Kornimate/medical-research-clean huggingface dataset:
anti-cd19 car-t therapy bridging to hsct for cd19+ b-cell malignancies

Conditions: Acute Lymphoblastic Leukemia; B Cell Lymphoma

Summary: this is the second stage of the previous anti-cd19 car-t therapy (nct02965092). the study aims to evaluate the safety and efficacy of consolidative allo-hsct following car-t therapy in patients with relapsed or refractory b cell malignancies.

anti-cd19 car-t therapy has been confirmed effective for relapsed/refractory b-cell malignancies. however, its ability to keep patients in maintained remission is limited. in order to keep patients in long-term remissions, patients who had achieved mrd-negative complete remissions through car-t therapy (nct02965092) will, on their own accord, receive allo-hsct if there are no previous hsct, contraindications, and other restrictions.

Eligibility criteria:
inclusion criteria: 1. the patient is pathologically and histologically confirmed as cd19 + b cell malignancies, and has achieved mrd-negative cr through car-t therapy (nct02965092); 2. b cell hematological malignancies include the following three categories: * b-cell acute lymphocytic leukemia (b-all); * indolent b-cell lymphoma (cll, fl, mzl, lpl); * aggressive b-cell lymphoma (dlbcl, bl, mcl); 3. \< 70 years old; 4. expected survival time \> 6 months; 5. female patients around childbearing age, negative pregnancy test before trial, and agreed to take effective contraceptive measures during the trial until the last visit; 6. voluntarily participate in this experiment and sign informed consent by themselves, or legally authorized representative. exclusion criteria: 1. with a history of epilepsy or other central nervous system diseases; 2. previous allogeneic hematopoietic stem cell transplantation; 3. the presence of clinically significant cardiovascular disease, such as uncontrolled or symptomatic arrhythmias, congestive heart failure or myocardial infarction within recent six months, or heart disease with cardiac function in any grade 3 (moderate) or 4 ( severe) (according to the new york heart association (nyha) functional classification system); 4. pregnant or lactating women (safety of this therapy for the unborn child is unknown); 5. not curable active infection; 6. patients with active hepatitis b or hepatitis c virus infection; 7. combined use of systemic steroids within two weeks (except use of inhaled steroid recently or currently); 8. creatinine\> 2.5 mg / dl (221.0 umol/l); alt / ast\> 3 x the normal amount; bilirubin\> 2.0 mg / dl (34.2 umol/l); 9. patients suffering from other uncontrolled diseases, and researchers believe that the patient is not suitable for trial; 10. patients with hiv-infection; 11. any situation that may increase the risk of patients or interfere with test results.
trauma and truth interventions (net) versus conflict resolution and social skills trainings for vulnerable youths in northern uganda

Conditions: PTSD; Depression; Aggression

Summary: more than 300,000 children are fighting in armed conflicts all over the world. in uganda an estimated number of 25,000 children have been abducted and forced to fight or work as porters and sex slaves on the side of the rebels during the conflict between the lord's resistance army (lra) and the ugandan government. each year, thousands of former child soldiers have returned to their communities after they had fled or were freed from the rebels. it is well known that a high percentage of these youths are suffering from mental health problems. this could be one of the possible reasons why they are facing difficulties to reintegrate into their communities. the main aim of the proposed project is two-fold. on the one hand, the investigators want to systematically explore the relationship between mental health and important variables for reintegration into the communities like aggression, hostility, feelings of revenge, compromises and conflict behaviour and readiness for reconciliation in formerly abducted and other vulnerable youth (orphans, child mothers and handicapped youths) in northern uganda. on the other hand, the investigators want to probe the efficacy of existing and newly developed interventions for formerly abducted and other vulnerable youths that are supposed to foster their mental well-being as well as their reintegration into the society and therewith are part of the long-term prevention of new conflicts in northern uganda.


Eligibility criteria:
inclusion criteria: * for individual net treatment: ptsd diagnosis * for group interventions: all youths in the selected vocational training centres will be included

Keywords: vulnerable youths in northern uganda formerly abducted children reintegration and reconciliation trauma treatment narrative exposure therapy reconciliation revenge feelings
epigenetics of tnbc in overweight and obese hispanic & non-hispanic white women

Conditions: Triple Negative Breast Cancer

Summary: a key tenet of this project is that of reaching translational human diagnosis and biomarker end points. to lay a foundation and make progress towards these translational goals, investigators will address the following specific aim: to determine if bmi/ obesity differentially influence expression and epigenetic signatures in triple negative breast cancer (tnbc) from hispanic compared to nhw women.

the intended goal of this project is to develop epigenetic biomarkers to monitor the role of obesity and ethnicity on he development of triple negative breast cancer (tnbc). the proposed approach will seek to clarify for the first time if bmi is a biological factor that regulates aromatic hydrocarbon receptor (ahr) expression and epigenetic activity at breast cancer susceptibility and hormone receptor genes based on hispanic or non-hispanic white (nhw) ethnicity. if successful, the proposed experiments have the potential to highlight the role of overweight and obesity for dietary prevention of tnbc and to underscore the consideration of breast cancer screening among overweight/obese hispanic women. additionally, this study will provide the opportunity to begin testing the utility of ahr as a biomarker of tnbc development related to bmi and ethnicity.

Eligibility criteria:
inclusion criteria: * hispanic or nhw women * ≥ 18 years of age * scheduled for a breast procedure as standard of care treatment - benign breast surgery or prophylactic mastectomy\\ * newly diagnosed tnbc - patients with tnbc will be eligible regardless of whether their treatment plan is surgery first or chemotherapy first (neoadjuvant chemotherapy) * eligible non-white women could be included exclusion criteria: * brca1/2 mutation carriers * family history of breast cancer in a first-degree relative and have not had genetic testing for brca1/2 * patients who have already undergone radiation or chemotherapy * pregnant women * male * prisoners

Keywords: triple negative breast cancer tnbc obesity overweight hispanic non-hispanic white
pharmacogenomics of methadone in spine fusion surgery

Conditions: Scoliosis; Kyphosis

Summary: the overall objective is to develop a patient oriented research program to efficiently evaluate the effects of pharmacogenetic variants on the dose-response relationships and safety of opioids and non-opioid analgesics. if an opioid regimen can be created that produces excellent opioid analgesia with minimal toxicity related to supratherapeutic opioid concentrations (i.e., ventilatory depression), other non-opioid analgesics (i.e., gabapentin/pregabalin, ketamine, lidocaine, cyclooxygenase inhibitors, etc.) that may decrease preoperative opioid requirements can be more efficiently and safely evaluated. these interventions may limit the opioid related toxicities related to effect site concentrations that are below those required when opioids are the predominant analgesic, such as opioid related ileus. methadone's slow elimination clearance and limited pharmacokinetic drug-drug interactions make it an attractive perioperative opioid. the first step towards personalized opioid analgesia is to determine the effect of common pharmacogenetic variants that affect either methadone metabolism (cyp2b6) or opioid elimination.

this study is being done to find the optimal dose of methadone (a long acting pain medication) that decreases the amount of pain that people have after spine surgery. five different doses of methadone will be compared to each other, while keeping the remainder of the anesthetic routine for surgery. the investigators will determine the analgesic dose-response of methadone. the investigators will also determine the effect of methadone on the incidence of opioid related side effects, the quality of outcome of recovery, and the change in the 3-month opioid use.

Eligibility criteria:
inclusion criteria: * asa physical status i, ii, and iii * male and non-pregnant female * english-speaking * undergoing elective \< 3 vertebral level lumbar spine fusion (with and without interbody fusion) exclusion criteria: * use of more than the equivalent of 20 mg of iv morphine/24 hr in the past 2 weeks * history of substance abuse at any time in the past * known qt prolongation * non-elective operations (i.e., cancer or trauma) * severe hepatic impairment (serum albumin \<3.0 g/dl, history of liver disease) * pregnancy

Keywords: spinal fusion opioid analgesia
clinical outcome of defect reconstruction using idrt single layer : results from a prospective multicentric trial

Conditions: Traumatic Wound; Reconstruction Wound

Summary: the aim of this study is to provide data and the guidelines for the use of idrt sl in small wounds, acute and chronic (less than 6 months), showing the benefits and the easy to use of this product as a one stage procedure.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * patient with 1 traumatic wound (burns included) or 1 reconstruction wound (oncological wounds included) * patients for whom the surgeon has recommended that an integra® sl matrix be implanted (even if the patient is not taking part in the study) with a split thickness skin graft in the same operating procedure * wound treated with only one layer of a maximum size 10cm\*12.5cm exclusion criteria: * immunosuppressed patient * chronic wound (with no healing since 6 months) * addition of any substances (growth factor, stem cells,...) in the idrt sl during the surgery * patient with a corticoid treatment with a daily dose greater than 5 mg * patients whose life expectancy is less than 12 months * patients whose mental health or health condition (visual deficiency, alzheimers...) would compromise completion of the self-evaluation questionnaires * patient with an hypersensitivity to bovine collagen, chondroitin * patient with clinical signs of infection (fever, pain, colour, swelling,...) and for whom the investigator diagnosed infection
effectiveness of transcranial direct current in patients with persistent covid-19 with headaches and chronic pain.

Conditions: COVID-19; Long COVID; Long Covid19; SARS CoV 2 Infection; Persistent COVID-19; Migraine Disorders; Headaches Chronic; Cluster Headache; Arthralgia; Myalgia; Chronic Pain; Post-COVID-19 Syndrome; Post COVID-19 Condition

Summary: this study aims to verify the efficacy / effectiveness of treatment with transcranial direct therapy (tdcs) in patients with persistent covid who present headaches, migraines and chronic pain, such as arthralgias and myalgias. transcranial direct therapy is used in the field of physiotherapy and rehabilitation, with results that prove to be effective for the treatment of patients suffering from symptoms such as migraines, headaches, chronic pain, fibromyalgia or chronic neuropathic pain. as can be seen, in the case of patients with persistent covid we find several of these symptoms, so it is suggested that, if transcranial direct current therapy (tdcs) is giving such good results, relieving these symptoms, why can not give such good results and help so much in patients with persistent covid, if many of the symptoms are the same, even if the origin or cause is different.


Eligibility criteria:
inclusion criteria: * patients with persistent covid * men and women * all ages from 16 years old * patients who passed the covid in its acute phase in an asymptomatic, mild and severe way. exclusion criteria: * patients without confirmation with positive pcr in the acute phase of covid-19 * patients with persistent covid who do not have at least one of these symptoms: migraines, headaches, chronic pain, neuropathic pain, arthralgia, myalgias * patients with pacemaker / defibrillator * patients with brain implants * patients with cranial fractures * pregnant

Keywords: transcranial direct current stimulation tdcs covid persistente
effect of cbd on the brain

Conditions: Fragile X Syndrome

Summary: this proposal focuses on the therapeutic relevance of the endocannabinoid (ecb) system for the treatment of fragile-x syndrome (fxs), the primary hereditary cause of autism spectrum disorder (asd). although most individuals with fxs have moderate to severe intellectual disability (id), caregivers are mainly concerned about aggressive behavior and anxiety problems, hallmark features of the condition. concurrent lines of evidence suggest that targeting the endocannabinoid (ecb) system by administration of cannabidiol (cbd) could upregulate gabaergic functions and correct inhibitory deficits presumed responsible for the neuropsychiatric phenotype of fxs. however, the ecb system and its effect on the brain remains unexplored in fxs patients. this clinical trial aims to define the therapeutic relevance of the ecb system for fxs using a multimodal neuroimaging approach to finely characterize the acute effects of oral cbd on the principal inhibitory neurotransmitter system (gaba) in a large cohort of fxs patients.


Eligibility criteria:
inclusion criteria: eligibility criteria for fxs participants will include: * age between 7 and 55 years, molecular diagnosis of fxs, * intelligence quotient (iq) \<70, * aberrant behavior questionnaire score (abc-c) \> 20, * \ 3 months. eligibility criteria for the control group: * 18 and 55 years old, * be in good general health, with no history of neurological or psychiatric disorders. eligibility criteria for all participants: * a minimum weight of 60 kg; * no history of liver problems (a complete blood profile to measure liver enzyme levels (bilirubin, aspartate aminotransferase (ast), argininosuccinate lyase (asl), alanine transaminase (alt), alkaline phosphatase (alp), gamma-glutamyl transferase (ggt)) will be obtained before randomization for all participants). exclusion criteria: * the presence of an absolute contraindication to the use of tms and mri / mrs (ie presence of metal in the head). * individuals with alt / asl levels greater than 3 times the upper normal baseline, or if bilirubin exceeds 2 times the upper baseline,

Keywords: mri cannabidiol gaba fxs mrs tms
intraosseous access in the emergency department for patients with failed attempts at intravenous access: a randomized trial examining resource utilization and patient satisfaction

Conditions: Difficult Peripheral IV Access

Summary: by doing this study, the investigators hope to learn whether patients with difficult to obtain iv access who are treated with io access are more satisfied with their care and have better outcomes. the investigators are specifically studying the time difference between groups and the difference in the number of attempts required to obtain vascular access and begin to treat with fluids and medications. the study will also measure patient satisfaction and procedural pain, the frequency of central line placement, the length of stay in the hospital and emergency department, and adverse events to intravascular access to determine whether io access can improve these measures. the investigators hypothesize that the use of a protocol utilizing an io device for select patients with failed iv access will reduce the time requirements to obtain vascular access, reduce the number of attempts needed to obtain iv access, reduce the ed los, and have no negative impact on patient satisfaction compared to the current ed practices.


Eligibility criteria:
inclusion criteria: 1. 18 years of age or older 2. hemodynamically stable 3. speaks english 4. able to consent 5. has difficult iv access exclusion criteria: 1. patients who are younger than 18 years of age, b) lack english fluency c) are unable to give informed consent d) require immediate central venous access e) have a history of osteomyelitis in the only target location of io access f) have a fracture in the bone of the only target io site g) have received an io in the last 24 hours of the only target site h) are allergic to lidocaine i) pregnant or j) require a contrast ct scan as part of their ed care will be excluded. while pregnant patients may benefit from rescue access the use of lidocaine to anesthetize the medullary space has not been studied in this population.

Keywords: intraosseous (io) vascular access
evaluation of a millimeter wave emission bracelet for improving parkinson's disease symptoms

Conditions: Parkinson Disease

Summary: idiopathic parkinson's disease is a common neurodegenerative disease, with a prevalence of around 2% in people over 65 years of age in france. this pathology affects the dopaminergic pathway but also other systems: cholinergic, noradrenergic and serotoninergic. the symptoms of parkinson's disease are motor but also non-motor with sleep, smell, cognitive, psychiatric, digestive, urinary, dysautonomic, painful disorders. the discomfort can be such that invasive and expensive solutions have been developed. invasive or expensive techniques (deep brain stimulation, lesional microsurgery by gamma knife or ultrasound, duodopa or apokinon pumps) brought significant benefits to patients. opportunities for clinical improvement using less expensive and lighter devices should be sought. the remedee endorphin band device is a device that emits millimeter-band electromagnetic waves on the wrist. the device stimulates subcutaneous nerve endings and activates a physiological response leading to the release of endorphins in the brain. endorphins are involved in several physiological processes, including pain control. mu-opioid receptor (mor) agonists do not only relieve pain, but have effects related to mesolimbic dopaminergic pathways. indeed, the opioid and dopaminergic systems are closely linked at the cellular level. endorphins, through inhibition of the release of the neurotransmitter gaba upon binding to the μ receptor, are also linked to an increase in dopamine.

intervention 1 name : verum description : experimental arm (verum): delivery of an active medical device for a period of 2 months. then delivery of a second active medical device for a period of 4 months. intervention 2 name : sham description: control arm (sham): delivery of an inactive medical device for a period of 2 months of use then delivery of an active medical device from m2 to m6 after inclusion

Eligibility criteria:
inclusion criteria: * patient over 18 years old * follow-up for parkinson's disease for more than 5 years * treatment stable for at least 3 months * having retained sufficient autonomy to allow participation in the study * hoehn and yahr score in on dopa \<4 exclusion criteria: * genetic forms of the disease * eva\> 7 over the previous week * moderate to severe cognitive impairment * pathology or condition (other than parkinson's disease) that can generate motor disorders * allergy to metals and / or silicone * dermatological pathology on the wrists * metal object at one of the wrists (implanted metal material, piercing) * presence of a tattoo on one of the wrists * wrist circumference \ 21 cm i.e. wrist incompatible with the md template * inability of the patient to put on and / or wear the template of the medical device * pregnant or breastfeeding woman
adenoma detection rate with position change at colonoscopy

Conditions: Polyps

Summary: the hypothesis to be tested is that position changes during the withdrawal phase of colonoscopy leads to a higher adenoma (polyp) detection rate because of better distension of the colon. since adenomas are precancerous lesions the enhanced adenoma detection will increase the success of colorectal cancer screening programmes. this study will provide evidence for the value of position changes and encourage endoscopist to adopt position change as a routine in their practice. may 2007: protocol amendment to include additional prospective analysis using high definition tv (hdtv).

colorectal cancer is the second commonest cause of cancer death. in a majority of cases it is preceded by a precancerous lesion called an adenoma (commonly known as polyp). detection and removal of adenomas at colonoscopy has been shown to reduce mortality from colorectal cancer. the success of the impending colorectal cancer screening programme to reduce cancer mortality in an average-risk population depends on optimal adenoma detection at colonoscopy. the detection of adenomas has been shown to vary between different endoscopist. some of the factors that have been reported to affect adenoma detection rates included the time spent viewing, the adequacy of the bowel preparation and the time spent cleaning the colonic mucosa of excess fluid. careful examination of proximal side of flexures, folds and valves by the endoscopist is equally important. however, even with careful examination adenoma detection rates have been shown to vary between endoscopist from 8.6% to 15.9%. previous experience and training may be contributed to this difference. some endoscopist adopt regular changes in position during the procedure to maximize distension of the colon. better luminal distension enhances mucosal views for detection of the smaller adenomas. the validity of this approach has never been tested and we propose that this factor may contribute to the differences in adenoma detection rates. patients will be randomised to either position 1 first then position 2 or vice versa and examined twice. during one withdrawal the colon will be examined with the participant in the left lateral position only (position 1) or with position changes (position 2)or vice versa. may 2007: protocol amendment to include additional prospective analysis using high definition tv (hdtv). no further patient data collection involved.

Eligibility criteria:
inclusion criteria: * patients referred ot colonoscopy, age between 50 - 70 years exclusion criteria: * patients with colorectal cancer, previous colonic surgery, active colitis and musculoskeletal problems patients may also be excluded after the first insertion, if painful, routine care will proceed

Keywords: position change adenoma colonoscopy