Kornimate/medical-research-clean huggingface dataset:
extracorporeal shockwave therapy in long-term functional outcomes of shoulder adhesive capsulitis

Conditions: Adhesive Capsulitis of Shoulder

Summary: adhesive capsulitis refers to the occurrence of pain and a gradual decline in the range of motion (rom) due to slow increases in synovial hypertrophy and the adhesion between the synovial membrane and articular surface. it leads to the loss of flexibility and difficulties with the activities of daily living (adls) due to chronic inflammation accompanied by intra-articular fibrosis. the real cause of this syndrome is unknown but there are some predisposing factors involved such as synovial cell hyperplasia, fibrosis of the capsule due to cytokines or other inflammatory factors. in the current study investigator will compare the effects of extracorporeal shockwave therapy (eswt) along with conventional therapy to treat the adhesive capsulitis.

this study will be a randomized controlled trail conducted at horizon hospital, lahore. the study will be completed within the time duration of six months. consecutive sampling technique will be used to collect the data. the sample size of 44 patients will be taken in this study to find the effects of eswt on pain, rom, functional mobility. patient will be divided into two groups. group a will be treated with eswt with conventional therapy and group b will be treated with conventional therapy. constant shoulder score (css) and the oxford shoulder score (oss) tools will be used to measure the outcomes of the study. one session of treatment per week for four weeks will be given. pretest, posttest at 4th week and followup of 24th weeks will be evaluated.

Eligibility criteria:
inclusion criteria: * relapsed or episode of pain score ≥5 at assessment with a past history of pain for at least 2 months. * rom restriction (\>75% rom loss in ≥2 directions including abduction, flexion and external rotation) * no treatment other than analgesics with unresponsive rom restriction for the past 2months. * unwilling or waiting and did not undergo joint injection. exclusion criteria: * bilateral shoulder involvement * history of previous surgery on the shoulder * shoulder fracture * cancer * glenohumeral or acromioclavicular arthritis * inflammatory disorders * bleeding disorders * diabetes mellitus * presence of severe osteoporosis * pulmonary diseases * any neuromuscular disorders * pregnancy * implanted pacemaker
type 1 diabetes and the brain in children

Conditions: Diabetes Mellitus, Type 1

Summary: the investigators have previously studied a group of young children with t1d using brain mri, age-appropriate neurocognitive testing and continuous glucose monitoring, followed for 18 months. the investigators observed significant differences in gray matter volumes and white matter microstructure in the children with diabetes as compared to controls. these differences appeared to increase over time, with slower rates of brain growth in the t1d group (mazelli, et al, diabetes 2014; barnea-goraly, et al, diabetes care 2014; mauras, et al, diabetes 2015). in this new protocol the investigators will include the same children with t1d and healthy controls previously studied and recruit new similar subjects to replace those lost by attrition. the investigators will be using structural and functional brain mri, neurocognitive testing and measures of glycemic control, to determine if changes in the brain persist or worsen over longitudinal follow up, and whether these changes are associated with measures of glycemic control and neurocognitive metrics as these children grow and progress through puberty.

study participation will last about 2 to 2 1/12 years and will include a brain mri without sedation, as well as a functional mri and neurocognitive testing. the children with t1d will wear a continuous glucose monitor (cgm), will follow up every 3 months and will be asked to wear the cgm each time. the structural and functional mri and neurocognitive testing will be repeated 2 yrs from baseline. the healthy controls will also undergo mri and cognitive testing as well as have a blood sample at baseline and after 2 years. parents of newly recruited subjects will also have abbreviated iq testing.

Eligibility criteria:
inclusion criteria for t1 diabetes group: * diabetes diagnosed after age 6 months * gestational age \>34 weeks, birth weight \>2kg inclusion criteria for healthy control group: * normal hba1c and fasting blood glucose * negative diabetes auto-antibodies (those that are siblings of t1d patients) * gestational age \>34 weeks, birth weight \>2kg exclusion criteria for both groups: * history of mental retardation, language or learning disability * known genetic or medical problem that could impair brain development * abnormality of the brain/nervous system, visual or hearing problem * history of seizures not associated with fever * previous inpatient psychiatric treatment * unable to have a mri of the head due to metal appliances

Keywords: brain growth and development cognition children continuous glucose monitoring mri functional mri
can ultrasound replace computed tomography (ct) scan in those unable to have computed tomography (ct) contrast agents

Conditions: Nephrotoxicity of CT Contrast Agents; CT Scans in Those With Renal Compromise; Sensitivity to CT Contrast Agents; US With CEUS as Replacement for Unenhanced CT Scan

Summary: computed tomography (ct) scan, performed with contrast enhancement, is one of the most commonly requested examinations in diagnostic imaging. in a patient with an elevated creatinine or an allergy to contrast agents, the scan may be performed without the benefit of contrast enhancement. ultrasound (us), performed with contrast agent enhancement does not have any nephrotoxicity and may be performed on patients with ct contrast allergy. the investigators propose that us with contrast enhanced ultrasound (ceus) is superior to unenhanced ct scan in this population.

contrast enhanced computed tomography (ct) is one of the most common investigations performed in any radiology department, used widely in evaluating pathology in any part of the body. historically, it is well known that the use of contrast agents for ct scans may result in nephropathy, or renal failure. nephrotoxicity associated with the injection of ct contrast agents may occasionally occur in healthy individuals and more commonly in those with borderline renal function. if abnormal kidney function is known to exist in a patient sent for ct scan, the examination is performed without the valuable assistance of contrast enhancement. further, if prior hypersensitivity to the contrast agent for ct scan is known, again, the scan will be performed without the use of contrast agent. ultrasound (us) performed conventionally in grayscale and with doppler is able to evaluate most abdominal and pelvic organs and also provides vascular information related to large vessel blood flow. contrast enhanced ultrasound (ceus) provides more precise information on blood flow than is available with doppler and has been shown to be comparable to ct scan in some circumstances. we believe that a comparison of conventional us, with ceus, and unenhanced ct scan would clearly favor ultrasound for detection of soft tissue pathology on the basis of its inherent tissue contrast differentiation.

Eligibility criteria:
inclusion criteria: * unenhanced ct scan of abdomen * known renal compromise * known hypersensitivity to ct contrast agents exclusion criteria: * ct scan performed with contrast agent

Keywords: ultrasound contrast enhanced ultrasound (ceus) nephrotoxicity ct contrast agents
a new blood score for myelofibrosis staging

Conditions: Myeloproliferative Neoplasm

Summary: bcr:abl1 negative myeloproliferative neoplasms (mpn) include three entities: polycythemia vera, essential thrombocythemia and primitive myelofibrosis. myelofibrosis is a life-threatening complication in mpn with several therapeutic options including hematopoietic stem cell transplantation (hsct) which remains the only curative treatment. bone marrow biopsy with histological analysis allows myelofibrosis identification and staging. however, it is an invasive procedure that remains painful and provides potential haemorrhagic complications. development of non-invasive biomarkers for myelofibrosis staging could help to better stratify this disease, better define patients' prognosis and lead to optimal cares. the main aim of this work is to develop a non-invasive blood score including several biomarkers for myelofibrosis staging in mpn using bone marrow biopsy as a gold standard.


Eligibility criteria:
inclusion criteria: * age \> 18 years * diagnosis of bcr::abl1 negative mpn according to who criteria classification * indication for bone marrow biopsy * non opposition * social security affiliation exclusion criteria: * non-contributory biopsy * aml transformation * organ fibrosis (liver, lung, kidney...) * hsct * chronic inflammatory disease
a randomized phase iii trial of stereotactic ablative radiotherapy for patients with up to 10 oligometastases and a synchronous primary tumor.

Conditions: Metastatic Tumor

Summary: this study is a phase iii multi-institutional randomized trial. patients will be randomized in a 1:2 ratio between current standard of care treatment (arm 1) vs. standard of care treatment + sabr (arm 2) to sites of known disease. patients will be stratified by two of the strongest prognostic factors, based on a large multi-institutional analysis3: histology (group 1: hormone-sensitive prostate cancer, breast, or renal; group 2: all others), and number of metastases (group 1: 1-3; group 2: 4-10).


Eligibility criteria:
inclusion criteria: * age 18 years or older * willing to provide informed consent * karnofsky performance status \&gt; 60 * life expectancy \&gt; 6 months * histologically confirmed malignancy with metastatic disease detected on imaging. biopsy of metastasis is preferred, but not required. * total number of metastases 1-10 at the time of enrollment, with a primary tumor also present * restaging completed within 12 weeks prior to randomization (see section 5.1) * for patients receiving thoracic radiotherapy, the enrolling physician must confirm there are no computed tomography (ct) changes suggestive of fibrotic interstitial lung disease (ild) (i.e. reticular changes, traction bronchiectasis, or honeycombing) reported on any prior ct scans. if any are present, the patient must be assessed by a respirologist to rule out ild prior to enrollment. * 10 or fewer lifetime metastases from the cancer for which participants are being enrolled exclusion criteria: * serious medical comorbidities precluding radiotherapy. these include ild in patients requiring thoracic radiation, crohn's disease in patients where the gastrointestinal (gi) tract will receive radiotherapy, or ulcerative colitis where the bowel will receive radiotherapy and connective tissue disorders such as lupus or scleroderma. * for patients with liver metastases, moderate/severe liver dysfunction (child pugh b or c); please see the child-pugh score calculator. * substantial overlap with a previously treated radiation volume. prior radiotherapy in general is allowed, as long as the composite plan meets dose constraints herein. for patients treated with radiation previously, biological effective dose calculations should be used to equate previous doses to the tolerance doses listed in appendix 1. all such cases must be discussed with a member of the study steering committee. * malignant pleural effusion * inability to treat all sites of disease * brain metastasis \&gt; 3 cm in size or a total volume of brain metastases greater than 30 cc. * metastasis in the brainstem * clinical or radiologic evidence of spinal cord compression * metastatic disease that invades any of the following: gi tract (including esophagus, stomach, small or large bowel), or skin * pregnant or lactating women
the effect of shotblocker

Conditions: Shotblocker; Injection Pain Prevention; Pain; Anxiety

Summary: this study was conducted as a randomized controlled experimental cross over study to examine the effect of injection pain, anxiety and comfort level with the use of shotblocker in geriatric patients undergoing subcutaneous injection. the study was defined on 80 patients who were inpatients in the internal wards of a hospital, and the experimental and control groups, which provided the appropriate conditions for the study, included the same people. ethics committee approval, institutional permission and written informed consent forms were obtained from the individuals. data were obtained by the researcher using personal information form, visual analog scale (vas), state and trait anxiety scale, comfort scale, visual patient satisfaction scale and shotblocker.

this study was conducted as a randomized controlled experimental cross over study to examine the effect of injection pain, anxiety and comfort level with the use of shotblocker in geriatric patients undergoing subcutaneous injection. the study was defined on 80 patients who were inpatients in the internal wards of a hospital, and the experimental and control groups, which provided the appropriate conditions for the study, included the same people. ethics committee approval, institutional permission and written informed consent forms were obtained from the individuals. data were obtained by the researcher using personal information form, visual analog scale (vas), state and trait anxiety scale, comfort scale, visual patient satisfaction scale and shotblocker.

Eligibility criteria:
inclusion criteria: voluntary participants in the study, over 65 years of age, cognitive ability to answer the questions, body mass index (bmi) 18.5- 29.9 kg / m2, no communication problems, subcutaneous injection in the treatment, no bleeding coagulation disorder, platelet, inr and aptt values within normal limits, no scar tissue, incision or infection findings in the injection area, no history of allergy exclusion criteria: patients with amputation in the right/left arm area to be studied, patients with any scar tissue, incision, lipodystrophy or signs of infection in the injection area in the arm area, patients receiving hemodialysis treatment and having a dialysis catheter, patients who underwent mastectomy surgery and should not undergo any application/treatment on the arm on the operated side were excluded from the study.

Keywords: shotblocker injection pain anxiety
recollection training in healthy older adults and older adults with amnestic mild cognitive impairment

Conditions: Amnestic Mild Cognitive Impairment; Aging

Summary: we have developed a training intervention that successfully improves older adults' memory. we have also shown that older adults whose memory is as good as younger adults' memory (hi-old) use an altered pattern of memory-related brain activity compared to younger adults, whereas healthy older adults with poorer memory (lo-old) do not. we have also shown that individuals with amnestic mild cognitive impairment (amci) have impairments of conscious, effortful, recollection-based memory processes, whereas their automatic, familiarity-based memory processes are intact. our primary current goal is to investigate whether our successful memory intervention will improve recollection and produce induce altered patterns of brain activity in the lo-old and amci. young, lo-old, hi-old, and amci will be scanned using functional magnetic resonance imaging while performing two memory tasks. half of the lo-old and half of the amci will then receive the memory intervention, while the other half in each group will receive a control program consisting of information and games about aging. the lo-old and amci will then be rescanned while performing the two memory tasks. we predict that the memory intervention will improve performance on a number of memory tasks, and will induce altered patterns of brain activity. in the lo-old, their brain activity after the memory intervention will look more like the hi-old, while brain activity will become more focal in the amci.


Eligibility criteria:
inclusion criteria: * 65-90 years old * english as a first language or learned before kindergarten * right handed exclusion criteria: * neurologic disorder * major medical disorder affecting cognition * psychiatric disorder * metal in the body that poses a hazard in the mri scanner

Keywords: recollection training aging amnestic mild cognitive impairment fmri
assessment of a robotic exoskeleton for upper limb rehabilitation

Conditions: Spinal Cord Injuries

Summary: rehabilitation robotics has the potential to facilitate rehabilitation at home and empower people with spinal injuries to self-manage increasing their independence and improving their quality of life. the objective of this study is to assess for the first time in the nhs the efficacy of a commercial robotic orthosis for upper limb rehabilitation in patients with spinal cord injury. the device is produced by myomo (myomo.com) which is an american company. we will be assessing the wearable robotic orthosis also known as robotic exoskeleton in two different neuro-rehabilitation centres: national spinal injuries unit in glasgow (scotland) and the robert jones and agnus hunt orthopaedic hospital in oswestry (england). the study will involve nine spinal cord injured tetraplegic inpatients in total. patients will follow a twelve-week rehabilitation programme with three to four sessions per week in addition to their usual care and rehabilitation. each session lasts for approximately 45 minutes. participants arm function, range of motion, spasticity level will be measured before, half-way and at the end of the programme to assess change in these and other parameters. training will focus on the dominant arm of the patient and compared to the other arm at every assessment stage. we shall evaluate therapists' and patients' satisfaction with the commercial device in addition to assessing various clinical measures to evaluate the efficacy of using the robotic orthosis in rehabilitation and recovery of arm function.


Eligibility criteria:
inclusion criteria: * age 18+ years. * the levels of c5 c6 asia c/d would provide individuals with elbow and hand impairment and potentially functional shoulder movements. c7, c8 individuals could also benefit from the hand component of the device. * some gross shoulder movement at start of the trial to enable changes at the elbow/hand, to have the greatest potential for functional change. * preservation of hand sensation as base for motor restoration. * some sitting balance would give the best opportunity for the arm to be released for functional upper limb activity. * emg (muscle activity) evidence of active finger flexion, extension and elbow flexion extension grade 1-2. * minimal or no community functional use of upper limb at start of trial. * spasticity mas 1-3/5.
evaluating the safety and efficacy of the indigo® aspiration system in acute pulmonary embolism

Conditions: Pulmonary Embolism

Summary: to determine the safety and efficacy of the indigo aspiration system for aspiration mechanical thrombectomy in patients with acute pulmonary embolism (pe)


Eligibility criteria:
inclusion criteria: * clinical signs and symptoms consistent with acute pe with duration of 14 days or less. evidence of pe must be from cta. * systolic bp ≥ 90 mmhg with evidence of dilated rv with an rv/lv ratio \> 0.9 * patient is 18 years of age or older exclusion criteria: * tpa use within 14 days prior to baseline cta * systolic bp \< 90mmhg for 15min or the requirement of inotropic support to maintain systolic bp ≥ 90 mmhg * pulmonary hypertension with peak pa \> 70 mmhg by right heart catheterization * history of severe or chronic pulmonary hypertension * fi02 requirement \> 40% or \>6 lpm to keep oxygen saturations \>90% * hematocrit \< 28% * platelets \< 100,000µl * serum creatinine \> 1.8 mg/dl * inr \> 3 * aptt (or ptt) \> 50 seconds on no anticoagulation * history of heparin-induced thrombocytopenia (hit) * contraindication to systemic or therapeutic doses of anticoagulants * major trauma \< 14 days * presence of intracardiac lead * cardiovascular or pulmonary surgery within last 7 days * cancer requiring active chemotherapy * known serious, uncontrolled sensitivity to radiographic agents * life expectancy \< 90 days * female who is pregnant * intracardiac thrombus * patients on ecmo * current participation in another investigational study

Keywords: pulmonary embolism clot
inspiratory muscle therapy in subjects with fontan circulations

Conditions: Single-ventricle

Summary: individuals who have undergone the fontan procedure are uniquely dependent upon respiratory mechanics to support pulmonary blood flow (pbf). the investigators hypothesized that enhanced respiratory muscle function via inspiratory muscle training (imt) would improve performance on cardiopulmonary exercise stress testing (cpet).

adult fontan subjects were recruited from 2 academic medical centers. following characterization of pulmonary function and functional class, cpet was performed using incremental and constant work rate protocols. subjects performed 6-8 weeks of imt using a handheld inspiratory loading device (threshold®, philips); both exercise tests were then repeated. patient-centered outcome data were collected before and after imt (rand-36 assessment and new york heart association (nyha) functional class).

Eligibility criteria:
inclusion criteria: single ventricle physiology status post fontan palliation exclusion criteria: * the presence of a sub-pulmonary ventricle * pregnancy or any contraindication to stress testing (e.g., uncontrolled symptomatic arrhythmia, severe systemic ventricular outflow tract obstruction or uncontrolled symptomatic heart failure). * height less than 4'11" due to limitations of the cycle ergometer.
intranasal insulin treatment in patients with schizophrenia

Conditions: Schizophrenia

Summary: this study is an 8-week, randomized, double-blind, placebo-controlled trial of intranasal insulin as an adjunctive therapy, with a 4-week follow-up, in 60 non-diabetic schizophrenia subjects to examine insulin's effect on psychopathology and cognition. in addition, the study will examine insulin's effects on weight, food intake, resting energy expenditure, and body composition.

the specific aims include: primary aims 1. examine the efficacy of intranasal regular insulin (40 iu 4 times per day) in improving cognitive deficits in patients with schizophrenia. 2. examine the efficacy of intranasal regular insulin in improving negative symptoms and positive symptoms of schizophrenia. secondary aims 1. examine intranasal insulin's effects on weight, food intake and resting energy expenditure. 2. examine intranasal insulin's effects on body composition, waist circumference, and waist/hip ratio.

Eligibility criteria:
inclusion criteria: 1. age 18-65 years. 2. diagnosis of schizophrenia, any subtype or schizoaffective disorder, any subtype. 3. stable dose of the current antipsychotic drug for at least one month. 4. well established compliance with outpatient treatment per treating clinician's judgement. 5. able to complete the cognitive assessment battery (must be english speaking). 6. female subjects will be eligible to participate in the study if they are of non-childbearing potential or of child-bearing potential and willing to practice appropriate birth control methods (complete abstinence from sexual intercourse, female sterilization, sterilization of male partner, implants of levonorgestrel, injectable progestogen, oral contraceptives, intrauterine devices, or double barrier methods of contraception using spermicide with either a condom or diaphragm) during the study. exclusion criteria: 1. inability to provide informed consent. 2. current substance abuse. 3. psychiatrically unstable per treating clinician's judgement. 4. significant medical illnesses including uncontrolled hypertension, diabetes, seizure. disorder, severe cardiovascular, cerebrovascular, pulmonary, or thyroid diseases. 5. pregnancy or breastfeeding.

Keywords: cognition, psychopathology