. in the long-term, however, the results do not seem convincing. schiano di visconte et al. report a recurrence of ods symptoms in 40 percent of the patients, treated with stapled transanal rectal resection in a 10-year follow up. the clinical outcome of surgical treatment of ods using transanal minimally invasive surgery (tamis) in the sense of a mucosal resection without stapling technique has not yet been investigated. this project is designed to show the short-term outcome of non-stapled mucosal resection through tamis.

Eligibility criteria:
inclusion criteria: * need of minimal invasive mucosal resection due to obstructed defecation syndrome after several unsuccessful conservative treatments over a period of more than 6 months with presence of an organic cause (symptomatic intussusception with or without rectocele) in medical examinations (defecography, endoluminal ultrasound, endoanal manometry) * age: 18-90 years * ability and willingness to understand and comply with planned interventions during the study. * voluntarily signed informed consent after a full explanation of the study to the participant. exclusion criteria: * any physical or mental disorder could interfere with the participant's safety during the clinical trial or with the study objectives. * inability to communicate well with the investigator due to language problems or reduced mental development. * inability or unwillingness to give written informed consent.

Keywords: obstructed defecation syndrome tamis mucosectomy
lifestyle change for better health

Conditions: Bladder Cancer; Telomere Shortening; Colorectal Adenoma

Summary: the goal of the research is to provide a first critical test of the novel scientific idea that a combined diet and exercise intervention may ameliorate shortening of leukocyte telomere length (ltl) in individuals with histories of successfully treated non-metastatic bladder cancer (bc) or colorectal adenoma (cra) compared to a diet only intervention.


Eligibility criteria:
inclusion criteria: * bmi between 25.0 to \<40 kg/m2 (allows for use of assessments such as dxa to be included) * history of histologically confirmed bladder cancer (non-metastatic) or colorectal adenoma * under clinical surveillance with no evidence of disease exclusion criteria: * who performance status 3-4 or deemed physically unable to participate by physician * currently pregnant or breastfeeding, were pregnant in the previous 6 months or breastfeeding in the previous 3 months, or planning pregnancy in the next year * history of bariatric surgery * medical condition that could affect body weight (e.g., diabetes mellitus, hyperthyroidism, uncontrolled hypothyroidism, chronic renal insufficiency, chronic liver disease, gastrointestinal disorders including ulcerative colitis) * cancer diagnosis (other than bladder cancer or non-melanoma skin cancer) in the previous 5 years * current congestive heart failure, signs or symptoms indicative of an increased acute risk for a cardiovascular event * history of myocardial infarction, coronary artery bypass or angioplasty, conditions requiring chronic anticoagulation (recent or recurrent dvt) * resting systolic blood pressure of \>160 mmhg or diastolic blood pressure \>100 mmhg * eating disorder that would contraindicate weight loss or physical activity * alcohol or substance abuse * current treatment for psychiatric issues (e.g., depression, bipolar disorder) or taking daily or extended release psychotropic medications in the previous 12 months * report exercising more than 100 minutes per week over the past 3 months (note: includes physical activity performed for sport, fitness, or recreational activity; physical activity performed as part of occupation or household chores is not included) * weight loss of greater than 5% or participating in a weight reduction diet in the past 3 months * report plans to relocate to a location not accessible to the study site or having employment, personal, or travel commitments that prohibit attendance to at least 80 percent of the scheduled intervention sessions and all of the scheduled assessments
use of allied-health professionals to improve treatment of disease

Conditions: Preeclampsia

Summary: the goal of this clinical trial is to learn if allied-health professionals can recruit and follow research participants, sustain engagement, and improve and diagnose treatment of diseases by facilitating transitions of care. participants will: take their blood pressure at home and return it to the research team; follow up with a research pharmacist for 12 months; return for a follow up visit after 12 months.

after consent, a research pharmacist will virtually monitor the participant's blood pressure until the 12-month follow up visit. the research pharmacists will have access to the participant's electronic medical records to monitor and document medications and clinic blood pressures for analysis . participants will be asked to measure and return 14 blood pressure measurements (2x per day for 7 days) using our text messaging platform. they will be allowed to choose the times that they are sent reminders to measure their blood pressure. if a participant has blood pressure values sufficient for a hypertension diagnosis, the pharmacist will communicate via electronic medical record with the participant's primary care team. if they do not have a primary care provider, the pharmacist will facilitate finding one. the pharmacist will continue monitoring the participant and making recommendations to the primary care team through the electronic medical record to quickly adjust therapy to improve blood pressure control. the pharmacists will typically contact the participants (via participant's choice of phone, text, or email) every 2-3 weeks while their hypertension is uncontrolled. once under control, the pharmacist will continue to contact the participant at least every 2 months to support adherence and reassess control.

Eligibility criteria:
inclusion criteria: * biological mothers delivering at uihc or attending a well-child visit for an infant between 1 month and 9 months * preeclampsia during pregnancy * preceived prenatal care at uihc * owns a smartphone exclusion criteria: * arm circumference greater than 17 inches * prisoner status * unable to provide own written informed consent
rhinological outcomes in endonasal pituitary surgery

Conditions: Pituitary Neoplasm; Pituitary Adenoma; Prolactinoma; Cushings Disease; Acromegaly

Summary: this is a prospective, multi-center observational study designed to address patient-reported nasal outcomes in adults undergoing endoscopic and microscopic surgical removal of pituitary tumors. the primary objective of this study is to determine the difference in nasal outcomes by using the anterior skull base (ask) nasal survey between patients treated with endoscopic surgical technique and those treated with microscopic surgical technique. patients will be given the ask nasal survey to assess their nasal functioning and overall health before their surgery, and at post-operative visits 1-2 weeks, 3 months, and 6 months.

the technical and patient factors that influence rhinological (nasal) outcomes following endonasal anterior skull base surgery and pituitary surgery are not well understood. several timely and controversial topics, such as the influence of endoscopic techniques and the impact of underlying disease on nasal outcomes are in need of further study. the anterior skull base (ask) nasal survey is a 24-item questionnaire designed to assess for common postoperative nasal complaints, such as crusting, nasal congestion, pain, sinusitis, sense of smell, and overall functioning. the survey is a brief and simple assessment that asks patients to score symptom severity on a five-point scale.

Eligibility criteria:
inclusion criteria: * pituitary tumor patients treated by transsphenoidal route * adults (age 18-80 years) * direct endonasal or endoscopic approach * non-functioning adenoma, cushing's disease, acromegaly exclusion criteria: * patients treated by expanded endonasal approaches (transtubercular approach) * sublabial approach

Keywords: pituitary surgery transsphenoidal surgery anterior skull base surgery endoscopic surgery patient survey nasal complications