Kornimate/medical-research-clean huggingface dataset:
effect of thermal stimulation on cortical excitability and motor function in chronic stroke patients

Conditions: Stroke

Summary: functional magnetic resonance imaging (fmri) has confirmed that thermal stimulation (ts) may facilitate cortical excitability in healthy adults. however, it is unknown whether ts can increase cortical excitability in stroke patients. compared to the fmri, the transcranial magnetic stimulation (tms) possesses more concise conditions in temporal resolution, and it can present the cerebrum activation situation more instantaneously. this study aimed to use tms examining the effect on corticomotor excitability, reorganization and functional motor recovery after ts on affected upper limbs of chronic stroke patients.

the study was an assessor-blinded randomized controlled clinical trial. the participants (more than 3 months posts-stroke)were randomly assigned to experiment (exp) and control (cot) groups. all participants received regular conventional rehabilitation programs. the exp and cot received additional upper extremity ts protocol for 30 minutes a day for 20 days. the ts temperature of exp for noxious stimulation was set at 46-47°c for heat and 7-8°c for cold stimulation; the temperature of cot for innoxious stimulation was set at 40°c for warm and 20°c for cold stimulation. the motor and sensory performance were evaluated at baseline and post-20th- ts by brunnstrom's recovery stage, modified ashworth scale (mas), barthel index (bi), upper extremity subscale of the fugl-meyer motor function assessment (ue-fm) and thermal quantitative sensory testing (tqst). at pre-1st-ts, post-1st-ts, post-10th-ts and post-20th-ts, focal tms was used to obtain measurement of motor threshold (mt), motor evoked potentials (meps), size of cortical motor output map and location of the amplitude-weighted centre of gravity of the motor output map (cog) from abductor pollicis brevis (apb) in bilateral upper extremities.

Eligibility criteria:
inclusion criteria: 1. first-ever stroke survivors with unilateral hemispheric lesions from a ischemic stroke. 2. stroke onset more than 3 months 3. no severe cognitive impairments and able to follow instructions 4. the ability to sit on a chair for more than 30 minutes independently 5. no family history of epilepsy exclusion criteria: 1. musculoskeletal or cardiac disorders that could potentially interfere with experimental tests; 2. diabetic history or sensory impairment attributable to peripheral vascular disease or neuropathy; 3. speech disorder or global aphasia; 4. participating in any experimental rehabilitation or drug studies; 5. skin injuries, burns, or fresh scars at the sites of stimulation; 6. contraindication of heat or ice application

Keywords: stroke thermal stimulation upper extremity motor recovery transcranial magnetic stimulation
aging biomakers and contrast induced nephropathy (actin) trial

Conditions: Contrast Induced Nephropathy

Summary: biomarkers such as kidney injury molecule-1 (kim-1) and neutrophil gelatinase-associated lipocalin (ngal) have been used for the early diagnosis of aki, although with no definitive results. the investigators explored the association between plasma aging biomakers such as sklotho and contrast induced nephropathy in patients undergoing percutaneous coronary intervention (pci) with contrast injection.

acute kidney injury represents an important clinical problem in hospitalized patients, with persistently high rates of mortality and morbidity. with an ever-increasing number of patients receiving intravascular injection of iodinated contrast media worldwide, contrast induced nephropathy (cin) has become the third leading cause of hospital-acquired aki. approximately half of these cases are in patients undergoing cardiac catheterization procedures. the prevention and early intervention of cin has been hampered mainly by the lack of a consensus definition and the paucity of early predictive biomarkers to accurately identify high-risk patients. cin is most frequently defined as an increase in serum creatinine (scr) by 25-50% above the baseline, generally occurring within the first 24 h after contrast exposure, in the absence of other causes. however, scr is an unreliable indicator during acute changes in kidney function, and alterations in scr levels are not particularly sensitive or specific for small changes in the glomerular filtration rate (gfr)e, gender, race and intravascular volume. biomarkers such as kidney injury molecule-1 (kim-1) and neutrophil gelatinase-associated lipocalin (ngal) have been used for the early diagnosis of aki, although with no definitive results.

Eligibility criteria:
inclusion criteria: * patients aged 18 years or older undergoing planed pci were prospectively recruited exclusion criteria: * pregnancy * lactation * sepsis * the intravascular administration of a contrast medium within the past 7 days, nephroprotective drug treatment (e.g., n-acetylcysteine, theophylline, sodium bicarbonate, prostaglandin e1) * nephrotoxic drug intake (e.g., non-steroidal anti-inflammatory drugs, metformin, aminoglycosides, cisplatin) within the past 7 days * a history of serious allergic to contrast media * renal transplantation * end-stage renal disease necessitating dialysis * severe concomitant disease of other systems.
a study on safety and tolerability of sar425899 in overweight to obese subjects and type 2 diabetes mellitus patients not requiring anti-diabetic pharmacotherapy with an optional 6-month safety extension period

Conditions: Type 2 Diabetes Mellitus

Summary: primary objectives: * main study: to assess in overweight to obese subjects and type 2 diabetes mellitus (t2dm) patients not requiring anti-diabetic pharmacotherapy the safety and tolerability of 3 different dose escalation regimens of sar425899 in terms of the relative and absolute frequency and severity of gastrointestinal (gi) adverse events (aes). * six-month safety extension period: to assess the safety and tolerability of sar425899 after 6 months treatment at the maximum dose that was individually well tolerated during the main part of the study in terms of the relative and absolute frequency and severity of gi aes. secondary objectives: main study and 6-month study extension period: to assess in overweight to obese subjects and t2dm patients not requiring anti-diabetic pharmacotherapy: * the effect of once-daily dosing of sar425899 on body weight (bw), fasting plasma glucose (fpg), and hemoglobin a1c (hba1c). * safety and tolerability.

main study: the maximum study duration is approximately 12 weeks per patient (up-to 3-week screening period, 8-week treatment period, 3-day post treatment follow-up period). six-month study extension period: the maximum study duration is approximately 9 months (up-to 3-week screening period, 8-month treatment period, 3-day post treatment follow-up period).

Eligibility criteria:
inclusion criteria: * male or female overweight to obese subjects and type 2 diabetes mellitus (t2dm) patients not requiring anti-diabetic pharmacotherapy. * patients who are motivated to lose weight. exclusion criteria: * type 1 diabetes mellitus. * body mass index \<27 kg/m2. * screening hemoglobin a1c (hba1c; glycosylated hemoglobin) \>7.0%. * previous treatment with glucose-lowering agent(s) (eg, insulin, thiazolidinediones, metformin, dpp-iv inhibitors (dipeptidylpeptidase 4), sglt-2 (sodium dependent glucose transporter-2) inhibitors, etc) within the last 6 months. * previous treatment with glucagon-like peptide 1 (glp-1) receptor agonists within the last 6 months. * uncontrolled hypertension. * laboratory findings at the time of screening: amylase and/or lipase \>2 times the upper limit of the normal laboratory range (uln), alanine aminotransferase \>1.5 uln, total bilirubin \>1.5 uln, serum creatinine levels ≥1.5 mg/dl \[males\]. ≥1.4 mg/dl \[females\], screening calcitonin ≥20 pmol/m, fasting serum triglycerides \>400 mg/dl. * personal or immediate family history of medullary thyroid cancer (mtc) or genetic conditions that predispose to mtc. * history of weight loss surgery. * history of pancreatitis or pancreatectomy. * pregnant or lactating women. * women of childbearing potential (wocbp) not protected by highly-effective method(s) of birth control and/or who are unwilling or unable to be tested for pregnancy. the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
covid-19 antibody responses in cystic fibrosis

Conditions: COVID-19; Cystic Fibrosis

Summary: coronavirus disease 2019 (covid-19) which is caused by the virus sars-cov-2 has resulted in an ongoing global pandemic. it is unclear whether the relatively low number of reported cases of covid-19 in people with cf (pwcf) is due to enhanced infection prevention practices or whether pwcf have protective genetic/immune factors. this study aims to prospectively assess the proportion of pwcf, including both adults and children with cf who have evidence of sars-cov-2 antibodies over a two-year period. this study will also examine whether pwcf who have antibodies for sars-cov-2 have a different clinical presentation and what impact this has on their cf disease. the proposed study will recruit pwcf from paediatric and adult cf centres in europe. serological testing to detect antibodies will be performed on blood samples taken at month 0, 6, 12, 18 and 24 with additional time-points if bloodwork is available via normal clinical care. clinical data on, lung function, cf-related medical history, pulmonary exacerbations, antibiotic use, and microbiology and vaccination receipt, will be collected during routine clinical assessments. associations will be examined between socio-demographic and clinical variables and serologic testing. the effects of sars-cov-2 infection on clinical outcomes and analyse end-points will be examined to explore any age-related or gender-based differences, as well as subgroup analysis of outcomes in lung-transplant recipients and pwcf receiving cftr modulator therapies. as pwcf receive covid-19 vaccination a comparison of the development and progression of anti-sars-cov-2 antibodies in pwcf following natural infection and vaccination sars-cov-2 over time will be performed


Eligibility criteria:
inclusion criteria: * person with cystic fibrosis of any age, genotype, transplant status and disease severity. * express consent obtained after informing the patient and/or his legal representatives or parents in france, written and informed consent will be requested. * for france, affiliation to a social security scheme or similar exclusion criteria: * refusal to give informed consent * contraindication to venepuncture * for france * person under guardianship / curatorship * person under legal protection
evaluation of the impact of within-hospital trajectories of patients admitted in intensive care units (icu) from emergency departments

Conditions: Intensive Care Units; Emergency Department

Summary: this multicenter cohort aims to assess the impact of within-hospital trajectories of patients admitted in intensive care units from emergency departments on vital prognosis of patients, duration of hospital stay and hospital costs. as secondary objectives, the study will: * assess the impact of clinical and demographic characteristics on hospital trajectories of patients. * assess the impact of emergency units workload, beds availability in medical units and in intensive care units, and global hospital organisation on patients care trajectories.

the study will be performed in emergency departments and icus of university hospitals. 15 emergency departments and 36 icus of aphp (the public hospital system of the city of paris) will be involved. the study will assemble the data from 50,000 to 80,000 patients in total. eligible patients are admitted in icus between 01/01/2007 and 12/31/2011. extraction of the patients' data will be performed with processing software utilised in aphp, i.e. healthcare information system program (pmsi, urqual, gilda...etc.). collected patients' data span the period from admission in emergency department or medical department unitl hospital discharge.

Eligibility criteria:
inclusion criteria: * adult patient directly admitted in icu from emergency departments of aphp (the public hospital system of the city of paris). * adult patient indirectly transferred to icu from an hospitalization unit, initially admitted from an emergency department of aphp. exclusion criteria: * patient transferred from aphp toward an external hospital, outside aphp, before being admitted in an icu.

Keywords: intensive care units emergency department
green dialysis: dialysis with reduced dialysate flow

Conditions: Uremic Syndrome

Summary: hemodialysis patients consume per year 18.720-26.208l of dialysis fluid (i.e. water). from an ecological point of view, the present study investigated whether reducing this water amount has an impact on the extraction and total solute removal of different uremic toxins. the efficiency of hemodiafiltration with a standard high-flux dialyzer is compared to hemodialysis with a medium cut-off dialyzer with a dialysate flow of either 700ml/min or 300ml/min.

hemodialysis is currently performed with dialysate flows in the range 500 and 700ml/min respectively in hemodialysis and hemodiafiltration mode. with a standard daytime dialysis scheme of three times four hours a week, each patient consumes up to 360-504l dialysate per week or 18.720-26.208l per year. from an ecological point of view, one can wonder whether patients can be dialyzed adequately enough using hemodialysis mode with a lower dialysate flow, and as such consuming less water. changing the mode from hemodiafiltration to hemodialysis mainly has an impact on the removal of larger toxins which benefit of the convective transport. lowering dialysate flow in hemodialysis mode mainly has an impact on the removal of small water soluble toxins which are mainly removed by diffusion. for this transport, different parameters are important: blood and dialysate flow, dimensions of the membrane (surface area and thickness), fiber diameter, and extra-luminal space, and membrane porosity (sieving coefficient). this also implies that, for the same blood and dialysate flow, the choice of the dialyzer will determine toxin transport. the use of a medium cut-off membrane with smaller and more open fibers might thus be more adequate in hemodialysis mode than a standard high-flux dialyzer with wider fibers. the aim of this study is to quantify instant extraction and overall total solute removal of representative uremic toxins in hemodiafiltration with a standard high-flux hemodialyzer versus hemodialysis with a medium cut-off membrane, either with a standard or reduced dialysate flow.

Eligibility criteria:
inclusion criteria: * stable chronic hemodialysis patient * well functioning vascular access exclusion criteria: * active infection * malignancies

Keywords: dialysis efficiency lowered dialysis fluid
5-day defibrotide treatment for hepatic sos/vod

Conditions: Sinusoidal Obstruction Syndrome; Veno-occlusive Disease; Bone Marrow Transplant Complications

Summary: sinusoidal obstruction syndrome (sos), also referred to as hepatic veno-occlusive disease (vod), is rare but serious complication of allogeneic stem cell transplantation (allo-sct). defibrotide is the only fda approved therapy to treat sos and has significantly improved outcomes. when applied early, sos symptoms often quickly improve and an abbreviated course can be applied. this study is looking at an abbreviated 5 day course of defibrotide in those patients with a complete response to therapy with the primary outcome being day 100 overall survival as compared to history data.

sinusoidal obstructive syndrome (sos) has a reported mean incidence of 13.7% and even among those undergoing reduced intensity conditioning regimens is approximately 9%. sos is a clinical syndrome characterized by painful hepatomegaly, jaundice, ascites, fluid retention, and weight gain. the onset is usually before day 35 after stem cell infusion. sos ranges in severity from a mild reversible disease to a severe syndrome associated with multiorgan failure (mof) and death. prior to the introduction of defibrotide, severe sos was nearly universally fatal with a mortality rate approaching 100% by day 100 after allo-sct. the diagnosis of sos/vod is clinical and should be considered in any patient who has undergone hematopoietic stem cell transplantation and develops liver dysfunction. patients with mild or moderate disease have reasonably good outcomes with supportive therapy alone while in contrast prognosis is much worse in severe sos which occurs in about 25-30% cases. defibrotide is the only established food and drug administration (fda) approved therapy to treat sos. it is now approved for use in adults and children with sos with renal or pulmonary dysfunction following hct. the standard treatment is 25 mg/kg/day in 4 divided doses of 6.25 mg/kg for 21 days. however, responses are frequently brisk and complete in many patients thus it has been postulated that in responding patients this treatment course could be abbreviated given the risk for adverse events such as hypotension/shock and hemorrhage. this is an open label pilot study evaluating an abbreviated 5 (as compared to 21) day course of defibrotide in patients with confirmed sos. the primary outcome is day 100 survival as compared to historical data.

Eligibility criteria:
inclusion criteria: 1. patients who underwent allogeneic stem cell transplantation 2. age \>/= 18 years 3. diagnosed hepatic sos/vod either by baltimore criteria or modified seattle criteria including up to 60 days post-transplantation. exclusion criteria: 1. significant uncontrolled bleeding 2. prior or concurrent systemic t-pa 3. concomitant use of therapeutic heparin or other anticoagulants (except use of heparin for central access patency) 4. hemodynamic instability (\>1 pressor gent to maintain blood pressure)

Keywords: defibrotide sinusoidal veno-occlusive bone marrow transplant allogeneic stem cell transplant
open label arimidex in gynecomastia

Conditions: Gynecomastia

Summary: the purpose of this study is to evaluate the safety, effectiveness, pharmacokinetics and pharmacodynamics of anastrozole (arimidex™) in the treatment of boys with gynecomastia.


Eligibility criteria:
inclusion criteria: * signed informed consent/assent (as per local requirements), males aged 11-18 yrs. (after his 10th and prior to 19th birthday), gynecomastia, one breast measuring ≥ 2 cm in diameter (by ultrasound or caliper measurement) that has not decreased during the prior 3 month period by medical history and has been present for 12 months or less (date of onset based on best estimate of treating physician after discussion with patient and or patient's parent/guardian), normal renal liver and thyroid function, no evidence of hormone producing tumor, no evidence of hypogonadism or androgen resistance. exclusion criteria: * patients who have been given medications known to cause gynecomastia within the previous 6 months, involvement in the planning and conduct of the study (includes az staff and investigative site staff), previous enrollment in the present study, investigators opinion patient would be unable to comply with study protocol.
evaluation the post operative pain of endodontic treated molar tooth with race and reciprocal systems among bandarabbas patients in 2017

Conditions: Endodontically Treated Teeth

Summary: extrusion of infected dentin into the periapical tissue has been suggested as a major source of pain after endodontic treatment. although debris extrusion is an inevitable finding even when instrumentation is limited to the confines of the canal, different armamentarium seem to be associated with different amounts of debris extrusion. studies on the effect of various rotary files on post-endodontic pain are very few and have yielded conflicting results with some favoring full-sequence and others leaning towards reciprocal rotary systems. this study aims at assessing the intensity of post-endodontic pain following two different rotary systems, reciproc and race. methods: in this single-blind, parallel-grouped randomized clinical trial a total of 150 otherwise healthy patients aged between 20 to 50 years old with a pulpal status of irreversible pulpitis for one tooth in the upper or lower molar region were analyzed. a clinician performed the endodontic treatment in two groups, a group instrumented using race and a third group with instrumentation performed using reciproc rotary systems.


Eligibility criteria:
inclusion criteria: * inclusion criteria: the otherwise healthy patients were aged between 20 to 50 years old with a pulpal status of irreversible pulpitis for one tooth in the upper or lower molar region. exclusion criteria: * exclusion criteria: previous endodontic treatment; a history of drug intake including corticosteroids; opioids and nsaids in the previous 12 hours; pregnancy; complicated anatomy (curves greater than 25 degrees); calcifications; internal \& external resorption; open apices; periodontal disease; swelling \& abscess; presence of periapical lesions; sensitivity to percussion and lack of occlusal contact.
exposure therapy for veterans with ptsd and panic attacks

Conditions: PTSD; Panic Attacks

Summary: to evaluate the feasibility, acceptability and effectiveness of multiple channel exposure therapy-veterans (mcet-v) as a treatment for returning service members with comorbid ptsd and panic disorder (pd). this study will examine the effectiveness of mcet-v by comparing it to cognitive processing therapy, a standard ptsd treatment.

with the increasing number of operations iraqi freedom and enduring freedom (oif/oef) veterans returning from war-zone areas, many will experience anxiety disorders such as ptsd and comorbid problems. currently, about one in every six oif/oef veterans experiences ptsd and co-occurring pd. although effective treatments exist for treating one or the other, we do not yet have treatments that can simultaneously target ptsd and pd. thus, recent attention has focused on the development of multi-component treatments that simultaneously address ptsd and pd. this study is the first systematic investigation of a time-limited, multi-component cognitive-behavioral treatment for veterans with specific comorbid anxiety problems. the purpose of the study is to evaluate the effectiveness of the multi-component cognitive-behavioral treatment in comparison to standard ptsd treatment in military personnel returning from active duty.

Eligibility criteria:
inclusion criteria: * being a veteran of any era; * being enrolled in the trp at the medvamc, with a current diagnosis of ptsd and pd; * being stable on psychotropic medication for 4 weeks before study participation; and * being at least 18 years of age. exclusion criteria: * active substance dependence, or bipolar or psychotic disorders; * severe depression and \[active suicidal ideation and intent\] (based on adis-iv \& bdi-ii); * cognitive impairment as indicated by the slums; and * veterans currently receiving psychosocial treatment specifically targeting ptsd or panic symptoms.
a study to determine the safety and efficacy of atralin (tretinoin 0.05%) gel for the treatment of rosacea

Conditions: Rosacea

Summary: to compare the efficacy and safety of tretinoin gel 0.05% to its vehicle when dosed once or twice daily in female subjects with rosacea.


Eligibility criteria:
inclusion criteria: * female * age 18-65 * diagnosed with classical, centrofacial, erythemato-telangiectatic rosacea exclusion criteria: * male, females less than 18 years * females over 65 years * no diagnosed rosacea

Keywords: tretinoin, efficacy, safety, rosacea