Kornimate/medical-research-clean huggingface dataset:
performances on cognitive functions and brain function and follow-up after different treatments in patients with autonomous cortisol secretion: a single-center, prospective, observational study

Conditions: Autonomous Cortisol Secretion; Adrenal Incidentaloma; Non-functioning Adrenal Adenomas

Summary: this is a single center, prospective, observational study to explore and evaluate the differences on cognitive function and brain function by functional-mri in autonomous cortisol secretion patients, and the different treatments methods on the cognitive function and brain function in patients with autonomous cortisol secretion

glucocorticoids, mainly cortisol, play a crucial role in the allostatic process of adjustment to stressors and can determine important changes in central nervous system structures. it is well known that cushing's syndrome (cs) is associated with neurocognitive impairment in about two-thirds of cases. in cs the most frequent reported alterations are memory impairment (about 83% of cases) and reduced concentration (66% of cases) . unfortunately, these alterations are only partially reversible after the hypercortisolism resolution. as so far, data related to the impact of autonomous cortisol secretion (acs) on cognitive function are scarce and lack of magnetic resonance indicators. few studies have studied the cognitive function changes of patients with acs by surgical and conservative treatment. in the single center, prospective and observational study we aim to explore cognitive functions and brain function by functional-mri in adrenal incidentaloma patients in relation to the presence of acs and, secondly, in a group of acs patients, the effect of adrenalectomy on cognitive functions and brain function.

Eligibility criteria:
inclusion criteria: * age 20-65 years; * ≥ 6 years of education； * right-handed; * complete entire cognitive function tests; * adrenal lesions ≥ 1 cm in diameter; * patients with non-functioning adrenal adenomas; * patients with autonomous cortisol secretion. exclusion criteria: * \< 6 years of education; * age \ 65 years; * maximum diameter of ai \<1cm; * active malignancies; * with a history of thyroid disease; * with a history of acute infection in the last month; * central nervous system diseases, including brain trauma, intracranial hemorrhage, acute cerebral infarction, etc; * contraindications of mri examination: such as implantation of metal prosthesis in vivo, claustrophobia, etc; * adrenal tuberculosis; * suspected or diagnosed adrenocortical carcinoma; * unable to complete entire cognitive function tests; * current use of steroids or any drugs known to alter steroid synthesis or metabolism in the previous 3 months; * clinical cushing syndrome; * cushing disease; * primary hyperaldosteronism; * pheochromocytoma; * severe impairment of heart, liver, kidney and other organs; * pregnant and lactating women

Keywords: cognitive function functional mri treatment
treatment strategy of human gamma globulin on the therapy for intensively ill children with inflammatory storm

Conditions: Critical Illness; Sepsis, Severe

Summary: the inflammatory storm in critically ill patients releases cytokines, causing systemic immune damage, which may be an important cause of multiple organ failure and even death. inflammatory storms exacerbate the deterioration of the disease in those children. gamma globulin may be an effective option to control inflammatory storms. however, this preliminary result needs to be verified from reliable and representative rcts. in our study, we conducted a retrospective study on the use of gamma globulin and an unused control group. at present, the indications of ivig are mainly focused on the neuromuscular system and the blood system. we hope to establish a more appropriate and operable evaluation table for the suitability of gamma globulin for clinical use.

in severe infective patients who survive the initial inflammatory storm, the immune response often evolves toward a state of immunosuppression, which contributes to increased mortality and severe secondary hospital-acquired infections. however, the role of gamma globulin therapy in patients with severe infection including sepsis and septic shock is discussed controversially. we intend to retrospectively analyze the efficacy and application evaluation of gamma globulin in severely infected children hospitalized in the intensive care unit. clinical and demographic data, as well as treatment outcome will be collected from the electronic health record. it is expected to provide evaluation basis for clinicians to formulate treatment plans and clinical pharmacists for special comments on the clinical use of gamma globulin.

Eligibility criteria:
inclusion criteria: * children hospitalized in picu of children's hospital of fudan university * children with severe infection complicated with inflammatory storm exclusion criteria: * discharge within 48 hours * patients without informed consent * incomplete clinical and demographic data

Keywords: sepsis critical illness inflammatory storm gamma globulin
single and double dna strand breaks in males with unexplained infertility attending fertility treatment

Conditions: Infertility, Male

Summary: the aim of this study is to investigate the extent of double-stranded dna damage in sperm in men with unexplained infertility.


Eligibility criteria:
inclusion criteria: * unexplained infertile men who will undergo 1st or 2nd ivf treatment * age over 18 years * normal sperm parameters according to who criteria * ivf treatment exclusion criteria: - icsi

Keywords: sperm dna fragmentation lifestyle doublestrand dna fragmentatio
effectiveness of unilateral versus bilateral intensive training in children with cerebral palsy

Conditions: Cerebral Palsy

Summary: this 3-year research project aims to investigate and compare the immediate and long-term treatment effectiveness as well as motor improving curve and potential predictors of the unimanual intensive training and bimanual intensive training protocols with an equivalent intervention period in children with hemiplegic cp and children with cp with apparently one side affected. in addition, based on the icf-cy model, comprehensive outcome measures including motor functions as well as psychological functions will be included.


Eligibility criteria:
the inclusion criteria of this study are: 1. aged between 3 and 16 years 2. diagnosed with congenital hemiplegic or children with cp with one more affected side; (3) apparently disuse phenomenon of the more affected hand at spontaneous contexts participants will be exclude for: 1. excessive muscle tone (modified ashworth scale ≤ 2 at any joints of the upper limb) before beginning treatment (bohannon \& smith, 1987) 2. severe cognitive, visual, or auditory disorders according to medical documents, parental reports, and the examiner's clinical observation 3. injections of botulinum toxin type a or operations on the ue within 6 months

Keywords: cerebral palsy, upper limb neurorehabilitation upper extremity neurological rehabilitation
soberlink - map outcomes study protocol

Conditions: Alcohol Addiction

Summary: the purpose of this study is to show the effectiveness of soberlink's remote alcohol monitoring system integrated with map's patient engagement platform (ehr) to monitor a sample size of at-risk alcohol use disorder (aud) population. ultimately, this data is leveraged to improve clinical outcomes and manage financial risk through facilitating early interventions and other means of mitigating recidivism and costly treatment episodes from aud population.

the study will include 30 clients with a primary or secondary diagnosis of alcohol use disorder (aud) and are enrolled in map's system where dedicated case managers are monitoring the client's relapse risk levels. soberlink's remote alcohol system will provide data to inform the case manager if the client has relapsed or is at risk of relapsing through the use of testing data compiled by the soberlink system. integrating soberlink results into map's emr will allow case manager to make better clinical decisions and reduce costs by mitigating the chances recidivism through early intervention. clients will use the soberlink device for a period of 90 days.

Eligibility criteria:
inclusion criteria: * male or female subject between ages of 21-65 years old * subject is active in map's program with recovery support services * subject has received acute professional treatment in the last 120 days * primary or secondary diagnosis is alcohol use disorder * subject willing to use soberlink device to provide bac * subject is willing to discuss soberlink test results with case manager * subject is willing to sign a soberlink client agreement * subject is english speaking and reading exclusion criteria: * alcohol use disorder is not a primary or secondary diagnosis * subject is currently taking anti-alcohol medications * subject will not be in the united states through duration of study * subject is unwilling to properly use the device * subject is non-english speaking and reading * subject is a child, adolescent, cognitively impaired, diagnosed with a mental disorder, such as schizophrenia
diurnal variation of uremic solutes in peritoneal dialysis

Conditions: Chronic Kidney Disease

Summary: study on the daytime variation of uremic retention solutes and markers of bone-mineral metabolism in patients with end-stage kidney disease treated with peritoneal dialysis

many epidemiological studies have pointed to the association between serum parameters of phosphate metabolism (phosphate, fgf23) and microbiotic protein fermentation (p-cresyl sulphate \[pcs\], indoxyl sulphate \[is\]) on the one hand and increased risk of all-cause and cardiovascular death on the other hand. hypothesis: due to failing feed-back mechanisms, diurnal variation of serum concentrations of serum phosphate and fermentation metabolites will be more pronounced in dialysis patients, especially in those with negligible residual kidney function. clinical studies assessing this issue are scarce to non-existing.

Eligibility criteria:
inclusion criteria: * age 18-55 * normal dietary habits exclusion criteria: * treatment with systemic antibiotics within one month major abdominal surgery drugs known to affect gastrointestinal physiology (acid secretion inhibitors, prokinetics, laxatives, probiotics, prebiotics,..)

Keywords: diurnal variation peritoneal dialysis uremic retention solutes phosphorous indoxyl sulfate p-cresol sulfate
hemodynamics in chronic hemodialysis patients undergoing isolated ultrafiltration compared to conventional hemodialysis

Conditions: End Stage Kidney Disease

Summary: patients treated with hemodialysis (hd) bear increased risk of cardiovascular events, which results in high morbidity and mortality among this cohort of patients. intradialytic hypotension (idh), which is an independent risk factor for mortality, occurs in up to 20% of hemodialysis session and may lead to myocardial stunning and cerebral ischemia resulting in increased white matter lesions, gastrointestinal ischemia and shunt vessel thrombosis. due to the deleterious effects of idh during hd, preventive measurements such as limiting interdialytic weight gain are recommended, but frequently fluid and salt restriction are not adhered to, thus increasing dialysis time or frequency of treatments is a common strategy in those patients.

a kdigo (kidney disease: improving global outcomes) controversies conference suggested that isolated ultrafiltration (iso-uf) may provide a benefit in hemodynamic stability, but whether this translates into benefits in hard outcomes is unclear and requires further research. so called-sequential dialysis, that is, isolated ultrafiltration followed by hd is commonly recommended, but evidence is very limited and mainly based on small older studies. in conclusion, the supposed benefit for intradialytic hemodynamic stability attributed to isolated ultrafiltration compared to hemodialysis seems to be due to less pronounced changes in vascular resistance, but the reason for this discrepancy is unclear. thus far, recommendations for using iso-uf to improve hemodynamic stability are mainly based on old studies which may not be applicable to modern technique used nowadays. furthermore, there is no standardized approach on how to use isolated ultrafiltration, with neither a time period nor ultrafiltration rate recommended by the guidelines. in this study, the investigators try to assess changes in peripheral resistance, osmolality, cardiac output, and cardiac power index and try to establish exploratory correlations to idh episodes. furthermore, the investigators want to assess the impact on dialysis quality by reduced time on dialysis.

Eligibility criteria:
inclusion criteria: * written consent of the participant after being informed * at least 18 years of age * end stage kidney disease patient undergoing hemodialysis * dry weight stable for a minimum of one month * interdialytic weight gain of \>2 liters in the short interdialytic interval exclusion criteria: * no informed consent was obtained * patients with a pacemaker or implanted medical device that prevents compliance with study regulations * patients treated with hemodiafiltration * patients treated with medium cut-off membranes (theranova, baxter) * patients with recurrent severe hyperkalemia after the short interdialytic interval (k+ concentration \> 6.0 mmol/l, requiring more than 2 hours of dialysis to ameliorate the post-dialytic shift from other compartments. * women of childbearing age not using contraception

Keywords: hemodialysis ultrafiltration
hematopoietic stem cell microtransplantation for in aml

Conditions: Acute Myeloid Leukemia

Summary: the purpose of this study is to evaluate the efficacy of hematopoietic stem cell microtransplantation for in acute myeloid leukemia (aml)patients who can not receive hematopoietic stem cell transplantation (hsct).

despite allogeneic hsct is the only curative therapy for aml, some patients can not receive transplantation due to intolerance of transplant-related toxicity or unwillingness of hsct. for these patients, microtransplantation seems an optional therapy. however, the efficacy still remain unclear.

Eligibility criteria:
inclusion criteria: * aml patients who have received induction chemotherapy with moderate-high dose ara-c and 3 courses consolidate chemotherapy * intolerance or unwillingness of allogeneic hsct * subjects (or their legally acceptable representatives) must have signed an informed consent document indicating that they understand the purpose of and procedures required for the study and are willing to participate in the study exclusion criteria: * any abnormality in a vital sign (e.g., heart rate, respiratory rate, or blood pressure) * patients with any conditions not suitable for the trial (investigators' decision)

Keywords: acute myeloid leukemia hematopoietic stem cell microtransplantation
a randomized comparison of intravitreal isis 2922 plus ganciclovir versus ganciclovir as treatment for patients with cytomegalovirus retinitis ( cmvr )

Conditions: Cytomegalovirus Retinitis; HIV Infections

Summary: to determine the clinically safe and effective dose of intravitreal isis 2922 alone and as an additive antiviral therapy to ganciclovir in aids patients with cytomegalovirus (cmv) retinitis.

in stage 1 of the study, 20 patients receive one of two doses of isis 2922 on days 1, 8, and 15 (induction) then every 14 days (maintenance), with ganciclovir given daily during both induction and maintenance. escalation to the second dose does not occur until all patients at the first dose level have reached their first maintenance dose (day 29). in stage 2 of the study, 174 patients are randomized to receive either a) isis 2922 at the dose established in stage 1 on days 1, 8, and 15 and then every 14 days, with ganciclovir given daily during both induction and maintenance, or b) ganciclovir daily for 14 consecutive days and then a lower dose as maintenance. patients may continue to receive isis 2922 biweekly if the dose is safe and their cmv retinitis is clinically controlled. per 2/8/96 amendment, patients are now in stage 2 at 150 mcg.

Eligibility criteria:
inclusion criteria patients must have: * aids. * cmv retinitis that is not adequately controlled (previously diagnosed patients with smoldering cmv retinitis or those with active cmv retinitis borders on indirect ophthalmoscopy). * no more than one previous progression of cmv retinitis. exclusion criteria co-existing condition: patients with the following symptoms or conditions in the eye to be treated are excluded: * external ocular infection. * other herpetic infections of the retina, toxoplasma retinochoroiditis, or other disease of the fundus. * ocular condition that will obstruct visualization of the posterior ocular structures. * retinal detachment. * silicone oil in eye. patients with the following other symptoms or conditions are excluded: * known or suspected allergy to phosphorothioate oligonucleotides. * syphilis. * retinal pigment epithelial stippling not associated with cmv retinitis. * pseudoretinitis pigmentosa. * chronic diarrhea that would impair absorption of oral ganciclovir. * intolerance to ganciclovir. concurrent medication: excluded: * foscarnet or other anti-cmv agents other than ganciclovir. * mellaril. * stelazine. * thorazine. * clofazimine. * ethambutol/fluconazole combination. * investigational medications for cmv retinitis. concurrent treatment: excluded: * investigational procedures for cmv retinitis. patients with the following prior conditions are excluded: * history of surgery to correct retinal detachment in eye to be treated. * history of intolerance to isis 2922. prior medication: excluded: * prior ganciclovir implant for cmv retinitis. * more than 4 months of prior ganciclovir.

Keywords: aids-related opportunistic infections ganciclovir drug therapy, combination acquired immunodeficiency syndrome antiviral agents cytomegalovirus retinitis injections
mesenteric bacterial translocation in evolved crohn's disease

Conditions: Crohn Disease

Summary: mesenteric fat can be invaded by gut bacteria through a process called bacterial translocation, which is the invasion of viable bacteria from the gastrointestinal tract to extraintestinal sites (mesenteric lymph nodes, liver, spleen, kidney, bloodstream, etc.). in crohn's disease (cd), bacterial translocation could increase the disproportionate inflammatory response already present and contribute to disease progression by stimulating the production of pro-inflammatory cytokines and immune-cell infiltration in the mesentery. several mechanisms may promote bacterial translocation, such as bacterial overgrowth, disruption of the intestinal mucosal barrier and alterations in the immune system. ileocecal surgical resection is required in some patients with complicated or refractory cd. unfortunately, post-surgical disease recurrence happens in up to 40% of cases, probably defining a subgroup of cd patients with a particular aggressive form of the disease. the complete microbiome (in gastrointestinal and extraintestinal sites) in cd patients that develop early post-surgical recurrence, as well as the association to innate immunity alterations, has not yet been studied. the primary aim of the study is to explore the bacterial microbiome of cd patients and its association with early post-surgical recurrence and clinical or genetic variables related to innate immunity. to achieve this, the bacterial dna present in mesenteric fat and ileal tissue (inflamed and non-inflamed) from surgical resection samples as well as blood samples from cd patients will be studied. genetic polymorphisms, relevant clinical data and disease recurrence will also be evaluated. the investigators hypothesize that bacterial translocation to the mesentery fat near the inflamed intestine is one of the mechanisms for perpetuation and chronicity of inflammation and therefore post-surgical recurrence in cd. the investigators expect to find a distinctive bacterial profile (in quantity and quality) in the mesenteric fat of patients with early post-surgical recurrence and/or with genetic variants that cause alterations in innate immunity. the study of the microbiome in cd could help to identify the patients with a more aggressive disease form that will probably present early post-surgical recurrence, and could raise the possibility of microbial modulation as therapy for cd.


Eligibility criteria:
inclusion criteria: * adults (18 years or older) * informed consent signed * to require an ileocecal resection as part of the treatment of crohn's disease * in the case of controls: not having inflammatory bowel disease and requiring an ileocecal resection for another reason exclusion criteria: * to require an ileocecal resection with definitive or transient ileostomy * in the case of controls: existence of a family history of inflammatory bowel disease.

Keywords: crohn disease mesenteric fat bacterial translocation innate immunity genetic polymorphisms
measuring parkinson's disease progression

Conditions: Parkinson's Disease

Summary: the measuring parkinson's disease progression study aims to use mri scans and a controlled dose of levodopa to find a biomarker (objective measurement) of parkinson's disease (pd). biomarkers would help determine the effectiveness of therapies in slowing or stopping pd progression, and accelerate the pace of research.

early in the course of parkinson's disease, a small dose of levodopa (l-dopa) provides benefit for many hours. the body responds as if the levodopa in the plasma filled a reservoir and then slowly leaked out to produce benefit. with disease progression, even though the same amount of levodopa circulates in the blood, the benefit wears off much faster, as if the reservoir had become leakier. this wearing off of benefit can be characterized by a single number, the effect site rate constant ke. on average, patients with more severe disease and longer disease duration have a larger ("leakier") ke when the response to drug is measured using clinical features like tapping speed. unfortunately, clinical measurements are influenced by confounding factors such as patient fatigue and comfort. a direct, objective brain measure of response to levodopa may improve the reliability of this measurement. fortunately, we can assess the effect of levodopa on the brain directly, using an mri machine to measure blood flow in different parts of the brain. for instance, the midbrain has a robust blood flow response to a single, clinically sensible dose of levodopa. this study's goal is to validate mri measurement of ke in the brain as an objective, quantitative measure of disease severity in pd. we will do this by comparing mri-based ke values from people with pd across a wide range of disease duration and severity. in a subgroup of participants, we will do this measurement twice, once before treatment and once after 6 weeks of treatment with carbidopa-levodopa (sinemet® and other brand names).

Eligibility criteria:
inclusion criteria: * age 40-79 at screening * meet accepted diagnostic criteria for parkinson disease exclusion criteria: key exclusion criteria: * deep brain stimulator (dbs) * pregnancy * patients taking a dopamine antagonist (like quetiapine) or dopamine partial agonist (like aripiprazole) * metal in the head or eye, or other contraindication to mri * claustrophobia * serious neurologic disease other than pd * head trauma with loss of consciousness for more than 5 minutes * severe or unstable systemic illness * certain psychiatric illnesses (dementia, psychosis, current major depression) * current alcohol use disorder * subjects who feel that going without nicotine for 3-4 hours would be uncomfortable * currently taking an extended-release formulation of a dopamine agonist (like mirapex er or requip xl)

Keywords: parkinson's disease pd levodopa