Kornimate/medical-research-clean huggingface dataset:
trial comparing stereotactic body radiation therapy to radiofrequency ablation for renal cell carcinoma

Conditions: Renal Cell Carcinoma

Summary: this study will assess whether stereotactic body radiation therapy (sbrt) can provide comparable local control, with similar or improved toxicity rates compared to radio frequency ablation (rfa) when treating small renal cell carcinomas.


Eligibility criteria:
inclusion criteria for sbrt vs. rfa randomization: * patients with renal cell carcinoma less than 4 cm in maximum diameter, who are poor surgical candidates are eligible for randomization between sbrt and rfa (renal cell carcinoma must be pathologically proven). * the primary tumor must be in a location amendable to rfa within the kidney. * patients must be appropriate candidates for rfa, with platelets ≥50,000/mm3 and an international normalized ratio of 1.5. * patients must have an ecog (a measurement of general well being and activities of daily living; scores range from 0 to 5 where 0 represents perfect health) score ≤ 3. * there is no required minimum renal function (patients will be counseled about the possible need for dialysis, if applicable, just as would be the case for radical or partial nephrectomy). * patients must sign an informed consent form approved for this purpose by the institutional review board (irb) of the university of michigan medical center indicating that they are aware of the investigational aspects of the treatment and the potential risks. * ability to understand and the willingness to sign a written informed consent. * if a patient is randomized to the rfa arm, but is deemed not to be an anesthesia candidate, he/she will be placed in the non-randomized sbrt cohort. inclusion criteria for non-randomized sbrt arm: * patients with renal cell carcinoma less than 8 cm in maximum diameter, patients with metastatic rcc who require local palliation or are progressing through systemic disease, patients who are poor surgical candidates and have tumor location not amenable to rfa, or patients who would prefer a noninvasive means of treatment are eligible for the non-randomized sbrt cohort (renal cell carcinoma must be pathologically proven). * there are no limitations based on location of the primary tumor within the kidney. * patients must have an ecog score ≤ 3. * there is no required minimum renal function (patients will be counseled about the possible need for dialysis, if applicable, just as would be the case for radical or partial nephrectomy). * patients must sign an informed consent form approved for this purpose by the institutional review board (irb) of the university of michigan medical center indicating that they are aware of the investigational aspects of the treatment and the potential risks. * ability to understand and the willingness to sign a written informed consent. exclusion criteria: * patients younger than 18 or pregnant women.
trial comparing kaffes stent with plastic prosthesis in the treatment of anastomotic biliary strictures post orthotopic liver transplantation

Conditions: Biliary Strictures Post Liver Transplantation

Summary: biliary anastomotic strictures (post liver transplantation) occur in 15-20 % of the cases. biliary stenting using plastic prosthesis during a period of 1 year is the treatment of choice. problematic in this approach is the regular change, necessary to overcome occlusion of the stent, resulting in cholestasis and/or infection. this change needs to be performed every 3 months or more frequently in patients with symptoms of stent occlusion. the kaffes stent (rms) is a metallic removable stent, especially constructed for the treatment of biliary anastomotic strictures post liver transplantation. the advantage could be that this stent is less prone to occlusion with a lower change frequency (e.g. every 6 months). no randomized, controlled trial (rct) or data exist comparing plastic stenting versus kaffes stenting.


Eligibility criteria:
inclusion criteria: * patients after orthotopic liver transplantation with a choledocho- choledochal anastomosis, presenting with an anastomotic stricture * diagnosis established by : * elevated liver tests * a narrowing of the anastomosis on magnetic resonance cholangiopancreatography (mrcp): with or without intrahepatic bile duct dilatation * no acute or chronic rejection * no cytomegalovirus (cmv) infection * no other possible causes of elevated liver tests * confirmation of the stricture needs to be confirmed during the diagnostic endoscopic retrograde cholangiopancreatography (ercp) procedure immediately before the therapeutic procedure. exclusion criteria: * non-anastomotic strictures * absence of informed consent * roux-en-y construction * living related liver transplantation patients.

Keywords: biliary strictures liver transplantation
electroacupuncture and laser therapy on neck pain

Conditions: Chronic Neck Pain

Summary: the purpose of the study examines the use of electroacupuncture and laser therapy to treat chronic neck pain.


Eligibility criteria:
inclusion criteria: * people with chronic neck pain, participants with a vas level between 3 and 10 will be included in the study exclusion criteria: * history of cancer, tuberculosis, pacemaker usage, pregnancy, hemophilia, cardiovascular disease, osteoporosis
genetic regulators of bone health that are unique to vertebral bone

Conditions: Age-Related Osteoporosis

Summary: osteoporosis is an age related disease in which a person's bone slowly becomes weaker with time. the bones may become so weak that they break easily such as a fall from standing height. the most commonly broke bones in osteoporosis are those of the hip, the spine or the wrist. osteoporosis runs in families meaning that genetic differences explain why some people break bones in old age and other do not. genetic studies have been done that show the the genes associated with spine (vertebral) fractures (broken bones) and hip fractures are different, suggesting that osteoporosis of the spine is not the exact same disease as osteoporosis of the hip. genetic studies tell us what part of the genome (i.e. genes) are associated with a disease, but do not tell us how these genes act biologically to cause that disease. in this study, we seek to determine how the genes uniquely associated with spine osteoporosis behave in normal and aged bone, to determine how they interact with each other as a team to impact spine bone. in this study, we will measure gene activity (so called gene expression) in bone samples taken from people undergoing major spine deformity surgery. we will using genetic data from these patients to determine how gene activity is controlled in bone and how that relates to measures of bone health such as bone mineral density data. the results of this study will provide critical data regarding how osteoporosis of the spine happens, and these data will be used to find better and safer treatments to prevent bone fractures of the spine that happen with age.


Eligibility criteria:
inclusion criteria: * men and women between the ages of 18 and 85 undergoing a multi-level spinal fusion (i.e. a t10 (or higher) fusion to the pelvis) -or- a 3 column osteotomy with a corpectomy from for short segment surgeries -or- a vertebral column resection (vcr) involving a corpectomy -or- any deformity correction surgery wherein the attending surgeon determines that a large amount of bone containing trabecular elements will be removed and discarded. * willing and able to provide informed consent exclusion criteria: * end stage renal disease. * any history of cancer. * reliance on a wheelchair for 70% or greater of their mobility for longer than 12 months. * quadra or paraplegia due to spinal cord injury. * current use of epilepsy medications. * confirmed marfans, osteogenesis imperfecta or other genetic syndrome known to impact bone formation (guacher's, vit d independent rickets, etc). * current glucocorticoid use lasting longer than 3 months, or greater than 6 months lifetime use. * current or suspected current infection associated with orthopedic hardware. * hiv or hep c positive and or currently on anti-viral medications. * history of gastric bypass surgery and or weigh loss exceeding 100 pounds. * primary or secondary hyperparathyroidism. * paget's disease

Keywords: bone mineral density, gene transcription, spine, genetic disease
healthcare provider attitudes towards patients with substance use before and after implementation of the sbirt model in the emergency room

Conditions: Patients With Substance Abuse; Healthcare Provider Attitudes

Summary: the purpose of this quality improvement research project is to briefly survey attitudes among healthcare providers toward patients with substance use disorders before and after substance abuse counselors are placed in the emergency room.

the purpose of this quality improvement research project is to briefly survey attitudes among healthcare providers toward patients with substance use disorders before and after substance abuse counselors are placed in the emergency room. sbirt stands for screening brief intervention and referral to treatment. the pre-test survey contains 10 questions about attitudes toward patients with substance use disorders and the post-test survey consists of 13 questions about attitudes toward patients with substance use disorders and questions regarding the sbirt model itself. health care providers will be surveyed before the sbirt counselors begin and again at 6 months, after full sbirt program with substance counselors on site has been in place, as a part of their regular staff education requirements. part of the goal of the sbirt counselors is to educate providers about treatment and analyze data collected by and comments of emergency room staff.

Eligibility criteria:
inclusion criteria: * uab emergency department staff (attending, resident, nurse, social worker, case manager, patient care technician) or psychiatry emergency services staff (nurses, social workers and residents) exclusion criteria: * not employed in uab emergency department
prophylactic radiofrequency left atrial posterior wall isolation to prevent atrial fibrillation after cardiac surgery

Conditions: Postoperative Atrial Fibrillation

Summary: the goal of this clinical trial is to learn if an epicardial radiofrequency left atrial posterior wall isolation (box lesion ablation) prevents atrial fibrillation after cardiac surgery. the main question it aims to answer is: - does box lesion ablation lower the number of patients experiencing de-novo atrial fibrillation requiring any treatment after cardiac surgery? researchers will compare box lesion ablation to no ablation to see if ablation prevents postoperative atrial fibrillation. participants will undergo ablation or no ablation at the time of other cardiac surgery. data will be collected while in hospital. additional information will be collected on 30th day after surgery by telephone call or during a visit.

postoperative atrial fibrillation (poaf) is a common complication after heart surgery that occurs in 10-60% of patients. it can cause hypotension, tachycardia, stroke, systemic embolism, or heart failure, and is associated with increased mortality rates, prolonged hospital stays and increased costs. several studies have investigated the use of radiofrequency ablation (the standard of surgical care for atrial fibrillation during concomitant cardiac surgery when the diagnosis is known preoperatively) to prevent poaf. however, these studies were limited mainly to pulmonary vein isolation and had methodological limitations such as small sample sizes, inclusion/exclusion criteria, and randomization procedures, and have not translated into clinical practice changes. the current study aims to investigate the use of radiofrequency left atrial posterior wall isolation, also known as box lesion ablation, as a more effective treatment compared to pulmonary vein isolation, in a properly designed randomized controlled trial.

Eligibility criteria:
inclusion criteria: * all patients undergoing cardiac surgery by a single surgeon (v.k.) * informed consent exclusion criteria: * history of atrial fibrillation/flutter * minimally invasive approach * off-pump surgery * emergent/salvage surgery * severe pericardial adhesions

Keywords: postoperative atrial fibrillation radiofrequency ablation box lesion ablation prophylactic ablation
prospective cohort study in evaluation of risk factors for infection during and after coronary graft operations.

Conditions: Surgical Wound Infection

Summary: we aim to prospectively evaluate the risk factors that can play a role before, during or after the surgical period.

surgical site infections (ssis) are either superficial or deep and may involve the organs, or spaces accessed during an operation. the reported incidence of ssis in coronary artery bypass grafting (cabg) surgery ranges between 0.3% and 8%. there is a strong suggestion that an impairment of vascular supply of the sternum may be one of the most important factors influencing the incidence of deep sternal wound infection (dswi). several studies have studied the risk factors for ssis including dswi in cardiac surgery. these risk factors included obesity, diabetes mellitus, chronic obstructive pulmonary disease (copd), connective tissue disease, steroid use, smoking, peripheral vascular disease and renal insufficiency. in addition, intraoperative factors (e.g., use of bilateral internal mammary arteries \[bima\] grafting, prolonged cardiopulmonary bypass \[cpb\] duration) and postoperative variables (e.g., prolonged mechanical ventilation, reoperation for bleeding, postoperative transfusions and gastrointestinal, nephrological and respiratory complications) have been shown to be associated with dswi. the risk for sternal wound infection (swi) is increased if cardiac surgery involves internal thoracic arteries grafting and a valve procedure, or use of a ventricular assist device. leg wound infections at donor sites account for \>70% of cases with severe infection following cardiac surgery. cardiac ssis increase the length of hospital stay (los) and increase treatment costs in proportion to the severity of the infection. these costs increase by 3.8%, 14.7% and 29.4% in mild, moderate and severe infections respectively. treatment is often confounded by the emergence of antibiotic-resistant pathogens and in addition, substantial proportions of these infected patients are elderly and have co-existing medical problems. in the past, such elderly patients with significant comorbidities would not have been considered for surgery.\[8\] as the population ages, it is reasonable to assume that older and sicker patients will be admitted for surgery, and this will inevitably increase the risk and incidence of ssis.

Eligibility criteria:
iinclusion criteria: 1. patient aged more than 18 yards old 2. sternotomy for: coronary artery bypass, exclusion criteria: 1. patient under age or 18years old. 2. patient who has endocarditis. 3. patient who underwent surgery with prothetic material, within the 12 months preceeding cardiac procedure.
eradication of malignant carcinoma in the breast tissue

Conditions: Breast Cancer

Summary: the purpose of this study is to confirm the findings of an early study and expand our knowledge of treating malignant carcinoma in the breast tissue using an atp (adenosine-5'-triphosphate) inhibitor.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of breast cancer * referred to the study by their treating physician exclusion criteria: * any type of treatment for breast cancer before starting the study
intensity modulated radiation therapy - gyne cancer (gy03.2)

Conditions: Cervix Neoplasms; Uterine Neoplasms; Vaginal Neoplasms

Summary: standard treatment for gynecological cancer is radiation therapy in two phases; whole pelvic radiation and then an internal radiation boost, also called a brachytherapy boost, to treat any remaining tumour. the purpose of this study is to test an alternative radiation boost treatment called conformal intensity modulated radiation therapy or imrt. currently, we do not have complete information on the overall effectiveness of imrt compared to brachytherapy or conformal radiotherapy. we know that imrt allows the radiation beams to be more accurately focused on the tumor, thereby sparing more normal tissue from radiation damage and lowering risks of side effects. we are investigating the extent to which imrt can be used to protect normal tissues in patients with cervix, uterine or vaginal cancer from the radiation beams and how much the side effects of radiation are reduced.


Eligibility criteria:
inclusion criteria: * biopsy-proven carcinoma of the cervix, uterus or vagina; figo stage t1b-4a, no/1, mo, treated with definitive radiotherapy with or without chemotherapy, or biopsy-proven pelvic recurrence of carcinoma of the uterus previously untreated or biopsy-proven vaginal carcinoma treated radically with radiotherapy but unsuitable for brachytherapy boost. * patients not suitable for intracavitary brachytherapy. * ecog performance status of 0, 1, or 2 * age ≥ 18 years * ability to give informed consent.
effects of the atkins diet versus a low fat diet on inflammation

Conditions: Cardiovascular Health; Obesity

Summary: the purpose of this research is to assess the effects of a low-carbohydrate (modified atkins) diet versus a low fat (heart healthy) diet on cardiovascular health.

the purpose of this study is to compare the effects of a modified atkins diet (low carbohydrate and low calorie) and a traditional heart healthy diet (low fat and low calorie) on biochemical markers of inflammation and metabolism, anthropometric measurements, vascular studies of endothelial function, adipose tissue composition, and patient compliance and satisfaction over a twelve week period in healthy men and women. patients will be recruited from the nutrition and weight management center at boston medical center. enrolled subjects will be randomly assigned to a reduced calorie diet (either the atkins diet or a traditional heart healthy diet), and will be counseled by a dietitian and a physician throughout the study period. the patients will have physical exams, labs, vascular studies of endothelial function, and adipose tissue biopsies at baseline and at twelve weeks to assess progress. participants dietary compliance will be assessed using food journals and 24 hour recall. the atkins diet appears to have potential to reverse the epidemic of obesity-linked cardiovascular disease (cvd) in the united states. obesity is in effect an inflammatory state in which adipose (fat) tissue releases adipokines- small, inflammatory proteins. high adipokine levels in the blood lead to an inflammatory response, ultimately damaging the endothelial cells which line the blood vessels and increases the risk of vascular disease. ultimately the effects of these two different diets will be analyzed to help determine if a low carbohydrate, low calorie diet is more beneficial than a traditional heart healthy diet (low fat, low calorie) at reducing the systemic inflammatory response by using physical exam measures, inflammatory blood markers, vascular ultrasound studies, and adipose tissue biopsies.

Eligibility criteria:
inclusion criteria: * age 18-65 years * bmi greater than or equal to 30 exclusion criteria: * currently pregnant or lactating * type 2 diabetes * use of oral anti-diabetes medications (with exception of metformin for control of pcos) * presence of known peripheral arterial or cardiovascular disease * change in body weight (greater or equal to 3% within the past 3 months) * recent use (within the four weeks prior to screening) of weight loss medications including but not limited to phentermine, sibutramine, orlistat, or over the counter weight loss products * history of an eating disorder or significant disordered eating behaviors such as binging/purging, abuse of laxatives or diuretics * history of established renal or hepatic disease * history of prior bariatric surgery * subjects who report routine tobacco use * subjects on angiotensin receptor blockers (medications such as but not limited too adicant, losartan, avapro, diovan, micardis, teveten, candesarten/thiazide, ibesarten/thiazide, valsartan/thiazide, losarten/thiazide, telmisarten/thiazide, teveten/thiazide
lithothamnion species on blood lactate during exhaustive exercise in trained cyclists

Conditions: Exercise-Induced Lactic Acidemia; Lactate Blood Increase

Summary: deep ocean mineral water has been shown to improve exercise phenotypes in human and animal models. however, there is yet to be an investigation of algae species such as lithothamnion that absorb and concentrate these minerals. therefore, the aap trial will investigate the effect of water soluble lithothamnion species on exhaustive exercise-induced blood lactate accumulation, recovery and power output in trained cyclists.

the potential for naturally derived combinations of marine minerals to improve exercise performance is growing throughout the scientific literature and has physiologically plausible mechanisms, likely through the diverse molecular and enzymatic actions of individual (or combinations of) minerals (such as calcium and magnesium). despite the biological potential, there is little consciences whether mineral supplementation can improving markers of, and exercise performance. one recent investigation of deep ocean mineral water (high in marine minerals) showed that when consumed prior to exercise, blood lactate response improved with hyperthermal running and is supported in animal models - however, this is not supported elsewhere in humans. nonetheless, others have shown, in human models, that deep ocean mineral water may improve exercise recovery, aerobic exercise performance, improve lower leg power output and hydration status compared to either placebo or sports drink. furthermore, animal models support these plausibilities with improved mitochondrial biogenesis, biomolecules of exercises performance, cardiovascular hemodynamics, inflammatory cytokine responses to exercise and overall exercise adaptation. as ocean minerals are absorbed by marine organisms, algae species such as lithothamnion have higher concentrations of the same ocean minerals but structured differently at the nano scale and thus may have the potential to be more effective at improving exercise phenotypes. therefore, the proposed exploratory rct will investigate the effects of water soluble lithothamnion species on exhaustive exercise-induced lactate accumulation, recovery and power output in trained cyclists, compared to a placebo.

Eligibility criteria:
inclusion criteria: * healthy male trained cyclist. * cycling for the purpose of exercise training (i.e. not cycling for transport) at least 100km per week for the last 6 months * vȯ2peak that is greater than 50 ml˙kg˙ml-1 exclusion criteria: * any muscle disorder * serious medical co-morbidities * thyroid dysfunction or specific allergies * contraindications to dependent variables * currently participation in another research study * currently not talking other nutrition supplements

Keywords: mineral rich algae mineral nutrition