Kornimate/medical-research-clean huggingface dataset:
effect of combined exercise training in patients with multiple sclerosis

Conditions: Multiple Sclerosis

Summary: the aim of this clinical trial is exercise in sarcopenic ms patients to demonstrate the effectiveness of education. the main questions it aims to answer are: -can exercise training make a change in muscle thickness in sarcopenic ms patients? --does exercise training have an effect on balance in sarcopenic ms patients? - does exercise training have an effect on the risk of falling in sarcopenic ms patients? participants will: they will continue combined exercise applications 3 days a week for 8 weeks. evaluations will be made before the application and at the end of the 8 weeks. the data will be analyzed afterwards.

a significant decrease in physical performance is observed in ms patients. the reasons for this can be changes in muscle contractile structures and symptoms such as sarcopenia. sarcopenia is a disorder characterized by loss of skeletal muscle mass and decrease in muscle strength and physical performance. loss of muscle mass seen outside of old age is defined as secondary sarcopenia. in recent years, studies on neurological disorders and their relationship with sarcopenia have increased. early diagnosis of sarcopenia in neurological patients and implementation of applications aimed at this are important from an early stage. the aim of this study is to examine the effect of exercise training in sarcopenic ms patients. in the study, participants will be applied a combined exercise program 3 days a week for 8 weeks. parameters such as muscle thickness, balance, and fall risk will be evaluated before and after physiotherapy application including aerobic exercise, balance exercises, and strengthening exercises.

Eligibility criteria:
inclusion criteria: * people diagnosed with ms by a neurologist * people with ambulation whose edss is 4.5 or below * people between the ages of 18-50 * people who do not exercise regularly and are not included in an exercise program exclusion criteria: * having been diagnosed with sarcopenia before ms diagnosis * having had an ms attack within the last 30 days * having any musculoskeletal problems that may affect walking and balance * having a diagnosed psychiatric disease that may affect cognitive status * having a neurological disease other than ms

Keywords: sarcopenia exercise
efficacy of sacral erector spinae plane block (sespb) on postoperative pain and catheter-related bladder discomfort

Conditions: Pain, Postoperative

Summary: the goal of this clinical trial is to evaluate the catheter related bladder discomfort in patients who will undergoing tur-p operation. the main questions it aims to answer are: * is sacral espb effective on the pudendal nerve dermatome? * is sacral espb as useful as pudendal block on crbd? participants will be divided into two groups and the first group will receive sacral espb after tur-p operation and the second group will receive pudendal block. investigators will be present for 24 hours * catheter related bladder discomfort * post-operative pain, * additional analgesic needs will be questioned and the difference between the two groups will be evaluated.

this is a prospective,randomised,double-blind, single-centre,study aiming to compare the effectiveness of us guided bilateral sacral espb and us guided bilateral pudendal block on crbd and pain after tur-p. 54 patients will be included in the study and divided into two groups. all patients will be standardly monitored and will receive general anaesthesia. at the end of the cases, sacral espb will be applied to the first group and pudendal block to the second group, and the patients and the data questioner physician will be blinded to the study. primary and secondary outcomes will be questioned for 24 hours and statistics will be made according to the result.

Eligibility criteria:
inclusion criteria: - american society of anesthesiologist (asa) physical status 1-3 exclusion criteria: * american society of anesthesiologist (asa) physical status 4-5 * refused to participate in the study * known allergy to local anaesthetic * where regional anaesthesia is contraindicated * with known neurological, haematological or muscular disease * patients with infection or anatomical changes in the lumbo-sacral region

Keywords: regional block pudendal block
antibiotic treatment of multiple erythema migrans

Conditions: Multiple Erythema Migrans

Summary: the purpose of this study is to compare the efficacy and safety of 15-day ceftriaxone versus 15-day doxycycline treatment in patients with multiple erythema migrans.


Eligibility criteria:
inclusion criteria: * multiple erythema migrans in patients \> 15 years exclusion criteria: * a history of lyme borreliosis in the past * pregnancy or lactation * immunocompromised status * serious adverse event to doxycycline or beta lactam antibiotic * taking antibiotic with antiborrelial activity within 10 days

Keywords: erythema migrans lyme borreliosis ceftriaxone treatment doxycycline treatment outcome subjective symptoms
systematic multi-domain alzheimer's risk reduction trial

Conditions: Dementia; Alzheimer Disease

Summary: the primary goal of this randomized controlled trial (rct) is to pilot-test a personalized, pragmatic, multi-domain alzheimer's disease risk reduction intervention in a u.s. integrated healthcare delivery system.

we propose to randomize 200 higher-risk older adults (age 70-89 with low-normal performance on cognitive testing and 2+ modifiable risk factors that will be targeted by our intervention) to a two-year systematic multi-domain alzheimer's risk reduction trial (smarrt) intervention or a health education (he) control. the smarrt team will work with participants randomized to the intervention arm to develop a tailored action plan to address risk reduction. targeted areas will include: increasing physical, mental and social activities; controlling cardiovascular risk factors (diabetes, hypertension); quitting smoking; reducing depressive symptoms; improving sleep; neuroprotective diet; and decreasing use of potentially harmful medications. he participants will receive periodic handouts on these topics by mail. changes made to the protocol due to covid-19, i.e. switching to telephone data collection, will likely limit our ability to examine cognitive change effectively, as several of the most important cognitive tests cannot be administered via telephone.

Eligibility criteria:
inclusion criteria: * 70-89 years of age * fluent in the english language * low-normal performance on a brief telephone cognitive screen, measured using the cognitive abilities screening instruments (casi). low-normal scores are defined as 26-29. * has at least two additional risk factors that will be targeted by the intervention. exclusion criteria: * residing in a skilled nursing or rehabilitation facility * receiving palliative care or hospice services * charlson comorbidity index score of greater than 5 * bipolar illness or schizophrenia * current alcohol or drug use disorder * receiving chronic opioid therapy * parkinson's disease, amyotrophic lateral sclerosis, or multiple sclerosis * severe visual or hearing impairment * requests not to be contacted or not to have their medical record reviewed for research * prior evidence of dementia
oral nitrite synthesis and post-exercise hypotension

Conditions: Blood Pressure; Sports Physical Therapy

Summary: exercise is probably the most effective approach to reduce blood pressure. in fact, a single bout of exercise induces a physiological response known as post-exercise hypotension (peh) where a prolonged decrease in resting blood pressure occurs in the minutes and hours after exercise. however, it is not fully understood how this response triggers. recent evidence suggests that oral bacteria may play a key role in blood pressure control by enhancing nitrite, and then nitric oxide (no) bioavailability under resting conditions in humans. however, no previous study has investigated whether this is a key mechanism involve in peh. thus, the main aim of this study was to investigate if the oral nitrate/nitrite pathway is a key regulator of peh and vasodilation in healthy humans.


Eligibility criteria:
inclusion criteria: blood pressure (sbp \< 130 mmhg; dbp \< 90 mmhg) bmi \< 30 kg/m2 age 18 to 50 years old exclusion criteria: smoker hypertension dyslipidaemia diabetes gingivitis or periodontitis using antibacterial mouthwash or tongue scrapes taking antibiotics 1 month before the start of the study females without have irregular menstrual periods
immunologic effect of fraction of inspired oxygen

Conditions: Immune System

Summary: during anesthesia and surgery, oxygen is routinely administered to all patients. inspired oxygen concentrations, however, vary between 30% - 100% and oxygen is often administered in a seemingly random manner.

during anesthesia and surgery, oxygen is routinely administered to all patients. inspired oxygen concentrations, however, vary between 30% - 100% and oxygen is often administered in a seemingly random manner.a striking conundrum is evident immediately when one review studies on the effects of oxygen on cytokines synthesis. most investigators have found that hyperoxia enhances proinflammtory cytokines transcription and translations (11). in contrast, hyperparic oxygen has generally been shown to suppress stimulus induced porinflammtory cytokine production (12). other studies have demonstrated that supplemental oxygen improves inflammatory and immune function (13), and it is not associated with clinically important side effect (14). we therefor undertook the current prospective randomized study to investigate whether perioperative supplemental oxygen (30% versus 80%) on pro and anti-inflammatory response in patients undergoing major abdominal cancer surgeries as our primary outcome.

Eligibility criteria:
inclusion criteria: * candidates for abdominal cancer surgeries exclusion criteria: * patients with chronic diseases, such as chronic obstructive pulmonary disease or pneumonia, * body mass index (bmi) \>35 kg/m2, * severe malnutrition (albumin \<3), * leukopenia (white blood cell \<4,000 g/dl), * surgery within the previous 30 days and * o2 saturation \< 90%, as measured using a pulse oximeter

Keywords: fraction of inspired oxygen hyperoxia immune system
the effect of virtual reality on fatigue and functional capacity in patients with ms

Conditions: Multiple Sclerosis; Multiple Sclerosis (MS) - Relapsing-remitting; Virtual Reality

Summary: this clinical trial aims to evaluate the effectiveness of virtual reality (vr) as a complementary intervention to traditional physical therapy for individuals diagnosed with multiple sclerosis (ms). ms is a chronic neurological condition that affects motor and cognitive functions, with fatigue being one of the most common and disabling symptoms. this study will assess whether the use of vr-based applications, in addition to standard physiotherapy, can reduce fatigue and improve functional capacity in individuals with ms. participants will be randomly assigned to two groups: one group will receive conventional physiotherapy only, while the other will receive vr-based therapy alongside physiotherapy. the intervention period will last four weeks, and both groups will be evaluated using standardized outcome measures before and after the intervention. these include the fatigue severity scale (fss), the timed up and go (tug) test, and the 6-minute walk test (6mwt). the study is designed to address a gap in current literature, as no prior research has specifically examined the impact of virtual reality on fatigue and functional performance in ms patients. the findings may provide valuable insights into innovative rehabilitation strategies that enhance patient outcomes and improve quality of life.


Eligibility criteria:
inclusion criteria: 1. individuals diagnosed as ms by a physician 2. expanded disability status scale (edss): 2.0-6.5 3. patient able to walk with or without the use of unilateral support (e.g., a cane) 4. patient had not experienced a severe exacerbation of symptoms requiring medical intervention in the previous month 5. subjects had to have the cognitive capacity to assure the requisite cognitive ability 6. spasticity up to 2 on ashworth scale. exclusion criteria: * 1. cognitive disorders hampering the execution of the exercises/assessment, 2. ability to maintain monopodalic-standing position for 10 s 3. cardiovascular disorders 4. orthopedic disorders that could negatively affect balance 5. uncorrected visual or auditory impairments 6. pregnancy

Keywords: multiple sclerosis virtual reality fatigue functional capacity physical therapy
bazedoxifene post approval safety study (pass) in the european union (eu)

Conditions: Osteoporosis, Postmenopausal

Summary: this observational cohort study is being conducted to further characterize selected adverse events of interest among a patient population with osteoporosis who are prescribed bazedoxifene, raloxifene, or a bisphosphonate in usual clinical care outside of a randomized clinical trial setting. the study will compare the rates of the selected clinical events among the three treatment groups.

all women in the database meeting the inclusion criteria will be included in the study without any statistical sampling.

Eligibility criteria:
inclusion criteria: * female * at least one prescription for bazedoxifene, raloxifene, or any bisphosphonate during the study inclusion period (index prescription); * a recoded diagnosis code of osteoporosis on or within 60 days prior to the index prescription date; * age \>=45 at the date of the index prescription; and * at least 6-months of follow-up data in the electronic medical record system prior to the date of the index prescription exclusion criteria: * there is no exclusion criteria. all women in the database who meet the inclusion criteria will be studied.

Keywords: osteoporosis
an open-label study in hiv+ patients to determine the effects of nevirapine (viramune) on the pharmacokinetics of clarithromycin and activity of cytochrome 3a4.

Conditions: HIV Infections

Summary: to evaluate the potential pharmacokinetic interaction between nevirapine and clarithromycin, and to determine the effects of nevirapine on cytochrome p450 3a4 (cyp3a4) activity in vivo.

the study is conducted in two separate groups. patients in group i receive clarithromycin orally for 32 days and nevirapine orally for 28 days. patients in group ii receive erythromycin intravenously on days 0, 14, 28, and 43 and nevirapine orally for 28 days.

Eligibility criteria:
inclusion criteria concurrent medication: allowed: antiretroviral drugs (i.e., zidovudine, zalcitabine, stavudine, lamivudine, didanosine, indinavir, saquinavir) provided that there has been no change in dosing of the medication \> 25% within 4 weeks of study entry. patients must have: * hiv positive status. * cd4 count \>= 100 cells/mm3. prior medication: allowed: patients may be on clarithromycin at study entry. exclusion criteria co-existing condition: patients with the following conditions are excluded: malabsorption, severe chronic diarrhea, or inability to maintain adequate oral intake. concurrent medication: excluded: macrolide antibiotics (erythromycin, azithromycin, dirithromycin), azole fungals (ketoconazole, fluconazole, itraconazole), rifampin, rifabutin, phenytoin, terfenadine, astemizole, cisapride, triazolam, midazolam, other non-nucleoside reverse transcriptase inhibitors, antibiotics containing clavulanic acid, and augmentin. patients with the following prior conditions are excluded: * history of drug allergy or known drug hypersensitivity. * history of clinically important disease including hepatic, renal, cardiovascular, or gastrointestinal disease. prior medication: excluded: * investigational drugs or antineoplastic agents within 12 weeks of study entry. * participation in a clinical trial that used ermby within one year of study entry. * systemic treatment with drugs known to be potent hepatic enzyme inducers or inhibitors (e.g., oral macrolide antibiotics, azole antifungals, cimetidine, rifampin, rifabutin, and carbamazepine) within 28 days of study entry. * use of protease inhibitors; ritonavir, nelfinavir, indinavir, or non-nucleoside reverse transcriptase inhibitor compounds e.g., delavirdine) within 4 weeks of study entry. prior treatment: excluded: radiotherapy within 12 weeks of study entry. risk behavior: excluded: current history (within the last year) of ivda, etoh, or substance abuse.

Keywords: antibiotics, macrolide clarithromycin nevirapine reverse transcriptase inhibitors cytochrome p-450 anti-hiv agents
equitable implementation of cascade screening for familial hypercholesterolemia

Conditions: Familial Hypercholesterolemia

Summary: design, refine, and pilot the two implementation approaches using behavioral economics and then seek further feedback prior to the proposed clinical trial, consistent with these recommendations. aim 1. co-design both implementation strategies using behavioral economics in partnership with the family heart foundation and key partners from diverse backgrounds. aim 2. pilot strategies with 20 patients with high cholesterol and/or with familial hypercholesterolemia (fh) to ascertain feasibility, acceptability, appropriateness.

aim 1. conduct interviews with patients with high cholesterol and/or fh and clinicians to identify common barriers and facilitators for individuals to engage in cascade screening. these activities will occur in the first 7 months and will serve as inputs into the design of the implementation strategies to ensure that strategies address determinants identified in the interviews. aim 2. to maximize success, pilot test the implementation strategies and the planned data collection approaches.

Eligibility criteria:
inclusion criteria: * patients with high cholesterol and/or fh (i.e., probands; aim 1 interviews, aim 2 pilot testing strategies, aim 2 interviews). adults aged 18 and older with clinically diagnosed fh and/or high cholesterol who are treated within penn medicine. * family members (aim 2 pilot testing strategies, aim 2 interviews). adults aged 18 and older who have a family member who has been identified as a patient with high cholesterol and/or fh who is treated within penn medicine (i.e., family members of probands). exclusion criteria: - none
olfactory training in various populations

Conditions: Olfactory Disorder; Smell Disorder; Traumatic Brain Injury; Concussion, Brain

Summary: to date, there is no validated pharmacotherapy for olfactory disorders. interestingly, olfactory training - the intentional exposure to odorants for the purposes of retraining the sense of smell - has shown success with as many as 28% of subjects over the course of 12 weeks.

study objectives: the overall, primary goals of these studies are as follows: 1. to compare the outcomes of our olfactory testing battery for olfactory training to the previously published literature 2. to determine if using a larger panel of odorants (our 15 scents versus the 4 scents previously used in the literature) yields a significant difference in olfactory recovery.

Eligibility criteria:
inclusion criteria: * age 18-80 * quantifiable or subjective olfactory dysfunction * ability to complete objective olfactory tests and comply with olfactory training protocol exclusion criteria: * anyone lower than the age of 18, or greater than the age of 80 * pregnant women, as sinonasal symptoms and changes in smell can occur in pregnancy and are multifactorial * patients with poor or questionable compliance, as participation requires daily compliance with study protocol * patient's that are unable to perform routine follow-up * patients who are participating in another study during this trial * patients with dementia, alzheimer's disease, parkinson's disease, or other neurocognitive disorders, as these conditions are associated with baseline olfactory dysfunction. * patients with other systemic conditions known to impact the sinonasal cavity such as wegener's granulomatosis, churg strauss, and immunodeficiency, as their impact on olfaction is unknown * patients who are allergic to any of the smells or components of our olfactory testing and training
pre-operative consultation on patient anxiety and first-time mohs micrographic surgery

Conditions: Anxiety; Surgery

Summary: to determine if in-office pre-operative consultation has a significant effect on the anxiety level and overall post-operative satisfaction of patients undergoing first time mohs surgery

this study is designed to determine if having a seperate in-office pre-operative consultation with the dermatologist before having a dermatologic procedure has any effect on patient anxiety levels and satisfaction following the procedure. the goal of the study is to help us understand if pre-operative consultation is beneficial to patients to reduce anxiety and increase satisfaction following the procedure.

Eligibility criteria:
inclusion criteria: * adults 18 years old or older * able to provide consent for participation * fluency in english * presenting for first-time mohs surgery for treatment of a cutaneous malignancy exclusion criteria: * • patients under 18 years old * prisoners * patients unable to provide consent * history of prior mohs surgery * patients requiring multi-disciplinary care (i.e. involvement of other surgical specialties such as plastic surgery or ophthalmology for reconstruction)
comparison of the proximal approach and distal approach of axillary vein catheterization under ultrasound guidance

Conditions: Central Venous Catheterization

Summary: ultrasound-guided axillary vein catheterization can be performed via the proximal or distal approach of the axillary vein. the aim of our study is to compare the first puncture success rate and safety between the two approaches of ultrasound-guided axillary vein catheterization in cardiac surgical patients with risk of bleeding.

for patients after cardiac surgery, antiplatelet drugs or anticoagulants are usually used for preventing thrombosis. use of those drugs is associated with increased risk of bleeding. any invasive procedures may put those patients at additional risk of bleeding. ultrasound (us) has become widely accepted to guide safe and accurate central venous catheterization.the axillary vein in the infraclavicular area is an alternative choice for subclavian vein. ultrasound images of the infraclavicular axillary vein differ according to its position. proximal infraclavicular axillary vein is a direct continuation of the subclavian vein. the associated anatomy is simple and the vein is straight and thick in longitudinal axis view, which are in favor of successful puncture. meanwhile, distal axillary vein also has anatomical advantages for safe and successful cannulations. distal axillary vein lies further away from the artery and chest wall, and the overlap between distal axillary vein and artery gets greater on moving laterally. it is still unknow that one of the puncture approaches is superior to the other. until now, there are no studies comparing two puncture approaches in high bleeding risk patients. the aim of the study is to compare the success rate of first puncture and safety of us-guided proximal and distal axillary venous catheterization in cardiac surgery patients with risk of bleeding.

Eligibility criteria:
inclusion criteria: * cardiac surgical patients in cardiac surgery intensive care unit * axillary vein catheterization is needed according to the clinical practice * receiving oral antiplatelet or anticoagulants at least three days exclusion criteria: * fracture of the ipsilateral clavicle or anterior proximal ribs * subclavian and/or axillary vein thrombosis * local infection of the puncture area * subclavian and/or axillary veins which are not clearly visualized using ultrasound * already presence of subclavian or axillary vein catheter * requiring an emergency axillary vein catheterization

Keywords: axillary vein central venous catheterization ultrasound cardiac surgery complication