Kornimate/medical-research-clean huggingface dataset:
mental imagery for lower limb functions

Conditions: Stroke

Summary: stroke is a neurological impairment occurs due to cardiovascular abnormality and cerebrovascular disease. the term 'stroke' is mostly used when there is sudden loss of function of the body due any abrupt changes.the rates of disability are increasing along with mortality and morbidity rates due to stroke. the poor motor performance of lower limb affects gait severely. the slow velocity and other gait deviations limit the stroke survivors' ability to perform adl's and interfere with their quality of life. hence, rehabilitation is obligatory for these patients to improve their quality of life

motor imagery is helpful in improving mobility in healthy and neurologically impaired patients. when the patient is asked to do a movement, for example the patient is asked to walk along a draw line and then that patient has to imagine this same action in kinesthetic imagery. neuroimaging shows that brain areas are more or less activated in the same manner. it can be concluded that there is some relation between mental imagery ability and muscular actions. in the stroke patients who have intact ability of mental imagery show activation of cortical areas demonstrating its ability to activate sub cortical areas also. therefore, these results amplify the concept of using mental imagery for rehabilitation purpose of even deep lesion in motor nervous system.

Eligibility criteria:
inclusion criteria: * stroke patients (both genders) * age 40-60 years * patients with sub-acute/ chronic stroke (\>3 months) * modified ashworth ranking scale 1-3 * moca scoring \>24-30 exclusion criteria: * any active pathological condition * visual or hearing impairment * orthopedic issues hindering mobility substantially (fractures, severe degenerative * joint diseases etc.) * psychological issues
basal insulin strategies before surgery

Conditions: Type2 Diabetes Mellitus

Summary: many patients with type 2 diabetes mellitus (t2dm) are currently being managed with basal insulin (bi). however, there is little evidence to support guidelines on dosing adjustments in the preoperative period. the society for ambulatory anesthesia does not advise a reduction in the dose of bi preoperatively, unless there is a specific history of hypoglycemia. the endocrine society suggests a 50% reduction in bi dose the evening before surgery. the authors hypothesized that a 25% reduction in bi dose the evening before surgery will result in better perioperative blood glucose control compared with our institutional 50% decrease.

a total of 40 subjects diagnosed with t2dm taking once-daily evening bi, scheduled to undergo elective surgery under general anesthesia will be consented and randomized in a 1:1 ratio to received either 50% or 25% reduction of their regular evening bi dose on the evening before surgery. blood glucose levels (bgl) will be recorded perioperatively according to institutional guidelines.

Eligibility criteria:
inclusion criteria: * subjects who have volunteered and consented to participation in the study during their outpatient preoperative anesthesia appointment. * type ii diabetics taking once-daily evening basal insulin (glargine or detemir) * patients that will undergo general anesthesia * patients who have been on basal insulin for ≥ 3months exclusion criteria: * inability to read, comprehend, and sign informed consent * patients with type i diabetes * patients who take short-acting insulin boluses which make up greater than 20% of their total daily insulin dose * patients who have been on chronic steroids ≥ 5 mg/dl prednisone daily or equivalent for ≥ 1 month within the past 12 months * pregnant patients * patients on twice-daily dosing of basal insulin * patient who take basal insulin in the morning * patients with a history of severe hypoglycemia, defined as any event in the previous year requiring assistance of another person to actively administer carbohydrate, glucagons, or other resuscitative actions * patients that will undergo cardiac, transplant, or brain surgeries * prisoners
study of optimizing neoadjuvant regimens in subtypes of breast cancer

Conditions: Breast Cancer; Neoadjuvant Chemotherapy

Summary: there are no standard neodjuvant regimens adapted according to the different subtypes of breast cancer. this is a phase 2, randomized study to evaluate several regimens in different subtypes of breast cancer.

breast cancer is a heterogenous disease with at least 4 intrinsic subtypes including luminal a, luminal b, her2 enriched, basal-like and normal breast like. different subtypes have different prognosis and treatment sensitivity. thus, it would be more suitable to administer different chemo-regimen in different subtypes. this is especially true in neoadjuvant chemotherapy setting where no standard regimen has ever been established. therefore, we designed this phase 2 randomized clinical trial to explore potential effective regimens in variable subtypes of breast cancer in neoadjuvant treatment. patients were first classified into luminal type, her2 positive type and triple-negative type by immunohistochemistry exam of er/pr/her2 in core needle biopsy and then randomized to received either dose dense paclitaxel in luminal type or dose dense paclitaxel plus carboplatin with or without trastuzumab in her2 positive type or dose dense paclitaxel plus carboplatin in triple-negative type.the control groups in each subtype all receive paclitaxel plus epirubicin every 3 weeks. the duration of treatment is 4-6 cycles. primary endpoint is the pathological cr rate in each subtypes. secondary endpoints include disease free survival, objective response rate, safety. tissue samples and blood samples will be collected at baseline and during treatment. there will be exploratory biomarkers analyses to identify predictive markers for efficacy in every subtypes.

Eligibility criteria:
inclusion criteria: * stage iia-iiic breast cancer patients plan to receive neoadjuvant chemotherapy * patients have enough tissue sample to do ihc test for subtype classification * patients have at least one measurable lesion according to recist1.1 * kps≥80 * no prior treatment for breast cancer * adequate bone marrow (neutrophil count ≥1500 ml and platelet count ≥100,000 ml), renal (serum creatinine \<1.5 times the upper limit of normal \[uln\] or a creatinine clearance of ≥60 ml/minute), hepatic (total bilirubin ≤1.5 uln; alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase ≤2.5 uln), and cardiac function (assessed by electrocardiogram or thoracic radiography) were required. exclusion criteria: * fertile women were excluded if pregnant or lactating or if they were not using adequate contraception. * previous chemotherapy for breast cancer. * history of other serious illness (e.g. congestive heart failure, angina pectoris, uncontrolled hypertension or arrhythmia, clinically significant neurologic or psychiatric disorders, uncontrolled serious infection, aids), had an organ allograft, severe gastrointestinal disorder, or other neoplasias (except for in situ cervical cancer, non-melanoma skin cancer, or previous diagnosis of cancer with no evidence of disease for \>10 years).
veterans enhanced recovery using integrative treatments around surgery

Conditions: Anesthesia; Surgery; Knee Arthropathy

Summary: the study aims to assess the implementation and effectiveness of integrative treatments - music medicine, aromatherapy, and battlefield acupuncture - in the management of perioperative pain and anxiety, and in the reduction of related pharmacologic treatments.

there is an urgent need for effective, safe, and low-cost nonpharmacologic treatments for postoperative pain. this study aims to: 1. assess the implementation of music medicine, aromatherapy, and battlefield acupuncture among patients presenting for procedures at the durham veterans affairs medical center; and, 2. compare the effectiveness of these treatments, alone and in combination, versus standard clinical practice not involving any of these treatments. patients from the durham veterans affairs medical center (durham vamc) scheduled to undergo procedures will be eligible to participate in this study. a sample of 400 veterans will be studied. we will offer treatments versus no treatment on alternate months. recruitment will end when 200 patients have received at least one of these treatments, and 200 patients have received no treatment.

Eligibility criteria:
inclusion criteria: * veterans scheduled to undergo procedures at the durham va exclusion criteria: * hearing loss * procedures on the ear * risk of bleeding * anosmia

Keywords: perioperative care complementary integrative health (cih) battlefield acupuncture (bfa) music medicine aromatherapy veterans integrative treatments
feasibility study of a dose increase by a boost of curietherapy in pulse dose rate (pdr) associated with the extern radiotherapy in prostate cancer

Conditions: Prostate Cancer With Intermediate Risk

Summary: the objective of the trial is to evaluating the feasibility of dose increase by a boost of curietherapy in pdr (at least 40 gy on d95) associated to extern radiotherapy (34 gy) in intermediate risk in prostate cancer.


Eligibility criteria:
inclusion criteria: * age ≥ 50 years and ≤ 75 years * life expectancy \>10 years * localized prostatic adenocarcinoma and histologically proven * intermediate risk cancer(t2b or psa between 10 and 20 or gleason = 7(3+4) according to amico criteria * metastasis or pelvic pathologic ganglion (≥ 10 mm) absence * oms \< 2 * no previous treatment by radiotherapy and/or curietherapy * hormonotherapy authorized before and during the study * rectal or uretero-vesical pathology * signed informed consent * social security system affiliation * individual deprived of liberty or placed under the authority of a tutor. * no anesthesia contraindication exclusion criteria: * adenocarcinoma not histologically proven * metastases presence * pathological nodes presence(≥ 10 mm) * prior prostate endoscopic resection * history of other malignancy except for appropriately treated superficial basal cell skin cancer * medical contraindications to anesthesia * patients with uncontrolled psychiatric disease or medical disease incompatible with the protocol * impossibility to respect the medical follow-up of the protocol for geographical, social or psychic reasons

Keywords: prostate curietherapy radiotherapy intermediate risk
blood sample collection in subjects participating in a lung cancer screening program

Conditions: Healthy

Summary: the primary objective of this study is to establish a control population to assess performance of an investigational diagnostic test targeting lung neoplasms.

subjects will be participating in a lung cancer screening program at enrollment. subjects will have a blood sample collected within 60 days of a low-dose ct scan (ldct). subjects with nodules present on the ldct or subjects with a clean ldct scheduled for a 12-month follow-up may have another blood draw at 12 months.

Eligibility criteria:
inclusion criteria: 1. subject is male or female, 50 years of age or older. 2. subject meets one of two lung cancer screening criteria below. 1. subject is a candidate for ldct lung cancer screening and is scheduled for a baseline ldct scan. there may be circumstances when a patient cannot have an ldct scan (e.g., due to insurance issues). in these cases, it is allowable for a patient to have a ct scan in order to meet the inclusion criteria. or 2. subject has had previous ldct scan(s) for lung cancer screening and the most recent ldct scan prior to enrollment is negative for pulmonary nodules (lung-rads category 1, no nodules). 3. subject understands the study procedures and is able to provide informed consent to participate in the study and authorization for release of relevant protected health information to the study investigator. exclusion criteria: 1. subjects with pulmonary nodules on the most recent ldct scan prior to enrollment (lung-rads category 1 nodules with specific calcifications such as complete, central, popcorn, concentric rings and fat containing nodules are excluded). 2. prior history of cancer within the past 5 years except for non-melanoma skin cancer. 3. prior removal of the lung, excluding percutaneous lung biopsy. 4. individual has a condition the investigator believes would interfere with his or her ability to provide informed consent, comply with the study protocol, which might confound the interpretation of the study results or put the person at undue risk.
codeine in sickle cell disease

Conditions: Sickle Cell Disease

Summary: the objective of this study is to determine if a subject's genetic make-up would affect the treatment response to codeine in subjects with sickle cell disease.

people with sickle cell disease require oral pain medications to manage an acute pain crisis. sometimes these individuals fail to obtain adequate pain relief with the medications prescribed for outpatient use resulting in emergency room visits and hospital admissions. subsequently, many patients are admitted to the hospital for pain management for a few days until the pain crisis resolves. the most common medications prescribed to sickle cell individuals for outpatient use include codeine and hydrocodone containing medications (i.e. tylenol #3™, vicodin™, lortab™). these medications must be broken down in the body to make the active pain reliever (morphine or hydromorphone, respectively). some individuals may not be able to break down these medications to the active pain reliever; therefore, these individuals will likely continue to experience pain unless they take other pain medications. we will determine whether genotype estimates the ability of cyp2d6 to break down codeine to the active pain reliever in individuals with sickle cell disease.

Eligibility criteria:
inclusion criteria: * age \>= 18 years old * sickle cell disease (hbss) * hydrocodone- or codeine-containing medications to manage an acute pain crisis in the past exclusion criteria: * renal dysfunction, serum creatinine (scr) \> 2.0 mg/dl * hepatic dysfunction, ast, alt or direct bilirubin \> 3 x upper limit of normal (uln) * codeine allergy * medications shown to induce or inhibit cyp2d6 * women who are pregnant or breast feeding * unable to provide written, informed consent

Keywords: codeine pain cyp2d6 genotype morphine sickle cell pharmacokinetic
comparative study of the analgesic effect of spinal anesthesia or infiltration anesthesia for hemorrhoidectomy

Conditions: Postoperative Pain

Summary: background and objectives: postoperative analgesia and early recovery are relevant for hospital discharge after hemorrhoidectomy. this study investigated the postoperative analgesic effect with local infiltration compared with spinal block. methods: this randomized study included 40 patients aged 18 to 60 years old. local group (lg) received local infiltration under general anaesthesia; spinal group (sg) received a subarachnoid block. lg received general anaesthesia with propofol, atracurium and propofol infusion as well as a local infiltration of 20 ml 0.75% ropivacaine. sg received 2 ml of 0.5% hyperbaric bupivacaine. analgesic supplementation was with 50µg of fentanyl for lg and 1% lidocaine for sg. there were assessed: postoperative pain intensity, sphincter relaxation, motor blockade of lower limbs, time to discharge, analgesic dose over 1 week and adverse effects.

this is a prospective, randomized study, including 40 patients between 18 and 60 years, of both genders, asa 1 or 2. patients in group 1( n= 19 ) will be submitted to spinal block and group 2 (n=21) to local infiltration. the spinal block will be performed with 10 mg of 0.5% bupivacaine. the infiltration will be performed with 10 ml of 0.75% ropivacaine on each side. will be evaluated: intensity of pain on a numerical scale from 0 to 10 every 30 minutes, relaxation of the sphincter muscles, intensity of pain after the operation every 30 minutes until reached the criteria for discharge, motor blocked of the lower limbs every 30 minutes, bp, hr, so2, fr, other items that determine the conditions of discharge (urine output, nausea and vomiting), time to hospital discharge, and duration of analgesia. adverse effects and complications will be noted.

Eligibility criteria:
inclusion criteria: * will be included 40 patients, asa physical status 1 or 2 undergoing hemorrhoidectomy after approval by the ethics committee and signed consent form. exclusion criteria: * there will be excluded patients with associated diseases (fistula, fissure) infection at the puncture site, using anticoagulants or analgesics (up to 2 weeks before the procedure) and pregnant.

Keywords: infiltration hemorrhoidectomy postoperative pain
children's drawing as a projective tool to assess dental anxiety

Conditions: Dental Anxiety

Summary: the aim in this study is to compare the results of anxiety measurement of the child using the cd:h scale with the long-used face,legs,activity,cry and consolability scale (flacc scale) , frankl behaviour rating scale and pulse oximeter reading, to see if the drawing alone can be a reliable tool to predict the child's behaviour before the dental procedure.

dental anxiety is one of the major problems facing us in pediatric dentistry, the new experience that the child has to go through together with the difficulty for the child to express his exact cause of fear increases the problem. research has shown that healthcare providers spend more time communicating with parents than pediatric patients. in a typical medical care visit, less than 20% of the communication engaged pediatric patients, regardless of age. most decision-making and treatment planning are done by dentists and parents. even when the dentist tries to engage the child in the conversation it usually includes the social aspect "his favourite hobby, toys, school topics, etc..." rather than the medical history or treatment decisions so the child is unaccustomed to discussing his dental fears and complaints to the dentist, hence we lose a lot of the child\&#39;s trust. drawing has been used in literature as a psychological method to express one\&#39;s thoughts and fears and can be analyzed by the healthcare provider to know the deeper thoughts of the child. thus, the current study aims to deeply understand the children\&#39;s point of view towards dental treatment and use the drawings as a projective tool to assess the dental anxiety in those children by simple index and defined scores that every dentist could learn and apply.

Eligibility criteria:
inclusion criteria: * children aged from 6 to 12 years. * children with past dental experience. * one or more primary teeth indicated for simple extraction procedure. exclusion criteria: * patients lacking cooperative behavior (very young age and patients with certain medical or psychological disorders) according to wright's classification. * refusal of participation. * lack of informed consent by the child's parents. * if the child shows any signs of disinterest in drawing.

Keywords: dental anxiety drawing projective tool
nicotinamide riboside in ulcerative colitis

Conditions: Ulcerative Colitis

Summary: this is a randomized, double-blind pilot study of nicotinamide riboside (nr) in pediatric-onset ulcerative colitis (uc).

the investigators hypothesize that nr will alleviate mitochondrial dysfunction and restore metabolic homeostasis in the intestinal epithelium in pediatric patients with uc. the purpose of the study are: 1. to establish the feasibility of an randomized clinical trial (rct) investigating the effects of nr in pediatric patients with uc. 2. to evaluate the effects of nicotinamide adenine dinucleotide (nad)+ repletion on intestinal epithelial mitochondrial structure and function in human uc patients. the investigators hypothesize that daily nr supplementation will restore nad+ levels, enhancing peroxisome proliferator-activated receptor gamma coactivator 1-alpha (pgc1α) activity and mitochondrial structure/function.

Eligibility criteria:
inclusion criteria: * pediatric patients (≤18yo); * diagnosis of mild to moderate ulcerative colitis as determined by pediatric ulcerative colitis activity index (pucai) and endoscopic scoring (mayo) at the time of colonoscopy; * although the investigators will target newly diagnosed patients (therefore, treatment naïve), patients with established disease will also be enrolled. exclusion criteria: * patients with acute severe ulcerative colitis; * concurrent gastrointestinal infection (ie. clostridium difficile, cytomegalovirus, etc.); * a diagnosis of crohn's disease; * indeterminate colitis/ibd-u; * in general, patients that have been treated with steroids or antibiotics in the past three months. patients on biologic medications may be enrolled if their dose has been stable for at least three months. final determination of eligibility will be at the discretion of the treating investigator. after the initiation of the study, subjects may receive any medication to treat their disease as dictated by their care providers; * patients who have other chronic inflammatory/autoimmune disorders or prior malignancy; * pregnant women (all women of childbearing age will be required to use contraception at the time of inclusion). * patients with existing renal or hepatic dysfunction; * per standard of care guidance, subjects with platelets \<50,000 do not undergo endoscopy and, therefore, are not eligible.

Keywords: nad
functional assessment-guided angioplasty in patients with coronary chronic total occlusion

Conditions: Coronary Occlusion; Angioplasty, Balloon, Coronary

Summary: the aim of this study is to investigate the role of functional evaluation for predicting clinical outcome in patients with coronary chronic total occlusion (cto) undergoing percutaneous coronary intervention (pci), and to evaluate the clinical evidence for the using of fractional flow reserve (ffr), coronary flow reserve (cfr), index of myocardial resistance (imr) and dynamic single photon emission computed tomography (d-spect) in these patients.

pci for cto has dramatically changed in recent years. although, with the improvement of devices and refinement of operator techniques, pci of cto can currently be performed with high success and low complication rates at experienced centers, the clinical benefit of recanalization of cto is still a matter of debate. accumulating evidence suggests that the improvement of left ventricular functional and prognosis is closely related with the area of viable myocardium, which has the potential for contractile recovery after revascularization. for the majority of interventional cardiologists, coronary angiography is the only invasive test deemed necessary for clinical decision-making, despite its weak ability to predict the functional impact of vascular occlusion on the subtended myocardium. to overcome this limitation, adjunctive diagnostic tools for functional evaluation, such as ffr, cfr, imr and d-spect, have been introduced. in non-cto patients, physiology-guided revascularization strategy has been definitely proven to be better than angiography-guided strategy in pivotal landmark studies. however, the clinical value of these functional parameters for the pci of cto is still unknown. the aim of this study was to determine whether functional evaluation is a better predictor of clinical outcome in patients with cto undergoing pci.

Eligibility criteria:
inclusion criteria: * age ≥ 18 and ≤80 * patients diagnosed with cto by coronary angiography * patient planned to receive pci * diameter of cto vessel \> 2.25 mm exclusion criteria: * age \>80 or \<18 * myocardial infarction with 1 months * inability to give informed consent

Keywords: coronary chronic total occlusion functional evaluation