Kornimate/medical-research-clean huggingface dataset:
pancreatic cancer screening through the detection of elastase-1 combined with other examinations

Conditions: Pancreatic Ductal Adenocarcinoma; Pancreatic Diseases; Pancreatic Elastase 1; Pancreatic Neuroendocrine Tumor; Pancreatitis; Pancreatic Neoplasms

Summary: this is a prospective cohort study. the investigators enroll subjects with pancreatic ductal adenocarcinoma (pdac), individuals at high risk for pdac, patients with other pancreatic diseases, patients with ca19-9 elevation and controls without pancreatic disease. this study aims to establish a diagnostic prediction model by using elastase 1, common clinical serological examinations, and imaging examinations including endoscopic ultrasonography (eus), and to explore the diagnostic ability of the model in the high-risk population of pdac. besides, the investigators search for new biomarkers by multi-omics studies of serum and pancreatic tissues to further improve the diagnostic performance of this model. in conclusion, this study seeks a robust diagnostic prediction model to diagnose pdac, especially early resectable pdac.


Eligibility criteria:
inclusion criteria: case groups (matching any of the following): 1. patients with pancreatic cancer with recognized diagnostic criteria or conclusions. 2. patients who are the high-risk group of pancreatic cancer. 3. patients with solid pseudo papilloma and neuroendocrine tumors of pancreas with recognized diagnostic criteria or conclusions. 4. patients with other diseases with abnormally elevated ca19-9. control group: (1) patients without pancreatic disease assessed by laboratory tests and imaging examinations have no ca19-9 elevation. exclusion criteria: 1. patients who are younger than 18 years of age. 2. patients with suspected pancreatic malignant lesions but has no confirmed imaging or pathological diagnosis. 3. patients who have not signed informed consent.
early parecoxib usage to decreases narcotic requirement and length of stay after traumatic rib fracture

Conditions: Parecoxib; Rib Fractures

Summary: patients diagnosed traumatic rib fracture and need admission will be included. patients will be divided two groups.the experimental group will be given parecoxib after visiting emergency department. the control group will be given narcotic agent such as morphine for pain control. the outcome such as numerical rating scale (nrs) and hospital length of stay will be recorded.

3.1 inclusion/exclusion criteria patients who are diagnosed ribs fracture and need admission. exclusion criteria included heart failure, coronary artery disease (cad) history. traumatic cardiac injury and cardiac tamponade will be excluded, too. 3.2 group design patients will be divided two groups, and the experimental group will be given parecoxib after visiting emergency department. and they will be kept given after admission by intravenous method every 12 hours for 4 days. the control group will be given narcotic agent such as morphine for pain control. the daily dose will be recorded. finally the end outcome will be recorded. 3.3 data collection the data of patient's medical history and laboratory results will be recorded on pre-designed case report forms (crfs) by study nurses. in all patients, age, gender, diagnosis, co-morbidities, length of hospital and intensive care unit (icu) stay, injury severity score (iss) score, numerical rating scale (nrs) and outcomes, will be recorded. in addition, all microorganisms isolated and antibiotic substances applied will be documented.

Eligibility criteria:
inclusion criteria: 1. investigators will prospective enroll patients who are diagnosed chest trauma with rib fractures 2. age ≧18 y/o exclusion criteria: 1. patients who have history of heart failure, cad history. 2. traumatic cardiac injury and cardiac tamponade 3. history of allergy effect for cyclooxygenase 2 (cox2) inhibitor or nsaid
randomized trial of tele vs. clinic tf-cbt in puerto rico

Conditions: Post-Traumatic Stress Disorder

Summary: the current study will evaluate tf-cbt delivered via tele-health for youth presenting with trauma symptoms via a randomized controlled trial. goals of the current study are to examine the effectiveness of tele-tf-cbt delivered by community providers in puerto rico in improving youth trauma outcomes. goals are also to support the feasibility, acceptability, and engagement outcomes of tele-health delivery.

the current study will use a randomized controlled trial to examine telehealth delivery of trauma focused-cognitive behavioral therapy (tf-cbt) for youth with trauma symptoms receiving care in community based clinics in puerto rico. first, the effectiveness of tele-tf-cbt in improving trauma symptoms will be examined compared with clinic-based tf-cbt. next, the feasibility, acceptability, and engagement outcomes of tele-tf-cbt will be examined in this population. lastly, implementation factors will be explored.

Eligibility criteria:
inclusion criteria: * 7-18 years old * experienced at least one traumatic event * present with clinically significant levels of post-traumatic stress symptoms exclusion criteria: * significant suicidal ideation * substance use disorder * active psychotic symptoms * pervasive developmental delays, * currently living with or in close contact with the perpetrator of their abuse

Keywords: trauma focused cognitive behavioral therapy telehealth community implementation
comparison of the result of tvt performed at the time of prolapse surgery or 3 months after

Conditions: Pelvic Organ Prolapse; Urinary Stress Incontinence

Summary: it is unknown whether it is best to do the tvt( procedure for urinary stress incontinence in women) at the time of prolapse surgery or at a later date. women with both conditions were randomized to both procedures together or the tvt 3 months after the prolapse surgery. any or no leakage when couching was the main end-point, evaluated 1 year after the last surgery

all women were evaluated by the pop-q (pelvic organ prolapse quantification) prior to surgery and 1 year after. examination for urinary leakage was done prior to surgery and 1 year after. group 2 was also examined after prolapse surgery to see if tvt was still needed.

Eligibility criteria:
inclusion criteria: pelvic organ prolapse that needs surgical repair and objectively proven urinary stress incontinence - exclusion criteria: not agreed to participate in randomization -

Keywords: pelvic organ prolapse urinary stress incontinence surgery
influence of yogic breathwork on csf circulation

Conditions: CSF Circulation

Summary: the purpose of this research study is to determine the influence of yoga breathing practices on cerebrospinal fluid (csf) circulation, and to find out primarily if a regular practice of 8-week yoga breathing would enhance csf circulation as well as if the intervention would improve participant's quality of life, quality of sleep, and reduce existing stress. participants will be randomized into two arms for different breathing practices.

the purpose of this research protocol is to determine the influence of an 8-week breathing intervention on cerebrospinal fluid (csf) circulation among healthy participants using a non-invasive real-time phase-contrast magnetic imaging (rt-pcmri) technique. this aim will be examined by studying the changes in each participant's pre- and post-intervention csf flow dynamics using the non-invasive rt-pcmri technique during two mri scans (one before and one after the 8-week intervention). the study protocol consists of 20 healthy participants (two groups; 10 in each group with different breathing practices) undergoing an 8-week intervention, and pre-and post-intervention outcome measures. the two 8-week interventions will be guided by two separate certified experienced yoga teachers. both interventions will consist of 60-minute weekly group on-site sessions (1day/week) with a 20-minute daily home sessions (in between on-site sessions; 6 days/week) using home-aid practice materials. participants' respiration data will be objectively tracked using a wearable respiration tracker device.

Eligibility criteria:
inclusion criteria: - 18-65 years of age, able to provide their consent to be in the study, available and able to participate in study activities, who can lie in supine, able to walk 15 feet, who have no prior/current mind-body practice inducing breath awareness or training such as yoga, meditation, ta-chi, qi-gong. exclusion criteria: - inability to provide informed consent, mri contraindications, need for muscle relaxants or anti-anxiety drugs in order to tolerate mri, history of neurological disorders, head trauma with loss of consciousness, craniospinal disorders, spinal injury, sleep disorders, allergic or respiratory disorders, major or uncontrolled psychiatric illness or major depression, lung and heart problems, any condition requiring the use of medication that acts on the brain like stimulants, sedatives current substance abuse issues, pregnancy or nursing.

Keywords: cerebrospinal fluid cerebrospinal fluid flow cerebrospinal fluid circulation yoga yogic breathwork magnetic resonance imaging breathing sleep rt-pcmri csf flow slow breathing respiration
a better choice for patients undergoing endovascular coil embolization

Conditions: Intracranial Aneurysms

Summary: the investigators designed a double-blind, randomized placebo-controlled study to determine the effects of dexmedetomidine on the recovery characteristics of patients who were scheduled to undergo endovascular coil embolization.


Eligibility criteria:
inclusion criteria:18-65 years old asa i or asa ii patients undergoing ece treatment for intracranial aneurysms were included. exclusion criteria:patients were excluded based on the following parameters: older than 65 yrs, a history of mental illness, recent use of sedatives or analgesics and with sensation.

Keywords: dexmedetomidine, endovascular coil embolization
peg-granulocyte-colony stimulating factor (gcsf) for coronary collateral growth in coronary artery disease patients

Conditions: Coronary Artery Disease

Summary: the purpose of this study in patients with stable coronary artery disease (cad) treatable by pci (percutaneous coronary intervention) is to evaluate the long-term efficacy and safety of subcutaneously applied, pegylated granulocyte colony stimulating factor (pegfilgrastim, peg-g-csf; neulasta®, amgen switzerland) with regard to the promotion of collateral growth.

coronary artery disease (cad) is the leading cause of death in industrialized countries. current revascularization therapies are pci or surgical revascularization. however, inherent to them are procedure-related risks and the fact, that progression of cad is not prevented. additionally, up to one fourth of all cad patients are not amenable to standard revascularization therapies. thus, there is a need for alternative therapies. the coronary collateral circulation is prevalent in humans, and in cad the amount of collateral flow is a pivotal protective factor with respect to infarct size, all-cause- and cardiac mortality. coronary collateral growth promotion is an alternative to conventional revascularization which can be achieved by cytokine-based approaches (e.g. with colony-stimulating factor-therapy) in humans. the goal of collateral promotion is to reduce myocardial damage in case of a coronary occlusion.

Eligibility criteria:
inclusion criteria: 1. age \> 18 years old 2. 1- to 3-vessel coronary artery disease (cad) 3. stable angina pectoris 4. at least 1 stenotic lesion suitable for pci 5. no q-wave myocardial infarction in the area undergoing cfi measurement 6. written informed consent to participate in the study exclusion criteria: 1. acute myocardial infarction 2. unstable cad 3. cad treated best by cabg 4. patients with overt neoplastic disease 5. patients with diabetic retinopathy 6. liver or kidney disease 7. pre-menopausal women

Keywords: coronary artery disease stable coronary collaterals therapeutic collateral promotion (tcp)
medical and economical evaluation of computer-assisted reconstruction of the anterior cruciate ligament (acl)

Conditions: Knee Injuries; Anterior Cruciate Ligament; Arthroscopy

Summary: a poor outcome in anterior cruciate ligament (acl) reconstruction is often related to tunnel position. the researchers believe that improving the accuracy of tunnel position will lead to an improved outcome in acl surgery. the researchers' purpose is to perform a controlled study on a series of 500 patients in two groups: group i (250 cases) using conventional instrumentation and group ii (250 cases) using navigation (surgetics acl julliard protocol).

this study compares the percentage of patients in 2 groups (full success) at 1 year of follow up. the results were evaluated on clinical outcome based on the ikdc (international knee documented committee, subjective evaluation) form between one group using conventional instrumentation and another group using navigation. secondary aims: * to compare in 2 groups: * gain of ikdc score at one year (based on pre-operative ikdc score) * evolution of ikdc subjective (pre-operative, at 12 months) * to compare performances at one year (% class a or b) in terms of initial instability measured with laximetry score * study of the learning curve * evaluate: lasting quality, complication rate, extra-operative time * evaluate frequency of thrombovenous complications * evaluate delay to return to sport

Eligibility criteria:
inclusion criteria: * first knee surgery * patients more than 18 years old exclusion criteria: * knee surgery already done * patients unable to understand informed consent sheet

Keywords: surgery navigation acl ikdc comparative study
impact of intensive follow-up for bone metastasis on characteristics and prognosis of chinese breast cancer patients

Conditions: Breast Cancer; Bone Metastases

Summary: the purpose of this study is to retrospectively collect and analyse the characteristics of breast cancer patients with bone metastasis, and compare the impact of intensive follow-up with standard post-operative surveillance on survival of chinese breast cancer patients.

breast cancer is one of the most common malignant tumors in women, and the incidence rate is gradually increasing, accounts for the first place in the incidence of female malignant tumors. bone metastasis is the most common distant metastatic site for breast cancer, accounting for approximately 70% of all patients with advanced breast cancer. about 26%-50% of breast cancer patients with primary metastases are bone. autopsy results showed that the overall incidence of breast cancer bone metastasis was about 47%-85%. postoperative routine screening for bone metastases in breast cancer patients, whether domestic or foreign, is not recommended in most guidelines. these recommendations were based on two prospective randomized controlled trials in italy in 1990s, indicated that a bone scan every six months or annually didn't provide a survival benefit to the patient. however, there were researches showing that about 11% of patients with asymptomatic breast cancer have bone metastases, suggesting that early screening might detect more patients with asymptomatic bone metastases. the meta-analysis also pointed out that early screening may prolong the disease-free survival of patients. besides, the imaging techniques have advance rapidly and remarkably since then. new trials are needed to figure out whether imaging screening of asymptomatic patients should be routinely performed to detect more asymptomatic bone metastases needs further investigation.

Eligibility criteria:
inclusion criteria: a. histologically proven breast cancer confirmed by biopsy or pathological examination of the resected tumor. b. histologically confirmed breast cancer patients, fulfilling any of the following: 1. . multiple bone metastases indicated by bone scan 2. . bone scan positive, and proven by other imaging examinations, including computed tomography (ct), magnetic resonance imaging (mri) and x-ray. 3. . bone scan positive, with clinical symptoms, including bone pain, pathologic fracture, spinal cord compression and so on. 4. . bone metastases indicated by pet-ct 5. . histologically proven bone metastases exclusion criteria: a. no bone metastases confirmed by pathological examination b. bone metastases secondary to other malignant tumor other than breast cancer c. secondary primary tumor
frailty and functional ability in alzheimers

Conditions: Alzheimer Disease

Summary: the primary aim of this study is to investigate the association between frailty as defined by the fried frailty phenotype and risk of functional decline in patients with alzheimer's dementia. the hypothesis is that frailty is associated with greater functional decline in community-dwelling older people with alzheimer's dementia compared to those without frailty. secondary aims include investigation of long-term risk of institutionalization (through administrative follow-up) and trajectories of assessment components in future assessment. the study is designed as a prospective cohort study. participants in the study will undergo an assessment battery at baseline, 1 years of follow-up, and administrative follow-up for 5 years. participants will be recruited from patients of the unit of dementia at aalborg university hospital within 3 months of dementia diagnosis. the time frame of 3 months after diagnosis was chosen to ensure that cognitive assessment in the unit of dementia was reflective of patient's cognitive level and thereby ability to consent at inclusion. patients will be eligible for inclusion if they are 65 years or older, have a diagnosis of mild or moderate alzheimer's or mixed (alzheimer's and vascular) dementia, live at home, and are able to walk 5 meters independently of other people (walking aids will be allowed). the severity of dementia will be defined according to score on the mini mental state examination (mmse) as it has done in other studies. according to this definition a mmse score between 20-30 indicates mild alzheimer's dementia and a mmse score from 15-19 indicates moderate dementia. people with moderately severe and severe alzheimer's dementia defined as mmse score below 15 will not be eligible to participate.


Eligibility criteria:
inclusion criteria: * diagnosis of alzheimers dementia * mmse \> 14 * age \>= 65 * not living in institution * able to walk 5m without assistence (walking aids accepted) exclusion criteria: * no available caregiver/proxy * unable to give informed consent as judged by caregiver/proxy or researcher * time from diagnosis \> 3 months
community based self management of copd facilitated by a palliative care team:impact on health care utilization and qol

Conditions: Pulmonary Disease Chronic Obstructive

Summary: the purpose of this study is to compare in home support services for patients with copd with usual care. the study is designed to evaluate the impact of an interdisciplinary palliative care team on community based self management of advanced copd. a total of thirty patients will be enrolled into this study. twenty patients will be randomly assigned to receive usual care, and ten patients will be randomly assigned to usual care plus in home support services. this study will use objective criteria to identify patients with copd likely to benefit from home based palliative care services. the patients will undergo initial assessment by medical, social work, and spiritual care personnel followed by a family meeting to establish a care plan. periodic scheduled visits, and as needed unscheduled visits to address urgent needs will occur over one year's time in an attempt to return patients with copd to the center of decision making regarding their care, avoid acute exacerbations and thereby avoid unscheduled clinic and er visits. patients will complete the qol survey and symptom assessment scale upon initial intervention. after obtaining information from all patients who qualify for the study, participants will be randomized into cohorts. those who are randomized to serve as cases will be provided with community based self management services by an interdisciplinary palliative care team. the control group will receive standard care. at the conclusion of 12 months both cases and controls will again complete the qol survey,medical utilization, and symptom assessment.


Eligibility criteria:
inclusion criteria: * age 60 or greater * dx of copd * received 2 or more unscheduled acute care visits during the 12 months from jan 2007-dec 2007 * smdc primary care provider * lives within 50 miles of duluth minnesota * informed consent exclusion criteria: * non english speaking * too ill or cognitively impaired to provide baseline data or informed consent * lives more than 50 miles from duluth * nursing home resident

Keywords: community based self management of copd with palliative care
enhancing diagnosis in chronic b-cell lymphoproliferative disorders using next-generation sequencing

Conditions: Lymphoma

Summary: to enhance the diagnosis of unclassifiable, non-cll b-lpds using next-generation sequencing technology.

in recent years, next generation sequencing has revealed the genomic landscape of lymphoid disorders and identified mutations that have improved our understanding of their pathogenesis. it has also revealed new targets for drug development. while some of these mutations, such as the braf v600e mutation in hairy cell leukaemia (hcl)2, are now accepted as disease defining mutations, others such as myd88 and notch1/2 mutations are found in more than one subtype of b-lpd3. the overlapping nature of some of these molecular aberrations could have important implications for treatment of these disorders as we move towards targeted therapy. ezh2 inhibitors, which are currently in early phase trials, are one such example of targeted therapy for b-lpds based on mutations identified by next generation sequencing (ngs)4. the genetic makeup of these tumours is also likely to influence future classification systems. at present, an integrated approach incorporating morphology and immunophenotyping remains integral to the classification of b-lpds. the haemato-oncology department at the royal marsden hospital has an international reputation in the development of immunophenotyping as a tool for the diagnosis of lymphoproliferative disorders. for example, the cll score developed by the haemato-oncology department continues to be used in several centres around the world for the diagnosis of cll5. a similar score proposed for hcl by our haemato-oncology department is also widely used (6). on a service evaluation, we found 100% concordance between a hcl score of 4 and presence of the braf mutation in samples referred to us (unpublished data). our plan therefore is to systematically study unclassifiable groups of b-lpd by creating a well-defined immunomorphology work flow for their identification. samples thus identified will be screened using a next-generation sequencing (ngs) panel which is able to detect well established, b-lpd associated translocations and genetic mutations.

Eligibility criteria:
inclusion criteria: * chronic, mature clonal b-cell malignancy that is not assignable to a specific who category by current technology (see flowchart in section below). exclusion criteria: * non-clonal b-cell proliferation. * high grade and/or immature clonal b-cell malignancy. * bone marrow samples with less than 20% infiltration will be excluded * samples from patients with a known classifiable chronic b-lpd based on lymph node biopsy for e.g. staging bone marrow samples on a patient with marginal zone lymphoma. if a definitive diagnosis is established on a subsequent lymph node biopsy, patient will remain on study and this will be correlated with ngs findings. * patient unable to provide consent for tumour and germ line samples.

Keywords: lymphoma unclassifiable next generation sequencing