Kornimate/medical-research-clean huggingface dataset:
causes of acute undifferentiated fever in outpatients in the democratic republic of congo

Conditions: Undifferentiated Acute Fever

Summary: fever is one of the main reasons for outpatient consultations in sub-saharan africa. following the introduction of malaria rdts, clinicians face a high number of malaria-negative patients for whom they do not have a clear diagnosis. through clinical history and examination, acute fever patients are categorized into: acute respiratory infections, urinary tract infections and other focal infections, diarrheal fevers and undifferentiated fevers. the latter being patients where no focal source of infections can be found during the consultation visit. in this proposal, the investigators focus on these acute undifferentiated fevers in an outpatient clinic. these fevers have the challenge of few point-of-care tests (poct) available for the clinicians to identify the etiology of fever and guide treatment in resource-limited countries. as a consequence, over-prescription of antibiotics has increased. in order to improve patient outcomes while supporting judicious use of antimicrobials, there is an urgent need to change the management of febrile patients in low-income countries. this can only be achieved by providing evidence-based clinical guidelines for the management of these acute febrile patients. to develop such guidelines, epidemiological data on etiologies of undifferentiated fever need to be generated. the investigators will evaluate pathogen infection (such as dengue, chikungunya and others) in 640 patients ≥ 2 years old with acute undifferentiated fever. to evaluate the existence of aspecific and subclinical infections and co-infections, the investigators will also test a subsample of 200 patients with ari, uti, diarrheal fever and malaria. the investigators expect to have as main results: proportions of each syndrome among fever patients, key pathogens associated with undifferentiated fever and their clinical presentation and demographic characteristics.


Eligibility criteria:
inclusion criteria: * at least 2 years old * a history of acute fever (i.e. ≥ 2 days and ≤ 7 days) * an axillary temperature of ≥37.5°c * written informed consent obtained; exclusion criteria: * main complaint for consultation is an injury, trauma or poisoning * hospitalization or delivery in the preceding 2 weeks * suspicion of meningitis/encephalitis
high tone pelvic floor dysfunction

Conditions: Vulvovaginal Atrophy

Summary: dyspareunia, or painful intercourse, is one of the most commonly reported complaints in postmenopausal women. one common cause of dyspareunia is vaginal atrophy (vva), which occurs in \>50% of postmenopausal women. at the time of menopause, a lack of estrogen thins the vaginal mucosa and lessons lubrication, making sex painful. some women with vaginal atrophy will also have high tone pelvic floor dysfunction (htpfd) (also known as levator spasm). successful treatment of the sexual pain requires treatment of both vaginal atrophy and htpfd. how often vaginal atrophy and htpfd coexist has not been studied. in fact, the prevalence of htpfd is unknown. this is most likely due to the fact that many clinicians are unaware of its existence or how to diagnose or treat it. also, sexual symptoms tend to be underreported due to embarrassment or hesitation to seek care. htpfd frequently coexists with other conditions that cause pain like vaginal atrophy, endometriosis or interstitial cystitis. treatment includes treating both conditions. if only one is treated, then sexual pain is likely to continue. there are several available treatments for htpfd that have been studied including physical therapy, botox and intravaginal diazepam. this is an area where clinicians may be under treating a condition and limiting the possibility of restoring normal sexual function to many women. treating only vaginal atrophy without appropriate evaluation and treatment of htpfd leaves a cohort of women still struggling with sexual pain. with a better understanding of the relationship between htpfd and vaginal atrophy, the investigators hope to bring awareness concerning the importance of treating both in restoring normal sexual function.

this is a retrospective chart review that will be performed to identify all female patients in the electronic medical records with a diagnosis of vulvovaginal atrophy (vva). the records of these patients with vva will be examined for demographics, symptoms, answers to standardized questionnaires ( e.g. female sexual function index - fsfi - that is routinely assessed during clinical evaluation), work-up, diagnosis, and/or treatment of high tone pelvic floor dysfunction (htpfd). symptoms of htpfd include but are not limited to pelvic pressure or pain, and dyspareunia. these data will then undergo statistical analysis.

Eligibility criteria:
inclusion criteria: * diagnosis of vulvovaginal atrophy (vva) exclusion criteria: * not meeting the inclusion criteria
effect of intense multi-modal training on bone health and quality of life in persons with spinal cord injury

Conditions: Spinal Cord Injury; Obesity

Summary: bone loss is a common secondary complication of spinal cord injury (sci), and treatments used to reverse this condition have equivocal effectiveness. the aim of this study is to determine the effect of intense multi-modal training on bone health, body fat, and quality of life in persons with sci. participants will complete 6 months of training during which various measures will be obtained at 0, 3, and 6 months. control subjects are also being recruited to complete testing but not participate in training.


Eligibility criteria:
inclusion criteria: * stable spinal cord injury below c2 * doctor's permission to participate in the study * non-pregnant exclusion criteria: * see above

Keywords: paralysis paraplegia obesity
reducing pain intensity during spinal needle insertion: valsalva maneuver vs. control technique

Conditions: Undefined

Summary: this study was aimed to observe the efficacy of valsalva maneuver in reducing pain intensity during spinal needle insertion.

spinal anesthesia is one of the regional anesthesia techniques needed to provide motor, sensory, and autonomic blocks specifically for lower limbs by delivering local anesthetics into subarachnoid space. this technique is not difficult to perform and relatively inexpensive. however, spinal anesthesia may cause an intense pain during needle insertion. valsalva maneuver is an attempt to force expiration by pushing a closed airway, such as covering nose or mouth. this maneuver can lead to anti-nociceptive stimulation and may decrease the pain. thus, this study was aimed to observe the efficacy of valsalva maneuver in reducing pain intensity during spinal needle insertion.

Eligibility criteria:
inclusion criteria: * elective patients having spinal anesthesia * patients with no previous history of spinal anesthesia * patients with criteria of american society of anaesthesiologist (asa) i-ii * patients willing to participate in the study and signing informed consent form exclusion criteria: * patients with contraindications of spinal anesthesia * patients with difficulty in blowing 30 mmhg for 20 seconds * patients having allergic reactions due to local anesthetics and opioid
diagnosis of individuals with pulmonary nodules by different bronchoscopy combination

Conditions: Lung Neoplasms; Early Diagnosis; Bronchoscopy

Summary: this study evaluates the value of different bronchoscopy combination for diagnosing peripheral pulmonary lesions suspected to be cancer. one-third of participants will receive routine bronchoscopy, while one-third of participants will receive bronchoscopy combined with a guiding equipment and the other one-third of participants will receive bronchoscopy combined with two or more guiding equipments. these guiding equipments include virtual bronchoscopic navigation(vbn), endobronchial ultrasonography with a guide sheath(ebus-gs) and fluoroscopy.


Eligibility criteria:
inclusion criteria: * eligible subjects are adults with solitary peripheral pulmonary lesions (mean diameter, ≤30mm and \>8mm from axial ct images) suspected to be cancer but were not pathologically confirmed. exclusion criteria: * patient has dysrhythmia or cardiovascular disease that poses a risk during exercise. * patient has uncontrollable hypertension (sbp \> 180mmhg). * patient has severe organ dysfunction (shock, severe hepatic and renal dysfunction, massive hemorrhage of upper gastrointestine, diffuse intravascular coagulation(dic) and massive hemoptysis,etc). * patient has blood coagulation disorders (pt\>2 times the upper limit of normal(uln) or platelet(plt)\<50000/ul）. * patient has severe dyspnea. * patient is allergic to local anesthetic. * patient is unable to provide informed consent. * patient is not an appropriate candidate for of is unable to tolerate flexible bronchoscopy procedures. * patient has any disease or condition that interferes with completion of initial or follow-up assessments of the effectiveness endpoints. * patient has demonstrated unwillingness or inability to complete screening or baseline data collection procedures. * patient participated in a study of an investigational drug or device within the past 30 days prior to participation in this study, or is currently participating in another clinical study. * female patient of childbearing potential has a positive result from a pregnancy test.

Keywords: lung neoplasms bronchoscopy virtual bronchoscopic navigation(vbn) fluoroscopy endobronchial ultrasonography with a guide sheath(ebus-gs) diagnosis
effect of meal frequency on weight loss and body composition of obese and overweight women

Conditions: Overweight and Obesity

Summary: studies showing the relationship between meal frequency, weight loss and anthropometric measurements are contradictory. this study is planned and conducted to observe the effects of meal frequency (3 meals+3 snacks vs 3 meals) on weight loss, anthropometric measurements and body composition with 3-month energy restricted medical nutrition therapy program in 19-64 years old women with a bmi ≥ 27 kg/m2.

the study was conducted with 40 female volunteers between the ages of 19-64 years, with a body mass index (bmi) ≥27. energy restricted individualized weight loss programs were applied with different meal frequencies (3 meals+3 snacks/day vs 3 meals/day) in a 3 month follow up period. 20 participants were randomized in 3 meals+3 snacks and 20 participants were randomized in 3 meals group. food consumption was questioned, and anthropometric measurements and body composition were measured before the study and repeated each week till the end of the study. three day food records (2 week days and 1 weekend day) taken before the intervention were evaluated and five hundred calorie was subtracted from the average energy calculated form the food records to determine the energy of the weight loss plans . breakfast, lunch and dinner are planned as main meals and the beverages and/or food eaten between main meals were planned as snacks (50-200 kcal). for both of the groups dietary weight loss program was planned by the same dietitian. macronutrient composition of the weight loss plan was designed according to the recommendations of the turkish dietary guidelines as 45-60 % carbohydrate, 10-20 % protein and 20-35 % fat for both of the groups.

Eligibility criteria:
inclusion criteria: * 19-64 years old women, * healthy subjects with no chronic diseases, * subjects who were not taking any drug or dietary supplements, * subjects who have not made any changes in their physical activity or eating habits for weight loss in the last 6 months, * subjects with a bmi ≥ 27 kg/m2 exclusion criteria: * failure to meet the criteria for inclusion

Keywords: meal frequency body composition bmi waist circumference
nasopharyngeal carcinoma treated with reduced volume intensity modulated radiation therapy:10-year outcome and late toxicity, quality of life

Conditions: Nasopharyngeal Carcinoma

Summary: nasopharyngeal carcinoma (npc) is a type of head and neck cancer. the last three decades of research in head and neck radiation oncology have largely focused on improvements in survival, which have mostly come at the cost of long term toxicity for surviving patients.this is an observational study that is being done to evaluate the long-term efficacy, learn about the toxicity and quality of life that survivors of nasopharyngeal carcinoma may have following treated with reduced volume intensity modulated radiation therapy.


Eligibility criteria:
inclusion criteria: * received treatment with reduced volume intensity modulated radiation therapy * age 18 or above, upper limit 65 * ability to comply with the protocol exclusion criteria: * history of recurrent nasopharyngeal disease * a history of any physical, psychological or social condition which would impair with the ability of the patient to cooperate in this study * unable to provide consent
intermittent oro-esophageal tube feeding vs. nasogastric tube feeding in infants with pierre robin syndrome

Conditions: Pierre-Robin Syndrome; Dysphagia

Summary: this was a randomized controlled study. the infants enrolled were randomly divided into the ioe group (with intermittent oro-esophageal tube feeding, n=25) and the png group (with nasogastric tube feeding, n=23), all receiving systemic therapy. before and after 4-week treatment, pulmonary infection, swallowing function, nutritional status and body weight between the two group were compared.

pierre robin syndrome (prs) can cause dysphagia. in china, persistent nasogastric tube feeding (png) is the mainstream choice as nutrition support in the dysphagic infants with prs. however, png is associated with various complications, necessitating the exploration for a safer and more effective nutritional support approach. therefore, this study aims to observe the clinical effect of intermittent oro-esophageal tube feeding (ioe) compared to png in the dysphagic infants with prs who received systemic therapy. this was a randomized controlled study. the infants enrolled were randomly divided into the ioe group (with ioe, n=25) and the png group (with png, n=23), all receiving systemic therapy. before and after 4-week treatment, pulmonary infection, swallowing function, nutritional status and body weight between the two group were compared.

Eligibility criteria:
inclusion criteria: * meeting the diagnostic criteria for pierre robin sequence based on ct and x-ray examinations, combined with clinical manifestations and physical signs. * with spontaneous vaginal birth, aged 1 to 12 months. * with dysphagia screened by the water drinking test and further confirmed by the assessment of dysphagia disorders survey (dds), dysphagia severity scale (dss), or schedule for oral motor assessment (soma) * before the treatment, the tube feeding was required and feasible after evaluation. * stable vital signs. * with nasogastric tubes placed before the treatment. * sufficient human milk could be provided by the mothers of the patients (with the help of a manual suction device). exclusion criteria: * abnormalities in brain development or other neurological lesions revealed by ct or mri scans. * dysphagia caused by other diseases. * other congenital malformations, such as down syndrome, cleft lip, and palate, etc. * severe systemic disease (such as severe infection, severe hepatic and renal dysfunction). * participants who need to receive other therapy which would potentially affect the result of this study.

Keywords: infant pierre robin syndrome dysphagia rehabilitation
semi-permanent acupuncture effect on cervical ripening

Conditions: Pregnancy Complications

Summary: cervical ripening is a medical treatment that can cause physical or emotional discomfort in pregnant women and is not without risks. this is a pilot study to assess feasibility and calculate the number of participants necessary for a complete clinical trial. the aim is to evaluate whether acupuncture can reduce the need for treatment (cervical ripening) in pregnant women at low or intermediate risk. participants will be divided into two groups: one group will receive acupuncture, and the other will receive a simulated treatment of acupuncture.


Eligibility criteria:
inclusion criteria: * anticipated delivery at the study center. * ability to collaborate in necessary evaluations. * legal capacity to provide informed consent. * signature of the informed consent for inclusion in the study, by oneself. exclusion criteria: * pregnancy with high or very high risk as described by the pregnancy and childbirth monitoring protocols of the department of health of catalonia * history of cesarean delivery. * language barrier preventing collaboration in study procedures. * cognitive or affective pathology limiting the ability to collaborate with study procedures. * participation in another clinical trial involving an experimental intervention during the period of this trial and/or establishing a visit frequency incompatible with this trial.

Keywords: cervical ripening acupuncture therapy
outcome of facial palsy following rehabilitation

Conditions: Facial Paralysis

Summary: retrospective case series,the aim of this study is to assess the outcome and rate of complications in patients with facial palsy following rehabilitation, a retrospective study.

data from all patients presenting to the outpatient clinics of the physical medicine, rheumatology and rehabilitation department. faculty of medicine, alexandria university in the past 3 years will be collected. the outcome and complications from rehabilitation of facial palsy will be recorded. primary outcome: complications of facial palsy following rehabilitation. confidentiality of all records will be ensured.

Eligibility criteria:
inclusion criteria: * all patients with primary idiopathic peripheral facial palsy exclusion criteria: * all patients with secondary causes of facial palsy
motivational incentives to reduce secondhand smoke in nicu infants' homes

Conditions: Exposure to Secondhand Smoke in Neonatal Infants

Summary: a randomized, controlled, parallel group design will be used to test whether a secondhand smoke exposure program initiated in the hospital and completed in the home using motivational interviewing plus motivational incentives (mi+) is more effective than conventional care (cc) with neonatal incentives care unit infants' parents.


Eligibility criteria:
inclusion criteria: * have an infant that is at least 1 week prior to the estimated date of hospital discharge in the nicu at children's memorial hermann hospital (cmhh) * report at least one person living in the home who smokes * agree to attend intervention sessions and to invite other household members * live within 50 miles of our center * have access to a telephone. exclusion criteria: * severe cognitive, and/or psychiatric impairment, per judgment of nicu and research staff, that precludes cooperation with study protocol * inability to read, write, and speak english or spanish * inability or unwillingness to provide signed consent for participation * inability or unwillingness to meet study requirements, including home visits for data collection and intervention purposes.

Keywords: motivational incentives motivational interviewing secondhand smoke neonatal intensive care unit nicu high respiratory risk infants low birth weight infants environmental tobacco smoke smoking contingency management infants children
the diagnostic ultrasound enthesitis tool (duet) study

Conditions: Psoriatic Arthritis; Psoriasis; Non-Inflammatory Rheumatic Conditions

Summary: psoriatic arthritis (psa) is a type of joint disease that can lead to severe joint damage and disability within the first few years of the disease. this is why early detection and treatment of the disease is essential to prevent serious joint damage and improve long-term outcomes in these patients. however, there is currently no reliable way to tell the difference between psa and other types of joint disease. this makes it difficult to detect psa early. enthesitis is an inflammation of the area where muscle tendons and ligaments attach to bones. enthesitis is a key feature in psa and can be easily detected using ultrasonography. the aim of this research study is to develop a system to evaluate enthesitis using ultrasonography, which can be used as an effective tool in the early detection of psa. this will help in providing patients with early treatment to prevent further joint damage.


Eligibility criteria:
general inclusion criteria: * age ≥18 * able to provide an informed consent specific inclusion criteria for psa: * meets the caspar criteria for psa * early psa - less than 5 years from a rheumatologist diagnosis of psa specific inclusion criteria for psoriasis: * dermatologist confirmed diagnosis of psoriasis * no prior diagnosis of psa or signs of psa on physical examination * psoriasis epidemiology screening tool (pest) score \< 3 specific inclusion criteria for non-inflammatory rheumatic disease: * referred to rheumatology for musculoskeletal symptoms such as joint pain, stiffness, back pain * no evidence of inflammatory rheumatic condition including rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, scleroderma, gout, septic arthritis or recent joint trauma/surgery * no psoriasis * no inflammatory bowel disease exclusion criteria: * using any biologic medications including tumor necrosis factor (tnf) inhibitors, interleukin (il)-17 inhibitors, il-23 inhibitors, il-12/23 inhibitors, janus kinase (jak) inhibitors * prednisone ≥ 7.5 mg/day

Keywords: enthesitis psa musculoskeletal ultrasound diagnosis
the role of hrm and specific biomarkers of inflammation in the diagnosis of patients with dysphagia and suspected eoe

Conditions: Eosinophilic Esophagitis

Summary: the aim of the project is to assess the correlation between the results of high-resolution oesophageal manometry and specific biomarkers of inflammation (eotaxin 3, major basic protein, il-5, il-13, tgf-beta1) with symptoms of dysphagia, endoscopic and histological features and the assessment of quality of life in patients with eosinophilic esophagitis. research hypothesis: the results of high resolution esophageal manometry (hrm) and specific inflammatory biomarkers correlate with symptoms of dysphagia, endoscopic and histological features, and assessment of quality of life in patients with eosinophilic oesophagitis. hrm, along with the determination of specific inflammatory biomarkers present in the peripheral blood, may serve as a less invasive method of assessing the effectiveness of the treatment of eosinophilic oesophagitis in relation to the currently used endoscopic examinations.


Eligibility criteria:
inclusion criteria: * patients over 18 years of age, * patients referred for endoscopic diagnostics due to dysphagia. exclusion criteria: * already diagnosed chronic diseases with possible eosinophilic infiltration of the gastrointestinal tract (eosinophilic esophagitis, eosinophilic gastroenteritis, crohn's disease, celiac disease), * rheumatological, dermatological and genetic disorders with possible peripheral eosinophilia, * dysphagia caused by a diagnosed neoplastic infiltration of the esophagus.

Keywords: eosinophilic esophagitis eotaxin 3 major basic protein interleukin 5 interleukin 13 transforming growth factor beta 1 high-resolution manometry gastrointestinal quality of life index