Kornimate/medical-research-clean huggingface dataset:
analysis of the incidence of post-operative wound infections after spine surgery

Conditions: Infection

Summary: post-operative wound infections can prolong hospital stays, increase rates of readmission to the intensive care unit, and increase the costs of treatment significantly. this study will conduct a prospective chart review of all patients undergoing elective spinal surgery on both the neurosurgery and orthopedic spine services at two facilities on an academic campus. the investigators will collect the data of those patients who develop post-surgical infections. this data will then be analyzed and compared to published data from other studies. the aim of this investigation is to passively collect this infection data, which may ultimately provide needed baseline incidence rates using current and standard protocols.

this is a chart review study.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * patients undergoing elective spinal surgery on either the neurosurgery and orthopedic spine services * patients who develop post-operative wound infections within 90 days of surgery exclusion criteria: * patients younger than 18 years of age * patients who are not undergoing elective spinal surgery on either the neurosurgery and orthopedic spine services * patients who do not develop post-operative wound infections within 90 days of surgery

Keywords: spinal surgery, surgical site infection
a randomized controlled trial of using video images in dementia

Conditions: Dementia

Summary: background: advance care planning (acp) is the process in which patients plan for future medical care under circumstances of impaired decision-making. video is an underutilized medium that can assist clinicians in discussions of future health states, such as the state of advanced dementia. video may enable patients to visualize the future by concisely providing complex information vital for acp. this study will examine whether the use of video could facilitate a more comprehensive understanding of advanced dementia and inform clinician-patient discussions about the level of care a patient would want in the event of advanced dementia. research plan: we propose to conduct a randomized trial studying acp for 200 elderly subjects using a video depiction of a patient with dementia compared to the traditional verbal narrative. specific aims 1 and 2 assess the effect of a video of advanced dementia on the clinical decision making of elderly subjects compared to the traditional verbal narrative.

outcome measures were what subjects wanted if they had advanced dementia.

Eligibility criteria:
inclusion criteria: * over 64 exclusion criteria: * can't speak english

Keywords: dementia
the radial forearm flap in reconstruction of upper limb injuries

Conditions: for Upper Limb Soft Tissue Coverage

Summary: the radial forearm flap is a very useful and versatile flap with a long vascular pedicle and a thin, pliable skin. it's used in reconstruction of the mutilated hand as a reverse pedicled flap. the dominant pedicle is the radial artery, with venous outflow through the dual system of the venae comitantes and cephalic vein. sensory innervation may be derived from the medial and lateral antebrachial cutaneous nerves. the radial forearm flap offers the advantage of a large area of donor tissue from the involved extremity with the potential for inclusion of bone, nerve, and tendon grafts. sacrifice of the radial artery has not been associated with significant patient symptoms however, the donor defect can be troublesome, frequently requiring skin grafting directly over the paratenon of the flexor tendons, producing an undesirable donor site appearance


Eligibility criteria:
inclusion criteria: * patients aging 5 to 80 years. * soft tissue defects following mca injuries. * defect size less than 30 cm exclusion criteria: * peripheral vascular disease * underling bone osteomyelitis * unhealthy skin of volatile aspect of donor forearm * defect more than 30 cm * ulnar artery previous ligated
assessment of breathing pattern during niv

Conditions: COPD (Chronic Obstructive Pulmonary Disease); Obesity Hypoventilation Syndrome (OHS)

Summary: copd and ohs are respiratory conditions that disrupt normal breathing. positive airway pressure, specifically non-invasive ventilation (niv), has been shown to improve breathing and reduce symptoms in patients with these conditions. regular use of niv can lead to better symptom management, improved quality of life, and reduced use of healthcare resources. the type of mask used for breathing support can greatly affect a patient's comfort and willingness to use it. for conditions like obstructive sleep apnea (osa), which is a physical blockage of the airway caused by the relaxation of the muscles of the throat, nasal masks are often used because they are comfortable and work well. but for breathing support in the hospital, full face masks are typically used because patients are having significant trouble breathing and tend to breathe through their mouth. however, it's important to note that we don't yet fully understand the best way to provide breathing support for long-term niv users, like copd and ohs patients. the understanding of breathing route is currently only established for osa. however, conditions like copd affect the lungs and the overall system used for breathing, which is different from the throat blockage seen in osa. so, the assumptions we make based on conditions like osa may not apply to these other conditions. more research is needed to understand this better.

* participants undergo psg, lying on their backs while their breathing route is recorded for about 30 minutes. * the participants are then put on their prescribed airway pressure support with the first randomized mask, and their breathing is recorded again for 30 minutes. * the mask is switched to the second mask, and the same procedure is repeated. participants are then moved to the sleep laboratory for the night where they are provided with beds. * they continue niv therapy with the last mask used during the awake test. * after at least 60 minutes of recording, participants are awakened to switch back to the first mask. they are then allowed to sleep uninterrupted for the rest of the night.

Eligibility criteria:
inclusion criteria: * age over 18 years * prescribed nocturnal niv for copd or ohs * able to complete an overnight sleep study * comfortable to sleep on a standard double bed * capacity to complete informed consent exclusion criteria: * uncontrolled sleep apnea (apnea-hypopnea index (ahi) over 15 events/hour off personal niv device data) * prescribed ipap above 25 cmh2o * self-reported pregnancy * allergic to adhesive of the sensors * self-reported cold/flu symptoms
eras swallowing rehabilitation in elder patients

Conditions: The Upper Esophageal Sphincter Contraction Strength

Summary: the investigators studied that swallowing function of patients receiving the early recovery accelerated swallowing (eras-w program) training will recover fast than that of patients in the control group. the eras program training will be initiated before surgery and continue to after surgery.

the older patients (≥65 years old) with ofi-8≥4 undergoing elective orthopedic surgery requiring tracheal intubation will be recruited. patients will be randomized into an intervention and a control group. patients in the intervention groups will received the eras-w program, while those in the control group will receive the swallowing education video.

Eligibility criteria:
inclusion criteria: * elective surgery * general anesthesia with endotracheal intubation exclusion criteria: * major organ dysfunction, ex: chronic kidney disease, hear failure * bleeding tendency
the validity of forced expiratory maneuvers in ataxia telangiectasia studied longitudinally

Conditions: Ataxia Telangiectasia

Summary: rationale: forced spirometry maneuvers are not routinely performed in patients with ataxia telangiectasia (a-t), even though they suffer from respiratory illnesses. objectives: to study the feasibility and validity of forced spirometry in a-t patients. methods: patients will perform spirometry during clinical visits. parameters studied will be technical quality, relation to predicted values, age, pulmonary illness, body mass index, mutational status and mutation.


Eligibility criteria:
inclusion criteria: * patients with proven ataxia telangiectasia exclusion criteria: * inability to perform spirometry

Keywords: ataxia teleangiectasia spirometry respiratory rare diseases
a randomized, three-arm study comparing vonaprazan 10 mg, vonaprazan 20 mg, and esomeprazole 40 mg for the healing of la grade b or higher reflux esophagitis at 8 weeks

Conditions: GERD

Summary: primary objective • to compare the healing rates of la grade b or higher reflux esophagitis at 8 weeks among patients treated with vonaprazan 10 mg, vonaprazan 20 mg, and esomeprazole 40 mg once daily. secondary objectives * to assess the improvement in reflux symptoms using the gerd-q score at 8 weeks. * to evaluate the incidence of adverse events across treatment groups.

study design: * this is a randomized, open-label, parallel-group, non-inferiority trial. randomization and blinding * participants will be randomized in a 1:1:1 ratio to receive vonaprazan 10 mg, vonaprazan 20 mg, or esomeprazole 40 mg once daily for 8 weeks. * randomization will be stratified by baseline severity of esophagitis (la grade b vs. c/d). * the study will be open-label, but the outcome assessors will be blinded. study arms 1. vonaprazan 10 mg once daily 2. vonaprazan 20 mg once daily 3. esomeprazole 40 mg once daily duration: * 8 weeks of treatment, followed by endoscopic assessment and symptom evaluation. i study procedures: baseline : * perform upper gi endoscopy to confirm la grade b or higher esophagitis. * record baseline gerd-q score. * randomize participants into one of the three treatment groups. * dispense study medication. follow-up (week 4 - interim assessment) * assess gerd-q score. * monitor adherence and adverse events. end-of-treatment (week 8 - primary outcome assessment) * repeat upper gi endoscopy to assess mucosal healing. * reassess gerd-q score. * collect adverse event data. * conclude study participation.

Eligibility criteria:
inclusion criteria: * adults ≥18 years of age. * endoscopically confirmed la grade b, c, or d reflux esophagitis. * gerd symptoms (heartburn, regurgitation) for at least 4 weeks prior to enrollment. * willing to provide informed consent and comply with study procedures. exclusion criteria: * previous or ongoing treatment with vonaprazan or esomeprazole in the last 4 weeks. * prior esophageal surgery or radiation therapy. * barrett's esophagus, esophageal stricture, or malignancy. * pregnant or breastfeeding women. * history of ppi-refractory gerd or severe gastroparesis. * significant hepatic or renal impairment (alt/ast \>3× uln, egfr \<30 ml/min). * use of nsaids, steroids, or anticoagulants affecting healing.
" en face " oct's contribution in the detection of macular retinal toxicity signs linked to the chronic treatment of synthetic antimalarials

Conditions: Maculopathy

Summary: the maculopathy induced by the retinal toxicity of the synthetic antimalarials must be detected at the infra-clinical state, when it can still be reversible. identifying early retinal anatomical changes has always represented (a challenge for medical interns, dermatologists, rheumatologists, and ophthalmologists). currently, the gold-standard for its screening and its diagnostic is the multifocal electroretinogram (mferg), however it is a long and tedious exam, offered by only few medical centers. it is recommended to find a simple non-invasive alternative, on a commonly used equipment. the study of the ellipsoid (junction line between, the external and internal photoreceptor segments) using optical coherence tomography (oct-sd) "en face" enables us, to obtain a panoramic viewing of the state of the photoreceptor layer, and to detect any modification, even subtle, within this layer. the oct-sd "en face" can be easily done by any ophthalmologist who owns one. the proportion of "en face" oct-sd showing suggestive retinal damage and patients who present retinal damage in relation with synthetic antimalarial treatments and diagnosed by mferg is considered in this study.


Eligibility criteria:
inclusion criteria: * patients treated with synthetic antimalarials with retinal damage (in relation with the antimalarial treatment) recently diagnosed by mferg * patients treated with synthetic antimalarials in the past, who stopped treatment because of a supposed retinal damage not confirmed by mferg exclusion criteria: - state of ocular structures preventing the realization of exams

Keywords: toxicity, drug
moxibustion for mild and moderate ulcerative colitis

Conditions: Ulcerative Colitis

Summary: the purpose of this study is to determine whether moxibustion is effective to mild and moderate ulcerative colitis and the effect of moxibustion on metabolism.


Eligibility criteria:
inclusion criteria: * meet the diagnosis of uc * mayo ≤10 * patients should have never received any pharmacological therapy or if they are receiving aminosalicylates and/or prednisolone (the dosage has been taken at least 4 weeks, and should be kept the same as before throughout the trial) * patients should have never received antibiotic, biologicals, probiotics, acetaminophen, acetamide and contraceptive. * a written informed consent exclusion criteria: * patients with cardiac, encephalic, hepatic, nephric, hematopoietic system, psychotic or any other serious diseases * pregnancy or lactation
catheter ablation and surgical ablation of persistent atrial fibrillation with severe atrial fibrosis

Conditions: Persistent Atrial Fibrillation

Summary: this is an open label, randomized parallel control clinical trial evaluating the efficacy and safety of catheter ablation and surgical ablation in patients with persistent atrial fibrillation with severe atrial fibrosis.

this is an open label, randomized parallel control clinical trial. patients with persistent atrial fibrillation with severe atrial fibrosis are 1:1:1 randomized into the group a (circumferential pulmonary vein isolation + linear ablation + bi-atrial mapping + driver ablation), group b (circumferential pulmonary vein isolation + linear ablation + vein of marshall ethanol infusion) and group c (surgical ablation). postoperative recurrence rate and other indicators are analyzed to evaluate the efficacy and safety of catheter ablation and surgical ablation in patients with persistent atrial fibrillation with severe atrial fibrosis.

Eligibility criteria:
inclusion criteria: 1. aged 18 to 80 years old; 2. persistent af with severe atrial fibrosis; 3. nonresponse or intolerance to ≥1 antiarrhythmic drug. exclusion criteria: 1. with uncontrolled congestive heart failure; 2. having significant valvular disease; 3. with myocardial infarction or stroke within 6 months of screening; 4. with significant congenital heart disease; 5. ejection fraction was \<40% measured by echocardiography; 6. allergic to contrast media; 7. contraindication to anticoagulation medications; 8. severe pulmonary disease e.g. restrictive pulmonary disease, chronic obstructive disease (copd); 9. left atrial (la) thrombus; 10. having any contraindication to right or left sided heart catheterization; 11. previous atrial fibrillation ablation; 12. presence of an implanted cardioverter-defibrillator; 13. previous history of cardiac surgery; 14. poor general health; 15. life expectancy less than 6 months.

Keywords: persistent atrial fibrillation severe atrial fibrosis catheter ablation surgical ablation
empiric versus imaging guided left ventricular lead placement in cardiac resynchronization therapy

Conditions: Heart Failure

Summary: the aim of this study is to investigate if imaging guided optimal left ventricular (lv) lead placement improves the response rate to cardiac resynchronization therapy (crt). consecutive patients meeting the standard criteria for crt are included in a prospective, double-blinded, randomized trial to lv lead positioning either 1) guided by cardiac imaging using echocardiography, single-photon emission computed tomography, and visualization of cardiac venous anatomy (cardiac computed tomography (ct), venography) to target an epicardial vein at the site of latest mechanical activation without scar tissue or 2) using standard lv lead placement.


Eligibility criteria:
inclusion criteria: * symptomatic heart failure (new york heart association functional class ii - iv) despite stabile optimal medical therapy. * ecg with qrs ≥ 120 milliseconds and left bundle branch block (lbbb) or paced qrs ≥ 180 milliseconds. * lv systolic dysfunction (ejection fraction ≤ 35%). * written informed consent. exclusion criteria: * expected lifetime \< 6 months. * recent myocardial infarction (\< 3 months). * pregnant or lactating. * inadequate echocardiographic images for determination of site with latest mechanical activation * no written informed consent.
dna changes that affect vitamin d metabolism in patients with colorectal cancer receiving vitamin d supplements

Conditions: Colorectal Cancer

Summary: rationale: studying samples of blood from patients with cancer in the laboratory may help doctors learn more about changes that occur in dna and identify biomarkers related to cancer. purpose: this clinical trial is studying changes in dna that affect vitamin d metabolism in patients with colorectal cancer receiving vitamin d supplements.

objectives: * to identify cyp24 single nucleotide polymorphisms (snps) using peripheral blood mononuclear cell genomic dna from patients with colorectal cancer receiving cholecalciferol supplementation. * to evaluate the effects of these cyp24 snps on baseline serum vitamin d_3 metabolites (25-d_3, 24,25-d_3, and 1,25-d_3), and parathyroid hormone levels (pth). * to evaluate the effects of these cyp24 snps on serum vitamin d_3 metabolites and pth levels during cholecalciferol treatment. * to examine cyp24 splicing, protein expression, and enzyme activity at baseline and during cholecalciferol treatment. * to determine the relationship, if any, between serum cholecalciferol pharmacokinetic parameters and cyp24 snps, splicing variants, and enzyme activity. outline: patients receive oral cholecalciferol 2000 iu once daily for 1 year. patients without response to vitamin d supplementation (serum 25-d_3 level \< 32 ng/ml) by 6 months will have their cholecalciferol dose increased to 4000 iu once daily. blood is collected at baseline and on days 14, 30, 60, 90, 180, 270, and 360. peripheral blood mononuclear cells for cyp24 genotyping, protein expression, enzyme activity, and splicing variants are analyzed by polymerase chain reaction (pcr), western blot, high performance liquid chromatography, and reverse transcriptase pcr, respectively. serum is analyzed for vitamin d_3 metabolite levels (by radioimmunoassay), calcium (to monitor for hypercalcemia), and parathyroid hormone assays (to measure vitamin d effect).

Eligibility criteria:
disease characteristics: * prior or current documented diagnosis of colorectal cancer * all stages * 25oh-d3 level \< 50 ng/ml patient characteristics: * ecog performance status 0-2 * life expectancy \> 6 months * serum creatinine \< 2.0 mg/dl * serum bilirubin \< 2.0 mg/dl * no prior or current hypercalcemia (defined as albumin corrected serum calcium \< 10.2 mg/dl) * no known contraindication for vitamin d supplementation * no genitourinary stones within the past 5 years * no severe comorbid conditions such as uncompensated heart failure or active infection prior concurrent therapy: * no supplemental vitamin d beyond what is provided through the study * at least 2 months since prior vitamin d supplementation exceeding 800 international units (iu) * nondietary vitamin d supplements should not have exceeded 800 iu/day within the past 2 months

Keywords: recurrent colon cancer stage i colon cancer stage ii colon cancer stage iii colon cancer stage iv colon cancer recurrent rectal cancer stage i rectal cancer stage ii rectal cancer stage iii rectal cancer stage iv rectal cancer
impact of adjuvant folfox on quality of life and sensory neurotoxicity in patients with advanced gastric cancer

Conditions: Stomach Neoplasms

Summary: the primary objective of this trial is to determine the impact of the folfox regimen on quality of life and the incidence of chemotherapy induced neurotoxicity.

gastric cancer is one of the main cancer-related causes of death in the world. there is more than one standard treatment for non-metastatic advanced disease. among the therapeutic alternatives there is high level of evidence to recommend surgery followed by chemoradiotherapy or chemotherapy and for perioperative chemotherapy. these strategies have not been compared in adequate powered trials, so there are important regional differences in their use. postoperative chemotherapy with oxaliplatin based chemotherapy may offer some advantages in limited resource settings, because of its lower logistic requirements and it could be specially useful in centers with high quality surgery. on the other hand one of its most important downsides could be a higher impact on quality of life particularly related to oxaliplatin induced neuropathy which can last long after the end of treatment. this is a prospective observational trial in which after consent subjects are going to be evaluated with the eortc (european organization for research and treatment of cancer) questionnaires c30 and cipn20 during folfox (5-fluorouracil/leucovorin with oxaliplatin) adjuvant treatment.

Eligibility criteria:
inclusion criteria: * diagnosis of gastric adenocarcinoma * ecog (eastern cooperative oncology group) functional status of 0 or 1 * treated with surgery with curative intent * tnm stage ii - iii or tnm stage i with positives lymph nodes exclusion criteria: * surgery with microscopical or macroscopical residual tumour * adjuvant chemotherapy refusal * ecog functional status of 2 or more * previous peripheral neuropathy * significant cardiovascular disease or other organ disfunction
spark- a digital platform to improve self-management of gestational diabetes

Conditions: Gestational Diabetes Mellitus

Summary: gestational diabetes mellitus (gdm) is an increasing public health challenge. innovative, effective and scalable lifestyle interventions to support women with gdm to manage their disease and to prevent adverse obstetric and neonatal outcomes as well as later morbidity are requested.the aim of this project is to evaluate whether a novel, mobile health (mhealth) platform (spark) can improve self-management of gdm and prevent adverse maternal and offspring outcomes. spark is a multi-centre randomised controlled trial recruiting women diagnosed with gdm in south eastern sweden. women will be randomised to the control or intervention group. all women will receive standard care. the intervention group will also receive support through the spark platform for healthy eating, physical activity and glycaemic control. pregnancy outcomes are glycaemic control (primary), diet, physical activity, metabolic and inflammatory biomarkers in gestational week 36-37 as well as adverse obstetric and neonatal outcomes. secondary outcomes also include cardiometabolic risk, physical activity and healthy eating behaviours one-year postpartum.


Eligibility criteria:
inclusion criteria: * a confirmed diagnosis of gdm detected by oral glucose tolerance test in accordance with the world health organization guidelines exclusion criteria: * known pre-pregnancy diabetes * twin pregnancy * \<18 years of age * severe co-morbidities that would limit participation or a previously diagnosed severe psychiatric illness.