Kornimate/medical-research-clean huggingface dataset:
potentiation of the effects of prismatic adaptation by transcranial direct current stimulation (tdcs) : evaluation of functional interest in negligence rehabilitation

Conditions: Neurologic Neglect Syndrome

Summary: following stroke, over 50% of patients keep severe neurological deficiency whose unilateral neglect, mostly following a right hemispheric lesion. the prismatic adaptation involves to pointing movements toward visual targets wearing prismatic glasses. these prismatic glasses induce a shift to the right visual field for improving symptoms in short term. transcranial direct stimulation (tdcs) has been evaluated for different types of deficiency resulting from stroke with encouraging results. the hypothesis of the study is to evaluate the usefulness of brain stimulation as an adjunctive intervention to optimize and increase the rehabilitation of unilateral neglect to long-term. thus, the main objective is to evaluate the effectiveness of standard treatment with prismatic adaptation with anodal tdcs or sham tdcs.


Eligibility criteria:
inclusion criteria: * right-handed * all subjects must be between the ages of 18-80 * patient with unilateral negligence consecutive to a right hemispheric stroke * hospitalized in the department of physical medicine and rehabilitation (day or week) or external monitoring * ischemic or hemorrhagic stroke with right hemispheric topography - evidenced by a radiological report * diagnosis of negligence evidenced by behavioural inattention test (bit) : score ≤ 129 * stroke \>1 month prior to study enrollment exclusion criteria: * degenerative neurological complaint * uncontrolled epilepsy * temporo-spatial disorientation * language disorders or psychiatric disorders preventing understanding instructions * history of prior stroke, multiple stroke * medical condition not stabilized * pregnancy * implanted material (pacemaker, defibrillator, cochlear implant, surgical clips, metal object) * intra-cranial material * unweaned alcoholism

Keywords: neurologic neglect syndrome post stroke transcranial direct current stimulation (tdcs) prismatic adaptation
rabies immune plasma booster study

Conditions: Rabies

Summary: rabies immune globulin is a product that is lifesaving to unvaccinated individuals exposed to the rabies virus. rabies immune globulin is made from plasma from immune donors. currently the only practical method to obtain this plasma is to immunize normal volunteer source plasma donors and collect their plasma while titers are adequate. the use of rabies vaccine for immunization of normal source plasma donors is currently limited to a level that, while protective for the individual, is unsuitable for production of rabies immune globulin. the objective of this study is to obtain efficacy and safety data regarding the rabies boostering program to demonstrate that: 1. rabies immune plasma production can be substantially increased by giving booster doses to previously immunized donors whose titers are below 10.0 iu/ml. 2. it is safe for normal source plasma donors to receive booster doses of rabies vaccine on a regular basis. this study utilizes two rabies vaccines approved by the fda, imovax® (sanofi-pasteur) and rabavert® (novartis).


Eligibility criteria:
inclusion criteria: * meet requirements for source plasma donors * completed initial series of rabies antibody injections with no serious adverse events for at least 90 days prior to enrollment * compliance with program requirements * signed informed consent exclusion criteria: * failure to meet requirements to be source plasma donor * non-compliance with the program * experience a serious adverse reaction

Keywords: rabies immune globulin source plasma donors booster immunization
glucocorticoids for post-operative patients with acute type a aortic dissection (the glad trial)

Conditions: Methylprednisolone; Glucocorticoid; Aortic Dissection; Organ Dysfunction

Summary: this study is designed to evaluate the effects of glucocorticoid(gc) on improving post-operative organ dysfunction in patients with acute type a aortic dissection(ataad). subjects with confirmed diagnosis of ataad undergoing surgical treatment will be enrolled and 1:1 randomly assigned to receive either glucocorticoids or normal treatment. all patients in the glucocorticoids group will be given methylprednisolone intravenously for 3 days after enrollment. the primary endpoint will be the amplitude of variation of sequential organ failure assessment score on post-operative day 4 compared to baseline.


Eligibility criteria:
inclusion criteria: * informed consent * age above 18 years old (including 18 years old), regardless of gender; * confirmed type a aortic dissection with computer tomography and received surgical intervention * life expectancy \> 3 days after surgery exclusion criteria: * history of cardiac surgery within the past 3 months or possible iatrogenic aortic dissection * bacterial or fungal infection in the past 30 days * glucocorticoid or any other anti-inflammatory drug usage in the past 14 days * allergic to glucocorticoid * pregnant * implantation of icd or permanent pacemaker * patients diagnosed with malignant tumor undergoing chemotherapy and immunotherapy. * patients with pre-operative severe liver dysfunction (ctp grade c) * patients with pre-operative renal insufficiency (patients receiving renal replacement therapy before surgery)
food reward in native american women

Conditions: Obesity

Summary: this study aims to characterize the neurobiology of obesity in american indians (ai) using functional mris to examine the correlation between brain response to food stimuli in ai women. a functional mri (fmri) is used to visualize brain activity when obese and lean ai women look at images of fattening food, non-fattening food and non-food objects. additionally examined is the effect of the drug naltrexone to suppress brain response to visual food cues and calorie intake in the women.

the study looks at both obese and lean women. each woman comes in for two visits. each woman takes both the naltrexone or placebo (one during each visit). research staff and participants are blinded. drugs are not used as treatment, but rather to provide information for possible future treatments. hypotheses are: 1. compared with their lean counterparts, obese women will demonstrate more fmri activation in the brain in response to visual food cues. 2. naltrexone will reduce the activation in reward-relevant brain sites in response to viewing photographs of fattening food as compared in placebo in both groups. 3. naltrexone will suppress spontaneous intake of food in obese and lean ai women.

Eligibility criteria:
inclusion criteria: * female * self-identified ai * bmi over 30 or between 20 and 24.9 * must see clearly with or without glasses * capable of giving informed consent exclusion criteria: * smokes more than one cigarette a day * drinks more than two alcoholic drinks a day * uses recreational drugs * is pregnant * has had weight loss surgery * other major medical problems (e.g. diabetes) * taking medications that alter appetite or body weight * significant food allergies
assessment of updated educational materials for instanyl®

Conditions: Pain; Cancer Pain

Summary: the purpose of the instanyl study is to learn how much doctors know and understand about instanyl® before and after they receive updated educational information, including the risks of its unapproved use. in this study, the doctors will complete two surveys: one three months before they receive the updated educational information, and one about six months after they receive this information. they will answer questions about their prescribing behavior plus their knowledge of instanyl® including any risks.

this is a non-interventional, observational, cross-sectional study of prescribers of instanyl®. this study will assess the prescribers' awareness of the updated ems and changes in prescribers' knowledge and understanding of the key information contained in the updated ems. the study will enroll approximately 259 prescribers. the first survey (pre-em survey) will be conducted three months before the distribution of updated ems, second survey (post-em survey) will be conducted six months following the distribution of updated ems. the data will be collected, through a self-administered web-based questionnaire. all participants will be enrolled in a single observational group: • prescriber of instanyl® this multi-center study will be conducted in france, the netherlands, and poland. the overall duration of the study will be approximately 22 months.

Eligibility criteria:
inclusion criteria: 1. specialists of any of those medical specialties targeted for the ems as agreed with each national competent authority. the foreseen specialties include the following (subject to changes after the em distribution plan is completed and agreed with national competent authorities): * oncologists and oncoradiologists * anaesthesiologists * pain management prescribers * palliative care prescribers * internal medicine prescribers * general practitioner (gps) * other specialties may be locally included such as hematology. current and potential prescribers may vary between country; thus, some countries may have modified lists of target specialties. 2. physicians who have prescribed instanyl® in the past 12 months (pre-em survey) or since the updated ems (post-em survey) and who intend to prescribe instanyl® in the following months after each survey. exclusion criteria: 1. physicians who may have a conflict of interest (that is, prescribers employed by regulatory bodies, pharmaceutical industries). 2. inactive or retired prescribers. 3. physicians who did not prescribe instanyl® in the past 12 months (pre-em survey) or since the updated ems are distributed (post-em survey) and do not foresee treating a participants with instanyl® in the following 12 months, regardless of whether they have prescribed instanyl® before.

Keywords: drug therapy
study to evaluate the efficacy and safety of erenumab (amg 334) in migraine prevention

Conditions: Migraine

Summary: the primary objective of the study was to evaluate the effect of erenumab compared to placebo on the change from baseline in monthly migraine days.

this was a multicenter, randomized, double-blind, placebo-controlled, parallel-group trial. the trial consisted of four phases: screening (≤ 3 weeks of initial screening and a 4-week baseline phase); the double-blind treatment phase (24 weeks) in which participants received placebo or erenumab 70 mg or 140 mg daily; the active-treatment phase, in which participants underwent repeat randomization and were assigned to receive 70 mg or 140 mg of erenumab (28 weeks); and a safety follow-up phase (12 weeks).

Eligibility criteria:
inclusion criteria: * history of migraine (with or without aura) for ≥ 12 months prior to screening according to the international headache society (ihs) international classification of headache disorders (ichd-3) classification * migraine frequency: ≥ 4 and \< 15 migraine days per month on average across the 3 months prior to screening and during baseline * headache frequency: \< 15 headache days per month on average across the 3 months prior to screening and baseline * demonstrated at least 80% compliance with the ediary. exclusion criteria: * older than 50 years of age at migraine onset * history of cluster headache or hemiplegic migraine headache * unable to differentiate migraine from other headache * no therapeutic response with \> 2 medication categories for prophylactic treatment of migraine after an adequate therapeutic trial * used a prohibited medication, device, or procedure within 2 months prior to the start of the baseline phase or during the baseline phase * concomitant use of 2 or more medications with possible migraine prophylactic effects within 2 months prior to the start of the baseline phase or during the baseline phase. if only 1 prophylactic medication is used, the dose must be stable within 2 months prior to the start of the baseline phase and throughout the study

Keywords: migraine headache prevention prophylaxis
unraveling the blood microbiome in postoperative recurrence of crohn's disease

Conditions: Crohn&#39;s Disease (CD)

Summary: crohn's disease, a chronic inflammation of the gastro-intestinal tract, is a disease with a complex pathogenetic background. hereditary factors, environmental factors and the gut flora play a varying role in its onset, however, this role remains unclear to date. we hypothesize to detect tiny fragments of microbial dna from the gut in the bloodstream, due to disruption in the natural defences of the gut lining. if this is true, it may hold the key to understanding why crohn's disease recurs after surgery. our objective in this study is to test retrospectively, if we can detect any difference in microbial dna from the blood of ileocolonic resection (icr) patients that do and do not show recurrence at the time of follow-up endoscopy at 6 months.


Eligibility criteria:
inclusion criteria: * diagnosis of crohn's disease * adult ≥ 16 years * undergoing an ileocolonic resection or reresection * written informed consent exclusion criteria: * use of antibiotics in the past 8 weeks at the timepoints when blood is withdrawn and feces is collected. * use of probiotics in the past 8 weeks at the timepoints when blood is withdrawn and feces is collected. * not willing to collect extra biosamples

Keywords: ileocolonic resection blood microbiome postoperative recurrence
vedolizumab, anti-cd25 antibody, rapid reduction of glucocorticoids for sr-agvhd with gastrointestinal involvement

Conditions: Safety and Efficacy

Summary: acute graft-versus-host disease (agvhd) is the most common life-threatening complication of allogeneic hematopoietic stem cell transplantation. the investigators try to observe the efficacy and safety of application of vedolizumab, anti-cd25 monoclonal antibody and rapid reduction of glucocorticoids in the treatment of grade 3-4 steroid-refractory agvhd(sr-agvhd) with lower gastrointestinal involvement.

sample size: according to simon optimal two-stage design, p0=60%, p1=80%, α=0.05, β=0.2, a sample size of 45 was chosen. objects: adults ages 18-65 diagnosed with grade 3-4 sr-agvhd with lower gastrointestinal involvement. design participants with grade 3-4 sr-agvhd with lower gastrointestinal involvement(progression after 3 days or lack of improvement after 5 days of 1-2 mg/kg/d systemic steroids) receive combined therapy of vedolizumab and anti-cd25 monoclonal antibody, with methylprednisolone terminated in 7-10 days. vedolizumab is given 300mg, day 1/15/43, and then once every 8 weeks until gastrointestinal gvhd reaches grade 1 (1 episodes for minimum). basiliximab is given 20mg twice a week for week 1, and then once a week until gvhd of the participants reaches grade 2(3 episodes for minimum). if basiliximab is not available, it can be replaced by recombinant humanized anti-cd25 monoclonal antibody injection, 50mg once with the same frequency. methylprednisolone is reduced to 1mg/kg/d at day 1 and is aborted in 7-10 days. if chronic gvhd or overlap syndrome is considered later during treatment, steroids (ie. methylprednisolone 0.5mg/kg/d) can be administered again. intravenous cyclosporine or tacrolimus is given and plasma concentration is monitored in a safe and effective range. best supportive treatment is given, including broad-spectrum anti-infection, nutrition support, and blood transfusion. the investigators access the efficacy and safety of second-line therapy once a week from day 14 until complete remission is received. then the investigators access the hematological disease status, agvhd, cgvhd, infection state once a month.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of grade 3-4(according to magic criteria) steroid-resistant acute graft-versus-host disease(progression after 3 days or lack of improvement after 5 days of systemic 1.5-2 mg/kg steroids) with gastrointestinal involvement. * age 18-65. * ecog score≤3. * must be able to understand and willing to participate in the study and sign the informed consent. exclusion criteria: * refractory/secondary graft-versus-host disease. * severe complications such as myocardial infarction, chronic cardiac insufficiency, * hepatic failure, renal insufficiency, etc. * clinically uncontrolled active infections. * other malignant tumors with progression. * heart failure: ef\<30%, nyha≥grade iii. * pregnant or lactating women. * expected survival \<60 days. * undergoing other drug clinical trials.
clinical diagnostic approach for cases of thyroid nodules

Conditions: Thyroid Nodule

Summary: thyroid nodules are a common presentation in the clinic, with an increasing incidence, especially in women. their clinical significance is mainly related to excluding malignancy (4.0 to 6.5% of all thyroid nodules).

thyroid nodule is a discrete lesion in the thyroid gland that is radiologically distinct from the surrounding thyroid parenchyma. thyroid nodules are a common presentation in the clinic, with an increasing incidence, especially in women. the detection rate among healthy individuals is as high as 50%-60%, but the reported incidence of malignant nodules in all thyroid nodules has ranged from only 1.6%-12%. they are discovered either clinically on self-palpation by a patient, or during a physical examination by the clinician or incidentally during a radiologic procedure such as ultrasonography (us) imaging, computed tomography (ct) or magnetic resonance imaging (mri) of the neck; with the increased use of sensitive imaging techniques, thyroid nodules are being diagnosed incidentally with increasing frequency in the recent years. though thyroid nodules are common, their clinical significance is mainly related to excluding malignancy (4.0 to 6.5% of all thyroid nodules), evaluating their functional status and if they cause pressure symptoms. thyroid nodules can be caused by many disorders: benign (colloid nodule, hashimoto's thyroiditis, simple or hemorrhagic cyst, follicular adenoma and subacute thyroiditis) and malignant (papillary cancer, follicular cancer, hurthle cell cancer, anaplastic cancer, medullary cancer, thyroid lymphoma and metastases). initial assessment of a patient found to have a thyroid nodule either clinically or incidentally should include a detailed and relevant history plus physical examination. laboratory tests should begin with measurement of serum thyroid-stimulating hormone (tsh). thyroid scintigraphy/radionuclide thyroid scan should be performed in patients presenting with a low serum tsh. thyroid ultrasound should be performed in all those suspected or known to have a nodule to confirm the presence of a nodule, evaluate for additional nodules and cervical lymph nodes and assess for suspicious sonographic features. the next step in the evaluation of a thyroid nodule is a fine needle aspiration (fna) biopsy, which is the gold standard diagnostic test.

Eligibility criteria:
inclusion criteria: * all patient presented by thyroid nodules either discovered clinically or incidentally. exclusion criteria: * no

Keywords: thyroid nodules t.s.h thyroid us fnac
multiparametric whole-body mri: a game changer in metastatic prostate cancer

Conditions: Prostate Cancer (Adenocarcinoma)

Summary: wb-mri is a next-generation imaging technique standardized with the first version of met-rads-p guidelines.this narrative review aims to analyse the main scientific evidence available in the literature, explaining what wb mri is and showing its decisive role in metastatic pc.

prostate cancer ranks among the most prevalent tumours globally. while early detection reduces the likelihood of metastasis, managing advanced cases poses challenges in diagnosis and treatment. current international guidelines support the concurrent use of 99tc-bone scintigraphy and contrast-enhanced chest and abdomen ct for the staging of metastatic disease and response assessment. however, emerging evidence underscores the superiority of next-generation imaging techniques including psma-pet/ct and whole-body mri (wb-mri). this review explores the relevant scientific literature on the role of wb-mri in metastatic prostate cancer. this multiparametric imaging technique, combining the high anatomical resolution of standard mri sequences with functional sequences such as diffusion-weighted imaging (dwi) and bone marrow relative fat fraction (rff%) has proved effective in comprehensive patient assessment, evaluating local disease, most of the nodal involvement, bone metastases and their complications, and detecting the increasing visceral metastases in prostate cancer. it does have the advantage of avoiding the injection of contrast medium/radionuclide administration, spares the patient the exposure to ionizing radiation, and lacks the confounder of flare described with nuclear medicine techniques. up-to-date literature regarding the diagnostic capabilities of wb-mri, though still limited compared to psma-pet/ct, strongly supports its widespread incorporation into standard clinical practice, alongside the latest nuclear medicine techniques.

Eligibility criteria:
inclusion criteria: literature extracted through the pubmed search engine, following prisma checklist, using the keywords: * "whole body mri" * "diffusion weighted imaging" * "pet-ct and wb-mri" * "metastatic prostate cancer" * "biochemical recurrence in metastatic prostate cancer" * "dwibs" * "multiparametric mri" * "response assessment in metastatic prostate cancer" * "dixon method", * "bone biopsy in metastatic prostate cancer", * "bone metastases in prostate cancer", * "met-rads". * analysis from 1995 to april 2024. exclusion criteria: * duplicates * repetitive, * irrelevant, * unrelated, * out-of-date guidelines, * case reports
linkage to care - part i

Conditions: HIV

Summary: this first phase of a two-phase study involves three components: 1. review of existing linkage-to-care protocols and sources of referrals for care; 2. semi-structured telephone or face-to-face interviews with a minimum of two personnel per site who are associated with linkage to medical care. (preference will be given to personnel with direct experience in linkage to care); and 3. structured observations of referral sessions.


Eligibility criteria:
inclusion criteria: * component 1: documents identified by clinical site personnel as pertaining to post-test counseling, linkage to care, or standard operating procedures addressing post-test counseling and linkage to care. * component 2: persons employed by one of the amtus or an identified linkage-to-care partner and work as clinical staff or a case-manager or is a person familiar to linkage to care; or persons involved in posttest counseling and linkage-to-care processes. clinical staff and case managers are chosen based on direct experience in the assistance of hiv seropositive youth obtaining medical care. this definition includes, but is not limited to, physicians, nurses, psychologists, social workers, and case managers (who may have diverse professional backgrounds). * component 3: all amtu sites will be included. exclusion criteria: * component 1: no a priori exclusions. * component 2: no a priori exclusions. * component 3: no a priori exclusions.

Keywords: care engagement linkage to care hiv infections