Kornimate/medical-research-clean huggingface dataset:
caspofungin for pneumocystis pneumonia in plwhiv.

Conditions: HIV-1-infection; Pneumocystis Pneumonia

Summary: pneumocystis jirovecii pneumonia is a significant concern in peaple with hiv/aids, often severe and potentially fatal. while trimethoprim/sulfamethoxazole remains the primary treatment, safety concerns exist with alternative options. research on pneumocystis jirovecii's beta-d glucan composition has prompted investigations into echinocandins like caspofungin, showing promise in murine models and some positive results in human studies. evaluating caspofungin's efficacy through observational studies is crucial due to safety advantages over current treatments and limited documented data.

pneumocystis jirovecii pneumonia (pcp) is a significant opportunistic disease in immunocompromised patients with hiv/aids, becoming increasingly prevalent. this condition can range in severity, at times being fatal and necessitating drastic measures. the standard first-line treatment, trimethoprim/sulfamethoxazole, has been unchanged for over three decades. while other drugs have been approved as second-line treatments, they come with safety concerns such as increased risk of hypersensitivity reactions and adverse effects. research on pneumocystis jirovecii has faced challenges due to difficulties in cultivation, requiring in vivo models for study. previous studies have found that the wall of pneumocystis spp. contains beta-d glucans in one phase of its life cycle. this discovery has led to investigations into the effectiveness of echinocandins, specifically caspofungin, on pneumocystis spp. promising results have been observed in murine models; however, these studies were conducted on species that do not affect humans. clinical observational studies in humans have shown positive response and safety, albeit using caspofungin in combination with other drugs rather than as monotherapy. considering the superior safety profile of echinocandins compared to first-line treatments for p. jirovecii, and the limited documented data in case reports or series, it is important to assess the efficacy of caspofungin in observational studies to address this gap.

Eligibility criteria:
inclusion criteria: * diagnosis of probable or proven pcp, according to its diagnostic classification (refer to classification at the end of this section). * have clinical laboratory and virological diagnostic laboratory studies at the time of admission. * classification criteria for pneumonia by p. jirovecii according to robert-gangneux et al.: proven: confirmation by pathology or microbiology. possible: presence of three out of four clinical or radiological criteria. probable: presence of one clinical or radiological criterion without another identified microorganism. exclusion criteria: * with a treatment switch to caspofungin after day 7 of treatment initiation (applies only to group b). * patients who have developed an additional opportunistic lung infection during their hospitalization, other than cytomegalovirus pneumonitis or sars-cov-2 pneumonia.

Keywords: pneumocystis jirovecii pneumonia echinocandins caspofungin
comparison of superior vs nasal/temporal laser peripheral iridotomy in primary angle closure

Conditions: Glaucoma, Angle-Closure

Summary: the purpose of this study is to determine if location of laser peripheral iridotomy (lpi) that is the standard of care treatment for angle closure glaucoma is related to changes in post-operative intraocular pressure (iop), endothelial cell count,anterior chamber angle morphology and onset of new visual disturbances.

study hypothesis: location of laser peripheral iridotomy affects occurrence of post-operative dysphotopsia symptoms, intraocular pressure, anterior chamber angle morphology and corneal endothelial cell count study design: multicenter randomized, prospective, single masked trial trial setting: hospitals trial type: treatment interventions: south indian subjects aged 30 years or greater, with primary angle closure suspect (pacs) or primary angle closure/ primary angle closure glaucoma(pac/pacg) will be randomized to either bilateral superior or nasal/temporal laser peripheral iridotomy. subjects will undergo noninvasive testing and imaging studies to measure iop, anterior chamber angle morphology and endothelial cell count and asked to answer a questionnaire at baseline and again at 2 weeks and 6 months after treatment primary outcome measures: occurrence of new self-reported general eye or dysphotopsia symptoms. secondary outcome measures: intraocular pressure, anterior chamber and anterior chamber angle morphology, endothelial cell count.

Eligibility criteria:
inclusion criteria: * diagnosis of pacs or pac/pacg in at least one eye exclusion criteria: * bilaterally pseudophakic * prior iridotomy, iridoplasty, or incisional glaucoma surgery in either eye * signs or symptoms consistent with acute angle closure at time of enrollment
uddevalla skövde transscleral micropulse study

Conditions: Primary Open Angle Glaucoma; Pseudoexfoliation Glaucoma

Summary: micro pulse transscleral laser treatment (mp-tlt) is a relatively new method to reduce the intraocular pressure (iop) in glaucoma. new recommendations regarding the treatment protocol has recently been developed and was published 2022. the overall objective is to evaluate the efficacy and safety of the proposed treatment method in an independent study. in addition, the outcome of mp-tlt in patients with pseudoexfoliation glaucoma, which is relatively common in the nordic countries, and primary open angle glaucoma will be studied separately. the iop change over the course of one year will be monitored, as well as success rate and survival. further, patient-reported discomfort from the treatment and the occurrence of any adverse events or complications will be studied.

forty patients scheduled for mp-tlt by their ophthalmologist will be recruited. one eye per patient is included, based on randomization, even if both are treated. mp-tlt will be performed according to the current recommendations. baseline iop will be calculated as the mean of three separate measurements taken on different days preoperatively. iop will then be measured 1 week, 1 month, 3 months, 6 months and 12 months after mp-tlt. the central corneal thickness (cct), the central retinal thickness (crt), anterior chamber flare and the visual field (hfa 24-2 faster) will also be measured preoperatively and during follow up. in accordance with the world glaucoma association guidelines, no adjustment for multiple comparisons is planned in this study.

Eligibility criteria:
inclusion criteria: * diagnosis of primary open angle glaucoma (poag) or pseudo exfoliative glaucoma (pxfg) * age ≥ 18 years * the patient is expected to be able to adequately undergo and cooperate in the treatment and follow-up as described in the study protocol. * the patient is judged to have good compliance with already prescribed pharmacological glaucoma treatment. exclusion criteria: * allergy or hypersensitivity to tetracaine or lidocaine * prior transscleral laser or cryo treatment. * prior eye surgery (including intravitreal injection) or pressure-lowering laser treatment (slt/alt/mdlt) during the last 2 months. * planned or expected eye surgery (eg., cataract surgery or intravitreal injection) in the coming year. * history of macular edema. * history of corneal edema. * history of uveitis during the past year. * existing thinning in the sclera of a greater extent than 30 degrees (one "clock-hour") of the circumference.

Keywords: micro pulse transscleral laser treatment (mp-tlt)
muscle energy technique versus back stretching among non-specific low back pain-subacute

Conditions: Low Back Pain

Summary: this study will highlight lbp management using met and stretching application among subacute type of back pain

this study will explore effects of two approaches , out of two met has not been used in clinical practice more often, therefore this study will explore its physiological impact among back pain

Eligibility criteria:
inclusion criteria: - low back pain (subacute) * vas score( more than 3 cm) * quadratus lumborum and erector spinae tightness present exclusion criteria: * back pain (specific)

Keywords: low back pain
rehab cares in usa: clinical trial

Conditions: Stroke; Hemiplegia

Summary: in phase 2, patients in a community-based setting who have had a stroke will be evaluated by rehabilitation professionals and asked to perform a battery of clinical assessments before and after standard of care and robot assisted therapy with rehab cares system of simple force-feedback robots that are adapted to deliver single and group therapy.

in phase 2, we will develop the hardware to allow three haptic robots to dock (a gym) and be configured to allow patients to play therapy games alone or collaboratively. we will test the safety and feasibility of the gym in a community-based rehabilitation setting. we will treat 36 patients randomized to either a control group getting standard of care therapy and a robot group receiving standard of care with upper limb therapy being given using the robot gym instead of an occupational therapist. therapy will occur over 4 weeks with two follow-up assessments. key milestones will be to show that the robot group has the same or better functional outcomes, motivation, and adverse events as the control group. also to show that the robot gym is a cost-effective solution to increasing access to quality rehabilitation care in low-resource, community-based settings. success here will validate this potential solution, justify design changes revealed via user-feedback and a larger clinical trial.

Eligibility criteria:
inclusion criteria: * age 55 and older (based on who is admitted to the cbr site) * \>3 months post-stroke * stroke diagnosis * diagnosis of hemiparesis as a result of stroke (verified by radiology data) * motor control score on upper extremity fugl-meyer scale \> 15 and \< 60; * able to understand and speak * upper arm manual muscle strength scores \>1 * pain scores \< 8 based on nih pain intensity scale exclusion criteria: * no cerebellum lesions due to stroke * severe cognitive function
cough peak flow for extubation prediction

Conditions: Extubation in ICU Patients

Summary: successful weaning from mechanical ventilation in icu patients depends on patient ability to breathe spontaneously and on cough efficiency. previous studies found that cough peak flow (cpf) at 60 l/min threshold predicted extubation failure. these studies measured cpf using a dedicated flow-meter that required patient disconnection from the ventilator, limiting the generalizability of this procedure. this study aimed to predict extubation outcome in a consecutive series of patients by measuring cpf from the ventilator flow-meter. cpf measurements were done by freezing ventilator screen and scrolling the cursor to the maximal value of cpf during expiration and tidal volume (tv) in preceding inspiration. the objective was to assess the performance of cpf to predict early extubation outcome.


Eligibility criteria:
inclusion criteria: * age \> 18 years * intubation \> 24h * eligible for scheduled weaning trial and then scheduled extubation * mechanical ventilation from evita xl ventilator (dräger, germany) * patient's agreement to participate exclusion criteria: - withdrawal decision of life supporting care

Keywords: cough peak flow scheduled weaning trial scheduled extubation prognosis
the effect of a self-management program on individuals with scleroderma

Conditions: Scleroderma; Systemic Sclerosis

Summary: introduction: individuals with systemic sclerosis (ssc) have problems with perceived occupational performance and satisfaction in daily life activities due to many symptoms caused by the disease. purpose: this study will plan to examine the effect of a self-management program for individuals with ssc on perceived occupational performance and satisfaction. materials and methods : twenty-nine individuals with ssc, 28 females and 1 male will participate in the study. perceived occupational performance and satisfaction levels before and after the program will evaluate with the canadian ocupational performance measure (copm). the training programme will design according to the activities of copm, the needs of the patients, and the literature. the programme consists of 8 sessions for 8 weeks, 1 day a week for 45 minutes.

in this study, 36 individuals, diagnosed with scleroderma by a rheumatologist at gazi university, were included. in the study approved by the gazi university clinical research ethics committee (21.09.2020, decree no: 635) and planned by the declaration of helsinki, consent forms were sent to all participants to confirm that they were volunteers. demographic information of the individuals was obtained. the canadian occupational performance measure (copm) was used to identify occupational problems and to implement a person-centered program. this information was obtained by submitting online forms. the videos were prepared by a team of physiotherapists, occupational therapists, and rheumatology doctors. the program manager was an occupational therapist. 29 people completed the 8-week program, which included 40-50 minute videos and assignments (keeping a pain diary, creating an exercise routine, etc.). at the end of the program, individuals were reminded of the difficult occupations again so that the canadian occupational performance measure could be re-scored. initially, the open-ended question "in which ways did the program contribute to you?" was asked. individuals were evaluated in the first and last week of the program and the results were compared. these evaluations and interventions were made during the covid-19 pandemic.

Eligibility criteria:
inclusion criteria: clinical diagnosis of scleroderma's disease, being in remission period for 6 months, being between the ages of 18-65, knowing how to use technological devices. exclusion criteria: neurological disease, continuing a different study or rehabilitation programme, having covid-19 infection, exacerbation the disease in the last 6 months.
study to determine the feasibility of using an at-home foot temperature monitoring device (thermidas)

Conditions: Foot Ulcer, Diabetic

Summary: this is a feasibility study, designed to assess the acceptability of at home temperature monitoring (aitm) by patients at high risk of diabetes foot ulceration. the investigation hopes to identify any problems with the study design before progressing to a full-scale evaluation, and will assess the ease of use of the technology and if there are any barriers to using this. participants will be provided with an infrared camera and smart phone and trained in how to use them. the participants will then be expected to capture images of both the plantar and dorsal aspects of their feet that will be sent to the research team for review. the two images will be captured once per day. the intervention period will be 12 weeks. if a raised temperature is identified, the participant will be offered a face to face review appointment where they will receive podiatry treatment (if required), ulcer prevention advice and more detailed thermal imaging. patient and health care professional (hcp) questionnaires will be used at the start and end of the study period to assess quality of life impact and device ease of use.


Eligibility criteria:
inclusion criteria: * written informed consent * male or female \>/ = 18 years of age * diabetes mellitus type 1 or 2 according to who criteria * independently ambulatory * deemed high risk/ in remission via sci diabetes foot risk stratification tool * expected to comply with study schedule exclusion criteria: * active foot ulcer or open amputation site * active charcot neuro-osteoarthropathy * active foot infection based on pedis classification criteria * amputation proximal to the chopart joint in one or both feet * critical limb ischaemia (according to pedis classification) * severe illness that would make 6-month survival unlikely based on the clinical judgement of the physician or podiatrist * concomitant severe physical or mental conditions that limit the ability to follow the instructions of the study, based on the clinical judgement of the physician or podiatrist
the aid study 2: artificial intelligence for colorectal adenoma detection 2

Conditions: Colon Cancer

Summary: colonoscopy is clinically used as the gold standard for detection of colon cancer (crc) and removal of adenomatous polyps. despite the success of colonoscopy in reducing cancer-related deaths, there exists a disappointing level of adenomas missed at colonoscopy. "back-to-back" colonoscopies have indicated significant miss rates of 27% for small adenomas (\< 5 mm) and 6% for adenomas of more than 10 mm in diameter. studies performing both ct colonography and colonoscopy estimate that the colonoscopy miss rate for polyps over 10 mm in size may be as high as 12%. the clinical importance of missed lesions should be emphasized because these lesions may ultimately progress to crc. limitations in human visual perception and other human biases such as fatigue, distraction, level of alertness during examination increases such recognition errors and way of mitigating them may be the key to improve polyp detection and further reduction in mortality from crc. in the past years, a number of cad systems for detection of polyps from endoscopy images have been described. however, the benefits of traditional cad technologies in colonoscopy appear to be contradictory, therefore they should be improved to be ultimately considered useful. recent advances in artificial intelligence (ai), deep learning (dl), and computer vision have shown potential to assist polyp detection during colonoscopy. average experienced endoscopists (each having performed \<2000 screening colonoscopies) will perform the endoscopic procedure.


Eligibility criteria:
inclusion criteria: * all 40-80 years-old subjects undergoing a colonoscopy exclusion criteria: * subjects with personal history of crc, or ibd. * patients with inadequate bowel preparation (defined as boston bowel preparation scale \> 2 in any colonic segment). * patients with previous colonic resection. * patients on antithrombotic therapy, precluding polyp resection. * patients who were not able or refused to give informed written consent.

Keywords: artificial intelligence
effect insulin pump therapy to patients with diabetic nephropathy

Conditions: Insulin Pump Therapy in Treating Diabetic Nephropathy

Summary: the recent study suggested that oxidative stress resulting from increased production of reactive oxygen species (ros) plays a crucial role in the development of diabetic complications. the researches aim to monitor the level of oxidative stress of patient in different stage of diabetic nephropathy before and after insulin pump therapy.

worldwidely, about 30% of type 1 diabetes mellitus (t1dm) and 20%-50% of t2dm patients suffered diabetic nephropathy (dn). oxidative stress resulting from increased production of reactive oxygen species (ros) plays a crucial role in the development of diabetic complications. insulin pump therapy is better than subcutaneous injection in terms of the drug safety and effectiveness. the researches aim to monitor the level of oxidative stress of patient in different stage of diabetic nephropathy before and after insulin pump therapy.

Eligibility criteria:
inclusion criteria: diabetic patients with fasting plasma glucose (fpg) ≥10mmol/l and/or 2 hours' plasma glucose (2hpg) ≥15mmol/l. exclusion criteria: diabetic patients who 1. using antioxidant drugs within one month; 2. accompanied with acute and chronic severe complications, fever, malignant tumor, nephritis, congestive heart failure. 3. accompanied with diabetic ketosis, ketoacidosis, severe hypoglycemia, hyperosmolar hyperglycemic state; 4. with other endocrine diseases, autoimmune diseases, or connective tissue diseases; 5. having history of infection within 1 month; 6. having drug or alcohol dependence; 7. severe hypoxia and stress state (e.g., cardiovascular events, trauma, surgery, and consumptive disease, etc.)

Keywords: diabetic nephropathy insulin pump intensive therapy
comparison between 2 techniques for bilateral salpingectomy

Conditions: Sterility, Female

Summary: a comparison between 2 techniques for bilateral salpingectomy during cesarean section. primary outcomes are total operative time and bilateral completion of the randomized procedure. secondary outcomes included surgical complications and post operation complications.

ovarian cancer is the most lethal gynecologic malignancy. major contributors to this high mortality are the lack of effective screening strategies, diagnosis at advanced stage of presentation as well as the high risk of recurrence. in the last years the gynecologic associations worldwide have recommended that total salpingectomy be considered for potential ovarian cancer risk reduction in benign gynecologic surgeries after completion of childbearing. however, the data are limit regarding the preferred surgical technique during cesarean section. in this randomized controled trial the investigators will compare between various techniques for bilateral salpingectomy during cesarean section. primary outcomes are total operative time and bilateral completion of the randomized procedure. secondary outcomes included surgical complications and post operation complications.

Eligibility criteria:
inclusion criteria: * participants undergoing elective cesarean section and are interested and have signed informed consent regarding bilateral salpingectomy. exclusion criteria: * inability to give informed consent. * preterm delivery (\< 37 weeks' gestation). * fetal demise. * prenatal diagnosis of fetal or placental abnormalities. * previous tubal surgery. * the use of anticoagulants. * associated immunosuppressive conditions.