Kornimate/medical-research-clean huggingface dataset:
recurrences after surgery for deep endometriosis depending on the involvement of the surgical margins in the specimen

Conditions: Deep Endometriosis; Recurrences; Margins in the Specimen; Laparoscopy; Prognosis Factors

Summary: the recurrence of endometriosis after surgery a formidable challenge for the gynecologist. recurrence rates reported in the literature are very high, being 21.5% at 2 years and 40-50% at 5 years. several theories attempt to explain these high figures. the three most widely accepted are: * the presence of residual endometriotic tissue or residual endometriotic cells not completely eradicated during surgery * the growth of undetected microscopic endometriosis during surgery * the development of endometriotic lesions de novo patients with symptomatic endometriosis diagnosed by ultrasound or mri and suitable for surgery will participate in the study. the surgical specimens sent for pathology from bladder, vagina, uterosacral, sigma or rectum will be properly marked for studying the presence of endometriosis.

patients of dexeus universitary institute that are having a laparoscopic surgery for deep endometriosis will participate in the study. a patient information sheet will be provided and written consent will be obtained. patients who give written consent will participate in the trial. all patient information will be confidential and only be available to researches involved in the study. only three expert surgeons of the gynecological department of dexeus universitary institute will participate in the study.

Eligibility criteria:
inclusion criteria: * patients with symptomatic endometriosis superior to 6 in a visual scale (vas; huskisson, 1974)diagnosed by ultrasound or mri and suitable for laparoscopic surgery exclusion criteria: * previous surgeries for deep endometriosis * non complete surgery
cognitive behavior therapy for insomnia in primary care

Conditions: Insomnia

Summary: the aim of this study was to investigate the clinical effectiveness of protocol-driven cognitive behavioral therapy (cbt) for insomnia delivered by ordinary primary care personnel (primary care nurses and social workers) in general medical practice with unselected patients, in line with a stepped care approach. the study design was a randomised controlled parallel group design, with allocation to cbt and waiting list control group (wl). following an active treatment-control period, the control group were re-assigned to cbt. the study hypothesis was that the cbt group would experience less symptoms of insomnia after treatment compared with the wl group. primary outcome measure was a brief self-report screening form, insomnia severity index.


Eligibility criteria:
inclusion criteria: * fulfilled research criteria for chronic insomnia exclusion criteria: * other untreated sleep disturbance * pregnancy * shift work * concurrent medical or psychiatric condition that could be negatively affected by the treatment * drug abuse * severe depression * dementia

Keywords: insomnia cognitive behavior therapy primary care
mindfulness for alzheimer caregivers

Conditions: Alzheimer Disease; Neurodegenerative Diseases; Dementia

Summary: mindfulness based health care (mbhc) includes meditation techniques to help caregivers of alzheimer patients to be made more aware of their experience in the present moment. half of the caregivers will learn the practice of mindfulness meditation once a week through 8 classes, and the other half will not receive any therapy. the primary purpose of this study is to explore the effects of this mindfulness program for caregivers on the neuropsychiatric symptoms in alzheimer patients, as well as on anxiety and depression symptoms in their caregivers. secondarily, to examine the effect of this program on cognitive function, daily activity living and quality of life in alzheimer patients, as well as on the burden of caregiving, quality of life, psychological well-being, occupational balance, executive function and self-compassion in their caregivers.

alzheimer's disease is a progressive brain disorder that involves the loss of the ability to live independently, functional capacity and safety. thus, patients often suffer neuropsychiatric disorders and need help from another person to live every day. due to the burden of caregiving, the main caregivers can have anxiety and depression symptoms. with this scenario, we will conduct this randomized controlled trial aimed to evaluate the effect of mindfulness program for caregiver's vs control group on: 1) neuropsychiatric disorders, cognitive function, daily activity living and quality of life in alzheimer patients; 2) anxiety and depression symptoms, burden of caregiving, quality of life, psychological well-being, occupational balance, executive function and self-compassion in their caregivers.

Eligibility criteria:
inclusion criteria of caregivers: * be a caregiver of alzheimer disease patient * age over 18 years * score mini mental state examination ≥26 points inclusion criteria of patients: * score of scale global deterioration from 3 to 7 points (inclusive) * alzheimer disease diagnostic * non-institutionalized exclusion criteria: * patient or caregivers with central nervous system disease with a neurological alteration (acquired brain damage, epilepsy, traumatic brain injury, multiple sclerosis and other movement disorders). * patient or caregivers with current or past history of alcohol or drug abuse * patient or caregivers with visual or hearing impairment * patient or caregivers with serious psychiatric illness (depression, psychosis, schizophrenia)

Keywords: mindfulness anxiety and depression symptoms caregivers alzheimer neuropsychiatric disorders
do iron supplements impact the gut microbiome of women of reproductive age?

Conditions: Iron-deficiency; Microbial Colonization; Anemia

Summary: in this randomised controlled trial the investigators will determine whether taking iron supplements compared to placebo for 21 days alters the bacteria (microbiome) in the large intestine of non-pregnant female participants.

background: many women take iron-containing supplements during pregnancy. indeed, the world health organization recommends that all pregnant women in low-income countries take an iron supplement containing 60 mg/day of elemental iron to reduce iron deficiency and iron-deficiency anaemia. however, oral iron has poor bioavailability, less than 10% absorbed with the remainder passing into the large intestine unbound, potentially providing a competitive advantage to iron-dependent opportunistic pathogens in the large intestine. in a large randomized control trial in children, iron supplementation was shown to promote the growth of pathogenic species (e. coli, s. aureus, and l. monocytogenes) and inhibited the growth of commensal species (lactobacillus and bifidobacterium). these pathogens are associated with enteric infections, while the commensals act on the host's immune system to prevent colonization and invasion by pathogens. it is not known if iron supplementation during pregnancy impacts the maternal and infant microbiome and, by extension, how this affects the neonatal risk of infection and immune dysregulation. vertical transmission of the maternal microbiome to the newborn is a major determinant of infant health. if maternal iron supplementation affects the infant's health, strategies would be required to mitigate this risk. the investigators require preliminary data to show how oral iron supplementation alters the intestinal microbiome in women. the investigators will recruit non-pregnant female participants as there is no risk of vertical transmission to an infant in non-pregnant women. the investigators will conduct the study in australia because there is not a natural abundance of pathogens that could potentially cause harm to the women. nevertheless, the investigators would expect a shift in the microbiome from non-iron to iron, requiring bacterial species to return to baseline after women stop taking the iron. hypothesis: daily iron supplementation versus placebo for 21 days will alter the stool microbiome composition compared to placebo in non-pregnant female participants of reproductive age. methods: 80 female participants (18-45 y) will be randomized to receive capsules containing iron (65.7 mg of elemental iron as ferrous fumarate) or placebo to take daily for 21 days. stool samples will be collected at baseline, 21 days, and 42 days (washout).

Eligibility criteria:
inclusion criteria: * able to give informed consent exclusion criteria: * pregnant or breastfeeding. * planning on becoming pregnant * diagnosed with iron deficiency and/or anaemia in the previous three months * taken antibiotics in the past three months * taken iron containing supplements in the past three months

Keywords: iron supplements microbiome women
evaluate mesothelin as a biomarker for the clinical management of esophageal adenocarcinoma (eac)

Conditions: Esophageal Cancer; Adenocarcinoma

Summary: the purpose of this study is to find out whether a protein, called mesothelin, found in the blood and tissue can be used as "marker" for esophageal cancer. doctors at memorial sloan-kettering cancer center would like to compare levels of this protein in patients with abnormal cells or tissue of the esophageal to the levels of this protein in patients being treated for cancer for the esophagus.


Eligibility criteria:
inclusion criteria: * patients with t1 adenocarcinoma or suspected adenocarcinoma who are scheduled for a biopsy and mucosal resection (group 1) * patients with a t1-2n0 adenocarcinoma or suspected adenocarcinoma who are scheduled to undergo and esophagectomy (group 2) * patients with t2n1 and t3n0-1 adenocarcinoma or suspected adenocarcinoma who are scheduled to undergo endoscopy and biopsy and/or endoscopic ultrasound and biopsy prior to pre-operative chemo-radiotherapy and have baseline and surgical tissue available for staining (group 3) exclusion criteria: * patients \<18 years of age * patients unfit medically for endoscopy surveillance and therapy * patients unfit medically for esophagectomy * patients with stage iv esophageal adenocarcinoma * patients previously treated with chemo-radiotherapy for their esophageal cancer * patients with squamous cell carcinoma of the esophagus * patients who have a history of cancer within 3 years or have a concurrent cancer.

Keywords: esophagectomy endoscopy biopsy tissue mesothelin serum mesothelin 11-037
utilization of mass in patients undergoing lt for hcc

Conditions: NAFLD; Hepatocellular Carcinoma; Liver Diseases; Liver Cancer; Cirrhosis, Liver; Hepatitis C

Summary: the aim of this study is to determine the effects of liver transplantation and standard immunosuppression on body composition in patients with compensated cirrhosis and hepatocellular carcinoma.

the combination of hepatocellular carcinoma and chronic liver disease represents a dual impact on overall metabolism. the major risk factors for chronic liver disease related-hepatocellular carcinoma (hcc) include nonalcoholic fatty liver disease (nafld), alcoholic liver disease and hepatitis c virus (hcv), among other etiologies of chronic liver injury. of particular interest is how the changing landscape of liver disease impacts the care of patients in the peritransplant period. numerous recent studies have reported that nonalcoholic steatohepatitis (nash)-related cirrhosis is the most rapidly growing indication for liver transplantation (lt) in the western world. nafld related hcc is already a leading indication in women. the impact of nafld on public health and mortality is substantial: incident decompensated cirrhosis due to nafld is predicted to increase by 168%, from 39,230 cases annually in 2015 to 105,430 cases in 2030. the corresponding burden of nafld cirrhosis on liver transplantation (lt) is expected to increase by 59%. finally, 3% per year of cirrhotic patients because of nafld, develop hcc and noncirrhotic nafld-hcc continues to be an area of investigation. since nafld is becoming one of the most frequent causes of cirrhosis, hcc, and liver transplantation worldwide, it is crucial to identify changes in the peritransplant period that are associated with adverse muscle health and unfavorable metabolic status in the context of all chronic liver diseases.

Eligibility criteria:
inclusion criteria: * age between 18 and 75 years * diagnosis of cirrhosis and hcc * listed or in evaluation for liver transplantation exclusion criteria: * history of prior solid organ transplantation * in evaluation or listed for any other solid organ transplant (other than liver transplant) * contraindication to mr examination * metastatic hcc

Keywords: nafld hepatocellular carcinoma liver diseases liver cancer cirrhosis, liver hepatitis c
the impact of diaphragm training on dysphagia in elderly nursing home residents

Conditions: Dysphagia

Summary: the goal of this clinical trial is to explore the diaphragm training on swallowing function in elderly nursing home residents (≥60 year old) with swallowing disorders. it primarily aims to address: the effects of diaphragm training on swallowing function and quality of life in elderly nursing home residents. all participants are divided into 2 groups. the intervention group is required to undergo a continuous three-week (21 days) diaphragm training, with weekends off and training conducted only on weekdays. the training will be conducted two sessions per day, lasting 30 minutes each.

diaphragm training for dysphagia in elderly nursing home residents involves exercises and techniques aimed at strengthening the diaphragm muscle to improve swallowing function. dysphagia, or difficulty swallowing, is common among older adults and can lead to complications such as malnutrition, dehydration, and aspiration pneumonia. diaphragm training may include breathing exercises, postural adjustments, and swallowing maneuvers designed to enhance coordination and strength in the muscles involved in the swallowing process. by targeting the diaphragm, which plays a crucial role in breathing and swallowing coordination, this training approach aims to alleviate dysphagia symptoms and improve overall swallowing function in elderly nursing home residents, thus enhancing their quality of life and reducing the risk of associated health complications. the goal of this clinical trial is to explore the diaphragm training on swallowing function in elderly nursing home residents (≥60 year old) with swallowing disorders. it primarily aims to address: the effects of diaphragm training on swallowing function and quality of life in elderly nursing home residents. all participants are divided into 2 groups. the intervention group is required to undergo a continuous three-week (21 days) diaphragm training, with weekends off and training conducted only on weekdays. the training will be conducted two sessions per day, lasting 30 minutes each.

Eligibility criteria:
inclusion criteria: * age over 60 years old. * no hospitalization within the past six months. * with clear consciousness and able to cooperate with questionnaires and training. * the elderly people who voluntarily participate and agree to adhere until the end of the study. * early dysphagia caused by sarcopenia. exclusion criteria: * complicated with severe liver and kidney failure, tumors, or hematological disorders. * physical disability. * difficulty in mobility. * simultaneously receiving other therapies that might influence this study. * individuals with a gastrostomy. * abnormalities of the oral, pharyngeal, or esophageal structures.
trial to assess the efficacy of combination formula of aspirin plus clopidogrel in patients with coronary stent

Conditions: ANEURYSM CORONARY ARTERY

Summary: the purpose of this study in to evaluate efficacy and tolerability of clopirin and clopidogrel with aspirin in korean patients with post-percutaneous coronary artery intervention.


Eligibility criteria:
inclusion criteria: * over 3 months, the patient who were the administration of aspirin or the co-administration of clopidogrel-aspirin coronary artery patients after treated with percutaneous coronary intervention(pci) that have safety progress. * korean men and women between the age of 20 and 85 * patients who understand the study requirements, are willing to comply with all study procedures and have provided written informed consent. exclusion criteria: * patients who were not treated with pci or intended to treat with pci but failed. * patients who were taking or had taken other antiplatelet or anticoagulant for more than 2 weeks within the prior 30 days. * patients who had a history of alcohol abuse or intoxication. * patients who had hypersensitivity to clopidogrel or aspirin. * patients who had severe hepatic dysfunction aspartate aminotransferase(ast) or alanine aminotransferase(alt) \> 3 times upper normal reference values. * patients who had blood coagulation disorders, uncontrolled severe hypertension, active bleeding, or history of severe bleeding, such as intracranial hemorrhage or ulcer bleeding - surgery within 48hr, platelet counts below 50,000/mm3 in laboratory tests. * patients who were pregnant, breastfeeding. * patients who were not using effective methods of contraception. (proper contraception : hormonal contraception, condom, intrauterine device, spermicide) * patients who medically, psychologically had investigational product administration's prohibition. * patients who were not participated in this clinical trial decided by other investigators.
the effectiveness of telerehabilitation-based physiotherapy in covid 19 patients

Conditions: Covid19; Telerehabilitation; Physical Therapy

Summary: problems such as breathlessness, exercise intolerance and loss of peripheral muscle strength can be observed in individuals who have been diagnosed with covid19 and have been discharged. in our study, it was aimed to investigate the effect of telerehabilitation physical therapy intervention to these cases by using videoconferencing method on the physical condition of the cases.

problems such as breathlessness, exercise intolerance and loss of peripheral muscle strength can be observed in individuals who have been diagnosed with covid19 and have been discharged. in our study, it was aimed to investigate the effect of telerehabilitation physical therapy intervention to these cases by using videoconferencing method on the physical condition of the cases. the exercise program will be a total of 6 weeks, 3 days a week. online access will be carried out synchronously by telephone or computer, and training sessions will not be recorded in order to protect patient personal information. the cases will be evaluated online at the beginning of the study and at the end of the 6-week exercise program. the selected evaluation parameters have been selected considering the ease of online application.

Eligibility criteria:
inclusion criteria: * being between the ages of 18-75 * being diagnosed with covid19 and being discharged by being treated * having technological facilities suitable for telerehabilitation access exclusion criteria: * any presence of comorbidity that may prevent them from exercising * not agreeing to be included in the study

Keywords: exercise videoconference
solutions for hunger and regulating eating

Conditions: Overweight and Obesity

Summary: the objective of this proposed study is to collect efficacy data on roc+ compared to an active comparator (ac) and to behavioral weight loss (bwl) for participants who are high in food responsiveness.

the investigators have developed a new model for the treatment of obesity, called regulation of cues (roc), which is based on behavioral susceptibility theory. the roc program targets two theorized mechanisms for overeating; decreased sensitivity to appetitive cues and increased sensitivity to external food cues. considering that bwl has merit for some people, but fails to facilitate maintenance, this study will compare bwl, roc with some aspects of bwl (roc+) and an active comparator (ac). all treatment groups will be 1.5 hours (including weigh-ins) and will be provided in groups of 15-20 participants weekly for 4 months and twice a month for 2 months (total treatment duration = 6 months, 20 meetings). the investigators will recruit adults with overweight or obesity who are high in food responsiveness (fr) and will assess them at baseline, post-treatment (month 6), mid-follow-up (month 12) and follow-up (month 18).

Eligibility criteria:
inclusion criteria: * high food responsiveness * bmi between 25kg/m\^2 and 45kg/m\^2 * able to read english at a 5th grade reading level * willing and able to participate in assessment visits and treatment sessions, whether held in-person or via password protected zoom meetings * able to provide data through questionnaires * has a smart phone through which they can complete ecological momentary assessments exclusion criteria: * major medical conditions such as diabetes or recent history of coronary heart disease; symptoms of angina, stroke, osteoarthritis, osteoporosis, orthopedic problems that would limit activity during the following 18 months; or any other serious medical condition that would make physical activity unsafe * bulimia or anorexia, significant cognitive impairment, a known psychotic disorder, acute suicidal ideation, moderate or severe alcohol or substance use disorder, or unstable psychiatric illness (e.g., recent psychiatric hospitalization in the past year) * medical or psychological problems that could make adherence with the study protocol difficult or dangerous * pregnant, lactating, or planning to become pregnant in the next 18 months * participating in other weight control programs and/or taking medication for weight loss * previous bariatric surgery * moving out of the san diego area for the duration of their study enrollment (18 months)

Keywords: food responsiveness satiety responsiveness weight loss overeating