Kornimate/medical-research-clean huggingface dataset:
radiotherapy combined with immunochemotherapy in metastatic esophageal squamous cell carcinoma

Conditions: Esophageal Squamous Cell Carcinoma; Esophageal Cancer; Metastatic Esophageal Squamous Cell Carcinoma

Summary: scr-escc-01 is a multicenter, randomized, phase ii study aiming to investigate the benefit of early involvement of low-dose radiotherapy(ldrt) and conventionally fractionated radiotherapy(cfrt) in the first-line anti-pd-1 based treatment of metastatic escc.

in metastatic esophageal cancer, radiotherapy is often administered for palliative purposes to alleviate the symptom of dysphagia. recent studies have shown that the combination of radiotherapy and immunotherapy may have a synergistic effect on treatment outcomes. the study aims to investigate the benefit of ldrt in combination with conventionally fractionated radiotherapy (cfrt) in improving the outcome of metastatic escc concurrently treated with first-line immunochemotherapy. the recruited patients will be randomly (1:1) assigned to receive either pd-1 inhibitor plus chemotherapy (paclitaxel and platinum regimen) (arm b) or in combination with ldrt and cfrt (arm a). the primary endpoint is median progression-free survival (pfs).

Eligibility criteria:
inclusion criteria: 1. age ≥18; 2. metastatic esophageal squamous cell carcinoma (stage ivb, m1) confirmed by pathology; 3. ecog performance status: 0-1 point; 4. no prior anti-tumor treatment; 5. adequate hematologic, renal, hepatic, and cardiac functions that meet the requirements for chemotherapy and immunotherapy assessed by investigators. exclusion criteria: 1. non-squamous cell esophageal carcinoma or escc mixed with other pathological types of esophageal cancer; 2. patients who are potentially curable with surgery as assessed by investigators; 3. pleural metastasis or malignant pleural effusion, pericardial effusion; 4. any prior anti-tumor therapy for esophageal cancer, i.e., surgery, radiotherapy, chemotherapy, or immunotherapy; 5. high risk of gastrointestinal bleeding, esophageal fistula, or perforation; 6. patients with patient-generated subjective globe assessment (pg-sga) score≥9; 7. unstable cardiac diseases or symptoms; 8. history of interstitial pulmonary disease, non-infectious pneumonitis; pulmonary fibrosis, or other uncontrolled acute pulmonary disease; 9. active autoimmune disease or history of autoimmune disease; 10. conditions of immunodeficiency or active infection requiring systemic therapy; 11. pregnant or breastfeeding; 12. patients with synchronous second primary cancer and a history of malignancy within the past 5 years (excluding completely cured cervical carcinoma in situ or basal cell or squamous cell skin carcinoma).

Keywords: immunotherapy low-dose radiotherapy esophageal squamous cell carcinoma immunoradiotherapy
factors influencing the racial disparity in sudden infant death syndrome (sids)

Conditions: Sudden Infant Death Syndrome

Summary: the overall purpose of this investigation is to better understand factors contributing to the high incidence of prone sleep positioning in african-american infants. in addition, the investigators are interested in investigating other races and ethinicities to understand their beliefs and perceptions and determine differences socioeconomically and socioculturally within and between groups. the investigators will address the following specific aims: (-) to compare knowledge, attitudes, and practices regarding infant sleep position in parents of higher and lower ses. (-) to identify risk factors for non-use of recommended supine sleep position in families with higher and lower ses (-) to develop a phenomenologic understanding of the decisions made by parents of higher ses and lower ses who do nt use recommended supine sleep position, using qualitative techniques.

epidemiologic studies have demonstrated prone position to be a major risk factor for sids. studies have consistently demonstrated an increased rate of prone positioning in african american infants, but very little is known about the reasons why african american parents use the prone position more often than other racial groups. furthermore, no studies have taken advantage of the observed socioeconomic status associated variablility in sids and prone sleeping within the african american community. by examing within-group differences, it is possible to move beyond comparative racial descriptions (i.e. comparisions of white and african american) to identification of potentially modifiable factors that might respond to culturally acceptable interventions within a disadvantaged group.

Eligibility criteria:
inclusion criteria: * parents who are 18 years old wth children less than 6 months old are eligible to participate if they self-identify as african american, with parents born in the united states. exclusion criteria: * if the parent is male, not the custodial parent of the child, unable to complet the interview in english or if their child has a chronis illness that would preclude use of the supine sleep position, severe gastroesophageal reflux or recent spinal surgery.

Keywords: sids african american infants disparity
prevalence of hiv +ve cases with aids defining opportunistic infections among art naive patients attending art centre

Conditions: HIV Infections; Tuberculosis; Candidiasis, Esophageal; Cryptococcosis; Leishmaniasis; Toxoplasmosis

Summary: hiv patients are likely to suffer from opportunistic infections, in absence of highly active retroviral therapy. this happens due to lack of awareness of hiv status among patients or unresponsive to anti retroviral drugs. this study is for the prevalence of aids defining ois among treatment naive hiv patients.

oppotunistic infections (ois) happen in persons with weakened immune system. hiv patients, who remain untreated due to lack of knowledge of existing hiv infections, often get ois. hiv patients with aids defining ois fall into stage 3 of hiv illness. prevalence of ois in resource poor settings are tuberculosis (pulmonary and extra pulmonary), toxoplasmosis, cryptococcosis, and oesophageal candidiasis. there are a few data to show aids defining ois in treatment naïve hiv patients. incidence of ois among hiv patients in united states, and canada between 2000 to 2019 was 9%. leading ois were peumocystis jiroveci, oesophageal candidiasis and disseminated mac or m. kansassi. minimal diagnoses at poor settings can be made by observation of symptoms, use of microscope, imaging and diagnostic therapy.

Eligibility criteria:
inclusion criteria: • haart naïve hiv patient exclusion criteria: * patients died during screening * transferred in hiv patients

Keywords: hiv opportunistic infection cd4+ t cells aids defining condition
peripartum anesthetic management of patients with preeclampsia

Conditions: Preeclampsia

Summary: the investigators will conduct a prospective, observational multicentral international study of perioperative management of patients with preeclampsia. the data will be collected from the maternity files and information systems of the medical centers including obstetric, anesthetic and neonatal parameters according to the attached excel data table. results of the study will help to improve the management of patients with preeclampsia and will help to understand the nature and rate of complications. in addition, the study will help in comparing collected data to the data in the literature and as a result improve the safety of care and service that these patient receive in the institution.

in recent years, there has been a growing interest in anesthetic management of parturients diagnosed with preeclampsia. the management of patients with preeclampsia is influenced by maternal conditions that include airway changes, coagulation dysfunction and significant hemodynamic changes. without changing regular practice the investigators will observe and collect data about: the type of anesthesia during surgery, perioperative monitoring and management of these patients (please see study outcomes). complications reported in the literature include significant elevated blood pressure during laryngoscopy and development of intracranial hemorrhage, spinal/epidural bleeding during neuraxial anesthesia in patients with preeclampsia, and coagulation abnormalities. although the number of patients diagnosed with preeclampsia is estimated at five to ten percent of the general maternity population, there is a lack of prospective studies regarding the anesthetic management, obstetric complications and neonatal outcomes. in most centers the data regarding the rate of general anesthesia for cesarean section, the difficulty in performing neuraxial anesthesia, complications related to coagulation dysfunction and other complications, is limited. in studies published by gynecologists or neonatologists, there is a significant lack of data relevant to the daily practice of anesthesiologists.

Eligibility criteria:
inclusion criteria: * parturient with diagnosis of preeclampsia for cesarean section exclusion criteria: * no

Keywords: obstetric anesthesia anesthetic management preeclampsia regional anesthesia complication
entecavir for subjects with chronic hepatitis b infection: an early access program

Conditions: Hepatitis B; Chronic Disease

Summary: the purpose of this clinical research study is to provide entecavir to subjects with chronic hepatitis b infection who have failed or who have demonstrated intolerance of marketed therapies or for those in whom use of these agents is contraindicated and that have no other available treatment options.


Eligibility criteria:
inclusion criteria: * hepatitis b early access program
femtosecond laser assisted cataract surgery in the nhs

Conditions: Cataract; Surgery

Summary: this study aims to examine the health economic impact of adopting femtosecond laser technology to assist high volume cataract surgery (flacs) within a state-funded healthcare system, the national health service (nhs).


Eligibility criteria:
inclusion criteria: * patients must have reduced visual acuity or visual symptoms attributed to the presence of cataract in one or both eyes by the examining ophthalmologist or else must require cataract surgery on clinical grounds other than visual symptoms. * patients must be willing to attend for follow-up at 1 month after cataract surgery. * patients must be sufficiently fluent in english for informed consent and self-completion of the patient reported outcome questionnaires. exclusion criteria: * children below the age of 18 * already enrolled in another study the principle exclusion criteria relate to clinical contraindications for flacs, such as: * significant corneal opacities * small pupils following pharmacological dilatation * patients unable to lie sufficiently flat so as to be positioned underneath the laser machine.
pilot of reconnecting to internal sensations and experiences in undergraduates

Conditions: Suicidal Ideation; Eating Disorder Symptom

Summary: project rise is a randomized control trial. the intervention consists of four modules that focus on multiple aspects of interoception including: body awareness, body sensations/movement, eating, health and self-care, emotional awareness, and understanding the self in relation to others. the comparator condition is called "health habits" and is matched for time and attention; participants complete modules related to healthy habits such as financial planning, hygiene, stretching, and healthy eating. variables of interest include self-report measures of interoception, eating pathology, suicidality, physiological measures of interoception (electrocardiograph; ecg; pain tolerance measured via algometer), and an implicit association test (iat) with death and life stimuli (meant to measure implicit associations with suicidality). the population will be college students, with current or past suicidality or low interoception.


Eligibility criteria:
inclusion criteria: * low interoceptive awareness * history of suicidal ideation or attempt * 18 or older exclusion criteria: \*below the age of 18
renal sympathetic denervation prevents atrial fibrillation in patients with hypertensive heart disease: a pilot study

Conditions: Hypertension; Hypertensive Heart Disease; Atrial Fibrillation; Autonomic Imbalance

Summary: the autonomic nervous system plays an important role in the precipitation of af in structurally-abnormal hearts. restoration of autonomic imbalance may therefore prevent new-onset af. renal artery denervation (rdn) is a novel percutaneous procedure that uses radio-frequency energy to destroy the sympathetic renal nerves. symplicity 1 and -2 studies have shown that rdn effectively reduces blood pressure in up to 80% of treated patients. lvh regression and improvement of diastolic dysfunction follow as a consequence of afterload reduction and renin-angiotensin-aldosterone system modulation. rdn may thus also reduce intra-atrial pressure resulting in less stretch of the pulmonary venous ostia where most ectopic af-foci originate. hypothesis: rdn restores autonomic imbalance in hthd and lowers intra-atrial pressure by reducing afterload. these synergistic mechanisms may prevent new-onset af.

one hundred consenting patients meeting all inclusion criteria will undergo an exercise stress test, 2d and m-mode echocardiograms and 24-hour ambulatory blood pressure holter monitoring prior to being randomised to receive either renal denervation (rdn) with a symplicity renal denervation catheter plus medical therapy or medical therapy alone. coronary angiography with/without coronary revascularisation will be performed as per the treating cardiologist's clinical judgement and a reveal® holter will be implanted in all patients at the end of the procedure. time zero will be defined as starting at three months after the procedure. follow up visits will be scheduled to scan the holter for the primary end point, i.e. high atrial rates (af-surrogate defined as: "episodes of atrial rate \>190 beats per minute for more than 6 minutes") or new-onset af. patients will be followed six monthly for three years.

Eligibility criteria:
inclusion criteria: * must have an indication for coronary angiography e.g. * acute coronary syndrome * positive stress ecg: - defined as ≥1mm st segment shift (depression or elevation) in ≥2 contiguous leads with/without chest discomfort) * age ≥55 years * office blood pressure ≥160/90mmhg in non-diabetics or ≥150/90mmhg in diabetics * subjects must be on at least 3 anti-hypertensive drugs, including a diuretic agent * sinus rhythm * left ventricular hypertrophy defined on echo as: * estimated lv mass \> 255 g or lvmi \>131 g/m2 for men * estimated lv mass \>193 g or lvmi \>113 g/m2for women * left atrial diameter ≥45mm on any echocardiographic window exclusion criteria: * estimated glomerular filtration rate (egfr) \< 45ml/min/1.73m2 * renal artery anatomy unsuitable for rdn * substantial stenotic valvular heart disease * pregnancy or planned pregnancy * thyrotoxicosis * patients needing to undergo coronary artery bypass surgery

Keywords: hypertension hypertensive heart disease atrial fibrillation autonomic imbalance
three-dimensional printed customized titanium mesh for mandibular augmentation

Conditions: Alveolar Bone Loss

Summary: completely or partially edentulous patients suffer from resorption of the alveolar bone, they always seek rehabilitation which becomes challenging. alveolar ridge augmentation is widely done now to offer these patients functional and esthetic restoration. many techniques have been proposed to obtain good results of ridge augmentation. titanium mesh (time) is widely used, also digital and computer-guided surgery now plays an important role to improve the techniques and results in ridge augmentation procedures.


Eligibility criteria:
inclusion criteria: * patients will have a posterior mandibular atrophic ridge * distance between the crest of the ridge and the superior border of the inferior alveolar canal will be from 5 mm to 7 m * adequate inter-arch space exclusion criteria: * patients who have any uncontrolled systemic disease contraindicated to oral surgery ( diabetes, hypertension, and patients under chemotherapy treatment ) * patients who have any relevant bone disease. * patients who are smokers
shared medical appointments to improve outcomes in adolescents with type 1 diabetes

Conditions: Type 1 Diabetes

Summary: adolescents and emerging adults with type 1 diabetes (t1d) experience significant struggles with their diabetes management resulting in worsening diabetes health and increased complications. this population's declining well-being occurs during a time when they should be at their healthiest and enjoying multiple exciting life transitions. their worsening diabetes management is complicated by the fact they are also learning how to become more independent from their family in preparation for eventually leaving home. furthermore, the number of people under 20 years of age diagnosed with t1d has increased dramatically over the past 10 years giving rise to increased concern about providing care to this population. the team clinic intervention is an innovative clinical care approach to address the medical and developmental needs of adolescents with t1d and their families. a group medical appointment format will be used for routine diabetes clinic visits in middle school and high school adolescents with t1d. parents of these patients will be participating in their own group during these clinic visits. the team clinic model incorporates developmentally tailored peer support and novel learning tools, (e.g. games, physical activity, and/or interaction through internet resources, e.g. blogs, forums) into the shared medical appointment design. the goal of team clinic intervention is to improve medical and psychological outcomes in adolescents with t1d and their parents. the study will investigate, in a randomized controlled trial, the efficacy of a novel clinical care model that addresses the unique developmental strengths and weaknesses of the t1d adolescent population. the team clinic format streamlines clinical care delivery to this often-challenging patient population without placing additional burden on youth, families, or clinics because the intervention will be completed during routine diabetes care visits. moreover, the team clinic approach maximizes the benefits of peer support by delivering care in a group format to address the sense of isolation that teens and families coping with chronic illness often feel. if successful, the team clinic intervention will not only positively impact adolescents with t1d and their families, but it could be used as a model of care for other adolescents with chronic medical conditions struggling to remain involved and invested in their medical care. team clinics may be one approach to successfully engaging adolescents in their diabetes care prior to their transition away from home, which will help them remain invested and active in their medical care through adolescence and young adulthood.


Eligibility criteria:
inclusion criteria: * t1d \>1 year duration, 6th-10th grade exclusion criteria: * non-english speaking * severe behavioral, developmental, or psychological diagnosis making group participation difficult
study evaluating cci-779 and letrozole in post-menopausal women with breast cancer

Conditions: Breast Neoplasms; Neoplasm Metastasis

Summary: in this clinical research study, postmenopausal subjects with metastatic breast cancer will be given either the combination of temsirolimus (cci-779) and letrozole or a placebo and letrozole in first-line hormonal treatment. the primary endpoint of this study is to determine overall progression free survival. individual subjects will participate in the active treatment phase of the study until disease progression or withdrawal of consent, provided that test article is being tolerated. all subjects will be asked to participate in the long-term follow-up phase of the study, which includes follow-up every 3 months until disease progression (for subjects who withdraw for reasons other than documented progressive disease) or until any new cancer treatment is received, and for survival. the estimated duration of study participation is 34 months.


Eligibility criteria:
inclusion criteria: * women aged greater than 18 years. * postmenopausal subjects * confirmed diagnosis of locally advanced (not amenable to curative surgery and/or radiation) or metastatic breast cancer (stage 3b or 4 respectively, by american joint committee on cancer criteria) exclusion criteria: * extensive visceral disease * subjects with bone as the only site of disease * prior radiation therapy to the site of measurable disease for subjects with a solitary measurable lesion

Keywords: breast cancer
finnish telestroke pilot 2007-2009

Conditions: Stroke

Summary: objective is to describe two years experience from the finnish telestroke piloting between helsinki university central hospital (huch), department of neurology, the hub, and five hospitals, the spokes. the participating hospitals are from rovaniemi (lapland), kemi (north-west of finland), lappeenranta, kuusankoski and kotka from south-east of finland. all the participating hospitals have a stroke unit and the thrombolysis treatment and the follow up of the patients are carried in the treating hospital. the aim of the pilot is to provide these hospitals expertise in thrombolysis treatment during off-hours through teleconsultations. the teleconsultations were begun between the participating hospitals 05/2007 after about 1 years preparation period. during the preparation period the staff from participating hospitals were trained with simulation training and lectures held by the local staff and the faculty of the helsinki university hospital. telestroke consultation: during two way interactive audio-visual consultation the thrombolysis decision is based on: 1) the consultant going through a check up list of indications and no contraindications to the treatment together with the treating physician and 2) clinical assessment of nihss by the treating physician under guidance of the consultant through the two way video system besides 3) evaluation of the head ct scan. the data registered is based on documents made at huch and the follow up data provided by the chief neurologist of the other hospitals. 109 teleconsultations have been documented over 2 years period. a unique feature of the finnish pilot is the high percentage of consultations leading to thrombolysis treatment. another special feature is that the consultant does the teleconsultation work besides other on call duties.


Eligibility criteria:
inclusion criteria: * all stroke patients inside 4.5 hours from the symptom onset considered as thrombolysis candidates by the treating physician of the spoke. in suspected basilar artery thrombosis up to 48 h from symptom onset. exclusion criteria: * symptom onset \> 4.5 h

Keywords: stroke thrombolysis telestroke