Kornimate/medical-research-clean huggingface dataset:
neurorealign therapy for balance and gait rehabilitation in stroke survivors

Conditions: Stroke

Summary: the goal of this randomized controlled trial is to investigate the effects of neurorealign therapy on balance and gait in stroke survivors in the chronic stage (\>6 months). the study will include male and female participants aged 18-70 years. the main questions it aims to answer are: does neurorealign therapy improve balance in stroke survivors compared to conventional physiotherapy? does neurorealign therapy enhance gait performance more effectively than conventional physiotherapy? researchers will compare neurorealign therapy to conventional physiotherapy to determine its effects on balance and gait. participants will: undergo neurorealign therapy or conventional physiotherapy for 4 weeks. have their balance assessed using the berg balance scale (bbs), activities-specific balance confidence scale (abc scale), and fear of falling questionnaire (fofq). have their gait evaluated using the dynamic gait index (dgi), rivermead mobility index (rmi), timed up and go (tug), 6-minute walk test (6mwt), and 10-meter walk test (10mwt). complete outcome assessments at baseline and after the intervention (week 4).


Eligibility criteria:
inclusion criteria: * patients with ischemic or hemorrhagic stroke * have a stroke more than 6 months * age between 18 and 70 exclusion criteria: * patients with severe cognitive impairments * patients cannot walk independently
incidence of postoperative delirium after cardiac surgery in adults.

Conditions: Postoperative Delirium; Adult Cardiac Surgery; Covid19

Summary: postoperative delirium is an acute syndrome of mental deterioration characterized by acute onset and fluctuating course during the day. very frequent delirium is a presage of other serious comorbidities i.e.: sepsis, acute kidney injury, circulatory and/or respiratory failure. a detailed knowledge of symptoms and early diagnose of delirium increase the chances of early therapy. to what extent the occurrence of postoperative delirium influences hospital therapy in the cardiac surgical postoperative icu in university clinical centre in gdańsk is unknown so far.

study type: prospective, observational cohort study. facility: tertiary, university hospital methods: patients will undergo routine, continuous observation for symptoms of delirium by a trained nursing staff. occurrence of delirium, delirium observation screening scale (doss) grading, and therapy will by annotated on case record forms (crfs) every 12 hours. additionally, collected will be known risk factors of delirium: schedule type, age, arterial hypertension, atrial fibrillation, body mass index (bmi), angiotensin converting enzyme (ace) inhibitors / angiotensin receptor blockers (arbs) therapy, hearing loss, dementia, peripheral artery disease, myocardial infarction, depression, diabetes, corona virus disease 2019 (covid19) infection and/or vaccination; and outcome data: hospital-los, prolonged sedation, antipsychotic therapy, surgical reintervention, hours on mechanical ventilation (hov), number of tracheal intubations, length of consciousness disorders, blood product transfusions, cardiopulmonary resuscitation (cpr), renal replacement therapy (rrt), mechanical circulatory support (mcs), duration of catecholamine support, icu readmissions, new antibiotic therapies, 30-day mortality. statistical methods: delirium morbidity and risk will be calculated from two-by-two table. associations between delirium and secondary outcome measures will be evaluated by simple and logistic regression with use of anova test for continuous variables with homogeneous distribution, or kruskal-wallis test for continuous variables with non-homogeneous distribution, or categorical variables. significant will be considered results with p\<0.05. a period of one year was assumed sufficient to draw conclusions on the primary endpoints of the study.

Eligibility criteria:
inclusion criteria: * adult patients (\>18 y.a.), undergoing cardiac surgery, who will sign an informed consent to participate in the study. exclusion criteria: * deny to sign or absence of an informed consent.

Keywords: postoperative delirium cardiac surgery covid19
protein for premies

Conditions: Extreme Prematurity

Summary: although expressed breast milk is considered the optimal nutritional source for preterm infants, the macronutrient content is insufficient to enable optimal growth during neonatal intensive care. optimal dose and optimal mode of administration (standardized or individualized) of enteral protein supplementation to very preterm infants have not been established. this study aims to compare the effects on weight gain of different modes of enteral protein supplementation.


Eligibility criteria:
inclusion criteria: * very preterm infants \<32 weeks gestation and \<1500g birth weight * \> 100ml/kg/d of enteral feeding exclusion criteria: * missing informed consent * decision not to feed breast milk * congenital malformations * age \> 7 days at study entry
safety and preliminary efficacy of meldonium in patients with metastatic renal cell carcinoma and treatment-associated fatigue

Conditions: Renal Cell Cancer Metastatic; Kidney Cancer; Fatigue Related to Cancer Treatment

Summary: fatigue is a prevalent adverse event associated with systemic therapy using tyrosine kinase inhibitors (tkis). meldonium, a fatty acid oxidation inhibitor, modifies the carnitine pathway, a nutrient critical for fat metabolism. the world anti-doping agency (wada) classified meldonium as a banned substance due to its documented use by athletes aiming to enhance physical performance. in this study, the safety and preliminary efficacy of meldonium in treatment-related fatigue will be assessed.

fatigue is a frequent symptom of cancer and the most common adverse event of treatment with tyrosine kinase inhibitors. for example, in phase 2 randomized study 59% of patients with metastatic renal cell carcinoma experienced any grade fatigue during treatment with the combination of lenvatinib and everolimus. fourteen percent of patients had grade 3 fatigue or asthenia. fatigue was also most frequently reported treatment-related adverse event in patients with unresectable hepatocellular carcinoma (30%), and advanced thyroid cancer (60%) treated with lenvatinib. additionally, fatigue is one of the most common adverse events associated with the administration of checkpoint inhibitors. frequency of fatigue was 55% in patients with endometrial cancer treated with combination of pembrolizumab and lenvatinib. meldonium is a fatty acid oxidation inhibitor, and it is now principally used for heart conditions, such as angina, heart attack, heart failure, and others. the compound works by altering pathways for carnitine, a nutrient involved in fat metabolism. meldonium received the greatest fame in sport. the world anti-doping agency (wada) added meldonium to their list of banned substances in 2016 because of evidence of its use by athletes with the intention of enhancing performance. center for preventive doping research and european monitoring center for emerging doping agents showed that mildronate demonstrates an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of the central nervous system functions. based on these data, meldonium can be a possible option in cancer patients with fatigue treated with targeted or imminotargeted therapy. moreover, the compound could decrease the number of vascular adverse events of tkis.

Eligibility criteria:
inclusion criteria: * metastatic renal cell carcinoma * measurable disease based on recist 1.1 criteria * systemic therapy with targeted or immunotargeted therapy * any grade of fatigue associated with targeted or immunotargeted therapy * ecog ps \&lt;2 * signed informed consent exclusion criteria: * any treatment for fatigue * uncompensated hypothyroidism * anemia * pregnant or nursing * local and/or systemic infections requiring antibiotics or covid-19 within 28 days prior to study entry * other malignancy * brain metastases
post-market clinical follow-up of wovex (wovex® polyester vascular prostheses) bifurcated prostheses from lemaitre vascular society in the treatment of aneurysms or occlusive diseases of the abdominal aorta.

Conditions: Aneurysms or Occlusive Disease of the Abdominal Aorta

Summary: the wovex bifurcated dacron vascular prostheses have been available on the french market since 2008. they are mainly used to treat aneurysmal or occlusive aortic diseases. to date, they have not been the subject of a specific clinical efficacy/safety study, unlike other dacron prostheses used in the same field. we purpose a monocentric, retrospective, consecutive study based on medical data, including all the patients operated for aneurysms or occlusive disease of the abdominal aorta at dijon bourgogne university hospital between 2013 and 2017 and who received a wovex bifurcated prosthesis (wovex® polyester vascular protheses). the objective is to explore the safety (short-term postoperative morbidity and mortality at 5 years) and efficacy (primary permeability, secondary permeability and dilatation of the prosthesis at 5 years) of the wovex prosthesis.


Eligibility criteria:
inclusion criteria: * subject is volontarily agree to participation * patients operated for aneurysms or occlusive disease of the abdominal aorta at dijon bourgogne university hospital between january, 1st 2013 and december 31, 2017 who received a wovex bifurcated prosthesis (wovex® polyester vascular protheses) from lemaitre vascular society exclusion criteria: - deceased patients who have expressed their refusal of post-mortem processing of their personal health data
persistence of rabies antibody 1-5 years after the post-exposure prophylaxis with vero cell antirabies vaccine and antibody response to a single booster dose

Conditions: Rabies

Summary: this study is to investigate the persistence of rabies chinese manufactured antibody 1-5 years after the post-exposure prophylaxis with vero cell antirabies vaccine and antibody response to a single booster dose. a total of 160 subjects would be enrolled. these subjects were all administered chengda antirabies vaccine from 2005 to 2009. after informed consent is obtained, these subjects would be tested for their antirabies antibody titer and given a single booster dose. seven and 14 days later, the investigators would re-evaluate the antibody titer.


Eligibility criteria:
inclusion criteria: * 20 to 60 years old * healthy * given chengda rabies vaccine * good compliance * obtained informed consent exclusion criteria: * other than inclusion criteria

Keywords: rabies anti-rabies antibody persistence
incidence of residual neuromuscular blockade in fraility in oncogynae surgery

Conditions: Frailty; Neuromuscular Blockade; General Anesthetic Drug Adverse Reaction; Gynecologic Cancer; Surgical Complication

Summary: frailty among patients undergoing surgery is strongly associated with an elevated risk of adverse perioperative outcomes, heightened incidence of postoperative complications, increased mortality rates, and prolonged hospital length of stay. our focus centers on investigating the frailty index in the context of complications experienced by patients undergoing oncologic gynecology surgery. the principal objective of this research is to elucidate the extent to which residual neuromuscular blocking agents are linked to frailty.

among patients undergoing oncologic gynecological procedures, such as those for vulvar cancer, endometrial cancer, and ovarian cancer, the incidence of frailty has been observed to range from 14% to 45%. frailty directly influences the metabolism of anesthetic agents and intraoperative management. furthermore, the prevalence of residual neuromuscular blocking agents following surgery can be as high as 26% to 53%. no prior research has investigated the correlation between residual muscle relaxants and frailty in gynecologic oncology patients. this study is designed to assess the prevalence of residual muscle relaxants in these patients with frailty. additionally, data on the incidence of frailty and its impact on postoperative outcomes and prognosis in patients undergoing gynecologic oncology surgery will be collected and reported.

Eligibility criteria:
inclusion criteria: * age \>,= 18 years * patients undergoing elective gynecologic-oncology surgery exclusion criteria: * unable to communicate thai * unable to understand the questionnaire * preexisting neuromuscular disease * preexisting disease involved wrist that may affect the nerve stimulator examination

Keywords: neuromuscular blocking agents frailty gynecologic oncology surgery anesthetic complications
study to determine quicker methods of diagnosing pneumonia caused by a breathing machine in critically ill patients

Conditions: Ventilator Acquired Pneumonia

Summary: critically ill patients on a breathing machine are at risk of developing a type of pneumonia called ventilator acquired pneumonia (vap). the purpose of this study is to determine if regular lung rinses sent for microbiological testing can reduce the time to diagnose vap. the study also plans to test the accuracy and speed of a new technology, using multiplexed automated digital microscopy, to identify the germs causing the vap.

ventilator-associated pneumonia (vap) is a common, life-threatening hospital-acquired infectious complication of prolonged mechanical ventilation (mv). despite aggressive efforts to prevent vap, rates remain high because clinical diagnosis is imprecise and microbiological diagnosis is frequently delayed. diagnosis of vap depends on clinical signs as well as microbiologic evidence from bronchioalveolar lavage (bal) cultures. ordinarily, these cultures are only ordered after the patient presents with clinical signs and symptoms of vap, which can significantly delay diagnosis and effective therapy. this research proposes to implement additional surveillance bal cultures in order to reduce the time to diagnosis of vap in mechanically ventilated critically ill adults. to further reduce the time to diagnosis of vap, this research aims to test part of the bal cultures using a novel flowcell/surface-capture device that allows direct from specimen visualization of bacteria using multiplexed automated digital microscopy (baccel™) for rapid bacterial identification and antibiotic resistance testing. additionally, molecular assays of the bal sample will characterize lower respiratory tract antimicrobial peptide host-innate immune molecule and local anti-oxidant defenses in mechanically ventilated adults at risk for vap.

Eligibility criteria:
inclusion criteria: 1. written, informed consent (by surrogate if unconscious or if altered mental status) 2. ≥ 18 years old 3. admission to a medical intensive care unit 4. orally/nasally intubated, evaluable within 72 h of initial intubation 5. expected to remain mechanically ventilated for at least 48 h after the first study procedure exclusion criteria: 1. previously documented cystic fibrosis 2. diffuse bronchiectasis 3. severe or massive hemoptysis 4. presence of an advanced directive to withhold life-sustaining treatment 5. morbid state or expected to survive less than 14 days because of an advanced co-morbid medical condition 6. participation in a clinical trial of any unlicensed drug or device within 30 days 7. pregnant or nursing
evaluation of onfi conversion therapy replacing clonazepam in patients with medically refractory epilepsy

Conditions: Refractory Epilepsy

Summary: the purpose of the study is to examine the clinical safety, tolerability, and efficacy of clobazam (onfi) when it replaces the pre-existing clonazepam therapy in patients with refractory epilepsy.

the study is designed to answer frequently asked questions when clinicians replace existing 1,4-benzodiazepine to onfi, as follows: 1. what should be the optimal equivalent doses for conversion? 2. how quickly should it be converted? 3. would there be significant improvement of seizure control? 4. should we expect difference in tolerability? if so, what are common adverse events? 5. would the tolerance to the therapeutic effect differ with onfi after conversion?

Eligibility criteria:
inclusion criteria: * subject has a confirmed diagnosis of medically refractory epilepsy with or without secondary generalization for at least 12 months prior to the initial study visit. * currently taking stable dosing regimen of clonazepam (0.5-4mg daily) for seizure control. * takes at least one additional anti-epileptic drug besides benzodiazepine. * age 18-70 years, inclusive. * in opinion of investigator, can be safely treated with onfi. * minimum of 2 seizures, but no more than 24 complex partial or generalized seizures, during the 8-week baseline period prior to study entry. * able to communicate effectively with study personnel and considered reliable, able, willing, and cooperative with regard to complying with protocol-defined requirements, including completion of study diary. exclusion criteria: * clinically relevant current illness or history of that may interfere with the subject's ability to complete the study as determined by the investigator. * history of status epilepticus within 6 months prior to the initial study visit. * history of suicidal attempts or suicidal ideation within 12 months of initial visit.

Keywords: epilepsy onfi clonazepam
evaluation and predictive value of genetic polymorphisms in the management of hormonal treatment of prostate cancer

Conditions: Prostate Cancer

Summary: androgen deprivation therapy (adt) by surgical castration or administration of lhrh agonists or antagonists is the gold-standard systemic treatment of prostate cancer. the efficacy, severity and frequency of side effects of adt vary from a patient to another. the exact cause of this variability is not known, however certain genetic polymorphisms affecting enzymes implicated in the synthesis and metabolism of sex-steroids seem to be involved in these processes. to perform a longitudinal study to evaluate the prevalence of various genetic polymorphisms affecting genes in the sex-steroid synthesis and metabolism pathway (cyp1a1, cyp1b1, cyp19a1, 17hsd, hsd3b1, ar, esr1, esrrg, il6, tnf-alpha) in men with prostate cancer receiving adt and the possible association between polymorphisms and frequency and severity of side-effects of adt.

prostate cancer patients for which reimbursed adt with a gonadoliberin antagonist is indicated, for a period of at least 6 months will lbe enrolled. at 0, 3 months and 6 months of adt, aging males' symptoms (ams), eq-5d (euroqol), and hot flashes intensity and frequency (moyad scale) will be collected, as well as routine assessments: vital signs (blood pressure, heart rate), weight, waist perimeter, fat percentage, body mass index (bmi) and routine laboratory assessments. determine genotypes of polymorphisms of interest by pyrosequencing. determine the prevalence of the polymorphisms of interest in the studied population. perform initial assessment of the association between genetic polymorphisms and questionnaire results.

Eligibility criteria:
inclusion criteria: * prostate cancer patients for which reimbursed adt with a gonadoliberin antagonist is indicated, for a period of at least 6 months. exclusion criteria: * prostate cancer patients who are already receiving adt with a gonadoliberin antagonist.
detection of clinically significant prostate cancer using a urinary multimarker sensor

Conditions: Prostate Cancer

Summary: this trial aims to develop and validate the urinary multimarker sensor which can measure trace amounts of biomarkers from naturally voided urine in men referred with clinical suspicion of prostate cancer who have had no prior prostate biopsy. the investigators hypothesize that urinary multimarker sensor will help to avoid unnecessary prostate biopsy while detect the clinically significant cancers.

the investigators will develop a urinary multimarker sensor, able to measure trace amounts of biomarkers from naturally voided urine. 1. urine specimen collection. this study was approved by the institutional review board of the asan medical center (seoul, republic of korea) and informed consent will be obtained from all subjects. biomarkers diffused passively from prostate tissue to the urethra and will be collected from naturally voided urine. urine will be collected in a sterilized specimen cup containing 10 vol% rna stabilizer and 1vol% antibiotics and stored in a refrigerator for less than a week before shipping the sample to the laboratory 2. to measure the electrical signals from the four different biomarkers in the urine, the four sensing channels in the extended gate of an field-effect transistor biosensor will be conjugated to antibodies, thus capturing different biomarkers. 3. without any pretreatment, urine will be added directly to the four different sensing channels. after 20 min of reaction time in the four channels, the bottom gate voltage shifts will be measured at the reference current (1 na). each urine sample will generate four independent sensing signals from the corresponding biomarkers. the set of sensing signals collected for each patient will be then analyzed.

Eligibility criteria:
inclusion criteria: 1. men undergoing a first-time prostate biopsy to rule out cancer 2. serum psa ≥3ng/ml, ≤20ng/ml 3. age≥50 years, ≤80 years 4. clinical stage ≤t2c 5. patients must be able to provide written informed consent. exclusion criteria: 1. patients has any prior needle biopsy of the prostate 2. patients has a prior history of prostate cancer 3. patients has a prior history of pelvic radiation therapy or androgen deprivation therapy 4. patients has a prior history of bph operation 5. patient with uncorrectable coagulopathies 6. unable to tolerate a trus guided biopsy. 7. patients had 5-alpha reductase inhibitor in the past six months. 8. the patient has had a urinary tract infection or acute prostatitis in the last three months.

Keywords: prostate cancer biopsy urine biomarker nanoparticle
influence of frailty on cardiovascular events and mortality in patients with copd.

Conditions: Role of Frailty in COPD

Summary: observational study on the influence of frailty on cardiovascular risk in copd.

the study will investigate the influence that frailty can have on cardiovascular risk in patients with copd. the project will assess the association between frailty and all-cause mortality, and the relationship between frailty and cardiovascular mortality, by comparing copd patients living with frailty vs non-frail copd patients. the study participants will be outpatients with diagnosis of copd according to the global initiative for chronic obstructive pulmonary disease (gold) guidelines (www.goldcopd.org). frailty will be measured using the clinical frailty scale (grades 1-9). patients who are terminally ill (cfs = 9) will be excluded. cognitive function will be explored using the montreal cognitive assessment (moca) test. the follow up will be at 12 and 24 months.

Eligibility criteria:
inclusion criteria: * patients with age ≥18 years, with diagnosis of copd of at least 1 year, in stable condition, without acute exacerbation in the last 30 days and/or all-cause hospitalisation in the last 3 months * smoking history of ≥ 10 pack/years * diagnosis of copd according to gold guidelines (www.goldcopd.org) * individuals able to provide their written informed consent. exclusion criteria: * concurrent diagnosis of interstitial lung disease * presence of restrictive pattern on spirometry * no history of smoking habit * individuals not able to provide their written informed consent.