Kornimate/medical-research-clean huggingface dataset:
phase 2 rct of alvimopan vs. placebo after crs/hipec

Conditions: Ileus

Summary: the purpose of this study is to investigate the ability of alvimopan to reduce the time to return of bowel function in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. half of the participants will receive alvimopan or and half will receive placebo immediately before and for up to seven days after surgery.

cytoreductive surgery (crs) and hyperthermic intraperitoneal chemotherapy (hipec) is a surgical procedure to treat cancer that has spread to the lining of the abdominal cavity (peritoneal metastases). it is associated with a prolonged time for return of bowel function after surgery. alvimopan is a drug used to speed up the time for return of bowel function after surgery. it works by blocking the opioid receptors in the gastrointestinal tract, which normally slow down bowel function in patients receiving postoperative opioid pain medication. it has not previously been tested in patients undergoing crs/hipec.

Eligibility criteria:
inclusion criteria: * ability to understand and the willingness to sign a written informed consent. * scheduled to undergo open (non-minimally invasive) crs/hipec. * scheduled to receive postoperative pain management with intravenous opioids. * age \> 18 years. * eastern cooperative oncology group (ecog) performance status ≤ 2. * women of child-bearing potential with negative pregnancy test prior to initiating study drug dosing. exclusion criteria: * greater than 7 days of consecutive opioid use immediately prior to scheduled surgery. * child-pugh class c hepatic impairment. * end-stage renal disease (gfr \< 15 ml/min/1.73 m2 and/or on peritoneal dialysis or hemodialysis). * complete mechanical bowel obstruction. * contraindication or inability to tolerate oral medication postoperatively. * presence of gastrointestinal ostomy after crs/hipec. * pancreatic or gastric anastomosis performed during crs/hipec. * history of allergic reactions or hypersensitivity attributed to compounds of similar chemical or biologic composition as alvimopan at the treating investigators discretion. * severe or uncontrolled medical disorder that would, in the investigator's opinion, impair ability to receive study treatment (i.e. uncontrolled diabetes, chronic renal disease, chronic pulmonary disease or active, uncontrolled infection, psychiatric illness/social situations that would limit compliance with study requirements). * history of myocardial infarction in the 12 months prior to scheduled surgery. * pregnant or nursing.

Keywords: hipec peritoneal carcinomatosis
efficacy of non-invasive neuromodulation treatments for covid-19 sequelae

Conditions: Covid-19 Recurrent

Summary: the goal of this clinical trial is to demonstrate the effectiveness of non-invasive neuromodulation as a therapy in neurological, respiratory and musculoskeletal pathologies derived from the consequences of covid-19. it will also estimate the impact of non-invasive neuromodulation treatment on the functionality and quality of life of patients with covid-19 sequelae.the main question it aim to answer is: - is non-invasive neuromodulation effective as a therapy in neurological, respiratory and musculoskeletal pathologies derived from the consequences of covid-19. researchers will compare non-invasive neuromodulation to a placebo (treatment with the machine turned off). participants will: * be evaluated before starting treatment. * be evaluated 3 weeks after. * be evaluated at 5 weeks, or 15 sessions or completion of treatment. * be evaluated 6 weeks after finishing the treatment or 11 weeks after starting treatment.

the waves of sars-cov-2 disease continue to be continuous and we are increasingly aware of the consequences it causes both in the respiratory system, musculoskeletal system and in the central and peripheral nervous system. likewise, non-invasive neuromodulation acts with a pump of ions, generating endogenous stimuli that modulate the central nervous system. the aim of this clinical trial is to demonstrate the effectiveness of non-invasive neuromodulation as a therapy in neurological, respiratory and musculoskeletal pathologies derived from the consequences of covid-19. to carry out this study, pain was measured with the visual analogue scale. it was also measured the joint amplitude, a muscle assessment with the help of a strength dynamometer, the patient's independence with the katz index and the functionality of the lower or upper limbs, depending on the affected joint.

Eligibility criteria:
inclusion criteria: * patients between the ages of 18 and 60. * patients with a positive diagnosis of covid-19. * patients with post-covid-19 sequelae with musculoskeletal, respiratory or neurological symptoms due to taste or smell lasting at least 30 days, with no history of respiratory and/or neurological and/or musculoskeletal diseases. * patients who signed the informed consent. exclusion criteria: * patients aged before 18 years and after 60 years. * healthy people with no history of neurological, neurological and/or respiratory and/or musculoskeletal diseases * patients with secondary diseases that could directly affect the systems to be evaluated who were not diagnosed positive for covid-19.

Keywords: covid-19 non invasive neuromodulation smell
anticipating decline and providing therapy

Conditions: Cognitive Impairment; Dementia; Post ICU Syndrome; Critical Illness; Cognitive Impairment, Mild

Summary: this pilot feasibility study will be a randomized control trial of usual care following intensive care unit (icu) discharge compared to the anticipating decline and providing therapy (adapt) screening and support intervention. the trial aims to enroll 120 older adults (age 60 or older).

anticipating decline and providing therapy (adapt) is a program designed to support the implementation of a routine post-icu cognitive impairment screening and support intervention. the program includes a routine validated cognitive screen for high-risk older adults at 6 weeks and 6 months post-icu discharge. patients with a screening assessment that may be consistent with cognitive impairment or dementia will receive additional resources including a specialized care plan developed by the sticht center for healthy aging and alzheimer's prevention. the specialized care plan is adapted from a health system-based dementia care intervention and designed to support post-icu cognitive concerns. it was adapted with input from geriatrics, intensive care, and outpatient primary care clinicians. also conducted are semi-structured interviews with 22 older adult icu survivors and 6 primary care physicians to elicit preferences and the intervention was further adapted based on these results.

Eligibility criteria:
inclusion criteria: * age 60 and older at time of discharge from intensive care unit * minimum 72 hour intensive care unit stay in an icu at atrium health wake forest baptist * delirium during icu stay as determined by positive confusion assessment method (cam)-icu score, review of clinical - documentation, or discussion with clinical team * primary care provider in the atrium health wake forest system or intention to follow with primary care physician in atrium health system * english speaking exclusion criteria: * death during initial hospitalization and/or discharge to hospice * life-expectancy \< 6 months from pre-existing illness (defined as diagnosis of metastatic cancer, cirrhosis, advanced heart failure, prior palliative care referral) * acute traumatic brain injury * continued residence in skilled nursing facility or rehab that prevents ability to complete study telephone call at time of first cognitive screen attempt * prior history of dementia in electronic health record * language or communication barrier that prohibits intervention participation * participant cannot identify family or caregiver contact or family/caregiver unwilling to participate * subject or legally authorized representative (lar) decline consent * unstable telephone service for contact after hospital discharge * primary residence outside of north carolina

Keywords: post icu post-icu screening older adults aging
exercise-snacks for breaking the sedentary lifestyle and improving the physical fitness of obese adolescents?

Conditions: Obese Adolescents; Sedentary Time; Exercise

Summary: the management of a person with obesity involves long-term behavioral changes with a balanced diet in both quantity and quality, along with the adoption of a more active lifestyle: increasing physical activities and reducing sedentary behaviors. the school setting has been identified as a favorable environment for interventions aimed at reducing and interrupting the time adolescents spend sitting and preventing the associated negative health consequences. recently, very short (\&lt; 1 minute) and intense exercises, called 'exercise-snacks,' have been reported to be effective in adults for 1) improving physical fitness over 6 weeks, and 2) improving vascular function and lowering blood glucose levels over a single day. additionally, in adolescents with diabetes, they have been shown to reduce body fat. this raises the question of whether adding \&#39;exercise-snack\&#39; sessions to a multidimensional care program for hospitalized obese adolescents could further improve their physical fitness in the short and medium term. the objective of this project is to compare the effects of a traditional multidimensional care program with the addition of 'exercise-snacks' to the same care program without \&#39;exercise-snacks\&#39; on the physical fitness, body composition, vascular function, and physical activity and sedentary behaviors of obese children in the short and medium term. thirty-six obese adolescents will be included. the \&#39;exercise-snack\&#39; group will perform six exercise sessions per day for three weeks in addition to the standard care. the control group will receive only the standard care. assessments of physical fitness, body composition, vascular health, and questionnaires on physical activity, sedentary behavior, and cognitive restraint will be conducted at the beginning and end of the three-week program, as well as 1 and 3 months after the end of the program.


Eligibility criteria:
inclusion criteria: * body mass index z-score corresponding to stage 2 obesity, * no weight loss of more than 5% of total body weight in the past 3 months, * parental consent * minor\&#39;s acceptance exclusion criteria: * contraindication to physical activity * current participation in a clinical trial
correlation between suv on 18f-dcfpyl pet/ct and gleason score in prostate cancer

Conditions: Prostate Cancer

Summary: prostate specific membrane antigen (psma) is a unique membrane bound glycoprotein, which is overexpressed manifold on prostate cancer cells and is well-characterized as an imaging biomarker of prostate cancer. positron emission tomography / computer tomography (pet/ct) is a nuclear medicine procedure based on the measurement of positron emission from radiolabeled tracer molecules. 18f-dcfpyl is a tracer for prostate cancer pet imaging which binds to psma. the strength of functional imaging methods is in distinguishing tissues according to metabolism rather than structure. studies have shown that pet/ct imaging with 18f-dcfpyl can detect prostate cancer lesions with excellent contrast and a high detection rate even when the level of prostate specific antigen is low. the objective of this study is to evaluate if the patient-wide suvmax on 18f-dcfpyl pet/ct in locoregional and metastatic prostate cancer correlates with histopathologic gleason score at initial biopsy. it is hypothesized that suvmax will correlate positively with gleason score. this is of interest because non-invasive risk stratification may be possible in the future.


Eligibility criteria:
inclusion criteria: * resident of canada * male sex * age 18 years or older * previous diagnosis of prostate cancer with gleason score available * ecog performance status 0 - 3, inclusive * able to understand and provide written informed consent * under referring physician's care * able to tolerate the physical/logistical requirements of a pet/ct scan including lying supine for up to 40 minutes with the arms above the head and tolerating intravenous cannulation exclusion criteria: * medically unstable patients (e.g. acute cardiac or respiratory distress or hypotensive, etc.) * patients who exceed the safe weight limit of the pet/ct bed (200 kg) or who cannot fit through the pet/ct bore (70 cm diameter) * patients with unmanageable claustrophobia
a study of total neoadjuvant therapy for high-risk locally advanced rectal cancer

Conditions: Rectal Cancer

Summary: a phase ii study of total neoadjuvant therapy for high-risk locally advanced rectal cancer

recommended treatment of patients with locally advanced rectal cancer (larc) includes preoperative chemoradiation (crt), total mesorectal excision (tme) and postoperative adjuvant chemotherapy (act). however, treatments fail to show an improved therapeutic effect on high-risk patients now. total neoadjuvant therapy (tnt) is a new try for rectal cancer treatment,and this trial aims to identify and select the more promising tnt sequence. this trail is a multicenter, randomized, phase ii trial . eligible patients age from 18 to 75 years with histologically confirmed rectal adenocarcinoma. mri is mandatory, and patients of stage ii or iii rectal cancer are eligible if any of the following criteria are fulﬁlled: categories t4,categories n2, mrf involvement, emvi positive, and lateral lymph node involvement. patients are randomly assigned to 3 groups, group 1: concurrent chemoradiotherapy → tme → adjuvant chemotherapy (control group);or group 2: concurrent chemoradiotherapy → consolidation chemotherapy → tme (cnct group);or group 3: induction chemotherapy → concurrent chemoradiotherapy →tme ( inct group).the primary end point is the rate of tumor down-staging, which is deﬁned as stage yp0-ii after surgery,and watch-and-wait strategy after complete clinical response (ccr) was allowed. secondary end points include acute toxicity, compliance with tnt, surgical complications, 3-year overall survival (3yos),3-year disease free survival (3ydfs),3-year distant metastatic free survival(3ydmfs),3-year locoregional recurrence-free survival(3ylrrfs) and quality of life.

Eligibility criteria:
inclusion criteria: 1. 18-75 years old, regardless of gender 2. histologically confirmed rectal adenocarcinoma; 3. up to 12 cm above the anal verge on the basis of rigid rectoscopy. 4. mri of the rectum is acceptable; 5. patients in stage ii or iii rectal cancer are eligible if any of the following criteria are fulﬁlled: categories t4,categories n2, mrf involvement, emvi positive, and lateral lymph node involvement. 6. ecog score 0-1 or kps score ≥80. exclusion criteria: 1. history of malignant tumor in other parts; 2. cannot complete mri; allergic to 5-fu drugs; allergic to platinum drugs; 3. during thrombolytic and anticoagulant therapy, the patient has bleeding diathesis or coagulation dysfunction; or aneurysm, stroke, transient ischemic attack, arteriovenous malformation in the past year; 4. history of kidney, urine test found proteinuria or clinical renal function was significantly abnormal; 5. history of digestive tract fistula, perforation or severe ulcer; 6. active infection is present; clinically obvious heart disease; new york heart association (nyha) of ⅱ level or congestive heart failure; unstable symptomatic arrhythmia or peripheral vascular disease ≥ grade ii; myocardial infarction and cerebrovascular accident occurred within 6 months before enrollment.

Keywords: rectal cancer radiotherapy high risk total neoadjuvant therapy
selection of a protective t cell-based hiv-1/fiv vaccine

Conditions: HIV

Summary: the purpose of this research study is to develop a vaccine against human immunodeficiency virus (hiv), a disease that causes aids in people,. the investigator will be looking at viruses similar to hiv in animals. since these viruses are very similar to hiv, the blood from humans who have been exposed to hiv will be tested to see if the immune system will recognize the hiv and prevent infection. hiv targets the immune system by attacking certain t cells called cd4+ t cells. there are parts on the aids viruses that help the virus infect these cells and other parts that help the immune system prevent viral infection by activating protective t-cells that fight hiv. different t-cell populations are very important in most vaccines as they act as "effectors" that work as part of the immune system to recognize and fight off hiv infection. when effector t cells are activated by appropriate "protective" part(s) of the virus they either block hiv from reproducing or kill hiv infected cells. by finding these common protective parts of each of these human and animal aids viruses, the investigator hopes to make a vaccine that helps the immune system prevent hiv infection by avoiding parts that attack cd4+ t cells and may worsen hiv infection and selecting for parts that stimulate effector t cells that fight hiv infection.

as a participant in this study a blood drawn will performed.

Eligibility criteria:
inclusion criteria: * male and female subjects between 18 and 65 years old who are hiv positive exclusion criteria: * persons with other immune diseases that would result in autoimmunity or aberrant immune responses (such as subjects who have undergone chemotherapy within the past year).

Keywords: hiv vaccine t cell
mri in patients with kennedy disease

Conditions: Bulbo-Spinal Atrophy, X-Linked; Kennedy Disease

Summary: kennedy disease is an inherited neuromuscular disorder that is characterized by progressive muscle wasting and weakness. it typically starts with muscle spasms and tremors in the arms, followed by muscle weakness and atrophy of muscles in the arms and legs. the facial and bulbar muscles are also involved. however, the muscle involvement pattern has not been investigated systemically in kennedy disease. the primary aim of the study is to investigate the muscle involvement in patients with kennedy disease using mri. secondary aims are to examine disease severity and to test mri as a potential outcome measure for future clinical trials in kennedy disease. approximately 40 patients with kennedy disease and 20 gender and age matched healthy voluntary controls will be recruited. the study consists of one visit per subject lasting 4-5 hours.


Eligibility criteria:
patients with kennedy disease: inclusion criteria: * confirmed kennedy disease exclusion criteria: * all contraindications for undergoing an mri scan healthy controls inclusion criteria: * fit age and gender criteria exclusion criteria: * all contraindications for undergoing an mri scan
cardiac magnetic resonance predictors of outcome of rhythm control in patients with atrial fibrillation/flutter

Conditions: Rhythm Monitoring

Summary: evaluate the impact of various features in cmr on the mid-term/long-term success rate of rhythm control for paroxysmal atrial fibrillation/flutter .

* atrial fibrillation/flutter are widely prevalent. * reported antiarrhythmic drug efficacy to restore \& maintain sinus rhythm is 52% which is far from optimal. * on the other hand, 5-year arrhythmia-free survival after catheter ablation was previously reported to be 63%. * therefore, there is a need for better characterization of the underlying atrial substrate, to improve treatment outcomes in terms of efficacy and safety

Eligibility criteria:
inclusion criteria: * age\>18 years. * patients undergoing successful cardioversion (pharmacologic or electric) for atrial fibrillation/flutter, or symptomatic patients with paroxysmal atrial fibrillation/flutter scheduled for trans-catheter ablation. * index cardioversion or index ablation procedure. exclusion criteria: * la thrombus on tee or cmr. * contraindications to cmr. * contraindications to gd-based contrast.

Keywords: cmr predictors of rhythm control in patient with afibirilation/flutter
translational research in identifying molecular mechanisms for rectal cancer metastasis

Conditions: Rectal Cancer; Chemoradiation

Summary: rectal cancer, comprised of 30% of overall colorectal cancer cohort, is one of the leading cancers of taiwan. in patients with advanced disease, the standard of care is concurrent chemoradiotherapy (ccrt) before surgery. after ccrt, the abscopal effect, a phenomenon that localized radiation not only destroys local tumor but also inhibits the growth of tumor at the remote site, has been observed. this effect is believed to be associated with tumor immune response. in addition, other immune checkpoint molecules, such as programmed cell death-1(pd-1), programmed cell death ligand-1 (pd-l1), and cytotoxic t-lymphocyte associated protein 4 (ctla-4), have been reported associated with therapeutic outcome. however, after ccrt, more than 50% of patients were still either having persistent disease or developed distant metastasis. to improve therapeutic outcome of patients with rectal cancer, this project, thus, aims at exploring the evolution of factors that may affect the abscopal effect and immune checkpoint functions in tissues and in blood before and after ccrt.

for most patients, preoperative chemoradiotherapy results in clinically tumor regression, but the degree of response varies among patients. there are approximately 40-60% of larc patients treated with ccrt achieve some degree of pathologic response. however, there is yet an effective method before the commencement of ccrt that can predict how patients will respond to ccrt and can subsequently render better survival. identify patents who will benefit most from ccrt is crucial not only in lowering treatment-related morbidity and sustaining local control but also to improve survival rate in larc.

Eligibility criteria:
inclusion criteria: * rectal cancer patients in china medical university hospital (age limit: 20 yrs and older) exclusion criteria: * pregnancy, disabilities
effectiveness of dry needling versus cupping therapy for pain in piriformis syndrome

Conditions: Piriformis Syndrome

Summary: this study aims to compare the effectiveness of two popular therapeutic interventions, dry needling and cupping therapy, in alleviating pain associated with piriformis syndrome. piriformis syndrome is a neuromuscular disorder caused by the compression or irritation of the sciatic nerve by the piriformis muscle, leading to buttock pain and radiating numbness.

the study will recruit participants diagnosed with piriformis syndrome and will randomly assign them to receive either dry needling or cupping therapy over a specific period. the primary outcome will be the reduction in pain intensity measured by standardized pain assessment tools. secondary outcomes will include improvements in functional mobility and quality of life. by analyzing the efficacy and patient-reported outcomes of both therapies, the study aims to provide evidence-based recommendations for clinicians treating piriformis syndrome.

Eligibility criteria:
inclusion criteria: * adults aged between 18 to 65 years. * diagnosed with piriformis syndrome. * experiencing chronic pain for at least 3 months. * willingness to comply with the study protocol and attend all therapy sessions. exclusion criteria: * recent surgery on the lower back or hip. * presence of systemic diseases affecting muscle function (e.g., multiple sclerosis, rheumatoid arthritis). * pregnant or breastfeeding women. * use of anticoagulant medication or having a bleeding disorder. * participating in another clinical trial simultaneously