Kornimate/medical-research-clean huggingface dataset:
spinal stimulation for upper extremity recovery in the home

Conditions: Cervical Spinal Cord Injury

Summary: the purpose of this research is to evaluate the safety, feasibility, and tolerability of non-invasive spinal stimulation used in the home and/or community in combination with a functional home exercise program for the upper extremities (arm/hand function) as well as their combined impacts on changes in upper extremity function. the expected duration of participation in this study is about 31-33 hours over a 13-25-week period. enrollees in this study will be randomly assigned to one of two groups: 1) upper extremity functional task-specific training combined with non-invasive transcutaneous spinal stimulation, or 2) waitlist control, which involves the same intervention, but with a 12-week delayed start. participants complete initial testing (one time if in group one and three times \[at weeks 0, 8, and 12\] if in group two), 24 1-hour training sessions (2x/week in home with caregiver/companion support and 1x/week with research team in person or via video conference for 8 weeks), a post-treatment evaluation, and a final evaluation (4 weeks after post-treatment).


Eligibility criteria:
inclusion criteria: * age 18 or older * history of traumatic sci * less than 12 months post sci * sci injury level c1-c8 * sci categorized as ais b-d * have passive range of motion (rom) within functional limits at wrists, shoulders, and elbows * have caregiver support to attend three in-person sessions and ongoing training at home * have a caregiver who, in the judgment of the research team, is qualified to assist the participant in the safe use of tss * able to complete in-person training sessions and return to craig hospital for assessments * experience no complicating physical or cognitive conditions as determined by their physician that would preclude the safe use of electrical stimulation * if using prescribed anti-spasticity medications, must be at a stable dose for at least four weeks prior to starting study procedures * agrees to comply with investigational devices instructions for use, protocol visits, and return of the device * able to provide informed consent exclusion criteria: * experience unstable chronic cardiac or respiratory complaints * have a recent history of fracture, contractures, or skin pressure injuries that might interfere with the intervention * received botox injections to the ues, neck, or hands within the last three months * pregnant, planning to become pregnant, or currently breastfeeding * have breakdown in skin area that will come into contact with electrodes * prior nerve or tendon transfer procedure for the ues * concurrently are participating in another drug or device trial that may interfere with this study * have an implanted pacemaker, spinal cord stimulator, ventriculoperitoneal shunt, deep brain stimulator, or intrathecal pump * in the opinion of the investigators, the study is not safe or appropriate for the participant
duloxetine for multiple sclerosis pain

Conditions: Multiple Sclerosis

Summary: this study is designed to primarily assess the efficacy and safety of duloxetine 60-120 mg once daily (qd) compared with placebo on the reduction of pain severity in participants with central neuropathic pain due to multiple sclerosis.

study is a multicenter, randomized, double-blind, parallel, placebo-controlled, 20-week trial with 4 study periods. participants who screen successfully (study period i) will be randomized in a 1:1 fashion to duloxetine 60 mg qd or placebo. starting with study period ii, participants will be treated in a double-blind manner for 6 weeks. participants who complete the 6-week, double-blind period will have the opportunity to participate in a 12-week, open-label, flexible-dose portion of the study (study period iii). study period iv is a taper phase designed to reduce the occurrence of discontinuation adverse events. participants may enter study period iv at any time after visit 3.

Eligibility criteria:
inclusion criteria: * have central neuropathic pain due to multiple sclerosis (ms) based on the disease diagnostic criteria * adult males or females * have a score of 4 or greater on the daily 24-hour average pain score * females must test negative for pregnancy at study entry * complete the daily diaries for at least 70% of the days of the study * participants may continue other prescription and nonprescription analgesic pain medications as long as the dose has been stable for 1 month prior to study entry, and they agree to maintain that stable dose throughout the study disease diagnostic criteria: * diagnosis of ms at least 1 year prior to study entry * no ms flares or change in disease treatment for the 3 months prior to study entry * daily pain due to ms for a minimum of 3 months prior to study entry exclusion criteria: * are currently in a clinical trial of ms disease-modifying therapy * have pain that cannot be clearly differentiated from causes other than ms * any current or historical diagnosis of mania, bipolar disorder, psychosis, or schizoaffective disorder * history of substance abuse or dependence * are pregnant or breast-feeding

Keywords: central neuropathic pain multiple sclerosis
donor outcomes following hand-assisted and robotic living donor nephrectomy: a retrospective review

Conditions: Transplant; Kidney Diseases

Summary: 1.1. background: renal transplantation is the treatment of choice for eligible patients with end-stage renal disease. it provides better outcomes in terms of life expectancy and quality of life than dialysis (liu, narins, maley, frank, \& lallas, 2012). kidney transplants from living donors also have additional benefits in terms of graft function and survival compared to transplants from cadaver donors (galvani et al., 2012). living donor transplants provide an opportunity to have good quality grafts and to perform the procedure when the recipient is in an optimal clinical status (creta et al., 2019). laparoscopic donor nephrectomy was first introduced in 1995 and is currently accepted as the gold standard for kidney procurement from living donors. the first worldwide robotic assisted laparoscopic donor nephrectomy was performed in 2000 by horgan et al. (horgan et al., 2007). the main obstacle to living donation is the exposure of a healthy subject to the risks of a major surgical intervention. therefore, efforts have been made to reduce complications and postoperative pain, achieve faster recovery, and minimize the surgical incisions. minimally invasive procedures like hand-assisted and robotic approaches greatly enhance living donation rates, and in 2001 the number of living donors exceeded the number of cadaver donors (horgan et al., 2007). 1.2. aim(s)/objective(s): the objective of this study is to compare intra- and postoperative patient outcomes of kidney donors following hand-assisted and robotic kidney transplants at a single center. 1.3. rationale for the study: more research is needed regarding the differences between minimally invasive approaches to kidney transplantation.

this is a retrospective, single-center cohort study. clinical data will be collected from electronic medical records (emrs) on donors and recipients who underwent a minimally invasive kidney transplantation procedure. data from all patients who had a hand-assisted or robotic minimally invasive kidney transplantation procedure at methodist dallas medical center (mdmc) between january 2006 and november 2019 will be included in the study.

Eligibility criteria:
inclusion criteria: * ≥ 18 years of age * kidney donors and recipients who underwent a hand-assisted or robotic kidney transplant exclusion criteria: * patients that do not meet the study inclusion criteria laid out above

Keywords: kidney transplant nephrectomy
acta-port score as a predictor of acute kidney injury in addition to blood transfusion in cardiac surgery: extending its clinical utility

Conditions: Cardiac Disease; Blood Transfusion; Acute Kidney Injury

Summary: in the scope of this study, it will be determined whether the acta-port (association of cardiothoracic anesthetists perioperative risk of blood transfusion) scoring system can predict the incidence of events in other organ systems, and the feasibility of conducting multiple assessments using a single simple score will be investigated.

acta-port (association of cardiothoracic anesthetists perioperative risk of blood transfusion) score is a simple, reliable, and validated tool used to predict the risk of transfusion in patients undergoing heart surgery. in calculating acta-port score, age, gender, hemoglobin, body surface area, euroscore, creatinine, and type of operation are used. in this study, it will be determined whether the acta-port (association of cardiothoracic anesthetists perioperative risk of blood transfusion) scoring system can predict the incidence of events in other organ systems, and the feasibility of conducting multiple assessments using a single simple score will be investigated. the files of patients undergoing open heart surgery in the cardiovascular surgical operating rooms of ankara bilkent city hospital, along with anesthesia records, transfusion records, and test results identified through the hospital information management system, will be prospectively evaluated. data will be collected after patients are admitted to the intraoperative and postoperative intensive care unit.

Eligibility criteria:
inclusion criteria: * patients over 18 years old * patients having open heart surgery * patients undergoing surgery by using cardiopulmonary bypass pump exclusion criteria: * patients under 18 years old * patients diagnosed with kidney disease

Keywords: cardiopulmonary bypass cardiac surgery transfusion acute kidney injury acta port
the impact of exercise counseling on exercise behavior in people with type 2 diabetes: a randomized clinical trial

Conditions: Diabetes Mellitus, Type 2

Summary: the purpose of this randomized clinical trial is to investigate the impact of physical therapist-directed exercise counseling combined with fitness center-based exercise training on stage of exercise behavior in people with type 2 diabetes.

type 2 diabetes is a chronic, metabolic disease characterized by hyperglycemia resulting from insulin resistance. research studies indicate that complications such as cardiovascular disease, peripheral vascular disease, retinopathy, and loss of physical function are associated with type 2 diabetes. clinical management of people with type 2 diabetes consists of medical nutrition therapy, pharmacological therapy, and exercise. exercise has been shown to improve risk factors associated with complications of type 2 diabetes such as elevated plasma glucose, elevated blood pressure, loss of muscular strength, and loss of exercise capacity. in fact, the american diabetes association and american college of sports medicine have published position statements recommending the use of exercise, specifically resistance and aerobic training, as an intervention for people with type 2 diabetes. however, 31 percent of people with type 2 diabetes have reported no regular physical activity and an additional 38 percent have reported less than recommended levels of physical activity. therefore, interventions to promote regular exercise behavior in people with type 2 diabetes are clinically important by potentially preventing type 2 diabetes-related complications. previous studies have investigated the impact of exercise counseling on exercise behavior in people with type 2 diabetes. however, these studies have limitations such as lack of agreement with exercise training guidelines for people with type 2 diabetes and research design flaws. this current study investigates the effect of a novel, physical therapist-directed exercise counseling combined with fitness center-based exercise training intervention on stage of exercise behavior in people with type 2 diabetes.

Eligibility criteria:
inclusion criteria: * type 2 diabetes * consider medically stable to participate by a physician exclusion criteria: * contraindication for exercise testing * uncontrolled hypertension * proliferative retinopathy * severe peripheral neuropathy * nephropathy * autonomic neuropathy * unable to participate due to a physical impairment * fasting plasma glucose greater than 250 mg/dl * involved in resistance or aerobic training on 2 or more days per week

Keywords: diabetes mellitus, type 2 exercise counseling behavior
effect of plyometric exercises on upper extremity function in children with unilateral cerebral palsy

Conditions: Sports Physical Therapy

Summary: plyometric training includes muscle contraction that moves rapidly from the eccentric to the concentric phase of movement while using proper biomechanics. it is an effective neuromuscular stimulus that can improve motor functions of children with cp. in plyometric training, muscles exert maximum force in short intervals of time, with the goal of increasing power.

this is a prospective double-masked randomized controlled trial.

Eligibility criteria:
inclusion criteria: - spastic hemiplegia exclusion criteria: - fixed deformities

Keywords: plyometric exercises unilateral cerebral palsy cerebral pslay hand grip strength upper extremity function selective motor control
intravenous versus perineural effect dexamethasone in interscalene nerve block with levobupivacaine

Conditions: Shoulder Pain

Summary: interscalene brachial plexus block can be used as an additive to general anaesthesia or as the primary anaesthetic for shoulder surgeries for pain management. the investigators compared the effect of perineural versus intravenous dexamethasone on the prolongation of the action of levobupivacaine in ultrasound guided interscalene block for shoulder and upper arm surgeries.

dexamethasone had been shown to prolong the duration of postoperative analgesia when given as an adjuvant for peripheral nerve blocks. the investigators compared the effect of perineural versus intravenous dexamethasone on the prolongation of the action of levobupivacaine in ultrasound guided interscalene block for shoulder and upper arm surgeries. the study hypothesized that adding perineural dexamethasone to levobupivacaine in ultrasound guided interscalene block may be more superior to adding intravenous dexamethasone to levobupivacaine and levobupivacaine alone in shoulder and upper arm surgeries as regard analgesic effect, duration of analgesia and hemodynamic stability.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists physical status grade i and grade ii. exclusion criteria: * patient refusal. * neuromuscular diseases (as myopathies, myasthenia gravies, ......) * hematological diseases, bleeding or coagulation abnormality. * psychiatric diseases. * local skin infection * sepsis at site of the block. * known intolerance to the study drugs. * body mass index \> 40 kg/m2 * contralateral phrenic palsy * pneumothorax * pneumectomy * severe copd
post-operative thoracic epidural analgesia and incidence of major complications: a large retrospective dual center experi-ence

Conditions: Neuropathic Pain; Chronic Pain; Thoracic Cancer

Summary: a retrospective observational dual center study investigating side effects and major complications after thoracic epidural insertion according to local safety protocols.

abstract: (1) background: thoracic epidural analgesia is considered the gold standard in post-operative pain management following thoracic surgery. this study was designed to explore the safety of thoracic epidural analgesia and to quantify the incidence of its post-operative side-effects in patients undergoing thoracotomy for major surgery, such as resection of lung malignancies and lung transplantation. (2) methods: this is a retrospective, dual-center observa-tional study implementing patients that underwent major thoracic surgery including lung trans-plantation and received concurrent placement of thoracic epidural catheters for postoperative an-algesia. an electronic system of referral and documentation of complications was used, and information was retrieved from our electronic critical care charting system. side effects such as nausea and vomiting , itching, catheter related issues and also major complications such as epidural haematoma, abscess, or permanent nerve damage were investigated. the study aims to highlight the importance of a solid documentation and recording system alongside with the implementation of safety protocols.

Eligibility criteria:
inclusion criteria: 1. all patients undergoing major thoracic surgery asa1-3 2. all patients undergoing lung transplantation exclusion criteria: 1. active bleeding 2. coagulopathy 3. high inflammatory markers 4. sirs 5. lack of patients' consent for throracic epidural insertion -
feasibility of rapid covid-19 testing in disadvantaged populations

Conditions: Coronavirus Disease (COVID-19)

Summary: the purpose of this study is to assess the feasibility of establishing severe acute respiratory syndrome coronavirus 2 (sars-cov-2) testing at a federally-qualified health center (fqhc) during a global health crisis to mitigate covid-19 disparities in socioeconomically disadvantaged populations.

accurate and early diagnosis of covid-19 infections are critical for rapid initiation of quarantine interventions to reduce population spread and to provide appropriate medical care to reduce related morbidity and mortality during the current pandemic. the purpose of this study is to assess the feasibility of establishing a drive-through rapid covid-19 testing site at a federally-qualified health center (fqhc) during a global health crisis to mitigate health consequences in socioeconomically disadvantaged populations. the investigators also seek to evaluate the effectiveness of community-driven communication in increasing access to rapid testing for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) in this population. this will inform public health decisions about improving access to testing for sars-cov-2 in underserved populations, particularly those receiving care in fqhcs or community health centers. the specific aims of the study are to: aim 1. to determine the feasibility of a community-engaged research partnership to support rapid sars-cov-2 testing for symptomatic patients of all ages in the underserved population during the covid-19 crisis. a rapid testing strategy (drive-through testing site) at a fqhc using mayo clinic laboratory (mcl) diagnostic processing will be piloted. aim 2. to compare the effectiveness of community-driven messaging in increasing uptake of rapid sars-cov-2 testing compared with usual sources of health information. a simple random sample will be drawn of fqhc patients (n=1000, age 18+) with 1:1 randomization of communication about covid-19 and availability of rapid testing from the fqhc versus usual sources (control).

Eligibility criteria:
inclusion criteria: * this study will include all patients receiving clinically indicated testing for covid-19 at a federally qualified health center (fqhc, open cities health center, st. paul, mn). * there will be no formal recruitment of patients in this research. exclusion criteria: -

Keywords: covid-19 testing community engagement community-based participatory research racial and ethnic minorities community health
hepatic vein-sparing hepatectomy for colorectal liver metastases at the caval confluence

Conditions: Secondary Malignant Neoplasm of Liver

Summary: major hepatectomies are generally selected for tumors involving the hepatic vein (hv) at the caval confluence (cc). as alternative, hv reconstruction has been proposed. the present study aimed to evaluate the feasibility and safety of a hv-sparing policy guided by intraoperative ultrasonography (ious) in a cohort of patients having at least one colorectal liver metastasis (clm) in contact with a hv at cc. hv section can be avoided in the large majority of cases thanking to clms detachment or to hv partial resection or reconstruction: this policy seems feasible, safe, reduces the need of major hepatectomies, and oncologically provides an adequate local control.


Eligibility criteria:
inclusion criteria: * diagnosis of at least one clm in contact with hv at caval confluence and hv patency at preoperative imaging * at least 6 months of follow-up after surgery exclusion criteria: * suspected or ascertained thrombosis or full tumoral involvement of hv at preoperative imaging * portal pedicle infiltration and/or thrombosis * unresectability at laparotomy for any extra-hepatic or intrahepatic reason not related to tumor-vessel relations
the effects of spiritual needs on spiritual well-being in patients with brain tumors: a structural equation modeling approach

Conditions: Brain Tumor

Summary: the aim of this study is to describe a patient's spiritual needs and related factors that contribute to a patient's spiritual well-being in the context of perioperative care. the primary objective of this study is to examine the fit of the structural equation model (sem) of the theory on spiritual well-being (swb) and explain how swb is affected by symptom burden (sb), psychological distress (psd), and spiritual needs (sn) reported by the patients with brain tumors before having surgery.

the aim of this study is to describe a patient's spiritual needs and related factors that contribute to a patient's spiritual well-being in the context of perioperative care. the primary objective of this study is: to examine the fit of the structural equation model (sem) of the theory on spiritual well-being (swb) and explain how swb is affected by symptom burden (sb), psychological distress (psd), and spiritual needs (sn) reported by the patients with brain tumors before having surgery. this study will address the following secondary objectives: 1. to examine bivariate relationships between sb, psd, and sn. 2. to explore effects of patients' spirituality on the relationship between patients' sn and swb. this study is not powered to test hypotheses concerning the secondary objectives but will specifically examine through descriptive statistics and confidence intervals the following: 1. sn, psd, and sb are positively correlated with each other. 2. sn negatively influences swb. 3. sn positively influences spirituality. 4. spirituality positively influences swb.

Eligibility criteria:
inclusion criteria: * outpatients at mdacc who are 18 years or older; * are being/have been seen at the md anderson neurosurgery clinic; * have a diagnosis of a primary or metastatic intracranial or skull-based brain, pituitary, or meningeal lesions; * are scheduled to undergo surgical intervention. exclusion criteria: * have preferred language listed other than english on the chart; * present with cognitive functional impairment, evidence of expressive or receptive aphasia, or gross dysfunction limiting memory or ability to complete a self-report questionnaire, which will be determined by reviewing provider's notes; * refusal to participate in research.