Kornimate/medical-research-clean huggingface dataset:
transvaginal noses versus conventional laparoscopic surgery for right hemicolectomy

Conditions: Colon Cancer

Summary: it is controversial that totally laparoscopic right hemicolectomy with transvaginal natural orifice specimen extraction (noses viiia) can provide non-inferior oncological outcomes compared to conventional laparoscopic surgery with mini-laparotomy in the treatment of right colon cancer. we aim to carry out a multicenter, open-lable, parallel, non-inferiority, phase iii, randomized controlled clinical trial, which enrolls 356 female patients with ct1-3nxm0 right colon adenocarcinoma. they are randomly assigned to the experimental group (noses viiia) or the control group (laparoscopic surgery with mini-laparotomy) in a 1:1 ratio. perioperative indicators, pathological results, quality of life and cosmetic evaluation will be compared between the two groups. then, a three-year follow-up of these patients will provide evidence for long-term oncological outcomes of noses viiia.


Eligibility criteria:
inclusion criteria: * volunteer to participate and the informed consent signed; * 18-75 years; * female who have given birth; * pathologically confirmed adenocarcinoma/high-grade intraepithelial neoplasia by preoperative colonoscopy and biopsy; * preoperative ct or mri indicates that the tumor diameter is no more than 5.0 cm; * preoperative staging ct1-3nanym0 * body mass index \<30 kg/m2; * willing to undergo laparoscopic right hemicolectomy exclusion criteria: * contraindications for laparoscopic surgery; * emergency surgery due to acute intestinal obstruction, perforation or bleeding; * distant metastasis; * multiple colorectal cancer; * has received preoperative chemoradiotherapy; * with a history of other malignant tumors; * unwilling to sign the informed consent or receive follow-up according to the study protocol.
subconjunctival injection of triamcinolone acetonide and limited peritomy during pterygium excision

Conditions: Pterygium

Summary: pterygium is characterized by encroachment of a ﬂeshy fibrovascular tissue from the bulbar conjunctiva on to the cornea. although previously thought to be a solely degenerative disease, a new evidence has demonstrated the role of cell proliferation and inflammation in the pathogenesis of pterygium , and also by the clinical data that steroids are beneﬁcial in halting progression of impending recurrent pterygium . many techniques have been developed for pterygium surgery over time. the simple method of removing the head and body of pterygium and leaving the sclera uncovered, the so-called bare-sclera technique, has been associated with high recurrence rates of 32-88% . to reduce the recurrence rate after pterygium surgery with a bare-sclera technique, various adjunctive modalities have been used such as chemical agents including mitomycin c , 5-ﬂuorouracil . furthermore, when removal of pterygium is accompanied with a graft, such as conjunctival autograft or amniotic membrane transplantation , lower recurrence rates have been achieved . however, it remains unclear why the bare sclera technique has poorer outcome with higher recurrence rate than other procedures.

one of the factors that may have a role in the outcome of pterygium surgery is postoperative conjunctival inflammation , treatment of which has been demonstrated to improve the ﬁnal outcome . it has been shown that persistent conjunctival inflammation around the surgical site after pterygium surgery is present in 31-84% of cases with amniotic membrane transplantation, and in 15% of eyes with conjunctival autograft . however, the rate of conjunctival inflammation after pterygium surgery with a bare-sclera technique has not been reported in literature . also, it has been suggested that higher recurrence rate after pterygium with amniotic membrane transplantation compared with conjunctival autograft may be due to higher rate of postoperative conjunctival inflammation . therefore, it may be speculated that higher recurrence rate after pterygium surgery with a bare-sclera technique is partly due to higher rate of postoperative conjunctival inflammation .

Eligibility criteria:
inclusion criteria: * primary pterygium. exclusion criteria: * preexisting glaucoma . * patient with family history of glaucoma
the efficacy of preoperative low-residue diet on postoperative ileus following cesarean section

Conditions: Cesarean Section Complications

Summary: the aim of the present study was to evaluate the efficacy of preoperative low-residue diet on postoperative ileus in women undergoing elective cesarean section. it is a surgeon-blind, randomized controlled trial enrolling pregnant women at ≥39 weeks of gestation undergoing elective cesarean section. patients were preoperatively randomized to receive either low-residue diet (arm a) or free diet (arm b) starting from three days before surgery. the primary outcome was the postoperative ileus at 24 hours after surgery. the secondary outcomes were the postoperative pain (assessed through vas scale), the quality of the surgical field (scored using a 5-point scale, from poor to excellent), postoperative complications, and the length of hospital stay. perioperative data were collected and compared between groups.


Eligibility criteria:
inclusion criteria: * pregnant women at ≥39 weeks of gestation scheduled for elective cesarean section at the department of gynecology of policlinico umberto i (sapienza university of rome) who gave written informed consent. exclusion criteria: * urgent/emergent surgery * patients with gastrointestinal disorders * complicated pregnancy (e.g., active infection, placental adhesive disorders, hypertensive disorders), which would potentially prolong their hospitalization * incomplete medical records.

Keywords: enhanced recovery after surgery low-residue diet obstetrics perioperative management cesarean section postoperative ileus
a novel e-health approach in optimizing treatment for seniors (optimum study)

Conditions: Breast Neoplasms; Medication Adherence

Summary: background: in women with hormone receptor positive (hr+) breast cancer, adjuvant endocrine therapy (aet) is associated with a significant survival advantage. nonadherence is a particular challenge in older women, even though they stand to benefit the most from aet. therefore, a novel e-health tool (optimum) that integrates real-time analysis of health administrative claims data was developed to provide point-of-care decision support for clinicians.

objectives: 1) to determine the effectiveness of a patient-specific, real-time e-health alerts delivered at point-of-care in reducing rates of aet discontinuation and to understand patient-level factors related to aet discontinuation. 2) to assess integration of e-health alerts regarding deviations from best practices in administration of aet by cancer care teams. methods: a prospective, two group controlled comparison pilot study will be conducted at two urban, mcgill university-affiliated hospitals, the royal victoria hospital and st. mary's hospital. a minimum of 43 patients per study arm will be enrolled through site-level allocation. follow-up is 1.5 years. healthcare professionals at the intervention site will have access to the e-health tool which will report to them in real-time: medical events with known associations to aet discontinuation, aet adherence monitor, and a discontinuation alert.

Eligibility criteria:
inclusion criteria: 1. must be ≥ 65 years old, 2. have been diagnosed with incident (non-metastatic) breast cancer, 3. have a histologically-confirmed breast adenocarcinoma, 4. have undergone breast surgery for stages i-iii disease, 5. have medical insurance with the régie de l'assurance maladie du québec (ramq) for at least 1 year prior to surgery, 6. have hr positive disease, 7. have no history of aet use prior to the diagnosis of breast cancer, 8. expected to initiate aet or have only recently initiated aet (\<6 months) but are free of previous discontinuation events, 9. have the ability to consent for herself. exclusion criteria: male gender

Keywords: administrative claims, healthcare aromatase inhibitors breast neoplasms health services for the aged medical informatics applications medication adherence outcome and process assessment (health care) selective estrogen receptor modulators telemedicine
uark 2005-01 study of velcade, thalidomide, and dexamethasone (vtd) with or without adriamycin® in relapsed/refractory patients

Conditions: Multiple Myeloma

Summary: the main goal of this study is to evaluate the effectiveness of the combination of these drugs, and whether they can be given safely together.

in this study, there will be two arms (or groups). one arm will receive velcade, thalidomide, and dexamethasone (vtd), and the other arm will receive vtd with adriamycin. this study has the following specific goal: to evaluate the efficacy and toxicity of two treatments in multiple myeloma patients, relapsing after at least one course of high-dose treatment and an autologous stem cell transplant, or after at least two lines of conventional chemotherapy.

Eligibility criteria:
inclusion criteria: * patients with relapsing multiple myeloma (mm) * patients must have adequate platelet count of \> 20,000 x 10\^9/l, independent of transfusions, unless it is due to massive myeloma infiltration. * anticipated life expectancy of at least 3 months * ejection fraction by echocardiogram (echo) or multiple gated acquisition (muga) scan performed within 60 days prior to registration; left ventricular ejection fraction (lvef) \> 40% by echo or muga. * female patients of child bearing age are required to have a negative pregnancy test as indicated in thalidomide safety guidelines * patients must have a performance status of 0-2 based on southwest oncology group (swog) criteria. patients with a poor performance status (3-4), based solely on bone pain, will be eligible. * all patients must be informed of the investigational nature of this study and must have signed an institutional review board (irb)-approved informed consent in accordance with institutional and federal guidelines. exclusion criteria: * evidence of central nervous system (cns) involvement * grade \> 2 peripheral neuropathy * hypersensitivity to velcade, boron, or mannitol * recent (\< 6 months) myocardial infarction, cerebrovascular accident (cva)/stroke, unstable angina, difficult to control congestive heart failure, uncontrolled hypertension, or difficult to control cardiac arrhythmias. * evidence of chronic obstructive or chronic restrictive pulmonary disease. * prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease free for at least three years. * patients must not have significant co-morbid medical conditions or uncontrolled life threatening infection. * pregnant or nursing women. women of child-bearing potential must have a negative pregnancy test documented within one week of registration. women and men of reproductive potential may not participate unless they have agreed to use an effective contraceptive method for the duration of the study treatment.

Keywords: myeloma
effects of an exercise rehabilitation programme with a nasal inspiratory restriction device in copd patients

Conditions: Pulmonary Disease, Chronic Obstructive; Breathing Exercises; Exercise Tolerance

Summary: this study evaluates the effects of a nasal restriction device for inspiratory muscle training (feelbreathe) after 8 weeks of exercise intervention on exercise capacity, quality of life, dyspnea and inspitarotory muscle strength in patients with stable copd. participants were divided in three groups: 1) exercise intervention using the feelbreathe® device (fb group), 2) exercise intervention with oronasal breathing without fb (onb group) and 3) no participation in the exercise intervention as control group (cg).

the feelbreathe® device, tested in the investigator's study can be used in static and dynamic situations and is a nasal ventilatory flow restriction device made by a strip of hypoallergenic material (3m spain, s.a. medical specialties / o.e.m.) that is placed and adhered under the nostrils impairing the free pass of air through the nose by producing resistance to flow. depend on the size or/and porosity of the device, the inspiratory process is more or less difficult. it can be used while performing dynamic exercise or doing daily living activities. the feelbreathe® device (fb) has been authorized by the spanish agency for medicines and health products for application on copd patients (expedient 521/15/ec. aemps-madrid-spain-patent nº: p200902402).

Eligibility criteria:
inclusion criteria: * men with diagnosis of copd according to guidelines criteria * with moderate or severe airflow obstruction (gold 2 or 3) * dyspnea grade 2 or greater by mmrc scale * stable clinical condition for at least 2 months. exclusion criteria: * poor compliance * treatment with oxygen therapy or non-invasive mechanical ventilation * co2 retention * medical conditions that can produce or increase dyspnea on exercise in addition to copd (cardiovascular, metabolic or other respiratory diseases) * osteoarticular or neuromuscular diseases that may limit the correct performance of the 6mwt

Keywords: pulmonary rehabilitation medical device feelbreathe exercise intervention equipment and supplies
ebv infection as a risk factor for ptld in pediatric and adult renal transplant recipients

Conditions: Epstein-Barr Virus Infections

Summary: question: in which stage of an ebv-infection is a selective reduction of immunosuppressive medication reasonable to minimize the risk for ptld, without putting the transplant recipient at risk of acute rejection episodes due to under immunosuppression? aim of study: identification of patients at high-risk for ptld.

ptld represents a heterogeneous group of abnormal lymphoid proliferations, generally of b-cells, that occur in the setting of ineffective t-cell function because of pharmacological immunosuppression. because the vast majority of ptlds are associated with epstein-barr virus (ebv) infection, surveillance of ebv infection may have the potential to prevent the development of ptld by early intervention. however, the cut-off values of "high" ebv viral load remain badly defined due to a lack of prospective studies and assay standardization. the aim of this ongoing multicenter prospective study is the serial detection of primary ebv infection or reactivation in a homogeneous patient population of pediatric renal transplant recipients during the first 2 years posttransplant by the combined analysis of quantitative ebv viral load by a standardized quantitative pcr technique, ebv serology and ebv-specific t-lymphocytes for the identification of high-risk patients.

Eligibility criteria:
inclusion criteria: * male and female pediatric and adult renal transplant recipients with written informed consent exclusion criteria: * psychological illness which does not allow patient to understand the study and participate following his own free will * no written informed consent

Keywords: ebv ptld rtx pediatric
potential of deep learning in assessing pneumoconiosis depicted on digital chest radiography

Conditions: Pneumoconiosis

Summary: pneumoconiosis is relatively prevalent in low/middle-income countries, and it remains a challenging task to accurately and reliably diagnose pneumoconiosis. the investigators implemented a deep learning solution and clarified the potential of deep learning in pneumoconiosis diagnosis by comparing its performance with two certified radiologists. the deep learning demonstrated a unique potential in classifying pneumoconiosis.

the investigators retrospectively collected a dataset consisting of 1881 chest x-ray images in the form of digital radiography. these images were acquired in a screening setting on subjects who had a history of working in an environment that exposed them to harmful dust. among these subjects, 923 were diagnosed with pneumoconiosis, and 958 were normal. to identify the subjects with pneumoconiosis, the investigators applied a classical deep convolutional neural network (cnn) called inception-v3 to these image sets and validated the classification performance of the trained models using the area under the receiver operating characteristic curve (auc).

Eligibility criteria:
inclusion criteria: * industrial workers with a history of exposure to dust and underwent dr screening of pneumoconiosis from 2015 to 2018 exclusion criteria: * patients with poor image quality * patients with incomplete clinical data
hyperdynamic left ventricular ejection fraction as a predictor of mortality in intensive care unit patients with septic shock

Conditions: Hyperdynamic; Left Ventricular Ejection Fraction; Mortality; Intensive Care Unit; Septic Shock

Summary: the study aimed to evaluate the cause and prognosis of hyperdynamic left ventricular ejection fraction in critically ill patients with sepsis.

cardiovascular dysfunction is increasingly being recognized as a significant complication in sepsis, affecting patient outcomes. among the key parameters used to evaluate cardiac performance is the left ventricular ejection fraction (lvef), typically assessed via transthoracic echocardiography (tte). lvef has been extensively studied; most investigations into preserved ejection fraction tend to group all values ≥50% together, thereby overlooking the potential clinical implications of lvef ≥70%, often referred to as hyperdynamic lvef (hdlvef).

Eligibility criteria:
inclusion criteria: * age over 18 years. * both sexes. * patients who were diagnosed with septic shock. exclusion criteria: - patients with previously documented abnormal transthoracic echocardiography (tte) findings, such as severe valvular disease, poor echocardiographic windows, patients admitted to cardiothoracic intensive care unit (icu), and those not meeting sepsis criteria.
the effect of a ketone drink on liver glucose production in people with type 2 diabetes

Conditions: Diabetes Mellitus; Ketosis

Summary: what is the effect of a ketone drink on liver glucose production, and postprandial glycemia, in people with type 2 diabetes.

background: ketones are molecules that are naturally produced by our body during fasting or diets low in carbohydrates. ketones can affect how our liver produces and maintains our body's blood sugar levels, which could be important in the management of type 2 diabetes (t2d), where high blood sugar levels are partly because of excess sugar production by the liver. objectives: to determine if, and how, a ketone drink can lower blood glucose in people with t2d following a meal. methods: twelve people with t2d will visit our laboratory in the morning on two occasions and ingest a drink containing ketones or placebo on each visit in a random order before ingesting a milkshake style drink containing sugar. blood samples will then be taken at regular intervals over 4 hours to determine if the ketone drink has lowered blood sugar levels in response to the meal, and if this was due to reduced sugar production by the liver. value: this research will provide new knowledge about the regulation of liver blood sugar production in response to ketone ingestion. this may also inform future clinical trials to establish if ketone drinks could be used as a treatment for t2d.

Eligibility criteria:
inclusion criteria: * diagnosed with type 2 diabetes by a physician, a current hba1c of 6.5-8.5%, and receiving treatment with lifestyle advice or oral glucose-lowering medications. * non-smoking * blood pressure \<160/100 mm/hg exclusion criteria: * exogenous insulin or sglt2 inhibitors for type 2 diabetes treatment. * following a low-carbohydrate ketogenic diet, periodic fasting diet, or consuming ketogenic supplements. * other diagnosed chronic metabolic, cardiovascular, respiratory, neurological, or gastrointestinal disease. * smoker * blood pressure \>160/100 mm/hg * lactose intolerant

Keywords: diabetes exogenous ketones postprandial glycemia endogenous glucose production
mechanical insufflator-exsufflator in patients after video-assisted thoracoscopic operations with one-lung ventilation

Conditions: Thoracic Diseases

Summary: postoperative pulmonary complications (ppc) are a common problem in patients undergoing surgery using one-lung invasive ventilation. major pulmonary complications such as atelectasis, bronchospasm, and pneumonia can lead to respiratory failure. ppc are the main cause of mortality in the postoperative period in patients after thoracic surgery. the study aimed to compare the effectiveness of using a mechanical insufflator-exsufflator after video-assisted thoracoscopic surgery using one-lung ventilation to reduce postoperative pulmonary complications as compared to standard therapy.

postoperative pulmonary complications (ppc) are a common problem in patients undergoing surgery using one-lung invasive ventilation. major pulmonary complications such as atelectasis, bronchospasm, and pneumonia can lead to respiratory failure. ppc are the main cause of mortality in the postoperative period in patients after thoracic surgery. the incidence of ppc ranges from 5% to 80%. patients undergoing thoracic surgery are usually at high risk. most often these are elderly people with concomitant diseases. most of these patients are smokers, have occupational exposures, and are therefore at even greater risk of developing pulmonary complications. part of their problem is due to poor baseline pulmonary function. improving mucus production in the postoperative period using a mechanical insufflator-exsufflator may help reduce the incidence of complications.

Eligibility criteria:
inclusion criteria: * video-assisted thoracoscopic surgery using one-lung ventilation * age 18-65 years forced expiratory volume in one second (fev1) 60% of predicted or more * absence of pronounced bronchial secretion before surgery * written informed consent. exclusion criteria: * age less than 18 and more than 65 years * presence of pneumothorax 6 hours after surgery on radiography * pulmonary hemorrhage of any intensity * unstable hemodynamics * forced expiratory volume in one second (fev1) is less than 60% of predicted during preoperative examination * the scope of the operation is more than a lobectomy * bilateral and combined operations * mechanical ventilation after surgery for more than 6 hours * anesthesia risk according to american society of anesthesiologists (asa) 4 and 5 points

Keywords: one-lung ventilation postoperative pulmonary complications mechanical insufflator-exsufflator randomized trial
emotion and craving regulation among individuals with internet gaming disorders

Conditions: Internet Gaming Disorder; Emotion Regulation

Summary: to investigate the potential deficits in emotion and craving regulation capacities of drug-naïve young adults with internet gaming disorder as compared with healthy controls.

the purpose of this study is to examine the differences in young adults' capacities of utilizing cognitive appraisal versus mindfulness to regulate negative emotions and/or craving in response to negative affective stimuli or gaming cues, respectively. this project will be conducted in beijing, china.

Eligibility criteria:
inclusion criteria: internet gaming disorders (igd): 1, dsm-5 recommended diagnosis of internet gaming disorder : 1. the scores of the 9 items of dsm-5 recommended diagnosis for internet gaming disorder ≥ 5. 2. engagement in popular internet games (e.g. arena of valor, league of legends and player unknown's battle grounds) for over 20 hours per week for a minimum of 12 months. 2, the scores of the y-iat(young-internet addiction test) ≥ 50 healthy controls (hcs): dsm-5 scores less than 5 and less than 20 hours gaming time per week. exclusion criteria: current or history of use of illegal substances and gambling; current or history of psychiatric or neurological illness; current use of psychotropic medications; being left-handed.

Keywords: emotion and craving regulation