Kornimate/medical-research-clean huggingface dataset:
functional navigation in surgery of cerebral tumors and vascular malformations

Conditions: Tumor, Brain; Arteriovenous Malformations; Cavernoma

Summary: the purpose of the study is to assess accuracy, advantages of functional neuronavigation and calculate safe distance from motor areas to brain tumors and vascular malformations in image-guided surgery.

functional images (functional magnetic resonance imaging (fmri), transcranial magnetic stimulation (tms), tractography) loaded in neuronavigation are called functional navigation. it is usually combined with anatomical data and allows to display eloquent brain areas. currently there are plenty of studies concerning possibilities of it's use. in our research we plan to confirm this data and to supplement them with calculating a safe distance from motor areas to various mass lesions in preoperative scans where neurological deficits is not likely to appear after surgery. in case of success this data can be a foundation for further researches specifying indications for use of intraoperative neuromonitoring and possibility of it's replacement with functional navigation in some cases. the purpose of the study is to assess accuracy, advantages of functional neuronavigation and calculate safe distance from motor areas to brain tumors and vascular malformations in image-guided surgery. for each patient a surgeon intraoperatively will assess locations of motor cortex and corticospinal tract found with direct cortical and subcortical stimulation and capture them. after surgery he will compare this data with functional preoperative scans and virtual motor centers constructed based on tractography. influence of various factors on precision of functional navigation will be studied and safe distance between motor brain areas and mass lesion borders will be calculated.

Eligibility criteria:
inclusion criteria: * all intracranial tumors * arteriovenous malformations * cavernous malformations * supratentorial localization * newly diagnosed * age 18-79 years * unaltered consciousness * error of patient registration in neuronavigation no more than 2 mm * possibility to perform "positive mapping" strategy exclusion criteria: * contraindications to magnetic resonance imaging or transcranial magnetic stimulation * inability to build tractography in neuronavigation * predicting of intraoperative brain shift 6 mm and more without possibility to correct it * real intraoperative brain shift 6 mm and more without possibility to correct it * previously performed brain radiotherapy * pregnancy * breast feeding

Keywords: brain tumor arteriovenous malformation cavernoma cavernous malformation functional navigation
the effect of valproate on benzodiazepine withdrawal severity

Conditions: Substance Withdrawal Syndrome

Summary: the aim of this study is to determine whether valproate is effective in the treatment of benzodiazepine withdrawal symptoms in subjects receiving maintenance treatment for opiate dependence.

in finland, 90% of subjects with opioid dependence are dependent on benzodiazepines too. concurrent use of opioids and benzodiazepines has increasingly caused deaths. benzodiazepine withdrawal treatment usually comprises gradual drug discontinuation. in one study, valproate was shown to improve benzodiazepine discontinuation success in chronic benzodiazepine users. in the present study, the effectiveness of gradual benzodiazepine discontinuation combined with valproate treatment and carried out in an inpatient setting is compared with gradual discontinuation without pharmacological augmentation.

Eligibility criteria:
inclusion criteria: * diagnosis of benzodiazepine dependence (dsm iv-r) * induction of buprenorphine or methadon maintenance treatment, or need of benzodiazepine withdrawal treatment during ongoing buprenorphine/methadon maintenance exclusion criteria: * pregnancy * history of convulsions * unstable somatic diseases
enhancing sleep quality for nursing home residents with dementia - r33 phase

Conditions: Alzheimer Disease; Dementia; Sleep Disorder; Sleep Disturbance

Summary: this study seeks to improve clinical outcomes for an important, growing, and vulnerable population-nursing home residents with alzheimer's disease or related dementias-by testing an evidence-based intervention to improve these residents' sleep. it will also examine the implementation and sustainment of this intervention.

disturbed sleep places older adults at higher risk for frailty, morbidity, and even mortality. yet nursing home (nh) routines frequently disturb residents' sleep through use of noise and light or efforts, for example, to reduce incontinence. nh residents with alzheimer's disease or related dementias-almost two-thirds of long-stay nh residents-are likely to be particularly affected by sleep disturbance. this study tackles these important issues and substantially moves forward goals of the national plan to address alzheimer's disease 2018 update by proposing to implement an evidence-based intervention to improve sleep: a nh frontline staff huddling program known as lock. the lock program is derived from evidence supporting strengths-based learning, systematic observation, relationship-based teamwork, and efficiency. this is an incomplete stepped-wedge randomized controlled trial to test the impact and sustainability of the lock sleep program. in 24 community nursing homes (nhs)-eight from each of 3 national nh corporations-our multi-disciplinary team will examine these aims: (1) implement the lock-based sleep program for residents with adrd using the train-the-trainer model. (2) estimate impact of the lock sleep program on sleep (primary outcome) and on psychotropic medication use, pain and analgesic medication use, and activities of daily living decline (secondary outcomes). (3) examine factors, using mixed methods, associated with variation in the program's implementation and its sustainability.

Eligibility criteria:
inclusion criteria: * nursing home residents aged \>=50 years with an alzheimer disease or related dementia (adrd) diagnosis, identified by nursing home staff participating in frontline lock sleep huddles as having sleep problems exclusion criteria: * residents with a high risk of osa who are not being treated for osa because actigraph measurements are inaccurate in that population. * residents who have a persistent bilateral resting tremor or paralysis in both arms (a subset of persons with parkinson's disease and related significant tremor-causing diagnoses), due to actigraph measurement inaccuracies
effect of visuomotor training using pablo system on hand function in children with hemiplegic cerebral palsy

Conditions: Cerebral Palsy

Summary: the aim of this study was to investigate the efficacy of virtual reality on hand function in saudi children with hemiplegic cerebral palsy.

the aim of this study was to evaluate the effect of virtual reality on hand function in children with hemiplegic cp. forty children with hemiplegic cp were assigned randomly into two groups (a \& b). control group (a) was received conventional rehabilitation program for the hand. study group (b) was received conventional rehabilitation program as in group (a) in addition to virtual reality by using the pablo system.patients' evaluation was carried out before and after training to assess hand function. .

Eligibility criteria:
inclusion criteria: * they had a diagnosis of spastic hemiplegia derived from medical records. * scored i-iii on the manual ability classification system. * not have musculoskeletal disorders that would make it difficult for them to use the vr. * they had normal or corrected hearing and vision. * they had no prior experience with the vr. * they comprehend and follow straightforward instructions to complete the tasks. exclusion criteria: * they have had upper limb surgery within the last six months. * they have uncontrollably occurred seizures. * they have medical conditions that can make using virtual reality dangerous. * they have attention deficit issues.
spectroscopic analysis of tongue tumor samples.

Conditions: Mass Spectroscopy; Molecular Profile; Surgical Margins; Squamous Cell Carcinoma; Oral Cavity; Tongue

Summary: in squamous cell carcinoma of the tongue, complete surgical resection of the tumor generally represents the primary treatment strategy. among factors determining the disease prognostic, the surgical margins status is essential for the continued management of the patient, with or without complementary therapies. generally, surgical margins are defined using visual and tactile elements. unfortunately, in 15 to 30 percent of cases, they are defined as positive after histopathological examination, on average 5 to 7 days post-surgery. techniques have recently been developed to analyze the cancerous and non-cancerous nature of tissues, using the spectral properties of tumor cells. spidermass™ is an instrument equipped with a probe for tissue micro-sampling and real-time molecular profile analysis. it is thus ultimately a tool for anatomopathological decision support, for diagnosis and prognosis of the disease. used in the operating room, spidermass™ could also become an innovative surgical tool to precisely define cancerous areas in situ and the margins status in intraoperative conditions. based on the principle of artificial intelligence, the spidermass™ machine must initially learn to recognize pathological tissues versus healthy. this project aims to accomplish this first phase of machine learning for squamous cell carcinoma of the tongue.


Eligibility criteria:
inclusion criteria: * age : 18 years and older * squamous cell carcinoma of the tongue * surgical resection as first-line treatment * tumor classification t1 to t4. exclusion criteria: * metastatic disease * neoadjuvant therapies

Keywords: mass spectroscopy molecular profile surgical margins squamous cell carcinoma oral cavity tongue
effect of liraglutide on body weight in non-diabetic obese subjects or overweight subjects with co-morbidities: scale™ - obesity and pre-diabetes

Conditions: Metabolism and Nutrition Disorder; Obesity

Summary: this trial is conducted in africa, asia, europe, oceania, north america and south america. the aim of this clinical trial is to evaluate the potential of liraglutide to induce and maintain weight loss over 56 weeks in obese subjects or overweight subjects with co-morbidities. furthermore, the aim is to investigate the long term potential of liraglutide to delay the onset of type 2 diabetes in subjects diagnosed with pre-diabetes at baseline. based on body mass index (bmi) and pre-diabetes status, subjects will be randomised to either 68 weeks (56 weeks of randomised treatment followed by a 12 week re-randomised treatment period) or 160 weeks of treatment (160 week treatment will only be applicable to subjects with pre-diabetes status at baseline).


Eligibility criteria:
inclusion criteria: * informed consent obtained * body mass index (bmi) of 30.0 kg/m\^2 or above * body mass index (bmi) of 27 kg/m\^2 or above in the presence of co-morbidities of treated or untreated dyslipidemia and/or hypertension * stable body weight * preceding failed dietary effort exclusion criteria: * known type 1 or type 2 diabetes * glycosylated haemoglobin (hba1c) of 6.5 % or above (screening visit 1) or fpg of 126 mg/dl (7 mmol/l) or above (screening visit 2) or 2 hour post-challenge (ogtt) plasma glucose of 200 mg/dl (11.1 mmol/l) or above (screening visit 2) * screening calcitonin of 50 ng/l or above * family or personal history of multiple endocrine neoplasia type 2 (men2) or familial medullary thyroid carcinoma (fmtc) * personal history of non-familial medullary thyroid carcinoma * history of acute or chronic pancreatitis * obesity induced by drug treatment * use of approved weight lowering pharmacotherapy * previous surgical treatment of obesity * history of major depressive disorder or suicide attempt * uncontrolled hypertension (systolic blood pressure of 160 mmhg or above and/or diastolic blood pressure of 100 mmhg or above)
anti-cd25 rhmab for agvhd prevention in high-risk adults using the dagoat model

Conditions: Acute Graft-versus-Host Disease

Summary: to assess the efficacy and safety of using recombinant humanized anti-cd25 monoclonal antibody injection as a prophylactic strategy for reducing the incidence of severe acute graft-versus-host disease (agvhd) in adult patients at intermediate to high risk, as predicted by the dynamic agvhd onset anticipation tianjin (dagoat) model, following allogeneic hematopoietic stem cell transplantation (allo-hsct).


Eligibility criteria:
inclusion criteria: 1. age ≥ 16 years, regardless of gender. 2. patients with hematologic disorders who are scheduled to receive allo-hsct. 3. voluntarily join this study, sign the informed consent form, have good compliance, and be willing to cooperate with follow-up. exclusion criteria: 1. patients who have received a second or multiple transplants. 2. patients who are allergic to, or intolerant of, a recombinant humanized anti-cd25 monoclonal antibody injection. 3. pregnant or lactating female patients or female patients who are unable to take effective contraceptive measures during the entire trial period.
hyperbaric oxygen for covid-19 patients with moderate to severe hypoxemia

Conditions: Covid19

Summary: of the many treatments proposed for covid-19, few directly address the severe hypoxia among covid-19 patients. interim results from our single-center, non-randomized clinical trial (nct04332081) suggest that hyperbaric oxygen therapy may reduce inpatient mortality or the need for mechanical ventilation among covid-19 patients by more than half. hyperbaric oxygen therapy is delivered by increasing the atmospheric pressure surrounding a patient, which results in increased oxygen delivery to a patient's blood at a rate higher than any other available modality. it is already fda-approved for several indications, including conditions with impaired gas exchange and severe infectious processes. furthermore, several studies have found that hyperbaric oxygen therapy inhibits the production of proinflammatory cytokines, which may play a role in the pathophysiology of covid-19. the goal of this proposal is to perform a multi-center, randomized controlled trial to evaluate the short-term and long-term efficacy of hyperbaric oxygen therapy for covid-19 patients. this proposal will rigorously test whether hyperbaric oxygen therapy can reduce the substantial mortality and morbidity of this challenging disease.


Eligibility criteria:
inclusion criteria: 1. age \> 18 years 2. positive covid 19 test or clear clinical diagnosis of covid-19. positive covid-19 test will be confirmed based on a pcr or antigen test result or patient reported history. clear clinical diagnosis of covid-19 will be a combination of respiratory symptoms and clinical findings based on laboratory values and radiographs. 3. moderate to severe hypoxemia defined by a baseline supplemental oxygen requirement of 6 liters or higher (including high flow oxygenation devices) as measured within the 24 hours before enrollment exclusion criteria: 1. pregnancy 2. untreated pneumothorax, which must be evaluated with a baseline chest radiograph or computerized tomography scan at least 72 hours prior to enrollment 3. presence of pneumomediastinum, pneumopericardium, significant subcutaneous emphysema, or pulmonary blebs, which should also be evaluated with a baseline chest radiograph prior to enrollment 4. current invasive mechanical ventilation 5. current non-invasive mechanical ventilation 6. any patient who will not be stable for transport to the hyperbaric chamber, in addition to any relative contraindications identified by the treating hyperbaric physician or inpatient hospital team (e.g., severely impaired cardiac output due to significant myocardial injury). 7. any patient without the capacity to provide informed consent

Keywords: hyperbaric oxygen
effect of ropinirole hydrochloride in progressive myoclonic epilepsy of unverricht-lundborg type

Conditions: Unverricht-Lundborg Syndrome

Summary: the progressive myoclonus epilepsy of the unverricht-lundborg disease (uld) type is an autosomal recessive disease characterized by progressive stimulus-sensitive and action-related myoclonic jerks. the mainstay of the current treatment in myoclonic epilepsies including uld are valproic acid and clonazepam among several other antiepileptic drugs. unfortunately the disease may often be resistant to antiepileptic drugs leading to major reductions in daily activities and disability to walk without assistance. therefore new treatment modalities are needed. experimental treatments of uld patients with dopamine agonists have relieved myoclonic symptoms. further, in accordance with this, a recent study indicates decreased dopaminergic neurotransmission in the basal ganglia of uld patients, determined by pet. the purpose of this study is to investigate the effect of dopaminergic medication (ropinirole hydrochloride, requip ®) on relieving the symptoms of uld patients. patients will undergo sixteen weeks intervention period. the main efficacy determinants are changes in unified myoclonus rating scale (umrs), nerve conduction, multi-modality evoked potentials including visual evoked potential (vep), somatosensory evoked potential (ssep) and brainstem auditory evoked potential (baep), blink reflex habituation and electroencephalography (eeg). tolerability and the safety of the medication are determined. the study setting is placebo controlled, crossover, two-group and double blind study.


Eligibility criteria:
inclusion criteria: * unverricht-lundborg syndrome exclusion criteria: * pregnancy * intolerability to ropinirole hydrochloride * mental illness
effect of addition oral montelukast to standard treatment in acute asthma in hospitalized preschool children

Conditions: Acute Asthma; Acute Wheezy Bronchitis

Summary: leukotriene receptor antagonists (ltras) are well established in the management of outpatient asthma. montelukast is a potent, specific, orally active, cysteinyl leukotriene receptor antagonist with a rapid onset of action.however, there is very little information as to their role in acute asthma exacerbations. the purpose of this study is to determine if adding oral montelukast to the maximal standard treatment in children hospitalized for acute asthma has any additive benefit.

background: montelukast is a potent, specific, orally active, cysteinyl leukotriene receptor antagonist with a rapid onset of action. objective: to evaluate the effect of the addition of a single dose of oral montelukast to standard therapy in acute asthma. design: double-blind, randomised, controlled, parallel group trial. setting: pediatric service of education and training hospital patients: children with the ages of 6-60 months who were hospitalized for acute asthma intervention: children received montelukast 4 mg or placebo orally in addition to the standard therapy. clinical asthma score was recorded before administering study medication and thereafter, 4 hourly until discharge. main outcome measure: the primary outcome was discharge rates.

Eligibility criteria:
inclusion criteria: * medical history of at least 4 wheezing attacks * children with the ages of 6-60 months * children whose parents accept to give written informed consent exclusion criteria: * chronic diseases (e.g. malnutrition, anatomic malformation of the respiratory tract, chronic lung or heart disease, gastroesophageal reflux disease and cystic fibrosis) * children with a history of chronic drug use (e.g. antiepileptics and immune suppressives)

Keywords: acute asthma montelukast hospitalized children preschool children
clinical echography in emergency prognostic evaluation of pulmonary embolism: ecu -ep study.

Conditions: Embolism, Pulmonary

Summary: pulmonary embolism (pe) is a frequent disease, the third cause of cardiovascular death after stroke and myocardial infarction. according to european guidelines of european society of cardiology (esc) and of european respiratory society (ers), the prognostic stratification of pe severity is mandatory as soon as pe is diagnosed. this stratification includes the hemodynamic status, and specific tools : the assessment of the spesi score, and the evaluation of pe's impact on right ventricle (rv) : increased biomarkers (troponin, bnp) and right ventricle/left ventricle (rv/lv) ratio. the rv/lv ration may be evaluated ideally by transthoracic echo (tte), or by ct scan. unfortunately, only 10% of patients with pe are evaluated with tte by a cardiologist in the initial time of pe diagnosis. hence, the ct scan is the most frequent way to assess rv/lv ratio. however, ct is not possible for all patients (patients with contra-indication) or may have difficulties to provide a clear assessment because of technical issues. then, there is a need for morphological evaluation of rv as soon as pe is diagnosed, in every clinical setting. the improvement in technologies allowed the development of clinical echography (ce) in emergency departments. ce is already available, non-invasive, less expansive, and may be a good way to assess rv/lv ratio in patients with pe diagnosed in emergency departments. the investigators propose a prospective, multicenter study to assess the sensitivity of ce in patients with pe, compared to ct scan to detect rv/lv ≥0.9.


Eligibility criteria:
inclusion criteria: * adult patients with pulmonary embolism confirmed * simplified pulmonary embolism severity index (spesi) ≥ 1 exclusion criteria: * contra-indication to ct scanner * patients with high-risk pulmonary embolism (shock, hypotension) * simplified pulmonary embolism severity index (spesi) =0

Keywords: embolism, pulmonary echocardiography emergency prognosis