Kornimate/medical-research-clean huggingface dataset:
postoperative proton radiotherapy with chemo for pancreatic cancer

Conditions: Pancreatic Cancer

Summary: the purpose of this study is to find out what effects, good and/or bad, proton radiation combined with chemotherapy has on resected pancreatic cancer.

proton radiation with concomitant chemotherapy

Eligibility criteria:
inclusion criteria: * histologic proof of primary head of pancreas invasive adenocarcinoma managed with a potentially curative resection * post resection ca19-9 tumor marker baseline exclusion criteria: - previous history of invasive malignancy (except non-melanoma skin cancer and low to intermediate risk prostate cancer) unless the patient has been disease free for at least 5 years prior to study consent

Keywords: proton radiation chemotherapy pancreatic cancer postoperative
a randomized evaluation of emergent immobilization in external rotation in the management of acute anterior dislocations of the shoulder

Conditions: Primary Anterior Shoulder Dislocation

Summary: shoulder dislocations are quite common, the prevalence over a lifetime being estimated at 2% in the general population. in young patients, recurrence after a primary dislocation is also common (\~60%) and multiple recurrent episodes can cause significant disability over time. following initial reduction of the joint, the traditional treatment for primary shoulder dislocations has been immobilization in a sling, with the arm in a position of adduction and internal rotation. the length of the immobilization period is controversial, however most authors would recommend between three to six weeks in a sling followed by several months of rehabilitation to include range of motion and strengthening exercises. the clinical course of patients after this approach has been extensively investigated. of particular interest is the relatively high rate of recurrent instability in young patients, reported to be between 17 and 96%. a prospective randomized trial is needed to determine whether in young patients (16-30 yrs of age) following reduction of a first-time traumatic anterior shoulder dislocation, does emergent (\<4 hours post reduction) immobilization of the affected shoulder in external rotation reduce the rate of recurrent instability experienced within 12 months versus emergent immobilization in a traditional internal rotation sling? eligible patients will be randomly allocated to the sling or er brace. the results of this study will provide the best evidence for choosing emergent immobilization for shoulder dislocations.


Eligibility criteria:
inclusion criteria: * skeletally mature patients between 18 - 35 years of age inclusive * patient is seen within 24 hours from time of injury. * sustained an acute, first-time, traumatic anterior dislocation of the shoulder as defined by; * mechanism of abduction, external rotation * sudden pain in the shoulder * manipulative reduction required or * radiograph documenting a dislocated joint * willing to participate in follow-up for at least 24 months. exclusion criteria: * incompetent or unwilling to consent * inability or unwillingness to comply with rehabilitative protocol or required follow-up assessments. * previous instability of the affected shoulder * significant associated fracture (exception hill sachs or bankart lesions) * concomitant ipsilateral upper extremity injuries which may affect the patient's ability to participate in, or benefit from, a rehabilitative program. * neurovascular compromise of the affected limb * a medical condition making the patient unable to wear a brace or sling * patient is seen within 24 hours from time of injury
imaging biomarkers of knee osteoarthritis

Conditions: Osteoarthritis

Summary: this study aims to develop, evaluate and translate highly accelerated imaging sequences (each protocol under 5 minutes) for in-vivo knee osteoarthritis applications on a standard clinical 3t scanner using novel compression sensing and parallel imaging strategies.the overarching objective of the study is to establish a non-invasive imaging biomarker based on the development of rapid relaxation mapping with compressed sensing (cs) that will be clinically useful for assessment of early osteoarthritis. a total of 90 subjects including 30 patients with high risk of developing knee osteoarthritis (oa), 30 patients with mild oa and 30 healthy controls will be accrued.

current noninvasive imaging methods to evaluate knee joints include plain radiographs, computed tomography (ct), and clinical morphological magnetic resonance imaging (mri) of joint structures. these techniques can only detect later-stage, macroscopic joint structural abnormalities that are irreversible and not amenable to early therapy. this study aims to develop highly accelerated imaging sequences for ex-vivo knee oa applications on a standard clinical 3t scanner using novel cs and parallel imaging (pi) strategies.

Eligibility criteria:
inclusion criteria: * patients in the hjd oa database, ages 40-75 with high risk of developing oa as defined by: (i) kl score of 0 (ii) knee pain present in at least 1 knee (iii) normal radiographs, (iv) at least one abnormal clinical mr finding such as prior knee injury, overweight or traumatic bone marrow edema lesions * patients ages 40-75 with early oa as determined by kl scores 1-2 * healthy controls in the hjd oa database (kl score 0, no knee pain, no meniscal or ligament tears) exclusion criteria: * contraindications for mris (e.g. pacemakers, ferromagnetic vascular clips, metal implants, claustrophobia, etc). * subjects with any joint disease (example: rheumatoid or inflammatory arthritis) other than knee oa, corticosteroid injections within the previous 3 months, and history of avascular necrosis, paget's disease of bone, wilson's disease, gout, total knee replacement (or plan for replacement within next 24 months). * major co-morbidities such as diabetes, mellitus, cancer, congestive heart failure and chronic infectious diseases. * alignment interventions such as insoles and knee braces * vulnerable patients will not be recruited for this study
micropulse laser trabeculoplasty (532nm) versus conventional laser trabeculoplasty (532nm)

Conditions: Open Angle Glaucoma

Summary: this study will investigate if micropulse laser trabeculoplasty (532nm) is as effecttive as or better than the conventional laser trabeculoplasty (532nm), it might be a new treatment strategy for glaucoma patients. it is done with a laser device that can also be used for many other ophthalmic applications, thus reducing the economic burden of treatment.


Eligibility criteria:
inclusion criteria: * individuals over 18 years old * willing to sign an informed consent and able to comply the requirements of the study * having no other ocular diseases besides glaucoma exclusion criteria: * history of ocular trauma * intraocular surgery (except for phaco) * pigment dispersion and exfoliation glaucoma

Keywords: laser trabeculoplasty glaucoma
study of antibodies to anti-tnf agents in juvenile idiopathic arthritis

Conditions: Juvenile Idiopathic Arthritis

Summary: the purpose of this study is to analyze the frequency of the formation of antibodies against three different anti-tnf biologic agents used for the therapy of juvenile idiopathic arthritis.

juvenile idiopathic arthritis (jia) is the umbrella term for a heterogeneous group of inflammatory arthropathies that can affect children and young adults and is the most common rheumatic disease of the pediatric population. in high-income countries it has a yearly incidence of 2-20 cases per 100 000 population and a prevalence of 16-150 cases per 100 000 population. treatment of jia includes a combination of pharmacological interventions, physical and occupational therapy, and psychosocial support. although a definitive cure is still not available, the prognosis for patients with jia has improved greatly in recent years due to improved disease management and with the introduction of biologics that can provide an efficient alternative for patients who are nonresponsive to other treatments. traditionally, biologic treatments in jia have focused on blocking one of the central mediators of the inflammatory response, the cytokine tumor necrosis factor (tnf). currently there are three anti-tnf agents available for the treatment of jia: infliximab, adalimumab and etanercept. one of the major drawbacks of these therapeutics is the production of anti-drug antibodies (ada) that have been correlated with an increased risk of adverse events and loss of drug efficacy. the study will evaluate the frequency of the formation of anti-infliximab antibodies in patients treated with infliximab, anti-adalimumab antibodies in patients treated with adalimumab and anti-etanercept antibodies in patients treated with etanercept. a common practice in cases nonresponsive to one of the described anti-tnf agents is the discontinuation of therapy and switching to a different ant-tnf agent. therefore, the frequency of the formation of antibodies to each of the described anti-tnf agents will also be compared between patients who have previously received a different anti-tnf agent and patients who have not received any previous anti-tnf therapy. the results of this study will highlight the risks of formation of antibodies to three different anti-tnf biologic agents used for the therapy of jia either alone or after the previous discontinuation of a different anti-tnf agent.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of juvenile idiopathic arthritis * must be treated either with infliximab, adalimumab or etanercept exclusion criteria: * contraindications to anti-tnf therapy * concurrent treatment with any biologic agent other than infliximab, etanercept, or adalimumab * previous treatment with rituximab

Keywords: juvenile idiopathic arthritis rheumatic diseases antibodies biological therapy
collagen-povidone for diabetic seniors' tenosynovitis

Conditions: Diabetes Complications

Summary: diabetes affects 415 million adults globally, leading to hand issues. povidone collagen shows promise in managing tenosynovitis. a clinical trial was conduced to compared its efficacy in adults over 60. it is shown that the intervention reduces pain, improves functionality, and grip strength with no complications. collagen povidone holds potential for treating diabetic hand issues.

a randomized clinical trial from january 2022 to january 2023 compared povidone collagen intervention with a placebo in adults aged 60 and above suffering from stenosing tenosynovitis. participants were randomized into case (collagen-povidone) and control (physiological solution) groups. the study evaluated parameters like tenosynovitis, diabetes, pain, functionality, and grip strength.

Eligibility criteria:
inclusion criteria: * diagnostic of stenosing tenosynovitis * diagnostic of diabetes * adults aged 60 or older exclusion criteria: * adults aged 60 or older

Keywords: intervention stenosing tenosynovitis collagen-povidone
tailored mediterranean lifestyle education in participants with subjective cognitive impairment

Conditions: Subjective Cognitive Impairment

Summary: it is estimated that 30% of alzheimer's disease cases globally are associated with changeable risk factors, such as diet and physical activity. in particular, a mediterranean diet (md) has been associated with reduced risk of cognitive decline and improved brain function. the investigators developed educational resources on the mediterranean diet and lifestyle (think-med) in accordance with the medical research council guidance for developing and evaluating complex interventions, based on a systematic literature review and informed by qualitative work with patients with mild memory problems.the feedback gathered informed refinements and tailoring of the resource and overall md intervention. this study aims to evaluate feasibility of the "think-med" mediterranean lifestyle educational intervention to encourage dietary behaviour change among community-dwelling people with subjective cognitive impairment.

this pilot rct aims to evaluate the feasibility of a theory-based, tailored mediterranean lifestyle education intervention (think-med) to encourage behaviour change among participants who have subjective cognitive impairment. this study will be a 6 month randomised controlled trial (rct) with a total of 30 participants who will be randomised to 1 of 3 groups: 1. group 1 will receive the "think-med" mediterranean lifestyle education for memory resource on one occasion at baseline (n=10) 2. group 2 will receive the "think-med" mediterranean lifestyle education for memory resource at monthly intervals for 5 months, with an initial face-to-face visit from the research dietitian (month 1) and accompanied by telephone feedback (month 2-5) (n=10) 3. group 3 is a control group. participants in this group will receive the "think-med" mediterranean lifestyle education for memory resource after completing the 6 month study (n=10)

Eligibility criteria:
inclusion criteria: * have subjective cognitive impairment - montreal cognitive assessment (moca) score ≥ 26/30 * mediterranean diet score (mds) ≤ 4 (estruch et al. 2006) * willing to make changes to their diet exclusion criteria: * diagnosis of dementia * moca score of ≤ 25/30 * individuals with a visual or english language impairment * psychiatric problems e.g. depression * significant medical comorbidity * body mass index (bmi) ≤ 19 and ≥ 40 kg/m2 * excessive alcohol consumption * dietary restrictions/allergies that would substantially limit ability to complete study requirements * inability to provide informed consent * history of, or comorbid condition which may alter performance on cognitive tests e.g. stroke, head injury, parkinson's disease, learning disability

Keywords: mediterranean diet lifestyle
proprioceptive, calisthenic, and kinesthetic exercises for chronic low back pain

Conditions: Chronic Low Back Pain (CLBP)

Summary: numerous studies have emphasized the debilitating effects of chronic low back pain (clbp), which persists for over 12 weeks and impacts approximately 20% of the global population. the etiology of clbp encompasses various factors, such as sedentary lifestyles, diminished muscle strength, poor neuromuscular control of deep trunk muscles, and compromised proprioception, all contributing to lumbar spine strain. these factors result in limitations in essential daily activities, significantly diminishing the overall quality of life. continued exploration in this field is essential to furthering our understanding of managing chronic low back pain. investigating alternative treatment approaches, such as proprioceptive, calisthenic, and kinesthetic exercises, contributes to expanding the range of solutions available for addressing this issue. embracing a diverse array of interventions not only proves beneficial but also holds promise in providing long-term advantages for enhancing patients' overall well-being. therefore, this study aims to comprehensively investigate the combined effects of proprioceptive, kinesthetic, and calisthenic exercises, alongside core stabilization exercises, in alleviating chronic low back pain and their potential to enhance range of motion and diminish functional disability in individuals with clbp in lahore, pakistan.


Eligibility criteria:
inclusion criteria: * minimum 3 months or above lbp * moderate pain (nprs: 3-7) * disability score of 19% or greater as evident from the modified oswestry disability questionnaire (modq) exclusion criteria: * history of inflammatory joint diseases e.g. rheumatoid arthritis, gouty arthritis, psoriatic arthritis, and ankylosing spondylitis * history of neurological deficit e.g. paresthesia, sensory loss, radiculopathy, myelopathy * history of surgery related to spine, lower extremities, metal implants on lower extremities * history of any mental illness * subjects on medication e.g. antidepressants, corticosteroids, and anti-inflammatory medications * other conditions include peripheral vascular diseases, recent fractures including lower limb or spine, osteoporosis, spine or other joint deformities, brain injuries, neuromuscular disorders, and respiratory diseases * pregnancy

Keywords: chronic low back pain calisthenic exercises proprioceptive exercises kinesthetic exercises disability
high flow nasal cannula in the emergency department

Conditions: Acute Respiratory Failure

Summary: the aim of this study was to describe the changes in respiratory rate, heart rate and dyspnea, before and after using hfnc in patients presenting to our emergency department with arf.

a retrospective cohort study was performed. to all adults presenting to the emergency department who used high flow nasal cannula to treat clinical signs of acute respiratory failure based on the presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis despite conventional oxygen therapy ≥ 6 l/min. demographic variables and clinical and gasometric parameters before and after two hours using hfnc were recorded.

Eligibility criteria:
inclusion criteria: * patients aged ≥ 18 years * attended between july 1st, 2015 and january 31st , 2017 in the emergency department of the hospital italiano de buenos aires * with clinical signs of acute respiratory failure exclusion criteria: - pulse oximetry \> 90% breathing room air

Keywords: high flow nasal cannula emergency department respiratory care
birth & breastfeeding support study

Conditions: Breastfeeding; Breastfeeding Initiation; Breastfeeding Duration; Birth; Birth Practices; Gestational Diabetes Mellitus (GDM); Preeclampsia

Summary: the goal of this observational study is to learn about the effects of birth practices such as cesarean section and vacuum assisted birth and diseases such as gestational diabetes and preeclampsia on exclusive breastfeeding. the main question it aims to answer is: • does cesarean section, vacuum assisted birth, gestational diabetes and preeclampsia affect exclusive breastfeeding three months after birth? participants answer eight online survey questions. one survey is distributed before birth and the remaining seven surveys are distributed after birth at three, seven and four-teen days, as well as one, three, six and twelve months after birth.


Eligibility criteria:
inclusion criteria: 18 years, intention to breastfeed, single gestation, reads and understands danish - exclusion criteria: twin gestation, less than 18 years, no intention to breastfeed, does not read and understand danish -

Keywords: birth, birth practices, gestational diabetes, preeclampsia breastfeeding
exploring cancer evolution, prognostic and predictive biomarkers in egfr-mutant nsclc

Conditions: Non-small Cell Lung Cancer

Summary: to investigate genomic architecture, cancer evolution and their relationship with clinical outcomes in egfr-mutant nsclc.

egfr mutations are detected in about 50% of east asian nsclc and 10% of western nsclc. egfr-mutant nsclc harbors distinct genomic architecture including high ith, early diversification, genome instability, low background mutation rates. but despite its high ith, egfr-mutant nsclc usually have better prognosis than nsclc with other driver mutations even without the application of targeted therapies, indicating that egfr mutations may have distinct impacts on cancer evolution. this study intends to investigate the genomic architecture, cancer evolution trajectories and their relationship with clinical outcomes in egfr-mutant nsclc, and to identify prognostic and predictive biomarkers for this population that could potentially guide therapeutic decisions and improved clinical outcomes.

Eligibility criteria:
inclusion criteria: 1. aged 18 years or older 2. histologically or cytologically confirmed non-small-cell lung cancer 3. ecog ps=0-2 4. egfr mutations confirmed by tissue or peripheral blood 5. can provide tumor tissue samples (fresh or archived) 6. the subject should have good compliance, who would participate in the research voluntarily, and sign the informed consent exclusion criteria: 1. history of other malignancies within 5 years (excluding basal cell carcinoma of the skin or other carcinoma in situ that has been resected). 2. unable to provide sufficient tumor tissue for analysis. 3. subjects with active, unstable systemic diseases, such as active infection, uncontrolled hypertension, heart failure (nyha class \>= ii), unstable angina pectoris, acute coronary syndrome, severe arrythmia, severe liver, kidney or metabolic diseases, hiv infection. 4. subjects who are deemed unable to comply with the study requirements or complete the study.

Keywords: egfr mutation
computer-based alcohol use disorder recovery system

Conditions: Alcohol Dependence

Summary: the purpose of this grant is to develop and test a proven computer based quality improvement/behavior change e-health system (chess--comprehensive health enhancement support system) to help prevent relapse in alcohol dependent patients being discharged from residential treatment. the investigators' primary hypothesis is that achess (addiction chess) will improve competence, relatedness and autonomy, which will reduce the days of risky drinking over a 12-month period.

the system to be tested (achess - addiction chess) will be delivered through a new modality (smart-phone rather than pc) to make access more widespread, focus on new patients (alcohol dependent patients leaving residential care), offer optional audio delivery to improve access for those who have literacy challenges and be enhanced with services tailored to relapse prevention. achess will offer: 1) communication with peer support groups and addiction experts; 2) timely monitoring to assess risk of relapse, 3) reminders and alerts to encourage adherence to therapeutic goals; 4) addiction-related educational material and tools tailored to the needs of the particular patient, 5) access to selected internet based resources and 6) communication with a care manager. patients randomly assigned to achess will learn to use it prior to discharge from residential care.

Eligibility criteria:
inclusion criteria: * all subjects must be at least 18 years of age * all subjects must be willing to participate in the study * all subjects must be willing to identify two people who could provide contact information about their location for the next year * if randomized into achess, all subjects must agree to allow monitoring of their achess usage, including internet browsing * all subjects must pass a literacy test exclusion criteria: * homelessness * psychiatric or medical condition that precludes participation in the study including: subjects with a history of suicidality, significant developmental/cognitive impairments that limit their ability to understand the material or have vision problems will not be included in this study.

Keywords: alcohol addiction alcohol treatment alcohol recovery post residential treatment dsm-iv diagnosis of alcohol dependence
a study to determine effects of fluticasone propionate on sputum neutrophils after inhaled lipopolysaccharide challenge in volunteers

Conditions: Pulmonary Disease, Chronic Obstructive

Summary: study to assess effect of fluticasone propionate on acute lung inflammation following inhaled lipopolysaccharide (lps) challenge. study will be conducted in healthy volunteers. assessment of inflammation will be via sputum induction.

methodology validation

Eligibility criteria:
inclusion criteria: * healthy volunteers * normoresponsive airways - histamine pc20\>16mg/ml * able to complete sputum induction successfully exclusion criteria: * non (or ex) smokers * no lps challenge in previous 4 weeks

Keywords: copd