Kornimate/medical-research-clean huggingface dataset:
evaluation of memantine in the preservation of memory and neurocognition following csi

Conditions: Neurocognitive Dysfunction

Summary: the goal of this clinical trial is to evaluate the role of memantine in preservation of memory and neurocognition in patients undergoing craniospinal irradiation. participants will be randomised into two arms and the interventional arm will receive memantine along with the standard treatment. researchers will compare the neurocognitive tests of participants in both the arms to see if memantine leads to significant preservation of memory and cognition post radiation therapy.

craniospinal irradiation (csi) involving radiation (rt) of brain and spine, along with tumor-bed boost with or without chemotherapy, is the current standard treatment for medulloblastoma and other primitive embryonal tumors of the central nervous system (cns). the delayed side effects following csi include memory loss, hearing and balance difficulties, hormonal imbalance, and secondary cancers. decline in memory severely affects the quality of life in long term survivors of these diseases. hence, various strategies are being tried to prevent it. memantine has been proven to effectively prevent the memory decline induced by rt. it is fda-approved for alzheimer's disease and is widely used in the children for several developmental disorders. with this study, we are trying to investigate the role of memantine in patients receiving csi to prevent memory decline. after screening for the study, eligible patients will be randomly allocated (by computerised system) to one of the two arms that are described as follows. patients in the experimental arm (memantine) will be started on memantine, starting dose of the same will be 5mg once daily at bedtime for 1 week, followed by 5mg twice daily for 1 week, and finally increased to the full dose of 10 mg twice daily for 6 months. patients will continue on radiation and chemotherapy (when indicated) as per schedule. all patients in the study will undergo neurocognitive evaluation, the time points for which will be pre-radiation (baseline), 6 months post-rt, 1-year post-rt, and annually after that for 5 years from radiation. following completion of rt or treatment, standard follow-up protocols will include a clinical examination 3 monthly for the first 2 years, followed by 6 monthly visits till 5 years post-rt. no additional risk is expected from the current study other than the common side effects of the standard treatment. based on the results from the study, if primary endpoints are achieved, it will establish the role of memantine in preventing memory decline from csi, which can be used as a standard treatment measure to help patients in the future.

Eligibility criteria:
inclusion criteria: * age at irradiation: 5 to 39 years * planned for csi (with or without boost dose) with or without systemic chemotherapy * informed consent or assent taken * karnofsky performance status / lansky performance status ≥ 60 exclusion criteria: * re-irradiation * prior exposure to memantine * inability to undergo wechsler test
the impact of covid-19 on surgical practice in jordan during the second outbreak

Conditions: Covid19

Summary: background: covid-19 is an acute respiratory pandemic with no available effective antiviral treatment or widely available effective vaccine. surgical practice has faced widespread problems due to the pandemic including viral transmission risk and cross-infection, staffing problems, prioritizations of surgical procedures and lack of beds due to occupancy of hospitals and icu beds with covid-19 patients; methods: a survey was conducted between october 31 to november 4, 2020, through google forms. the questionnaire involved 16 questions sent to consultants and specialists of all general and special surgical specialties and subspecialties in jordan;

a survey was conducted between october 31 and november 4, 2020. the questionnaire was made through google forms, and a consent was taken from the jordan medical association to send the link to surgeons in jordan through the social media and the official whatsapp groups. the survey was introduced with the invitation to participate of surgeons of all general and special surgical specialties and subspecialties. the aim of the survey was mentioned in the introduction which was to evaluate the impact of covid-19 on surgical practice in jordan during the second outbreak of covid-19, and it was explained that the aim of the survey was for research purposes only and that it was totally anonymous with privacy preserved, and no identifying information required. also, it was noted that we have added spaces for written views and recommendations. the questionnaire involved 16 questions of the multiple-choice, the dropdown, the multiple check, and the short answer questions. the first 2 questions were about the specialty and the place of work whether it was the ministry of health, the royal medical services, the university hospitals, or the non-governmental organizations. the 3rd and 4th questions were about the hospital where the participant works whether it admits covid-19 patients and/or ordinary patients. the questions from the 5th to the 8th were about the volume of work in terms of the number of elective and emergency surgeries during the month of october 2020 in comparison to the average monthly rate during the year 2019. the questions from the 9th to the 15th were about the problems that might have been faced in managing elective and emergency cases during the month of october 2020 in relation to covid-19. the last question was a multiple checkbox question with an added space for giving the possible recommendations to manage the situation.

Eligibility criteria:
inclusion criteria: * consultants and specialists of all general and special surgical specialties and subspecialties in jordan exclusion criteria: * none
association between cytokines and severity of respiratory syncytial virus (rsv)-induced illness in the elderly

Conditions: Respiratory Syncytial Virus Infections

Summary: this research study involves studying the genes that may affect how ill you become during respiratory infection with respiratory syncytial virus (rsv). rsv is a virus that often causes common colds. cytokines are chemicals that are naturally made by your body. cytokine levels are increased in some people when they have common colds or wheezing caused by respiratory syncytial virus (rsv). the purpose of this study is to study the genes that may control cytokine levels during infection with rsv in the elderly population.


Eligibility criteria:
inclusion criteria: * subjects \> 65 years of age diagnosed with rsv-induced respiratory illness * diagnosis (based upon icd-9-cm codes) for pneumonia, upper respiratory illness, bronchitis, copd, asthma, viral illness, or congestive heart failure (chf) * willing to sign informed consent. exclusion criteria: * not willing to sign informed consent. * subjects less that 65 years of age * subjects not diagnosed with a respiratory illness

Keywords: respiratory rsv-induced respiratory illness
prolonged popliteal fossa nerve blockade (prolonged pop)

Conditions: Postoperative Pain

Summary: this study looks at addition of medications to the local anesthetic for the nerve blockade.

following major foot and ankle surgery patients complain of severe pain. currently, hospital for special surgery (hss) usually uses nerve blocks (injections of local anesthetic near nerves supplying the lower leg) to help manage pain after this type of surgery. patients also receive additional pain pills, including narcotics as needed. this study looks at addition of medications to the local anesthetic for the nerve blockade. the investigators hope that these medications (dexamethasone and buprenorphine) will prolong the pain relief from the nerve block. there are 3 groups in the study. one group is a control, and receives usual therapy: nerve block + pain pills. this is typically what the patient would receive as standard care if they were not in the study. one group uses a nerve block with additives (+ pain pills). one group gets a nerve block (local anesthetic only) + pain pills + intravenous buprenorphine - this is meant to see if the buprenorphine acts directly on the nerve that was blocked, or indirectly acts on the brain. patients will be followed while in the hospital, and contacted by telephone and/or email after discharge for 2-3 days. patients will be asked about their pain levels and the duration of their block. the investigators will enroll 90 patients.

Eligibility criteria:
inclusion criteria: * patients of dr. levine or dr. roberts at hospital for special surgery * patients aged 18-75 * patients scheduled for discharge from hss after foot or ankle surgery * a single-injection popliteal fossa nerve block is judged appropriate * surgery confined to foot and ankle (no iliac crest bone graft planned - iliac aspirate is not an exclusion criterion) exclusion criteria: * \ 75 * surgery that will cause pain at sites outside the distal lower extremity (e.g. iliac crest bone graft) * bilateral surgery * chronic pain (defined as regular use of opioid analgesics for \> 3 months) * chronic use of steroids (defined as regular use of steroids for \> 3 months) * contraindication to performance of the popliteal fossa nerve block with 30 cc 0.25% bupivacaine (e.g. alleged bupivacaine sensitivity, low body weight, etc.) * contraindications to dexamethasone or buprenorphine (e.g. allergy, insulin dependent diabetes mellitus, etc.) * patients who have been diagnosed with altered pain perception or have lack of sensation * inability of the patient to describe postoperative pain (e.g. psychiatric disorder, dementia) * non-english speaking patients (the questionnaire is in english, and translations would have to be separately validated)
spd503 (guanfacine hydrochloride) in adhd plus oppositional symptoms

Conditions: ADHD

Summary: to assess efficacy and safety of spd503(guanfacine hydrochloride) in subjects with adhd and oppositional symptoms.


Eligibility criteria:
inclusion criteria: * healthy subjects with adhd and oppositional symptoms * adhd-rs\>=24 * cgi \>=4 * t-score of opp subscale cprs-r:l \>=65 * normal ecg and bp * \>= 55 lbs
efficacy and safety of sofosbuvir/ledipasvir fixed-dose combination ± ribavirin in cirrhotic subjects with chronic genotype 1 hcv infection

Conditions: HCV Infection

Summary: this study is to determine the antiviral efficacy of sofosbuvir (sof)/ledipasvir (ldv) fixed-dose combination (fdc) with and without ribavirin (rbv), and to evaluate the safety and tolerability of each regimen as assessed by review of the accumulated safety data. approximately 150 participants with genotype 1 hcv infection, who have previously received treatment for hcv, and who have a diagnosis for cirrhosis will be enrolled. participants will be randomized to 1 of 2 groups. group 1: sof/ldv fdc tablet plus placebo to match rbv for 24 weeks group 2: delayed treatment group: placebo to match sof/ldv fdc plus placebo to match rbv for 12 weeks, followed by sof/ldv fdc once daily plus rbv in a divided daily dose for 12 weeks randomization will 1:1 to the two groups and will be stratified by hcv genotype (1a, 1b; mixed or other genotype 1 results will be stratified as genotype 1a), and prior hcv therapy treatment response (never achieved hcv rna \< the lower limit of quantitation (lloq), or achieved hcv rna \< lloq).


Eligibility criteria:
inclusion criteria: * age equal to or greater than 18 years, with chronic genotype 1 hcv infection * hcv rna ≥ 10,000 iu/ml at screening * prior virological failure after treatment with pegylated interferon (peg-ifn), rbv and a protease inhibitor following documented prior virology failure after treatment with a peg-ifn + rbv regimen * evidence of cirrhosis * screening laboratory values within defined thresholds * use of two effective contraception methods if female of childbearing potential or sexually active male exclusion criteria: * pregnant or nursing female or male with pregnant female partner * current or prior history of clinical hepatic decompensation * prior exposure to approved or experimental hcv specific direct-acting antivirals other than a nonstructural protein (ns)3/4a protease inhibitor * history of solid organ transplantation, including liver transplant * hepatocellular carcinoma or other malignancy (with exception of certain resolved skin cancers) * chronic use of systemic immunosuppressive agents * history of clinically significant illness or any other medical disorder that may interfere with subject treatment, assessment or compliance with the protocol

Keywords: hepatitis c hcv cirrhosis
hydrogen-oxygen gas mixture inhalation in patients with sudden sensorineural hearing loss

Conditions: Hearing Loss, Sensorineural

Summary: idiopathic sudden sensorineural hearing loss (isshl) is defined according to american academy of otolaryngology as a hearing loss of at least 30 decibel over 3 contiguous test frequencies occurring within a 72h period. it affects 5 to 20 people per 100,000 annually and is characterized by sudden-onset, generally unilateral, sensorineural hearing loss. its cause is idiopathic in most of the patients; however, vascular disorders have been proposed as the final common pathway. recent studies have reported that the impaired microvascular perfusion occurring during an ischemic event may be related to oxidative stress which may be synergistically responsible for endothelial damage, especially in terminal microvascular systems. hydrogen, which serves as a free radical scavenger and can reduce the strong oxidants, is found as a therapeutic gas in cochlea in recent studies. both antioxidant and anti-inflammatory effects have been seen with hydrogen administration in animal models. since cisplatinum toxicity and acoustic trauma both involve oxidative stress to the cochlea, hydrogen may prove useful in these conditions. the efficacy and safety of hydrogen inhalation are also proved in clinical studies. given the theories mentioned above, the purpose of our study is to use inhaled hydrogen as an adjuvant therapy for treating idiopathic sudden sensorineural hearing loss. the systemic inflammation status and oxidative stress will be monitored. both subjective and objective efficacy after treatment will be assessed.


Eligibility criteria:
inclusion criteria: 1. meet the criteria of definition of sudden sensorineural hearing loss: hearing loss of 30 db or more over at least three contiguous frequencies, over a period of 72 hours or less. 2. the event attacked within 14 days. - exclusion criteria: 1. pregnancy or other vulnerable groups 2. specific etiologies of sudden sensorineural hearing loss 3. diabetes mellitus patients -
a pilot study of individualized adaptive radiation therapy for hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma

Summary: this is a pilot single arm study with the primary endpoints of feasibility and preliminary estimates of safety and efficacy. this protocol builds on over 25 years of experience with high dose liver rt (radiation therapy), and in particular adaptive rt aimed at adjusting the global radiation dose based on a patient's measured sensitivity to treatment. this current protocol uses functional imaging and specialized radiation planning techniques to spare highly functional portions of the liver to preserve function. the investigators feel this will further improve the safety and efficacy of rt for all patients by customizing treatments to each. if this approach is promising, the investigators will proceed to a phase ii randomized study of standard versus spatially and dosimetrically adapted rt.


Eligibility criteria:
inclusion criteria: * patients must have hepatocellular carcinoma. * patients must not have extrahepatic cancer. * patients must not be eligible for a curative liver resection or have refused resection * patients must have recovered from the acute effects of prior liver-directed therapy and 4 weeks must have passed since the last procedure and protocol therapy. * patients must have a zubrod performance status of less than or equal to 2 (zubrod performance status is a measure that attempts to quantify a cancer patients' general well-being. scores run from 0 to 5 where 0 denotes normal activity and 5 denotes death). * patients must be 18 years of age or older. * patients must have adequate organ function. * patients must understand and be willing to sign an irb (institutional review board) approved informed consent form. exclusion criteria: * patients with known allergies to intravenous iodinated contrast agents. * patients with a contraindication to contrast-enhanced mri are excluded.
ketamine and epigenetic aging

Conditions: Depression; Post Traumatic Stress Disorder

Summary: this is a prospective, clinical pilot study (n=20) to evaluate the impact of a ketamine treatment for major depressive disorder (mdd) or post traumatic stress disorder (ptsd) on epigenetic aging by the truage epigenetic age laboratory test.

subjects with mdd or ptsd will have a series of six ketamine infusions over two to three weeks.

Eligibility criteria:
inclusion criteria: * be 18-64 years old of any sex, gender orientation, and ethnicity * read, understand, and provide written informed consent in english, * meet criteria for a primary psychiatric diagnosis of major depressive disorder (mdd) or post-traumatic stress disorder (ptsd) for greater than 4 weeks, * have a history of at least 1 failed medication trial targeting mdd or ptsd * have a reliable form of transportation to lodging or home following the completion of each ketamine infusion treatment day, * be generally healthy, as assessed by medical history, physical examination (including vital signs), and clinical laboratory evaluations, * be of non-childbearing potential or utilizing an acceptable form of birth control (females-only) * report a pre-treatment symptom level of ≧15 on the phq-9 or ≧ 33 on the pcl-5 * consent to participation in venipuncture, drug test, pregnancy test (for females) psychiatric evaluation, rating scale completion and ketamine infusion treatment series of six over the course of two to three weeks. exclusion criteria: * delirium or dementia diagnosis, * unstable medical illness or clinically significant laboratory results, * history of clinically significant cardiovascular disease or electrocardiogram (ekg) findings, or medical conditions that put the patient at high risk for possible cardiac side effects, or uncontrolled hypertension * history of multiple adverse drug reactions, * current or past history of psychotic disorder or psychotic symptoms, * current manic symptoms, * active substance use disorders with the exception of nicotine and caffeine, within the past six months or any past history of ketamine or pcp abuse, * requirement of excluded medications that interact with ketamine, * pregnancy, breastfeeding or unacceptable means of birth control in a female of child-bearing age, * current acute suicidal or homicidal risk, * previous exposure to ketamine
multitarget stool fit-dna study for colorectal cancer early screening in china

Conditions: Colorectal Cancer; Adenomatous Polyps; Adenoma; Advanced Adenoma

Summary: the primary objective is to determine the diagnostic sensitivity and specificity of the newly developed multitarget fit-dna colorectal cancer (crc) screening test (coloclear) for detecting advanced neoplasia (including colorectal cancer and advanced adenomas) in high risk patients, using colonoscopy as the reference method. the secondary objective is to compare the screening performance of the multitarget fit-dna test with commercially available fit (fecal immunochemical test) assay in detecting advanced neoplasia.

the study will be carried out in 8 tier-3a hospitals throughout china. patients who are at high risk of developing colorectal cancer and willing to conduct colonoscopy examination will be asked to collect stool sample prior to bowl preparation for multitarget fit-dna test and commercially available fit assay. colonoscopy and histopathologic examination are used as reference.

Eligibility criteria:
inclusion criteria: * willing to provide written consent * able to provide stool sample for high risk crc screening group: * scheduled for colonoscopy voluntarily or by physician prescription * crc high risk profile as defined below: * history of fit positivity * family history of crc * any of two of the following clinical symptoms: chronic constipation/diarrhea, stool with mucous, chronic appendicitis, chronic bilary track diseases, mental stress for crc group: * confirmed crc patients * no prior treatment with chemotherapy, radiotherapy, and prior to any surgical procedures exclusion criteria: * unwilling to provide stool samples * fap (familial adenomatous polyposis), crohn's disease, ulcerative colitis * prior history of colonoscopy within the past 5 years and removal of lesions * history of crc * other conditions deemed not suited for the study by investigators

Keywords: cancer colorectal cancer colorectal neoplasms adenomatous polyps adenoma advanced adenoma gastrointestinal diseases colonic diseases neoplasms digestive system diseases intestinal neoplasms gastrointestinal neoplasms digestive system neoplasms neoplasms by site intestinal diseases rectal diseases glandular and epithelial neoplasms by histologic type
investigating the effect of respiratory exercise diary on pain in cardiovascular surgery

Conditions: Cardiovascular Surgery

Summary: the study was carried out to evaluate the effect of respiratory exercise diary use on postoperative pain in patients undergoing elective cardiovascular surgery in a training and research hospital in istanbul.

the randomised controlled experimental study was conducted between 11 july 2024 and 11 january 2025 in the cardiovascular surgery inpatient wards of a training and research hospital in istanbul. the study was conducted with a total of 74 patients, 37 in the control group and 37 in the intervention group. data were collected by the researcher through face-to-face interviews with the patients. 'patient identification form', "visual analogue scale (vas)", "respiratory exercise diary" were used.

Eligibility criteria:
inclusion criteria: * no barriers to verbal communication (mental, physiological and psychological) * patients undergoing elective cardiovascular surgery, * individuals who agreed to participate in the study, * patients whose haemodynamics are suitable for respiratory exercise exclusion criteria: * being in the intensive care unit after surgical intervention, * patients undergoing re-operation after surgical intervention, * those who do not accept the study or who want to leave during the study.

Keywords: cardiovascular surgery exercise diary nursing care pain postoperative pain postoperative period respiratory exercise spirometer