Kornimate/medical-research-clean huggingface dataset:
epidural oxycodone for pain management for lower limb amputation

Conditions: Epidural; Oxycodone; Pain; Lower Limb Amputation

Summary: the aim of this study is to evaluate the effect of epidural oxycodone for pain management after lower limb amputation.

phantom limb pain (plp) is often described as tingling, throbbing, sharp, pins/needles in the limb that is no longer there. it occurs more commonly in upper extremity amputations than lower extremities and tends to be intermittent in frequency. pain severity varies, and onset can be immediate or years afterward. the preventive strategies for the plp pain are difficult to manage and if not addressed adequately may lead to chronic pain. the perioperative role of the anesthesiologist and the acute pain physician is important in the management of somatic and sometimes neuropathic postoperative pain. oxycodone is a semi-synthetic narcotic analgesic and historically has been a popular drug of abuse among the narcotic abusing population. oxycodone is used orally or intravenously.

Eligibility criteria:
inclusion criteria: * age 18 to 65 years. * both sexes. * american society of anesthesiologists (asa) physical status ii or iii. * undergoing lower limb amputation. * under epidural anesthesia. exclusion criteria: * hypersensitivity to opioids. * cardiac arrhythmias. * acute asthma or other obstructive airways disease. * severe renal impairment. * pregnancy.
a randomized controlled trial of inhaled amphotericin b for maintaining remission in allergic bronchopulmonary aspergillosis

Conditions: Allergic Bronchopulmonary Aspergillosis

Summary: inhaled amphotericin, a antifungal drug would decrease aspergillus colonization and decrease the occurrence of exacerbations of allergic bronchopulmonary aspergillosis (abpa).


Eligibility criteria:
inclusion criteria: abpa in remission defined as follows: 1. age 12-65 years 2. diagnosis of abpa in the chest clinic 3. received glucocorticoids for management of abpa according to the chest clinic protocol (0.5 mg/kg/day for 4 weeks, 0.25 mg/kg/day for 4 weeks, 0.125 mg/kg/day for 4 weeks, subsequently taper and stop steroids over the next 4 weeks). 4. clinicoradiologic improvement with decline in ige levels. the chest radiograph and ige levels after four months of steroid therapy would serve as the baseline exclusion criteria: 1. failure to provide informed consent 2. pregnancy 3. involved in any other research protocol

Keywords: abpa
efficacy and safety of ixekizumab in patients with refractory guttate psoriasis

Conditions: Guttate Psoriasis

Summary: the goal of this clinical trial is to analyse efficacy and safety of ixekizumab in participants with refractory guttate psoriasis. the main question it aims to answer is: what percentage of participants achieved more than 90% reduction from baseline in psoriasis area index （pasi 90） after 12 weeks of ixekizumab treatment? participants will receive a 12-week treatment of ixekizumab, with follow-up visits every 2 weeks during the treatment period. keep a diary of their symptoms and psoriasis area index.

this study was a single-arm, open-label, single-center multi-dose trial. approximately 50 participants are scheduled to receive subcutaneous injection of ixekizumab for 12 weeks, with follow-up every 2 weeks during the treatment period. after the treatment period, the primary endpoint was assessed at week 16, and patients who achieved pasi 90 response were followed up at week 34 and week 52 to the medical center to assess disease recurrence or progression. to evaluate the efficacy of ixekizumab in the treatment of refractory guttate psoriasis.

Eligibility criteria:
inclusion criteria: 1. patients voluntarily participate in the study and sign an informed consent form; 2. age between 18 and 70 years, both genders are eligible; 3. clinically diagnosed with guttate psoriasis; 4. previously treated with traditional therapies for plaque psoriasis for more than 4 weeks (including antibiotics, topical corticosteroids, topical calcipotriene, phototherapy); 5. current pasi score ≥ 3 or dlqi score ≥ 6; 6. investigator assesses participants's suitability for treatment with ixekizumab; 7. no prior use of biologic agents for treatment; 8. basic understanding of the purpose of the trial, its effects, and potential adverse events, and willing to sign the informed consent form according to the principles of the helsinki declaration; 9. agree to receive regular treatment, follow-up, and undergo relevant examinations according to the clinical research protocol. exclusion criteria: 1. presence of other psoriasis phenotypes such as plaque, pustular, erythrodermic, or psoriatic arthritis; 2. concomitant severe skin diseases, tumors, other systemic diseases (such as inflammatory bowel disease), or mental disorders; 3. concurrent infections such as tuberculosis, hiv, hepatitis b, hepatitis c, etc.; 4. allergy to ixekizumab; 5. received systemic corticosteroids or immunosuppressive/immunomodulatory drugs for psoriasis treatment within the previous 4 weeks (including but not limited to methotrexate, cyclosporine, acitretin, azathioprine, hydroxychloroquine, apremilast, jak inhibitors, etc.); 6. participation in another clinical trial within the past 3 months; 7. pregnant, lactating women, or those planning to become pregnant during the trial; 8. other circumstances deemed inappropriate for inclusion by the investigator.
high-volume plasma exchange versus standard medical treatment in patients with acute liver failure

Conditions: Acute Liver Failure

Summary: the study will be conducted on patients admitted to department of hepatology from jan 2016 to jan 2018 at institute of liver \& biliary sciences, new delhi. study group will comprise of patients with acute liver failure (alf) who have no option for liver transplant (due to any reason) or have contraindications for liver transplant or have no prospective living donor and will be assessed for enrollment in the trial.


Eligibility criteria:
inclusion criteria: * patients with acute liver failure defined as : patients with jaundice which is complicated by encephalopathy and coagulopathy within 4 weeks of the onset of jaundice and without underlying chronic liver disease. exclusion criteria: * age \ 75 years * hepato-cellular carcinoma * active untreated sepsis/dic * any evidence of active bleed secondary to coagulopathy * hemodynamic instability requiring high dose of vasopressors * coma of non-hepatic origin. * pregnancy * comorbidities associated with poor outcome (extrahepatic neoplasia, severe cardiopulmonary disease defined by a new york heart association score \>3, or oxygen/steroid-dependent chronic obstructive pulmonary disease). * patients being taken up for liver transplant * refusal to participate in the study.
development of kinect-assisted home-based bilateral arm training program for cerebral palsy

Conditions: Cerebral Palsy

Summary: the purpose of the present study is to develop a long term cost-effectiveness (efficient protocol, playful context, and practical strategy) training program for school-age children with cerebral palsy. also, evaluate efficacy of kinect-assisted bilateral arm training program for children with cerebral palsy.


Eligibility criteria:
the inclusion criteria of children with cp are: 1. diagnosed with congenital hemiplegic 2. no excessive muscle tone (modified ashworth scale ≤ 3 at any joints of the upper limb) the exclusion criteria of children with cp are: 1. have severe cognitive, visual, or auditory disorders according to medical documents, parental reports, and the examiner's clinical observation 2. have injections of botulinum toxin type a. the inclusion criteria of typically developing children are: 1. absence of medical or developmental diseases which would affect physical and cognitive performances 2. having normal corrected vision 3. studying in regular education classroom in primary school for the 6-12 year-old children. the exclusion criteria of typically developing children are: (1) having score not within normal limits in botmp-short form

Keywords: cerebral palsy occupational therapy upper limb motor training
freezing of gait - clinical outcomes assessment

Conditions: PD - Parkinson's Disease

Summary: to develop a reliable and accurate clinician-reported outcome (clinro) measure (against a new and precise definition) and patient reported outcome (pro) for use by clinicians and researchers to quantify the severity of freezing of gait (fog).


Eligibility criteria:
inclusion criteria: 1. diagnosis of idiopathic parkinson's disease (pd) made by a neurologist according to the movement disorders society guidelines; 2. able to walk independently for a distance of 10 meters, without walking aid; 3. absence of a deep brain stimulator; 4. stable pd treatment in the 4 weeks prior to participation that is not expected to change in the course of the study. 5. for patients with fog: a score of ≥ 1 on the new freezing of gait questionnaire (nfog-q). exclusion criteria: 1. occurrence of any of the following within 3 months prior to informed consent: myocardial infarction, hospitalization for unstable angina, stroke, coronary artery bypass graft (cabg), percutaneous coronary intervention (pci), implantation of a cardiac resynchronization therapy device (crtd), active treatment for cancer or other malignant disease, uncontrolled congestive heart disease (nyha class \>3), acute psychosis or major psychiatric disorders or continued substance abuse, other neurological (than pd) or orthopaedic impairment that significantly impacts on gait. 2. unwilling to temporarily delay the morning anti-parkinsonian medication. 3. preganacy and
effect of peep on lung recruitment and homogeneity over time in moderate to severe ards

Conditions: ARDS; Critical Illness; Ventilator-Induced Lung Injury

Summary: this study evaluates the effect of airway pressure release ventilation (aprv) on lung homogeneity and recruitment in patients with moderate to severe acute respiratory distress syndrome (ards). it will do this by comparing the homogeneity of ventilation and recruitment prior to a patient being ventilated on aprv, and at 30, 60 and 120 minutes after starting aprv.

ventilator-induced lung injury (vili) is a well-recognised problem of ventilation in patients with ards, and is currently treated with lung-protective ventilation, which limits tidal volumes and airway pressures by applying higher levels of positive-end expiratory pressure (peep). however, it is not known whether higher levels of peep increases recruitment and homogeneity of ventilation within the lungs. aprv is a mode of inverse ventilation, where high levels of peep are maintained with brief releases of pressure, and has been proposed as an appropriate method of ventilation in patients with ards. this study will assess homogeneity of ventilation and recruitment in 15 patients before aprv is started, and 30, 60 and 120 mins after commencing aprv. it will do this using electrical impedance tomography (eit), nitrogen wash in/wash out technique, and lung strain.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years and \< 80 years * weight \> 35 kg and bmi \< 40 * informed consent according to local regulations * hemoglobin ≥ 70 g/dl * haemodynamically stable \> 4 hours * moderate to severe ards (pao2/fio2 \ 5 cmh2o) as per berlin definition of ards exclusion criteria: * expected survival \< 72 hours * suspected pregnancy (negative pregnancy test required for women of child-bearing potential) * open abdomen * documented or suspected raised intracranial pressure * active air leak (pneumothorax, pneumomediastinum, subcutaneous emphysema) * morbid obesity bmi \> 40 * recent \< 1 week cardiac or thoracic surgery * unstable thorax and sternum with paradoxical chest wall movement * severe chronic respiratory disease (copd) - gold 3 or 4 emphysema with bullae * severe smoking (\> 40 pack-year history) * liver failure: child-pugh class c * massive ascites * lung fibrosis * severe cardiac disease (one of the following): new york heart association class iii or iv, acute coronary syndrome or persistent ventricular tachyarrhythmias * sickle cell disease

Keywords: recruitment lung homogeneity airway pressure release ventilation
pronostic and predictive value of emt in localized lung cancer

Conditions: NSCLC, Stage I, II, IIIA, IIIB; Surgery; Progression; Epithelial Mesenchymal Transition

Summary: the goal of the present research is to identify an "emt signature", associated with long term disease-free survival after surgery in nsclc. this study will potentially lead to specific treatment recommendations, thanks to an integrated molecular approach including dna, rna and mir profiling in vitro analyses using lung cancer cell lines will subsequently be conducted to validate markers identified in tumor screenings.

one critical issue in studying oncogenesis is the comprehensive understanding of tumor genome complexity. molecular subtypes may be identified through large-scale molecular screenings or gene expression analyses and molecular signatures are recognized as a relevant source of disease stratification. the investigators will focus on nsclc patients with localized diseases included in the oncohegp tissue collection project (oncohegp, ministere de la recherche n° dc 2009-950). the investigators had previously shown that in egfr mutated cancer, reactivation of twist1 was reversibly linked to emt and to survival. to go further, the investigators plane to investigate emt in a large cohort of patients with lung cancer to identify prognostic and predictive markers of long term survival. the investigators will integrate mutation, and copy number alterations to emt gene expression analyses and to emt related mir quantification. tumor phenotype, mir signatures, mutation status will help classify patients according to survival. clinical data will be assessed thanks to the epithor database. epithor is a government-recognized clinical database, accredited by the french health authorities (haute autorité de santé) and is supported by the national cancer institute (institut national du cancer). emt characterization and scoring will be done using 10 markers by qpcr, mutation and cnv screenings by targeted ngs analysis, mirs signature by mirseq and qpcr.

Eligibility criteria:
inclusion criteria: * patient with nsclc stage i ii iiia iiib, treated by surgery at georges pompidou hospital (hegp) informed consent oncohegp signed exclusion criteria: * informed consent oncohegp not signed
study to evaluate tezepelumab in adults & adolescents with severe uncontrolled asthma

Conditions: Asthma

Summary: a multicentre, randomized, double-blind, placebo controlled, parallel group, phase 3 study to evaluate the efficacy and safety of tezepelumab in adults and adolescents with severe uncontrolled asthma

this is a multicentre, randomized, double-blind, placebo controlled, parallel group study designed to evaluate the efficacy and safety of tezepelumab in adults and adolescents with severe, uncontrolled asthma on medium to high-dose ics and at least one additional asthma controller medication with or without ocs. approximately 1060 subjects will be randomized globally. subjects will receive tezepelumab, or placebo, administered via subcutaneous injection at the study site, over a 52-week treatment period. the study also includes a post-treatment follow-up period of 12 weeks.

Eligibility criteria:
inclusion criteria: * age. 12-80 * documented physician-diagnosed asthma for at least 12 months * subjects who have received a physician-prescribed asthma controller medication with medium or high dose ics for at least 12 months. * documented treatment with a total daily dose of either medium or high dose ics (≥ 500 µg fluticasone propionate dry powder formulation equivalent total daily dose) for at least 3 months. * at least one additional maintenance asthma controller medication is required according to standard practice of care and must be documented for at least 3 months. * morning pre-bd fev1 \<80% predicted normal (\<90% for subjects 12-17 yrs) * evidence of asthma as documented by either: documented historical reversibility of fev1 ≥12% and ≥200 ml in the previous 12 months or post-bd (albuterol/salbutamol) reversibility of fev1 ≥12% and ≥200 ml during screening. * documented history of at least 2 asthma exacerbation events within 12 months. * acq-6 score ≥1.5 at screening and on day of randomization exclusion criteria: * pulmonary disease other than asthma. * history of cancer. * history of a clinically significant infection. * current smokers or subjects with smoking history ≥10 pack-years and subjects using vaping products, including electronic cigarettes. * history of chronic alcohol or drug abuse within 12 months. * hepatitis b, c or hiv. * pregnant or breastfeeding. * history of anaphylaxis following any biologic therapy. * subject randomized in the current study or previous tezepelumab studies.

Keywords: asthma, uncontrolled asthma, severe uncontrolled asthma
prospective observation of cardiac safety with proteasome inhibition

Conditions: Heart Failure; Multiple Myeloma

Summary: the purpose of this study is to better define and understand potential cardiac toxicities of proteasome inhibitors and to understand optimal management strategies to treat and prevent cardiovascular events.

cancer treatments, using proteasome inhibitors, have the potential in induce cardiac toxicities including heart failure (hf), hypertension, arrhythmias and ischemic heart disease. while the presence of cardiac events may be a class effect of proteasome inhibitors (pi), the effect may be more profound with the irreversible inhibition of carfilzomib compared with reversible inhibition with bortezomib. data available from currently published clinical trials may be inadequate to fully understand the incidence and severity of cardiac injury in patients treated with proteasome inhibitors because the trials were not designed to fully assess cardiac events. the purpose of this study is to better define and understand potential cardiac toxicity and begin to understand optimal management strategies.

Eligibility criteria:
inclusion criteria: * relapsed multiple myeloma at any time-point in treatment course and planning to start a proteasome inhibitor-based therapy as part of standard care * received at least one prior line of therapy for multiple myeloma (induction therapy followed by stem cell transplant and consolidation/maintenance therapy will be considered as one line of therapy) * males and females ≥ 18 years of age * able to provide written informed consent in accordance with federal, local, and institutional guidelines exclusion criteria: * poems syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) * known or suspected al amyloidosis, secondary amyloidosis or cardiac amyloidosis * plasma cell leukemia (\> 2.0 × 109/l circulating plasma cells by standard differential) * waldenström macroglobulinemia * myelodysplastic syndrome * history of mi within the last 3 months * symptomatic unstable cardiac arrhythmia requiring treatment in the past 3 months * class 3 or 4 new york heart association heart failure in the past 3 months * any other clinically significant medical disease or condition that, in the investigator's opinion, may interfere with protocol adherence or a subject's ability to give informed consent

Keywords: heart failure cardiac toxicity multiple myeloma bortezomib carfilzomib
china stemi-pci program

Conditions: ST Segment Elevation Myocardial Infarction

Summary: 1. registration 2. performing in three stages 3. major aim: much more and standard reperfusion therapy in stemi patients


Eligibility criteria:
inclusion criteria: * onset of stemi within 12h * onset of stemi within 12-36h needing primary pci exclusion criteria: -

Keywords: stemi reperfution primary pci
effects of social media on oral hygiene with orthodontic patients

Conditions: Periodontal Inflammation; Orthodontic Appliance Complication

Summary: the aim of this study was to compare the efficacy of traditional and social media motivation strategies in improving oral hygiene with fixed orthodontic treatment.

in this prospective, controlled clinical trial, 44 orthodontic patients were equally allocated to a social media (facebook, instagram and x (twitter)) and control group. the control group received only traditional communication including verbal and written instructions at the beginning of the therapy. the patients assigned to social media group received two posts twice a week reminding hygiene procedures in addition to standardized oral hygiene instructions. periodontal scores were obtained at 4-6-week intervals during six appointments (t1-t6) using the gingival index (gi), bleeding index (bi), and planimetric plaque quantification (pi) on photographs

Eligibility criteria:
inclusion criteria: * class 1 malocclusion who had simple or moderate crowding and did not require tooth extraction. exclusion criteria: * patients with functional appliances; surgical patients; those with a history of periodontitis, poor orthodontic hygiene, and/or physical or mental disabilities were excluded from the study.

Keywords: oral hygiene social media fixed orthodontic treatment
memory and mri changes with hippocampus avoidance prophylactic cranial irradiation(ha-pci) for small cell lung cancer(sclc)

Conditions: Small Cell Lung Cancer

Summary: this is a prospective, randomized phase-ii study observing the memory preservation and functional brain mri changes with conformal avoidance of the hippocampal neural stem-cell compartment during prophylactic cranial irradiation for small cell lung cancer patients.

brain metastasis is rather high in small cell lung cancer patients. prophylactic cranial irradiation(pci) is the standardized treatment. however, cognitive dysfunction like memory damage is observed in quite a number of patients after brain irradiation, which may due to the hippocampus being irradiated. thus, the investigators conduct the study by reducing the dose to the hippocampal neural stem-cell compartment (haz) during pci. patient population: age: 18-65y; small cell lung cancer undergoing pci; eastern cooperative oncology group (ecog) score: 0-1. the patients are randomized to 2 arms: arm routine pci: ptv(planning target volume) 25gy/10f. arm hippocampus avoidance pci(ha-pci): ptv 25gray(gy)/10fraction(f), haz dmin\<9gy dmax\<16gy). measurements: hopkins verbal learning test(hvlt) and functional brain magnetic resonance imaging.

Eligibility criteria:
inclusion criteria: 1. histologically conformed small cell lung cancer; 2. complete response (cr)/partial response (pr) after chemo-radiotherapy; 3. ecog (eastern cooperative oncology group) : 0-1; 4. no imaging evidence of brain metastasis before pci; 5. normal hemodynamic indices before the recruitment (including white blood cell count\>4.0×109/l, neutrophil count\>1.5×109/l, platelet count \>100×109/l, hemoglobin≥90g/l, normal liver/kidney function); 6. able to understand this study and have signed informed consent. exclusion criteria: 1. unable to receive mri; 2. medical history of central nervous system, cognitive or psychological diseases; 3. the expectation of life is less than 6 months; 4. female in pregnancy or lactating; 5. the researchers consider the patient not appropriate to be enrolled.

Keywords: hippocampus avoidance volumetric modulated arc therapy functional mri hopkins verbal learning test prophylactic cranial irradiation