Kornimate/medical-research-clean huggingface dataset:
graded exposure (gexp) in vivo versus physiotherapy in complex regional pain syndrome type i (crps-i)

Conditions: Complex Regional Pain Syndrome Type I

Summary: background: research on the treatment of crps-i, as described in the dutch evidence based treatment guidelines (richtlijn complex regional pain syndrome type i, 2006), mainly showed improvement at the level of pain and coping with pain. only little improvement in functional restoration was found. research in other pain populations such al neck- and back-pain patients has shown that pain related fear contributes to the development of functional disability. gexp in vivo which aims on systematically reducing fear of movement, shows promising results in crps-i patients (de jong et al., 2005). objective: the objective of the proposed project is to compare the effectivity of gexp in vivo with that of standardized physiotherapy in crps-i patients with pain related fear. design: the study concerns a single blinded, single center, randomized clinical trial. the treatment will be preceded by two pre-measures. after treatment there will be one post-measurement and 3, 6 and 12 month follow-up measurements. population: the study population will consist of chronic crps-i patients between 18 and 65, with pain related fear (phoda-le-score ≥ 35 and phoda-ue-score ≥ 32). intervention: the two interventions that will be compared are gexp in vivo (de jong et al., 2005) and standardized physiotherapy according to the protocol of oerlemans, oostendorp, de boo en goris (1999). the gexp in vivo comprises 17 sessions of one hour, the physiotherapy treatment of 34 sessions of 30 minutes. both treatments will be given over a period of 17 weeks.


Eligibility criteria:
inclusion criteria: 1. diagnosis crps-i according to iasp criteria. 2. pain related (phoda-le-score ≥ 35 and phoda-ue-score ≥ 32) 3. age between 18 and 65. 4. rehabilitation treatment has been indicated. exclusion criteria: 1. pregnancy. 2. insufficient fluency in dutch. 3. generalized pain syndrome. 4. dystonia. 5. sympathectomy of the affected extremity. 6. psychopathology 7. involvement in a claim regarding the disease. 8. substance abuse. 9. symptoms on both upper or both lower extremities.

Keywords: complex regional pain syndrome type i graded exposure in vivo physiotherapy pain-related fear
early ra mri early intensive treatment study

Conditions: Early Rheumatoid Arthritis

Summary: to compare the effectiveness of two treatment strategies in early rheumatoid arthritis (era), namely the delayed usual care and early intensive care, in hong kong. * the delayed usual care reflects the usual treatment practice in hong kong * the early intensive care includes tight monitoring and immediate adjustment of therapy

this study is a 1-year non-randomized clinical trial. two groups of patients (delayed usual care and early intensive care) with diagnosis of rheumatoid arthritis (ra) and with symptoms onset of less than 2 years and disease modifying anti-rheumatic drugs (dmards) naive will be recruited. remission is reached if patients fulfill the boolean criteria.

Eligibility criteria:
inclusion criteria: for usual care group: * patients with at least 1 tender and swollen joint * duration of symptoms less than 2 years * no previous use of dmards for intensive care group: * patients with at least 1 tender and swollen joint * duration of symptoms less than 2 years * no previous use of dmards * patients who fulfill the 2010 acr/eular classification criteria for ra exclusion criteria: * patients with renal impairment (on dialysis or estimated glomerular filtration rate (egfr) \<30 ml/min/1.73m\^2)

Keywords: early rheumatoid arthritis usual care intensive care boolean criteria
effect of exogenous lactate on neurocognitive in brain trauma

Conditions: Traumatic Brain Injury

Summary: mild traumatic brain injury (tbi) is the most common type of brain injury. post-mild tbi disability could stem from cognitive, physical, psychological and social dysfunction which resulted in significant disability and unemployment. long-term behavioral impairments which affected the individual's occupation, lifestyle, and family frequently occurred in individuals with mild to moderate brain injuries who physically fully recovered. in-vitro and in-vivo studies showed a better recovery of cognitive function after administration of exogenous lactate in traumatic brain injury. therefore, this study is aimed to evaluate the effect of exogenous lactate infusion contained in hyperosmolar sodium lactate solution on cognitive function assessed by mini mental state examination(mmse)scale.

mild traumatic brain injury (tbi) is the most common type of brain injury. post-mild tbi disability could stem from cognitive, physical, psychological and social dysfunction which resulted in significant disability and unemployment. cognitive impairment post traumatic brain injury is due to the disruption of brain vascular bed and microstructural damage. currently, there is no specific therapy for individual with mild tbi. neuropsychological assessment and early management immediately after mild traumatic brain injury have been shown to reduce long term cognitive disability. in-vitro and in-vivo studies showed a better recovery of cognitive function after administration of exogenous lactate in traumatic brain injury. the role of lactate in cerebral energy metabolism has been investigated widely. the ability of lactate as the sole energy substrate to support synaptic function has been demonstrated by different studies. in many studies, lactate has been proven to be a preferred or even an obligatory substrate over glucose for aerobic energy production during the initial stage of recovery from cerebral ischemia or hypoxia for recovery from atp-depleted synaptic function and exogenously supplied lactate can support the early recovery of synaptic function after hypoxia. however, the clinical studies evaluated the effect of lactate administration on cognitive function in patients with mild traumatic brain injury are still limited. therefore, we conduct a study to evaluate the effect of exogenous lactate infusion contained in hyperosmolar sodium lactate solution on cognitive function assessed by mini mental state examination (mmse) score evolution in mild traumatic brain injury compared with patients receiving hyperosmolar sodium chloride 3 % as a control group. mmse score can be used as a tool to describe cognitive function.

Eligibility criteria:
inclusion criteria: * mild traumatic brain injury * glasgow coma scale (gcs) of 14-15 * requires emergency neurosurgery procedures * physical status asa i-ii * onset of trauma \< 9 hours exclusion criteria: * multiple injury * pregnancy/lactation * history of alcohol or barbiturate consumption prior to the injury

Keywords: brain injury cognitive function sodium lactate mmse score
using eye mask and earplugs on prevention of delirium

Conditions: Delirium

Summary: this research is planned as a randomized controlled experimental study to examine the effect of using eye mask and earplugs in preventing delirium with evidence-based nonpharmacological nursing interventions in intensive care units.

in the prevention of delirium, the necessity of using a multicomponent, nonpharmacological interventions is emphasized and focused on nursing interventions. in this regard, it is believed that the use of eye mask and ear plugs, which have recently started to take place in the guides, as well as known evidence-based nursing interventions, will provide nurses with power to improve delirium-related outcomes. the research is expected to consist of intervention and control groups older than 18, volunteering to participate in the research, which the expected length of stay in the icu more than 24 hours at başkent university ankara hospital. data will be collected through patient information form, apache ii, glasgow coma scale, richmond sedation agitation scale, nursing-delirium screening scale, richard-campbell sleep scale and daily monitoring form. in preparation step of the research, nurses will be trained, guidelines are required for nurses, necessary interventions will be planned. at the application stage , after determining the experimental and control groups, eye mask and ear plugs will be given before going to sleep in addition to the patients in the experimental group, before going to sleep, and followed for three days. also, it will be examined through a semi-structured interview technique for the examination of patients in the experimental group.it is believed that the early diagnosis of delirium, nonpharmacological interventions to be implemented will affect the diagnosis-treatment costs positively by reducing morbidity and mortality rates.

Eligibility criteria:
inclusion criteria: * age ≥ 18 * the expected duration of stay in the intensive care unit is more than 24 hours. * in the first 24 hours of hospitalization, * on mechanical ventilation, conscious patients * patients who volunteered to participate in the study * not using sleeping pills\* \* prescription drugs (benzodiazepines, nonbenzodiazepines), quetiapine, antihistamines, antidepressants used for their sedative effects exclusion criteria: * illness * suspected or approved drug or alcohol poisoning * contraindication to the use of earplugs or eye masks (eg facial trauma or other safety concerns) * patients using hearing aids * severe neurological deficits defined as coma (richmond agitation sedation score \<-4 or -5 (deeply sedated and coma) due to cranial trauma, malignancy, anoxic brain injury, or cerebral edema) * having a known cognitive disorder (such as dementia, alzheimer's, psychosis.) * patients with a glasgow coma scale (gcs) of 8 and below

Keywords: delirium intensive care unit earplugs eyemask nursing
confirming and notifying death

Conditions: Notifying Death to Loved Ones

Summary: most physicians are confronted with the death of patients during their practice, often as early as residency. it is their legal responsibility to certify a patient's death, as well as often to notify their loved ones. yet, these duties currently receive little or no specific training during the various cycles of medical education. this task is not easy, however, and young professionals experience it with difficulty. literature data show that residents are confronted with death late in their medical education and that they are insufficiently prepared when they have to perform their first death certificate. indeed, residents report significantly correlated practical and emotional difficulties. these difficulties are notably linked to a feeling of lack of preparation through theoretical courses, a lack of familiarity with administrative procedures, and insufficient mastery of communicating with families. the highlighting of these difficulties and the desire for appropriate and respectful care for the deceased and their families, for whom the moment of announcement influences the experience of grief, call for an improvement in teaching on these topics. it is in this sense that the project was born to explore whether the creation of training, before their independent exposure to death and its announcement, i.e. at the end of the second cycle, was relevant. a prerequisite for this type of training project is indeed to question the acceptability of such an approach by students.


Eligibility criteria:
inclusion criteria: * dfasm3 student, * at the faculty of medicine of strasbourg, france, for the 2023-2024 academic year, * having taken the national ecos (thus becoming an intern at the start of the following academic year in november 2024), * aged 18 years or older, * not opposed to participating in the study. * not having completed an internship in specialized palliative care facilities exclusion criteria: * refused to participate in the study. * not having taken the national ecos.

Keywords: notifying death
study of crs-207, pembrolizumab, ipilimumab, and tadalafil in metastatic pancreatic cancer

Conditions: Pancreatic Cancer

Summary: the purpose of this study is to evaluate the safety and clinical activity of tadalafil, pembrolizumab, ipilimumab, and crs-207 in subjects with metastatic pancreatic adenocarcinoma who have progressed after at least 1 prior chemotherapy regimen.


Eligibility criteria:
inclusion criteria: * age ≥18 years. * have histologically or cytologically proven adenocarcinoma of the pancreas. * have previously treated metastatic disease. * have radiographic disease progression. * patients with the presence of at least one measurable tumor lesion. * patient's acceptance to have a tumor biopsy at baseline and on * eastern cooperative oncology group (ecog) performance status 0 or 1 * patients must have adequate organ and marrow function defined by study-specified laboratory tests. * for both women and men, must use acceptable form of birth control while on study. * ability to understand and willingness to sign a written informed consent document. exclusion criteria: * known history or evidence of brain metastases. * had chemotherapy, radiation, or biological cancer therapy within the last 14 days. * have received an investigational agent or device within the last 28 days. * had surgery within the last 28 days. * expected to require any other form of systemic or localized cancer therapy while on study. * have received a vaccine within the last 14 days (7 days for the covid vaccine) or received a live vaccine within the last 30 days. * have received steroids within the last 14 days. * use more than 4 g/day of acetaminophen. * use of organic nitrates. * use of guanylate cyclase (gc) stimulators such as riociguat. * consumption of substantial amounts of alcohol (≥5 units/day) * use of strong or moderate cytochrome p450 3a4 (cyp3a4) inhibitor or inducer. * patients on immunosuppressive agents within the last 7 days * known allergy to both penicillin and sulfa. * severe hypersensitivity reaction to any monoclonal antibody. * history of severe hypersensitivity to tadalafil. * have implant(s) or device(s) that has not and cannot be easily removed. * have artificial joints or implanted medical devices that cannot be easily removed. * have any evidence of clinical or radiographic ascites. * have significant and/or malignant pleural effusion * uncontrolled intercurrent illness. * subjects with active, known or suspected autoimmune disease. * have a tissue or organ allograft, including corneal allograft. * have been diagnosed hiv, hepatitis b or c positive. * is on supplemental home oxygen. * has an unhealed surgical wound or ulcer, or a bone fracture considered non-healing. * has clinically significant heart disease * prior history of non-arterial ischemic optic retinopathy. * history of significant hypotensive episode requiring hospitalization within 6 months. * has insufficient peripheral vein access. * is unwilling or unable to follow the study schedule for any reason. * is pregnant or breastfeeding.

Keywords: pancreatic cancer pembrolizumab ipilimumab crs-207 tadalafil immunotherapy anti-pd-1 anti-ctla-4 adenocarcinoma carcinoma
vascular ct assessment of structural autograft and allograft healing

Conditions: Bone Tumors

Summary: the purpose of this study is to determine the ability of a cone beam ct to measure bone healing.

the purpose of this study is to investigate quantitative vascular cone beam ct(cbct) in a clinical pilot of patients that have received a structural allograft for bone cancer or a vascularized structural autograft for bone cancer or traumatic injury. development of a minimally invasive, longitudinal outcome measure to quantify intramedullary vascular volume and cortical bone volume of structural allografts in patients is required to translate "revitalizing" structural allograft in clinical trials. our novel vascular cbct will be able to demonstrate the significant differences between vascularized fibular autografts vs. structural allografts in patients that will undergo structural grafting. these data will be used to devise a power calculation for a definitive clinical trial to evaluate the efficacy of the revitalizing allograft.

Eligibility criteria:
inclusion criteria: * male or female * all races will be included * autograft or allograft of long bone as part of treatment for bone tumor exclusion criteria: * pregnancy * patients with a history of iv contrast reactions * contraindication to use of epinephrine or diphenhydramine * hypertyroidism or history of sensitivity to iodine * kidney disease (abnormal urinalysis or calculaged gfr) or poor hydration due to poor intake or other causes

Keywords: cone beam ct cbct bone tumors autographs allographs
effectiveness of robot-assisted rehabilitation in persons with stroke

Conditions: Stroke

Summary: this study is to investigate the effects of robot-assisted hand with visual feedback intervention on cortical excitability, brain structure, spasiticity, gross and fine motor of upper limb and hand in individuals with stroke. twenty participants will be recruited in this study. they will be allocated to two group: robot-assisted hand combined with traditional occupational therapy group (10), only traditional occupational therapy group (10).

participants will be randomized allocated to two groups: robot-assisted hand combined with traditional occupational therapy (ot) group and traditional ot group. all participants underwent six weeks, 3 sessions per week, and 60 minutes per session training program. motor evoked potential (mep), fugl-meyer assessment (fma), modified ashworth scale (mas), box and block test (bbt) and purdue pegboard test (ppt) will be assessed before and after intervention in all participants.

Eligibility criteria:
inclusion criteria: 1. mini-mental state examination score is above 23 2. a first-ever stroke with unilateral hemiplegia or hemiparesis. 3. medical and psychological condition is stable. exclusion criteria: 1. balance and walking ability affected by other neurological problems 2. functional performance affected by medication or medical condition 3 unable to tolerate rehabilitation. 4. severe hearing or visual problem. 5. having pacemaker.

Keywords: stroke robot-assisted rehabilitation
prevalence and outcome of hypermetabolism in initial prevalence and outcome of hypermetabolism in initial phase of intensive care unit patient: a prospective observational study

Conditions: SIRS; Sepsis; Septic Shock

Summary: patients in critical illness frequently present hypermetabolism， which can extremely increase the rest energy expenditure（ree）. we hypothesize that if we alleviate the extremely increased ree will improve icu patients' outcome

this study focuses on the early changes of ree of critical ill patients when they admitted to icu.

Eligibility criteria:
inclusion criteria: * older than 18 year. * apacheⅱ score≥8 exclusion criteria: * hypercortisolism * thyroid disease * tracheoesophageal fistula * fio2\>60 or peep\>12cm h2o in mechanical ventilate * pregnancy

Keywords: rest energy expenditure,critical ill, outcome
comparative study using negative pressure dressing with & without silver alginate to promote healing in chronic wounds.

Conditions: Wound Healing

Summary: the randomized control trial will be conducted in the department of plastic and reconstructive surgery at dr. ruth k.m. pfau civil hospital karachi.general population admitted in civil hospital karachi, for wound coverage with skin grafting meetimg inclusion criteria will be included.

wound will be covered with negative pressure dressings that are composed of a sterile foam dressing surrounded by an occlusive film that adheres to the nearby, normal skin. suction is applied to the dressing and a draining tube connect to a wall fixed assisted vacuum canister. patients will be provided with paper chits with a or b marked on it. patients picking up a chit will be dealt as a group where wound will be covered with vac dressings only where by patients picking up b chit will be dealt as b group where wound will be covered with a single layer of ag+ hydrocolloid dressings. such pattern of dressing will be followed in every change of dressing in 48 hours. the wound site will be photographed after every change of dressings. the wound site will be photographically monitored by a team of plastic surgeons to assess granulation tissue, by noting the size of wound, color and shine of granulation tissue and edema.

Eligibility criteria:
inclusion criteria: * both genders above 18 years * wounds for more than 6 weeks * history of trauma, tumor, congenital physical abnormalities * hemoglobin levels more than 10 g/dl * platelet count above 150 x 10e9/l * size of wound \> 10\*10cm. exclusion criteria: * pressure ulcers * co-morbidities like diabetes or hypertension * bleeding vessels * presence of necrotic tissue * malignancy in wounds
preoperative vr cartoon viewing reduces postoperative pain and anxiety in pediatric tonsillectomy patient

Conditions: Tonsillectomy; Adenoidectomy

Summary: the aim of this study is to determine the effect of watching a cartoon with a virtual reality headset before surgery on the pain and anxiety levels of children aged 7-12 years.

the aim of this study is to determine the effect of watching a cartoon with a virtual reality headset before surgery on the pain and anxiety levels of children aged 7-12 years. in line with this aim, children aged 7-12 who were scheduled for tonsillectomy and adenoidectomy at the ear, nose, and throat department of uşak university education and research hospital were shown a cartoon with a virtual reality headset before surgery, and their pain and anxiety levels were examined. the study was conducted as a randomized controlled experimental study at the ear, nose, and throat unit of uşak university education and research hospital. the population of the study consisted of children aged 7-12 who applied for tonsillectomy and adenoidectomy surgery at the ear, nose, and throat unit of uşak university education and research hospital. the sample of the study included a total of 102 children, with 51 in the experimental group and 51 in the control group, who met the research criteria and volunteered to participate in the study between november 10, 2023, and june 1, 2024. data collection tools included the informed consent form, sociodemographic questionnaire, vital signs assessment form, visual analog scale, and the perioperative multidimensional anxiety scale for children.

Eligibility criteria:
inclusion criteria: child's criteria: * children aged between 7 and 12 years * ability to understand pain and anxiety scales * possession of communication skills * absence of mental issues * absence of physical illnesses * absence of chronic illnesses * willingness of the child and family to participate in the study * no visual, hearing, or speech problems exclusion criteria: * children younger than 7 years or older than 12 years * presence of any chronic illness that could affect pain and anxiety levels * presence of psychosocial issues * children or parents who meet the inclusion criteria but do not wish to wear the virtual reality headset (vrh) glasses * children who need to wear glasses other than the virtual reality headset (vrh) * children with hearing problems * children who do not wish to watch the shrek cartoon

Keywords: virtual reality cartoon pain level anxiety level