Kornimate/medical-research-clean huggingface dataset:
evaluation of nephrectomy specimen for intracranial aneurysm development in adpkd

Conditions: Kidney Transplant; Complications; Aneurysm, Brain; Polycystic Kidney Diseases

Summary: adpkd is the most common form of hereditary kidney disease and is known to occur in 1 of 400 to 1000 population in the u.s. adpkd consists of 2.8% of patients receiving kidney transplantation in the investigator's center. it is known that adpkd is associated with vascular anomalies, including abdominal aneurysms, valvular anomalies and especially intracranial aneurysms. intracranial aneurysms occur in 9\~12% of the adpkd population which is higher than 2\~3% in the general population and is known to be associated with pkd1 or pkd2 heritage. until now, most of the studies regarding intracranial aneurysms in adpkd are conducted in animal models, and there are only few cellular studies conducted from human samples. total 154 patients received kidney transplantation for adpkd from 1994 to december 2018 at asan medical center, seoul, korea. while performing kidney transplantation to esrd adpkd patients, nephrectomy has been routinely performed for polycystic kidney and the nephrectomy specimens can be obtained. the objective of this study is to investigate the mechanism of intracranial aneurysm in adpkd patients by analyzing gene characteristics from nephrectomy specimens.

adpkd is associated with pkd1 gene on chromosome 16 and pkd2 gene on chromosome 4 and these gene respectively code polycystin 1 and polycystin 2. currently the hypotheses for increased intracranial aneurysm rate in adpkd patients is that mutation of polycystin is not only confined to nephron tissues but also in endothelial cells and vascular smooth muscle cells and results in mutation of vascular phenotype. also recent studies show polycystin complex causes cystic changes through mutation in primary cilia in renal epithelium. wild type endothelial cells respond to fluid shear stress by regulating levels of intracellular calcium and nitric oxide, however, pkd1 or pkd2 mutation in fetal aortic endothelial cells revealed loss of these responses. during kidney transplantation, bilateral nephrectomies are routinely performed to adpkd patients. in this study, the investigators plan to perform pkd gene tests and gene sequencing from polycystic kidney nephrectomy specimens of154 adpkd patients who received kidney transplantation at asan medical center between 1994 and 2018. the aim of this study to analyze the gene mutation of adpkd patients and investigate mechanisms associated with intracranial aneurysm occurence in adpkd patients.

Eligibility criteria:
inclusion criteria: * adult patients between age 18 and 80, * patients who received kidney transplantation for adpkd at asan medical center between 1994 and 2018, * patients who received nephrectomy for polycystic kidney exclusion criteria: * those who refuse or are unable to provide consent form, * pregnancy
epidemiological study of chronic thromboembolic pulmonary hypertension in china

Conditions: To Assess the Long-term Risk for Adverse Events After PE.

Summary: chronic thromboembolic pulmonary hypertension (ctph) is associated with considerable morbidity and mortality. its incidence after pulmonary embolism and associated risk factors are not well documented in chinese population. we conducted a prospective, long-term, follow-up study to assess the incidence of symptomatic ctph in consecutive patients with an acute episode of pulmonary embolism but without prior venous thromboembolism. patients with unexplained persistent dyspnea during follow-up underwent transthoracic echocardiography and, if supportive findings were present, ventilation-perfusion lung scanning and pulmonary angiography. ctph was considered to be present if systolic and mean pulmonary-artery pressures exceeded 40 mm hg and 25 mm hg, respectively; pulmonary-capillary wedge pressure was normal; and there was angiographic evidence of disease.


Eligibility criteria:
inclusion criteria: * patients with an episode of acute symptomatic pulmonary embolism without prior pulmonary embolism or venous thrombosis exclusion criteria: * have other diseases (e.g., systemic sclerosis or severe emphysema) that could have caused nonthromboembolic pulmonary hypertension, * have preexisting exertional dyspnea, * geographically inaccessible for follow-up, * decline to participate in the study.
evaluation of whether functional strength training can enhance recovery of mobility after stroke

Conditions: Stroke

Summary: the purpose of this study is to test the hypothesis that adding functional strength training to uk conventional therapy improves muscle function and walking than either uk conventional therapy alone or increased intensity of uk conventional therapy

neuromuscular weakness occurs frequently after stroke and the processes underlying recovery are still poorly understood. accepted practice in uk physiotherapy is to avoid training of muscle strength after stroke but there is preliminary evidence that it might be effective. an observer-blind randomised clinical trial. subjects will be within 3 months of first stroke with some voluntary movement in the paretic lower limb. a power calculation estimated the sample size as 300. research physiotherapists, blinded to measurement, will recruit subjects, allocate subjects to one of the three intervention groups using sequentially numbered sealed envelopes containing previously randomised allocated intervention cards and provide interventions. the research assessors, blinded to intervention allocation will undertake all measurements. conventional therapy (control) will be provided as normal for the clinical setting, the additional conventional therapy (experimental 1) or functional strength training (experimental 2) will be provided for one hour, four times a week, for six weeks. subjects in the two experimental groups will also receive the conventional therapy standard in their clinical setting. blinded measurement will be made before randomisation, at the end of intervention and 12-weeks thereafter. primary outcomes are maximum torque around the knee joint, and gait velocity. the secondary outcomes include movement analysis, functional ability, corticospinal transmission (transcranial magnetic stimulation) and health related quality of life (euroqol). the primary analysis will be analysis of covariance. a multiple comparison procedure (gabriel's test) will be used to compare each pair of treatments. euroqol data will be used to estimate the relative costs of the interventions and to calculate the incremental cost per qualy gained. every effort will be made to invite patients for assessment at outcome and follow-up even if they have withdrawn from therapy to allow the intention-to-treat principle to be applied.

Eligibility criteria:
inclusion criteria: subjects in this study will: * be aged over 50 years. * be between one week and three months after stroke when recruited to the study; * have been independently mobile indoors, with or without aids, before the stroke; * have some voluntary movement in the paretic lower limb i.e. score above 28/100 on the lower limb section of the motricity index43; * demonstrate adequate orientation and communication (be able to complete a one-stage command using the non-paretic upper limb e.g. point at the ceiling). in addition those who agree to participate in tms measurement will have no contraindications to tms.

Keywords: stroke rehabilitation physical therapy
the association between psoriasis and intestinal bacterial population

Conditions: Psoriasis

Summary: at least 20 psoriasis patients will be compared to at least 20 participants without psoriasis bacterial genomic dna will be extracted from stool samples of participants. the intestinal bacterial populations will be compared in order to examine whether there are differences between the groups.

intestinal bacterial population has a significant influence on health and sickness conditions. it affects the development and the function of the immune system (th2, th1 or th17) by bacterial protein expression and by the composition of the bacterial population. psoriasis is an immune related dermal disease. the trigger for this disease is currently unknown but, it is possible that intestinal bacteria are a factor in its development. study design: participants will be divided into 3 groups: * psoriasis patients treated with topical medications * psoriasis patients treated with iv or sub-cutaneous medications (e.g biological medications) * healthy participants (control group) bacterial genomic dna will be extracted from stool samples of participants. the intestinal bacterial populations will be compared in order to examine whether there are differences between the groups.

Eligibility criteria:
inclusion criteria: * dermal psoriasis patients diagnosed by a dermatologist. exclusion criteria: * treatment with antibiotics or probiotics within the prior 3 months. * incapable of signing an inform concent.

Keywords: psoriasis microbiota
the swedish study of liver transplantation for non-resectable colorectal cancer metastases

Conditions: Colorectal Cancer; Liver Metastases; Colorectal Liver Metastases

Summary: to evaluate if the addition of liver transplantation primarily utilizing liver grafts from extended criteria donors not utilized for approved indications to conventional treatment of non-resectable/ non-abatable colorectal liver metastases (clm) increases overall survival compared to best alternative care.


Eligibility criteria:
inclusion criteria: * patients with non-resectable, non-ablatable liver metastases from colorectal adenocarcinoma. * male or female 18 years or above. * primary tumour removed with an r0 resection, and histologically verified adenocarcinoma from colon or rectum * liver metastases measurable by mri or ct according to recist version 1.1 imaging within 4 weeks prior to inclusion. * no signs of extrahepatic metastatic disease or local recurrence according to mri and ct of thorax/abdomen and whole body positron-emission tomography (pet)/ computed tomography (ct) scan. * a colonoscopy performed within the last 12 months in order to exclude multifocal colorectal cancer (crc) tumours. * eastern cooperative oncology group (ecog) performance status of 0 or 1. * satisfactory blood tests: hb ≥ 90 g/l (transfusions are permitted to achieve baseline hemoglobin level), white blood cell count (wbc) \>3,0x109/l, absolute neutrophil count (anc) ≥ 1.5 × 10\^9/l, platelet count (plt) \>75, bilirubin\<2 x upper normal level, aspartate aminotransferase (asat), alanine aminotransferase (alat)\<5 x upper normal level, calculated creatinine clearance ≥ 50 ml/min(mdrd). * received at least 2 months of chemotherapy with no signs of progressive disease according to recist-criteria at the last evaluation before randomization. * one year or more from the initial crc diagnosis to the date of inclusion in the study * patient accepted for transplantation by a national study board * signed and dated written informed consent before the start of specific protocol procedures. exclusion criteria: * evidence of extrahepatic disease by pet-ct or ct-thorax/abdomen. * pregnant or breast-feeding patients. women of childbearing potential must have a negative pregnancy test performed within seven days prior to the start of study. * weight loss \>10% the last 6 months * other malignancies within the last 5 years, except crc and low risk tumours such as basaliomas. \* liver metastases larger than 10 cm. * pathological lymphatic nodes in the abdomen. if a patient has pathological lymphatic nodules in the hepatoduodenal ligament, a staging operation with histo-pathological examination from the nodules with no signs of tumour cell involvement has to be performed before inclusion. * braf (a gene that encodes a protein called b-raf) mutation in primary tumour * microsatellite instability (msi-h) in primary tumour * previous organ transplantation

Keywords: colorectal cancer liver metastases liver transplant non-resectable colorectal cancer metastases
respiration validation for cpm device

Conditions: Cardiopulmonary Disease

Summary: this study is designed to be a clinical validation study to ready the cpm system for fda 510(k) submission. this study will be conducted as a prospective non-randomized. the study is non-significant risk since the cpm device is noninterventional and noninvasive. the study is primarily designed to validate the accuracy of the respiration rate and the changes in relative tidal volume. all participants will be fitted with both the cpm device as well as reference devices (capnography and ecg). participants will be randomized between 4 procedures (a-d) which will determine the order of 10 exercises. each exercise has about 2 minutes of device recording and two minutes of rest. each exercise contains two positions: sitting up for one minute and lying down for one minute. for some exercises, the participant will be instructed to breathe at a certain rate (assisted by a metronome). for other exercises, the participants will breathe at a normal rate but change how deep the are breathing. for the last, all capnography reference devices will be removed, and an ecg reference device will be placed. after exercise 18, the participant will have all devices removed and the study visit will terminate. the participant will receive a safety follow-up call about 1 week after their visit.


Eligibility criteria:
inclusion criteria: * adults over the age of 18 and who are willing and able to give informed consent * willing and able to participate in all activities related to this study, including trimming chest hair and wearing a reference device and the cpm wearable device * volunteers of any race, any gender * range of physiques * healthy exclusion criteria: * injury or skin disturbance in the area of the test device * allergies or sensitivities to silicone/acrylic-based adhesive * pregnant * currently smokes cigarettes * has known respiratory conditions that might prevent them from following the study procedure such as: * flu * pneumonia/bronchitis * shortness of breath/respiratory distress * respiratory or lung surgery * emphysema, copd, lung disease * has self-reported heart or cardiovascular conditions such as chest pain, afib, chf, cardiomyopathy, or other conditions that could interfere with cardiopulmonary function * has other self-reported health conditions that could interfere with the breathing patterns and exercises detailed in the protocol (including wearing a capnography mask)
cognitive reserve-building activities in multiple sclerosis

Conditions: Multiple Sclerosis

Summary: the study is a crossover randomized controlled trial investigating the effect of increasing engagement in cognitive leisure activities for individuals with multiple sclerosis.

the study is a crossover randomized controlled trial investigating the impact of cognitive leisure activities on the cognitive functioning of individuals with multiple sclerosis (ms). the goal is to investigate whether increasing leisure activities may help prevent cognitive impairment in individuals with ms. the trial consists of two studies. the first is a randomized controlled trial examining the effects of increasing engagement in cognitive leisure activities. the second is a qualitative interview-based study to identify factors that may improve adherence and acceptance of the intervention. the study employs a randomized, controlled crossover design, with 60 participants (30 with relapsing-remitting ms, 30 with progressive ms) assigned to either an intervention group or a passive control group for 12 weeks. after the initial 12 weeks the groups are crossed over and followed up after an additional 12 weeks. the intervention group will receive instruction and support to engage in cognitive leisure activities, while the control group will continue with their usual daily activities. for a detailed description of the project, the full protocol can be found at: https://dmsc.dk/onewebmedia/crams%20research%20protocol.pdf

Eligibility criteria:
inclusion criteria: * rrms, spms or ppms * age 18-65 * edss score ≤ 6.5 * sdmt (or pasat) score below -1 sd * no depression based on the mdi * able to use computer or smartphone and has internet access * if in treatment with one or more of the following medications, the dosage must be stable: * cannabinoids * anticholinergic medications * sedatives e.g., benzodiazepines * opioids * antispasmodics * beta-blockers * antidepressant medication * fampridine exclusion criteria: * planned start-up or discontinuation of one or more of the above-mentioned medications * structural brain changes following previous head trauma or neurological conditions other than which lead to structural changes or affect cognitive abilities * epilepsy * significant psychiatric co-morbidity * significant somatic co-morbidity including, but not limited to, severe cardiovascular disease as well as liver, kidney, and endocrine diseases * relapse 3 months prior to inclusion

Keywords: cognition multiple sclerosis cognitive rehabilitation cognitive reserve cognitive leisure activities leisure activities intellectual enrichment relapsing-remitting multiple sclerosis secondary progressive multiple sclerosis progressive multiple sclerosis
effectiveness of the astym technique, the graston technique, and therapeutic ultrasound in the treatment of lateral epicondylosis.

Conditions: Lateral Epicondylitis; Tennis Elbow; Posterolateral Rotator Instability

Summary: the purpose of this study is to examine the effectiveness of three common techniques for the treatment of lateral epicondylosis. through objective and subjective assessments this study will determine the effectiveness of the astym treatment technique, the graston treatment technique, and therapeutic ultrasound in the conservative treatment of lateral epicondylosis. it is hypothesized that the more manual astym technique and graston technique will produce more significant results than the more frequently utilized ultrasound.


Eligibility criteria:
inclusion criteria: * clients who are admitted to nyulmc center for musculoskeletal care for outpatient occupational or physical therapy with a diagnosis of lateral epicondylosis will be included. to participate in the study participants must: * be able to follow a home exercise program * be able to consent to participation in the research study exclusion criteria: * clients who are deemed unable to consent to participation in the research study and/or unable to following a home exercise program will not be included in this study * clients with additional acute orthopedic injuries and/or surgeries to the involved upper extremity will not be included in this study. * clients with open wounds of the involved upper extremity that will interfere with treatment techniques will not be involved in this study.

Keywords: extensor carpi radialis brevis therapeutic ultrasound astym treatment technique graston treatment technique
a safety study of sunitinib in combination with pemetrexed in patients with advanced solid malignancies

Conditions: Neoplasm, Malignant

Summary: this study will assess if the combination of sunitinib and pemetrexed is tolerable when coadministered at each recommended dose/schedule.


Eligibility criteria:
inclusion criteria: * patients with a diagnosis of a solid malignancy that is refractory to standard therapy or for which no standard therapy exists. * patients has a good performance status (ecog 0 or 1) exclusion criteria: * prior treatment with either pemetrexed or su011248. * coughing up blood within 4 weeks before starting study treatment (small amounts okey). * hypertension that cannot be controlled by medications.

Keywords: solid tumor malignancy sunitinib pemetrexed phase 1 neoplasms
study on the long-term risk of recurrence of anoperineal fistula in crohn's disease

Conditions: Crohn Disease

Summary: this research aims to evaluate the long-term recurrence risk of perianal fistulas in crohn's disease patients who have undergone treatment with anti-tnf therapy and seton drainage.the research seeks to identify factors influencing recurrence and assess the long term effectiveness of these treatments in preventing fistula recurrence. this study will provide insights that could enhance treatment strategies and improve patient outcomes.

scientific justification : ● perianal fistulas are a common and challenging complication of crohn's disease, significantly impacting patient quality of life. infliximab, an tnfα antagonist has shown its efficacy in inducing remission of these fistulas. seton drainage is often used alongside anti-tnf therapy to promote fistula healing and prevent abscess formation. however, data with long term follow up are still lacking on the impact of these treatments. understanding the long-term outcomes of these combined treatments is crucial for optimizing therapeutic strategies and improving patient management. treatment strategy : ● the treatment involves administering infliximab to control inflammation and promote fistula closure, along with seton drainage to maintain fistula patency and prevent abscesses, ensuring continuous drainage and reducing infection risk. follow-up description : ● patients are monitored retrospectively through medical records for a period ranging from several months to years, assessing recurrence rates and potential predictors of recurrence. follow-up includes regular clinical evaluations, biological evaluations (blood test and fecal calprotectin), colonoscopy, imaging studies such as mri, and patient-reported outcomes to gather comprehensive data on the long-term efficacy and safety of the combined treatment approach.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of crohn's disease * drainage of an anal fistula with seton combined with the initiation of anti-tnf alpha treatment * patient who was treated in the digestive center of the toulouse university hospital for drainage of an anal fistula between january 1, 2000 and december 31, 2010 exclusion criteria: patient followed less than 6 months after seton drainage

Keywords: perianal fistula anti-tnf seton drainage inflammatory bowel disease
a phase i clinical study of shr-2005 intravesical instillation in the treatment of intermediate and high-risk non-muscle invasive bladder cancer (nmibc)

Conditions: Intermediate and High-risk Non-muscle Invasive Bladder Cancer

Summary: this study is an open-label, multicenter phase i clinical trial to evaluate the safety, tolerability, pharmacokinetics and efficacy of shr-2005 for intravesical perfusion in patients with intermediate and high-risk non-muscle invasive bladder cancer.


Eligibility criteria:
inclusion criteria: 1. subjects must voluntarily agree to participate in the trial and sign a written informed consent form; 2. ≥18 years of age, either sex; 3. previous pathological biopsy was diagnosed as intermediate or high-risk nmibc ; 4. ecog performance status of 0-1; 5. life expectancy ≥ 2 years; 6. adequate bone marrow and organ function. exclusion criteria: 1. received turbt or other surgical treatment or radiotherapy for bladder lesions within 2 weeks before the first administration; 2. patients who were receiving treatment in other clinical trials or less than 4 weeks from the end of the first administration in this study; 3. history of serious cardiovascular and cerebrovascular diseases; 4. severe infection within 2 weeks prior to the first dose; 5. adverse reactions of previous anti-tumor treatment have not recovered to grade ≤ 1 per nci-ctcae v5.0; 6. oversize surgery or severe trauma within 4 weeks before the first use of research drugs; 7. previously received any tnfr agonist antibody therapy, such as ox40, cd137, cd27, cd357 antibodies.