Kornimate/medical-research-clean huggingface dataset:
evaluation of brain health and surgical efficacy in patients with carotid artery stenosis

Conditions: Carotid Artery Stenosis; Image

Summary: the purpose of this study is to explore the relationship between the recovery of cerebrovascular morphology and cognitive function before and after surgical treatment in patients with carotid artery stenosis and their preoperative cardiac health status. and combined with preoperative cognitive status, serum markers, and cardiovascular health evaluation indicators, evaluate and predict the possibility of postoperative neurodegenerative diseases and the level of cerebrovascular health in patients.

the aim of this study is to evaluate the brain health status and surgical efficacy of patients with carotid artery stenosis. firstly, investigate whether hemodynamic parameters such as blood flow reserve fraction at the carotid artery stenosis site are correlated with white matter hyperintensities and cerebral vascular morphological changes in elderly patients with normal cognition and mild cognitive impairment; then, when the blood flow of carotid artery has been improved after surgery, compare the cerebrovascular health of patients before surgery and the way of cerebral vascular reconstruction; combined with the postoperative neuropsychological cognitive test to explore the postoperative cognitive recovery of patients, and combined with the postoperative imaging data and the biomarker in the blood of patients at various stages, to explore the way of cerebral vascular reconstruction and changes in brain structure and function of different groups of patients behind cognitive changes.

Eligibility criteria:
inclusion criteria: * aged over 50 years old; * conscious and capable of completing neuropsychological scales * clinical detection of carotid artery stenosis requires surgical treatment; * compliant with carotid artery stenting or carotid endarterectomy surgical standards * individuals with normal cognition and mild cognitive impairment exclusion criteria: * degree of vascular blockage in other intracranial segments ≥ 50% * have a history of mental illness, nervous system disease (such as stroke) or brain injury with loss of consciousness for more than five minutes; * neurological and psychiatric disorders unrelated to ad (schizophrenia, depression, etc.), post-traumatic stress disorder, obsessive-compulsive disorder, multiple sclerosis, amyotrophic lateral sclerosis) * have a history of alcohol or drug abuse * there are contraindications for magnetic resonance imaging examination * those with significant organ dysfunction such as lung, liver, and kidney; * patients with intracranial tumors, infectious diseases, and blood system diseases; * participating in other clinical studies at the same time

Keywords: carotid artery stenosis mri imaging
project frazier 3 regulatory clinical evaluation

Conditions: Diabetes Mellitus; Healthy Volunteers

Summary: clinical evaluation of blood glucose monitoring systems (bgmss)

user performance, system use, system accuracy, user instruction for use and marketing claims evaluation of blood glucose monitoring systems.

Eligibility criteria:
summary of inclusion criteria * age - subject is at least 12 years old. * informed consent - subject reads the appropriate participant information sheet and signs the informed consent form (section 12.0). * diabetes diagnosis when applicable - type 1 or type 2 diabetes mellitus. * language - subject reads and understands local language * smbg status confirmed * subject agrees to complete all aspects of the study summary of exclusion criteria * conflict of interest * pregnancy - subject is pregnant (as confirmed by subject) * user performance accuracy testing - technical expertise
study of the participation of people with aphasia post stroke and their caregivers in valladolid region (spain)

Conditions: Stroke; Aphasia

Summary: the objective of this study is to determine the level of community participation of people with post-stroke aphasia and their caregivers, as well as the factors that facilitate or interfere with this participation in the valladolid region (spain). the main questions that this study aims to answer are: 1. what is the retained activities of the people with aphasia post-stroke? 2. what is the retained activities of the caregivers of people with aphasia post-stroke? 3. what factors influence the community participation of people with aphasia post-stroke and their caregivers?


Eligibility criteria:
inclusion criteria: * chronic stroke (stroke onset above six months). * aphasia post stroke. * residents in valladolid region. * age over 18 years. * ability to walk equal to or greater than 3 according to the functional ambulation category (fac). * informed consent acceptance. exclusion criteria: * stroke onset below of six months * age under 18 years * both in the case of the person with aphasia and their caregiver, presence of other pathologies that affect functional independence

Keywords: aphasia post stroke caregiver community participation occupational therapy speech language therapy
chronic total occlusion registry

Conditions: Coronary Occlusion; Coronary Artery Stenosis; Coronary Stenosis

Summary: this study evaluated the long-term outcome of patients with chronic total occlusion treated with percutaneous coronary intervention, medical treatment or coronary artery bypass grafting.

this study is connected with decision-cto trial(nct01078051). randomized subjects and registry group subjects from decision-cto trial continue 10 years follow-up on this study.

Eligibility criteria:
inclusion criteria: * patients with angina or silent ischemia and documented ischemia * patients with de novo chronic coronary occlusion ≥ 3months and reference diameter ≥ 2.5 mm on coronary angiography * age \> 18 years exclusion criteria: * refuse to participate in this study

Keywords: cto pci cabg medical treatment decision cto
isis 104838, an inhibitor of tumor necrosis factor, for active rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: isis 104838 is an antisense oligonucleotide drug that reduces the production of a specific protein called tumor necrosis factor (tnf-alpha), a substance that contributes to joint pain and swelling in rheumatoid arthritis. isis 104838 works by blocking tnf-alpha messenger rna, the "instruction" molecule that is required for the production of tnf-alpha protein. this trial will assess the safety and efficacy of isis 1048383 by subcutaneous injection, administered by 3 different dosing regimens for 3 months, versus placebo. approximately 160 tnf-alpha inhibitor-naïve rheumatoid arthritis patients will be evaluated at 32 sites in the u.s. and canada.


Eligibility criteria:
inclusion criteria 1. age \>/= 18 years. 2. rheumatoid arthritis for \>/= 6 months. 3. active disease as defined by \>/= 6 swollen and \>/= 9 tender joints, and an abnormal c-reactive protein or westergren erythrocyte sedimentation rate lab test, or morning stiffness \>/= 1 hour. 4. use of at least one dmard, and ability to discontinue any current dmard. exclusion criteria 1. onset of rheumatoid arthritis before the 16th birthday. 2. wheelchair or bed-bound functional level. 3. no previous infliximab or etanercept treatment, or investigational therapy (not placebo) with other tnf-alpha inhibitors. 4. prednisone \> 10 mg per day or more than one nonsteroidal anti-inflammatory drug. 5. patients with an active infection, a history of tuberculosis, multiple sclerosis, other poorly controlled medical illness, or a malignancy within the last 5 years. 6. patients who require intravenous heparin therapy or with a history of a bleeding problem.
application of the stem cell therapy in the end stage liver disease and assessment its consequences in the quality of live style as well as development of hcc.

Conditions: Hepatocellular Carcinoma in Hepatitis C Virus Infected Patients

Summary: prospective study to calculated the incidence of hepatocellular carcinoma in hepatitis c virus infected patients after stem cell therapy.

our prospective research is carried out in one of the stem cell therapy centers in egypt where 140 hepatitis c virus infected patients attending for stem cell therapy are enrolled in our study and the patients will be followed up after stem cell therapy where the incidence of hepatocellular carcinoma after stem cell therapy will be calculated , another group of hepatitis c virus infected patients attending to kasr el aini university hospital to receive the standered line of care as indicated will be enrolled in our study and will be followed up , where the incidence of hepatocellular carcinoma will be calculated and compared to the previous group , to determine if there is a significant difference between both groups regarding the incidence of hepatocellular and determine whether stem cell therapy affecets the incidence of hepatocellular carcinoma in hepatitis c virus infected patients.

Eligibility criteria:
inclusion criteria: * male or female patients aged from 20 to 65 years of age. * evidence of chronic liver insufficiency. * the presence of decreased serum albumin and/or increased bilirubin and/or increased international normalized ratio (inr). * patient is unlikely to receive a liver transplant. * ability to give written consent * women of childbearing potential may be included, but must use a reliable and appropriate contraceptive method exclusion criteria: * patients below the age of 20 or above the age of 65 years * pregnant or lactating women * patients with recent recurrent gi bleeding or spontaneous bacterial peritonitis * patients with evidence of hiv or other life threatening infection * patients unable to give informed consent * patients with a history of hypersensitivity to g-csf * patients who have been included in any other clinical trial within the previous month * patient with recurrent attacks of hepatic encephalopathy. * evedince of portal vein thrombosis by ultrasound.

Keywords: hepatocellular carcinoma hepatitis c virus
erector spinae plane (esp) block with 20 ml versus 30 ml in cardiac surgery

Conditions: Cardiac Surgery; Postoperative Pain

Summary: even though erector spinae plane (esp) block is shown to be efficient in cardiac surgery, it is still controversial how much volume is necessary for efficient analgesic effect for sternotomy and drain tube pain relief. this study aims to investigate the optimal local anesthetic volume (20 ml versus 30 ml) with esp block for open-heart cardiac surgery.

in cardiac surgery, the most common cause of pain during the first two days postoperatively is median sternotomy. in a study in which 705 patients who had undergone cardiac surgery were followed up prospectively, postoperative 24 hours pain scores ranging from 5.3 to 6.5 out of 10 with deep breathing and coughing were shown. in these patients, it may increase the frequency of atelectasis due to reasons such as failure in pain control, weak coughing, and limitation of movement, and these may lead increase in morbidity and hospital stay. although nonsteroidal analgesics and opioids are used successfully in the control of this severe pain, they are far from being ideal analgesics alone due to their side effects such as kidney damage, bleeding risk, sedation, respiratory depression, itching, nausea, and vomiting. the complications of neuraxial techniques seem to be the disadvantages of these methods. erector spinae plane (esp) block is one of the regional anesthesia techniques that has been shown to be effective in reducing sternotomy pain in sternotomy-guided cardiac surgeries. the erector spinae plane (esp) block was first described by forero in 2016. in this block technique, a local anesthetic is given to the plane between the erector spinae muscle and the vertebral transverse process. the dorsal and ventral branches of the spinal nerves are blocked in this plane. however, due to individual regional anatomical differences, there is not enough data to determine the optimum volume at which the appropriate spread of local anesthetic will occur. volume-based cadaver studies have some handicaps since they do not have the characteristics of living tissue. this study aims to compare the postoperative analgesic efficacy of esp block applied at the same dose but with different local anesthetic volumes in cardiac surgeries to be performed with sternotomy.

Eligibility criteria:
inclusion criteria: * adult patients who will undergo coronary artery bypass grafting surgery with median sternotomy exclusion criteria: * emergency surgeries * patients with allergic reactions to anesthesia and analgesia drugs to be used * patients who do not want to participate in the study voluntarily * severe systemic disease (kidney, liver, pulmonary, endocrine) * substance abuse history * history of chronic pain * psychiatric problems and communication difficulties * patients who need revision due to hemostasis in the postoperative period * patients with severe hemodynamic instability due to infection, heavy bleeding, etc.

Keywords: erector spinae plane block local anesthetic volume bupivacaine sternotomy
therapy of atrial flutter by afib ablation

Conditions: Atrial Fibrillation; Atrial Flutter

Summary: ablation of the cavotricuspid isthmus (cti) in the right atrium is currently the therapy of choice for the treatment of typical atrial flutter (3,4). it is a curative approach and has a high success rate (5). it has been recognized that patients with typical atrial flutter often complain of atrial fibrillation (1,2). current clinical and experimental studies confirm the close relationship between atrial flutter (afl) and atrial fibrillation (af) and raise a question, if both arrhythmias are different forms of a common electrical phenomenon with atrial fibrillation being the underlying clinical problem (6).

current clinical and experimental studies confirm the close relationship between atrial flutter (aflut) and atrial fibrillation (afib). after initiation of afib this may organize under special intrinsic conditions or due to antiarrhythmic medication to aflut so afib may be supposed the underlying arrhythmia. therefore after successful ablation of aflut this reentrant circuit is not longer possible and afib persists. after new occurrence of afib a long diagnostic and therapeutic marathon begins with af ablation at the end of all therapeutic efforts. this double burden for the patient and the health system can probably be avoided by directly and effectively treating the underlying arrhythmia af.

Eligibility criteria:
inclusion criteria: * patients with- in 12-channel-ecg documented atrial tachycardia suggestive of typical isthmus dependent atrial flutter * \> 21 years exclusion criteria: * - afl as secondary to an accessory pathway * antiarrhythmic treatment for af * af * previous af ablation * dilatation of left atrium \> 6 cm * cardiac surgery less \< 3 weeks * congenital heart disease * cardiac ischemia or coronary artery disease that needs intervention * life expectancy less than 2 years

Keywords: pulmonary vein isolation isthmus ablation recurrence
the effects of prednisone on hiv levels and the immune system

Conditions: HIV Infections

Summary: the purpose of this study is to see if it is safe and effective to give prednisone to hiv-infected patients. prednisone is a corticosteroid, a hormone produced by the body that inhibits immune cell responses. prednisone may be able to lower the level of hiv in the body (viral load) by reducing the number of cells that hiv can infect. at the same time, prednisone may be able to increase cd4 cell counts (cells of the immune system that fight infection).

by inhibiting cellular activation, corticosteroids such as prednisone may inhibit hiv expression and reduce the population of potentially infectable cells. furthermore, no studies have been performed to systematically evaluate immune function in prednisone-treated, hiv-infected patients or the immune mechanisms that may facilitate increases in cd4+ cell number. this study explores this issue. patients are separated into 2 arms according to whether or not they are currently receiving a protease inhibitor (pi) as part of their antiretroviral (arv) therapy regimen (pi vs no pi therapy). arm i: current stable arv therapy plus prednisone for 8 weeks, followed by 4 weeks at half the prior dose, then a 2-week taper. arm ii: current stable arv therapy plus prednisone placebo for 12 weeks.

Eligibility criteria:
inclusion criteria you may be eligible for this study if you: * are hiv-positive. * have a cd4 cell count of 200-600 cells/mm3 within 30 days of study entry. (this study has been changed. you now must have a cd4 cell count of 200-700 cells/mm3 within 45 days of study entry.) * have had your viral load measured within 30 days of study entry. * have been on stable anti-hiv therapy with at least two anti-hiv agents for at least 12 weeks, and you intend to remain on this therapy during the study. * are at least 18 years of age. * agree to abstain from sex or use effective methods of birth control during the study and for 30 days after. exclusion criteria you will not be eligible for this study if you: * abuse alcohol or drugs or have a serious psychological condition. * are allergic to prednisone or other corticosteroids. * have a history of opportunistic (aids-related) infections, including cytomegalovirus (cmv), mycobacterium avium complex (mac), or kaposi's sarcoma (ks). * have a history of a serious medical condition, including heart problems, tuberculosis (tb), cancer, diabetes, or osteoporosis. * are being treated for herpes at study entry. * have received certain medications, including blood pressure medication. * are pregnant or breast-feeding.

Keywords: drug therapy, combination prednisone anti-hiv agents
accelerated radiation therapy (art) to the breast and nodal stations

Conditions: Breast Cancer

Summary: this protocol is for patients with newly diagnosed breast cancer with an indication for post-operative radiotherapy after neo-adjuvant chemotherapy and surgery.

protocol has two cohorts. cohort 1 will receive radiation to breast and chest wall. prone whole breast or chest wall 3d-crt or imrt at 2.7 gy x 15 fractions (40.50 gy) with a concomitant boost of 0.50 (7.5 gy) to the original tumor bed in post-segmental mastectomy patients or mastectomy scar in post-mastectomy patients. patients who have undergone reconstruction will not receive concomitant boost. cohort 2 patients will receive radiation to breast, chest wall and levelii/scv nodes. in addition to receiving radiation to the original tumor bed, patients will also receive radiation to level iii axillary nodes and supraclavicular nodes: 3d-crt or imrt at 2.7 gy x 15 fraction (40.50 gy). patients will complete treatment in three weeks (15 fractions). all patients will be followed at 3 months after the completion of treatment then yearly for the next 5 years.

Eligibility criteria:
the study will also include patients who because of covid had undergone up to 3 months neoadjuvant hormonal therapy before surgery for clinical t1/t2 bc. inclusion criteria: * age older than 18 * pre- or post-menopausal women with stage i-iii breast cancer * status post neoadjuvant systemic therapy * status post-chemotherapy breast surgery * original biopsy-proven invasive breast cancer, excised with negative margins of at least 1 mm (patients with focally positive margin are not excluded). * status post segmental mastectomy or mastectomy, with either negative sentinel node biopsy and/or axillary node dissection (at least 6 nodes removed). * patient needs to be able to understand and demonstrate willingness to sign a written informed consent document exclusion criteria: * previous radiation therapy to the ipsilateral breast and/or nodal area * active connective tissue disorders, such as lupus or scleroderma requiring flare therapy * pregnant or lactating women * concurrent chemotherapy, with the exception of anti her2neu therapies * inadequate axillary dissection in a setting of positive sentinel node * patients with more than 5 nodes involved at axillary dissection will be excluded from this study since they will be eligible to receive radiotherapy to level i and ii axilla.
determination of liver stiffness in chronic liver disease patients by acoustic radiation force imaging (arfi) ultrasound

Conditions: Chronic Liver Disease

Summary: a prospective, pilot study using acoustic radiation force imaging (arfi) ultrasound (us) to quantify liver stiffness in children and young adults with chronic liver disease. arfi results will be compared to the current clinical standard of magnetic resonance elastography (mre) and to liver biopsy when available.

arfi us is a novel technique, recently fda approved for use in children and adults, which provides an alternative method for quantifying liver stiffness. arfi us has been shown in a small pilot investigation in europe in children to be reliable and rapid in estimating moderate to severe liver stiffness using histology as a reference gold standard. arfi measures the speed of a shear wave in the examined tissue, expressed in m/s. this shear wave velocity can be mathematically converted into a liver stiffness value, which can then be used to estimate degree of liver fibrosis. the technique is non-invasive, uses no ionizing radiation, and is fast (several minutes to complete). it is possible that arfi us will be more accurate than mre in quantifying liver stiffness. in addition, arfi us will ultimately be a less expensive clinical test, shorter in duration, and will not require sedation/anesthesia in younger children as mre requires.

Eligibility criteria:
inclusion criteria: * less than 25 years old with chronic liver disease exclusion criteria: * subjects without clinically ordered mre * subjects who cannot cooperate with performance of the short arfi exam
universal exercise unit and rebound therapy on genu recurvatum cerebral palsy childeren

Conditions: Genu Recurvatum

Summary: to investigate and compare between effectiveness of universal exercise unit and rebound therapy on genu recurvatum, muscle strength, balance, functional mobility and quality of life in spastic cerebral palsy children

children will be equally assigned into three groups using simple randomization, control group, study group (a) and study group (b). each group will consist of 20 children with spastic cp to overcome any drop out may occur. control group: children in this group will receive a traditional physical therapy program. study group (a): children in this group will receive a traditional physical therapy program in addition to universal exercise unit program. study group (b): children in this group will receive the same traditional physical therapy program in addition to rebound therapy. evaluation will be carried out for each child individually before and after 3 months of treatment.

Eligibility criteria:
inclusion criteria: * -children with spastic cp both hemiplegic and diplegic. * their ages will be ranged from 5-7 years old. * they will have mild spasticity (grade 1 and 1+) according to modified ashworth scale . * they will be in level i and ii according to gross motor function classification system (gmfcs) . * they will be able to understand orders given to them. exclusion criteria: * subjects will be excluded if they have the following: 1. visual or hearing impairment. 2. severe limb deformities as structural genurecurvatum. 3. surgical interference in the lower limbs for the last 6 months. 4. botulinum toxin injection of the spastic lower limb muscles during the last six months.

Keywords: genu recurvatum, cerebral palsy, universal exercise unit, rebound therapy