Kornimate/medical-research-clean huggingface dataset:
the effectiveness of telerehabilitation modalities in physical therapy in the management of chronic low back pain

Conditions: Low Back Pain

Summary: low back pain (lbp), a common disorder, causes disability, functional decline and high health care costs. patient care programs include specific exercises for promoting function and improving health. self-practice and adherence to treatment are important for treatment success and better outcomes. telerehabilitation (tr) might improve patient symptoms, compliance to treatment and reduce patient symptoms, however, its effectiveness in treating lbp, still needs further investigation. the overall aim of this study will be to examine the effectiveness of combining telerehabilitation within physical therapy treatments for patients with lbp

the study will include 60 patients complaining of chronic nonspecific lbp over a 6 month period of time and referred for physical therapy treatment. they will undergo a routine physical examination and be assigned a personal treatment (manual therapy and electrotherapy) and exercise program in accordance with their condition. participants will receive a total of 8 treatments over a 4-week period (twice a week). the sample will be randomly divided into 2 groups: a. research group a will receive a video of the exercises via e-mails or to their cellphones; b. a control group will receive the exercises printed on paper. the exercises will be recorded and be supplemented by a verbal explanation and instructions as to how to correctly perform the exercises. in total, there will be ten videos, found to be important and effective for lbp patients. from these videos, a physical therapist will choose the most suitable exercises for the patients after each treatment meeting (face to face). the patients will be assessed at baseline, at the end of treatment and at a 3 month follow-up telephone assessment.

Eligibility criteria:
inclusion criteria: * main complaint of nonspecific lbp over a 3 month period * possess a smartphone, e-mail and the understanding of using these tools for viewing videos. exclusion criteria: * signs or symptoms of possible malignancy are present, such as unexplained weight loss, slight or no reduction of pain while in a recumbent position or subjects were not screened prior to referral to physical therapy. * two or more of the following signs are present on physical examination: lower extremity weakness in a myotome distribution, decreased sensation in a dermatomal distribution, altered lower extremity deep tendon reflexes, pathological reflexes, a positive straight leg raise (slr) test, crossed slr or femoral nerve stretch test. * symptoms began immediately after a significant trauma (motor vehicle accident, fall from a height) and subjects were not been screened for possible fractures. * physical therapy or chiropractic treatment for lbp was provided during the 6 months prior to participation in the study or are currently being treated.

Keywords: telerehabilitation, exercises, video, physical therapy
feasibility study of game technology in the early diagnosis of mild cognitive impairment and alzheimer's disease

Conditions: Dementia Alzheimers

Summary: this study will test g:data, a simple computer game designed to diagnose alzheimer's disease, in three different groups of people, some of whom have alzheimer's disease. it will look at whether the results of g:data match the results of tests that are used to diagnose people with alzheimer's disease now. the investigators will also ask patients and healthcare staff for participant views on the g:data game.

alzheimer's disease is a type of dementia that causes progressive deterioration to memory, thinking and behaviour. it is currently thought to affect 50 million people globally, although 75% of those affected are thought to be undiagnosed, with no access to treatment.\[2\] diagnosis requires extensive clinical evaluation, involving a range of techniques that are resource-intensive and can only be performed in clinical settings. research has demonstrated a direct link between carefully designed spatial learning within computer games and the detection of deterioration in specific brain cells first affected by alzheimer's disease, overlooked by existing assessment techniques. this research will look at the feasibility of using a computer game diagnostic tool, called g:data, in the diagnosis of alzheimer's disease. it will do this by providing a clinical benchmark, consolidating the results of gameplay performance against current clinical gold-standard assessments, during a clinical study conducted with two patient groups (patients with mild cognitive impairment (mci), patients with mild ad-related dementia) and a healthy controls group. outcomes will include validity data of the game's output in diagnosing alzheimer's disease, together with data on the tool's usability, and acceptability.

Eligibility criteria:
inclusion criteria: * aged between 55-79 years * willing and able to provide informed consen- exclusion criteria: * a concurrent diagnosis of epilepsy * a history of severe visual impairment, e.g. macular degeneration, diabetic reti-nopathy, as determined by the clinical team * a history of head trauma * presence of sleep apnoea * history of alcohol dependence * history of illicit drug use * severe upper limb arthropathy * the use of cognitive enhancing drugs e.g. cholinesterase inhibitors-
phase 2 study of et-743 (trabectedin) in patients with persistent or recurrent endometrial carcinoma

Conditions: Endometrial Neoplasms; Uterine Neoplasms; Genital Neoplasms, Female Urogenital Neoplasms

Summary: the purpose of this is to test the safety and effectiveness of an investigational chemotherapy agent in patients with persistent or recurrent endometrial cancer.

patients will be enrolled in the study after all study-specific entry criteria are met and informed consent is obtained. patients will be required to attend regular clinic visits to receive study medication and have their status monitored. they will also be required to have radiologic tumor assessments performed at multiple times throughout the study. a detailed explanation can be provided by the investigator conducting this study. trabectedin 1.3 mg/m2 will be given every 21 days to patients intravenously (i.v). over a 3-hour period via a central venous catheter (referred to as a "central line") which is a tube (ie, catheter) placed into a large vein that is used to administer medications. dexamethasone 4 mg will be given orally (p.o.) the day before trabectedin and dexamethasone 20 mg will be given i.v. 30 minutes before trabectedin. dexamethasone 4 mg p.o. will be given for 2 days following trabectedin administration.

Eligibility criteria:
inclusion criteria: * diagnosis of advanced or metastatic endometrial carcinoma * progressive disease after 1 cytotoxic chemotherapy regimen given for advanced/metastatic disease * at least one measureable tumor lesion * adequate bone marrow, hepatic and renal function * performance status ecog 0 or 1 exclusion criteria: * prior exposure to trabectedin * known hypersensitivity to dexamethasone or to any of the components of trabectedin * less than 4 weeks since last radiation therapy or since last dose of hormonal therapy, biological therapy, therapy with any investigational agent, or chemotherapy * history of another neoplastic disease unless in remission for more than 5 years * known metastases (spread) of cancer to the central nervous system or other serious illness as specified in the protocol * current pregnancy, lactation, or childbearing potential without adequate method of contraception.

Keywords: endometrial cancer carcinoma trabectedin ecteinascidin 743 et743 antineoplastic agents alkylating agents molecular mechanisms of pharmacological action
a casefinding and referral system for older veterans within primary care

Conditions: Depression; Incontinence; Cognitive Impairment

Summary: underdiagnosis and undertreatment of elderly persons remains a widespread problem. while many innovative geriatric care programs exist within vha, we still lack a systematic process for identifying at-risk elders from the larger va population who are likely to benefit from specialized geriatric services.

background: underdiagnosis and undertreatment of elderly persons remains a widespread problem. while many innovative geriatric care programs exist within vha, we still lack a systematic process for identifying at-risk elders from the larger va population who are likely to benefit from specialized geriatric services. objectives: our goal is to improve care for at-risk older veterans through a comprehensive system of casefinding, assessment, referral and follow-up within the primary care setting. we hypothesize that subjects receiving this intervention will have more complete evaluation and treatment for selected geriatric conditions (i.e., falls, urinary incontinence, functional status impairments, depression, and cognitive deficits), better continuity of care, less decline in functional status, and better general health than subjects receiving usual care. methods: this randomized controlled trial is being performed at the sepulveda va outpatient clinic. the study sample is composed of community-dwelling veterans aged 65 and older who are not receiving va geriatric services. veterans are mailed a health screening survey to identify those at risk for decline based on criteria established in pilot work. at-risk respondents who are in the intervention group receive a structured telephone assessment (casefinding) and referral to appropriate geriatric services, including a geriatric assessment and teaching clinic integrated with primary care, and telephone case management. subjects in the control group receive usual care. major outcome measures collected by telephone interview at baseline, 12, 24, and 36 months include functional status, self-rated health, satisfaction, and health care utilization. medical records are reviewed for evidence of evaluation and treatment of the target conditions. status: data collection for this project was completed on september 30, 2001. the subject recruitment phase was completed in august, 1998. collection of 36 month follow-up data has been completed for all subjects enrolled. data analysis and preparation of publication is in press.

Eligibility criteria:
inclusion criteria: subjects have to have a score of 4 or higher in a screening questionnaire and have been seen at clinic in the past 18 months. exclusion criteria:
prevalence of insufficient analgesia in caesarean section under neuroaxial anesthesia (paican)

Conditions: Cesarean Section; Analgesia

Summary: pain during caesarean section under neuraxial anesthesia is often underestimated and could be related to perinatal psycholocal disorders. the implementation of an evidence-based anesthestic management protocol for caesarean sections aims at reducing intraoperative and postoperative pain. this prospective observational single-center study aims at determining whether this protocol helped to reduce the prevalence of insufficient analgesia in during caesarean sections.

caesarean surgery is one of the most frequent surgeries around the world and neuroaxial anesthesia is the preferred anesthesia technique in most settings. still, many women experience pain during caesarean section, and it has implications in their birth experience. the paican study (prevalence of insufficient analgesia in caesarean section under neuroaxial anesthesia) aims to study how the implementation of a specific protocol of anesthetic management during caesarean section reduces the intraoperative pain and the need of postoperative painkillers. other objectives are: * to study the adherence to the new protocol in our centre * to understand the mechanisms of the failure of neuraxial anesthesia * to study the related factors to insufficient analgesia during surgery (demographic, obstetric, anesthetic, etc.). hypothesis: the implementation of an anesthestic management protocol for caesarean sections under neuroaxial anesthesia decreases the prevalence of insufficient analgesia during surgery and in the recovery room. design: prospective observational single-center study.

Eligibility criteria:
inclusion criteria: - pregnant women aged 18 or more undergoing a caesarean section under neuraxial anesthesia exclusion criteria: * non pregnant women * women under 18 years old * general anesthesia as first option for anesthesia * refusal to participate in the study * women with cognitive impairment or held in an institution by legal or official order

Keywords: cesarean section neuraxial anesthesia pain analgesia
acute effects of waterpipe smoking on cognitive measures and cardiorespiratory parameters

Conditions: Waterpipe Smoking

Summary: title: acute effects of waterpipe smoking (wps) on cognitive measures and cardiorespiratory parameters objectives: to evaluate the acute effect of one cession of water pipe smoking on: 1. executive functions which evaluated by cognitive tests administered included the digit span subtest wechsler adult intelligence scale (wais)-version iii hebrew battery, and the paced auditory serial addition test (pasat) 2. cardiorespiratory parameters included vital signs, spirometry parameters and lung clearance index (lci) value 3. serum carboxyhemoglobin, nicotine, and cytokines design: prospective study evaluating these parameters before and after 30 minutes of water pipe smoking (wps). sample size: 55 participants (35 study group, 20 control group) participant selection: adults subjects who regularly smoke water pipe. intervention: each subject will undergo evaluation including cognitive tests, cardiorespiratory parameters, carboxy- hemoglobin levels, nicotine levels, serum cytokines levels. all measurements will be evaluated before and after one cession of 30 minutes water pipe smoking

the effect of repeated testing 30 minutes apart without water pipe smoking (wps) was evaluated in a group of 20 volunteers (age and sex matched). primary outcome parameter: change in cognitive tests scores secondary outcome parameter:change in cardiorespiratory parameters included vital signs, spirometry parameters and lung clearance index (lci) value, serum carboxyhemoglobin, nicotine, and cytokines, before and after water pipe smoking

Eligibility criteria:
inclusion criteria: * healthy volunteers aged 18 years or older who previously experienced wps. exclusion criteria: * pregnant or lactating women * acute viral or bacterial illness * oral or intravenous steroid treatment in the previous two weeks * wps during the previous 24 hours * cigarette smoking during the previous 6 hours * massive exposure to fire smoke during the previous 24 hours.

Keywords: cognitive tests carboxyhemoglobin nicotine
mitigating the impact of shoulder movement dysfunction; a randomized controlled trial

Conditions: Shoulder Injuries; Shoulder Pain

Summary: the purpose of the proposed work is to screen the effectiveness of an evidence-based, targeted, treatment intervention versus a non-specific, generalized, treatment intervention to treat symptomatic shoulder instability in collegiate swimmers. the results of the study will allow direct observation of treatment effects designed to mitigate the effects of symptomatic shoulder instability. these results will facilitate the optimization of future treatments and interventions.

currently, there is an unmet need for an effective method to treat shoulder instability. namely, there is minimal evidence to mitigate the impact of shoulder instability with non-surgical interventions. the presence of shoulder instability can drastically decrease upper extremity function and lead to subsequent shoulder pathology. while there is observational and retrospective evidence to support the use of specific, guided, therapeutic exercise interventions to treat shoulder instability, there are only two randomized controlled trials (rct) investigating the effects of these types of interventions. while current evidence demonstrates that rehabilitation interventions are capable of decreasing pain and improving self-reported function in individuals with mdi, these investigations include heterogeneous samples and lack thorough investigation of the biomechanical effects of these interventions. the results of this study will allow direct observation of treatment effects designed to mitigate the effects of symptomatic shoulder instability with gold-standard biomechanical techniques. these results will facilitate the optimization of future treatments and interventions. further, the results will contribute to the current field of musculoskeletal medicine by enhancing biomechanics-based treatment interventions and promote patient-reported outcomes research. the long-term goal of the proposed research is to expand to investigations of treatment effectiveness to more diverse populations and a broader range of movement-related shoulder dysfunctions.

Eligibility criteria:
inclusion criteria: * be an active member of the university of minnesota intercollegiate swim team * be able to actively raise arm over 150 degrees as measured with a standard goniometer exclusion criteria: * are pregnant or are trying to get pregnant * are breastfeeding * have a previous history of shoulder surgery within the past 12 months * have neck pain at the time of enrollment * do not speak english
the effect of combined surgery in management of congenital pseudarthrosis of tibia

Conditions: Congenital Pseudarthrosis of Tibia

Summary: the study aims to evaluate the clinical result of combined surgery in management of congenital pseudarthrosis.

the study aims to evaluate the clinical result of combined surgery in management of congenital pseudarthrosis. the combined surgery includes sleeve resection of the pathological soft tissues, retrograde intramedullary rodding, packaged lilac bone autograft,and appliance of llizarov external fixation device. bone uion rate,average time of healing, healing index, ankle valgus, limb length discrepancy, tibia axis alignment are recorded and evaluated.

Eligibility criteria:
inclusion criteria: * the inclusion criteria consists of patients with congenital pseudarthrosis of tibia exclusion criteria: * patients are complicated with mental, neurological disorders (such as hypoxic-ischemic encephalopathy, epilepsy and dementia) or significant barriers to growth. * patients with pseudarthrosis of tibia caused by trauma, tumor,infection, etc * children are complicated with dysfunction of liver and kidney , blood disorders, immune deficiency disease and ecg abnormalities. * parents refused further treatment.
mandibular advancement device (mad) in pregnant women with obstructive sleep apnea (osa)

Conditions: Obstructive Sleep Apnea of Adult; Pregnancy Related

Summary: we propose a single-arm trial to test the patient uptake and preliminary efficacy of mad in a sample of 10 pregnant women with mild-to-moderate osa. study outcomes include patient-reported symptoms and objectively assessed sleep parameters assessed before treatment, during and after 10 weeks of mad intervention (during pregnancy) and postpartum.

the purpose of this study is to explore mad as an alternative treatment option for osa in pregnant women. we are recruiting a small number of 10 healthy pregnant women with uncomplicated osa (absence of significant cardiovascular, metabolic or neurocognitive consequences) who, after being offered cpap as the recommended standard treatment, prefer to use a mad over cpap. all patients are recruited from a single center. we would like to get a first impression on the comfort level of these women with the mad and their self-reported compliance and any improvement of symptoms with treatment. additionally, we would like to test efficacy in controlling osa with pregnancy progression. finally, we would like to derive overall treatment effectiveness of the mad in pregnant women as defined as a combination of efficacy and compliance.

Eligibility criteria:
inclusion criteria: 1. singleton pregnancy, gestational week 14-20. 2. age ≥ 18, english-speaking. 3. reliable internet access (questionnaires/surveys) 4. untreated mild to mild-moderate osa defined as ahi between 5-20 events/hour on the most recent home sleep study 5. no significant hypoxemia on the initial sleep study defined as sao2 nadir ≥70% and sao2 equal or less than 30 minutes ≥88% 6. the sleep study must have been a home sleep test that uses peripheral arterial tone signal for evaluation of apneic events. the home sleep test has to be a watchpat device (watchpat® home sleep study device \| itamar medical ltd.). 7. no significant confounding comorbidities including restless leg symptoms and circadian disorders (shift work) 8. bmi less or equal to 40 and neck size less or equal to 40 cm 9. good oral health with manual dexterity and at least 8 tooth per arch exclusion criteria: 1. high risk pregnancy (age \>40y, superimposed preeclampsia, pre-existing cardiac disease, severe organ dysfunction such as liver or renal failure, any condition that requires anticoagulation), and any condition dr. pitts or dr smith deem serious risk to mother/fetus. well controlled chronic hypertension and diabetes are allowed and will not be excluded. 2. dental exclusion criteria: complete edentulous arch, ongoing oral rehabilitation, uncontrolled periodontal disease, ongoing orthodontic treatment or completed treatment in a period less than 5 years, temporomandibular dysfunction (active acute pain or limitations on mandibula movements of any kind), prior oropharyngeal surgery, maximum protrusion less 5 mm 3. significant acute health problems that are unrelated to pregnancy or dental diseases including unstable psychiatric disease 4. non-english speaking 5. unable to provide informed consent
opinions of healthcare providers about neuromodulation

Conditions: Neuromodulation; Pain; Survey

Summary: the goal of this online survey is to gain further insight in the goals, expectations and definition of success for neuromodulation for pain, according to healthcare providers.


Eligibility criteria:
inclusion criteria: - male and female adults who are involved in the management of chronic pain and more specifically in neuromodulation for pain (including but not limited to anesthesiologists, neurosurgeons, nurses). exclusion criteria: - not involved in management of chronic pain through neuromodulation.