Kornimate/medical-research-clean huggingface dataset:
treating thought problems in patients with schizophrenia

Conditions: Schizophrenia

Summary: this study will compare cognitive adaptation training (cat) to minimal schizophrenia treatment. this study will also determine whether the intensity of cat can be reduced and still provide benefits to patients with schizophrenia.

many schizophrenia patients have serious difficulties that affect their quality of life. cognitive adaptation training (cat) may improve adaptive functioning, quality of life, and rates of relapse in schizophrenia patients. cat, which involves compensatory strategies or environmental supports, is tailored to each individual and is based on executive functioning levels and other factors. participants are randomly assigned to cat, minimal environmental supports (mes), or treatment as usual for 2 years. participants receiving cat will have a trained therapist make weekly visits to their home for 9 months. over the following 3 months, the frequency of cat visits will be slowly reduced to once a month. for the remaining 12 months of treatment, patients receive cat only once a month. participants assigned to the mes group receive a generic set of supplies and equipment (calendar, alarm clock, watch, bus passes, etc.) at the beginning of the 2-year period. each month, the supplies are replenished as necessary during the patient's scheduled clinic visit. in all groups, assessments of adaptive function and quality of life occur at study start and at 3, 6, 9, 18, and 24 months.

Eligibility criteria:
inclusion criteria: * dsm-iv diagnosis of schizophrenia or schizoaffective disorder * treatment with an atypical antipsychotic medication * stable living environment * able to read, understand, and complete rating scales and neuropsychological testing * willing to participate in psychosocial treatments for schizophrenia that may involve home visits exclusion criteria: * history of significant head trauma, seizure disorder, or mental retardation * alcohol or drug abuse that could interfere with participation in the study * treatment by an act team * history of violence in the past year * score \> 80 on the sofas * hospitalized in the past year
rct of ghrelin in stroke patients

Conditions: Stroke, Ischemic

Summary: about half of the patients with acute ischemic stroke treated with endovascular thrombectomy (evt) remain dependent on the help of others or die in the first 90 days. we hypothesize that treatment with ghrelin, started in the first six hours after stroke onset, improves early recovery and long-term functional outcome in these patients. ghrelin is a naturally occurring hormone and mildly excitatory neurotransmitter also known as the 'hunger hormone.' treatment with acylated ghrelin consistently improved functional and histological recovery in in vitro and in vivo models of ischemic stroke.

we will include 80 patients with acute ischemic stroke caused by large vessel occlusion of the anterior circulation, eligible for evt. the study population will be drawn from adult patients with acute ischemic stroke treated with evt at umc utrecht, rijnstate, mst or isala. treatment in the intervention group will consist of intravenous acylated ghrelin, 600micrg dissolved in 50cc normal saline, by bolus (short term) infusion in 30 minutes, twice daily, for five days. this treatment will be additional to standard treatment, including intravenous thrombolysis, if indicated.

Eligibility criteria:
inclusion criteria: * a clinical diagnosis of acute ischemic stroke, caused by intracranial large vessel occlusion of the anterior circulation (distal intracranial carotid artery or middle (m1/proximal m2) cerebral artery) confirmed by neuro-imaging (cta or mra), * treatment with evt, defined as groin puncture in the angio suite, * ct or mri ruling out intracranial hemorrhage, * a pre-evt score of at least 10 on the nihss, * age of 18 years or older, * written informed consent (deferred). exclusion criteria: * pre-stroke disability defined as mrs ≥ 2, * life expectancy shorter than one year, * child-bearing potential.

Keywords: endovascular thrombectomy ghrelin
far infrared irradiation for control, management and treatment of amyotrophic lateral sclerosis (als)

Conditions: Amyotrophic Lateral Sclerosis

Summary: amyotrophic lateral sclerosis (als, sometimes called lou gehrig's s disease, or maladie de charcot) is a progressive, usually fatal, neurodegenerative disease caused by the degeneration of motor neurons, the nerve cells in the central nervous system that control voluntary muscle movement. this study will investigate the use of far infrared radiation for the control, management and treatment of als.

as a motor neuron disease, als causes muscle weakness and atrophy throughout the body as both the upper and lower motor neurons degenerate, ceasing to send messages to muscles. unable to function, the muscles gradually weaken, develop fasciculations (twitches) because of denervation, and eventually atrophy due to that denervation. the patient may ultimately lose the ability to initiate and control all voluntary movement except of the eyes. observations from our research studies indicate that, far infrared rays provide energy to the body, improve the autonomic functions of the nervous system, restore the functions of the endocrine system, strengthen the immune system, improve blood circulation and increase the level of oxygen in the cells and promote the regeneration of muscle cells, nerves and brain cells. it is hereby postulated that irradiation using far infrared, with wavelength between 5 to 20 microns, of the central nervous system, the endocrine system and the whole body could prevent, control, manage or possibly lead to complete rehabilitation of people who have als.

Eligibility criteria:
inclusion criteria: * patients with als exclusion criteria: * none

Keywords: als (amyotrophic lateral sclerosis) amyotrophic lateral sclerosis with dementia amyotrophic lateral sclerosis, guam form dementia with amyotrophic lateral sclerosis gehrig's disease guam form of amyotrophic lateral sclerosis lou gehrig disease
evaluation of left ventricular volumes by real-time 3-dimensional echocardiography

Conditions: Heart Diseases

Summary: quantitative measurements of left ventricular volume and ejection fraction are useful in the management of patients with heart disease. several imaging methods exist, but are limited by cost, invasiveness, or exposure to radio-isotopes. conventional echocardiography is a noninvasive method that allows estimation of left ventricular size and function; however, quantitative measurements of volume are not widely used due to lack of reproducibility and inaccurate measurements. real-time three-dimensional echocardiography is a new technique that can be used to derive volume measurements from a single image acquisition. we hypothesize that real-time three-dimensional echocardiography is an accurate method for making left ventricular volume measurements. we therefore propose to measure left ventricular volumes using real-time three-dimensional echocardiography in human subjects and correlate these measurements with magnetic resonance imaging, a more accurate noninvasive method for obtaining these measurements.

quantitative measurements of left ventricular volume and ejection fraction are useful in the management of patients with heart disease. several imaging methods exist, but are limited by cost, invasiveness, or exposure to radio-isotopes. conventional echocardiography is a noninvasive method that allows estimation of left ventricular size and function; however, quantitative measurements of volume are not widely used due to lack of reproducibility and inaccurate measurements. real-time three-dimensional echocardiography is a new technique that can be used to derive volume measurements from a single image acquisition. we hypothesize that real-time three-dimensional echocardiography is an accurate method for making left ventricular volume measurements. we therefore propose to measure left ventricular volumes using real-time three-dimensional echocardiography in human subjects and correlate these measurements with magnetic resonance imaging, a more accurate noninvasive method for obtaining these measurements.

Eligibility criteria:
normal volunteers and patients with any form of heart disease who agree to undergo mri and echocardiographic examination studies. adults older than the age of 18 years. no pregnancy, atrial fibrillation, unstable angina, recent myocardial infarction (less than 5 days), or other acute medical illness. no pacemaker, aneurysm clip, neural stimulator, ear implant, and metallic foreign body such as shrapnel or bullets.

Keywords: cardiac function mri reconstruction ultrasound heart disease (cardiovascular disease)
tele-rehabilitation in children with cerebral palsy in the covid-19 pandemic

Conditions: Cerebral Palsy; Telerehabilitation; Motor Learning

Summary: the investigators study aimed to observe the effect of motor learning-based tele-rehabilitation on quality of life in children with cerebral palsy during the covid-19 pandemic.

cerebral palsy; it is defined as a permanent, non-progressive disorder that occurs as a result of the effects of the developing fetal or infant brain for different reasons in prenatal, perinatal or postnatal periods. children with cerebral palsy experience fundamental limitations in the postural control of static and dynamic tasks such as sitting, standing, and walking. however, children with cerebral palsy need rehabilitation. the covid-19 pandemic prevents effective provision of rehabilitation services for children with cerebral palsy. however; lack of access to rehabilitation services in individuals with cerebral palsy during the covid-19 pandemic has increased the need for alternative and complementary methods. during the covid-19 pandemic process, the tele-rehabilitation process will be able to achieve functional and social participation in children with cerebral palsy.

Eligibility criteria:
inclusion criteria: * children with spastic cerebral palsy, ages 3-16 * to be at 1-2-3 levels according to gmfcs * the tele-rehabilitation group is not receiving treatment in any center. * voluntary participation in the study with the consent of the parents exclusion criteria: * application of muscle tone reduction 6 months before the start of the study (eg botulin toxin, baclofen pump therapy) or those undergoing orthopedic surgery.
gabapentin and chronic post surgical pain

Conditions: Pain, Postoperative; Scoliosis Idiopathic

Summary: the purpose of this study is to investigate the effect of a common pain medication (gabapentin) on chronic postsurgical pain in pediatric patients who require surgery for idiopathic scoliosis.

pain after surgery can last for a long time. when it lasts for over two months, it is considered chronic postsurgical pain (cpsp). this is a problem in kids and adolescents that can impact many areas of the patient's life and their family. many patients who undergo surgery for their scoliosis develop cpsp. the purpose of this study is to investigate the effect of a common pain medication (gabapentin) on chronic postsurgical pain in pediatric patients who require surgery for idiopathic scoliosis.

Eligibility criteria:
inclusion criteria: * be aged 10-18 years at the time of surgery * have a diagnosis of idiopathic scoliosis and/or kyphosis * be undergoing elective posterior spinal fusion * have only mild systemic disease exclusion criteria: * a diagnosis of neuromuscular scoliosis and/or kyphosis * a diagnosis of chronic pain * used opioids in the past 6 months * developmental delay * liver or kidney disease * obstructive sleep apnea * body mass index \>40 * be pregnant or breastfeeding

Keywords: gabapentin pain medication chronic postsurgical pain pediatric idiopathic scoliosis surgery
mobile health solutions for behavioral skill implementation through homework

Conditions: Oppositional Defiant; Conduct Disorder

Summary: the primary purpose of this study is to develop a mobile health (mhealth) application that will both advance theory in and clinical practice of homework (hw) implementation. the mobile health application will enhance the existing evidence informed curriculum of a multiple family group model (called 4 rs and 2 ss for strengthening families model) for families with children who have disruptive behavior disorders. this mobile application consists of two primary components that will support engagement and integration of the model's core concepts in family life. the first component focuses on delivering homework via a highly engaging, multiplayer, interactive, cooperative, and skill-building game platform aimed at improving the "design" and "do" process of homework.the second component focuses on targeting factors putatively related to poor hw implementation within the "do" process.


Eligibility criteria:
inclusion criteria: * youth between the ages of 7 to 11 years and an accompanying adult primary caregiver available to participate in the research and intervention activities * english speaking youth and adult caregiver and * the child should meet criteria for a primary diagnosis of oppositional defiant or conduct disorder. exclusion criteria: * a significant cognitive impairment or emergent psychiatric needs of the caregiver or child that interferes with understanding of program content or informed consent process or requires a higher level of care.
clinical characteristics, outcomes and risk factors for mortality in pregnant/puerperal women with covid-19 admitted to icu in turkey: a multicenter, retrospective study from a middle-income country.

Conditions: Key Words:COVID-19; Pregnancy; Intensive Care Unit; SARS-CoV-2; Mortality

Summary: we performed a national, multicenter, retrospective, cohort study. the study was announced on the turkish society of intensive care medicine website, which included the study protocol, and the directors of icus caring for covid-19 patients were invited. the study population comprised all sars-cov-2-infected pregnant or puerperal women (up to 6 weeks after birth) who were admitted to participating icus between 1 march 2020 and 1 january 2022. the exclusion criteria were patients aged \<18 years old, patients with negative covid-19 pcr test results, patients with active malignant disease, and organ transplant recipients.the following data were collected: patient demographics, gestational age or postpartum day on admission, date of icu admission, comorbidities, vaccination status, acute physiology and chronic health evaluation ii (apache-2) and sequential organ failure assessment (sofa) scores on admission, the worst sofa score during the icu stay, the ratio of lung infiltrates if diagnostic imaging was performed, the time interval from the start of symptoms to icu admission, the duration of icu stay, laboratory values on admission and the worst laboratory values during the icu stay, the development of extrapulmonary organ injury,the presence of non-covid-19 infections, the worst pao2/fio2 ratio during the icu stay, the most invasive respiratory support method applied, and therapies were also recorded. immunomodulatory therapies such as corticosteroids, il inhibitors, intravenous immunoglobulin (ivig) and cytokine hemadsorption, were also recorded. fetal and neonatal complications were collected. lasso regression and multiple logistic regression analyses were used to identify risk factors for maternal icu mortality.


Eligibility criteria:
inclusion criteria: * the study population comprised all sars-cov-2-infected pregnant or puerperal women (up to 6 weeks after birth) who were admitted to participating icus between 1 march 2020 and 1 january 2022. exclusion criteria: * patients aged \<18 years old, patients with negative covid-19 pcr test results, patients with active malignant disease, and organ transplant recipients.
assessment of metabolic complications in patients with adrenal tumors through radiological images

Conditions: Adrenal Cancer

Summary: retrospective study based on data already available at each center. pseudonymized ct images of each patient in dicom format will be sent from each center to the coordinating center to perform radiomics analysis.

retrospective study based on data already available at each center. participating centers will identify patients based on shared inclusion/exclusion criteria. pseudonymized ct images of each patient in dicom format will be sent from each center to the coordinating center to perform radiomics analysis. images will be transferred via file transfer protocol while respecting the anonymity of enrolled patients. images will be deposited in a dedicated study folder created by the aoubo ict service. images will be accessible only to the investigator and principal investigator and/or their delegates via personalized credentials, which can be accessed only from irccs aoubo computers and facilities. the folder to which the images will be transferred will be accessible only to the principal investigator and his/her collaborators through customized private credentials usable only through irccs aoubo networks, computers and facilities. radiomics, which will be applied to existing ct images, will in no way affect the care pathway of patients

Eligibility criteria:
inclusion criteria: * age ≥18 years * patients with adrenal tumor who underwent adrenectomy surgery from 1-1-2000 to 30-5-2023, performed according to clinical necessity and indications of international guidelines,with availability of histologic diagnosis or adrenal tumor that did not undergo adrenectomy surgery with diagnosis of benignity confirmed by radiologic stability at 6-12 months after first finding(as indicated in guidelines) * availability of radiological images in dicom format of abdominal ct scan in which the adrenal tumor is first described, obtained on the date of first evaluation at the participating center (necessarily before surgery for patients undergoing adrenectomy) * signature of informed consent exclusion criteria: * none
potassium binder in ckd patients (with hyperkalemia) (dipo trial)

Conditions: Chronic Kidney Diseases; Hyperkalemia

Summary: this study hypothesizes that the administration of sodium zirconium cyclosilicate in ckd patients with hyperkalemia while avoiding dietary potassium restriction will normalize their serum potassium levels. additionally, we aim to assess the effects of a high potassium diet on renal function, endothelial function, acidosis, systemic inflammatory status and gut microbiota.

a diet rich in fruits and vegetables is associated with better outcomes in ckd patients. however, the presence of hyperkalemia can prevent patients from increasing plant-based foods in their diets. while hyperkalemia can have severe health consequences in advanced ckd, the decreased consumption of plant-based foods can be associated with adverse health outcomes in this population. sodium zirconium cyclosilicate (szc) is a non-absorbed cation exchanger that selectively binds potassium in the intestine. this study plans to enroll ckd patients with an egfr ≤45ml/min and a serum potassium ≥ 5meq/l, administering szc to achieve normokalemia, and provide them with a diet rich in fruits and vegetables. endothelial function, inflammatory biomarkers and stool microbiota will be measured to assess the potential benefits of providing a diet rich in fruits and vegetables, albeit rich in potassium, in advanced ckd patients. because these patients are usually restricting the intake of plant-based proteins and foods due to the concerns of hyperkalemia, eliminating this serious and potentially-life threatening clinical condition might carry health benefits, such as improved endothelial function and decreased inflammation

Eligibility criteria:
inclusion criteria: * men and women over the age of 18 * ckd stage 3-4 with an estimated gfr less or equal to 45 ml/min but greater than 15 ml/min * serum potassium level ≥5 meq/l on two blood tests in the past 3 months but less than 6.5meq/l exclusion criteria: * on dialysis * have been on szc in the past 3 months * reside in a nursing home * pregnant patients * patients with known cognitive disability * history of bowel disease such as but not limited to short bowel syndrome, bowel obstruction, inflammatory bowel disease

Keywords: nutrition kidney disease potassium binder sodium zirconium cyclosilicate
evaluation of accelerometer-based neuromuscular monitoring reliability to exclude postoperative residual paralysis

Conditions: Postoperative Residual Paralysis

Summary: accelerometer-based neuromuscular monitoring is not the gold-standard method to evaluate residual postoperative paralysis but it represents the most simple, inexpensive and widespread tool in clinical practice. train-of-four ratio (tof-ratio) of 100% is considered the gold-standard to avoid porc (post operative residual curarization). this clinical trial is conducted to verify the reliability of accelerometer-based neuromuscular monitoring in order to exclude postoperative residual paralysis which is not highlighted by this instrument at a tof-ratio=100%. the study evaluates patients' neuromuscular recovery evaluated using pulmonary function tests after extubation at a tofratio=100%. administering placebo or sugammadex at a tof ratio=100% allows to evaluate whether the recovery of muscle function is concrete, although the monitoring device shows a complete decurarization; patients treated with sugammadex should not be capable to perform better pulmonary function tests if a tof ratio=100% is reliable.

from the beginning of the surgery to the time of extubation neuromuscular block is monitored with accelerographic monitor tof-watch sx. patients are extubated when tof-ratio is 100%. patients will perform pulmonary function tests (pfts): * the day ahead of surgery (for elegibility and training) * 60 minutes before surgery * 10 minutes after extubation * 5 minutes after sugammadex or placebo administration * 20 minutes after sugammadex or placebo administration. the following parameters will be evaluated and compared between the 2 groups: * maximal inspiratory pressure (mip) * maximal expiratory pressure (mep) * forced expiratory volume in the first second (fev1) * forced vital capacity (fvc) * ratio of maximum expiratory flow and maximum inspiratory flow rate at 50% of vital capacity (mef50/mif50) * pao2, paco2, ph * heart rate, blood pressure and respiratory rate changes of pulmonary tests performed before and after sugammadex or placebo will be compared between study groups.

Eligibility criteria:
inclusion criteria: * patients undergoing major abdominal surgery * age between 18 and 70 years * asa class 1 or 2 * patients scheduled for blended anesthesia (epidural + general anesthesia) * patients capable to perform pulmonary function tests (preoperative values of mip, mep, fev1% and fev1/fvc in normal ranges). exclusion criteria: * known or suspected respiratory, cardiovascular or neuromuscular disease * renal or hepatic failure * known or suspected allergies to drugs used in the study * risk for malignant hyperthermia * pregnancy * diagnosed depressive disorder