Kornimate/medical-research-clean huggingface dataset:
treating traumatic brain injury with transcranial direct current stimulation

Conditions: Traumatic Brain Injury

Summary: traumatic brain injury (tbi) often results in a wide array of cognitive impairments, which can significantly diminish quality of life for affected individuals. while traditional rehabilitation methods typically adopt a standardized approach, it's crucial to acknowledge the significant heterogeneity within the tbi patient population. neglecting these variations reduces the likelihood of otherwise effective treatments being considered for widespread adoption. emerging evidence highlights the potential of transcranial direct current stimulation (tdcs) as a promising adjunctive therapy. tdcs, a noninvasive and safe neuro-rehabilitative procedure, has shown efficacy when integrated with cognitive training across various neurological disorders, such as depression, post-stroke aphasia, and neurodegenerative conditions. this study aims to investigate the effectiveness of tdcs paired with behavioral therapy, particularly cognitive training, in improving cognition and executive function in chronic tbi patients. additionally, tdcs targets in the current study will be tailored to each individual patient, recognizing the patient's unique needs and circumstances

objective: this pilot study (targeting a sample of 10 tbi patients) aims to investigate whether combining cognitive training with anodal tdcs can enhance cognitive function more effectively compared to cognitive training alone in individuals with chronic tbi. the target for tdcs application will be the left dorsolateral prefrontal cortex (dlpfc), thought to be the area associated with executive impairment in tbi patients. study design: each participant will undergo an initial neuropsychological evaluation and functional magnetic resonance imaging (fmri). following the preliminary evaluation, participants will undergo either tdcs or sham stimulation for 3 weeks, with follow-up assessments immediately after and 2 months later, to measure cognitive training progress. after the 2-month follow-up, participants will undergo another 3 weeks of cognitive training with either sham or tdcs, based on the participant's condition in phase 1. post-training, there will be additional follow-ups immediately after and 2 months later.

Eligibility criteria:
inclusion criteria: * diagnosis of traumatic brain injury (tbi) at least 2 years prior to participation * right-handed * english - speaking exclusion criteria: * uncorrected visual impairment * uncorrected hearing impairment * stroke or other premorbid neurological disorders affecting the brain * premorbid learning disorders mri exclusion criteria: * severe claustrophobia * cardiac pacemakers, ferromagnetic implants, cochlear implants * pregnant woman

Keywords: tbi traumatic brain injury chronic traumatic brain injury transcranial direct current stimulation tdcs computerized cognitive therapy
veno-arterial extracorporeal membrane oxygenation prior to left ventricular assist device implantation.

Conditions: Cardiogenic Shock; Heart Failure; Extracorporeal Membrane Oxygenation; Left Ventricular Assist Device

Summary: cardiogenic shock is an uncommun pathology with a high mortatily rate around 45%. veno arterial extracorporeal membrane oxygenation (va-ecmo) is a temporary extracorporeal assist device which restore an adequate blood flow when a circulatory failure occures. va-ecmo main indication is refractory cardiogenic shock whatever the etiology. current medical care of terminal cardiac failure includes use of long-term mechanical circulatory support devices (mcsd) such as left ventricular assist device (lvad). lvad therapy may lead to heart transplant (bridge to transplantation), to recovery (bridge to recovery) or to permanent implantation (destination therapy). few patients with refractory cardiogenic shock treated with va-ecmo may secondarily need a long term mcsd with lvad. lvad long-term heart assist showed interesting survival rate when implantation occured (71% after 2 years follow-up and 45% after 4 years follow-up) out of acute heart failure situation. there are only few datas concerning lvad implantion during refractory cardiogenic shock, with a mortality between 20 to 50% in different studies. in this way, in comparaison of current few datas on the subject of lvad implantation under va-ecmo, the investigators (15 french-speacking centers) would retrospectively describe a large population.


Eligibility criteria:
inclusion criteria: * veno-arterial extracorporeal membrane oxygenation prior to left ventricular assist device implantation. * veno-arterial extracorporeal membrane oxygenation at the left ventricular assist device implantation operative time exclusion criteria: * extracorporeal membrane oxygenation weaving before left ventricular assist device implantation. * cardiac assist devices other than veno-arterial extracorporeal membrane oxygenation

Keywords: left ventricular assist device extracorporeal membrane oxygenation refractory cardiogenic shock heart failure cardiovascular diseases myocardial infarction myocardial ischemia shock
citicoline as neuroprotector in preterm

Conditions: Pre-Term

Summary: citicoline as neuroprotector in preterm

efficacy of citicoline as neuroprotector in preterm; a randomized controlled trial.

Eligibility criteria:
inclusion criteria: * preterm on cpap or ventilator exclusion criteria: * multiple congenital anomalies
childhood acute lymphoblastic leukemia treatment protocol moscow-berlin 2008

Conditions: Childhood Acute Lymphoblastic Leukemia

Summary: questions and objectives of all-mb-2008 study 1. whether the early peg-asparaginase in induction will lead to the earlier achievement of remission, improvement of days 8 and 15 responses leading to an earlier reconstitution of bone marrow and immunocompetence, decrease of severe infections and early mortality rate? 2. whether the use of peg-asparaginase in induction will allow to avoid the anthracyclines in standard risk group patients and to reduce treatment myelotoxicity? 3. whether the administration of 9 doses of peg-asparaginase 1,000 u/m2 instead of 18 doses of e.coli l-asparaginase 5,000 u/m2 in standard risk patients will improve treatment outcome? 4. whether the administrations of high dose methotrexate (2 g/m2 in 24 hours) during 1-st consolidation in intermediate risk patients will result in decrease of central nervous system relapse incidence and improvement of event-free and overall survival? whether the increase of 6-mercaptopurine starting dose up to 50 mg/m2 in 1-st consolidation phase (instead of 25 mg/m2) will decrease in relapse risk, but would not be accompanied with enhanced toxicity? 5. is it possible to completely avoid the cranial irradiation in intermediate risk patients? in some subgroup of intermediate risk patients? is it enough to control neuroleukemia in these patients to introduce additional tit in the consolidation phase of treatment? how will change the possible late effects in these patients according to the third arm of randomization? 6. will the new risk group stratification to improve overall and event-free survival?


Eligibility criteria:
inclusion criteria: 1. age at diagnosis at 1 to 18 years. 2. the start of induction therapy within a time interval of study recruitment phase. 3. the diagnosis of all is to be proved by the morphological, cytochemical, and immunological analysis of tumor cells in bone marrow. 4. informed consent of the parents (guardians) of the patient to be treated in one of the clinics included in this multicenter study. exclusion criteria: 1. all is a second malignant tumor; 2. the disease is a relapse of previously misdiagnosed and, therefore, inadequately treated all; 3. there is severe concomitant disease, which significantly impedes chemotherapy protocol (such as multiple malformations, heart diseases, metabolic disorders, etc.); 4. there is a lack of important basic data needed for the exact adherence to the cytostatic therapy according to a specific protocol of chemotherapy (differential diagnosis of acute lymphoblastic/myeloid leukemia is not possible, stratification according to risk group is not possible); 5. the patient was treated before for a long time with cytotoxic drugs; 6. there were deviations in the treatment not covered by the protocol and/or not due to side effects of treatment and/or complications of the disease

Keywords: acute lymphoblastic leukemia, children, adolescents, l-asparaginase, methotrexate
clinical utility and safety of human umbilical cord mesenchymal stem cell secretome in drug resistant epilepsy single center, non-randomized, phase i clinical trial

Conditions: Epilepsy; Drugs Resistant Epilepsy

Summary: the goal of this clinical trial is to learn if human umbilical cord mesenchymal stem cell (hucmsc) derived secretome injection is safe and effective in patient with epilepsy. the main questions it ams to answer are: 1. how is the relationship between secretome therapy and the reduction in seizure frequency and duration in patients with drug-resistant epilepsy in the adult age group? 2. how does secretome therapy affect eeg and qeeg results in patients with drug-resistant epilepsy in the adult age group? 3. how is the relationship between secretome therapy and the mini mental state examination (mmse) score in patients with drug-resistant epilepsy in the adult age group? 4. how does secretome therapy affect stress levels as measured by the perceived stress scale (pss) in patients with drug-resistant epilepsy in the adult age group? 5. how does secretome therapy affect gait deviation index (gdi) scores in patients with drug-resistant epilepsy in the adult age group? 6. how does secretome therapy affect quality of life as measured by the quality of life in epilepsy inventory (qolie-31) in patients with drug-resistant epilepsy in the adult age group?


Eligibility criteria:
inclusion criteria: * individuals aged 18 to 60 years. * individuals with a clinical diagnosis of epilepsy confirmed by a neurologist based on internationally accepted criteria. * individuals with a seizure frequency of at least 6 times in 12 months. * individuals who have a history of recurrent seizures that are not controlled with standard antiepileptic treatment of at least 2 types of drugs for at least 12 months. * individuals who are in stable general health, without life-threatening acute illnesses or uncontrolled medical conditions. * individuals who do not have a history of other neurodegenerative diseases or severe psychiatric disorders that could affect the results of the study. * individuals who are not pregnant or breastfeeding. * individuals who are willing to provide written consent after receiving complete information about the study. exclusion criteria: * individuals with a history of stroke or evidence of stroke on medical examination. * individuals who have undergone surgery for the treatment of epilepsy. * individuals with a history of allergy or hypersensitivity reactions to the secretome or related components. * individuals with active or uncontrolled autoimmune disease. * individuals receiving immunosuppressive therapy. * individuals with severe hepatic or renal impairment. * individuals with significant vascular or blood vessel disease.

Keywords: secretome stem cells epilepsy drug resistant epilepsy qeeg
afatinib osimertinib sequencing nis

Conditions: Carcinoma, Non-Small-Cell Lung

Summary: this is a non-interventional, multi-country, multi-centre cohort study based on existing data from medical records of patients with egfr mutation-positive advanced nsclc treated with afatinib (gi(l)otrif®) as the first-line treatment followed by osimertinib in case the t790m resistance mutation was developed.


Eligibility criteria:
inclusion criteria: * patients with egfr mutation-positive advanced non-small cell lung cancer (nsclc) * the tumour harbours common egfr mutations (del19, l858r) at start of first-line treatment * patients who initiated second-line osimertinib treatment for acquired t790m mutation at least 10 months prior to data entry, and who were treated with afatinib (gi(l)otrif®) in the first-line * patients treated with osimertinib within an eap/cup or regular clinical practice * age ≥ 18 years * signed and dated written informed consent per regulations (exemption of a written informed consent for nis based on existing data in countries per local regulations and legal requirements) exclusion criteria: * patients who received drug(s) other than osimertinib as the second-line treatment and/or patients who received drug(s) other than afatinib (gi(l)otrif®) as the first-line treatment * patients with active brain metastases at start of treatment (either afatinib/gi(l)otrif® or osimertinib)
the effect of gabapentin on the sensation and impact of tinnitus

Conditions: Tinnitus

Summary: this study evaluated the effectiveness of gabapentin in treating tinnitus in two populations: tinnitus with associated acoustic trauma and tinnitus without associated acoustic trauma. the hypothesis was that gabapentin would decrease both subjective and objective features of tinnitus in the trauma group, but would be less effective in the non-trauma group.'

methods. a prospective, placebo-controlled, single-blind study of the effect of gabapentin on tinnitus was employed. audiograms and personal histories were used to categorize tinnitus etiology as either secondary to acoustic trauma, or not associated with acoustic trauma. participants were restricted to those with moderate-to-severe tinnitus for at least one year. all participants received gabapentin in a graduated ascending-descending dose series over 20 weeks (peak dose of 2400 mg/day). results. there was a significant improvement in tinnitus annoyance for the trauma group (p = 0.05). other subjective aspects of tinnitus were not significantly affected in either group. between-subject variability of therapeutic response was considerable. nevertheless, considering subjective loudness ratings, 4/19 non-trauma participants, and 6/20 trauma participants showed an improvement of 20 percent or better. considering psychoacoustic loudness estimates, 4/19 non-trauma and 6/20 trauma participants showed a 15 db (hl) improvement. evenly dividing each group into high and low responders revealed significant improvement in loudness at 1800 and 2400 mg/day for the trauma high-response subgroup (p = 0.007). no significant improvement was obtained for other subgroups.

Eligibility criteria:
inclusion criteria: * non-pulsatile tinnitus present \> 1 year * tinnitus handicap questionnaire score \> 30 * ability to perform psychophysical matching procedure exclusion criteria: * evidence of depression * renal insufficiency * conductive hearing loss

Keywords: chronic tinnitus acoustic trauma psychophysics loudness match gabapentin
expression of oncogenic human papillomavirus e6/e7 protein in tampon self-tests

Conditions: Normal Uterine Cervical Cytology; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

Summary: the purpose of this study is to examine for hpv e6/e7 mrna in tampon self-tests, and compare with the cytological and histological diagnoses. study hypothesis: expression of hpv e6/e7 mrna in tampon self-tests are a suitable alternative to the routine cervical smear.


Eligibility criteria:
inclusion criteria: * women with cervical dysplasia been referred to conisation. * women invited to cervical screening program and with only normal smear and normal smears in their history. exclusion criteria: * women not performing the tampon self-test before conisation. * women not performing the tampon self-test at least 3 month after having a normal pap-smear taken.

Keywords: self test pap smear tampon test e6/e7 mrna hpv
influence of health determinants on physical exercise therapy with a neurocognitive focus on chronic low back pain

Conditions: Chronic Low-back Pain

Summary: protocols in which pain neuroscience education is combined with physical exercise have shown recently greater effectiveness in the treatment of low back pain in comparison to protocols based only on one of the two approaches. the professional caregiver has a high incidence of low back pain related to the specific aspects of this collection with the low physical condition, the typical tasks performed and other psychosocial aspects. individual characteristics of these caregivers may condition the effectiveness of the therapy as well as demographic aspects or the alliance between patient and physiotherapist. the aim of this study is to determine the influence of certain health determinants on the effectiveness of a therapy that combines pain neuroscience education and motor control training from a neurocognitive perspective on chronic low back pain in a population of professional caregivers in bages, analyzing the reduction of low back pain, the improvement of functionality, the reduction of muscle movement and the improvement of muscle coordination. it will be a quasi-experimental pre-post design, prospective, with a control group, lasting 3 months. the intervention will be performed using a sample of professional caregivers, and the data will be collected before the intervention, at the end of the intervention, and 3-6 months after the intervention. pain, functionality, conducts of fear/avoidance, and muscular coordination will be analyzed


Eligibility criteria:
inclusion criteria: * of legal age * participants who present lumbar or lumbosacral pain all the time for more than 1 year * score of 6 on the visual analogical scale * have been at work (same position) longer than 1 year exclusion criteria: * other alterations and diseases of the musculoskeletal system that may interfere with the results of the intervention. * pregnancy during the study time * older than 65 years old
performance and stress during full scale simulator training

Conditions: Performance in Simulated Emergencies; Stress During Simulator Scenario; Behaviour of Physicians in Simulated Emergencies

Summary: in intensive care medicine, critical incidents are not rare and may result in fatal outcome. high fidelity patient simulators are commonly used in training curricula for healthcare professionals especially in anesthesiology, emergency medicine, and intensive care medicine. several different course concepts have previously been published. as we know from recently published data, up to 80% of all critical incidents in the field of medicine are caused by human error. the authors of the present study aimed to investigate the effects of two different course concepts (one addressing technical skills in intensive care medicine and on addressing non-technical skills) on stress and performance. stress and performance are measured in a pre-intervention and a post-intervention testing scenario.


Eligibility criteria:
inclusion criteria: * physician with experience in intensive care medicine. exclusion criteria: * no experience in intensive care medicine * previously taken part in simulator training

Keywords: patient simulation education, medical, continuing education, medical, graduate stress
genetic factors that influence chronic obstructive pulmonary disease in hispanics

Conditions: Pulmonary Disease, Chronic Obstructive; Lung Diseases, Obstructive

Summary: the purpose of this study is to examine genetic factors that influence the development of chronic obstructive pulmonary disease (copd) in hispanics, a minority group at high risk for the disease.

design narrative: this study will concentrate on a genetically isolated hispanic population with a high prevalence of copd living in the central valley of costa rica. nine hundred individuals from descendants of the costa rican central valley founder population will be enrolled. to identify regions of the genome that are likely to contain genetic determinants of copd-related phenotypes in this population, the study will collect phenotypic and genotypic data on 30 large families with a history of moderate to severe copd that have multiple individuals affected with smoking-related airflow obstruction. a genome scan will be conducted on these individuals using short-tandem repeat (str) markers. linkage analysis will be performed on 6 copd-related phenotypes, which will include the following: 1) chronic bronchitis; 2) airflow obstruction; 3) forced expiratory volume in one second (fev1); 4) fev1/fvc\[forced vital capacity\];5) bronchodilator responsiveness; and 6) total serum immunoglobulin e. within genomic regions demonstrating linkage to copd-related phenotypes in the genome scan, narrowly spaced str markers will be genotyped and tested for linkage between these markers and copd-related phenotypes. within selected genomic regions, the association will be tested between single nucleotide polymorphisms (snps) in candidate genes and copd-related phenotypes. by enrolling a large number of participants of a genetically isolated population and utilizing a family-based study design, this study should be able to address an important yet unstudied issue: the genetic influences on the expression of the copd phenotype in hispanics.

Eligibility criteria:
inclusion criteria: * copd * reduced fev1 after administration of bronchodilator (less than or equal to 60% of predicted value) * at least six great-grandparents born in the central valley of costa rica * at least one sibling with a history of smoking (10 or more packs per year) exclusion criteria: * chronic respiratory disorder other than copd (as determined by a questionnaire and high-resolution ct chest scan) * severe alpha 1-antitrypsin deficiency

Keywords: chronic obstructive pulmonary disease