Kornimate/medical-research-clean huggingface dataset:
effect of parenteral nutrition with n-3 pufas on patients with intestinal failure

Conditions: Intestinal Failure

Summary: randomized, double-blind, controlled clinical trial to evaluate the effect of parenteral nutrition (pn) supplemented with lipid emulsions containing 0.1-0.2 g omega 3 polyunsaturated fatty acids (n-3 pufa)/kg body weight/day for 7 days on malondialdehyde (mda) levels, a marker of lipoperoxidation of reactive species, compared with a control group (without n-3 pufa) in patients with intestinal failure (if).

if is the loss of intestinal function that affects the decrease in the absorption of macronutrients, water, and electrolytes, so it requires intravenous supplementation such as pn and/or intravenous fluids to maintain health and/or growth. if type ii is associated with complex infectious and metabolic complications and patients require pn for weeks or months. long-term pn use, however, includes the risk of complications, among which a serious one is the intestinal failure-associated liver disease (1). it has been proposed that metabolic endotoxemia (2-3), inflammation (4) and oxidative stress (5) are involved in the development of this intestinal failure-associated liver disease. although some studies have reported beneficial effects of n-3 pufa to prevent and reverse the liver disease associated with if (6-7), due to its antioxidant (8-10) and anti-inflammatory activity (11-12) and in the modulation of the intestinal microbiota (13), the literature on the use of n-3 pufa in non-critical patients with if and pn is limited and the results have not been conclusive. therefore, a randomized, double-blind, controlled clinical trial to evaluate the effect of pn supplemented with lipid emulsions containing n-3 pufa/kg body weight/day for 7 days on oxidative stress (concentrations of mda), compared with a control group (without n-3 pufa) will be performed.

Eligibility criteria:
inclusion criteria: * patients admitted in the non-critical areas of the instituto nacional de ciencias médicas y nutrición salvador zubirán (incmnsz) with a nutritional risk between january 2019 and july 2020 will be considered eligible. * patients with recent diagnosis of if type ii (an evolution \>28 days) originate from various gastrointestinal or systemic diseases (short bowel, intestinal fistula, intestinal dysmotility, mechanical obstruction, and extensive small bowel mucosal disease). exclusion criteria: * patients with contraindications for pn * patients with known allergies to the components of the pn formula * severe liver or renal insufficiency * uncontrolled diabetes mellitus * certain acute and life-threatening conditions * immunological diseases (such as autoimmune diseases, human immunodeficiency virus infection, cancer, etc.) * those that take immunosuppressant medications * severe hemorrhagic disorders * pregnant or lactating

Keywords: omega 3 polyunsaturated fatty acids intestinal failure oxidative stress
study of plitidepsin (aplidin®) in combination with bortezomib and dexamethasone in patients with multiple myeloma

Conditions: Multiple Myeloma

Summary: study of plitidepsin (aplidin®) to determine the recommended dose (rd) of plitidepsin in combination with bortezomib and dexamethasone in patients with relapsed and/or refractory multiple myeloma.

phase i multicenter, open-label, dose-escalating clinical and pharmacokinetic trial of plitidepsin (aplidin®) to determine the recommended dose (rd) of plitidepsin in combination with bortezomib and dexamethasone in patients with relapsed and/or refractory multiple myeloma (mm), to determine the efficacy of the combination plitidepsin/bortezomib/dexamethasone, to evaluate the safety and tolerability of the combination in patients with relapsing and/or refractory mm and to study the pharmacokinetics (pk) and pharmacodynamics (pdy) of plitidepsin in combination with bortezomib and dexamethasone.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years. * prior autologous transplantation (hsct) patients are allowed. * patients must have received at least one previous treatment line of induction, chemotherapy, chemotherapy and transplantation or previous treatment with bortezomib or another proteasome drug exclusion criteria: * previous treatment with plitidepsin. * active or metastatic primary malignancy other than mm. * serious concomitant systemic disorders * history of hypersensitivity reactions to bortezomib, polyoxyl 35 castor oil or mannitol * neuropathy * pregnant and/or lactating women * hiv infection * active hepatitis b or c virus infection. * treatment with any investigational medicinal product (imp) in the 30 days before inclusion in the study * plasma cell leukemia at the time of study entry * contraindication for the use of steroids

Keywords: multiple myeloma plitidepsin aplidin
nurse-led interprofessional mental health promotion intervention for older home care clients

Conditions: Depressive Symptoms

Summary: objective: the objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. methods/design: this one-group pre-test post-test study aims to recruit a total of 250 long-stay (\> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in ontario, canada. the nurse-led intervention is a multi-faceted 6-month program led by a registered nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. the primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the centre for epidemiological studies in depression scale. secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. changes in the costs of use of health services will be assessed from a societal perspective.


Eligibility criteria:
inclusion criteria: * long-stay (\> 60 days) home care clients * 70 years or older * newly referred to and receiving pss through the ccac * living in the community (not in a long-term care home) * mentally competent to give informed consent (or with a substitute decision-maker available) * competent in english (or with an interpreter available) * screens positive for depressive symptoms exclusion criteria: * receiving palliative care services * not competent in english and no interpreter available * not mentally competent to give informed consent and no substitute decision-maker available

Keywords: depression aging clinical effectiveness home care nurse-led
postoperative cesarean delivery pain relief; diclofenac versus bupivacaine

Conditions: Cesarean Delivery

Summary: this randomized controlled trial, compared postoperative pain score in patient undergoing cesarean delivery between bupivacaine peritoneal and subcutaneous infiltration and diclofenac intramuscular injection

postoperative cesarean delivery was painful that can effect daily activity, resulted in poor quality of life and required morphine injection to relief pain which had both maternal and breastfeeding infancy side effect. so this study compare efficacy of diclofenac and bupivacaine by measured the pain score and requirement of morphine injection.

Eligibility criteria:
inclusion criteria: * patients undergo elective or urgency cesarean delivery at rajavithi hospital in 2016-2017 * urgency conditions: cpd, fail induction of labor, antepartum hemorrhage without hypovolemic shock, dystocia, previous cesarean section and active labor, malpresentation in labor, macrosomic presentation in labor * pregnant women more than 20 years of age * gestational age more than 37 week * cesarean section under regional or general anesthesia * ability to communicating, writing and reading thai language exclusion criteria: * inability to communicating or writing or reading thai language * contraindicated to bupivacaine or diclofenac or morphine * pregnant women with emergency conditions * have one or more complication of pregnancy * intraoperative arrhythmia * pregnant women less than 20 years of age * regional anesthesia with morphine
ultrasound-guided intervention and hand tenosynovitis in patients with diabetes mellitus

Conditions: Ultrasound Guided Injection

Summary: evaluates the efficacy of ultrasound guided versus clinically guided steroid injection in the management of tenosynovitis in dm patients.

the current study will based on follow up study, conducted among patients presenting at outpatient rheumatology clinics of al-azhar university hospitals, egypt. with diabetes mellitus duration at least 3 years and tenosynovitis of hand tendons with richie tenderness grade 3. all patients will randomized in two groups: group one: 26 patients dm patients with tenosynovitis were injected by triamcinolone under ultrasound guidance. group two: 26 patients dm patients with tenosynovitis were injected by triamcinolone under clinical guidance. the affected tendons will scanned and scored for inflammation using ultrasound in all patients before the triamcinolone injection and then to be reassessed one month after the injection to determine the change in the tendons in both groups.

Eligibility criteria:
inclusion criteria: * • diabetes mellitus. * disease duration 3 years or more. * tenosynovitis of hand tendons with richie tenderness grade 3. exclusion criteria: * • patients with recent hand trauma. * patients with inflammatory hand arthritis. * previous tendon surgery. * previous tendon injection. * patients with contraindication for injection as related infection, uncontrolled dm or bleeding tendency.

Keywords: tenosynovitis ultrasound diabetes mellitus
one-hour troponin using a high-sensitivity point-of-care assay in emergency primary care

Conditions: Acute Myocardial Infarction (AMI); Chest Pain; Acute Coronary Syndromes (ACS); Non-cardiac Chest Pain; Troponin; Point of Care Testing; Out-of-hours Medical Care; Primary Care

Summary: acute chest pain is a prevalent medical emergency in primary emergency care settings. triage of chest pain prior to hospital admission presents significant challenges due to the absence of sufficiently sensitive diagnostic tools. clinical signs, symptoms, risk assessment scores, or a normal electrocardiogram (ecg) can reliably exclude acute myocardial infarction (mi). this diagnostic uncertainty has resulted in chest pain being the second most common cause for acute hospital referrals from norwegian emergency primary care, even though chest pain is frequently non-cardiac in origin. in acute mi events, cardiac troponins are released into the bloodstream from the damaged myocardium, where low values are used to exclude mi. until recently, such testing has necessitated using high-sensitivity cardiac troponin (hs-ctn) assays, which have been limited to hospital laboratories. however, recent technological advancements in point-of-care (poc) testing allow access to whole-blood assays that meet high-sensitivity criteria. in this upcoming project, the investigators will evaluate the implementation of a whole-blood poc assay (quidelortho triagetrue hs-ctni) across six norwegian emergency primary care clinics. the study plans to enrol 2,500 patients over a period of 1.5 years. the clinical performance of the novel strategy will be investigated, as well as its impact on healthcare utilization and hospital referrals compared to standard care. additionally, the investigators will assess the prevalence of persistent chest pain and its effects on quality of life, alongside psychological stress and anxiety, through validated questionnaires. this project aims to offer better and more comprehensive management of the large group of emergency primary care patients with acute chest pain, contributing to reduced hospital referrals, improved quality of life, and more sustainable use of healthcare services.


Eligibility criteria:
inclusion criteria: * patients (18+ years) with non-traumatic acute chest pain presenting in emergency primary care * troponin testing requested by the treating physician exclusion criteria: * acute stemi (direct hospital referral required) * haemodynamically unstable (direct hospital referral required) * not able to provide written, informed consent (i.e., due to time restraints, language barriers, impaired cognitive function, or other reasons)

Keywords: triagetrue poc hs-ctni 0/1-hour algorithm troponin chest pain primary care ooh out-of-hours acute myocardial infarction point-of-care out-poc quidelortho
effects of individualized training to reduce fatigue in patients with newly and advanced diagnosed multiple sclerosis

Conditions: Sclerosis; Fatigue

Summary: multiple sclerosis (ms) is a chronic autoimmune inflammatory disease of the central nervous system. it is characterized by complex and heterogeneous symptoms. chronic fatigue is the most reported symptom in ms patients (80%). current pharmacological treatments for ms patients reduce the number of relapses and their severity but do not improve symptoms such as fatigue. physical activity is a therapy that helps reduce this fatigue, in addition to improving muscular and cardiorespiratory functions. however, the results are not optimal because ms patients remain less active than the general population. the improvement of the benefits of exercise therapy could therefore be based on three approaches: personalization of the training program, home practice and early initiation.

the objective of this study will be to investigate the effects of individualized home-training, guided by a mobile application, to reduce fatigue in patients with newly (n) and advanced (a) diagnosed ms.

Eligibility criteria:
inclusion criteria * relapsing-remitting ms (rrms) defined according to the criteria of mcdonald * ms diagnosed less than 2 years ago or whose first symptoms are estimated to be less than 5 years old or ms diagnosed more than 2 years ago and whose first symptoms are estimated to be less than 5 years old * with a high level of fatigue, corresponding to an fss score \> 4 * expanded disability status scale (edss) score \< 4 * medical research council (mrc) testing ≥ 4 in all leg muscles * ability to walk for 10 minutes without stopping (self-reported) * have a mobile phone with internet access * affiliated with or benefiting from a social security scheme * have freely given their written consent after being informed of the aim, the procedure and the potential risks involved exclusion criteria * spasticity or severe cerebellar ataxia in either leg. * abnormal range of movement of the toes and/or ankle * musculoskeletal injury that impairs pedalling * appearance of a multiple sclerosis attack in the 90 days preceding the study * recent adjustment of any medication or drug that may have an impact on fatigue: treatment of neuropathic pain: anti-epileptic and/or taking stimulants for fatigue (e.g. modafinil, amantadine, fampridine...) * history of comorbid illness or conditions that would compromise the subject's safety during the study * participation at the same time in another medical intervention study or having participated in such a study in the 30 days prior to this study * pregnant and breast-feeding women * patients who are unable to understand the purpose of the study and the conditions under which it will be conducted, or who are unable to give their consent. * patients deprived of their liberty or under guardianship

Keywords: fatigue neuromuscular function muscle characteristics physical capacity
intra-aortic balloon pump in extensive myocardial infarction with persistent ischemia

Conditions: Acute Myocardial Infarction; Persisting Ischemia; No Reflow

Summary: patients presenting with large myocardial infarction and signs of persistent ischemia after successful percutaneous coronary intervention, have a poor prognosis with respect to outcome and development of heart failure in the future. the hypothesis of this study is that in patients in whom persistent ischemia is present, use of intra-aortic balloon pump will be beneficial and improve outcome.

in some patients presenting with large myocardial infarction and poor hemodynamic condition, intra-aortic balloon counterpulsation is effective in alleviating cardiogenic shock. in others, the use of intra-aortic balloon pump has no effect at all. the investigators believe this is dependent on the presence of persisting ischemia after successful epicardial reperfusion, known as no-reflow. in the presence of persisting ischemia, the investigators believe us of the intra-aortic balloon pump will relieve ischemia and improve outcome.

Eligibility criteria:
inclusion criteria: * acute st-segment elevation myocardial infarction with summed st-segment deviation ≥15 mm. * insufficient st-segment resolution (\<50%) on the ecg made 10-30 minutes after the primary pci in the catheterization laboratory. exclusion criteria: * initial summed st-segment deviation less than 15 mm * st-segment resolution \> 50% on the ecg performed in the catheterization laboratory * chest pain onset less than 2 or more than 8 hours before arrival * severe aortic valve stenosis/regurgitation * aortic abnormalities prohibitive for use of intra aortic balloon pump * full blown cardiogenic shock with immediate requirement of left ventricular assist device as judged necessary by the operator * inability to provide informed consent * pregnancy * inability to perform coronary angiography by the femoral approach

Keywords: acute myocardial infarction persisting ischemia no reflow intra-aortic balloon pump exhausted autoregulation
performance of two toric silicone hydrogel contact lenses

Conditions: Astigmatism

Summary: prospective study to evaluate the clinical performance of fanfilcon a toric contact lens and senofilcon a toric contact lens after two weeks of wear.

the aim of this prospective study is to evaluate the clinical performance of avaira vitality toric and acuvue oasys® for astigmatism contact lenses after 2-weeks of wear in each pair.

Eligibility criteria:
inclusion criteria: * is between 18 and 40 years of age (inclusive) * has had a self-reported visual exam in the last two years * is an adapted soft contact lens wearer * has a contact lens spherical prescription between +6.00 to - 9.00 (inclusive) * have no less than -0.75d of astigmatism and no more than -2.25 d in both eyes. * can achieve best corrected spectacle distance visual acuity of 20/25 (0.10 logmar) or better in each eye. * can achieve a distance visual acuity of 20/30 (0.18 logmar) or better in each eye with the study contact lenses. * has clear corneas and no active ocular disease * has read, understood and signed the information consent letter. * patient contact lens refraction should fit within the available parameters of the study lenses. * is willing to comply with the wear schedule (at least 5 days per week, \> 8 hours/day assuming there are no contraindications for doing so). * is willing to comply with the visit schedule exclusion criteria: * has a cl prescription outside the range of the available parameters of the study lenses. * has a spectacle cylinder less than -0.75d or more than -2.50 d of cylinder in either eye. * has a history of not achieving comfortable cl wear (5 days per week; \> 8 hours/day) * has contact lens best corrected distance vision worse than 20/25 (0.10 logmar) in either eye. * presence of clinically significant (grade 2-4) anterior segment abnormalities * presence of ocular or systemic disease or need of medications which might interfere with contact lens wear. * slit lamp findings that would contraindicate contact lens wear such as: * pathological dry eye or associated findings * pterygium, pinguecula, or corneal scars within the visual axis * neovascularization \> 0.75 mm in from of the limbus * giant papillary conjunctivitis (gcp) worse than grade 1 * anterior uveitis or iritis (past or present) * seborrheic eczema, seborrheic conjunctivitis * history of corneal ulcers or fungal infections * poor personal hygiene * has a known history of corneal hypoesthesia (reduced corneal sensitivity) * has aphakia, keratoconus or a highly irregular cornea. * has presbyopia or has dependence on spectacles for near work over the contact lenses. * has undergone corneal refractive surgery. * is participating in any other type of eye related clinical or research study.
follow up of autoantibodies in active tuberculosis

Conditions: Tuberculosis

Summary: we have previoulsy shown that patients with active tuberculosis develop a wide array of autoantibodies including rheumatoid factor, anti-ccp, antinuclear facyor and anti sm antibodies. the purpose of this study is to evaluate whether the level of autoantibodies decrease after treatment aganist tuberculosis.


Eligibility criteria:
inclusion criteria: * active tuberculosis treated exclusion criteria: * none

Keywords: tb patients with tuberculosis
a single dose fmt infusion as an adjunct to keytruda for metastatic mesothelioma

Conditions: Mesothelioma

Summary: the investigators propose to ensure a favorable gut microbiome by fecal microbiota transplant to enhance the efficacy keytruda

studies have shown that a favorable microbiome can be the difference between response and non-response of certain cancer treatments such as pd-1 blockade inhibitors. as such the investigators propose to ensure a favorable microbiome in this patient by fecal microbiota transplant to enhance the efficacy of such a drug, keytruda.

Eligibility criteria:
inclusion criteria: * patient with metastatic mesothelioma deemed a candidate for pd-1 blockade inhibitor therapy exclusion criteria: * patient unable/unwilling to comply with protocol * patient deemed not a candidate for pd-1 blockade inhibitor therapy
effects of mirror therapy versus fine motor activities on hand function in chronic stroke patients.

Conditions: Stroke, Ischemic; Acute Pain; Weakness, Muscle

Summary: to compare the effects of the mirror therapy and fine motor activities on hand function in chronic stroke patients

this study will be conducted to compare the effects of mirror therapy and fine motor activities in chronic stroke patients. total twenty eight hemiplegic patients will be recruited according to inclusion criteria and data will be collected from riphah rehabilitation centre lahore and mian munshi hospital lahore (dhq). the patients will randomly assigned to a mirror therapy group (n=14) and fine motor activities group (n=14). the patients in both groups will undergo conventional therapy for 4 weeks (60minutes/day, 5 days/week). the patients will be evaluated at the beginning and end of the treatment by fugl- meyer aassessment (fma) wolf motor assessment scale and the functional independence measure (fim). after approval from ethical committee, data collection will be started and informed consent will be taken from all patients.

Eligibility criteria:
inclusion criteria: * a score greater than 24 on the mini-mental state examination test * chronic stroke patients whose episode of stroke onset was 6 months to 2 years. * patients who are able to communicate well and grasp the therapist's spoken instructions exclusion criteria: * patients who have restricted joint movement in their healthy upper extremities. * neglect syndrome or a visual field deficiency * patients with recurrent stroke. * spine surgery.

Keywords: stroke, ischemic acute pain weakness, muscle