Kornimate/medical-research-clean huggingface dataset:
establishing of the reliability of the purdue pegboard test in adults after a stroke

Conditions: Motor Activity

Summary: the main aim of the pilot project is to establish inter-rater reliability, internal variability and variability of results got by testing adults patients after a stroke by the use of purdue pegboard test administered according to the new czech extended version of its manual.

new czech manual for the purdue pegboard test which is updated and extended by new rules for unification of their performing will be used for testing adult people with disability - adults after a stroke. the manuals include instructions for performing three trials of each subtest. at least 30 adult patients after a stroke will be tested by use of purdue pegboard test administrated according to the new czech extended version of its manual. video of performance of each adult will be obtained. performance of each patient, firstly in real time and secondly from video record will be evaluated twice, to obtain result for establishing all types of variability and reliability mentioned below. the inter-rater reliability, internal variability and variability of results will be established.

Eligibility criteria:
inclusion criteria: * czech language as a mother tongue * age from 18 to 65 years * patient after a stroke hospitalized at rehabilitation institute kladruby * fine motor skills allowing them correct manipulation with components of purdue pegboard test exclusion criteria: * severe disorder of orientation (neglect syndrome) * use of drugs affecting attention * vision impairment uncorrectable with glasses * severe hearing loss * inability to understand instructions * inability to read or write * inability to complete complete testing due to severe spasticity or spastic dystonia * failure to sign informed consent for probation with inclusion to research and consent to the collection and processing of personal data during the study at the rehabilitation institute kladruby

Keywords: standardized test occupational therapy fine motor skills purdue pegboard test czech language inter-rater reliability internal variability stroke adults
the efficacy of erector spinae block versus transversus abdominis plane block in laparoscopic nephrectomy

Conditions: Post Operative Pain Management

Summary: the investigators hypothesis that erector spinae block better than transversus abdominus plane block regarding the post operative pain management.

aim of the work: the purpose of this study to compare erector spinae block to transversus abdominus plane block in laparoscopic nephrectomy regarding analgesic efficacy and postoperative morphine consumption. statistical analysis i. sample size: sample size was calculated using g-power software. a previous study (reference) reported that the amount of morphine used in the first 6 hours in patients received tap block in nephrectomy was 12.4 ± 8.4. assuming that the amount will change by 50% at least with the other block, a power of 80% and an alpha error of 0.5, the minimum sample size required will be 60 patients (30 in each group). we will increase it to 35 in each group to compensate for drop-outs. (15) ii. statistical analysis: all measurement indexes will be expressed as mean ± sd/standard error of the mean or number (%). after analysis of normality of data distribution, normally distributed data will be compared by the independent sample t-test. unpaired quantitative variables will be evaluated by the student t-test and analysis of variance. the mann-whitney u test will be employed for intergroup comparison, and the wilcoxon signed-rank test for comparison between different time points within the same group. intergroup comparison of categorical variables will be performed by the chi-square test. values of a p value less than 0.05 will be considered statistically significant. all data will be statistically analyzed by statisticians using the spss 16.0 software package (ibm corp., armonk, ny, usa).

Eligibility criteria:
inclusion criteria: * patient age (\>18 and \<60) * both sexes * american society of anesthesiologists (asa) physical status classes i and ii * patients scheduled for laparoscopic nephrectomy surgery. exclusion criteria: * refusal of regional block * patients with uncontrolled diabetes or hypertension * patients with neurological, psychological disorders or those lacking cooperation * patients with anatomic abnormalities at site of injection, skin lesions or wounds at site of proposed needle insertion. * patients with bleeding disorders defined as (inr \>2) and/ or (platelet count \<100,000/µl) * patients with hepatic disease e.g. liver cell failure or hepatic malignancy or hepatic enlargement. * patients who are allergic to amide local anesthetics. * cases converted to open surgery will also be excluded from the study
assessment of hand grip strength using jamar dynamometer

Conditions: Type2diabetes

Summary: hand grip strength will be measured for all the type 2 diabetic patients. measurement of maximal grip strength will be performed using jamar dynamometers, which estimate the muscle strength primarily generated by the flexor muscles of the hand and the forearm. the jamar displays grip force in both pounds and kilograms, with a maximum of 200 lb (90 kg). it has a peak-hold needle that automatically retains the highest reading until reset. the jamar test is isometric, with no perceptible motion of the handle, regardless of the grip strength applied. the participants will be encouraged to produce their maximal grip strength. three trials will be recorded, consisting of a 2-4-second maximal contraction, with a 30-second rest period between each trial. the average of the three readings will be taken.

sarcopenia is an age related, progressive, and generalized skeletal muscle disorder involving the accelerated loss of muscle mass and function and physical performance below a defined threshold1. it is associated with increased adverse outcomes including increased risk falls, physical frailty, prolonged hospitalization, dependency, physical disability and impairment, limitation of mobility, decreased quality of life and increased mortality. sarcopenia is known to be more prevalent in older populations, but the decline in muscle mass starts from \~40 years onwards2. sarcopenia not only affects the ability to lead an active lifestyle but also contributes to increased obesity, type 2 diabetes (t2dm) reduced quality of life, osteoporosis, and metabolic health1. hand grip strength (hgs) is considered as an important value when diagnosing sarcopenia. lower muscle strength using hgs is mandatory to diagnose sarcopenia. ewgsop group recommends that the mean reference cut-off value of hand grip is \< 30 kg in men and \< 20 kg in women. there is evidence that strength could be an important risk factor for diabetes. low hand-grip strength has been predictive of incident diabetes in prospective cohort studies3. lower grip strength was associated with higher prevalence of diabetes, independent of confounding factors, across all ethnicities in both men and women. diabetes prevalence was approximately three- to fourfold higher in south asian participants across all levels of grip strength3 . however, there are no studies in india assessing sarcopenia in type 2 diabetic patients.

Eligibility criteria:
inclusion criteria: all patients with type 2 diabetes of any duration coming for first time in opd exclusion criteria: 1. patients with hand fracture 2. thyroid dysfunction 3. any musculoskeletal condition causing difficulty in holding the dynamometer 4. patients with type1 diabetes (t1dm) and gestational diabetes (gdm)
dose-dense docetaxel before or after doxorubicin/cyclophosphamide in axillary node-positive breast cancer

Conditions: Breast Cancer

Summary: this study will determine if docetaxel will be administered before or after doxorubicin/cyclophosphamides in an adjuvant chemotherapy regimen to be evaluated in a subsequent phase iii trial.

rationale: studies suggest that chemotherapy agents docetaxel, doxorubicin, and cyclophosphamide have some efficacy against different types of breast cancer. however, the optimal sequence in which to administer these treatments remains unknown. the current study assesses two separate sequences of docetaxel, doxorubicin, and cyclophosphamide. purpose: this study will evaluate two different combination chemotherapy schedules for patients with axillary node-positive breast cancer. combination one is docetaxel before doxorubicin and cyclophosphamide. combination two is docetaxel after doxorubicin and cyclophosphamide. the combination with no dose reductions of docetaxel within 10 weeks will then be tested in a phase iii study. the toxicities of docetaxel will also be assessed in study participants. treatment: patients in this study will receive one of two chemotherapy combination schedules. a computer will randomly assign patients into their treatment group. group one will receive docetaxel before doxorubicin and cyclophosphamide. group two will receive docetaxel after doxorubicin and cyclophosphamide. patients in group one will receive docetaxel every two weeks for a total of eight weeks. these patients will then be given combination doxorubicin and cyclophosphamide every two weeks for a total of eight weeks. patients in group two will receive combination doxorubicin and cyclophosphamide every two weeks for a total of eight weeks. these patients will then be given docetaxel every two weeks for a total of eight weeks. several tests and exams will be given throughout the study to closely monitor patients. treatments will be discontinued due to disease growth or unacceptable side effects.

Eligibility criteria:
inclusion criteria: * must have histologically or cytologically confirmed breast cancer * no metastatic disease * prior lumpectomy or mastectomy * no prior chemotherapy or hormone treatments for breast cancer * must have normal organ and marrow function. * eastern cooperative oncology group (ecog) performance status 0 or 1. exclusion criteria: * peripheral neuropathy of grade ii or higher. * history or evidence upon physical exam of cns (central nervous system diseases)disease. * history of unstable angina or myocardial infarction within the last six months. * pregnant or nursing women. * known allergies to polysorbate 80. * hiv-positive patients.

Keywords: adjuvant trial dose-dense axillary node-positive
mild versus conventional ovarian stimulation for poor responders undergoing in vitro fertilisation

Conditions: Infertility

Summary: the investigators will examine the balance between ivf success in terms of outcome parameters, using a mild ovarian stimulation protocol, opposing it to the conventional stimulation regimens in poor responders undergoing ivf.


Eligibility criteria:
inclusion criteria: * poor responders (age\>40, previous por, abnormal or test) * indication for ivf * regular cycling patients * bmi 19-35 exclusion criteria: * contraindication for clomiphene citrate use or to gnrh agonists antagonists * bmi \> 35

Keywords: ovarian stimulation climiphene citrate gonadotropin-releasing hormone agonists/antagonists follicle stimulating hormone
comprehensive management of rectal cancer

Conditions: Rectal Cancer

Summary: study on the strategy we have adopted for rectal cancer treated with chemoradiotherapy in the case of a complete reponse ( surveillance vs. surgery) particular case of patients with complete response after crt. traditionally, for patients with mid or lower rectal cancer, a protocol involving chemoradiotherapy followed by surgery 8 to 10 weeks after the end of radiotherapy and chemotherapy is systematically indicated after a post-chemoradiotherapy reassessment using pelvic mri. in a certain number of patients (25%), it was noted that the reevaluation through pelvic mri after chemoradiotherapy shows complete tumor disappearance. however, these patients were still operated on according to the standard procedure, and pathologists found no tumor in the surgical specimen (sterile specimen). these are patients with a complete radiological and pathological response. in such cases, it is possible to resect the scar that remains at the site of the tumor (radiotherapy sequelae) and closely monitor the patient to detect recurrence in the short and medium term, thus avoiding mutilating surgery that impacts quality of life (fecal and gas incontinence, increased bowel movements, urinary and gynecological sexual disorders). this is known as the "watch and wait" strategy. "watch and wait" strategy. an initial opportunistic approach, also called watch and wait (w\&w), involves monitoring patients who are considered to have a complete response after crt or total neoadjuvant treatment, regardless of the initial stage. this approach was developed by habr-gama et al. in brazil and published in 18 different articles, involving a cohort of 361 patients, with complete response rates ranging from 20% to 30%. local recurrence rates varied from 5% to 25% depending on the articles and the timing of complete clinical response evaluation, while maintaining a 5-year disease-free survival rate of 52% and an overall survival rate of 85%. these series primarily included ct2 or ct3 tumors, but also ct4 tumors. complete clinical response was defined as the absence of any clinical tumor residue (no tumor, no ulcer, and negative biopsy), and patients were monitored monthly. however, the evaluation timeline for complete response varied across the articles, ranging from 8 weeks to 14 months. at present, no official recommendations validate this strategy; it remains an expert opinion. the aim is to demonstrate that we could avoid surgery in patients with a complete response (we have favored rectal surgery for the majority of our patients due to organizational obstacles, patient-related issues, and the difficulty in applying rigorous surveillance in certain cases). the purpose of this research is to improve our practices in managing rectal cancer in patients with a complete response.


Eligibility criteria:
inclusion criteria: * all patients managed in our facility who achieved a complete response after preoperative radio-chemotherapy. exclusion criteria: * minor patients * non-responding patients, or partial responders. * anal canal cancer
continuous subcutaneous insulin infusion strategy versus multiple daily insulin injections strategy

Conditions: Type 2 Diabetes

Summary: the current study will compare the different efficacy of two transient intensive insulin treatment strategies: continuous subcutaneous insulin infusion (csii) and multiple daily insulin injections (mdi) in patients who are not well controlled with oral hypoglycaemic agents.


Eligibility criteria:
inclusion criteria: 1. using at least two kinds of oral hypoglycaemic agents, one of which must be insulin secretagogues (at least half of the maximum permitted daily dose); or at least two kinds of oral hypoglycaemic agents, one of which must be insulin secretagogues (at least half of the maximum permitted daily dose), plus once daily basic insulin treatment (daily dosage \< 30iu); 2. the anti-diabetic therapy is stable within 3 months before study screening; 3. age: 25-65years, both gender, bmi: 20-35kg/m2; 4. good compliance with the follow-up 5. signed informed consent 6. hba1c ≥ 8.0 % and ≤ 12% exclusion criteria: 1. having the history of using insulin therapy twice daily or mdi or insulin pump (except the insulin therapy during gestational diabetes mellitus) 2. for once daily insulin therapy: daily dose insulin therapy dosage \> 30iu 3. having the history of using glp-1 for therapy within 3 months before screening 4. women in pregnancy or under breast feeding 5. having acute diabetic complications within 6 months before screening or having severe chronic diabetic complications at screening 6. allergic to study drugs 7. severe liver dysfunction, including serum alanine aminotransferase concentration more than 2.5 times above upper limit of normal range, abnormal renal function (gfr \< 60ml/min) 8. other severe conditions which will put the patients in high risk during the study 9. recently drug or alcohol abuse

Keywords: efficacy safety intensive insulin therapy
predicting toxicity in elderly patients with head and neck cancer

Conditions: Head and Neck Cancer

Summary: predicting toxicity in elderly patients with head and neck cancer: validating a disease-oriented toxicity predictive tool and integrating it with avail-able screening tools for better outcomes.

we aim to analyze clinical and biochemical variables to prospectively create and validate an independ-ent predictive score to identify the probability of g3-5 toxicity in hnc elderly patients candidated to a curative treatment with radiation treatment +/- systemic treatment.

Eligibility criteria:
inclusion criteria: * patients aged ≥ 70 years * histological diagnosis of squamous cell or undifferentiated hnc in stage iii-iv ajcc ed viii (si-nonasal, nasopharynx, oral cavity, oropharynx, unknown primary with hpv pos, larynx and hy-popharynx) and candidated to curative non surgical treatment (radiotherapy alone, chemora-diation with platinum salts; radiation+cetuximab) * evaluable disease accordingly to recist criteria 1.1 * willing of sign a written informed consent * adequate organ function exclusion criteria: patient with cancer in other sites than hn \< than 2 years except for prostate cancer ct1-2, gleason 3+3, nimbc, initial non melanoma skin cancer, in situ cervical cancer) * ps ecog 3-4 * patients who received systemic treatments in the past for other primary tumors
rapid identification and susceptibility testing of pathogens from blood cultures

Conditions: Bacteremia; Fungemia; Bloodstream Infection

Summary: would rapid identification of bacteria and rapid detection of methicillin-resistant s. aureus (mrsa) and vancomycin-resistant enterococci (vre) (using an fda-cleared assay) in positive blood culture bottles improve patient care at mayo clinic rochester (or just lead to increased cost)?

we hypothesize that the filmarray blood culture id panel will reduce the duration of empiric broad-spectrum antimicrobial therapy typically administered in patients who have positive blood cultures, improving clinical outcome and reducing cost. to test this hypothesis we propose a prospective, randomized controlled study comparing outcomes among patients with positive blood cultures who receive either: standard culture and antimicrobial susceptibility testing (ast) of positive blood culture bottles as is done today (control), standard culture and ast of positive blood culture bottles plus the filmarray blood culture id panel (intervention group 1), or standard culture and ast of positive blood culture bottles plus the filmarray blood culture id panel testing along with expert infectious diseases phone consultation (intervention group 2). in both intervention groups, results of the filmarray test will be communicated by phone to the primary service, along with templated comments about optimal antimicrobial therapy, based on the result. (templated comments will also be used in the control group). in intervention group 2, an infectious diseases pharmacist or physician will provide patient-specific recommendations to modify antimicrobial therapy, if appropriate, based on microbiology results and clinical information obtained through medical record review and discussion with the primary service.

Eligibility criteria:
inclusion criteria: * positive blood culture during the study period. * no positive blood cultures in prior 7 days * minnesota state research authorization provided exclusion criteria: * no minnesota state research authorization * deceased or transitioned to comfort care within 24 hours of enrollment * positive blood culture in prior 7 days * previously enrolled in this study * negative gram stain

Keywords: bacteremia fungemia bloodstream infection susceptibility mrsa vre
prediction model for delayed extubation of tracheal intubation in patients with maxillofacial space infection after abscess incision and drainage surgery

Conditions: Oral Infection

Summary: retrospective exploration of the risk factors associated with mechanical ventilation and tracheal extubation twenty-four hours after abscess incision and drainage surgery in patients with maxillofacial space infection.

1. retrospective exploration of the risk factors associated with mechanical ventilation and tracheal extubation after 24 hours of abscess incision and drainage in patients with maxillofacial space infection. 2. prediction model: based on the identified risk factors, establish a model to predict the risk of tracheal intubation withdrawal 24 hours after abscess incision and drainage surgery in patients with maxillofacial space infection.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years old (actual age of the patient) * patients diagnosed with maxillofacial space infection upon admission exclusion criteria: * serious errors or omissions in key demographic information and medical records

Keywords: oral infection
fixed diet plan and calorie counting diet in adolescents

Conditions: Pediatric Obesity

Summary: obesity is a chronic illness and multifactorial etiology, related to genetic factors, environmental and behavioral. features association with several metabolic abnormalities in childhood, leading to increased risk of cardiovascular disease in adult life. the treatment involves lifestyle change, with balanced diet guidance and encouraging physical activity. the treatment in this age group have brought limited data, in addition to high drop-out rates. a unique type of food guidance is the equivalent calorie count, where calories are converted into points. the objective of this study was to evaluate the variance of z score of body mass index (zimc) of obese adolescents undergoing orientation of two groups of low-calorie diet: traditional and based on the points system, as well as evaluate anthropometric variables, body composition, food intake, metabolic changes and self-monitoring. methods: randomized clinical study with duration of 24 weeks, with 66 adolescents with an average age of 13.7 ± 0.7 years of both genders, with scores of bmi \>= 2 to \<= 4 curve adjusted for gender and age of the world health organization. were verified weight, height, blood pressure and waist circumference, intensity of physical activity and self- monitoring, as well as performed the nutritional guidance to each visit. laboratory parameters, applying the scale of binge eating, pubertal, stage and body composition were evaluated at the beginning and end of the action. the patients were divided into two groups: one that received guidance of traditional low-calorie diet and meet the food consumption record (rca), three days (group a) and another that received low-calorie diet guidance based on the system of points and meet the daily rca (group b).


Eligibility criteria:
inclusion criteria: * age 12 to 15 years old * zbmi ≥+2.0 according to world health organization exclusion criteria: * zbmi≥+4 * obesity related to genetic syndromes * end-organ damage * taking drugs that promote weight changes
a study to assess the pharmacokinetics of methotrexate given with and without azd9056 in rheumatoid arthritis patients

Conditions: Rheumatoid Arthritis

Summary: the main aim of this clinical study is to investigate whether the blood concentration of methotrexate changes when azd9056 is co- administered together with methotrexate.


Eligibility criteria:
inclusion criteria: * patients diagnosed with rheumatoid arthritis * currently on methotrexate treatment * provision of informed consent exclusion criteria: * history of malignancy (except for treated squamous and basal cell carcinoma of the skin more than 5 years prior to entry) * patients who were taking prescription of medications listed below: medications that are hepatic enzyme inducers and that were inhibitors of cytochrome p450, lovastatin * leflunomide, hydroxychloroquine, cyclosporin or anti-tumour necrosis factor therapies within 90 days of visit 1, or treatment with rituximab within 1 year before visit 1

Keywords: azd9056 pharmacokinetics interaction methotrexate rheumatoid arthritis