Kornimate/medical-research-clean huggingface dataset:
oscillatory acoustic-electric stimulation in patients with disorders of consciousness

Conditions: Consciousness Disorder

Summary: altered gamma activity has been observed in several neurological and psychiatric disorders, including a reduction in gamma synchronization in patients with disorders of consciousness. modulation of gamma oscillations with rhythmic stimulation has been used as a possible therapeutic tool. hence, we try to use acoustic and electric stimulation at gamma frequency to restore brain oscillation and thereby to improve conscious awareness in patients with disorders of consciousness.

we propose a matched-pair parallel study in patients with disorders of consciousness to investigate whether combined acoustic and trigeminal nerve stimulation can modulate brain oscillations, as measured by electroencephalography (eeg), and whether the brain activity changes are coupled with improvements in consciousness.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of disorders of consciousness based on crs-r * time post-injury ranging from one to twelve months * no history of acquired brain injury or psychiatric or neurological diseases exclusion criteria: * not medically stable * any contraindication to electric stimulation * hearing impairment before brain injury

Keywords: disorders of consciousness electric stimulation
does duloxetine reduce sub-acute pain after knee arthroplasty?

Conditions: Total Knee Arthroplasty

Summary: we are investigating the impact of duloxetine ("cymbalta"), a serotonin and norepinephrine reuptake inhibitor, on pain after total knee arthroplasty (tka). specifically, the investigators will determine whether duloxetine, 60 mg daily for 2 weeks, reduces pain scores 2 weeks after tka.


Eligibility criteria:
inclusion criteria: * patients with osteoarthritis scheduled for primary tricompartmental total knee arthroplasty with a participating surgeon * age 25 to 75 years * planned use of regional anesthesia * ability to follow study protocol * english speaking (primary outcome obtained via telephone call and secondary outcomes include questionnaires validated in english only) * patients planning on being discharged home or to a rehabilitation center that has agreed to participate exclusion criteria: * concurrent use of duloxetine or other snris, maois, tricyclic antidepressants, triptans (sumatriptan, rizatriptan, naratriptan, zolmitriptan, eletriptan, almotriptan, frovatriptan), lithium, buspirone, st. john's wort * hepatic insufficiency * renal insufficiency * patients younger than 25 years old and older than 75 * patients intending to receive general anesthesia * allergy or intolerance to one of the study medications * patients with an asa of iv * chronic gabapentin/pregabalin use (regular use for longer than 3 months) * chronic opioid use (taking opioids for longer than 3 months) * patients with major prior ipsilateral open knee surgery
evaluation of an intervention for improving community-based pediatric attention-deficit hyperactivity disorder (adhd) care

Conditions: ADHD

Summary: adhd is the most prevalent mental health disorder of childhood. the majority of children with adhd receive their care in primary care settings. while the american academy of pediatrics (aap) issued evidence-based guidelines and recommendations for pediatricians, most pediatricians have difficulty adhering to these guidelines. given observed deficiencies in evidence-based adhd care and the likely effects on child outcomes, the development and testing of interventions aimed at improving adhd care in primary care settings is necessary. cincinnati children's hospital medical center has developed a model intervention, termed the adhd collaborative, to comprehensively address this issue. the adhd collaborative intervention model includes academic detailing, quality improvement methods, and innovative tools (e.g., web portal) designed to promote and support the systematic use of the aap guidelines. this intervention model has been used to train over 200 physicians at 55 practices in the greater cincinnati area. the intervention appears to produce 2- to 4-fold increases in the use of evidence-based adhd-related practice behaviors in participating physicians. to date, the intervention has been implemented as a quality improvement project with few experimental controls. the primary goal of the proposed study is to conduct an experimentally-controlled cluster randomized trial of the adhd collaborative intervention. thirty-two pediatric practices will be randomly assigned to receive the adhd collaborative intervention or to provide usual care. approximately 96 physicians and 576 of their adhd patients will be included in the study. chart reviews, parental interviews, and parent and teacher rating scales will be collected. between- and within-group hierarchical linear modeling analyses will examine whether the intervention produces significant improvements in pediatrician practice behaviors, patient satisfaction with adhd care, and child outcomes over and above typical adhd care. also, the relative cost effectiveness of the adhd collaborative intervention over typical care will be established by computing incremental cost-effectiveness ratios using cost and effect size estimates.


Eligibility criteria:
inclusion criteria: * practice must have a minimum of two pediatricians who agree to participate. * practice must have an electronic billing system. * practice must have internet access at office. * practice must not have an on-site mental health professional. * practice must have a member of practice staff willing to be trained in human subjects certification and willing to consent families. * children must be in grade 1-5. * children must be newly diagnosed with adhd. exclusion criteria: -
effect of edaravone on radiation-induced temporal lobe necrosis

Conditions: Nasopharyngeal Carcinoma; Brain Necrosis

Summary: it is hypothesized that excessive generation of free radicals involves in the pathogenesis of radiation-induced brain necrosis. this study therefore evaluated the effect of free radical scavenger, edaravone, on radiation-induced temporal lobe necrosis (tln) in patients with nasopharyngeal carcinoma (npc) after radiotherapy.

radiation-induced temporal lobe necrosis (tln) is the most serious sequelae of radiotherapy and impairs the patients' quality of life profoundly. steroid is one of the conventional treatment methods for tln. however, its response rate was still not so satisfactory (about 30%-35%).the mechanism of tln is under exploring and not completely understood. it has been proposed recently that chronic oxidative stress and inflammation involve in the pathogenesis of radiation-induced late normal tissue injury. edaravone(3-methyl-1-phenyl-2-pyrazolin-5-one), which is proved to be an excellent free radical scavenger, has been applied to a wide range of oxidative stress-related diseases.thus, it may exert a therapeutic effect on radiation-induced temporal lobe necrosis. to support this hypothesis, the investigators carried out a randomized study of combining edaravone with common fundamental management versus common fundamental therapy in patients with tln, and analyzed the late effects of normal tissues -subjective, objective, management, analytic (lent/soma) scale before and after treatment.

Eligibility criteria:
inclusion criteria: * ①patients must have received radiation therapy for histologically confirmed nasopharyngeal carcinoma. * prior irradiation \>/= 6 months prior to study entry. * radiographic evidence to support the diagnosis of radiation-induced temporal lobe necrosis without tumor recurrence(15). * age\>/= 18 years. * no evidence of very high intracranial pressure that suggests brain hernia and need surgery. * fertile women who are willing to take contraception during the trial. * routine laboratory studies with bilirubin \ /= 4,000 per cubic millimeter; white-cell count \>/=1500 per cubic millimeter, platelets \>/= 75,000 per cubic millimeter; hb \>/=9.0. prothrombin time(pt), activated partial thromboplastin time(aptt),international normalized ratio(inr) in a normal range. * ability to understand and willingness to sign a written informed consent document. exclusion criteria: * ①tumor recurrence or metastases. * diseases of central nervous system, such as cerebral vascular events, inflammatory, degenerative disease, and significant cardiovascular diseases. * severe systemic diseases. * history of anaphylactic response to edaravone.

Keywords: radiotherapy radiation-induced brain necrosis edaravone effectiveness safety
preoperative pregabalin vs gabapentin in elderly undergoing surgry,controlled trial

Conditions: Anxiety; Anxiety Disorder (Panic Disorder or GAD)

Summary: several studies have evaluated the efficacy of pregabalin in reducing preoperative anxiety, with inconsistent results. similarly, inconclusive results have been reported regarding gabapentin and its effects in reducing preoperative anxiety. a previous study reported that a single dose of gabapentin or pregabalin administered 60 minutes before surgery in adults under general anesthesia was effective in reducing acute preoperative anxiety and elevated levels of sedation before and after surgery, with pregabalin having better anxiolytic and sedative effects than gabapentin. however, no previous studies have compared the efficacy of preoperative pregabalin or gabapentin as premedication to reduce intraoperative anxiety and induce sedation in geriatric patients undergoing major surgery with regional anesthesia


Eligibility criteria:
inclusion criteria:this study will include : 1. geriatric patients, aged 65 years or older, 2. both sex, 3. scheduled for elective abdominopelvic surgery with regional anesthesia 4. american society of anesthesiologists (asa) physical status i or ii. exclusion criteria:we will exclude patients with any of the following: 1. history of allergy to gabapentin or pregabalin; 2. current use of gabapentin or pregabalin for other indications 3. history of chronic pain or chronic daily use of analgesics; a 4. history of epilepsy, other neurological disorders, cognitive impairment, or severe psychiatric disorders; 5. severe cardiovascular or respiratory diseases; 6. impaired renal function; and a history of drug or alcohol abuse. 7. patients with anticipated prolonged duration of surgery for more than two hours
effects of amino acid/electrolyte-based beverages on hydration status

Conditions: Dehydration

Summary: older adults typically do not drink later in the day to avoid the necessity of interrupting sleep to urinate. sometimes they also limit ingestion of fluids to avoid the need to urinate when engaged in certain activities such as traveling or attending an event. therefore, beverages that have greater fluid retention in the body leading to a more sustained positive hydration status could be advantageous in such situations. the composition of a beverage as well as other factors such as volume ingested and metabolism of components can affect the retention of the fluid in the body. age may be another factor. the beverage hydration index (bhi), first described in 2016, was used to indicate the hydration response to thirteen well-known beverages in young male adults. the current study assesses the bhi of four beverages and how that response is affected by age following the standardized protocol. the four beverages have been chosen for inclusion in this study because they have been used by older adults to prevent dehydration.

subjects sign an informed consent form and undergo a medical screening prior to participation. the screening includes a physical exam, anthropometry, chemical and lipid profiles, as well as measures of liver and renal function. the subjects are assigned to one of two groups based upon age. subjects participate in five experimental trials, one for each of the five beverages. the beverages are commercially-available and contain ingredients that are generally recognized as safe (gras). the order of the beverages is randomized. the list of ingredients on the bottle containing the beverage is obscured. the trials are identical and separated by at least five days. for each experiment, baseline measurements are conducted. then the subjects consume one liter of the test beverage over thirty minutes. additional measurements are performed thirty minutes post ingestion and then every hour for four hours post ingestion. this study yields two bhi numbers for each beverage, one number for each study-group. the bhi numbers are indicative of the amount of fluid remaining in the body four hours after consumption of the beverage. the bhi number is inversely related to the amount of urine produced over the four hours. a greater bhi number indicates better fluid retention and maintenance of plasma volume.

Eligibility criteria:
inclusion criteria: * 18-30 years or ≥60 years exclusion criteria: * cardiovascular, renal, or digestive diseases * pregnancy * breastfeeding * smoking and/or use of nicotine-containing products * illegal/recreational drug use * medications that alter fluid balance (e.g., diuretics) * allergy to latex * men with prostate issues that interfere with urination.

Keywords: hydration plasma volume amino acids glucose electrolytes fluid retention aging beverage hydration index dehydration oral rehydration
effect of recombinant human interferon α-2b spray on herpangina

Conditions: Herpangina

Summary: this is a multicenter, open，randomized controlled trial aiming to evaluate the effectiveness of recombinant human interferon α-2b spray compared with ribavirin treatment on pediatric patients with herpangina.


Eligibility criteria:
inclusion criteria: subjects should meet all of the following: 1. meet the diagnostic criteria for pediatric herpangina; 2. ages 1-7 years, no limitation for gender; 3. within 72 hours of onset; 4. the main organs (heart, liver, kidney and lung) function normally; 5. follow up according to requirements and be hospitalized for observation; 6. the guardian is fully informed and signed informed consent. exclusion criteria: subjects should be excluded if meet any of the following: 1. have allergy history of interferon; 2. heart failure, respiratory insufficiency,liver and kidney dysfunction or severe malnutrition and other serious disease, or immunodeficient; 3. children with epilepsy or other neurological disorders; 4. other pathogens exist at the same time; 5. the researchers believe that it is not appropriate to participate in this study.

Keywords: aged 1-7 years old, within 72 hours of onset patients with herpangina
use of penthrox in extra-hospital traumatology

Conditions: Pain, Acute; Trauma Injury; Pain Management

Summary: in pre-hospital settings, the administration of analgesics is often delayed because of difficult patient access (incarceration), difficulty finding a venous pathway or patient refusal. an optimization of the management of pain in urgency is therefore still necessary. a side from nitrousoxide of which usage remains restrictive, methoxyflurane (penthrox®) is the only volatile analgesic currently available for pre-hospital use. the purpose of this study is to answer the question: does the use of the inhaled route with penthrox add value to the treatment of acute traumatic pain in the pre-hospital stage?

in pre-hospital settings, the administration of analgesics is often delayed because of difficult patient access (incarceration), difficulty finding a venous pathway or patient refusal. an optimization of the management of pain in urgency is therefore still necessary. a side from nitrousoxide of which usage remains restrictive, methoxyflurane (penthrox®) is the only volatile analgesic currently available for pre-hospital use. methoxyflurane (penthrox®) is a single-use inhalation non-opioid analgesic for the management of moderate to severe traumatic pain. this treatment has been used in new zealand and canada for over 20 years for the management of acute pain in adults and children. it was granted marketing authorization in europe in 2016 and has been marketed in france since 2017. the purpose of this study is: * to study the efficacy and safety of penthrox, administrated at the beginning of the management of the traumatized adult patient. * assess the comfort of patients and caregivers * to answer the question: does the use of the inhaled route with penthrox add value to the treatment of acute traumatic pain in the pre-hospital stage?

Eligibility criteria:
inclusion criteria: * conscious patient * age ≥ 18 years * acute pain only of traumatic origin * pain \> 4 on a visual numerical scale (vns) * stable hemodynamic conditions (pa\> 90/60) non inclusion criteria: * pregnant or nursing woman * patient who has already received analgesics * patient benefiting from an intravenous approach for analgesia * known renal or hepatic disease * hypersensitivity to fluorinated anesthetics or history of malignant hyperthermia of the patient or family. * respiratory distress * patient who objected to the processing of his data exclusion criteria: * intravenous injection for analgesia

Keywords: methoxyflurane penthrox anesthetic analgesia acute traumatic pain prehospital setting visual numeric scale
comparison study between pet/ct and whole-body diffusion weighted mri in the detection of distant malignancies

Conditions: Distant Metastasis

Summary: the purpose of the study is to compare the efficacy of 18f-fdg pet/ct and dwi wb-mri in detection of distant metastasis of various cancers.

metastasis is the leading cause of morbidity and mortality in patients with cancer, accounting for \~90% of cancer-associated deaths. distant metastasis (dm) is a crucial point in the management of malignant tumors. dm is always associated with poor survival. conclusive diagnosis of dm is crucial for improving the prognosis, reduction of the recurrence rate and hence, elevation of the 5-year survival rate. positron emission tomography/computed tomography (pet/ct) allows the analysis of active tumor tissue in the whole body. so, it obtains improved sensitivity and specificity when compared to conventional imaging modalities. 18f-fdg pet/ct is a diagnostic imaging modality with good quantitative properties. it has proven its interest in diagnosing, staging, and evaluating tumor response. whole-body mri (wb-mri) has been proposed as another effective whole-body approach for assessing both local invasiveness and distant metastases in patients with newly diagnosed cancers providing several advantages. wb-mri primarily provides structural information (revealing a detailed image of the pathology or lesion) on tumor spread; however, the absence of functional datasets has been resolved by incorporating whole-body diffusion weighted imaging (wb-dwi) into medical practice. wb-dwi shortens examination interpretation times by directing the radiologist's attention to abnormalities, which may then be investigated on anatomic sequences. it enables early detection of skeletal metastases as well as spread to other sites (liver and brain). dw-mri measures the brownian motion of water molecules within intra- and extracellular spaces. this occurs in highly cellular lesions or in environments in which tissue architecture is disrupted and can be quantified by calculating the apparent diffusion coefficient (adc).

Eligibility criteria:
inclusion criteria: * only patients with malignancies proven by histology and patients with metastatic lesions proven by histopathology or cytology were included. exclusion criteria: * • as regard the pet/ct study, patients who have the general ct contraindications such as pregnancy, breast feeding, history of allergic reaction to the contrast medium, renal disease, etc. * as regard the mri study, general contraindications including claustrophobia, mr-incompatible pacemakers and mr-incompatible heart valves. * patients whose mri sequences were incomplete, low-quality and/or had no histopathological evidence of metastatic lesions were eliminated from the study. * low-quality or incomplete mri included mri exams with incomplete sequence(s), which is particularly common in elderly patients who are unable to tolerate the scan, or uncooperative patients who do not obey breathing instructions and motion artifacts that may impair images and lead to lower accuracy. * declined consent.

Keywords: pet-ct, wb-mri, cancer patients, distant metastasis
combination of docetaxel, cisplatin, and capecitabine (dcx) in the treatment of nasopharyngeal carcinoma

Conditions: Nasopharyngeal Neoplasms

Summary: the standard treatment strategy for locally advanced (stage iva) and metastatic (stage ivb) nasopharyngeal carcinoma has not been defined yet. generally induction chemotherapy is given to those patients in order to shrink the tumor volume and facilitate the following radiation therapy. thus, in this study, the investigators use the combination of docetaxel+cisplatin+xeloda (dcx) to treat locally advanced and metastatic nasopharyngeal carcinoma patients, in order to evaluate the efficacy and safety profiles.

the standard treatment strategy for locally advanced (stage iva) and metastatic (stage ivb) nasopharyngeal carcinoma has not been defined yet. generally induction chemotherapy is given to those patients in order to shrink the tumor volume and facilitate the following radiation therapy.however, the standard chemotherapy regimen has not been defined yet.combination of cisplatin and fluracil is the commonly used regimen with tolerable toxicity. recent studies have found that docetaxel has good efficacy on nasopharyngeal carcinoma patients, and capecitabine can be safely used instead of fluracil. thus, in this study, we use the combination of docetaxel+cisplatin+xeloda (dcx) to treat locally advanced and metastatic nasopharyngeal carcinoma patients, in order to evaluate the efficacy and safety profiles.

Eligibility criteria:
inclusion criteria: * stage iva and ivb nasopharyngeal carcinoma * at lease one measurable lesion * receive no chemotherapy or radiotherapy before * eastern cooperativeoncology group performance status of 0 to 2. * adequate hematologic function (eg, white blood cell ≥ 3×10e9/l,neutrophils count ≥1.5×10e9/l, and platelet count≥ 100×10e9/l),renal function (eg, serum creatinine≤1.5 mg/dl and creatinine clearance ≥50 ml minute), and hepatic function (e.g, total bilirubin≤ 2 times the upper limit of normal and aspartate and alanine transaminase levels ≤ 3 times the upper limit of normal) exclusion criteria: * mismatch the inclusion criteria * previous or concomitant malignancies and any coexisting medical problems that could cause poor compliance with the study protocol. * allergy to any of these three drugs

Keywords: nasopharyngeal carcinoma induction chemotherapy docetaxel xeloda