Kornimate/medical-research-clean huggingface dataset:
cold snare endoscopic mucosal resection (emr) vs cold emr with margin snare tip soft coagulation (stsc)

Conditions: Colorectal Polyp; Colon Adenoma; Colon Cancer

Summary: randomised controlled trial comparing cold snare endoscopic mucosal resection (emr) with cold snare emr and adjuvant margin stsc in the complete resection of 15-40mm lateral-spreading adenomas

rationale: conventional emr is well-established for the resection of lateral-spreading adenomas and has been shown to be highly efficacious with adjuvant stsc. cauterisation-related complications occur relatively frequently and while endoscopically treatable, still carry morbidity not seen in current cold snare polypectomy data. cold snare polypectomy has an excellent safety profile for smaller polyps, without cauterisation-related adverse events. limited data on cold emr for large adenomatous laterally-spreading lesions shows minimal complications. efficacy, however, is yet to be evaluated in prospective randomised trials. observational data demonstrates recurrence rates exceeding conventional emr. since stsc causes significant reduction in recurrence in conventional emr, the safety and efficacy of this adjuvant technique, when compared to isolated cold snare emr, has theoretical advantages in both safety and efficacy. the safety and efficacy of these two techniques will therefore be compared in a randomised controlled trial. hypothesis: cold snare emr of 15-40mm lateral-spreading adenomas with adjuvant stsc is expected to be superior regarding complete resection and adenoma recurrence rates as compared to cold snare emr.

Eligibility criteria:
inclusion criteria: * any patient undergoing colonoscopy who is older than 18 years of age, has a written consent for trial participation and has at least one laterally spreading lesion meeting the following description: * localisation in the colon or rectum * benign adenomatous surface features (kudo iii / iv, japan nbi expert team (jnet) 2a) * granular or non-granular topography * paris classification 0-iia/iib +/- is * if present, sessile component may be no greater than 10mm in size. * polyp size ranging from 15 to 40mm exclusion criteria: * current use of antiplatelet (excluding aspirin) or anticoagulants which have not appropriately been interrupted according to the guidelines. * known bleeding disorder or coagulopathy. * pregnancy * history of inflammatory bowel disease * previously attempted or otherwise non-lifting lesions * endoscopic features suggestive of submucosal invasion (kudo vi/n, jnet 2b / 3) or concurrent colorectal cancer * lesions involving the ileocaecal valve (icv), appendiceal oriface or anorectal junction (arj)

Keywords: colonoscopy polypectomy adenoma colorectal cancer
a comprehensive approach to head and neck cancer prehabilitation

Conditions: Cancer of Head and Neck

Summary: head and neck cancer accounts for 3% of malignancies in the united states. however, the diagnosis and treatment for head and neck cancer is considered to be debilitating. not because of its morbidity, but due to the extremely rigorous treatment course which has a profound impact on patients physical, social, and emotional functioning. disfigurement and sensorimotor deficits further compound this impact. head and neck cancer patients contend with treatments that can significantly affect their quality of life. treatment regularly results in decreased functional capacity and decreased quality of life. physical impairments are manifested through, but not limited to, disfigurement, deconditioning, communication issues, "swallowing, speech, breathing, and cancer-related fatigue". premorbid factors such as preexisting anxiety and depression, chemical dependency, financial barriers, and lack of social support system are unique obstacles to the head and neck cancer population impacting treatment and outcomes. due to these factors, patients experience higher rates of anxiety and depression, psychological distress, and fear of cancer recurrence. in fact, "compared with other survivors of cancer, head and neck cancer survivors are almost 2 times more likely to die from suicide". in view of the aforementioned research, roger maris cancer center's head and neck cancer will implement a prehabilitation program that evaluates each patient using standardized screening tools and provide personalized education and interventions. this project evaluates a more comprehensive and proactive multidisciplinary approach to improve treatment and outcomes in head and neck cancer patients.


Eligibility criteria:
inclusion criteria: * equal to or greater than 18 years of age * diagnosis of head and neck cancer * actively pursuing cancer treatment with a curative intent * willing and able to provide written consent exclusion criteria: * patients with cardiac arrhythmia with implanted pacemaker * patients with other implanted electronic equipment/device * patients undergoing external defibrillation * pregnant women (per bis instructions for use, pregnant women should not participate) * patient weight exceeding 375 lbs. * patient has a metal allergy
the value of lateral release in reconstruction of the diaphragmatic hiatus hernia

Conditions: Paraesophageal Hernia

Summary: patients scheduled for surgery for primary paraesophageal herniation are randomized to either conventional suturing of the crura or with the addition of lateral release.

patient undergoing surgery for primary paraesophageal herniation, are randomized to either conventional suturing of the diaphragmatic crura only or with the addition of a diaphragmatic incision "lateral release". the patients are examined by computed tomography before surgery and at 1 and 3 years after surgery. sf-36 (global quality of life instrument), gsrs (gastrointestinal symptoms rating scale), reflux frequency issues and watson's dysphagia score are completed before and at 3 and 6 month as well as 1 and 3 years after surgery. patients undergoing laparoscopic repair for paraesophageal hernia type ii-iv are eligible for inclusion in the study. included patients will be randomized to either reconstruction of the hiatus by suturing of the crura alone or in combination with an approximately 4 cm incision of the anterior aspect of the left diaphragma "lateral release" before crural suturing. the incision will be covered with a synthetic patch after crural closure is finished. all other aspects of the surgical procedure are similar in the two groups including complete mobilization of the hernia sac before and a total fundoplication after hiatal restoration, respectively.

Eligibility criteria:
inclusion criteria: * all patients with primary hiatus hernia type ii-iv who are deemed suitable for surgery exclusion criteria: * inability to understand the nature of the purpose of the study and/or to give informed consent. * american society of anesthesiologists physical status-system (asa) \>iii * achalasia or another severe esophageal motor disorder
ultrasound evaluation of the vascular anatomy of the neck to minimize the accidental risk of vascular puncture during percutaneous tracheostomy

Conditions: Tracheostomy Complication; Trachea

Summary: tracheostomy is a commonly performed procedure in intensive care and its incidence tends to increase over time as a consequence of the increase in chronic diseases and the average age of the population accessing intensive care. surgical open tracheostomy (st) is the standard procedure but has a relatively high incidence of peristomal infections and perioperative bleeding. percutaneous dilatational tracheostomy (pdt) was introduced in 1985 and has since become a common bedside procedure. compared to open st, pdt has the advantages of a lower risk of wound infection, lower bleeding-related mortality, shorter procedure times, and improved cost-effectiveness. fiberoptic bronchoscopy is commonly used during pdt to verify the safety of direct tracheal access \[5\]. however, bronchoscopy-guided pdt has several limitations regarding the precise identification of cervical anatomical structures and the prevention of complications such as vascular injury. preliminary ultrasound examination of neck anatomy has numerous potential benefits, including increased safety during the procedure, identification of cervical vascularization, and localization of the tracheal puncture site with lower risk of complications \[6-8\]. several studies have shown that the use of ultrasound in a preliminary and real-time manner can improve first-pass success rate and puncture accuracy, reduce procedure time, and complications. the objective of this study is to map the arterial and venous vascular anatomy of the neck in order to identify points with a lower risk of vascular injury during pdt. this helps prevent bleeding during tracheostomy, which is one of the major complications associated with the procedure.


Eligibility criteria:
inclusion criteria: * patients of eighteen years or older * informed consent exclusion criteria: * tracheostomized patients
integrated echocardiography and chest ultrasound assessment of lung recruitment in preterm infants

Conditions: Ventilator Lung; Echocardiography; Chest Ultrasound; High Frequency Ventilation; Lung Recruitment

Summary: the primary aim of this work is to evaluate the role of high frequency oscillatory ventilation (hfov) in recruitment of lung in preterm newborns 32 to 37 weeks gestational age with moderate to severe respiratory distress. the secondary aim is to evaluate the role of chest ultrasound in monitoring of lung recruitment in comparison to routine chest x ray in those babies. also cardiac hemodynamics will be assesed using functional echocardiography.


Eligibility criteria:
inclusion criteria: * infants will be enrolled if they are 32 to 37 weeks of gestational age, have respiratory distress (rd) in the first 24 h of life, intubated and have invasive respiratory support using hfov. signs of rd are tachypnea (respiratory rate \> 60/min), grunting, nasal flaring, chest retraction, and need of oxygen supplementation or other respiratory support. exclusion criteria: 1. known major congenital anomalies including congenital heart diseases. 2. fetal hydrops. 3. babies with congenital heart diseases

Keywords: premature infants
optoacoustic detection of inflammation using msot device

Conditions: Graft Vs Host Disease; Colitis; Crohn Disease

Summary: the purpose of this study is to evaluate the safety and potential of a new experimental imaging instrument called multispectral optoacoustic tomography (msot) to detect inflammation in patients with chronic graft versus host disease of the skin or gi tract, crohn's disease, or colitis disease.

this is a single arm, 3-cohort study that is designed to provide safety information regarding the use of the acuity msot device in the clinical setting, and the ability of msot imaging data to correlate with clinical findings identified via pathology or radiology. the device will be used to obtain images of the areas of inflammation in the above patients for investigational use only, to compare to clinical pathology and patient's medical record. patients will go through standard care procedures prior to imaging. medically established diagnostic procedures will be used to detect areas of inflammation associated with gvhd, crohn's, or colitis. images using the msot device will be obtained through intact skin. a second msot scan will be performed for all patients 4 weeks post treatment. the temperature of the patient's skin will also be measured prior to and after msot imaging. msot imaging will be for research only and no treatment decisions will be based on the msot images obtained.

Eligibility criteria:
inclusion criteria: * patients documented clinical/pathologic 1) acute or chronic colon or skin gvhd, 2) crohn's disease, or 3) colitis * have acceptable hematologic status \[total hemoglobin (thb) ≥ 7.0 mg/dl\] * patients ≥ 18 yrs of age * willing to comply with study procedures and be available for the duration of the study * patient has ability to understand and the willingness to provide a signed and dated irb-approved informed consent document. exclusion criteria: * patients with a tattoo over the area of inflammation * pregnant patients are not eligible for this trial. eligible patients (if applicable) will be required to document the date of the first day of their last menstrual cycle, and provide a negative pregnancy test if sexually active and of childbearing potential * patients who are breastfeeding * any open wound (skin ulcerations or infections) at or near the site of imaging that would preclude msot imaging. * any febrile illness that precludes or delays participation preoperatively

Keywords: imaging device inflammatory diseases
dose-dense biweekly docetaxel, oxaliplatin and 5-fluorouracil as first-line treatment in advanced gastric cancer

Conditions: Docetaxel, Oxaliplatin and Fluorouracil

Summary: this is an open-label, phase ii study to evaluate the efficacy and safety of biweekly docetaxel, oxaliplatin and de gramont regimen on unresectable gastric adenocarcinoma in the first-line therapy.

docetaxel 50mg/m2 oxaliplatin 85mg/m2 5-fu 2800mg/m2 repeated every two weeks

Eligibility criteria:
inclusion criteria: * signed written informed consent * patients with histologically or cytologically confirmed unresectable gastric adenocarcinoma whose ecog performance status are 0-2 * presence of measurable disease by radiographic study (including ct or mri scan, or chest x-ray) or physical examination * at least 3 weeks since last major surgery * at least 12 months since last adjuvant chemotherapy * at least 6 weeks since prior radiotherapy providing that the extent and site of radiotherapy fields are such that marked bone marrow suppression is not expected * patients who have received palliative radiotherapy must have recovered from any reversible toxic effects e.g. nausea and vomiting caused by radiation of fields * patients with reproductive potential must use effective bc * required screening laboratory criteria: hemoglobin 90g/l wbc 3.5 x 109/l neutrophils 1.5 x 109/l platelets 100 x 109/l creatinine 133 umol/l and creatinine clearance 60 ml/min * a probable life expectancy of at least 6 months exclusion criteria: * brain metastases * female of childbearing potential, pregnancy test is positive * concomitant malignancies or previous malignancies other than gastric cancer within the last five years, with the exception of adequately treated basal or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, or low grade prostate cancer * active infection * concurrent severe medical problems unrelated to the malignancy, which would significantly limit full compliance with the study or expose the patient to extreme risk * sexually active patients refusing to practice adequate contraception; patients with conditions which might affect absorption of an oral drug (for example intermittent obstruction) unless discussed and agreed with principal investigator * history of grade 3 or 4 toxicity to fluoropyrimidines
nfl dynamics as a predictor factor in patients with out of hospital cardiac arrest

Conditions: Out-Of-Hospital Cardiac Arrest; Neurological Injury

Summary: to investigate the pharmacodynamics of light chain of nfl in patients with out-of hospital cardiac arrest after successful resuscitation and determine the difference in the serum levels of nfl in patients with favorable neurological outcome compared to those with non-favorable neurological outcome.

to investigate the serum levels of the light chain of nfl at different time points after icu admission (12, 24, 30, 36, 42, 48 hours after icu admission) patients with out-of hospital cardiac arrest after successful resuscitation and determine the difference in the serum levels of nfl in patients with favorable neurological outcome compared to those with non-favorable neurological outcome.

Eligibility criteria:
inclusion criteria: * out-of-hospital cardiac arrest successfully resuscitated and admitted to the icu exclusion criteria: * trauma, drowning, electrocution, less than 18 years of age,
early ibuprofen treatment of patent ductus arteriosus (pda) in premature infants (triocapi)

Conditions: Patent Ductus Arteriosus

Summary: very premature infants with a large ductus, selected by an early echocardiogram, will receive either ibuprofen or placebo before 12 hours of life. follow-up will include repeated echocardiograms and cranial ultrasound at 36 hours, 14 days and 36 weeks of postconceptional age. the primary outcome will be survival without cerebral palsy at years.


Eligibility criteria:
inclusion criteria: * gestational less than 28 weeks * postnatal age less than 12 hours

Keywords: prematurity patent ductus arteriosus ibuprofen
synbiotics in infants with cyanotic congenital heart disease

Conditions: Congenital Heart Disease

Summary: infants with congenital heart disease have more frequent infections and exposures to antibiotics than healthy infants. the investigators hypothesized that synbiotics may reduce the rate of sepsis and necrotizing enterocolitis in infants with chd

infants with congenital heart disease have more frequent infections and exposures to antibiotics than healthy infants. probiotics may prevent pathogen colonization in infants with chd. therefore, the investigators hypothesized that synbiotics may reduce the rate of sepsis and necrotizing enterocolitis in infants with chd

Eligibility criteria:
inclusion criteria: * cyanotic congenital heart disease * infants \>35 weeks of gestational age * born at or transferred to sami ulus ch exclusion criteria: * congenital anomalies of the intestinal tract

Keywords: congenital heart disease, probiotic, prebiotic
efficacy of genicular nerve alcohol neurolysis in knee osteoarthritis pain

Conditions: Knee Pain Chronic

Summary: this study aimed to evaluate the efficacy of genicular nerve alcohol neurolysis in the treatment of pain caused by chronic knee osteoarthritis. the investigators will evaluate the efficacy of genicular nerve alcohol neurolysis using the numeric rating scale (nrs) and the western ontario and mcmaster universities osteoarthritis index (womac). nrs and womac scores will be evaluated before, 1, and 3 months after the procedure.

alcohol neurolysis of the genicular nerve is a procedure that involves injecting alcohol around the nerve branches that supply sensation to the knee joint. the alcohol destroys the nerve fibers and blocks the transmission of pain signals from the knee to the brain. this technique can be used to treat chronic knee pain caused by osteoarthritis (oa). several studies have reported that alcohol neurolysis of the genicular nerve can provide significant pain relief and functional improvement in patients with knee oa or postoperative pain. for example, dass et al. (1) reported two cases of alcohol neurolysis of the genicular nerve using fluoroscopy and ultrasonography in patients with knee oa or persistent postsurgical pain of the knee. both patients had more than 50% reduction in their numerical rating scale (nrs) scores and improved range of motion and quality of life at 3 months follow-up. ultrasonography-guided genicular nerve alcohol neurolysis is prominent with its easy applicability and low cost. there are no studies in the literature evaluating the efficacy of genicular nerve alcohol neurolysis for chronic knee oa. in this prospective study, the investigators will evaluate the nrs and womac scores of patients who underwent genicular nerve alcohol neurolysis for chronic knee oa before, 1, and 3 months after the procedure. in addition, the incidence of procedure-related adverse events (such as paresthesia) recorded in patient records will be analyzed. 1. dass rm et al. alcohol neurolysis of genicular nerve for chronic knee pain. korean j pain 2019; 32 (3): 223-227. https://www.epain.org/journal/view.html?doi=10.3344/kjp.2019.32.3.223

Eligibility criteria:
inclusion criteria: * moderate to severe knee pain due to knee osteoarthritis (0-10 pain of intensity 6 and above on an inter-numeric pain scale) * permanent pain for more than 6 months * grade 3 or 4 in the radiological kellgren-lawrence classification having osteoarthritis * pain with conservative methods such as analgesics and physiotherapy treatment failure exclusion criteria: * history of intra-articular knee intervention in the last 6 months * cognitive impairment * hepatic or renal insufficiency * severe psychiatric illness * local or systemic infection * coagulopathy

Keywords: osteoarthritis pain ultrasonography paresthesia
cataract dme - peri vs. intraop

Conditions: Diabetic Macular Edema; Cataract

Summary: goals of the study are to evaluate how peri-operative versus intra-operative anti-vegf intravitreous injections affect visual acuity (bcva) in patients with persistent diabetic macular edema who are undergoing cataract surgery; and to evaluate how peri-operative versus intra-operative anti-vegf intravitreous injections affect oct csf thickness and total number of postoperative injections in patients with diabetic macular edema who are undergoing cataract surgery.

along with age, diabetes is a major risk factor for cataract formation, which can lead to significant vision loss and disability without medical intervention. unfortunately, diabetic patients, particularly those with diabetic macular edema (dme), experience poorer visual outcomes after undergoing cataract surgery compared to non-diabetics. reasons for this is multifactorial but includes an increased risk in the development of post-operative cystoid macular edema, and exacerbation of baseline dme. this poses a significant challenge in managing concomitant dme and visually-significant cataracts. goals of the study are to evaluate how peri-operative versus intra-operative anti-vegf intravitreous injections affect visual acuity (bcva) in patients with persistent diabetic macular edema who are undergoing cataract surgery; and to evaluate how peri-operative versus intra-operative anti-vegf intravitreous injections affect oct csf thickness and total number of postoperative injections in patients with diabetic macular edema who are undergoing cataract surgery.

Eligibility criteria:
inclusion criteria: * adults over age 18 with diabetes mellitus, diabetic macular edema and visually significant cataracts planning to undergo cataract surgery exclusion criteria: * patients who have undergone panretinal photocoagulation (prp) in prior 4 months or an ocular condition (other than cataract and dme) that might affect visual acuity during course of study. * patients with history of vitrectomy. * patients with neovascular glaucoma.

Keywords: anti-vegf injections pre-existing dme cataract surgery
the influence of hospital environment on eyes infections in medical staff

Conditions: Eye Infections

Summary: the investigators want to find out if there is any difference between the microbiotic flora lining the conjunctiva of medical staff that work in the hospital and others who do not work in the hospital.


Eligibility criteria:
inclusion criteria: * healthy medical workers. exclusion criteria: * any ocular disease. * previous ocular surgery.

Keywords: conjunctival flora