Kornimate/medical-research-clean huggingface dataset:
iressa versus docetaxel (taxotere)

Conditions: Non-Small-Cell Lung Carcinoma

Summary: the purpose of this study is to compare the effects of zd1839 or docetaxel in patients with advanced non-small cell lung cancer (nsclc) that has recurred or progressed after receiving prior treatment with platinum-based chemotherapy.


Eligibility criteria:
inclusion criteria: * measurable (uni dimensional) disease by recist criteria in a lesion not previously irradiated or non measurable disease * locally advanced or metastatic nsclc, not amenable to curative surgery or radiotherapy * advanced non-small cell lung cancer (nsclc) that has recurred or progressed after receiving prior treatment with platinum-based chemotherapy * who performance status (ps) 0-2 * absolute neutrophil count (anc) \>1.5 x 109/liter (l) and platelets \>100 x 109/l * life expectancy of at least 8 weeks exclusion criteria: * prior zd1839 therapy * prior docetaxel treatment for nsclc * less than 14 days since completion of prior radiotherapy * less than 21 days since prior chemotherapy, immunotherapy or biological systemic anticancer therapy * evidence of clinically active interstitial lung disease * other co-existing malignancies or malignancies diagnosed within the last 5 years with the exception of basal cell carcinoma or cervical cancer in situ * newly diagnosed cns metastases that have not yet been treated with surgery and/or radiation. patients with previously diagnosed and treated cns metastases or spinal cord compression may be considered if they have evidence of clinically sd (no steroid therapy or steroid dose being tapered) for at least 28 days * patients with pre existing peripheral neuropathy \>= grade 2 (nci ctc criteria)

Keywords: non-small-cell lung cancer
comparison of femoral versus jugular routes for temporary hemodialysis in seriously ill patients

Conditions: Kidney Failure, Acute; Critical Illness

Summary: the purpose of this study is to determine whether a jugular route leads to a lower rate of complications as compared with a femoral route for catheterization in patients admitted in several intensive care units in france who develop acute renal failure requiring hemodiafiltration or hemodialysis.


Eligibility criteria:
inclusion criteria: * admitted in intensive care unit (icu) * requiring hemodialysis * clinicians have the choice between jugular and femoral routes exclusion criteria: * chronic renal failure requiring long term dialysis

Keywords: dialysis hemodialysis catheterization
reflexive coughing force in severe aspirators

Conditions: Stroke

Summary: to assess coughing force during reflex coughing test in those with severe dysphagia and severe aspiration and compare them to than those with stroke patients with no signs of dysphagia/aspiration.

severe aspiration with a compromised cough function can be a risk factor of aspiration pneumonia. reflexive coughing can be tested by administration of citric acid via a nebulizer. the objective of this study is to measure the cough force produced via citric acid inhalation challenge, and determine if those with severe aspiration with severe dysphagia have more weak cough force during reflexive cough testing that those post-stroke patients with no signs of aspiration or dysphagia after stroke. we also aimed to measure the strenght of the respiratory measures with the use of surface emg.

Eligibility criteria:
inclusion criteria: * confirmed stroke lesions * confirmed aspiration during vfss or fees examinations exclusion criteria: * episode of acute pneumonia or pulmonary embolism at time of enrollment * previous history of chronic respiratory disorders or other systemic disorders that may affect respiratory function ( ex, rheumatoid disease, spinal cord injury) * stroke patients with multiple brain lesions * episode of diaphragm weakness due to peripheral polyneuropathy or unilateral phrenic nerve palsy * previous episode of abdominal or thoracic surgery within one year of enrollment * concomitant diagnosis of myopathy, muscular dystrophy or other disorders that may affect respiratory muscles. * episode of rib fracture within one year of enrollment * chronic alcoholism * patient with previous diagnosis of dementia or with impaired cognitive function that may limit full participation at the evaluation * patient with tracheostomy state

Keywords: stroke deglutition disorders cough aspiration pneumonia diaphragm respiratory function
a randomised trial investigating the additional benefit of hydroxychloroquine(hcq)to short course radiotherapy (scrt) in patients aged 70 years and older with high grade gliomas (hgg)

Conditions: Glioblastoma

Summary: there is emerging evidence that hydroxychloroquine (hcq), a drug used commonly in the prevention/ treatment of malaria, rheumatoid arthritis and lupus erythematosus, may improve survival outcome in a variety of cancers including hgg, with few side effects. in this trial the investigators wish to investigate whether treatment with radiotherapy and hydroxychloroquine is more effective than treatment with radiotherapy alone.


Eligibility criteria:
inclusion criteria: * male and female patients aged ≥70 yrs identified through the neurooncology mdt. * a histological diagnosis of hgg, either from biopsy or resection. * a life expectancy of \> 2 months * an ecog performance status of 0/1 * absolute neutrophil count ≥ 1.5 x 109 * platelet count ≥ 100 x 109 * bilirubin ≤ 1.5 mg/dl (or ≤ 25.6 µmol/l) * creatinine ≤ 2 times upper limit of normal (uln) * alt and ast ≤ 4 times uln * mini mental status exam score ≥ 17 (appendix 10) * written informed consent * ready to start radiotherapy within 4 weeks of surgery exclusion criteria: * concurrent psoriasis unless the disease is well controlled and patient is under the care of a specialist for the disorder who agrees to monitor for exacerbations * prior macular degeneration or diabetic retinopathy * concurrent serious infection or medical illness that would preclude study therapy * another malignancy within the past 5 years except for curatively treated carcinoma in situ or basal cell carcinoma of the skin * porphyria * glucose- 6 phosphate dehydrogenase (g6pd) deficiency * alcoholic liver disease * any other concurrent severe/uncontrolled medical conditions * currently taking amiodarone * prior radiotherapy, chemotherapy, immunotherapy, biologic agents (e.g., immunotoxins, immunoconjugates, antisense agents, peptide receptor antagonists, interferons, interleukins, tumour-infiltrating lymphocytes, lymphokine-activated killer cell therapy, or gene therapy), or hormonal therapy for brain tumour * prior polifeprosan 20 with carmustine implant (gliadel wafer) or gliasite® brachytherapy * concurrent cytochrome p450 enzyme-inducing anticonvulsant drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, or oxcarbazepine) * other concurrent chemotherapeutic or investigational agents for this cancer (concurrent glucocorticoids will be allowed * documented side effects to chloroquine or related agents. * unable to give informed consent * patients with a history of a psychological illness or condition that in the opinion of the investigator may adversely affect compliance with study medication
comparison of recurrence rate of keloid after excision between intra-operative steroid injection and steroid with platelet-rich plasma injection combination therapy

Conditions: Patients With Keloid Scar

Summary: keloid scars are benign skin lesions characterized by excessive collagen deposition, and their treatment remains challenging due to a high recurrence rate even after surgical excision. combination therapies have been shown to be more effective than monotherapy. a common approach for treating recurrent keloids is surgical excision followed by intralesional corticosteroid injection; however, recurrence rates remain substantial. this study was conducted to evaluate the recurrence rate of keloid scars following surgical excision combined with intralesional corticosteroid and platelet-rich plasma (prp) injection, compared to corticosteroid injection alone administered intraoperatively.


Eligibility criteria:
inclusion criteria: * aged 18 years or older * having keloid scars less than 10 centimeters in length * undergoing complete keloid excision (extralesional excision) * undergoing surgery under local anesthesia exclusion criteria: * patients currently receiving immunosuppressive drugs or systemic steroids * patients with chronic diseases under active treatment, such as tuberculosis * pregnant or breastfeeding women * patients likely to have poor treatment adherence, such as those with cancer, epilepsy, or psychiatric disorders * patients with vascular diseases or hematologic/coagulation abnormalities

Keywords: keloid steroid triamcinolone platelet rich plasma prp
antibody-mediated nmda receptor encephalitis: symptoms, biomarkers, and mechanisms of the prolonged recovery stage

Conditions: Anti-NMDA Receptor Encephalitis

Summary: the encephalitis mediated by antibodies against the nmda receptor (nmdare) predominantly affects young adults and children resulting in severe neurologic and psychiatric deficits. after overcoming the acute stage, patients are left with long-lasting behavioral, cognitive, and psychiatric alterations with important socio-family-economical implications. here investigators postulate that a better knowledge of this stage will improve treatment decisions and outcome. in aim 1, the post-acute stage will be clinically characterized, tools to remotely follow cognitive, behavioral and psychiatric deficits will be provided, and the impact of cognitive rehabilitation will be assessed. in aim 2, biomarkers (autoimmune, inflammatory, neuronal injury) will be identified as signatures of the acute and post-acute stages. in aim 3, a mouse model of nmdare will be used to determine the underlying mechanisms and treatment of the postacute stage.


Eligibility criteria:
inclusion criteria: * patients ≥12 years old with nmdare in the post-acute stage of the disease; * ≤6 months from hospital discharge (acute phase) exclusion criteria (one of the following): * inability to obtain informed consent; * inability to travel to the center.

Keywords: cognitive impairment encephalitis autoimmune cognitive rehabilitation
early versus late application of stn dbs to pd patients with motor complications

Conditions: Parkinson Disease

Summary: although deep brain stimulation of the subthalamic nucleus(stn dbs) has become the surgical treatment of choice for parkinson's disease(pd), a consensus on the timing of surgery is lacking. this study is intended to demonstrate that early, compared with delayed, introduction of stn dbs is more beneficial for pd patients who have developed motor complications.

in this prospective study, 200 pd patients will be recruited for stn dbs over three years, including 133 with motor complications existing for more than three years (late complication group) and 67 less than three years (early complication group). to make a comparison of therapeutic efficacy between the two groups, motor and non-motor symptoms will be assessed using specific rating scales and questionnaires.

Eligibility criteria:
inclusion criteria: * idiopathic parkinson's disease with good response to levodopa(i.e. more than 30% improvement in the mds-updrs part iii score after an acute levodopa challenge) * presence of fluctuations and/or dyskinesias * age ranging from 18 to 75 years old * normal brain mri * absence of dementia (mini mental state examination ≥ 26) * absence of severe psychiatric diseases * written informed consent exclusion criteria: * presence of severe metabolic diseases * severe cardiac/respiratory/renal/hepatic diseases * secondary parkinsonism or multiple system atrophy * illiteracy or insufficient language skills to complete the questionnaires * poor compliance and unreasonable expectation * women who are pregnant or breast feeding * simultaneous participation in another clinical trial

Keywords: parkinson disease deep brain stimulation subthalamic nucleus motor complication quality of life
effect of backward walking training vs forward walking training to improve balance and mobility in children with cp

Conditions: Cerebral Palsy

Summary: children with cerebral palsy frequently experience balance issues and gait impairments; gait training is a crucial component of their rehabilitation because it greatly enhances the children's socialisation and quality of life.

since there is no known cure for cerebral palsy, the focus of treatment is shifting to enhancing activities like walking and self-care. enabling the child with cerebral palsy is the ultimate goal of therapy.

Eligibility criteria:
inclusion criteria: * only cp patients will be included. * patient will be included from bahawalpur only. * patient will be included having minimum age of 10 year. exclusion criteria: * other cities patient will not be included. * patient less than 10 years age. * patient suffering from other neurological conditions.
periarticular injection versus popliteal block

Conditions: Foot Surgery; Ankle Surgery

Summary: this study aims to determine the effectiveness and safety of two standard of care perioperative procedures for controlling pain following ankle and hindfoot osteotomy or fusion or ankle fracture repair.

this is a prospective, randomized, controlled research study of two perioperative standards of care for managing post operative pain. the first standard of care procedure is the periarticular injection; the second is the popiteal block.

Eligibility criteria:
inclusion criteria: * ankle or hindfoot osteotomy or ankle fracture repair * surgery scheduled at campbell surgery center (1410 brierbrook road, germantown, tn 38138) * 18-80 years of age * asa i-iii with medical clearances as needed * fluent ub verbal and written english * willing and able to comply with study instruction and commit to all follow-up visits for theduration of the study * willing and able to provide written consent exclusion criteria: * diagnosed with chronic pain syndrome * history of allergic reactions to lidocaine, marcaine, experal, bupivicaine, or other injectable anesthetic agents * injury associated with workers' compensation * surgery to be performed at a hospital * diagnosed with peripheral neuropathy * hbg a1c is \> 7 mg/dl in diabetic patients only * long term (chronic) preoperative narcotic usage
adx48621 for the treatment of levodopa induced dyskinesia in patients with parkinson's disease

Conditions: Parkinson's Disease

Summary: the primary objective of the study is to evaluate the safety and tolerability of adx48621 in parkinson's disease patients following four weeks of dosing. the secondary objectives of the study include the evaluation of the efficacy of adx48621 compared with placebo in reducing levodopa induced dyskinesia in patients with parkinson's; the evaluation of the effect of adx48621 on symptoms of parkinson's disease and patient ability to function, and the evaluation of the effect of coadministration of adx48621 on l-dopa efficacy.

first study of adx48621 in male and female parkinson's disease patients with levodopa-induced dyskinesia. four weeks, double-blind, placebo-controlled dose titration from 50 mg once daily up to 100 mg three times daily, at the start of week 4. safety and tolerability assessed by adverse events enquiry, heart rate and blood pressure, 12-lead ecg, haematology and biochemistry. efficacy assessments include abnormal involuntary movement scale (aims), unified parkinson's disease rating scale (updrs) patient pd symptom diaries, hospital anxiety depression scale (hads), patient and clinician global impression of change in pd and dyskinesia (pgic and cgic).

Eligibility criteria:
inclusion criteria: * outpatient with idiopathic pd according to the uk parkinson's disease society brain bank clinical diagnosis criteria (ukpdsbbcdc) * experiences moderately disabling dyskinesia (screening visit updrs 33 score≥2) * has an maims score at baseline ≥ 7 with a score ≥ 3 in at least one body area exclusion criteria: * surgical treatment for parkinson's disease (e.g. deep brain stimulation, within the last year or planned during the study) * unstable co-existing psychiatric disease including cognitive impairment that, according to the investigator, could interfere with the conduct of the study * has a history of a significant medical condition that may affect the safety of the patient or preclude adequate participation in the study. * is pregnant or breast-feeding. female patients who are of child-bearing potential must be using adequate contraceptive methods (e.g. oral contraceptive, double-barrier method, intra-uterine device, intra-muscular hormonal contraceptive), and have a negative pregnancy test at screening other protocol-defined inclusion and exclusion criteria may apply

Keywords: dyskinesia parkinson's disease
echocardiographic and arterial pressure waveform changes after reducing heart rate with esmolol in septic shock patients

Conditions: Tachycardia; Septic Shock

Summary: clinical study suggests that beta-blockers by decreasing heart rate together with an increase in stroke volume do not negatively affect cardiac output allowing an economization of cardiac work and oxygen consumption in patients with septic shock. whether this hemodynamic profile leads to an amelioration of myocardial performance is still unclear. the objective of the present study is therefore to elucidate whether a reduction in heart rate with esmolol is associated to an improvement of cardiac efficiency in patients with septic shock who remained tachycardic after hemodynamic optimization.

after 24-36 hours of initial hemodynamic stabilization, 44 septic shock patients with heart rate \> of 95 bpm and requiring norepinephrine to maintain mean arterial pressure (map) between 65 and 75 mmhg despite adequate volume resuscitation,will receive a continuous esmolol infusion to maintain heart rate between 94 and 80 bpm. norepinephrine will be titrated to achieve a map between 65 and 75 mmhg. to investigate myocardial performance, we will simultaneously assess lv ejection fraction (lvef), tricuspidal annular plane solid excursion (tapse) by echocardiography, the dp/dt max and the cardiac cycle efficiency (cce) both estimated from the arterial pressure waveform. finally we will analyze changes in static arterial elastance. data will be obtained at baseline and after four hours once achieved the predefined heart rate threshold.

Eligibility criteria:
inclusion criteria: * septic shock criteria * presence of heart rate \> 95 bpm. exclusion criteria: * pregnancy * age \< 18

Keywords: septic shock esmolol tachycardia betablockers
maraviroc-based gvhd prophylaxis in hla-unrelated and hla-mismatched related transplantation

Conditions: Graft-versus-host Disease; Hematopoietic Stem Cell Transplantation

Summary: hla-mismatched unrelated donor (mmud) and hla-haploidentical donor (haplo donor) hematopoietic stem cell transplantation (hsct) is associated with increased graft-versus-host-disease (gvhd) and impaired survival. the chemokine receptor 5 (ccr5) antagonist maraviroc has immunomodulatory properties potentially beneficial for gvhd control as it can blockade lymphocyte chemotaxis without impairing t-cell function. the aim of this study is to evaluate the safety and efficacy of maraviroc combined with standard graft-versus-host-disease prophylaxis in patients with hematologic malignancies after allogeneic stem cell transplantation from hla-unrelated or hla-mismatched related donors. based on the results of our previously small sample study with maraviroc combined with cyclosporine/tacrolimus and methotrexate for prophylaxis of gvhd, the investigators plan to perform the clinical trail.


Eligibility criteria:
inclusion criteria: 1. age 12-65 years (patient is older than 12.0 and less than 66.0 years old) 2. patients with acute leukemia, myelodysplastic syndrome or lymphoma who scheduled to undergo allogeneic stem-cell transplantation from hla-unrelated or hla-mismatched related donors 3. renal function: estimated creatinine clearance greater than 40 ml/minute (using the cockcroft-gault formula and actual body weight) 4. hepatic function: baseline direct bilirubin, alanine aminotransferase (alt) lower than three times the upper limit of normal 5. pulmonary disease: forced vital capacity (fvc) or forced expiratory volume at one second (fev1) \> 40% predicted 6. cardiac ejection fraction \> 40% 7. signed informed consent exclusion criteria: 1. patients not expected to be available for follow-up in our institution for at least 100 days after the transplant 2. prior allogeneic transplant 3. karnofsky performance score \< 70% 4. patients who are not undergoing standard gvhd prophylaxis with cyclosporine/tacrolimus and methotrexate 5. patients with uncontrolled bacterial, viral or fungal infections 6. patients receiving other investigational drugs for gvhd

Keywords: graft-versus-host disease hematopoietic stem cell transplantation acute leukemia myelodysplastic syndrome lymphoma
the clinical influence of developing a sustainable cardiac surgery service to reduce the burden of rheumatic heart disease in sub-saharan africa

Conditions: Rheumatic Heart Disease; Anticoagulant Adverse Reaction

Summary: in this bi-directional program of education, training and research activities based on sustainable development goals aim is to develop cardiac surgery service in ethiopia. the aim is to evaluate the short and long-term outcome of cardiac surgery for rheumatic heart disease in a low-income country compared to individuals not offered cardiac surgery due to limited availability of the service. second aim is to evaluate the quality of anticoagulant therapy in patients after cardiac surgery for rheumatic heart disease in a low-income country .

our objectives are: 1. to evaluate the 30- and 180-days outcome of cardiac surgery for rheumatic heart disease (rhd), and impact of gender, age, clinical findings and echocardiographic classification, during the time of development of cardiac surgery at black lion hospital, ethiopia, in comparison with matched individuals (from the same waiting list) which had no offer of surgery due to limited availability. 2. to evaluate the quality of anticoagulation therapy after cardiac surgery at black lion hospital, ethiopia by evaluating the patients proportion of time in therapeutic inr-level, complications as valve dysfunction, bleeding and thrombosis compared to control patients undergoing valvular replacement due to rhd at norwegian hospitals. population: approximately 50 rhd patients operated by our team at addis abeba university hospital, ethiopia. follow up for 180-days for objective 1 and continous follow-up for objective 2. comparison with matched controls. outcome measures: mortality, complications (heart failure, arrhythmias, thrombosis, bleedings, stroke, infections)

Eligibility criteria:
inclusion criteria: * cardiac surgery due to rheumatic heart disease at the governmental black lion university hospital during the bi-directional programme of education, training and research to establish cardiac surgery service exclusion criteria: * not willing or able to provide written informed consent