Kornimate/medical-research-clean huggingface dataset:
transcranial magnetic stimulation study of cortical excitability as marker of antidepressant response: excipsy study

Conditions: Major Depressive Disorder

Summary: depression is a common issue but there is no marker of response to an antidepressant treatment.the measurement of variation of the cortical excitability in responders to a selective serotonin reuptake inhibitor (ssri) (compared to no-responders) had never been done before. in the study of robol et al. (2004) concerning the acute effects of citalopram on markers of cortical excitability, the authors have pointed out an increase on the cortical silent period (csp) after administration of citalopram (2.5 hours). the investigators hypothesize that this effect remains later and that the diminution of cortical excitability could be a biomarker of antidepressant response. in this case, they expect that the variation of csp between day 1 and day 28 is higher in responders to a ssri (citalopram) compared to non-responders. the investigators lead a pilot, prospective, multicentric study in drug-naive patients to compare the variation of the markers of cortical excitability (the csp but to the resting motor threshold rmt, the motor evoked potential mep, the intra-cortical inhibition ici and the intra-cortical facilitation icf) between day 1 and day 28 in responders to citalopram, compared to non-responders.


Eligibility criteria:
inclusion criteria: * major depressive episode (according to dsm 5 criteria). severity of depressive episode assessed by hamilton depressive rating scale 21 items (hamd-21) : score \> 15 (significant impairment), low suicide risk (score \< 2 on suicide item). * drug-naive patient (or antidepressant stopped for more than 3 months). * patient covered by security social system. * patient who is able to read and understand the information paper. patient who is able to sign the consent. * for women of childbearing age, effective method of contraception (estrogen-progestin contraceptive or intra-uterine device or tubal ligation) for more than 1 month (negative pregnancy test). exclusion criteria: * coprescription of psychoactive or neurological drugs known to alter cortical excitability * other psychiatric disorders (psychotic disorders, eating disorders). * change of antidepressive drug during the study. * abuse or addiction at other substances than nicotine or caffeine. * unsteady consumption of nicotine or caffeine. * dermatologic disease, dementia, medical history of seizure or epilepsy, brain tumor, metallic biomedical implants in brain. * ongoing treatment by magnetic or electric stimulation (for example : transcutaneous nerve stimulation or spinal cord stimulation). * women of childbearing age without effective contraception, pregnant or breastfeeding. * patient who was already included in a clinical trial within 30 days before the inclusion visit. * patient deprived of liberty and under guardianship.

Keywords: cortical excitability marker of response
alternating and direct current stimulation for neuropathic eye pain

Conditions: Eye Pain; Neuropathy, Optic; Cerebral Injury

Summary: the goal of this clinical intervention is to test if two forms of transcranial current stimulation, transcranial direct current stimulation (tdcs) or transcranial alternating current stimulation (tacs) can alleviate neuropathic eye pain in a sample of 20 patients. the main aims are: * test if tdcs/tacs can alleviate neuropathic eye pain and/or other cerebral symptoms: brain fatigue, migraine, light sensitivity, etc. * test if one stimulation method is superior to the other patients will be treated for a total of fifteen 30-minute stimulation sessions, three times a day over a five-day period, each stimulation separated by approximately 4 hours, with either active tacs or tdcs over the scalp corresponding to primary sensory and motor areas. the patients will have questionnaires to monitor subjective experiences and pupillometry before and after treatment to monitor experimental outcomes.

brief summary sufficient

Eligibility criteria:
inclusion criteria: * persistent eye pain for at least 6 months * average eye pain intensity of 4 or more on a 0-10 numerical rating scale * naive to transcranial stimulation * eye pain having neuropathic-like characteristics exclusion criteria: * contraindication to transcranial stimulation (i.e., pacemaker, cardioverter defibrillator, neuro-stimulation (brain or spinal cord), bone growth stimulations, indwelling blood pressure monitors, epilepsy, pregnancy) * presence of ocular diseases that are the likely cause of pain (i.e., corneal and conjunctival scarring, corneal edema, uveitis, iris transillumination defects, etc.) * current participation in another study with an investigational drug or device within one month prior to screening
awareness and attitudes regarding prenatal and preimplantation genetic diagnosis for inherited breast/ovarian cancer risk

Conditions: Breast Cancer; Ovarian Cancer

Summary: we are inviting you to participate in a study of how people who have had genetic counseling for breast/ovarian cancer risk feel about certain reproductive technologies, preimplantation genetic diagnosis (pgd) and prenatal genetic diagnosis (pnd), that may reduce the chances of passing increased risk onto one's children. we would also like feedback from patients who have been to our clinic in the past on the best ways to talk about pgd and pnd during genetic counseling sessions. we are seeking both the opinions of people who are interested in these technologies and those who are not. it does not matter whether you have heard of pgd or pnd before - you can still participate. your past experience with genetic counseling is valuable to us in deciding how to communicate this information during sessions.


Eligibility criteria:
inclusion criteria: * females and males who are carriers of deleterious mutations in the genes brca1 or brca2. * over age 18 and: 1. for women, less than 43 2. for men, less than 50. * received genetic testing and counseling for brca. * fluent in english. exclusion criteria: * patients who are currently under treatment (chemotherapy, radiation) * individuals who refuse to discuss reproductive issues. * unable to give informed consent due to physical, cognitive, or psychiatric disability

Keywords: breast ovary mutation carrier
tools development for geriatric emergency regulation

Conditions: Emergency Geriatric Care

Summary: according to surveys, 13% to 20% of the service médical d'urgence (samu) centre 15 (french 911) calls concern elderly patients above 75 years of age. for these patients, the clinical pathway should be decided on the basis of the symptomatology described during the call, but also with the gathering of specific data such as medical social and psychological evaluation. these items allow the regulating doctor to assess comorbidity, on-going treatment, psycho-cognitive status, previous hospitalisations, social situation, and patient expectations and needs. however, data collected in order to assess the situation on the phone and take the orientation decision are mainly limited to the severity of clinical symptoms. medical, psychological and social aspects are rarely gathered, for several reasons : * phone call shortness : emergency calls should be treated quickly * regulating doctors are not trained to take in account the specificities or geriatric patients in their decision making. besides, they are not informed about alternatives to the hospital emergency department, such as "geriatric channel" system. an observational study was performed in 2012 on 692 calls about elderly patients referred to the samu centre 15 during 7 days : 63% of these patients were transferred to an emergency department. regardless of severe cases "hospital regulation", 55% of the least serious cases ("liberal regulation") were transferred to an emergency department. regulation is inadequate to elderly patients for whom 1) the situation assessment and the appropriate decision making require specific items that are not known by regulating doctors, 2) the medical care and the clinical pathway could be improved by the knowledge of on-field "geriatric channel", 3) the emergency department care is particularly long, 4) and could be pernicious to younger patients. 1920 patients will be recruited between january 2016 and august 2017, including a 6 months wash-out in order to train regulating doctors. this training will include geriatric patient's specificities, and geriatric channels. a 12% difference between the 2 groups (before and after the training) is expected, considering a 80% statistical power. the design is a time series experiment.


Eligibility criteria:
inclusion criteria: * patient above 75 years olds * patient calling for a liberal regulation * patient calling between 8 a.m. and 6 p.m. from monday to friday exclusion criteria: * patient calling for vital emergency (hospital regulation) * patient calling for inter-hospital transport

Keywords: geriatric emergency clinical pathway regulation samu training
hydroxychloroquine treatment of healthcare workers with covid19 illness at montefiore

Conditions: COVID; Coronavirus; COVID-19

Summary: given the high prevalence of covid19 illness (both sars-cov-2 rt-pcr confirmed and highly suspect cases) among healthcare workers (hcw) within the montefiore health system (mhs), hydroxychloroquine (hcq) will be prescribed to healthcare workers who are at the highest risk for severe covid19 illness.


Eligibility criteria:
inclusion criteria: * symptomatic with covid illness (either rt-pcr test confirmed or highly suspect clinical symptoms) * call into office within the first 7 days of illness * have any of the following high risk conditions: * age \>60 * htn, cad, or chronic heart disease * diabetes * chronic kidney disease * chronic lung disease * active or recent chemotherapy for malignancy * organ transplant * taking immune-suppressing medications * hiv with cd4 \<200 cells/mm3 * experiencing at least one of the following high risk symptoms: * severe cough * fever 100.0f or greater * diarrhea * shortness of breath * hypoxia exclusion criteria: • hcw not meeting high-risk criteria or those with a contraindication to hcq will not be offered hcq
effects of storage on lactate in blood samples

Conditions: HIV Infections

Summary: the purpose of this study is to determine whether laboratory storage of samples affects the amount of lactate over 3 years. lactate is a natural substance normally present in the body. lactate levels can go up for many different reasons, including treatment with nucleotide reverse transcriptase inhibitor drugs. this study will help researchers know if stored blood samples can be used to test lactate levels.

lactic acidosis syndrome is a complication of therapy with nucleoside reverse transcriptase inhibitor (nrti) drugs. measurement of lactate levels is important in clinical trials of antiretroviral treatments. the preferred collection method for determining plasma lactate is with naf/kox tubes, while a number of actg studies have stored blood in ethylenediaminetetraacetic acid (edta) tubes. this study will analyze lactate in samples collected and stored in naf/kox and edta tubes to investigate the reliability of lactate concentrations over time. pre- and post-exercise blood samples are drawn from participants into naf/kox and edta tubes and a portion is tested for lactate levels immediately. the remaining portions are frozen and tested at 1, 3, 6, 12, 18, 24, and 36 months.

Eligibility criteria:
inclusion criteria participants may be eligible for this study if they: * are at least 18 years old. * have sufficient forearm veins. exclusion criteria participants will not be eligible for this study if they: * have a physical disability that prevents forearm exercise. * have any known medical reason, such as anemia, for not having 82 ml of blood drawn.

Keywords: specimen handling blood cryopreservation lactic acid sodium fluoride oxalates
correlation between cardiac markers and severity of covid-19

Conditions: Cardiac Event

Summary: by july 9, 2020, the global pandemic of coronavirus disease 2019 (covid-19) caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2) infection had resulted in over 11.8 million confirmed cases and over 545000 deaths. patients with a history of cardiovascular disease are especially vulnerable and have a bad prognosis. according to the findings, cardiac injury manifested by cardiac biomarker elevation is detected in a significant number of covid-19 patients and is linked to poor outcomes and mortality. however, it is unclear how effective cardiac biomarkers are in covid-19 prognosis and how to use these indicators.

the pandemic of coronavirus disease 2019 (covid-19) caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2) infection has led to \>11.8 million confirmed cases with \>545000 deaths worldwide by july 9, 2020 patients with preexisting cardiovascular conditions are particularly at risk and have poor prognosis data suggest that cardiac injury, manifested by cardiac biomarker elevation, is detected in a sizable of covid-19 patients and is associated with adverse outcomes and increased mortality. however, how useful cardiac biomarkers are in covid-19 prognosis and how to utilize these markers have not been well defined the study will include all moderate to severe covid 19 patients admitted to icu. both genders within the age group 18-60 years were included. the primary outcome is the relation between cardiac markers and mortality rate in critically ill covid 19 patients the secondary outcome is the relationship between cardiac and inflammatory and coagulation markers

Eligibility criteria:
inclusion criteria: * all moderate to severe covid 19 patients who were admitted to icu. * both genders * age group 18-60 years exclusion criteria: * a refusal to participate in the study, * pregnant patients, * patients aged \ 60. years, * recent history of acute myocardial infarction (\< 1 month before admission).
2d vs 3d planning for high-dose rate (hdr) gynecological brachytherapy

Conditions: Cervix Cancer; Endometrial Cancer

Summary: demonstrate the limitations of conventional dosimetry (2d) for the adjuvant brachytherapy treatment and assess whether tridimensional dosimetry relates more faithfully with the occurrence of adverse effects.

radiotherapy is part of a multidisciplinary strategy to fight cancer in all stages, using ionizing radiation to cause damage in tumor cells. after radical surgical treatment of gynecological tumors, pathological findings, such as extension of the myometrium invasion, histologic grade, and vascular- lymphatic invasion predict the risk of locoregional recurrence of disease and, consequently, the need for adjuvant treatment. there are two main methods of adjuvant therapy after hysterectomy for malignant neoplasm of the cervix or endometrium: external beam radiotherapy with or without booster dose of vaginal vault brachytherapy or brachytherapy alone. there are few data in the literature and clinical experience with brachytherapy dimensional (3d) for adjuvant treatment of vaginal vault . objective: to demonstrate the limitations of conventional dosimetry (2d) for the adjuvant brachytherapy treatment and assess whether tridimensional dosimetry relates more faithfully with the occurrence of adverse effect. methods: a prospective study in the department of radiation oncology, antonio candido camargo cancer center will be developed with an expected duration of 14 months and will include 60 patients. dosimetric parameters of brachytherapy treatment of vaginal vault, able to influence the incidence of adverse effects will be evaluated. computed tomography for planning of external beam radiotherapy and brachytherapy planning will be used, after placement of intra- vaginal applicator and urinary catheter. for planning brachytherapy two fast acquisition sequences, one with a urinary catheter not pulled and pulled another with the probe will be obtained. the prescription dose obey the standard indication of document of the international commission on radiation units \& measurements (icru 38).

Eligibility criteria:
inclusion criteria: * malignant neoplasm of the cervix or endometrium; * tomography scan available in the planning system. exclusion criteria: * patients did not undergo surgery as initial treatment; * patients without available tomography for planning;

Keywords: 3d brachytherapy cervical cancer endometrial cancer vaginal vault brachytherapy
pilot study of transcranial stimulation (tdcs)to relieve neuropathic pain in cancer patients

Conditions: Pain

Summary: this is a pilot study designed to collect preliminary data on safety and efficacy of transcranial direct current stimulation (tdcs) to relieve pain in cancer patients who developed neuropathic pain in the affected area after a surgical intervention, radiation therapy, or chemotherapy to treat the disease.

this is a pilot study that aims to determine the effect of repetitive tdcs stimulation, performed on five consecutive days at intensity of 2 ma, on pain and somatosensory abnormalities in patients with neuropathic pain that followed surgical, radiation or chemotherapeutic treatment, and to evaluate safety of tdcs in the same model.

Eligibility criteria:
adult male and female patients with cancer who developed neuropathic pain in the affected area secondary the surgical procedure, chemotherapy or radiation that meet the following inclusion/exclusion criteria: inclusion criteria: pain on the side of the lesion * spontaneous pain with a score for "worst pain in the last 24 hours" \>4 on a numeric scale 0-10 * must present the following symptoms and signs: * continuous burning, shooting, or lancinating pain. * presence of hyperesthesia * presence of hyperalgesia (to pinprick) and/or allodynia (to light touch) exclusion criteria: * uncontrolled hypertension, uncontrolled diabetes, uncontrolled cardiovascular disease * pain/painful conditions unrelated to the cancer or related treatment * pregnancy * history of seizures/epilepsy * any implanted devices (e.g. a cardio stimulator, etc) * active illegal drug/alcohol abuse * unable to follow directions or complete tools in english
correlation between interdialytic weight gain and cardiovascular diseases in children with end-stage kidney disease undergoing hemodialysis

Conditions: End Stage Renal Disease on Dialysis

Summary: this study aimed to discuss the correlation between interdialytic weight gain and cardiovascular diseases in children with end-stage kidney disease undergoing chronic hemodialysis. the cardiovascular parameters used include left ventricular hypertrophy, systolic and diastolic function, carotid intima-media thickness, myocardial circumferential strain, and strain rate.


Eligibility criteria:
inclusion criteria: * end-stage kidney disease (chronic kidney disease stage 5) * undergo hemodialysis at least twice a week exclusion criteria: * history of congenital heart disease * critically ill patients with unstable hemodynamic status

Keywords: interdialytic weight gain cardiovascular chronic kidney disease hemodialysis
the effect of a multimodal lifestyle program on male fertility

Conditions: Infertility, Male

Summary: a non-pharmacological study, which examines the effect of lifestyle intervention on sperm quality among men in fertility treatment. the primary endpoint is to increase the total amount of motile sperm in male patients undergoing fertility treatment


Eligibility criteria:
inclusion criteria: * men of couples who are about to start 2nd or 3rd fertility treatment * \> 18 years old * sperm concentration between 2-40 mill./ml exclusion criteria: * use of testicular sperm

Keywords: male infertility semen quality lifestyle intervention
an analysis of the outcomes from protocolized perioperative care for patients receiving total hip or knee arthroplasty

Conditions: Knee Osteoarthritis; Hip Osteoarthritis; Knee Arthritis; Hip Arthritis

Summary: the care for patients receiving total hip and knee arthroplasty at the university of arkansas for medical sciences has followed a structured care pathway since july 2015. this system of perioperative care has focused on preoperative assessment of medical co-morbidities and risks to postoperative functional recovery, anesthetic care focused on postoperative nausea and vomiting prevention and optimizing immediate postoperative functional ability, and aggressive postoperative physical therapy. this is an observational study to look at the outcomes of this program at university of arkansas for medical sciences. areas of focus will be hospital length of stay, postoperative narcotic consumption, visual analog scale scores, incidence of postoperative nausea and vomiting, and 30-day readmission rates, and health literacy rates.


Eligibility criteria:
inclusion criteria: - all men and women 18 years and older who underwent total hip arthroplasty or total knee arthroplasty surgery at uams between 7/01/2015 and 7/01/2016. exclusion criteria: - none
evaluation of poc lung ultrasound combined with pressure-volume curve to titration adjust peep for ards lung recruitment

Conditions: Acute Respiratory Distress Syndrome

Summary: using lung ultrasound re-aeration score(lus-ras) combined with pressure-volume curve(pvc) adjust maintain positive end-expiratory pressure(peep) after recruitment maneuver, to achieve real-time adjustment, reduce ventilation-associated lung injury and the purpose of effective lung recruitment.

the traditional method, set peep according to pvc in ards mechanical ventilation, lacks morphological evaluation. for point-of-care lung ultrasound(poc-lus) is non-invasive, real-time, visualization, no need transport patients, getting more and more attention in the ards treatment. it has been reported that lus-ras is a meaningful assessment in recruitment maneuver. this study will combine poc-lus with pvc in set the initial peep, and then dynamic record lus-ras to feedback regulate peep. using the poc-lus and maximum oxygenation method to assess lung recruitment effect in experimental group and control group prospectively. the ventilator parameters, state of hemodynamic, arterial blood gas(abg) in each group will be recorded; statistical methods will be performed in term to understand the correlation.

Eligibility criteria:
inclusion criteria: * patient aged 18 years and older * ards patients with invasive mechanical ventilation exclusion criteria: * intracranial hypertension * pneumothorax and mediastinal emphysema * severe hypoxemia (oxygenation index \<100) * hemodynamic instability * chest deformity or surgical history * affect lung-ultrasound conditions: subcutaneous emphysema, chest wound etc.

Keywords: acute respiratory distress syndrome, ards point-of-care lung ultrasound,poc-lus pressure-volume curve, pvc positive end-expiratory pressure, peep ultrasound re-aeration score, us-ras