Kornimate/medical-research-clean huggingface dataset:
restarting early versus later anticoagulation for chronic subdural hematoma with atrial fibrillation

Conditions: Chronic Subdural Hematoma; Atrial Fibrillation (AF)

Summary: the goal of this randomized clinical trial is to assess the benefit of early resumption versus late resumption of oral anticoagulation medication in adults with atrial fibrillation undergoing surgery for chronic subdural hematoma. the main questions it aims to answer are: * does anticoagulation resumption 5 days after surgery as compared to 30 days after surgery result in fewer thromboembolic complications, without increasing the risk for bleeding? * does anticoagulation resumption 5 days after surgery as compared to 30 days after surgery affect the risk of reoperation, functional outcome, mortality, and healthcare use? researchers will compare early anticoagulation resumption (5 days) and late anticoagulation resumption (30 days) after chronic subdural hematoma surgery. participants will either resume the medication 5 days or 30 days after the surgery. the participants will be followed up for 3 months after the surgery.


Eligibility criteria:
inclusion criteria: * age ≥18 years. * patients with a symptomatic unilateral or bilateral csdh requiring burr-hole evacuation with drainage (csdh is predominantly hypodense or isodense on imaging \[ct/mri\]; clinical symptoms attributable to the csdh; patients with bilaterally operated csdhs will be treated with the same protocol on both sides and analyzed as a single study participant). * patients that are on an oral anticoagulation medication due to permanent, persistent or paroxysmal spontaneous atrial fibrillation previously known * randomization done within 4 days of the surgery exclusion criteria: * intraoperative or immediate postoperative hemorrhagic complication * csdh requiring surgical treatment other than burr-hole evacuation (e.g. craniotomy) * prior csdh surgery within 12 months * cerebrospinal fluid shunt * csdh is in an arachnoid cyst * if the operated hematoma is revealed to be a cerebrospinal fluid collection (hygroma) * conditions other than atrial fibrillation that require anticoagulation, including therapeutical dose of low molecular-weight heparin or heparin (for example, pulmonary embolism, deep vein thrombosis, hypercoagulability syndromes) * mechanical heart valve(s) * moderate or severe mitral stenosis (other valvular diseases and biological valves are eligible) * contraindication to anticoagulation medication (for example bleeding disorder, documented high risk of fall \[e.g. due to severe alcoholism\], severe thrombocytopenia, severe anemia) * concomitant use of antiplatelet medication * moderate to severe renal insufficiency (creatinine clearance \<30 ml/min or on dialysis) * not a permanent resident in finland (for finnish patients) or not a permanent resident in region stockholm (for swedish patients)

Keywords: chronic subdural hematoma atrial fibrillation oral anticoagulation warfarin direct oral anticoagulants surgery stroke hemorrhage prognosis
addiction of lung volume recruitment technique in lee silverman protocol for voice professionals

Conditions: Voice Quality; Singing

Summary: the goal of this clinical trial in voice professionals with both genders aimed to verify the changes in the vocal range profile and the changes in the glottic and vocal tract configuration for more efficient phonation after applying the adapted lee silverman method and the addiction of lung volume recruitment technique in acoustic and structural analysis.

a cross-over randomized trial with two arms-the lee silverman method and the addiction of lung volume recruitment technique (lvrt)-will be conducted with voice professionals to assess the effects of both interventions on the acoustic, perceptive, and visual aspects of voice and their impact on respiratory muscle strength.

Eligibility criteria:
inclusion criteria: * voice professionals with no voice disease exclusion criteria: * smokers * glottis paralysis and dysfunction * dental problems * mental and cognitive disorders

Keywords: voice training acoustic respiratory therapy
sphenopalatine ganglion block for nasal surery

Conditions: Emergence Agitation

Summary: nasal surgery carries many perioperative challenges, intraoperative bleeing and its effect on surgical field i the main intraoperative concern an postoperative agitation and its serious complications is the main postoperative challenge.


Eligibility criteria:
inclusion criteria: * patient written consent * elective surgery * age 18 - 55 year old exclusion criteria: * patient refusal * emergency surgery
clinical significance of leukocyte cell population data in patients with myeloproliferative neoplasms (mpns)

Conditions: Myeloproliferative Neoplasms (MPNs)

Summary: myeloproliferative neoplasms (mpns) are a group of clonal hematopoietic disorders which categorized according to the world health organization (who) into philadelphia chromosome positive (ph +ve) including chronic myeloid leukemia (cml) and philadelphia chromosome negative (ph -ve) like essential thrombocythemia (et), polycythaemia vera (pv), and primary myelofibrosis (pmf) . the aim of the study is to detection of leukocyte cell population data in patients with mpns and relation between leukocyte cell population and patients' clinical status.

mpns are characterized by sepsis, thrombosis, myelofibrosis and leukemic transformation as critical complications of the disease. most recently, the mpns have been described as "inflammatory diseases" because the chronic inflammation being identified as a key factor in the development and progression of the disease . it is characterized by persistent activation of immune cells, elevated leukocyte and platelet counts, release of various mediators, dna and tissue damage . consequently. when neutrophils are activated by different stimuli, they undergo degranulation and release neutrophil extracellular traps (nets) and microparticles, leading to thrombosis in mpns by blocking blood vessels . monocyte and its distribution are also a simple marker of activation useful for early sepsis detection . the leukocyte cell population data (cpd) are parameters used to provide quantitative information on the morphological and functional characteristics of leukocytes. cpd assessment involves measuring neutrophil and monocyte forward scatter (z axis) for cell size and side scatter (x axis) for internal complexity. additionally, fluorescence intensity (y axis) for dna/rna content and cell population variability (dispersion width) can also be evaluated. therefore, assessing of these parameters in the context of sepsis and thrombosis as a complication of mpns helps to understand how these conditions interact at the cellular level and provides insights into morphological changes and abnormal leukocyte distribution for early detection and management .

Eligibility criteria:
inclusion criteria: * patients with mpns according to the recent who classification. exclusion criteria: * patients with other types of myeloid neoplasms and/or not fulfil the who criteria for mpns diagnosis.

Keywords: leukocyte cell
i2-cort wtp9: upper extremity motor intervention, use of hand orthosis in people post-stroke

Conditions: Stroke; Upper Extremity Dysfunction

Summary: the upper extremity kinematics of people post-stroke will be monitored with/without an inactive hand orthosis (intervention: added weight to hand) during arat, fugl-meyer, and box and blocks tests. measurements will occur right after inclusion and repeated once after 7-8 weeks. upper extremity kinematics and test scores will indicate the influence of additional weight to hand as a possible confounder when, in the future, the hand orthosis would be used as a therapy tool.


Eligibility criteria:
inclusion criteria: * post-stroke * receive regular therapy at jessa hospital * able to willingly sign informed consent exclusion criteria: * relapse during study * secundary complications limiting upper extremity performance
transfusion-associated microchimerism in previously injured individuals who received a blood transfusion

Conditions: Chimerism; Blood Transfusion; Wounds and Injuries

Summary: blood transfusions are frequently necessary in situations in which there is a large amount of blood loss. in some individuals who receive a blood transfusion, white blood cells from the donor's blood may remain in the body for years, a condition known as microchimerism. this study will evaluate the occurrence of microchimerism among the following three groups of individuals who previously received transfusions: 1) individuals with traumatic injuries; 2) individuals with burn injuries; and 3) individuals who underwent elective orthopedic operations.

approximately 10% to 15% of injured patients who receive blood transfusions experience a condition known as transfusion-associated microchimerism. this occurs when white blood cells, or leukocytes, from the donor's blood persist in the recipient long after the transfusion occurs. the genetically distinct donor cells can remain in the individual for decades, and may account for as many as 4% of the white blood cells in the recipient's body. this suggests that the donor cells are tolerated by the recipient's immune system. the purpose of this study is to compare the incidence of microchimerism among individuals with three different types of injuries: 1) traumatic injuries; 2) thermal, or burn, injuries; and 3) injuries resulting from elective orthopedic surgical procedures. in this study, blood samples will be collected from individuals who were treated for traumatic injury, thermal injury, or elective orthopedic surgical procedures at the university of california at davis medical center. individuals who were treated from 2000 to 2003 and received a blood transfusion, as well as a control group of individuals who did not receive a transfusion, will be approached to enroll in the study. individuals who agree to participate will have their blood analyzed for evidence of microchimerism. information on health status, injury characteristics, hospital care, blood transfusion details, and blood donor characteristics will be collected from all participants.

Eligibility criteria:
inclusion criteria: * hospitalized for traumatic injury, thermal injury, or an elective orthopedic surgical procedure from 2000 to 2003 at the university of california at davis medical center * received at least 1 unit of transfused red blood cells exclusion criteria: * currently incarcerated * inadequate decision-making capacity of the participant and no available surrogate decision-maker * prior bone marrow or solid organ transplantation * prior blood transfusion other than at the time of hospitalization * any history of an autoimmune disorder prior to hospitalization

Keywords: microchimerism injuries burns orthopedic surgery leukocytes
schulze muscular dystrophy ability clinical study

Conditions: Muscular Dystrophies; Spinal Muscular Atrophy; Duchenne Muscular Dystrophy; Limb Girdle Muscular Dystrophy; FSHD; Cerebral Palsy; Becker Muscular Dystrophy

Summary: the primary objective of the schulze study is to evaluate the function of the upper limbs of subjects diagnosed with neuromuscular disorders, with and without use of the abilitech assist device in the clinic and home environments. functional outcomes will include documenting active range of motion and the ability to perform activities of daily living (adls) using the standardized canadian occupational performance measure (copm) and the role evaluation of activities of life (real) assessments. secondary objectives are to assess the safety record and report on adverse events (aes) and parameters related to device usage, including device usage time and the time required to don/doff the device. secondary objectives also include characterization of user upper limb performance based on etiology.


Eligibility criteria:
inclusion criteria: 1. subjects between 10 and 99 years of age, with onset of neuromuscular conditions that cause quadriparesis 2. mmt score of 1-3 in the elbow, wrist and hand; and a mmt score of 2-3 in the shoulder of at least one of the subject's arms 3. ability of subject to raise their forearm off of their lap or laptray 4. willingness to comply and participate with the study protocol and attend the study sessions 5. ability to communicate verbally and respond to questions and commands 6. ability to provide informed consent 7. selected for participation based on investigator discretion exclusion criteria: 1. use of invasive ventilator 2. open wounds or chronic pressure sores on upper extremities, neck, back or torso 3. significantly unstable upper extremity joints 4. unhealed bone fractures in the upper extremities 5. active rotator cuff tear, grade 2 or 3 6. surgical fixations limiting full passive range of motion 7. uncontrolled upper-limb spasticity that significantly limits normal range of motion 8. uncontrollable pain in the neck, shoulders or upper limbs 9. ability to fully raise both hands simultaneously above their head with ease as defined by the investigator 10. lack passive shoulder abduction of 120 degrees 11. lack 90 degrees of passive elbow extension 12. unable to follow instructions 13. exhibit significant behavioral problems 14. inability to provide consent
diagnostic accuracy of polymerase chain reaction for mycobacterium tuberculosis using ebus-tbna samples

Conditions: Lymphadenopathy; Tuberculosis; Sarcoidosis

Summary: the purpose of this study is to compare the diagnostic efficacy of nested and realtime polymerase chain reaction for mycobacterium tuberculosis using ebus-tbna samples in patients with isolated intrathoracic lymphadenopathy.

although endobronchial ultrasound-guided transbronchial needle aspiration (ebus-tbna) has been widely used to perform mediastinal lymph node sampling, little information is available on polymerase chain reaction for mycobacterium tuberculosis (tb-pcr) using ebus-tbna samples in patients with isolated intrathoracic lymphadenopathy. in addition, two methods of tb-pcr (nested pcr and realtime pcr) are available for the detection of mycobacterium tuberculosis and which method is superior for detection of mycobacterium tuberculosis has not been established in patients with isolated intrathoracic lymphadenopathy. thus, this study was design to compare the diagnostic efficacy of nested and realtime tb-pcr using ebus-tbna samples in patients with isolated intrathoracic lymphadenopathy in south korea, where the incidence of tuberculosis is intermediate (97/100,000 per year).

Eligibility criteria:
inclusion criteria: * patients with isolated intrathoracic lymphadenopathy exclusion criteria: * suspicion of primary lung cancer on ct or pet scan * suspicion of pulmonary tuberculosis on ct or pet scan * suspicion of sarcoidosis of lung parenchyma on ct or pet scan

Keywords: bronchoscopy ultrasonography tuberculous lymphadenitis polymerase chain reaction sensitivity and specificity
bone density in immediate implant placment and loading(bdiipl)

Conditions: Bone Density Increased

Summary: atrumatic extraction ,immediate implant placment , prf as plug,immediate loading , mesure bone density 0-3-6-9 month

atrumatic extraction unrestorable tooth in esthetic zone and immediate implant placment and withdrow 10cc blood sample to gain prf plug as membrane and immediate provisional for one week and final restoration after 1 week , and mesure bone density from 0-3-6-9 month

Eligibility criteria:
inclusion criteria: * unrestorable anterior tooth. * good oral hygine * adequate bone hieght apical to the alveolus of failing tooth to ensure primary stability . exclusion criteria: * systematic disease which affect osteointgration. * bad oral hygiene * broxism, clenching, deep bite, edge to edge and abnormal habits. * non-treated peeiodontal diseases. * pregnancy and smokers. severe infection. loss of labial crest after extraction of failing tooth.
chemoablation or bladder resection with adjuvant chemotherapy in recurrent non-muscle invasive bladder cancer

Conditions: Non-Muscle Invasive Bladder Cancer

Summary: the investigartors will conduct a randomized, multinational study with the aim to assess if the efficacy of a dose dense chemoablation with mitomycin c (mmc) with adjuvant bcg in non-responding patients is superior regarding long term effect compared to standard treatment with trans urethral resection of bladder tumors (turbt) and adjuvant intravesical instillation therapy in patients with recurrent ta lg tumors. the study is a natural follow-up study following the pivotal nicsa trial supported by the danish cancer society that has lead to the initial change in the european guidelines. in order to not only be comparable to current standard, but also to improve clinical outcome and furthermore confirm the previous findings, the investigators here suggest to implement at patient tailored approach through a new multicenter rct. the investigators hypothesize that chemoablation with mmc in patients with recurrent ta lg tumors will result in a permanent low recurrence rate in patients with complete response, whereas patients without complete response can be selected for adjuvant bcg which theoretically is more efficient in this select patient group. this will potentially result in a more favorable long term recurrence free survival (rfs) rate compared to the current standard regimen where all patients are treated with turbt and adjuvant instillation therapy. the incidence of bladder cancer in denmark is almost 2,000 per year. of these, 75% have non-muscle invasive bladder cancer (nmibc). the yearly recurrence rate of nmibc is approximately 35% and the disease is therefore one of the most costly cancers to manage on a per patient basis, due to the cost of operative procedures, follow-up cystoscopies and instillation therapies


Eligibility criteria:
inclusion criteria: * tumour recurrence after previous urothelial tumour of ta low-grade * tumours smaller than 2 cm in diameter * negative urine cytology (optional) * ≥18 years of age * ability to understand and comprehend the provided written and oral information * has provided written consent exclusion criteria: * known history of invasive tumour of the bladder (t1+) * known history of cis of the bladder * previous mmc or bcg-treatment except for single instillations following previous turbts * known allergy or intolerance to mmc * solid tumour with suspicions of invasion * tumour in the bladder neck or urethra * suspicion of cis (positive cytology with high-grade neoplastic cells combined with suspicious flat lesions seen at cystoscopy) * small bladder volume (less than 100 ml) or incontinence * prior radiation therapy to the pelvic area, as radiation affects the bladder function and instillation therapy is a suboptimal treatment for this patient group * acute cystitis * pregnancy or breast-feeding * averse to using secure contraception with regard to men with partners and premenopausal women

Keywords: recurrence ta low.grade chemoablation
characterization of myocardial interstitial fibrosis and cardiomyocyte hypertrophy by cardiac mri in heart failure

Conditions: Heart Failure

Summary: the investigators hypothesised that novel mri metrics derived from myocardium post-gadolinium t1 mapping analysis will improve the current knowledge about the role interstitial fibrosis and cardiomyocyte hypertrophy in the development of left ventricular (lv) remodelling and clinical heart failure (hf). the investigators believe that these recently described variables will be associated with prognostically important indices in hf development.

cardiac hypertrophy is one of the earliest manifestations of myocardial disease, representing a modifiable, prognostic response to hemodynamic stimuli across physiologic (e.g., exercise) and pathologic states (e.g., hypertension, aortic stenosis). the extent of myocardial hypertrophy is determined by a combination of cardiomyocyte size and extracellular volume (ecv) expansion/interstitial fibrosis: while physiologic (exercise-induced) hypertrophy reflects mostly reversible cardiomyocyte hypertrophy, pathologic hypertrophy (e.g., in heart failure) is a combination of both interstitial fibrosis (potentially irreversible) and cardiomyocyte hypertrophy (reversible). current methods to delineate the potential for lv reverse remodeling (e.g., natriuretic peptides and echocardiographic or clinical markers) detect primarily advanced disease, missing a critical opportunity to intervene and follow patients at an early disease phase where myocardial pathology may be reversible. therefore, establishing novel, quantitative metrics of myocardial tissue phenotype that define a transition from hypertrophy to fibrosis, and then to irreversible lv remodeling/dysfunction may facilitate targeting therapies at a modifiable stage of disease in hf. the investigator's group has recently extended cardiac t1 mapping mri techniques to quantify the intracellular lifetime of water (τic) serially as an index of cardiomyocyte diameter, validating this technique histologically in mouse models of pressure overload.

Eligibility criteria:
inclusion criteria: * age\> 18 years * functional limitation (new york heart association class ii or worse) * no contraindication to exercise (american college of cardiology / american heart association criteria) * eligibility to take mri (absence of metallic devices, and glomerular filtration rate \> 40ml / min / 1.73m2, etc.) * prior diagnosis of heart failure (by the framingham criterion) * therapy with diuretic and euvolemia state (evaluated by cardiologist and cardiopulmonary exercise testing) * transthoracic echocardiogram exclusion criteria: * severe ischemia in any stress test * hypertrophic cardiomyopathy or any infiltrative heart disease * chronic obstructive pulmonary disease , pulmonary hypertension (pulmonary artery pressure\> 60mmhg) * severe left or right valve disease. * pacemaker or implantable cardioverter defibrillator * myocardial infarction or revascularization in 3 months * anemia (hemoglobin \<10 grams / dl) until 1 month before cardiopulmonary exercise testing

Keywords: heart failure hypertrophy fibrosis magnetic resonance
study of bms-275183 in patients with pre-treated non-small cell lung cancer

Conditions: Non-small Cell Lung Cancer

Summary: the purpose of this clinical research study is to learn if bms-275183 can shrink or slow the growth of the cancer in subjects with non-small cell lung cancer (nsclc). the safety of this treatment will also be studied.


Eligibility criteria:
inclusion criteria: * advanced or metastatic pretreated nsclc * measurable disease * adequate hematologic, hepatic and renal functions * ecog performance status of 0-2 exclusion criteria: * inability to swallow capsules * recent significant cardiovascular disease * woman who are pregnant or breastfeeding