Kornimate/medical-research-clean huggingface dataset:
posterior fossa mutism on quality of life

Conditions: Posterior Fossa Mutism

Summary: posterior fossa mutism (pfm) occurs in up to 30% of patients after resection of a posterior fossa tumor, most commonly a medulloblastoma. pfm is characterized by delayed onset of mutism 1-6 days after surgery that can spontaneously improve on average from 7-8 weeks later. few patients recover normal speech. most of their speech continues to be marked by dysarthria, dysfluency and slowed rate. researchers have not identified the pathophysiologic mechanism for pfm nor have they found a cure. despite the improvements in speech, patients with pfm have shown multiple areas of neurocognitive deficits 12 months after diagnosis. few studies have looked at long term outcomes of patients affected by pfm. we propose to survey patients who developed pfm after resection of a medulloblastoma to determine long term effects of pfm on patient's quality of life.


Eligibility criteria:
inclusion criteria: patients must be between 8 years and 25 years of age at the time of enrollment and have completed treatment for their initial diagnosis of medulloblastoma. exclusion criteria: 1. patient is less than 8 years old or greater than 25 years old at the time of the administration of the survey. 2. patients are too ill to complete the survey as identified by their treating physician. 3. patients who are unable to speak or understand english. 4. patients who are currently being treated for their original diagnosis of medulloblastoma.

Keywords: mutism
clinical benefit of spa care on severe radiation-induced fibrosis after postoperative radiotherapy for breast cancer

Conditions: Breast Carcinoma; Fibrosis

Summary: this study evaluates the dermatological life quality six months after spa cares in patients with severe late toxicity involving the skin and / or soft tissues after postoperative radiotherapy for breast cancer. half of the patients will be treated with a combination of pentoxifylline (ptx) and alpha-tocopherol (vit e) when half of the patients will receive skin-oriented spa cares in addition.

the combination of ptx and vit e appears as the standard treatment of radiation induced fibrosis. synergism between ptx and vit e is likely, as treatment with each drug alone is ineffective. this combination was also positively evaluated in the treatment of osteoradionecrosis, radiation-induced pelvic neuropathies, pneumoniae as well as bowel pathologies. spa cares are part of the standard treatment of burn scars. two spa treatments per year enable the mitigation or disappearance (after several treatments) of pruritus, dysesthesia, local inflammation, hypertrophy and sclerosis. they promote the healing of chronic superficial erosions. the spa treatment combines baths, sprays and especially filiform showers with thermal water jets under high pressure for a few minutes.

Eligibility criteria:
inclusion criteria: * women * age ≥ 18 and \<80 years old * invasive or in situ breast carcinoma * non-metastatic disease. * postoperative radiotherapy completed since at least 6 months * unilateral breast radiotherapy * grade \> 2 dermal and/or soft tissue toxicity (ctcae v4.0) * no inflammatory ou infectious flare on the breast at the time of inclusion * ability to provide an informed written consent form * affiliation to a social security system exclusion criteria: * age \<18 or ≥ 80 years old * evolutive cancer * metastatic disease * patient undergoing specific treatment for breast cancer (except adjuvant endocrine therapy and / or adjuvant herceptin) at the time of inclusion * bilateral breast/chest wall radiotherapy * breast prosthesis bearer * body mass index \> 40 or \<18.5 * chronic skin ulceration within the treated breast at the time of inclusion * contraindications to spa care : * inflammatory disease in flare at the time of inclusion * active infections * heart failure (nyha class\> 1) * chronic respiratory failure * labile blood pressure * bullous dermatitis * evolutive chronic skin disease * hypersensitivity to pentoxifylline or any of the excipients * acute myocardial infarction * ongoing hemorrhage or major bleeding risk * use of oral anticoagulants * pregnant or likely to be in 6 months or breastfeeding * patients deprived of liberty or under supervision

Keywords: spa care randomised controlled trial pentoxifylline/tocopherol combination late sequelae radiotherapy
block duration after spinal block and iv dexamethasone.

Conditions: Postoperative Pain; Lower Limb Injury

Summary: it has been largely demonstrated that iv dexamethasone prolongs the duration of analgesia after peripheral nerve block. however, data are missing regarding the duration of analgesia after spinal block. the objective of this randomized controlled double-blinded trial is to assess whether intravenous dexamethasone administered after a spinal block, before the surgery would prolong sensory block characteristics without impacting the motor block duration.


Eligibility criteria:
inclusion criteria: * patient with asa i-iii status ; * patient scheduled for an osteosynthesis surgy of the lower limb exclusion criteria: * polytrauma patient * pregnancy * contraindication to spinal anesthesia * contraindication to dexamethasone administration * patient with chronic pain
test-retest reliability of uulex in patients with stroke

Conditions: Stroke

Summary: hemiplegia refers to a complete paralysis involving one side of the arm, trunk and leg. stroke causes loss of ability and leads to loss of functionality of daily life activities of individuals. changes in the anatomy of the joint should be analysed for a better understanding of upper extremity problems, especially shoulder problems and pain after stroke. in recent years, the prevalence of shoulder pain in haemiplegic patients has ranged between 5% and 84%. shoulder pain makes movements of the upper limb difficult and affects gait. lack of active movement and spasticity is an important cause of shoulder pain. pain and changes in muscle tone affect upper limb functionality by 30-66%. improvement in shoulder pain with the recovery of upper extremity functions is important in returning the person to active life independently, as well as obtaining effective hand function. there are many clinical tests used to evaluate upper extremity functionality after haemiplegia. one of them, the unassisted upper extremity exercise test (uulex), is a performance test that evaluates upper extremity performance. the unsupported upper extremity exercise test (uulex) is a simple, inexpensive field test developed to measure upper arm exercise capacity, but there are no reports on its reliability for use in patients with hemiplegia. the aim of our study was to determine the test-retest reliability of the uulex in stroke patients.


Eligibility criteria:
inclusion criteria: * having had a stroke * diagnosis of haemiplegia after a previous stroke * being between 18-78 years old * volunteering to participate in the study exclusion criteria: * presence of pain in the upper limbs or neck * cognitive disorders * presence of comorbidity affecting upper extremity and hand functions (carpal tunnel syndrome, trigger finger, impingement syndrome, thoracic outlet syndrome, lateral and medial epicondylitis) * history of upper extremity surgery

Keywords: stroke uulex upper extremity
decision impact study to measure the influence of decipher on treatment recommendations

Conditions: Prostate Cancer

Summary: this clinical utility study pilot is based on a review of real but de-identified and randomized patient cases and aims to evaluate urologists' treatment recommendations before and after reviewing the results provided by the decipher test. this is a pilot study and the primary intent is to help guide development and design of future clinical utility studies for decipher

the primary and secondary objectives will be assessed in retrospectively selected prostate cancer patients treated with radical prostatectomy with one or more adverse pathological features (apfs)

Eligibility criteria:
criteria (participant enrollment) inclusion criteria study participants: 1. practicing board-certified urologic surgeons 2. performing at least 40 radical prostate surgeries annually exclusion criteria study participants: (1) did not meet the inclusion criteria criteria (case selection) inclusion criteria case file: patient cases eligible for this study were treated with radical prostatectomy and have one or more adverse pathological features present defined as: pathological gleason score \>= 8 or gleason score 7 with primary pattern 4; pathological stage t3a (= extraprostatic extension) or t3b (=seminal vesicle invasion); positive surgical margins gleason grade upgrade from biopsy to surgery exclusion criteria case file: metastatic disease (m+) prior to surgery received any neo-adjuvant prostate cancer treatment with radical prostatectomy (radiation, hormone, chemotherapy)
feedback using behavioral economic theories on step counts in cardiovascular disease patients

Conditions: Cardiovascular Diseases; Rehabilitation; Behavioral Economics

Summary: this is a prospective, randomized controlled trial. the aim of the study is to verify the effectiveness of interventions using gamification with social incentives and social support to increase physical activity in patients with cvd through randomized controlled trials.

the three aims of this randomized controlled trials; 1. to demonstrate the effectiveness of loss framing in gamification for achieving increased physical activity in patients with cvd. 2. to demonstrate the effectiveness of social support in gamification for achieving increased physical activity in patients with cvd. 3. to evaluate the impact of the intervention using social incentives and social support through gamification on changes in participants; subjective assessment of physical activity levels, body mass index (bmi), and lipid panel in blood tests. secondary objective: 1. to assess whether the differences between study groups in achieving the goal of increased physical activity during the 6-week intervention period persist during the 6-week follow-up period. 2. to investigate how the increase in physical activity through gamification in patients with cvd is influenced by patients; behavioral characteristics and environmental factors. this trial will be a five-group, randomized controlled trial (rct) with an intervention period of 6 weeks and a follow-up period of additional 6 weeks.

Eligibility criteria:
inclusion criteria: * age 18 years or older * history of old myocardial infarction or chronic heart failure * ability to read and provide informed consent to participate in this trial * owning a smartphone capable of installing this application exclusion criteria: * having difficulty using smartphones (due to vision problems or it literacy issues) * exercise therapy is contraindicated (in accordance with the 2021 revised guidelines on rehabilitation in cardiovascular diseases) * ability to read and provide informed consent to participate in this trial * owning a smartphone capable of installing this application * participating in other studies related to physical activity * being pregnant * any other medical conditions or reasons they are unable to participate in a physical activity study for 12 weeks

Keywords: cardiovascular diseases rehabilitation behavioral economics health services
atorvastatin for haart suboptimal responders

Conditions: Acquired Immune Deficiency Syndrome Virus

Summary: we hypothesise that atorvastatin changes immune activation among haart-treated adults with suboptimal cluster cell differentiation 4 (cd4) recovery by 25%

the investigators have previously shown that up to 40% of haart-treated adults have suboptimal cd4 recovery despite viral suppression. the investigators have also shown that immune activation and exhaustion are significantly higher among patients that do not exhibit satisfactory rise in cd4 counts despite viral suppression (suboptimal responders); when compared with their counterparts with viral suppression and satifactory cd4 count recovery (optimal responders). given that atorvastatin changes immune activation in this pilot study, then larger studies can be done to understand its effect on cd4 count increase among suboptimal responders.

Eligibility criteria:
list of inclusion criteria: hiv-infected adults on antiretroviral therapy for at least 6 years with sustained viral suppression (viral load\<400 copies), and cd4 increase below 300 cells (difference between current and baseline cd4 count). list of exclusion criteria: history of an opportunistic infection within the previous six months, pregnancy, history of myositis, history of ingestion of lipid-lowering agents at the baseline visit, use of therapeutic agents known to have substantial drug-drug interactions with statins, and individuals on pi-containing haart

Keywords: immune activation antiretroviral therapy atorvastatin immune exhaustion adults africa
transplantation of acellular corneal matrix to treat corneal ulcer

Conditions: Corneal Ulcer

Summary: this study is to develop a lamellar keratoplasty method for corneal ulcer using acellular corneal matrix (acm) and to make an analysis among patients for its therapeutic effect.

infections, chemical injury, and other diseases result in acute or chronic corneal ulcer, which may damage corneal stroma and may lead to permanent corneal scars and blindness. corneal transplantation is standard method for corneal ulcer, but severe shortage of donor corneas limits its application. acellular porcine corneal matrix is similar to the native cornea, especially with the biological property and microstructure. recently, this matrix has been proved to be safe when transplanted to animal subjects and will not be rejected by the recipient. in animal lamellar keratoplasty experiments, acellular corneal matrix showed that they can integrate into the corneal wound bed and help reconstruction of the lamellar integrity of corneal stroma. this study will investigate its healing effect on human corneal ulcer. it will provide a potential corneal substitute for this disease.

Eligibility criteria:
inclusion criteria: * patients aged between 18 and 75 yrs. * corneal ulcer. * informed consent. exclusion criteria: * corneal perforation. * other ocular diseases. * the presence of systemic connective tissue diseases * severe allergic constitution * pregnancy * the presence of chronic disease, such as significant cardiovascular illness * the patients who received clinical experiments for other medicine or medical devices within 3 months prior to the transplantation. * any patient that is not suitable for recruitment, in the judgment of the investigator.
the effect of therapeutic neuroscience education on chronic low back pain

Conditions: Chronic Low-back Pain

Summary: ongoing fear and catastrophization in people with chronic low back pain (clbp) causes increased pain, disability and kinesiophobia, and decreased endurance of trunk muscles. nowadays, recurrent low back pain complaints are increasing day by day. besides the use of electrophysical agents and exercise in the treatment of chronic low back pain, education methods used to reduce the negative effects of psychosocial factors are important for healing. although there were studies about the combination of therapeutic neuroscience education (tne) with exercise in clbp, there are no studies that combine electrophysical agents, exercise and tne methods in the literature. therefore, in this study, we aimed to investigate whether tne combined with physiotherapy consisting of electrophysical modalities and home program exercise is superior to only physiotherapy in patients with clbp.


Eligibility criteria:
inclusion criteria: the inclusion criteria were: * aged between 18-60 years * to have clbp ˃ 3 months duration * to have independent walking ability * to be literate in turkish. exclusion criteria: * to have vertebral compression fractures * to have transitional vertebrae * to have an underlying tumoral, rheumatologic or inflammatory disease * to have trauma, surgical history * to be pregnant or less than six months postpartum period

Keywords: therapeutic neuroscience education chronic low back pain kinesiophobia pain
exploring neurosphere's remote monitoring and virtual clinic features in improve quality of life and reduce costs

Conditions: Chronic Neuropathic Pain; Chronic Pain Management; Spinal Cord Stimulation (SCS); Pain Modulation; Failed Back Surgery Syndrome

Summary: this study evaluates the effectiveness of abbott's proclaim™ and eterna™ spinal cord stimulator (scs) systems, along with the neurosphere™ virtual clinic platform, in managing chronic pain. the goal is to assess how remote monitoring and virtual care can improve pain relief and reduce healthcare costs compared to traditional in-person care. adults with chronic pain will either receive treatment through in-person visits or remotely using neurosphere™. the study will measure pain relief, quality of life, and healthcare expenses over six months, aiming to improve access to pain management, especially for patients in rural areas.


Eligibility criteria:
inclusion criteria: * adults aged 19 years and older experiencing chronic neuropathic pain that is refractory to medical treatment and eligible for scs based on fda-approved indications. * individuals who can legally provide informed consent. exclusion criteria: * patients unable or unwilling to adhere to the requirements of remote monitoring, follow-up schedules, or other aspects of the study protocol. * patients with uncontrolled psychiatric conditions, including severe depression or anxiety, which could interfere with their ability to participate fully in the study or accurately report outcomes. * women who are currently pregnant or breastfeeding, as the safety and efficacy of scs in these populations are not established. * patients who have previously experienced significant adverse events or complications from scs implantation or stimulation that would make further use unsafe or ineffective. * patients with other active implantable devices (e.g., pacemakers or defibrillators) that could interfere with the functionality of the scs system. * patients with a documented history of substance abuse within * patients with significant comorbid conditions (severe cardiovascular disease, unmanaged diabetes, uncontrolled infection, etc.)

Keywords: chronic pain spinal cord stimulation neuropathic pain remote pain management burstdr technology chronic pain in rural populations
the association between fluid administration, oxytocin administration, and fetal heart rate changes

Conditions: Pregnancy; Labor Pain

Summary: fetal heart rate patterns are an important parameter in the diagnosis of non-reassuring fetal status. combined-spinal epidural analgesia is a method of initiating labor analgesia used by approximately 90% of the parturients at prentice women's hospital. optimizing the variables which could affect fetal heart rate patterns at the time of initiation of analgesia, such as fluid administration and oxytocin management, could help us provide better care for our patients and their fetuses. hypotheses: the combination of fluid administration and lower doses of oxytocin administration will have fewer adverse fetal heart rate changes in the first 60 minutes following initiation of labor analgesia.

after obtaining informed, written consent, candidates were randomized to one of four groups at the time of request for labor analgesia. all subjects received a maintenance infusion of lactated ringers(lr). for candidates in groups a or b, an intravenous bolus of 1000 ml of lr was initiated. candidates in groups c and d did not receive any additional fluid. if randomized to group a or c, the oxytocin management was continued as per the normal active management of labor protocal (amol). if randomized to groups b or d, the dose of oxytocin that was being administered was halved and not increased until 60 minutes after the initiation of epidural analgesia. fetal heart rate monitoring and frequency of uterine contractions were recorded by external tocodynamometry.

Eligibility criteria:
inclusion criteria: * age 18-60 * healthy nulliparous or multiparous women * term (\>36 week gestation) * singleton pregnancy * spontaneous labor or with spontaneous rupture of membranes * receive oxytocin * request neuraxial analgesia exclusion criteria: * under 18 years of age * presence of any systemic disease (e.g., diabetes mellitus, hypertension, preeclampsia) * use of chronic analgesic medications * prior administration of systemic opioid labor analgesia * non-vertex presentation * induction of labor * contraindication to neuraxial analgesia.

Keywords: oxytocin labor, obstetric non-reassuring fetal heart rate epidural
a pilot study of lidocaine infusion for postoperative analgesia in elderly patients with colorectal cancer surgery

Conditions: Colorectal Cancer

Summary: patients who meet the enrollment criteria will be randomized 1:1:1:1 to the different doses of lidocaine or the placebo group. in the lidocaine groups, at the beginning of surgery, lidocaine 0.5mg/kg, 1.0mg/kg, and 1.5mg/kg per hour were continuously infused (using ideal body weight) respectively during the whole procedure. in contrast, the control group was infused with the same dose of normal saline. all the infusion procedures will be stopped at the end of surgery

patients who meet the enrollment criteria will be randomized 1:1:1:1 to the different doses of lidocaine or the placebo group. in the lidocaine groups, at the beginning of surgery, lidocaine 0.5mg/kg, 1.0mg/kg, and 1.5mg/kg per hour were continuously infused (using ideal body weight) respectively during the whole procedure. in contrast, the control group was infused with the same dose of normal saline. all the infusion procedures will be stopped at the end of surgery. subsequently, all subjects will receive an analgesic device named patient-controlled intravenous analgesia pump, briefly, pcia pump during the first 72 postoperative hours. pcia pump contains lidocaine 30mg/kg, sufentanil 2 μg/kg, and granisetron 12 mg diluted to 200 ml in 0.9 % normal saline, while in the placebo group, the lidocaine will be replaced with the equal dose of 0.9% normal saline and other components unchanged. all the background infusions of pcia will be set at 2 ml/h, the bolus volume of each pcia press is 2 ml and the lockout interval is 15 min.

Eligibility criteria:
inclusion criteria: * age over 60 years old； * american society anesthesiologygist(asa)i\~iii； * patients scheduled for colorectal cancer surgery； * the surgery takes more than two hours exclusion criteria: * bmi≥30kg/㎡or bmi≤18kg/㎡； * combined with other organ malignancies； * chronic opioid use, substance abuse, contraindication to the use or incompatibility of any drug in the study； * patients with liver and kidney insufficiency and chronic pain at the surgical site； * accompanied by severe heart disease (such as severe atrioventricular block, severe heart failure, etc.)； * a history of uncontrolled seizures or acute porphyria； * patients who have taken other experimental drugs or participated in or are participating in other clinical trials within 3 months before being enrolled in the study