Kornimate/medical-research-clean huggingface dataset:
robotic rehabilitation of the upper limb after a stroke

Conditions: Stroke

Summary: hemiparesis is the most common motor disorder after a stroke. most patients do not recover functional use of their paretic upper limb. the use of robotic assistance provides intensive motor training through a large number of repetitive movements, usually oriented and interactive tasks (pointing tasks, tracking paths tasks...). these feature have been demonstrated to be critical to stimulate brain plasticity after a brain damage. the inmotion arm 2.0 manipulator works with an adaptive algorithm that provide patients with real-time assistance-as-needed™ desgned to enhance motor performance. hypothesis: in the sub-acute phase of stroke, the structured practice of a large number of repeated movements will increase motor function of the upper limb compared to conventional rehabilitation. secondly, this practice will be more effective in a free active mode (without assistance) than an active assisted mode (assistance-as-needed™). expected secondary benefits: subjective impression of improved use of the upper limb in activities of daily living and reduction of spastic cocontractions affecting the agonist and antagonist muscles during movements of the upper limb. objectives: this randomized controlled trial will evaluate the effects of structured repetition programs of arm movements, on the function of the hemiparetic upper limb and motor control, between 4 and 10 weeks after the stroke, using a robotic device with or without assistance in partial substitution of conventional rehabilitation care, compared to a program with conventional care alone.


Eligibility criteria:
inclusion criteria: * age ≥18 years; * stroke hemiparesis on unilateral focal lesion dating from 4 to 10 weeks at baseline; * active flexion of the paretic shoulder ≥15 °; * average score on the modified scale of frenchay \<5; * patient having agreed to sign an informed consent. exclusion criteria: * passive extension of the paretic elbow \<120 °; * passive extension of the paretic wrist \<10 °; * cognitive dysfunction or progressive intercurrent illness making effective communication or participation in the study impossible; * infection, inflammation or complex regional pain syndrome of the paretic upper extremity; * injection of botulinum toxin to the upper limb less than 3 months old; * patient under safeguard of justice; * patient include in an other clinical trial.

Keywords: stroke robot, rehabilitation hemiparesis upper limb function motor control
fatigue one year after icu discharge

Conditions: Fatigue

Summary: the investigators contacted consecutive adult patients admitted to intensive care unit (icu) and mechanically ventilated for at least 72 hours to invite them to an interview at hospital. the investigators administered mini mental status examination, functional assessment of chronic illness therapy scale for fatigue (facit- f) and short form 36 questionnaires to the consenting patients.

fatigue is one of the most commonly symptoms reported by patients. there are many causes of pathological fatigue including mental and physical, both neurological (central and peripheral) and non-neurological diseases. among the last ones, cancer, infections and drugs are factors associated with fatigue, although the mechanism of how non-neurological diseases cause fatigue is not clear. evidence exists to suggest that patients who have been critically ill continue to face a multitude of physical, psychological and social difficulties in the long term after discharge. as far as fatigue is concerned, greater than 50% of intensive care unit survivors overall reported lowered energy levels and fatigue in the first year after discharge.

Eligibility criteria:
inclusion criteria: * aged \> 18 years * able to co-operate at the time of icu discharge * requiring mechanical ventilation for at least 72 hours * residents less than 30 km from the hospital exclusion criteria: * preexisting cognitive deficits * pre-existing psychotic illness * admitted for anoxic brain injury * residents more than 30 km from the hospital

Keywords: fatigue quality of life critically ill patients
effect of the genotype on postoperative dvt

Conditions: Venous Thromboembolism

Summary: postoperative venous thromboembolism events (vte) constitute a major source of morbidity and mortality after surgery. the aim of this study was to investigate whether commonly occurring single nucleotide polymorphisms (snps) are associated with vte in the surgical setting.

data extracted from the participants in the uk biobank collaborative study. two cohorts will be examined: 1. surgical cohort, consisting of all patients with a registered surgical procedure in the uk biobank repository 2. validation cohort, consisting of all non-surgical patients in the uk biobank repository. a gwas approach will be used to associated commonly occurring single nucleotide polymorphisms (snps) with a postoperative venous thromboembolic event (vte) within 30 days of a surgical procedure in the surgical cohort. findings from the surgical gwas step will be replicated in the validation cohort in order to assess whether the same snps drive both surgical and non-surgical vte risk. a final gwas model will be fielded, correction for confounders including sex, age, smoking, obesity and open/minimal invasive surgery (surgical discovery gwas only).

Eligibility criteria:
inclusion criteria: - all patients included in the uk biobank repository exclusion criteria: - none
relationship of essential hypertension and its treatments on the postoperative pain management: a prospective, observational, cross-sectional study

Conditions: Hypertension

Summary: numbers of postoperative pca related side effects among three groups will be determined by comparing and analyzing frequency distributions. to determine whether the patients with hypertension require less post operative opiate analgesics than others, multivariate analysis with repeated measures will be performed to identify the major and the minor factors predicting the use of postoperative pain therapy. the major aim of the study is to test the hypothesis that the morphine comsumpted by the hypertension group is less than those of the normotension group. the minor aims for the study are the difference related to pain intensity, or the incidence of side effects among groups.


Eligibility criteria:
inclusion criteria: * 300 eligible subjects * no contraindication for inhalation anesthesia * elective surgery * age between 20-75 y/o * no contraindication for postoperative morphine pain control * female or male * essential hypertension stage i and ii (140\<=sbp\<=180; 90\<=dbp\<=110) exclusion criteria: * liver disease * renal disease * those who is presumed to go to icu after surgery * the patients with dementia or conscious disturbance * pregnancy or breast feeding * secondary hypertension * events in recent 6 months myocardial infarction cardiac bypass surgery unstable angina cerebrovascular events congestive heart failure significant arrhythmia thoracic surgery
laparoscopic gastric plication compared with laparoscopic sleeve gastrectomy

Conditions: Morbid Obesity

Summary: the study must be performed in 100 patients suffering from morbid obesity, the procedure will be performed under general anesthesia doing two or three layers of suture to achieves gastric imbrication until transform the stomach to a sleeve. the patients will be followed during the time for 6 month, 1 year, two years and 5 years.

the patients will be selected with bmi more than 40, the operation will be primary between 18 to 60 years old. the patients will be informed about the procedure and different options. the patients will be in admission board for two or three days and any event will be recorded. the follow up will be recorded by the nurse, the surgeon and the dietitian, laboratory parameter includes cbc, t4,t3, tsh, ferrum, transferrin, ferritin, vit. b12, sma, lipids, the end point will be the ebw achieved and events occurred.

Eligibility criteria:
inclusion criteria: * bmi 40 or more * age between 18-60 years old * asa score 1-2 exclusion criteria: * bmi less than 40 * severe illness * psychiatric disorders

Keywords: laparoscopy obesity gastric restrictive
insulin glargine in type 2 diabetes mellitus

Conditions: Diabetes Mellitus, Type 2

Summary: primary objective: to evaluate in explorative manner the fasting blood glucose (fbg) coefficient of variability (cv)calculated on smbg values (smbg : self-monitoring of blood glucose). secondary objectives: the secondary objectives are the assessment of: changes in glycaemic control (hba1c), frequency of hypoglycaemias, changes in weight, final insulin dose, changes in lipid parameters, changes in urinary albumin-to-creatinine ratio, profile of patient which best fits each of the algorithms with the dependent variable of change in hba1c and independent variables of age, gender, race, tobacco use, diabetes complications, initial hba1c, initial weight, duration of diabetes mellitus, general education and diabetes education.


Eligibility criteria:
inclusion criteria: * diagnosis of type 2 diabetes mellitus for at least 5 years; * treatment with oral antidiabetic drugs in fixed combination (combo, i.e. glibenclamide 2.5 mg + metformin 400 mg, 2 or 3 tablets, at stable dose in the last 3 months); * hba1c \>= 8% and \<= 11%; * body mass index (bmi) \> 27 and \< 35 kg/m2; * willingness and demonstrated ability to inject insulin; * demonstrated ability and willingness to perform self-monitoring of blood glucose (smbg); exclusion criteria: * patients diagnosed with type 1 insulin dependent diabetes; * patients with latent autoimmune diabetes of adults (lada), defined as fasting c-peptide levels \< 1 ng/ml; * cardiac status nyha iii-iv; * impaired renal function as shown by (but not limited to) serum creatinine \>= 1.5 mg/dl for males or \>= 1.4 mg/dl for females; * planned pregnancy, pregnant or lactating females; * failure to use adequate contraception (women of current reproductive potential only); * any current malignancy, previous breast cancer, or malignant melanoma within the past 5 years; * diagnosis of dementia * hypersensitivity to insulin or any of their components or to metformin; * current or previous insulin therapy other than during hospitalisations; * inability or unwillingness to continue metformin at study dosages throughout the study; * treatment with intermittent doses of systemic steroids or large doses of inhaled steroids for the past one year (fixed doses for the past 6 months is acceptable providing there is no plan to change the dosage regime); * stroke, myocardial infarction (mi), coronary artery bypass graft (cabg), percutaneous transluminal coronary angioplasty (ptca), or angina pectoris within the last 12 months; * history of drug or alcohol abuse; * receipt of an experimental drug or use of an experimental device within the 30 days prior to study entry;
paraorbital-occipital alternating current stimulation therapy for optic neuropathy (mct_optnerve)

Conditions: Optic Nerve Diseases; Optic Nerve Injuries; Optic Neuropathies

Summary: aim is to validate that non-invasive brain stimulation can increase cortical excitability in the visual system. the investigators assess if transcranial alternating current stimulation (tacs) can improve visual field size in patients with optic nerve damage. hypothesis: tacs would improve visual functions within the defective visual field (primary outcome measure).

in addition, the correlation between the brain-derived neurotrophic factor (bdnf) or other plasticity markers are correlated to the improvement of the visual field after stimulation.

Eligibility criteria:
inclusion criteria: * patients with optic nerve lesion * stable visual field defect with residual vision * lesion age at least 6 months * age at least 18 years * no completely blindness, residual vision still existent exclusion criteria: * electric or electronic implants, e.g. heart pacemaker * any metal artefacts in head and truncus * epilepsy * auto-immune diseases in acute stage * mental diseases, e.g. schizophrenia etc. * unstable diabetes, diabetes causing diabetic retinopathy * addiction * high blood pressure (max. 160/100 mmhg) * instable or high level of intraocular pressure (i.e. \> 27 mmhg) * retinitis pigmentosa * pathological nystagmus * presence of an un-operated tumor anywhere in the body * pregnant or breast-feeding women * photo sensibility * fundus hypertonicus * acute conjunctivitis

Keywords: optic neuropathy visual field electric stimulation alternating current perimetry
comparing "salvage" radiotherapy and individualized psma pet/ct targeted treatment in with relapsing prostate cancer

Conditions: Prostate Cancer

Summary: less than 50% of patients receiving salvage radiation therapy (srt) to the pelvis as treatment for prostate cancer relapsing after surgery will achieve undetectable prostate specific antigen (psa) levels. despite srt, two-thirds of patients will again develop elevated psa, 20% will have distant metastases, and 10% will die from prostate cancer within 10 years. the reason for this is probably preexisting distant metastasis and lymph node metastasises which need to better targeted directly. additionally , there are well known permanent side effects to srt. standard imaging techniques have poor sensitivity detecting recurrence when psa is below 1.0 ng/ml. the surface protein prostate-specific membrane antigen (psma) is overexpressed on prostate cancer cells and 68gallium (68ga)- and 18fluorine (18f)-targeted radioligands have been developed. psma pet/ct is used increasingly but there is limited data of its impact. in this study patients with biochemical relapse of prostate cancer after surgery are randomised to the control or experimental group (1:2) and undergo a psma pet/ct scan. the experimental group receives individualised therapy based on the result of the pet/ct. the control group receives standard salvage therapy and the result of the pet/ct is blinded. the patients are followed-up with psa test and quality of life questionnaires.


Eligibility criteria:
inclusion criteria: * patients previously treated for prostate cancer with radical prostatectomy and now having a biochemical recurrence (bcr) defined as: psa \>0.2 \<2.0 ng/ml, and increasing measured twice. * multidisciplinary conference (mdk) decision to offer the patient srt * signed informed consent exclusion criteria: * patients previously treated for prostate cancer with biochemical recurrence * previous treatment with androgen deprivation therapy (adt) after surgery * previous pelvic radiotherapy * patients with positive lymph nodes at surgery

Keywords: psma pet/ct
closing the loop in adolescents during non-compliance behaviours

Conditions: Type 1 Diabetes

Summary: the ultimate goal of the investigators ongoing research is the development of a closed-loop system for insulin delivery, which can help people with type 1 diabetes (t1d) attain a tight glucose control avoiding the risk of hypoglycaemia. the main components of the system are a continuous glucose monitor (cgm), an insulin pump and a computer-based 'model-predictive algorithm', which computes the amount of insulin to be given by the insulin pump according to the cgm values. in the studies performed thus far the efficacy and safety of closed-loop glucose control was evaluated both overnight and over a prolonged period of time including the day-time in children and adolescents with t1d. the results showed that closed-loop improved control of blood glucose and prevented nocturnal hypoglycaemia, as compared to the conventional insulin pump therapy. the objective of the current study is to test the performance of closed-loop further, by evaluating the system during common non-compliant behaviours in the administration of meal insulin doses in adolescents with t1d. this will pave the way for a more comprehensive use of closed loop systems to control glucose levels in t1d under various "real-life mimicking" common circumstances. the present study adopts an open-label, randomised, 2 period cross-over design whereby closed-loop insulin therapy will be compared with the conventional insulin pump therapy in 12 adolescents with t1d. participants aged 12 to 18 years will be randomised for two 24 hour studies in a clinical research facility, during which glucose levels will be controlled by either the computer-based closed-loop algorithm (intervention arm) or by conventional insulin pump therapy (control arm). on both occasions, participants will under-estimate and omit the meal-related insulin dose for the evening-meal and lunch, respectively. the study will take place at the wellcome trust clinical research facility (wtcrf), cambridge with participants recruited from paediatric diabetes clinics in england.


Eligibility criteria:
inclusion criteria: * aged 12-18 years * type 1 diabetes diagnosed for \> 1 year * insulin pump treatment for at least 3 months * hba1c between 8 and 12% * subject willing to perform reduction/omission of meal insulin boluses during clinical studies exclusion criteria: * non-type 1 diabetes mellitus * physical or psychological disease likely to interfere with the normal conduct of the study * current treatment with drugs known to interfere with glucose metabolism * known or suspected allergy against insulin * subjects with clinical significant nephropathy, neuropathy or proliferative retinopathy * total daily insulin dose \>= 2 iu/kg/day * pregnancy, planned pregnancy, or breast feeding

Keywords: closed-loop insulin delivery non-compliant behaviours during adolescence
efficacy of 1072nm infrared stimulation on executive functioning in dementia

Conditions: Dementia

Summary: this study will employ a double-blind, placebo-controlled approach to assess the effect of 1072nm infrared (ir) phototherapy on the behavioral and cognitive symptoms associated with early and mid-stage dementia.

what hypotheses are you testing? we are seeking to determine if the provision of brief, repeated exposure to 1072nm infrared stimulation of the cortex surface improves cognitive and behavioral functioning as indicated by normalization of eeg activity, increased cerebral oxygenation and demonstrated improvement on standardized neuropsychological measures. intensive near infrared stimulation has been shown to be effective in accelerating healing of injuries and functional modification including increasing blood flow and perfusion. dementia research has suggested that hypoperfusion is a significant underlying mechanism in the progression of dementia. infrared spectroscopy has been shown effective in the non-invasive measurement of changes in cerebral oxygenation and perfusion. this study therefore seeks to explore whether the increasing of regional cerebral perfusion and oxygenation using infrared light stimulation will result in improved cognitive and behavioral functioning.

Eligibility criteria:
inclusion criteria: * aged between 50 - 85 years. * have established cognitive impairment, mini mental status examination (mmse) score between 15- 25 (from a possible score of 30). * generally healthy otherwise as indicated by recent physical examination. * have a caregiver/informant who has cared for the patient at least 5 days a week and is willing to attend study visits and provide information about the patient. * if taking any psychotropic medication should have been stable for the previous 3 months. * must have had b12, folic acid, full blood count and ferritin screen within the previous 6 months or be on b12 and/or folic acid replacement. exclusion criteria: * uncontrolled or unstable chronic illness, e.g., hypertension, chronic obstructive pulmonary disease (copd). * diagnosed actively growing intracranial pathology (tumors etc). * an associated psychotic illness. * misusing illegal substances or alcohol. * on regular systemic steroids or anti-metabolites. * systemic malignancies and/or space occupying lesions in the brain. * not fluent in english. * depressed as assessed by beck depression inventory score. * epilepsy. * lacking the capacity to give informed consent. * previous history of stroke or heart attack. * history of aggression or violence. * inability to travel to the research venue for multiple assessments. * a history of major psychiatric illness, seizure disorder, or physical illness that would compromise their participation in a daily treatment regimen. * a participant may be disqualified if their performance is above the normative mean or below the lowest interpretable score of neuropsychological tests provided during the initial assessment (see #6, sources of research material obtained from study participants, below).

Keywords: dementia alzheimers frontotemporal lyme, lewy body cognitive impairment
masitinib in patients with gastrointestinal stromal tumour after progression with imatinib

Conditions: Gastrointestinal Stromal Tumors

Summary: the objective is to compare the efficacy and safety of masitinib at 12 mg/kg/day to sunitinib at 50 mg/day in the treatment of patients with gastro-intestinal stromal tumor (gist) after progression with imatinib.

masitinib is a selective tyrosine kinase inhibitor with potent activity against wild-type c-kit, the juxta membrane domain of c-kit, and pdgfr. masitinib is also thought to promote survival via modulation of immunostimulation-mediated anticancer effects and modulation of the tumor microenvironment. the objective is to compare the efficacy and safety of masitinib at 12 mg/kg/day with respect to sunitinib at 50 mg/day in the treatment of imatinib-resistant gastro-intestinal stromal tumor (gist).

Eligibility criteria:
main inclusion criteria include: * patient with histological proven metastatic gist or non-operable locally advanced gist * patient with c-kit (cd117) positive tumor detected immuno-histochemically * patient after at least one progression with imatinib at a dose up to 800mg. progression is defined as a recist 1.1 and/or choi disease progression while receiving imatinib treatment. main exclusion criteria include: * patient treated for a cancer other than gist within 5 years before enrolment, with the exception of basal cell carcinoma or cervical cancer in situ * patient with active central nervous system (cns) metastasis or with history of cns metastasis * pregnant, or nursing female patient

Keywords: gastrointestinal stromal tumour gist non-resectable metastatic second line treatment resistance to imatinib tyrosine kinase inhibitor