Kornimate/medical-research-clean huggingface dataset:
n-acetyl cysteine: the effectiveness and safety in a cohort of pediatric patients with chronic kidney disease

Conditions: Chronic Kidney Diseases

Summary: anemia is a common comorbidity of ckd and is associated with a decreased quality of life and increased healthcare resource utilization. anemia increases the risk of ckd progression, cardiovascular complications, and overall mortality. the current standard of care includes oral or intravenous iron supplementation, erythropoiesis-stimulating agents, and red blood cell transfusion. treatment with high doses of erythropoiesis-stimulating agents increases rates of hospitalization, cardiovascular events, and mortality. resistance to erythropoiesis-stimulating agents is a therapeutic challenge in many patients . nac reduces the risk of progression of ckd of any etiology to end stage renal disease (esrd) but the mechanism by which it reduces the progression of ckd to esrd is unclear. it may be because of its antioxidant and vasodilatory nature. prolonged duration of administration and higher dosage of nac can protect kidneys.

all patients with chronic kidney disease on regular hemodialysis will be enrolled. - study location: the patients will be recruited from pediatric nephrology department, cairo university children's hospital and beni suef university. history taking including the age, sex, primary cause of ckd, onset of hemodialysis, medications including erythropoietin dose, frequency, and duration, oral or intravenous iron therapy, and frequency of blood transfusion. clinical examination focusing on pallor, blood pressure, and anthropometric measurements and their percentile. investigations including hemoglobin level at the start of the study and every month during the study period, serum ferritin, alanine aminotransferase, total oxidative stress (tos), total antioxidant capacity (tac), and oxidative stress index (osi) at the start and after 3 months of the onset of the study. patients will receive n-acetyl cysteine (10 mg/kg/day, orally). the duration of the study will 3 months.

Eligibility criteria:
inclusion criteria: * pediatric patients with chronic kidney diseases stage 3, 4 or 5 exclusion criteria: * unwilling to participate in the study. * non-compliant patients on the standard care of ckd. * patients with cardiac, endocrinal, and hepatic complications. * asthma or known allergy to nac. * any chronic infections prior to or during the study period.
a pilot-study with low-dose hril-2 for the treatment of systemic lupus erythematosus

Conditions: Systemic Lupus Erythematosus

Summary: dysfunction of regulatory t (treg) cells has been detected in diverse autoimmune diseases, which can be promoted by interleukin-2 (il-2). in a previous small sample trail performed by the investigator's group, the investigators found that the low-dose il-2 was effective and well tolerated in active sle, and the effect was associated with selective modulation of cd4+ t cell subsets. this clinical study will confirm the efficacy and safety of low dose il-2 treatment in sle. the investigators perform a single-centre, double-blind pilot trial with hril-2 in sle.the investigators evaluate the effectiveness and safeness of low-dose hril-2 for systemic lupus erythematosus by randomized controlled study (hril-2 (n = 30) versus placebo group (n = 30)).

each sle patients (n=60) with scores\>=8 on sledai received low-dose il-2 or placebo (active group: placebo group =1:1, 1 million units every other day subcutaneously (hril-2 1x 106, ip, qod) for a period of 14 days. after a 14-day rest, another cycle started) for 3 cycles. the end points were safety and clinical and immunologic response.

Eligibility criteria:
inclusion criteria: * meet the american college of rheumatology criteria for the diagnosis of sle，1997. * under standard treatment (≥ 2 months) at the time of inclusion * background treatment failed to control flares or to permit prednisone tapering * with at least one of the following manifestations: thrombocytopenia, disease-associated rash, mouth ulcer, non-infectious type of fever, active vasculitis, renal disorder(proteinuria\>0.5g/day), neuropsychiatric sle. * positive for at least one of the following laboratory tests: ana\>1:160, anti-dsdna, immunoglobulin\>20g/l, decreased c3 or c4, leukopenia\<3×10\^9/l, thrombocytopenia\<100×10\^9/l; * sle disease activity index(sledai) ≥ 8. * negative hiv test. * negative for hepatitis b and c virus. * negative urine pregnancy test. * written informed consent form. exclusion criteria: * sever chronic liver, kidney, lung or heart dysfunction; (heart failure (≥ grade iii nyha), hepatic insufficiency (transaminases\> 3n) ) * serious infection such as bacteremia, sepsis; * cancer or history of cancer cured for less than five years (except in situ carcinoma of the cervix or basocellular carcinoma); * high-dose steroid pulse therapy (\>1.5mg/kg) or iv bolus of corticosteroids in the last 2 months. * history of administration of rituximab or other biologics; * purified protein derivative (tuberculin) \>10mm * mental disorder or any other chronic illness or drug-abuse that could interfere with the ability to comply with the protocol or to give information; * inability to comply with il-2 treatment regimen.
effects of lumbopelvic manipulation on hip and knee neuromuscular activity

Conditions: Patellofemoral Pain Syndrome

Summary: the purpose of this study is to determined if a lower back treatment would change the hip and knee muscle activities in people with and without anterior knee pain. the investigators hypothesized that the lower back treatment may change the hip and knee muscle activities in people with anterior knee pain but not in people without anterior knee pain.


Eligibility criteria:
inclusion criteria for participants in the patellofemoral pain syndrome group: 1. insidious onset of symptoms of non-traumatic origin 2. pain with patellar facet palpation or compression 3. subjective knee pain rating of at least 3/10 on the pain visual analog scale during at least one of the following activities: * ascending stair * descending stair * kneeling * squatting * running * jumping * prolong sitting for more than 20 minutes exclusion criteria for all participants: 1. history of spine, hip or knee surgery 2. history of hip pathology or other knee condition 3. current significant injury of any lower extremity joints 4. pregnancy 5. sign of nerve root compression 6. osteoporosis or history of compression fracture age- and gender- matched control participants will be recruited if they have no signs or symptoms of patellofemoral pain syndrome and have none of the exclusion criteria
28-day study of testosterone co-administered with dutasteride in hypogonadal men

Conditions: Hypogonadism; Hypogonadism, Male

Summary: the combination of testosterone and dutasteride is intended for use in hypogonadal men. this study will evaluate the effect of 28-day repeat dosing of this combination with varying bid doses of testosterone (t), in combination with a fixed bid dose of dutasteride (d), as well as a testosterone alone arm, on t and d levels in the blood. the rationale is to look for the effects of each compound on the other, and to look for any safety problems that may result when the 2 drugs are given together.


Eligibility criteria:
inclusion criteria: * have a diagnosis of primary or secondary hypogonadism. * have very low testosterone levels on 2 separate days. * have a bmi within range of 18.5-35kg/m2. * have not taken dutasteride for one year, or finasteride for the past 3 months. exclusion criteria: * have had or have breast or prostate cancer, malabsorption syndrome, sleep apnea, psychiatric illness, polycythemia, or any other clinically significant current condition. * are diabetic with an hba1c \>= 8. * are taking any androgens, such as testosterone, saw palmetto. * are taking ritonavir, indinavir, itraconazole, ketoconazole, erythromycin, warfarin, digoxin, cholestyramine, or any dietary/herbal/vitamin supplements. * would donate more than 500 ml of blood over a 2 month period. * physician does not think it is a good idea for you to participate in the trial. - are unwilling to abstain from alcohol during the study. * have a positive urine drug screen test. * plan to change your smoking habits during the course of the trial. * have hepatitis c, hepatitis b, or hiv. * have a lab or ekg abnormality. * high or low blood pressure. * have used of any investigational drug or device during the study or within 30 days prior to 1st dosing of study medication.

Keywords: dht testosterone hypogonadism dutasteride androgen deficiency
pulmonary rehabilitation to improve physical capacity after pulmonary embolism

Conditions: Pulmonary Embolism

Summary: this project aims to evaluate a rehabilitation program as treatment and uncover potential pathophysiological mechanisms of a newly identified chronic condition named "post pulmonary embolism syndrome" (pps).

the newly identified post pulmonary embolism syndrome (pps) is characterized by chronic persistent, but unexplained dyspnea (i.e. without signs of pulmonary hypertension or pulmonary abnormality). symptoms are considerable, but less severe than in cteph patients. a recent study performed by our group confirmed that up to 50% of our patients complained of various grades of persistent unexplained dyspnea 1-10 years after the diagnosis of pe. in this multifaceted project we wish to evaluate the effect of an eight week rehabilitation program led and supervised by a trained physiotherapist on exercise capacity in pps patients. this interventional part of the study will be formed as a randomized controlled trial. patients will be randomized to either usual care or a physiotherapist-supervised rehabilitation program. the study also aims to explore potential underlying pathophysiological mechanisms in pps, using state of the art methods such as cardiac magnetic resonance imaging and transthoracic echocardiography involving novel methods focusing on the right ventricle. the pathophysiological part of the study will be formed as a case control study, where post pe-patients who do not fulfill the criteria for pps will serve as controls.

Eligibility criteria:
inclusion criteria: * objectively diagnosed symptomatic pulmonary embolism by ctpa or high-probability scintigraphy 6 months to 6 years before inclusion * persistent dyspnea defined as modified medical research council (mmrc) breathlessness scale \>= 1 that has appeared or worsened after the diagnosis of pe (eligibility criteria for randomization) exclusion criteria: * significant pulmonary disease (copd gold \>= 2, restrictive pulmonary disease, lung cancer or pleural disease. * heart failure (either hfref, hfmref or hfpef as defined in esc guidelines) * significant valvular heart disease * chronic thromboemboli pulmonary hypertension (cteph) * patients unfit for rehabilitation or walking tests du to old age, physical disability or disease * patients with a history of poor compliance or any condition that would interfere with the ability to comply with the study protocol e.g. history of drug abuse, excessive alcohol beverage consumption, cognitive dysfunction or severe psychiatric disease * active malignancy * life expectancy less than 3 months * pregnancy

Keywords: pulmonary embolism dyspnea post pulmonary embolism syndrome pps rehabilitation cardiac magnetic resonance imaging (cmr)
intraoperative mechanical power and ventilation-associated lung injury: assessing complications

Conditions: Lung Injury; Pulmonary Complication

Summary: this study investigates the relationship between intraoperative mechanical power and postoperative pulmonary complications in patients undergoing major abdominal surgery. the investigators record mechanical ventilation parameters and surgical characteristics, assessing the incidence of pulmonary complications within 24 hours postoperatively."

postoperative pulmonary complications (ppcs) are often underestimated yet remain a leading cause of perioperative morbidity and mortality. these complications encompass postoperative hypoxia, atelectasis, bronchospasm, pulmonary infections, infiltrations, aspiration pneumonia, acute respiratory distress syndrome (ards), pleural effusion, and pulmonary edema. they are prevalent and associated with significant costs, prolonging hospital stays, ventilation duration, and icu admissions, while also increasing mortality and morbidity risks. perioperative mechanical ventilation stands as a primary risk factor for the development of postoperative pulmonary complications. approximately one in four patients with normal lungs will develop some form of lung injury following mechanical ventilation, although much of this damage can be mitigated through the use of appropriate ventilation strategies. a range of pulmonary complications induced by mechanical ventilation is known as ventilator-induced lung injury (vili). a growing understanding of the injury mechanism aids researchers in identifying risk factors for lung injury, including tidal volume, respiratory rate, pressures, and flow. mechanical power, which combines tidal volume, respiratory rate, and airway pressure, has been identified as a potential contributor to vili. the greater the power, the higher the likelihood of lung injury occurring. mechanical power represents the total energy expended over a specific period and is typically expressed in joules per minute (j/min). the equation for mechanical power can help estimate the contribution of different causes of vili and their variations. this equation can be easily applied in the software of each ventilator. recent studies have investigated threshold values for mechanical power in relation to ventilator-associated lung injury using the simplified formula found for mechanical power

Eligibility criteria:
inclusion criteria: * patients aged 18 years and older * patients undergoing elective major abdominal surgery * patients with asa (american society of anesthesiologists) physical status classification i-iv * patients capable of providing voluntary consent exclusion criteria: * patients under 18 years of age * pregnant individuals * those who decline to participate in the study * patients requiring reoperation due to surgical complications * organ transplant recipients * patients who were intubated preoperatively * day surgery patients

Keywords: lung injury ventilators, mechanical perioperative care anesthesia risk factors ventilator-induced lung injury
exercise and mindfulness in patients with non-specific chronic low back pain: the backfit project

Conditions: Low Back Pain

Summary: chronic low back pain is among the most common health problems seen in primary care, and is responsible for disability and absenteeism in our country. in most cases, it is attributed to a non-specific cause and classified as non-specific chronic low back pain (nsclbp). taking into consideration that multidimensional programs usually present more effectiveness reducing pain than unimodal programs, the current research investigates the role of unexplored multidimensional program (exercise and mindfulness) in nsclbp. the primary aim of this project is to determine the effectiveness of a supervised exercise program (intervention 1) and a supervised exercise program + mindfulness (intervention 2) on pain, disability, trunk muscle endurance/strength, quality of life and gait parameters in patients with nsclbp.


Eligibility criteria:
inclusion criteria: * be previously diagnosed with nsclbp pain by a healthcare professional according to the criteria established by o'sullivan et al. * intend to participate in the intervention and perform all the tests included in the study. * able to read and understand informed consent, as well as the objective of the study. * able to walk and move without outside help. * able to communicate without problems * be between 18 and 65 years old. exclusion criteria: * having spondylolysis, spondylolisthesis, canal stenosis, degenerative disc disease, and/or disc herniation, tumor, trauma or fracture of the lumbar and lower limbs, cauda equina syndrome, and radicular leg pain (given that spine degeneration issues are commonly present in asymptomatic individuals and increase with age, only serious lumbar structural disorders were considered). * having lumbar surgery as source of pain. * having acute or terminal illness. * having medical prescription that prevents the performance of the tests. * having injury or circumstance that makes it impossible to perform the tests correctly. * having other physical or mental illness that prevents participating in the intervention.

Keywords: exercise, mindfulness, sedentary behaviour, strength, pain
dynamic focusing evaluation for prostate cancer treatment

Conditions: Cancer of Prostate

Summary: define the best acoustic parameters for the dynamic focusing hifu transducer in the treatment of localized prostate cancer.


Eligibility criteria:
inclusion criteria for primary care patients: * age \> 70 years * t1 or t2 * psa \< 15 ng/ml * 12 randomized biopsies * gleason score ≤ 3+4 * normal anal and rectal anatomy * american society of anesthesiologists risk (asa) 1 or 2 exclusion criteria for primary care patients: * t3 patients * american society of anesthesiologists risk (asa) 3 * metastatic disease (bone scan...) * previous prostate cancer therapy * distance between rectal mucosa and prostatic capsule of more than 8 mm thickness * prostate volume over 50cc * previous bladder cancer * contraindication to mri * previous rectal or urinary fistulae inclusion criteria for salvage patients: * age \> 50 years * t1 or t2 * biochemical recurrence after radiotherapy (phoenix definition: nadir+2ng/ml) * 12 randomized biopsies * normal anal and rectal anatomy * asa 1 or 2 exclusion criteria for salvage patients: * t3 patients * asa 3 * metastatic disease (bone scan...) * distance between rectal mucosa and prostatic capsule of more than 8 mm thickness * prostate volume over 50cc * previous bladder cancer * contraindication to mri * previous rectal or urinary fistulae

Keywords: hifu localized prostate cancer mri psa nadir biopsy high intensity focused ultrasound prostate specific antigen (psa)
combating cancer-related fatigue: a personalized supportive care program

Conditions: Indolent Lymphomas; Lymphoma; Chronic Lymphocytic Leukemia; Small Lymphocytic Lymphoma; Follicular Lymphoma; Marginal Zone Lymphoma; Lymphoplasmacytic Lymphoma; Waldenstrom Macroglobulinemia; Cutaneous T Cell Lymphoma

Summary: this health services study will assess a multidisciplinary intervention program directed at fatigue mitigation among patients diagnosed with indolent lymphomas. specifically, 30 subjects with chronic lymphocytic leukemia/small lymphocytic lymphoma (cll/sll) and 10 subjects with follicular lymphoma (fl), marginal zone lymphoma (mzl), lymphoplasmacytic lymphoma (lpl), waldenström's macroglobulinemia, or cutaneous t cell lymphoma (ctcl) will be included.

all subjects will be assigned to an exercise and dietary intervention program. patients will engage in two patient-clinician consultations for exercise and nutrition. the individualized exercise plan designed based on the subject's medical history, current exercise habits, and specific needs, will include a mix of aerobic and resistance training. concurrently, participants will receive nutritional consultations from a specialized oncology dietitian. these sessions will focus on creating a diet plan tailored to each participant's nutritional needs, considering their treatment and overall health. study participants will complete weekly exercise journals to track adherence to the exercise prescription and complete weekly assessments of their adherence to dietary recommendations on an integer scale ranging from 0-10.

Eligibility criteria:
in order to participate in this study a subject must meet all of the eligibility criteria outlined below. inclusion criteria: * written informed consent was obtained to participate in the study and hipaa authorization for the release of personal health information. * subjects are willing and able to comply with study procedures based on the judgment of the investigator. * age ≥ 18 years at the time of consent. * confirmed diagnosis of indolent lymphoma, waldenström's macroglobulinemia, or cutaneous t cell lymphoma. * significant symptoms of fatigue, as defined by promis fatigue score \>50. exclusion criteria: * other co-existing malignancies. * significant cognitive impairment as defined by mini-cog score 0-2 (out of 5) that would prevent understanding of assessments or interventions. * unstable or serious illness (e.g., unstable cardiac arrhythmia, severe anemia/thrombocytopenia) that would prevent safe participation in an exercise regimen, per the discretion of the treating physician. * individuals who are not able to consume an oral diet, due to swallowing difficulties or other reasons, as this might interfere with the nutritional intervention

Keywords: exercise dietary intervention
left atrial appendage occlusion under cone-beam computed tomography fusion image guidance

Conditions: Cardiovascular Diseases

Summary: left atrial appendage occlusion is being widely recommended as a treatment strategy for patients with nonvalvular af to prevent stroke, especially those who cannot tolerate long-term oral anticoagulation or have other reasons for nonpharmacologic therapy. currently, there are a number of guidance for left atrial appendage occlusion, such as transesophageal echocardiography, intracardiac echocardiogram, fluoroscopy, computed tomographic/computed tomographic angiography and so on. procedures such as atrial septal puncture, device size selection and operational view are guided by different methods in various centers. our center has developed a new approach to guidance: cone-beam ct and cardiac computed tomographic angiography were combined by three-dimensional - three-dimensional image fusion in guiding left atrial appendage occlusion.

eligible nvaf patients were recruited consecutively and received our laao workflow of local anesthesia, intracardiac echocardiography-guided transseptal puncture, and 3dcta-3dcbctf fusion-guided occluder implantation. the primary outcome was optimal occluder implantation (successful implantation with no occluder recapture and replacement). other outcomes were procedure/fluoroscopic time, contrast agent consumption, radiation dose, and peri-procedure complications. we compared our results with existing publications of laao guided by 3dcta and two-dimensional fluoroscopy (3dcta-2df) fusion images.

Eligibility criteria:
inclusion criteria: 1. an age of \>18 years; 2. a cha2ds2-vasc score of ≥2; 3. clinical conditions allowing tee and sedation; 4. left ventricular ejection fraction \>30%; 5. and at least one of the following indications: (a) has-bled score of ≥3; (b) intolerance to long-term oac, and (c) stroke, transient ischemic attack, or thromboembolism even under oral anticoagulation treatment; exclusion criteria: 1. a glomerular filtration rate of \<50 ml/min/1.73 m2; 2. the presence of a thrombus in the la and laa; 3. acute myocardial infarction or unstable angina, decompensated heart failure (new york heart association functional class iii-iv), or heart transplantation; 4. stroke or transient ischemic attack within 30 days; 5. very poor peripheral vessel access not allowing device delivery; 6. moderate or massive pericardial effusion.