Kornimate/medical-research-clean huggingface dataset:
transcranial direct current stimulation to enhance training effectiveness in chronic post-stroke aphasia

Conditions: Aphasia; Post-stroke

Summary: the aim of the study is to investigate whether intensive speech-language therapy (slt) combined with anodal transcranial direct current stimulation (tdcs) leads to better communication performance than slt combined with placebo stimulation (using sham-tdcs).

intensive speech-language therapy (slt) can promote recovery from chronic post-stroke aphasia, but effect sizes are moderate. this highlights the pressing need to explore adjunct strategies, such as transcranial direct current stimulation (tdcs), to enhance training effectiveness. recently, the investigators provided evidence from a single-center randomized controlled trial (rct) suggesting that anodal-tdcs of the left primary motor cortex (m1) improves naming and communication ability in chronic post-stroke aphasia, with medium-to-large effect sizes. however, prior to integration into clinical routine, a multi-center rct with adequate power, duration, and outcomes relevant to everyday life is required, which is the goal of the present study. after trial completion, a workshop with relevant stakeholders will ensure transfer into best-practice guidelines.

Eligibility criteria:
inclusion criteria: * left-hemisphere cortical or subcortical stroke with first-ever aphasic symptoms * at least 6 months post-onset of stroke; * aphasia, as determined by the aachen aphasia test (aat); * 13 moderate-to-severe word finding difficulties (maximum of 75% correct items on a computerized naming task at baseline); * at least 1 correct reaction on the first part of the aat subscale token test (ensuring basic comprehension skills); * at least 1 point on the communicative task of the aat subscale spontaneous speech (ensuring basic communication abilities); * german as first language; * intact left-hemisphere "hand knob" without right prefrontal lesions for placement of tdcs electrodes, as confirmed by magnetic resonance imaging or computer tomography scans. exclusion criteria: * contraindications for tdcs (e.g., cardiac pacemaker, history of seizures, implanted metal inside the head); * more than one clinically apparent stroke with aphasic symptoms; * other severe neurological diseases (e.g., brain tumor, and subdural hematoma); * epilepsy with seizures during the last 12 months prior to study start and/or intake of sedating antiepileptic drugs (barbiturates and benzodiazepines), * history of severe alcohol or drug abuse; * current severe depression; * current psychosis or other relevant psychiatric condition; * very severe apraxia of speech, as revealed by hierarchical word lists; * severe non-verbal cognitive deficits, as indicated by the corsi block-tapping task; * severe uncontrolled medical problems; * severely impaired vision or hearing that prevents patients from engaging in intensive slt; * changes in centrally active drugs within 2 weeks prior to study inclusion.

Keywords: rehabilitation intensive speech-language therapy transcranial direct current stimulation
erector spinae plane block in spine surgeries

Conditions: Lumbar Disc Disease

Summary: aim of this study was to assess the efficacy of erector spinae plane block (esb) for postoperative pain management in lumbar spine surgery.


Eligibility criteria:
inclusion criteria: * patients american society of anesthesiologists physical status (asa) i and ii. * both sexes. * age between 20 to 60 years old. * scheduled for lumbar spine surgeries. exclusion criteria: * patients who received long acting opioids preoperatively. * patients with bleeding disorders and coagulopathy. * infection at the injection site. * allergy to local anesthetics. * patients with significant cognitive dysfunction. * patients with diabetic neuropathy. * patients with uncontrolled hypertension or diabetes. * patients with advanced cardiac, respiratory, hepatic or renal disease. * patients with viral hepatitis or hiv.

Keywords: erector spinae block lumbar disc surgery
safety of intradermal versus intramuscular administration of hiv lipopeptides in hiv uninfected adult volunteers

Conditions: HIV Infections; HIV Seronegativity

Summary: intramuscular (im) administration of hiv lipopeptide vaccines have been shown to be able to induce hiv-1-specific t cell-mediated immune responses. the objective of this trial was to evaluate the safety and immunogenicity of lipo-4 vaccine (hiv lipopeptides including 4 peptides from gag, pol, rt and nef hiv-1 proteins, each peptide linked to tt) intradermally (id) compared to im administration.

dose-sparing strategies that use intradermal (id) delivery of vaccines may be one approach for improving a vaccines immunogenicity and reducing the cost of vaccines. in this study, 68 hiv-negative healthy adult volunteers, 21-55 years old, all belonging to the "volunteers for a vaccine" network set up by anrs, were randomized to receive at weeks 0, 4, and 12, either 3 im doses of 0.5 ml of lipo-4 containing 500 µg of each peptide (n= 35 volunteers), or 3 id doses of 0.1 ml, containing 100 µg of each peptide (n=33 volunteers). total follow-up was 48 weeks. safety was assessed clinically and by laboratory tests. participants were given diary cards to record adverse events. hiv-1 immune responses were assessed by elispot and lymphoproliferative assay at weeks 0, 2, 6, 14, 24, and 48

Eligibility criteria:
inclusion criteria: * hiv uninfected * acceptable methods of contraception for females of reproductive potential * good general health * signed written inform consent exclusion criteria: * risk to be infected by hiv virus * uveitis, chronic lyme disease, active syphilis, active mycobacterial diseases or sarcoidosis * autoimmune disease or immunodeficiency * medical history of food allergy, lyell's or steven johnson's disease, unstable asthma * active, generalized eczema or chronic urticaria * blood products within 2 months prior to first study vaccine administration * hiv vaccines in prior hiv vaccine trial or participation in an immunomodulator study * vaccines within 30 days prior to first study vaccine administration * pregnant * long-term immunosuppressive or immunomodulator medications or within 6 months to first study vaccine administration * blood transfusion within 6 months to first study vaccine administration * treated with extracted pituitary hormones

Keywords: hiv vaccines hiv seronegativity
the clinical outcomes of the percutaneous cholecystostomy, supportive care versus cholecystectomy.

Conditions: Acute Calculous Cholecystitis; Acute Acalculous Cholecystitis

Summary: percutaneous cholecystostomy (pc) is an effective treatment for cholecystitis in surgical high risk patients. however, there has been no definite agreement of the additional cholecystectomy in these patients. the investigators surveyed the clinical outcomes of the pc in surgical high risk patients. and the investigators tried to prove the pc can be appropriate and ultimate treatment for acute cholecystitis patients with critical illness through this study.

between 2007 and 2012, all patients admitted for acute cholecystitis, and then underwent ultrasonography guided percutaneous cholecystostomy in cheju halla general hospital were consecutively enrolled. among 82 patients, 35 were performed laparoscopic cholecystectomy after recovery (cholecystectomy group) and 47 treated by best supportive care without additional surgery (bsc group). the investigators analyzed their surgical risks and clinical outcomes of both patients retrospectively.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of acute cholecystitis * underwent the ultrasound-guided percutaneous cholecystostomy exclusion criteria: * transferred patients from other institute after cholecystostomy procedure.

Keywords: acute cholecystitis elderly critically ill patients surgical high risk percutaneous cholecystostomy cholecystectomy
evaluation of pet and laparoscopy in staging advanced gastric cancer

Conditions: Gastric Cancer; Staging; FDG-PET/CT; Diagnostic Laparoscopy

Summary: objective: to evaluate the impact and cost-effectiveness of fdg-pet/ct (pet) and diagnostic laparoscopy (dls) in addition to initial staging by ct and gastroscopy in patients with advanced gastric cancer. hypothesis: the study hypothesizes that performing dls and pet for advanced gastric adenocarcinomas results in a reduction in the number of futile gastrectomies performed and a favorable cost-effectiveness. according to the literature, in 27% of patients a futile gastrectomy can be prevented, and the annual cost-reduction is an estimated €916.438. study design: the study design is a prospective observational study. study population: the study population consists of patients with a surgically resectable, advanced gastric adenocarcinoma (ct3-4a,n0-3,m0), that are scheduled for treatment with curative intent after initial staging with gastroscopy and ct. usual care / comparison: both pet and dls were recently included in the new dutch guidelines for the treatment of gastric cancer, as staging modalities for advanced (t3-4) tumors after initial staging. the costs of the study population will be compared to retrospective data of patients who underwent curative surgery (gastrectomy) after initial staging with ct alone. outcome measures: the primary outcome of this study will be the proportion of patients in whom the pet or dls lead to a change in treatment strategy. the accuracy of each modality will be analyzed separately. secondary outcome parameters will be diagnostic performance, morbidity and mortality, quality of life, cost-reduction and cost-effectiveness. sample size: based on the expectation that 22% of patients will have a change in treatment strategy, at least 239 patients will be needed for this study to demonstrate that the diagnostic modalities in the new guideline are break-even. approximately 543 patients will be eligible for the study in 36 months. cost-effectiveness analysis: a state-of-the-art cost-effectiveness analysis and budget impact analysis will be performed on the additive value of pet and dls by both prospective and retrospective data collection


Eligibility criteria:
inclusion criteria: * histologically proven adenocarcinoma of the stomach or esophagogastric junction (siewert ii and iii), by gastroscopy. * underwent evaluation with computed tomography (ct) of the abdomen and chest. * surgically resectable, advanced tumor (ct3-4a,n0-3,m0), as determined by a multidisciplinary team meeting. an advanced tumor is defined as a transmural tumor with an irregular outer margin, objectified on ct. * intention to perform a curative gastrectomy exclusion criteria: * siewert type i esophagogastric junction tumor * unfit or unwilling to undergo surgery
prospective cohort study of children diagnosed with type 1 diabetes in türkiye between 2018 to 2022

Conditions: Type 1 Diabetes Mellitus (T1DM)

Summary: achieving glycemic targets with improved t1dm management reduces diabetes complications and the risk of progression. thus, it is essential to identify the challenges in t1dm management within the country and develop strategies for improvement. in türkiye, there is limited multicenter data regarding the clinical characteristics of children and adolescents with t1dm during the diagnosis and treatment process. this multicenter prospective cohort study aimed to determine the diagnostic and follow-up characteristics of children and adolescents with t1dm, assess the status of diabetes management in the country.


Eligibility criteria:
inclusion criteria: * type 1 diabetes mellitus can develop in individuals between the ages of 2 months and 18 years. exclusion criteria: * other types of diabetes mellitus

Keywords: type 1 diabetes mellitus children adolescent
assessment of coeliac disease in patients with type 2 diabetes

Conditions: Celiac Disease

Summary: this study aims to screen and diagnose coeliac disease in patients with type 2 diabetes and monitor the effect of gluten-free diet on the metabolic status

coeliac disease (cd) is a chronic disease with long-term consequences if untreated . cd has been traditionally associated with autoimmune disorders as type 1 diabetes . however, recent data suggest association with insulin resistance, metabolic syndrome and type 2 diabetes . in a recent study comparing prevalence of autoimmune markers in type 1 diabetes versus type 2, coeliac disease serologic markers were 5% versus 8.7% respectively . in a study published at nature communication, a genetic link between ig a levels, type 2 diabetes, and coeliac disease was found . gluten, among other factors, is thought to play a proinflammatory role exaggerating the damage to β-cells in both type 1 and type 2 diabetes . presentation of coeliac disease is very variable, ranging from asymptomatic, gastrointestinal symptoms, atypical symptoms, to malabsorption syndrome. our interest of the very wide atypical presentations is poorly controlled type 2 diabetes . moreover, it has been recently suggested that gluten-free diet improves glucose metabolism . screening and diagnosing coeliac disease remain a highly controversial topic, especially in individuals with atypical or no symptoms. a lifelong gluten avoidance can be only justified by a solid diagnosis, achieved by histopathological diagnosis. intestinal biopsy is invasive test with not that-accurate results. the new guidelines confirmed the accuracy of the no-biopsy approach, only in case of high-titre positive two antibody tests, as published by the european society pediatric gastroenterology, hepatology and nutrition (espghn) . however, guidelines intended for adults still insist on biopsy for confirming final diagnosis . the only exception is the interim guidance during corona virus -19 ( covid-19 ) allowing non-biopsy diagnosis with two separate serology tests . however, recent retrospective study confirmed that high titre ttg had more than 95% diagnostic rate, and duodenal biopsy was not needed . for screening, many approaches have been studied, with measuring total immunoglobulin a (iga) and iga tissue transglutaminase (ttg) is the obvious first choice. however, for resource-deficient economies, rapid easy cheap point-of-care tests for deamidated gliadin antibodies (dgp) have been suggested .

Eligibility criteria:
inclusion criteria: 1. adult patients ≥18 years old 2. diagnosed with type 2 diabetes mellitus exclusion criteria: 1. patients already diagnosed with co-morbid autoimmune disorder 2. patient diagnosed as systemic lupus 3. diagnosed as rheumatoid arthritis 4. already diagnosed with coeliac disease
ipad application to treat prosodic deficits in students with communication disorders

Conditions: Autism; Communication Disorders

Summary: the purpose of this study is to evaluate the utility of a specialized ipad application designed to treat difficulties with intonation (e.g., melody in voice) in children with autism spectrum disorders (asd) and other communication disorders.


Eligibility criteria:
inclusion criteria: * slps, in connecticut public schools, who provide intervention to students with autism spectrum disorders and related disorders * students, ages 4-18, who attend school in connecticut and demonstrate prosodic difficulties secondary to a diagnosis of asd, apraxia of speech, or other communication disorder exclusion criteria: * students with concomitant genetic disorders

Keywords: autism autism spectrum disorders prosody speech treatment
physiotherapy for non-specific neck pain in working age persons

Conditions: Neck Pain; Non-specific Neck Pain

Summary: the goal of this clinical trial is to learn about the effects of two different physiotherapy methods on non-specific neck pain in working age individuals. the main questions it aims to answer are: * what is the effect of self stretching exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals? * what is the effect of post-isometric relaxation exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals? * is any of the applied interventions (self-stretching or post-isometric relaxation exercise) superior to each other? participants will: * be evaluated by an experienced physiotherapist who will perform the interview and physical examination. interview includes questions about the age, sex, work profile, pain intensity and duration, and other complaints. physiotherapy examination includes a range of motion measurement, hand grip muscle strength and functional disability index evaluation. * two different interventions will be prescribed to the randomly assigned study participants: post-isometric relaxation and self-stretching. duration of interventions for both groups is 4 weeks (3 times per week, 12 sessions). duration of one session - 45 min.

the goal of this clinical trial is to learn about the effects of two different physiotherapy methods on non-specific neck pain in working age individuals. the main questions it aims to answer are: what is the effect of self stretching exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals? what is the effect of post-isometric relaxation exercise on non-specific neck pain, functional disability, range of motion of the cervical spine and hand muscle strength in working age individuals? is any of the applied interventions (self-stretching or post-isometric relaxation exercise) superior to each other? participants will: be evaluated by an experienced physiotherapist who will perform the interview and physical examination. interview includes questions about the age, sex, work profile, pain intensity and duration, and other complaints. physiotherapy examination includes a range of motion measurement, hand grip muscle strength and functional disability index evaluation. two different interventions will be prescribed to the randomly assigned study participants: post-isometric relaxation and self-stretching. duration of interventions for both groups is 4 weeks (3 times per week, 12 sessions). duration of one session - 45 min.

Eligibility criteria:
inclusion criteria: * current neck pain, * neck pain duration for at least 12 weeks, * admission through outpatient clinic in lithuania. exclusion criteria: * neurological disorders related to neck pain, * red flags (night pain, severe muscle spasm, loss of involuntary weight, symptom mismatch), * previous neck surgery, * low back pain, * medications used for pain.
comparison of bladder pressure versus regional intestinal tissue oxygenation in infants

Conditions: Intraabdominal Hypertension; Abdominal Compartment Syndrome

Summary: the goal of this clinical trial is to learn more about intestinal regional oxygen saturation measurements made with near-infrared spectroscopy and bladder pressure measurements in infants without risk of intraabdominal hypertension. the main question it aims to answer is if - in comparison to bladder pressure - the regional intestinal oxygen saturation measured with near-infrared spectroscopy is stable in the muscle-relaxed, intubated patients and the awake and non-sedated patient. in case of participation the bladder pressure and the regional intestinal oxygen saturation (measured with near-infrared spectroscopy) will each be measured once intraoperatively and once postoperatively. patients included in this study will be undergoing an operation which necessitates muscle-relaxation, as well as an indwelling urinary catheter during the operation and for a short-time thereafter for other reasons than this study.


Eligibility criteria:
inclusion criteria: * prepped and consented for laparoscopic pyeloplasty or minimal psarp with perineal or vestibular fistula or lateral thoracotomy for the correction of esophageal atresia * age of 12 months old or less at operation * legal custodian gives consent exclusion criteria: * anterior abdominal wall thickness greater than 12 mm measured on preoperative mri imaging if available * patients planned for additional intestinal surgeries or non-standard pyeloplasty, e.g. pyeloplasty with nephrostoma * patients planned for laparoscopic pyeloplasty whose intraoperative urine sample shows pathological results * patients with esophageal atresia who experience pulmonary decompensation and need urgent surgery for fistula clipping

Keywords: near infra-red spectroscopy bladder pressure intraabdominal pressure
systemic thrombolysis versus catheter directed management for acute intermediate-high pulmonary embolism

Conditions: Acute Pulmonary Embolism

Summary: to compare in hospital clinical outcomes and one month follow up of systemic thrombolysis versus catheter directed management for the treatment of acute intermediate- high risk pulmonary embolism (using streptokinase or tissue plasminogen activator (tpa) and catheter-based intervention group using penumbra system).


Eligibility criteria:
inclusion criteria: patients diagnosed with acute intermediate-high pulmonary embolism exclusion criteria: * patients less than 18 years of age. * low risk, intermediate low risk, acute pulmonary embolism * patients with rv masses will be excluded. * patient refusal of treatment strategy.

Keywords: intermediate-high acute pulmonary embolism systemic thrombolysis catheter- directed management
a trial of chinese traditional medicine combining with intradermal acupuncture for treating precocious puberty

Conditions: Precocious Puberty; Treatment; Alternative Medicine; Acupuncture

Summary: a randomized controlled study will be conducted to evaluate the therapeutic effect of traditional chinese medicine and acupoints stimulation on children with idiopathic precocious puberty.

traditional chinese medicine is effective for precocious puberty which is mild or moderate, but not effective for the one that is severe and rapidly progressing. acupuncture can effectively regulate sex hormone levels and ovarian function, promote ovulation, and have therapeutic effect for polycystic ovary syndrome and irregular menstruation. studies have shown that acupuncture and auricular point compression stimulation is effective for premature thelarche, yet there are few studies on idiopathic precocious puberty. clinical evidence is still needed to support whether acupuncture point stimulation combined with traditional chinese medicine herbs can enhance the effect and prevent the progression into severe or rapidly progressing precocious puberty, hence the study is to be carried out.

Eligibility criteria:
inclusion criteria: * girls are diagnosed as idiopathic precocious puberty, and their age of onset ≤7.5years; * tanner stages of breast in female patients ≤ tanner iii stage, diameters of mammillary nucleus ≤ 3cm; •b-type ultrasonography: the volume of uterus≥ 3ml, the volume of ovary≥1.5ml, the diameter of follicle≥4mm; * bone age: compared the chronological age, the bone age is less than 1 year and the bone age \<10 years old; * no gnrh analogs or sex hormones were administrated in the past; and all above are needed at the same time. exclusion criteria: * precocity caused by the central nervous system organic diseases; * precocious precocity caused by congenital hypothyroidism, congenital adrenal hyperplasia, adrenal tumor and ovarian or testicular neoplasms as well as mccune-albright syndrome, etc; * precocious precocity with a family history of diseases such as tumor, leukemia, diabetes, systemic lupus erythematous; * pseudo sexual precocity and partial precocious puberty.