Kornimate/medical-research-clean huggingface dataset:
can short latency afferent inhibition give us clues to better dyt 1 dystonia treatments?

Conditions: DYT-1; DYT1; DYT 1; Dystonia

Summary: this is a research study using transcranial magnetic stimulation (tms) to investigate interactions between the sensory system and the motor cortex in primary generalized dystonia (dyt1 dystonia) subjects who undergo deep brain stimulation (dbs) surgery. the sensory system is the body's sense organs - smell, sight, sound, etc. - and the motor cortex is the part of your brain where nerve impulses control voluntary muscle activity.

the cause of dyt1 dystonia is not clear. dyt1 dystonia symptoms include abnormal posture or repetitive twisting movements affecting one body part; in some patients, the entire body can twist and contort painfully. magnetic resonance imaging (mri) studies are normally used to evaluate changes in brain structure in dyt1 dystonia. transcranial magnetic stimulation (tms) is a painless, non-invasive method to test how your brain conducts electrical messages to the rest of your body, including your muscles. if you are a dyt1 dystonia patient, then this study involves up to three visits. the first visit (before dbs surgery) will last about 4 hours and the second and third visits (after dbs surgery) will last about 4 hours as well. these visits will include a complete physical and neurological exam, video recorded dystonia and mood rating scales, followed by electromyography (emg) and tms sessions. subjects who have already undergone dbs surgery may participate in applicable visits based on the length of time since their dbs surgery. if you are a control subject, this study involves one visit, about 4 hours long. this visit will include tms and emg sessions.

Eligibility criteria:
inclusion criteria: * between the ages of 10 and 80 years. (control subjects between 18-80 years) * diagnosis and genetic test results confirming diagnosis of dyt1 dystonia. * currently treated with medications and enrolled in evaluation process for dbs surgery to confirm candidacy - or - * previous dbs surgery exclusion criteria: * implanted pacemaker, medication pump, vagal stimulator, transcutaneous electrical nerve stimulation (tens) unit or ventriculoperitoneal shunt. * family or personal history of medication refractory epilepsy. * pregnancy: due to the frequent visits over a prolonged period and the lack of information on the safety of tms during pregnancy, pregnant women will not be eligible to participate in this study. women of childbearing potential will be eligible to participate, provided that they are using adequate contraception during tms treatments. this study is accepting healthy volunteers, aged 18-80, as control subjects. control subjects will not undergo dbs surgery. exclusion criteria (as it applies to healthy control subjects): * cannot have family history or personal history of medication refractory epilepsy

Keywords: dyt-1 dyt1 dyt 1 dystonia dbs deep brain stimulation tms transcranial magnetic stimulation
the consistency of drug screening in vitro and neoadjuvant chemotherapy results in breast cancer patients

Conditions: Breast Cancer; Drug Effect

Summary: neoadjuvant chemotherapy for breast cancer could make unresectable breast cancer be resectable and improve breast conservation rate. patients with triple negative or her2 enriched subtype who achieved pcr after neoadjuvant chemotherapy would have better survival. but the overall pcr rate of breast cancer was about 20%. and patients with luminal like subtype were less reactive for neoadjuvant chemotherapy. improving pcr rate maybe could achieve better survival. so, different methods have tried to select effective drug before chemotherapy.drug sensitivity screening in vitro for different chemotherapy drugs was a promising method. this study will explore whether drug screening by culturing breast cancer cells in vitro from breast cancer tissue could consistent with neoadjuvant chemotherapy in patients.40 breast cancer patients were recruited.the results of drug sensitivity in vitro and pathological evaluation after neoadjuvant chemotherapy were compared whether they were consistent.

neoadjuvant chemotherapy for breast cancer could make unresectable breast cancer be resectable and improve breast conservation rate. patients with triple negative or her2 enriched subtype who achieved pcr after neoadjuvant chemotherapy would have better survival. but the overall pcr rate of breast cancer was about 20%. and patients with luminal like subtype were less reactive for neoadjuvant chemotherapy. improving pcr rate maybe could achieve better survival. so, different methods have tried to select effective drug before chemotherapy.drug sensitivity screening in vitro for different chemotherapy drugs was a promising method. this study will explore whether drug screening by culturing breast cancer cells in vitro from breast cancer tissue could consistent with neoadjuvant chemotherapy in patients.40 breast cancer patients who would receive neoadjuvant chemotherapy were recruited.breast cancer tissues were obtained before chemotherapy. the breast cancer cells were cultured in unadhesive dishes. chemotherapy drugs were put in dishes and drug sensitivity were evaluated. patients received operation and pathological evaluationc after neoadjuvant chemotherapy. the results of drug sensitivity in vitro and pathological evaluation after neoadjuvant chemotherapy were compared whether they were consistent.

Eligibility criteria:
inclusion criteria: * invasive breast cancer candidates for neoadjuvant chemotherapy agreed to participate in this observative experiments could receive operation normal liver and renal function exclusion criteria: * inflammatory breast cancer recurrent breast cancer
microbiomes in patients of recurrent common bile duct stones

Conditions: Cholelithiasis; Choledocholithiasis

Summary: bile duct stones is a common biliary tract disease, which is characterized by high morbidity and frequent recurrence. endoscopic retrograde cholangiopancreatography (ercp) is an effective therapy for common bile duct stones, and endoscopic sphincterotomy (est) which associated with recurrent cholangiolithiasis often carried out on difficult intubation or extracting stones, probably due to enhanced reflux of intestinal contents that changes the microenvironment. patients with cholangiolithiasis were consecutively recruited and their bile was collected intra-operatively for high-throughput experiments. pyrosequencing of 16s ribosomal rna gene was performed to characterize the microbiota in the bile and other body fluids. a liquid chromatography mass spectrometry-based method was used to profile bile composition. clinical manifestation, microbiome, and bile composition were compared between patients with or without recurrent of bile duct stones. the aim of our study was to identify the impact of microbiomes on the recurrent of bile duct stones after ercp+est therapy.


Eligibility criteria:
inclusion criteria: 1. patients with recurrent common bile duct stones. 2. no antibiotics or probiotics are used for nearly three months. 3. in addition to common bile duct stones, possibly without other digestive diseases. exclusion criteria: 1. significant neurological or psychiatric disorders (psychotic disorders, dementia or seizures) that would prohibit the understanding and giving of informed consent. 2. pregnant or lactating females. 3. active hepatitis b or c or history of an hiv infection. 4. active uncontrolled infection. 5. billroth ii or roux-en y gastrointestinal alteration people.
promoting preconception care and diabetes self-management among reproductive-aged women with diabetes

Conditions: Diabetes Mellitus, Type 2; Electronic Health Record; Primary Health Care; Reproductive Behavior

Summary: this study is being done to investigate strategies that may improve patient's knowledge of type 2 diabetes during reproductive age and improve knowledge and engagement in self-care activities.

our promoting reproductive planning, and readiness in diabetes (prepared) strategy will utilize health information and consumer technologies to 'hardwire' preconception care and promote diabetes self-management among reproductive-aged, adult women with t2dm in primary care. specifically, prepared will leverage electronic health record (ehr) technology at clinic visits to: \[1\] promote medication reconciliation and safety, \[2\] prompt patient-provider preconception counseling and reproductive planning, and \[3\] deliver low literacy print tools to reinforce counseling and promote goal-setting for diabetes self-care activities. post-visit, a widely-available text messaging platforms will be used to: \[4\] encourage healthy lifestyle behaviors through goal-setting and daily reminders. our randomized trial will assess the effectiveness and fidelity of a technology-based strategy to promote preconception care and diabetes self-management among women with type 2 diabetes in primary care. aim 1: test the effectiveness of prepared, compared to usual care, to improve patient: a) knowledge of reproductive risks associated with t2dm and recommended self-care activities b) engagement in self-care behaviors, including: i) diet, ii) physical activity, iii) adherence to diabetes medications; and use of iv) folic acid, and v) most or moderately effective contraception, when indicated; and c) clinical measures, including hemoglobin a1c, blood pressure, and ldl cholesterol. aim 2: assess whether prepared reduces disparities in the above outcomes versus usual care. aim 3: evaluate the fidelity of prepared to prompt medication reconciliation and preconception counseling, and to deliver patient education and post-visit support of diabetes self-care behaviors.

Eligibility criteria:
inclusion criteria: * female * age 18-44 * english or spanish-speaking * have a chart diagnosis of type 2 diabetes * not currently pregnant * not infecund, sterilized, or in a monogamous relationship with a sterilized partner * have a private cell phone with text messaging capability. exclusion criteria: * severe, uncorrectable vision, hearing, or cognitive impairments that would preclude study consent or participation
comparison of prophylaxis and on-demand treatment in children with moderate to severe hemophilia a

Conditions: Prophylaxis; Hemophilia A

Summary: comparison of prophylaxis and on-demand treatment in children with moderate to severe hemophilia a. this study determines to compare the efficacy of prophylaxis and on-demand treatment in moderate to severe hemophilia a children in king chulalongkorn memorial hospital, bangkok, thailand


Eligibility criteria:
inclusion criteria: * age between 6 months to 18 years * diagnosis severe and moderate hemophilia a exclusion criteria: * platelet \< 100,000/mm3 * no factor viii inhibitor

Keywords: prophylaxis treatment on demand treatment severe hemophilia a moderate hemophilia a
respirophasic carotid artery peak velocity variation as a predictor of fluid responsiveness in patients with coronary disease

Conditions: Coronary Artery Occlusive Disease

Summary: the aim of this study is to investigate usefulness of the respirophasic variation in carotid artery peak flow velocity measured by doppler ultrasound, which is noninvasive and easily accessible, as a predictor of fluid responsiveness in patients with coronary artery disease.


Eligibility criteria:
inclusion criteria: 1. patients scheduled for elective isolated off-pump coronary artery bypass graft surgery exclusion criteria: 1. cardiac rhythm other than sinus 2. congestive heart failure 3. left ventricular ejection fraction \<35% 4. history of transient ischemic attack 5. pre-existing cerebrovascular disease and peripheral arterial occlusive disease 6. presence of carotid artery stenosis \>50%

Keywords: fluid responsiveness carotid artery peak velocity variation coronary disease
first-line r-cvp vs r-chop induction immunochemotherapy for indolent lymphoma and r maintenance.

Conditions: Follicular Lymphoma; Marginal Zone Lymphoma; Small Lymphocytic Lymphoma; Lymphoplasmacytic Lymphoma

Summary: evaluation of event free survival (efs) of patients treated with the study chemotherapy induction program: r-chop compared to the standard r-cvp regimen and response rates, time to best response, pfs, os, neutropenic fever rate, infection rate, change in ig levels, change in lymphocyte subpopulations counts in previously untreated indolent lymphoma patients in need of systemic treatment.

min. 3, max. 8 induction cycles. maintenance with rituximab q. 2 months x 12/24 months, started 2 months after last chemotherapy.

Eligibility criteria:
inclusion criteria: * histologically confirmed: * follicular lymphoma grade 1, 2, 3a * marginal zone lymphoma, including malt type * small lymphocytic lymphoma (bm inv. \< 30%) * lymphoplasmacytic lymphoma * clinical stage ii-iv (ann arbor). stage i is allowed if bulky (ø \> 7 cm) or if radiotherapy is not appropriate in judgment of treating physician * measurable lesion(s) in at least one site * patients previously untreated * patients presenting with symptoms requiring treatment: * progressive disease * symptoms related to tumor bulk * cytopenias related to bone marrow and/or spleen involvement b symptoms * age ≥ 18 years * performance status \</=2 * written informed consent exclusion criteria: * grade 3b fl * transformed lymphoma * cns involvement * patient taking steroids for \> 2 weeks during last 4 weeks at a dose equivalent to ≥ 20 mg prednisone * other malignancy * major surgery within 4 weeks * hb \< 8 g/dl, anc \< 1.5 x 109/l, plt \<100 109/l unless due to lymphoma * impairment of renal function (creatinine \> 1.5 x unv) or liver function (total bilirubin 1.5 x unv, sgot \> 2.5 x unv not due to lymphoma * known infection, with hbv, hcv (acute \< 6 mos. or chronic hepatitis) or hiv * serious underlying medical conditions * life expectancy \< 6 months * known allergy to murine protein

Keywords: lymphoma immunochemotherapy induction therapy maintenance therapy follicular lymphoma grade 1,2,3a marginal zone lymphoma, including malt type small lymphocytic lymphoma (bm inv. <30%)
erythropoietin in the prevention of acute mountain sickness

Conditions: Acute Mountain Sickness

Summary: acute mountain sickness (ams) is a syndrome of nonspecific symptoms and is therefore subjective. the lake louise consensus group defined acute mountain sickness as the presence of headache in an unacclimatized person who has recently arrived at an altitude above 2,500 m plus the presence of one or more of the following: gastrointestinal symptoms (anorexia, nausea, or vomiting), insomnia, dizziness, and lassitude or fatigue. an increase in rbc mass is a natural feature of altitude acclimatization. hypoxia-induced erythropoietin (epo) secretion begins hours after ascent and stimulates bone marrow production of red blood cells, but this takes weeks to effect an increase in red cell mass . therefore, it is feasible that epo therapy weeks before altitude exposure decrease high altitude illness. in 1996, young et al in u.s. army research institute of environmental medicine (usariem) reported that autologous erythrocyte infusion did not ameliorate the decrement in maximal oxygen uptake at 4,300m altitude despite increasing arterial oxygen carrying capacity. on the basis of this report, usariem did not recommend use of recombinant epo for altitude acclimatization. however, increases in erythrocyte count, hematocrit and hemoglobin associated with epo therapy have been shown to decrease fatigue and increase work capacity and exercise tolerance. in addition, improvement in cns function and cognitive ability has been noted with epo therapy. subjective benefits include improvement in sleep habits, tolerance to cold; decreased dyspnea, anginal symptoms and tachycardia and improved appetite, all of which are symptoms associated with high altitude illness. the investigators also reported improved muscle energy metabolism with epo in dialysis patients, but not with rbc transfusion. in this study, the investigators will conduct a randomised controlled trial to assess the effect of epo administration on ams at an altitude of 4,130 m.


Eligibility criteria:
inclusion criteria: * healthy adults exclusion criteria: * history of serious illness * current smoker or hemoglobin \>15.5gm/dl * uncontrolled hypertension

Keywords: hemoglobin erythropoietin acute mountain sickness
ultrasound guidance versus electrical stimulation for continuous popliteal-sciatic nerve blocks

Conditions: Postoperative Pain; Foot Numbness

Summary: research study to determine if pain relief following foot and/or ankle surgery is influenced by the technique used to place perineural catheter. the catheters are placed using ultrasound-guidance or nerve stimulation and the method is selected at random using a computer program. this may help to determine if one of these methods is associated with an increased success rate and incidence of foot numbness during the infusion.

specific aim 1: to determine the relationship between perineural catheter placement technique (ultrasound-guidance and electrical stimulation) and quality of postoperative analgesia during continuous popliteal-sciatic nerve blocks following moderate-to-severely painful orthopedic surgery. hypothesis 1: when inserting a perineural catheter for a continuous peripheral nerve block, the use of electrical stimulation, as compared with ultrasound-guidance, is associated with decreased pain the morning following moderate-to-severely painful orthopedic surgery as measured with a numeric rating scale. specific aim 2: to determine the relationship between perineural catheter placement technique (ultrasound-guidance and electrical stimulation) and degree of sensory deficit during continuous popliteal-sciatic nerve blocks following moderate-to-severely painful orthopedic surgery. hypothesis 2: when inserting a perineural catheter for a continuous peripheral nerve block, the use of electrical stimulation, as compared with ultrasound-guidance, is associated with increased sensory deficit the day following moderate-to-severely painful orthopedic surgery as measured with a simple 0-10 scale (0=no numbness; 10=completely insensate) of the part of the foot with the greatest sensory deficit at the time of the data-collection phone call.

Eligibility criteria:
inclusion criteria: * undergoing surgery with a planned popliteal-sciatic perineural catheter for postoperative analgesia * expected postoperative pain to be at least moderate in severity the day following surgery (often not adequately treatable with oral analgesics alone) * age 18 years or older exclusion criteria: * pregnancy * inability to communicate wiht the investigators and hospital staff * incarceration * current chronic opioid use (daily opioid equivalent of \>10mg oxycodone for more than the previous four weeks) * history of alcohol or opioid abuse * neuropathy in the surgical extremity * any physical, mental or medical conditions which may confound quantifying postoperative pain resulting from surgery

Keywords: catheter ultrasound-guidance nerve stimulation electrical stimulation nerve block ucsd orthopedic surgery foot/ankle pain foot/ankle numbness popliteal-sciatic catheters
testing a new app for children with glue ear

Conditions: Hearing Loss, Conductive

Summary: to assess whether children with glue ear ( and some normal hearing controls) and their families find the hear glue ear application acceptable and easy to use. whether the hearing screening section on the app is comparable to the hearing test data obtained from formal audiology hearing tests.

the hear glue ear application aims to provide up-to-date information for families as well as audiobooks, songs and games for children with hearing loss secondary to glue ear, to be able to aid with their developmental skills (particularly speech, language, auditory processing, auditory memory and listening skills) during the period of time when they have glue ear. outcome measures include acceptability of the application by the family (provided by questionnaires to the child and an adult parent/ carer), usability of the app (a member of the research team will observe the child using the app and how much difficulty they have such as how many times the researcher has to help/ intervene) and comparison of the hearing screen on the app with formal audiology hearing test result.

Eligibility criteria:
inclusion criteria: * aged 2-8 years old * had a formal hearing test at cambridge audiology clinic and has a diagnosis of gluem ear worse than 25db at more than 1 frequency or nornmal hearing diagnosed where 20db or better is recorded at 0.5, 1, 2, 4 khz exclusion criteria: * permanent hearing loss * english not a dominant language (since the app is written in english)

Keywords: glue ear
defibrotide in sickle cell disease-related acute chest syndrome

Conditions: Sickle Cell Disease; Acute Chest Syndrome

Summary: this study evaluates the safety of defibrotide in subjects with sickle cell disease (scd)-associated acute chest syndrome (acs).


Eligibility criteria:
inclusion criteria: * scd-associated acs with the presence of any two or more of the following signs not explained by other etiologies: fever, chest pain, cough, dyspnea, tachypnea for age, pulmonary infiltrate on cxr and/or chest ct scan, decreased o2 saturation with or without oxygen supplement; * age 2 to 40 years of age; * homozygous hemoglobin s disease, hemoglobin sc disease or hemoglobin s 0/+ thalassemia; * informed consent/assent; * consent of patient/parent within ≤72 hours after inpatient admission for scd-associated acs. * females of childbearing age will have a negative pregnancy test. exclusion criteria: * current grade iii or iv hemorrhage; * previous hypersensitivity reaction to defibrotide; * current systemic anti-coagulant therapy and/or fibrinolytic therapy; * consent of patient/parent greater than 72 hours of inpatient admission for scd-associated acs; * no signed informed consent
early enteral feeding after pylorus preserving pancreatoduodenectomy

Conditions: Pancreas Cancer; Bile Duct Cancer; Ampulla of Vater Cancer

Summary: pancreaticoduodenectomy is associated with a high incidence of postoperative complications. these postoperative complications could delay postoperative resumption of adequate oral intake. clinical study on postoperative feeding after pancreaticoduodenectomy is very limited. method of nutritional support (enteral feeding or total parenteral support)after pancreaticoduodenectomy is controversial. 1. to evaluate whether early enteral nutrition may be a suitable alternative to total parenteral nutrition 2. to evaluate whether enteral feeding improve nutritional status after pancreaticoduodenectomy

pancreaticoduodenectomy is associated with a high incidence of postoperative complications. these postoperative complications could delay postoperative resumption of adequate oral intake. the use of tpn significantly increases postoperative complications, especially those associate with infections. however, method of nutritional support (enteral feeding or total parenteral support)after pancreaticoduodenectomy is controversial. 1. to evaluate whether early enteral nutrition may be decreased the postoperative complications 2. to evaluate whether enteral feeding improve nutritional status after pancreaticoduodenectomy 3. to determine the optimal method for postoperative nutritional support

Eligibility criteria:
inclusion criteria: * periampullar carcinoma * pancreaticoduonectomy * karnofsky performance scale \> 70 * no history of major operation exclusion criteria: * creatinine level\>3mg/l * ascitis/portal hypertension * new york heart association class\>3 * copd * preoperative radiotheraly/chemotherapy * unresectable primary cancer * palliative surgery

Keywords: periampullar carcinoma pancreaticoduodenectomy enteral feeding total parenteral support