Kornimate/medical-research-clean huggingface dataset:
a trial of rivaroxaban versus warfarin in dissolving left atrial appendage thrombus in patients with atrial fibrillation

Conditions: Atrial Fibrillation; Left Atrial Appendage Thrombosis; Rivaroxaban

Summary: the purpose of this clinical randomized trial is to evaluate the efficacy and safety of rivaroxaban compared with warfarin in dissolving the laa thrombus in patients with atrial fibrillation.

left atrial appendage (laa) thrombosis is a common complication of atrial fibrillation and will significantly increase the incidence of stroke in patients. warfarin is a classical oral anticoagulant which can dissolve thrombus, but its clinical use has many limitations and it requires strict monitoring of coagulation. recently, some studies have shown that noac (dabigatran / rivaroxaban) can dissolve left atrial appendage thrombosis. the application of rivaroxaban in the x-tra study dissolved 41.5% of laa thrombus after 6 weeks, indicating its potential clinical application prospects. whether rivaroxaban is not inferior to warfarin for rapid dissolution of laa thrombus, there is no prospective randomized controlled trial.

Eligibility criteria:
inclusion criteria: 1. get informed consent from the patient or family. 2. non-valvular atrial fibrillation / atrial flutter. 3. the first transesophageal echocardiogram revealed a left atrial appendage thrombus (within 7 days of detection of thrombus). 4. age at 18-80 years old. 5. crcl≥ 30 ml/min (cockcroft-gault). 6. ast/alt is less than 2 times the upper limit of normal. 7. women of childbearing age need contraception. exclusion criteria: 1. pregnant or lactating woman. 2. can't understand or follow the research plan. 3. patients under 18 or over 80 years old. 4. low weight (\< 40 kg). 5. previously found laa thrombus and have taken anticoagulant drugs. 6. patients with contraindications for anticoagulation. 7. patients who need to use antiplatelet drugs simultaneously within 6-12 months after acs or pci. 8. a history of cerebral hemorrhage. 9. patients with active bleeding. 10. severe gastritis, gastroesophageal reflux patients. 11. combination of p-glycoprotein inhibitors and other drugs in the presence of noac contraindications. 13.patient with tumor. 14.planned surgery within 3 months. 15.other investigators believe that patients are not suitable for enrollment.

Keywords: atrial fibrillation left atrial appendage thrombosis rivaroxaban
altered structural-functional connectivity coupling on chronic subcortical stroke

Conditions: Stroke; Motor Activity

Summary: the current study aims to reveal the sc-fc coupling pattern and its relationship with motor function in post-stroke survivors with motor dysfunction by multimodal mri.

stroke is the leading cause of death and disability in china. recently, many previous studies suggested exploring the functional reorganization of the motor function among post-stroke survivors is urgent to be solved in both clinical work and applied basic research. investigating the structural connectivity (sc) of the brain could visualize the anatomical connections between different brain regions and exploring the functional connectivity (fc) could reveal the functional activity patterns of the human brain in resting- and task- states. previous studies suggested that sc-fc coupling analysis may shed light on exploring biological markers for the assessment and treatment of motor deficits in post-stroke survivors. the current study aims to reveal the sc-fc coupling pattern and its relationship with motor function in post-stroke survivors with motor dysfunction by multimodal mri.

Eligibility criteria:
inclusion criteria: 1. comply with the diagnostic criteria of "stroke" in the 2010 "guidelines for the prevention and treatment of cerebrovascular diseases in china," and confirmed by head ct or mri. 2. first onset unilateral subcortical stroke (basal ganglia, thalamus, internal capsule, corona radiata, lateral ventricles, etc.). 3. age ranged from 30 to 75 years old. 4. right-handedness before stroke. 5. greater than three months since stroke onset and brunnstrom graded as iii-vi; 6. the condition and vital signs are stable. 7. sign the informed consent form. exclusion criteria: 1. any contraindications for the mri examination. 2. history of other brain diseases and drug dependency. 3. unstable conditions or accompanied by malignant and rapidly progressing diseases, such as severe atrial fibrillation. 4. serious communication barriers, cognitive impairment, or cooperation with difficulties.

Keywords: stroke motor dysfunction mri structural connectivity functional connectivity
coronavirus associated pneumomediastinum and pneumothorax

Conditions: Pneumothorax; Pneumomediastinum; COVID-19 Pneumonia

Summary: spontaneous pneumomediastinum (pms) is defined as free air within the mediastinum. spontaneous pneumothorax (pnx) consists of the presence of air inside the pleural space. pms and pnx may sometimes occur secondly to an underlying pathology, or deriving from a sudden increase in intra-alveolar pressure such as functional alteration such as airway hyperactivity, valsalva maneuver, cough, barotrauma, and/or volutrauma with consequent rupture of the alveoli and subsequent leakage of air into the mediastinum due to the macklin effect. the escaping air can then spread inside the pericardium, the peritoneum, the muscles, and subcutaneous tissues, hence causing subcutaneous emphysema. pms and pnx are rare complications of several lung infections such as pneumocystis jirovecii pneumonia, tuberculosis, bacterial necrotizing pneumonia, and herpes pneumonia. however, an increasing number of pms and pnx has been described in patients with sars-cov2 interstitial pneumonia. pms and pnx can either present as the onset manifestation of covid-19 disease, or occur as complications of non-invasive and/or invasive ventilation, or following to cystic and/or fibrotic evolution of the pathology. the frequency of pms and pnx during covid-19 is not well defined, as the available data are limited to case collections and single reports. according to currently available scientific literature, pnx in covid-19 occurs with frequency rates of 1-3%, up to 6% in patients undergoing non-invasive ventilation (niv) and mechanical artificial ventilation (vam). in mcguinness's analysis, which compared the complications of barotrauma in patients with acute respiratory distress syndrome (ards) in vam, pnx and pms occurred with frequency rates of 9% and 10%, respectively, while in non-covid-19 population, pnx and pms frequency rates were 12% and 3%, respectively.


Eligibility criteria:
inclusion criteria: * patients 18 years of age or older hospitalized with sars-cov2 infection exclusion criteria: * failure to obtain clinical or radiological information about the case
emotional evaluation and reconstructed breast satisfaction

Conditions: Malignant Neoplasm of the Breast

Summary: data from the national cancer institute (inca) reveal that breast cancer is the most common type of cancer among women worldwide. in brazil, it is second only to non-melanoma skin cancer. breast cancer is a feared disease in the female universe because it is considered one of the major causes of death due to neoplasia among women. it brings also the stigma of suffering, mutilation, loss of female identity and loss of body contour. among other issues, problems with body self-image may have an impact on sexuality and fertility, and also, the incapacity to breastfeed. breast reconstruction can restore the patient's shape and physical integrity, among other benefits. the research justifies itself because information about the satisfaction of breast reconstruction can be achieved. it is also known that women having breast reconstruction after a mastectomy due to cancer have a favorable evolution. this study will analyze body contour satisfaction of women undergoing mastectomy and breast reconstruction as part of their breast cancer treatment. the breast q questionnaire will be used to measure patients satisfaction.

this is a prospective, quasi-experimental study. the subject sample will be composed of women submitted to mastectomy due to breast cancer and to breast reconstruction as part of their treatment. they will be evaluated twice. one when they receive the cancer diagnosis and the other six months after de reconstruction surgery. on both occasions, they will answer the brest q questionnaire.

Eligibility criteria:
inclusion criteria: * women over eighteen years of age; * women with proven histological diagnosis of breast cancer; * women who have an indication of mastectomy as part of their treatment; * women who have breast reconstruction, regardless of the technique used, as part of their treatment; * women under 70 years of age at the time of the reconstructive surgery exclusion criteria: * women diagnosed with breast cancer and treated with conservative surgeries; * women who refuse reconstruction as part of treatment; * women who refused surgery as part of the treatment for breast cancer

Keywords: breast cancer, breast surgery, breast reconstruction,
efficacy of pattern respiratory pnf associated aerobic training on lung volumes and 6mwt test in parkinson individuals

Conditions: Parkinson Disease

Summary: introduction: parkinson's disease (pd) is a neurodegenerative disorder that causes motor disorders such as bradykinesia, rigidity and tremor. in addition to the motor symptoms occurring in the overall pd patients, mostly there is associated respiratory disorders. the respiratory impairment may be due by postural changes, limiting the flexibility and expandability of the chest wall causing decreased lung volumes and flows. so the exercise proprioceptive neuromuscular facilitation (pnf) is a tool designed to reduce the changes in respiratory function, the commitment of the respiratory muscles, and allows greater flexibility of the chest wall, reducing the rigidity of the rib cage. to evaluate the effects of respiratory pattern of proprioceptive neuromuscular facilitation on the distribution of pulmonary ventilation, compartmental volumes of diaphragmatic mobility and functional capacity in patients with parkinson's disease. methods: the study is a clinical trial randomized, in which participants to be elected for the study should present diagnosis of pd, staging of disease between ii and iii according to hoehn and yahr. initially, the participants will undergo the collection of data on medical history, assessment of pulmonary function by spirometry and respiratory muscle strength measured by the manometer. then will undergo evaluation of the breathing pattern and tricompartmental distribution of the volume of the chest wall by hemithorax by plethysmography optoelectronic; quantify the mobility of the right diaphragm in total lung capacity for maneuver and during the current volume by ultrasonography. after the evaluation, participants will undergo intervention which will consist of three stages: first occur first session of the pnf later aerobic training for 30 minutes, ending with one pnf session.


Eligibility criteria:
inclusion criteria: * individuals with stage ii and iii between the hoehn and yahr classification; * minimum score of 28 on the mini mental examination for parkinson. exclusion criteria: * individuals with rheumatologic or orthopedic diseases or deformities / abnormalities in the spine that compromise the respiratory mechanics; * respiratory comorbidities; * history of smoking; * history of thoracic or abdominal surgery; * clinical instability characterized by infections and / or hemodynamic defined as greater than 150 bpm heart rate or systolic blood pressure less than 90 mmhg; * not present exchange of the drug in the last 30 days.
treatment of periodontal intrabony defects using autologous platelet rich fibrin vs titanium platelet rich fibrin

Conditions: Periodontitis

Summary: background: to compare the effectiveness of open flap debridement (ofd) alone and ofd along with either autologous platelet rich fibrin (prf) or titanium platelet rich fibrin (tprf) in the treatment of intrabony defects (ibds). materials and methods: study was conducted on subjects reporting to the department of periodontics, the oxford dental college and hospital, bangalore. 38 subjects with 90 periodontal ibds of moderate to severe periodontitis were selected and assigned to ofd alone (group i) or ofd with autologous prf (group ii) or ofd with tprf (group iii). in each subject, a minimum number of two sextants were present with probing pocket depths (ppd) ≥5mm in at least three teeth.


Eligibility criteria:
inclusion criteria: * presence of minimum 20 permanent teeth * age group 20-55 years * radiographic evidence of periodontal ibds * probing pocket depth (ppd) \>5mm in minimum two sextants in at least three teeth * clinical attachment (ca) loss of ≥ 3mm. exclusion criteria: * systemically compromised subjects * those on medications (corticosteroids/ bisphosphonate therapy) that may interfere with wound healing * grade iii tooth mobility * smokers and alcoholic subjects * pregnant and lactating mothers * subjects who underwent periodontal treatment within a period of 1 year.

Keywords: periodontal regeneration growth factors
indoor temperature and sleep apnea

Conditions: Obstructive Sleep Apnea

Summary: the purpose of this study is to test whether different indoor temperature affect the frequency of sleep apnea.


Eligibility criteria:
inclusion criteria: * obstructive sleep apnea exclusion criteria: * central sleep apnea

Keywords: sleep apnea syndromes, ambient indoor temperature
pilot evaluation of a healthy lifestyle intervention for adolescent and young adult survivors of pediatric cancer

Conditions: Pediatric Cancer

Summary: this is a feasibility and acceptability trial to test a newly developed healthy lifestyle intervention for adolescent and young adult survivors of pediatric cancer.


Eligibility criteria:
inclusion criteria: * participants will be adolescents and young adults (15-25 years of age) who have completed cancer treatment at johns hopkins all children's hospital any time in the last five years. this age range was chosen because it corresponds to the recommended age range for cancer-related adolescents and young adult studies38. * if the adolescent or young adult patient lives with a parent, other adult family member, or adult romantic/platonic partner, that person will also be invited to participate in the intervention as a support to the patient. * if the adolescent or young adult patient lives with a parent or romantic partner, the parent or romantic partner will also be invited to participate in the intervention as a support to the patient. a parent or romantic partner is eligible to participate if the patient lives with them at least 50% of the time. the parent or romantic partner will not receive separate financial compensation for participation. herein, we use the word "parent" only because we expect the vast majority of patients will live with a parent instead of a romantic partner. patients who do not live with a parent or romantic partner will participate alone. * the patient's cancer treatment must have included chemotherapy and/or radiation. * if a patient's cancer relapses during the study period, the patient's oncologist must agree to the patient continuing in this intervention. exclusion criteria: * potential participants who appear to have cognitive, motor, or language delays, as observed by research personnel or documented in the medical record, will be excluded from this study if delays preclude informed consent and/or study completion. participants may request that research personnel read all assessment, education, and intervention materials aloud in a structured interview format, in which case participants could respond to items verbally and/or by pointing to visual aids. because of this option, participants' ability to read and write are not requirements for participation. * because the motivational interviewing component of the intervention is language-dependent and requires significant time and training for certification in another language, non-english speaking patients will only be included in this study if the psychology postdoctoral fellow hired in this study is a native spanish speaker and can demonstrate motivational interviewing proficiency in spanish.

Keywords: pediatric cancer survivorship child adolescent weight obesity physical activity motivational interviewing problem solving culture exercise nutrition
a long term, safety study of apricitabine in hiv-infected subjects

Conditions: HIV Infection

Summary: the study will examine how safe and effective apricitabine is when given long term (as ongoing treatment) to hiv patients who have already completed the avx-201 trial

an ongoing study (avx-201) is examining the safety and efficacy of apricitabine compared to 3tc in hiv patients who are failing therapy containing 3tc and have the presence of the m184v mutation in reverse transcriptase. this extension study (avx-201e) is available to patients who complete the avx-201 protocol. patients will continue to receive apricitabine open label for a further 96 weeks (making a total of 144 weeks from starting avx-201) in addition to an optimised background. safety markers and efficacy markers will be followed.

Eligibility criteria:
inclusion criteria: * completed avx-201 protocol, plasma hiv rna \ 50 exclusion criteria: * pregnant or breastfeeding females, withdrawal from avx-201

Keywords: hiv apricitabine drug resistance reverse transcriptase lamivudine
arrhythmic manifestations and management in hospitalized covid-19 patients

Conditions: Coronavirus Infections

Summary: although arrhythmias appear to be common in covid-19 patients, arrhythmia mechanisms and characteristics, predisposing factors, incidence of sudden cardiac death and predictors, therapeutic strategies employed as well as long term outcomes are not well understood. hence, we seek to develop a multicenter registry aimed to characterize arrhythmic manifestations, employed treatment strategies and long-term outcomes among hospitalized covid-19 patients in the us.

the novel coronavirus (sars-cov-2) and the resulting respiratory tract infection (coronavirus disease 2019 or covid-19) is a pandemic with over 3 million cases globally and resulting in \>230,000 deaths at the time of this writing. from initial reports in wuhan, china, viral progression resulted in over 80,000 cases in january/february 2020 in china. the following global spread has involved more than 210 countries. unfortunately, the united states has been significantly affected, with over 1 million confirmed cases and over 60,000 deaths, the highest in the world. as this global pandemic continues to rage, cardiovascular, especially arrhythmic manifestations associated with covid-19 have become evident. a recent report from wuhan, china, noted that 16.7% of hospitalized and 44.4% of icu patients with covid-19 had arrhythmias. although arrhythmias appear to be common in covid-19 patients, arrhythmia mechanisms and characteristics, predisposing factors, incidence of sudden cardiac death and predictors, therapeutic strategies employed as well as long term outcomes are not well understood. hence, we seek to develop a multicenter registry aimed to characterize arrhythmic manifestations, employed treatment strategies and long-term outcomes among hospitalized covid-19 patients in the us.

Eligibility criteria:
inclusion criteria: * patients \> 18 years of age * hospital admission with covid-19 exclusion criteria: ● age \< 18 years

Keywords: covid-19 arrhythmic manifestations management strategies
internet-based cognitive behavior therapy for insomnia for parents who have lost a child

Conditions: Insomnia; Bereavement

Summary: the purpose of this project is to evaluate an internet-based cognitive behavioral therapy (icbt) for bereaved parents with insomnia. participants are randomized to either a therapist guided icbt or to an active control who receives written information on sleep, insomnia, and sleep hygiene. the primary purpose is to evaluate changes in insomnia severity for treatment compared control, after treatment and at 9 and 18 months follow up. a secondary purpose is to evaluate changes in symptoms of complicated grief and depression.


Eligibility criteria:
inclusion criteria: * clinical level of insomnia (more than 10 on isi) * meets criteria for insomnia according to dsm-5 * enough swedish language skills exclusion criteria: * other sleep disorders that require other treatment (e.g. sleep apnea) * somatic or psychiatric conditions requiring acute care

Keywords: cognitive behavior therapy internet treatment self-help treatment insomnia icbt cbt-i bereavement
the impact of chemotherapy on memory function and the development of traumatic symptoms in children with cancer

Conditions: Oncology; Trauma; Pediatric

Summary: background: while treatment for pediatric cancer has improved significantly over the past 40 years, the neurotoxic side-effects of the chemotherapy agents themselves are now being recognized. two drugs suspected of having acute impact on memory performance in children are methotrexate (mtx) and steroids (gcs). in addition, new evidence suggests that this neurotoxicity might actually protect these children from traumatization. working hypothesis and aims: this project aims to examine the acute impact of mtx and gc chemotherapy on memory performance in children and young adults with cancer, and the subsequent impact on the development of traumatic symptoms. we hypothesize that mtx and gcs will each produce acute declines in memory performance and that children with greater reductions in memory performance will have fewer traumatic symptoms. methods: the investigators will recruit 45 children being treated with mtx or gcs at dana children's hospital. to determine acute impact on memory, a battery of memory tests will be administered before and after a cycle of mtx and before and after a cycle of gcs. in addition, traumatic symptoms will be assessed at each post-chemotherapy evaluation point expected results: the investigators expect poorer memory performance after mtx and after gcs and that these performance declines will correlate with lower rates of traumatic symptoms. importance: the immediate impact of mtx and gcs on memory is not well known, especially in children. in addition, recent findings have led us to hypothesize that chemotherapy-induced deficits in memory function would paradoxically protect these patients from the traumatization often associated with cancer and its treatment. the proposed study will test this novel hypothesis for the first time.


Eligibility criteria:
inclusion criteria: * histologically proven diagnosis of acute lymphoblastic leukemia, non-hodgkin's lymphoma, or osteosarcoma * treatment protocol that includes at least one cycle of methotrexate or exogenous glucocorticoid * informed consent to participate in the study, according to institutional guidelines * fluency in hebrew, english, or arabic * age 6 to 25 exclusion criteria: * cranial irradiation within the past year * serious concomitant systemic disorders (including active infections) that would compromise the safety of the patient or compromise the patient's ability to complete the study * active meningitis or seizures occurring less than a month before study enrollment

Keywords: chemotherapy memory methotrexate glucocorticoids trauma pediatric oncology traumatization