Kornimate/medical-research-clean huggingface dataset:
dexmedetomidine and postoperative cognitive dysfunction (pocd)

Conditions: Postoperative Cognitive Dysfunction; Postoperative Pain

Summary: postoperative cognitive dysfunction (pocd) affects all age groups and can lead to increased morbidity and more extended hospital stays. dexmedetomidine reduces pocd by inhibiting the increase in proinflammatory cytokines il-6 and tnf-α, and its anti-inflammatory activity contributes to its protective effect. previous studies found that dexmedetomidine reduced pocd incidence in non-cardiac and cardiac surgery. therefore, the goal of this study was to specifically investigate if using tci dexmedetomidine to maintain anaesthesia in laparotomy surgeries reduces the incidence of pocd compared to inhalation anaesthesia by sevoflurane.


Eligibility criteria:
inclusion criteria: * aged \>= 18 years old * scheduled for laparatomy surgery exclusion criteria: * history of allergies to anaesthetic drugs * impaired consciousness * neurocognitive disorder * psychiatric disorder * mental disorder * cerebrovascular disorders * sick sinus syndrome * hypoalbuminemia * massive bleeding * liver disease * kidney diseases.

Keywords: postoperative cognitive complications dexmedetomidine pain hemodynamics
can alternative treatment have an impact on cervical dysplasia?

Conditions: Cervical Dysplasia

Summary: in this study two questions will be answered: * can mindfulness meditation help cell-changed on the cervix to disappear? * can mindfulness meditation lower the psychological distress when women have abnormal cervical cancer screening results?

200 women, who have participated in cervical cancer screening and have mild dysplasia, will be randomized into two groups; an intervention group and a control group. the intervention group will be asked to do mindfulness meditation twice a week listening to instructions from a cd. 200 additional women having normal cervical screening results will also be included in the project.

Eligibility criteria:
inclusion criteria: * women aged 23-29 years * participated in cervical cancer screening * having mild dysplasia and normal screening results exclusion criteria: * women who have previously had dysplasia

Keywords: screening cervical cancer cervical dysplasia adverse psychosocial effects alternative treatment
a study evaluating the efficacy and safety of sunitinib with or without bevacizumab in first-line patients with metastatic renal cell cancer (sabre-r)

Conditions: Renal Cell Carcinoma

Summary: this is a phase ii, multicenter, randomized, blinded, placebo-controlled study designed to evaluate the safety and efficacy of combining bevacizumab with sunitinib relative to placebo with sunitinib in patients with metastatic rcc who have not received prior systemic therapy for metastatic disease. the study will enroll approximately 100 patients at approximately 20 centers in the united states.


Eligibility criteria:
inclusion criteria: * signed informed consent form * histologically confirmed metastatic rcc * measurable disease, as defined by recist * age ≥ 18 years * ecog performance status of 0 or 1 * prior nephrectomy * ability and capacity to comply with study and follow-up procedures exclusion criteria: * rcc with predominantly sarcomatoid features * prior systemic or adjuvant therapy for rcc * radiotherapy for rcc within 28 days prior to day 1 * prior treatment with bevacizumab, sunitinib, sorafenib, axitinib, thalidomide, or other similar agents * current need for dialysis * life expectancy of \< 12 weeks * current, recent, or planned participation in an experimental drug study * inadequate organ function * active infection or fever \> 38.5°c within 3 days of starting treatment * history of other malignancies within 5 years prior to day 1 * any other medical conditions (including mental illness or substance abuse) deemed by the clinician to be likely to interfere with a patient's ability to provide informed consent, cooperate, or participate in the study, or to interfere with the interpretation of the results * inadequately controlled hypertension * prior history of hypertensive crisis or hypertensive encephalopathy * new york heart association (nyha) class ii or greater chf * history of myocardial infarction or unstable angina within 6 months prior to day 1 * history of stroke or transient ischemic attack within 6 months prior to day 1 * known cns disease except for treated brain metastasis * significant vascular disease (e.g., aortic aneurysm, aortic dissection) or recent peripheral arterial thrombosis within 6 months prior to day 1 * history of hemoptysis (≥ 1/2 teaspoon of bright red blood per episode) within 1 month prior to day 1 * evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation) * major surgical procedure or anticipation of need for major surgical procedure during the course of the study * serious, non-healing wound; active ulcer; or untreated bone fracture * known hypersensitivity to any component of bevacizumab * pregnancy (positive pregnancy test) or lactation * current, ongoing treatment with full-dose warfarin

Keywords: rcc renal cell cancer avastin sutent
the steps - totalis™ trial

Conditions: Lumbar Spinal Stenosis

Summary: the purpose of this study is to determine safety and effectiveness, as measured by changes in pain, disability, patient satisfaction, and claudicatory symptoms, at 6 months following treatment with the totalis™ direct decompression system or sham comparator surgical procedure in patients with lumbar spinal stenosis

subjects suffering from symptoms of neurogenic intermittent claudication secondary to a radiographically-confirmed diagnosis of central canal stenosis, with or without mild or moderate lateral recess stenosis, at one or two levels from l1 to l5 who meet all inclusion/exclusion criteria, including ≥6 months of non-operative management. patients included in the clinical investigation will return for follow-up visits at 1 week for safety evaluation, and at 6 weeks, 3 months, 6 months, 12 months, 18 months and 24 months post-treatment to collect data for evaluation of safety and effectiveness.

Eligibility criteria:
inclusion criteria: * male or female subjects greater than or equal to 55 years of age * neurogenic intermittent claudication (nic) symptoms defined generally as leg/buttock/ groin pain and/or paresthesias that are exacerbated with standing and walking and relieved by flexion * vas leg symptom severity \>50 (in either leg) during episodes of neurogenic claudication * subjects who are able to walk a minimum of 50 feet without experiencing nic symptoms * diagnosis of central canal spinal stenosis, with or without mild to moderate lateral recess stenosis, at one or two levels from l1-l5 with radiologic evidence * subjects with persistent lumbar spinal stenosis symptoms that, during the course of the last year, have been unresponsive to a minimum of 6 months of conservative therapy exclusion criteria: * significant back, buttock or leg pain from causes other than lumbar central canal stenosis * axial back pain only * severe foraminal stenosis at index level(s) and/or symptomatic foraminal stenosis at any lumbar level * severe lateral recess stenosis * lumbar spinal stenosis at more than two levels determined pre-operatively to require surgical intervention * prior decompressive surgery at index level (s) or fusion at any lumbar level * epidural steroid or nerve block steroid injection at index level(s) within 6 weeks of baseline assessments * spondylolisthesis (anterolisthesis or retrolisthesis) greater than grade 1 * spondylolysis (pars fracture) * significant degenerative lumbar scoliosis at index level(s) * morbid obesity * significant peripheral vascular disease * active significant co-morbidity * undergoing immunosuppressive therapy or long-term steroid use * current spinal cord stimulator or implanted pain pump * life expectancy less than 2 years * evidence of substance abuse within the year * involvement or potential involvement in litigation related to the spine or worker's compensation related to a back and/or leg issue
development and application of intelligent assessment system of longshi scale

Conditions: Stroke; Disability Physical

Summary: the purpose of this study was to verify convenience and feasibility of the novel intelligent longshi assessment system to provide an accurate and convenient evaluation tool for stroke survivors.


Eligibility criteria:
1. inclusion criteria: 1. stroke survivors * age≥18 years * diagnosis of cerebral infraction or intracerebral hemorrhage * stable vital signs * willingness to participate in the study with informed consent 2. professional evaluators: * one to ten years of working experience * experience in rehabilitation scientific research or education related work for more than two years * association with longshi scale research 3. non-professional evaluators： * the family or caregiver of stroke survivors * ability to read and communicate * willingness to participate in the study with informed consent 2. exclusion criteria: 1. stroke survivors: * brain tumor, parkinson's disease or active epilepsy within past three months * impaired cognitive functions * participation in any other clinical study 2. professional evaluators: * refusal to participate in the study 3. non-professional evaluators: * care for patients with serious mental health problems * refusal to participate in the study

Keywords: stroke activities of daily living electronic version
role of diffusion mri in differentiation of various bone marrow lesions

Conditions: Diffusion MRI; Bone Marrow Disease

Summary: bone marrow lesions are common, and imaging findings are associated with various aetiologies, as compared to conventional radiography and computed tomography (ct), mri is a better non-invasive imaging modality to evaluate vertebral bone marrow, due to better soft-tissue contrast, so the aim of our study is the use of mri diffusion in differentiating various vertebral bone marrow pathological lesions.

bone marrow lesions are common, and imaging findings are associated with various aetiologies, such as degenerative, infectious, traumatic, malignant, metabolic, and haematopoietic . as compared to conventional radiography and computed tomography (ct), mri is a better non-invasive imaging modality to evaluate vertebral bone marrow, due to better soft-tissue contrast as well as being non-ionising in nature . although conventional mri is essential for anatomical visualization and lesion detection in bone marrow pathologies ,but it often insufficient in distinguishing different vertebral bone marrow lesions, due to overlapping imaging features and often due to coexistence of bone marrow oedema that can be caused by fractures, infection, and bone marrow hyperplasia, thus reducing the specificity of conventional sequences . mri diffusion provides complementary information about tissue microstructure and cellular .it exploits the translational mobility of water molecules to obtain information on the microscopic behaviour of the tissues. on the other hand, apparent diffusion coefficient (adc) values provide quantitative measure of brownian movement with low adc values implying restricted diffusion and high values being a measure of free diffusion. therefore, dwi provides both qualitative and quantitative functional information concerning the microscopic movements of water at the cellular level. the benefits of dwi comprise a small scanning period that allows it to be easily included in the routine imaging protocols . for example, in healthy bone marrow, water diffusion is relatively unrestricted due to its cellularity and vascularity, while pathologies such as metastatic disease or myelofibrosis typically exhibit restricted diffusion. diffusion mri can also distinguish bone marrow edema like acute injury or inflammation, from infiltrative diseases such as multiple myeloma. edema typically shows higher adc values due to the increased water content, whereas infiltrative diseases reduce diffusion, resulting in lower adc values. these examples illustrate how mri diffusion can differentiate various vertebral bone marrow pathological lesions.

Eligibility criteria:
inclusion criteria: * all adult patients with vertebral lesions clinically suspected or diagnosed by other modalities as x-ray or ct were included in the study. exclusion criteria: * patients with metallic prosthesis which are not mri compatible . * patients with previous vertebral surgery. * patients with vertebral congenital anomalies * patients refused the examination. * patients who suffer from claustrophobia

Keywords: mri bone marrow pathologies
the minimally invasive coronary surgery compared to sternotomy coronary artery bypass grafting trial

Conditions: Coronary Artery Disease

Summary: mics cabg (minimally invasive coronary surgery), where coronary artery bypass grafting (cabg) is completed through a small incision over the left chest, has evolved to become a safe and less invasive alternative to conventional sternotomy cabg. several observational studies have suggested significantly shorter time to return to physical activity for mics cabg patients compared to sternotomy cabg patients. a randomized study is warranted to validate these findings, provide higher level of evidence, and potentially lead to changes in practice. the mist trial is a multi-centre, prospective, open label, randomized control trial comparing quality of life and recovery in the early post-operative period, between patients undergoing mics cabg versus patients undergoing sternotomy cabg. patients referred for isolated cabg for multi-vessel coronary artery disease and deemed technically suitable for sternotomy cabg as well as for mics cabg are considered for enrollment into the trial. quality of life questionnaires (the sf-36, seattle angina questionnaire and eq-5d-5l) will be used to assess the quality of life and recovery in patients undergoing sternotomy cabg or mics cabg at 1 month, 3 months, 6 months and 12 months follow up.


Eligibility criteria:
inclusion criteria: * 18 years of age or older * angiographically-confirmed multi-vessel coronary artery disease lesions with \>=70% in at least 2 major epicardial vessels in 2 or more coronary artery territories (left anterior descending (lad), circumflex (cx) and right coronary artery (rca)) or lesions \>=50% in the left main (lm) * patients who, in the opinion of the investigator, are amenable for coronary surgery through either median sternotomy or minimally-invasive approach. * patients who are willing and able to comply with all follow-up study visits. exclusion criteria: * \<18 years of age * concomitant cardiac procedure with cabg (e.g. valve repair or replacement) * previous cardiac surgery, mediastinal irradiation, or significant trauma to the chest * contra-indications for mics cabg, including: severe pectus excavatum; severe pulmonary disease; hemodynamically significant left subclavian stenosis; morbid obesity; severe left ventricular (lv) dysfunction; no adequate pda or marginal branch target; absence of femoral pulse bilaterally. * contraindications for conventional cabg via sternotomy * concomitant life-threatening disease likely to limit life expectancy to \<2 years * emergency cabg with hemodynamic compromise * inability to provide informed consent.
robot-based tele-echography ii - a comparative study

Conditions: Abdominal Injuries; Thoracic Injuries; High Energy Trauma

Summary: the aim of this clinical trial is to evaluate the concordance of diagnosis of injuries in thoracoabdominal trauma using two different echographic methods. the first method is a robot-based tele-echography performed by radiologists in a remote location. the second is bedside echography performed by emergency physicians according to the fast (focussed assessment by sonography of trauma) examination.

1. principal objective: to evaluate the concordance of diagnosis of injuries in thoracoabdominal trauma using two different echographic methods (robot-based tele-echography performed by radiologists in a remote location vs bedside echography performed by emergency physicians according to the fast examination). 2. objective 2: after the realization of a gold standard method, if there is a concordance between the two different echographic methods, sensitivity and specificity are estimated. if not, the evaluation of sensitivity and specificity of each method with analysis of their discordance is performed. 3. objective 3: qualitative evaluation of each echographic method by the patient and the physicians. 4. material and methods: this therapeutic, mono-centre, prospective, randomized, cross-over, open, controlled trial is being conducted in 70 patients. all the patients will have the two different echographic methods in a sequential but randomized way. the robot-based tele-echography is performed by a radiologist in the north university hospital of grenoble. the bedside echography is performed by the emergency physicians in the trauma center in the south university hospital of grenoble.

Eligibility criteria:
inclusion criteria: * person registered with the french social security or benefiting from an equivalent health insurance system * person sent to hospital for thoracoabdominal high energy trauma exclusion criteria: * ward of court or under guardianship * adult unable to express their consent * person deprived of freedom by judicial or administrative decision * person hospitalized without their consent * person under legal protection * person participating in another clinical study

Keywords: robot-based tele-echography tele-medicine
effect of smoking exposure on smoking relapse following brief abstinence - 2

Conditions: Tobacco Use Disorder

Summary: recent research on the effects of nicotine on the brain and behavior presents an opportunity to advance medication development. the purpose of this study is to develop a laboratory model for early-stage testing of new and existing treatments for nicotine addiction. specifically, the investigators will develop a laboratory model of relapse to cigarette use in nicotine dependent volunteers.

tobacco use is the leading preventable cause of death in the united states. recent research on the effects of nicotine on the brain and behavior presents an opportunity to advance medication development. the goal of this study is to develop a laboratory model for early-stage testing of new and existing compounds for the treatment of tobacco and nicotine addiction. in addition, the objective of this study is to develop a laboratory model of relapse induced by cigarette exposure that would reproduce the psychological and physiological processes that are involved when abstinent individuals progress from initial cigarette smoking (lapse) to a pre-abstinence level of use (relapse). such a model may be used to study the mechanisms of relapse and to screen medications that might be effective in preventing relapse in treatment seekers. this study will consist of two phases. each phase will consist of a 5-day inpatient stay. during the first portion of inpatient stay, participants will not be permitted to smoke. during the second portion of inpatient stay, smoking reinstatement will be modeled, as participant will have opportunity to smoke, following the exposure to tobacco-related or control cues. a variety of behavioral, subjective, physiological, and performance measures will be assessed throughout the study.

Eligibility criteria:
inclusion criteria: * diagnosis of nicotine dependence with psychological dependence * smokes at least 15 cigarettes per day for the three months prior to enrollment * currently not seeking treatment for nicotine dependence * medically healthy, on the basis of physical examination and medical history, vital signs, ekg, and laboratory tests * females must use an effective method of contraception for the duration of the study exclusion criteria: * diagnosis of abuse or dependence on alcohol or drugs other than nicotine * current axis i diagnosis or current treatment with psychotropic medications within the 3 months prior to enrollment * history of schizophrenia or other psychotic disorders, bipolar disorder, or anxiety disorders * currently seeking treatment for nicotine disorders * on parole or probation * history of seizures or head trauma with loss of consciousness, brain contusion, or fracture * history of significant recent violent behavior * blood pressure greater than 150/90 * history of eating disorders * pregnant

Keywords: tobacco use
effectiveness of early intervention in an underserved population

Conditions: Autism Spectrum Disorders

Summary: the purpose of this study is to test the applicability of a caregiver-implemented autism intervention protocol to a deliberately recruited low-income, underserved population.

families of racial/ethnic minority, lower levels of education, and those who live in non-metropolitan areas have been found to experience greater limitations in accessing services for autism spectrum disorder (asd) (thomas, ellis, mclaurin, daniels, \& morrissey, 2007). black and hispanic children have been found to have lower odds of having a documented asd classification than white children (mandell, wiggins, arnstein carpenter, daniels, durkin et al., 2009) and of those children who do receive an asd diagnosis, many of them are not diagnosed in early childhood. the age of first asd diagnosis received has been found to be significantly higher for african american and latino children compared to white children (mandell, listerud, levy, \& pinto-martin, 2002). for these reasons, it is important that the effectiveness of intensive early intervention for children with asd is examined across varying cultural and socioeconomic backgrounds. this project is directed by dr. catherine lord at the university of michigan, in collaboration with dr. amy wetherby at florida state university to test the applicability of a modified caregiver-implemented autism intervention (modified early social interaction; esi) to a deliberately recruited low-income, underserved population. um will recruit 28 children and fsu will recruit 16 children diagnosed with asd who are between 24 and 42 months of age over a period of 3 years, totaling 44 caregiver-child dyads. this study will utilize a multiple baseline single-subject research design. dyads will complete 1 month of weekly 1-hour baseline observations followed by three months of the modified esi intervention. child and family characteristics predicting response to intervention will be identified and findings will contribute to the development of autism interventions serving families from diverse backgrounds.

Eligibility criteria:
inclusion criteria: * caregiver(s) with less than a 4-year college degree * family income equal to or below 2x the federal poverty line * english as the predominantly-spoken language. * child received diagnosis of autism spectrum disorder before treatment * child is between 24 and 42 months at the start of treatment * child has normal hearing and adequate motor control to make simple actions (giving, reaching) * family agrees to 2-4 weeks of weekly 1-hour observations, 3 months of 2 intervention sessions per week, and 3 months of 1 intervention session per month. * family agrees to pre-treatment, post-treatment, and follow-up evaluation and videotaping of intervention sessions and weekly video check during the treatment. exclusion criteria: -must meet eligibility requirements stated above.

Keywords: autism autism spectrum disorders pervasive developmental disorders intervention low-income underserved populations underrepresented populations