Kornimate/medical-research-clean huggingface dataset:
infant modified constraint induced movement therapy paired with neuromuscular electrical stimulation: a case series

Conditions: Hemiplegia; Cerebral Palsy; Unilateral Cerebral Palsy

Summary: this study will compare the motor outcomes for five infants with asymmetrical hand function (ahf) who will receive two, three week episodes of standard care separated by a three week episode of mcimt paired with neuromuscular electrical stimulation. the results of this study will inform decisions on the feasibility and efficacy of the treatment for use in a larger study for infants with ahf at risk for unilateral cerebral palsy.

infants with asymmetrical hand function will participate in three consecutive phases of treatment. the first and third phase will consist of three weeks of standard care for children with asymmetrical hand function, 1 hour/day, 1 day/week. the therapist will provide weekly coaching with the parents so they can carry over activities at home one hour/day, six days/week during this phase. in addition, a sock or mitten will be used for short term constraint during the hour of training both in the clinic with the therapist and at home with the parent. the second phase will consist of three weeks of modified constraint induced movement therapy, 2 hours/day, 3 days/week paired with nmes, 15 minutes/day, 3 days/week. the infants will wear a soft splint on their preferred hand and forearm 24 hours/day during this phase. parents will be trained by the therapist to carry over activities with their child at home, 1 hour/day, 6 days/week. the children will return at chronological age of 18 months for follow up testing.

Eligibility criteria:
inclusion criteria: 1. infant is 7-10 months of age (cca) 2. clinical presentation of asymmetrical hand function, 3. grade 2/5 movement in more impaired upper extremity, 4. demonstrate potential to participate in 6 hours of therapy/week during 3 week episode of mcimt-nmes, as determined by principal investigator, 5. parent/guardian willing to be partners in study and participate in follow-up assessments until child is 18 months of age exclusion criteria: 1. medical or sensory condition that prevents full therapy participation (active seizures, significant visual impairment) 2. received botox injection to more impaired upper extremity within last 6 months, 3. nmes contraindicated (impaired skin integrity, presence of pacemaker, clotting disorder), 4. previous ue surgery or nerve injury (brachial plexus)

Keywords: infant constraint induced movement therapy early intervention cerebral palsy
umbilical cord blood transfusion in progeria syndrome

Conditions: Hutchinson-Gilford Progeria Syndrome

Summary: this is a pilot study on safety and efficacy of umbilical cord blood therapy for patients with hutchinson gilford progeria syndrome (hgps). this is an 1 year trial with 3 iv infusions (4 months apart from each infusion) of umbilical cord blood units with oral sirolimus to see the safety and efficacy.

this is a pilot study on safety and efficacy of umbilical cord blood therapy for patients with hutchinson gilford progeria syndrome (hgps). hgps is a rare genetic disease where affected lmna gene coding lamin a protein leads to premature aging and early death. teenagers with hgps are in high risk of atherosclerosis and ischemic stroke, and these are major reason of mortality in hgps.currently, there are no definite cure for this rare genetic disease. among the potential drugs under investigation, lornafarnib (farnesyltransferase inhibitor) lowered the carotid-femoral pulse wave velocity (cfpwv) and also lowered mortality. stem cell therapy has proven its efficacy in progeria mouse model. we are trying to study safety and efficacy of umbilical cord blood therapy in human hgps patients.

Eligibility criteria:
this is a pilot study including 2 patients with hgps. inclusion criteria: * those who were clinically and genetically diagnosed as hutchinson-gilford progeria syndrome exclusion criteria: * those who show definite hemorrhage or ischemia on brain mri * those who are affected with systemic infection during study enrolling period * those who are not able to able to make consents to the study; those who are not accompanying any guardians * those who were enrolled in other clinical trials within last 30 days * those who are not appropriate according to laboratory criteria 1. whose alt/ast \> 2 fold of normal limit 2. whose serum creatinine \> 1.5 fold of normal limit 3. whose total bilirubin \> 2 fold of normal limit 4. whose total wbc count \< 3000/mm3 5. whose platelet count \< normal lower limit * those who are diagnosed with other malignancies * those who are affected by other serious medical (cardiopulmonary, gastrointestinal, endocrinologic, etc.) conditions
upper limb intensive therapies in babies with unilateral cerebral palsy.

Conditions: Infantile Hemiplegia; Upper Extremity Paresis; Family; Constraint Induced Movement Therapy; Bimanual Intensive Therapy

Summary: mcimt and bit are therapies applied in children with hemiplegia which have a great evidence, but not in a early age. this research has the objective to know the effects of this therapies in infants diagnosed of infantile hemiplegia from 9 to 18 months applying 50 hours of dose for both interventions during 10 weeks, executing them at home by familes.


Eligibility criteria:
inclusion criteria: * infantile hemiplegia * age from 9 months to 18 months. * no use of the affected upper limb exclusion criteria: * associated pathologies * epilepsy no controlled with medicins * no collaborated families
combining shockwave therapy and platelet rich plasma to treat erectile dysfunction in diabetic men (cocktail-dm)

Conditions: Erectile Dysfunction With Diabetes Mellitus

Summary: the purpose of this research study is to evaluate whether the combination of shockwave therapy (swt) with platelet rich plasma (prp) is synergistic and can reverse the pathology of microvascular erectile dysfunction (ed) and enhance erectile function in diabetics patients.


Eligibility criteria:
inclusion criteria: 1. male 2. between 30 to 80 years of age (inclusive). 3. be able to provide written informed consent. 4. have a diagnosis of mild to moderate ed (12-21) or mild ed (22-25) based on international index of erectile dysfunction - erectile function (iief-ef) questionnaire score. 5. have diagnosis of diabetes mellitus (type 1 or type 2), as documented by history of hemoglobin a1c \> 7% or on medical therapy for diabetes. 6. be in a stable relationship and have a minimum of 2 sexual attempts per month for at least one month prior to enrollment. 7. agree to comply with all study related tests/procedures. exclusion criteria: 1. previous penile surgery of any kind (except circumcision and condyloma removal), such as penile lengthening, penile cancer surgery, penile plication, grafting. 2. previous history of priapism, penile fracture, peyronie's disease, or penile curvature that negatively influences sexual activity. 3. abnormal morning serum testosterone level defined as a value lower than 300 ng/dl (±5%). 4. psychogenic ed as determined by study investigator. 5. patients using intracavernous injections (ici) for management of ed. 6. patients with generalized polyneuropathy, neurological conditions, or psychiatric disease (such as bipolar disorder or depression). 7. have a serious comorbid illness or condition that, in the opinion of the investigator, may compromise the safety or compliance of the subject or preclude successful completion of the study. 8. history of consistent treatment failure with phosphodiesterase 5 (pde5) inhibitors for therapy of ed. 9. poorly controlled diabetes as indicated by hemoglobin a1c \> 7.5%. 10. use of antiplatelet medications
chemotherapy intensification in patients with high lactate dehydrogenase values and soluble syndecan1 levels

Conditions: Metastatic Colorectal Cancer

Summary: in first-line metastatic colorectal cancer (mcrc), baseline prognostic factors allowing death risk and strategy stratification are lacking. in this setting, a simple biological scoring system have recently been proposed, including ldh and cd138 binary status seric values, identifying one third of patients with worst prognostic. intensified-chemotherapy strategies, combining 5-fluorouracile, oxaliplatin, irinotecan and bevacizumab, are beneficial for patients having a bad prognostic, defined by the brafv600e mutation, concerning 5-8% of first line mcrc. for the 30% of patients with ldh-cd138 elevated score, the purpose of clavsyn phase ii study is to compare the pfs of one intensified arm (folfoxiri bevacizumab) to one standard chemotherapy arm, in order to better discriminate treatment strategies, at metastatic diagnosis.


Eligibility criteria:
inclusion criteria: * performance status ecog-who 0 or 1 * histologically proved metastatic colorectal adenocarcinoma, with non-resectable metastases * adequate hematological, hepatic, and renal functions * signed written informed consent exclusion criteria: * previous treatment (chemotherapy, targeted therapy, surgery) for metastatic disease * history of autoimmune disease * acute infectious disease * known hypersensitivity grade 3-4 or contraindication to any of the study drugs * patient with any medical or psychiatric condition or disease which would make the patient inappropriate for entry into this study. * bevacizumab contraindication * brain metastases * other malignancy within the last 2 years, except for adequately treated carcinoma in situ of the cervix or squamous carcinoma of the skin, or adequately controlled limited basal cell skin cancer. * pregnancy, breast-feeding or absence of adequate contraception for fertile patients * patient under guardianship, curator or under the protection of justice.

Keywords: metastatic colorectal cancer biomarker chemotherapy intensification syndecan1 ldh cd138
cranial electro therapy stimulation in reducing perioperative anxiety

Conditions: Anxiety

Summary: cranial electro stimulation (ces) provides safe, adequate, side-effect free sedation without excessive drowsiness in preoperative settings.

ces alpha-stim is a non-invasive device which has been in place and has been approved for patients to reduce anxiety by the fda. this study involves the use of ces alpha-stim device applied to the patient 30 minutes before and through-out cataract surgery procedure and then to measure the level of anxiety and discomfort by using a visual analog scale (vas). we propose that by applying the device the patients will be able to have markedly less level of anxiety and discomfort before and during the surgery and will ultimately avoid the traditional use of sedative or analgesic drugs being used for these kinds of surgery.

Eligibility criteria:
inclusion criteria: * patients of both genders between 50 and 90 years old scheduled for an outpatient "first eye" cataract phacoemulsification with topical anesthesia. * asa classification i ii and iii exclusion criteria: * asa classification iv (patients with a chronic or severe disease). * hypersensitivity to midazolam or benzodiazepines * acute narrow-angle glaucoma * untreated open-angle glaucoma * patients with any sort of psychiatric or neurological disorder * patients on anti-anxiety medication * patients who have demand-type pacemakers installed before 1999\* \*note: these are the exclusions listed for liability purposes by alpha-stim. there are no fda exclusions.

Keywords: cranial electro stimulation first eye cataract surgery preoperative sedation perioperative sedation
an trial of two dosing regimens of ap214 for the prevention of kidney injury in patients undergoing cardiac surgery

Conditions: Cardiac Surgery; Coronary Artery Bypass; Aortic Aneurysm; Valve Surgery; Kidney Diseases

Summary: this study investigates the effect of two dose-levels of ap214 on the prevention of (acute) kidney injury after cardiac surgery.


Eligibility criteria:
inclusion criteria: 1. has signed the trial-specific informed consent form. 2. patients ≥ 18 years old, male or female, not of childbearing potential (postmenopausal or permanently sterilized, e.g. tubal ligation, hysterectomy, bilateral salpingectomy), regardless of ethnicity. 3. patients undergoing combined coronary artery bypass grafting (cabg) surgery and surgery of one or more cardiac valve (valve(s) surgery), or 4. patients undergoing surgery of more than one cardiac valve (valves surgery), or 5. patients undergoing surgery of the aortic root or ascending part of the aorta, or 6. patients undergoing surgery of the aortic root or ascending part of the aorta, combined with cabg and/or valve(s) surgery, or 7. patients with stage iii chronic kidney disease (egfr 30-59 ml/min determined by the modification of diet in renal disease (mdrd formula)) undergoing cabg or valve surgery exclusion criteria: 1. cardiac surgery to be performed "off pump" without cardiopulmonary bypass. 2. cardiac surgery to be performed with hypothermic circulatory arrest. 3. confirmed or suspected endocarditis. 4. ef ≤ 20%, evaluated within 2 months prior to screening visit. 5. requiring a reoperation on one of the valves within 3 months following the original valve surgical procedure. 6. active peptic ulcer disease and gastritis. 7. receiving dopamine, adrenalin or noradrenalin at any dose at any time 14 days prior to day of surgery. 8. known or suspected hypersensitivity to the investigational medicinal product. 9. current participation in any other interventional clinical trial. 10. previously dosed with ap214. 11. use of investigational medicinal products within the previous 6 months. 12. body weight above 130 kg. 13. history of any organ transplant. 14. women who are of childbearing potential, pregnant, or breast-feeding. 15. current abuse of alcohol or substance, according to the investigator's medical judgment. 16. has a mental incapacity or language barriers precluding adequate understanding of trial procedures. 17. any history of cancer within the last 2 years 18. any history of dialysis. 19. is considered by the investigator unsuitable to participate in the trial for any other reason, for instance due to a significant serious underlying condition.

Keywords: cardiac surgery acute kidney injury
injection rate and erector spinae plane block

Conditions: Postoperative Pain; Breast Surgery

Summary: to evaluate the effect of injection rate on the block sensory level in the esp block.

many women experience severe acute postoperative pain after breast cancer surgery. regional techniques are frequently used as a part of multimodal analgesia in breast surgery. ultrasound-guided erector spinae plane (esp) block is a preferred method to reduce the postoperative opioid requirement for postoperative pain management. in this study, we aimed to evaluate the effect of injection rate on the block sensory level in the esp block.

Eligibility criteria:
inclusion criteria: * aged between eighteen and sixty-five * asa i-iii * undergo elective breast cancer surgery exclusion criteria: * under 18 years of age or over 65 years of age * asa iv and above * declined to give written informed consent * contraindications of peripheral blocks or local anesthetic infiltration * history of allergy against local anesthetics * chronic pain history * history of hepatic, neuromuscular, cardiac and/or renal failure * infection at the injection site

Keywords: erector spinae plane (esp) block postoperative pain breast surgery
assessment of a serious illness conversation guide (sicg) in advanced gastro-intestinal cancers

Conditions: Gastrointestinal Cancer; Colorectal Cancer; Pancreatic Adenocarcinoma; Gastric Cancer; Esophageal Cancer; Cholangiocarcinoma; Hepatocellular Carcinoma; Neuroendocrine Tumors; GIST, Malignant

Summary: the purpose of the study is to determine whether standardized implementation of a scripted template for discussing important issues that arise near the end of life improves the care of those who have advanced cancer.

primary objective: to determine whether the serious illness conversation guide will improve the consistency with which providers have and document conversations regarding patients' goals and priorities as they near the end of life. secondary objectives: 1. to assess whether having conversations as per this model will improve the quality of care near the end of life as determined by appropriate care in concordance with their goals of care. 2. to assess whether having conversations as per this model will improve patient quality of life (qol) as per a validated scale. 3. to assess in patients with concordant care whether this model will improve patient qol as per a validated scale 4. to assess provider opinions about end-of-life conversations.

Eligibility criteria:
inclusion criteria: * patients with metastatic colorectal cancer whose tumor has progressed on both folfox and folfiri. * exception: patients with metastatic colorectal cancer whose tumors demonstrate a braf v600e mutation may be enrolled regardless of prior chemotherapy. * exception: patients whose tumors are msi-h must have experience progression through immunotherapy in addition to the therapies mentioned above. * patients with metastatic pancreatic adenocarcinoma. * patients with metastatic gastric or esophageal cancer whose tumor has progressed through first-line chemotherapy of any type. * patients with metastatic cholangiocarcinoma whose tumor has progressed through first-line chemotherapy of any type. * patients with metastatic hepatocellular carcinoma whose tumor has progressed through pd1 blockade. * patients with metastatic high-grade neuroendocrine tumor. * a patient with a metastatic gist that has progressed through first-line tyrosine kinase inhibitor. * expected life expectancy of at least one month exclusion criteria: * any patient not meeting the above criteria * non-english speaking patients
n-acetyl-cysteine (nac) and kidney graft function

Conditions: Brain Death; Chronic Renal Insufficiency

Summary: the goal of this study is to evaluate the effect of n-acetyl-cysteine (nac) administration in organ donors on the kidney graft function of recipients.

ischemia-reperfusion is a major contributing factor for delayed renal function after transplantation. it has been shown that the administration of an antioxidant, i.e. nac, in patients with chronic renal insufficiency may prevent radio contrast-induced nephropathy. due to its antioxidant effects, organ donor pretreatment with nac has demonstrated to improve renal graft function in two experimental studies. study objectives: to compare the incidence of delayed graft renal function between two groups of patients, i.e., those receiving the graft from organ donors pretreated with nac and a group control. the primary endpoint was the number of delayed graft function defined as the requirement of at least one sequence of dialysis during the first seven days following transplantation. secondary endpoints: evolution of creatininemia, azotemia at day 1, 7, 14 and ,30 after surgery; acute and delayed transplant rejection; intrahospital mortality. patients inclusion: all organ donors and recipients were eligible exclusion criteria: for organ donors were preexistent chronic renal insufficiency and contra-indications for kidney procurement; for recipient were transplantation outside our hospital the donors were randomized in a single-blind fashion into two groups : the control group and the group receiving 600 mg iv of nac 1 hour before and 600 mg iv 2 hours after cerebral arteriography required to diagnose brain death. sample size has been calculated delayed graft function by 50% leading to include 118 recipients in each group. follow up: one year after transplantation. study beginning in september 2006. length of inclusion during 36 months.

Eligibility criteria:
inclusion criteria: * all recipient for kidney graft in our hospital exclusion criteria: * transplantation out side our hospital * refusal from the patient

Keywords: kidney graft, delayed graft function n-acetylcysteine
predictive role of klk10 and other neuroinflammatory molecules on clinical outcomes of ais

Conditions: Ischemic Stroke

Summary: this study aims to investigate the dynamic changes and differential expression characteristics of neuroinflammatory molecules such as kallikrein-related peptidase 10 (klk10), soluble triggering receptor expressed on myeloid cells 2 (strem2), and glial fibrillary acidic protein (gfap) in the plasma of patients with first-ever anterior circulation acute ischemic stroke (ais). it will analyze the correlation between these molecules and the severity of neurological deficits, infarct volume, brain edema, hemorrhagic transformation, progressive stroke, and clinical outcomes at three months. the goal is to assess the predictive value of these molecules for ais prognosis, guiding early treatment and new molecular targets for prevention and treatment.

1. informed consent and recruitment: participants will be recruited based on inclusion and exclusion criteria. 2. divided two groups: the case group(ischemic stroke group) and the control group(healthy individuals). 3. first survey(at the time of admission): baseline assessment- survey on gender, age, medical history, smoking, drinking habits, and current medication; nihss score at admission; measurement of plasma levels of klk10, strem2, and gfap; a collection of blood glucose, creatinine, high-sensitivity c-reactive protein, blood cell analysis report, and brain mri or ct imaging reports. 4. second survey(24 hours after onset): nihss score and plasma levels of klk10, strem2, and gfap detection. 5. third survey(within 7 days of onset): obtain brain ct or mri reports to extract information on infarct volume, brain edema, and hemorrhagic transformation; perform nihss scoring to assess the occurrence of progressive stroke. 6. forth survey( 3 months after onset): final assessment\ :record the modified rankin scale (mrs) score at 3 months after stroke.

Eligibility criteria:
inclusion criteria: for ais patients: * selection of 182 patients with first-ever acute ischemic stroke (ais) who are hospitalized at our hospital, aged ≥18 years, with no restriction on gender; * patients must be admitted within 24 hours of the onset of ais; * diagnosis must be confirmed by cranial magnetic resonance imaging (mri) or computed tomography (ct); * all enrolled patients must provide written informed consent. for healthy controls: * age and gender-matched; * no organic diseases; * written informed consent must be signed exclusion criteria: * intracranial hemorrhage; * pregnancy; * stroke with unknown onset time; * malignant tumors; * hematologic disorders; * severe liver or kidney dysfunction; * recent myocardial infarction (less than 3 months); * ongoing anti-inflammatory drug treatment.