Kornimate/medical-research-clean huggingface dataset:
thinking healthy program-technology assisted (thp-ta)

Conditions: Perinatal Depression; Depression, Postpartum

Summary: background the thinking healthy program (thp) is an evidence based task-shifted low intensity psychosocial intervention, recommended by the world health organization for the treatment of perinatal depression. the investigators developed a technology-assisted version of thinking healthy program (thp-ta) which allows peers to deliver the thp, while ensuring minimal resources for training of delivery agents and ensuring adequate fidelity. method this is a non-inferiority, pragmatic cluster randomized controlled trial designed to test the primary hypothesis that technology assisted delivery of thp is not worse than thp intervention delivered by community health workers, in increasing perinatal depression remission rates at 3 months postnatal. in addition, this study will also test the effectiveness of the thp-ta in improving recovery from perinatal depression at 6 months postpartum, quality of life and social support. this study also aims to evaluate the cost-effectiveness of the thp-ta.


Eligibility criteria:
inclusion criteria: 1. pregnant women with current major depressive episode in their second or third trimester (4 to 8 months of pregnancy). 2. aged 18 years and above 3. intent to stay in the study area for at least 1 year. exclusion criteria: 1. women requiring inpatient care for any reason (medical or psychiatric) as determined by their primary health care professional 2. those who do not comprehend urdu language will be excluded.

Keywords: perinatal depression perinatal anxiety perinatal mental health conditions electronic cbt cbt task shifting low-resourced settings task sharing thinking healthy programme lmic technology-assisted peers community health workers
a study of cbx 12 in subjects with platinum resistant or refractory ovarian cancer

Conditions: Platinum-resistant Ovarian Cancer; Refractory Ovarian Carcinoma

Summary: the purpose of this study is to assess the safety, tolerability, and efficacy of cbx-12 in female subjects with platinum resistant or refractory ovarian cancer at 2 doses; 125 mg/m2 every 21 days or 100 mg/m2 every 21 days.


Eligibility criteria:
inclusion criteria: * subjects must have histologically- or cytologically-diagnosed epithelial high-grade serous cancer of the ovary, fallopian tube cancer or primary peritoneum cancer that is refractory to prior therapy and must have platinum-resistant disease defined as: * subjects who have received only 1 platinum-based chemotherapy regimen for at least 4 cycles of platinum must have disease progression on treatment or occurring ≤ 26 weeks after their last dose of platinum. * patients who have progressed following a second course of a platinum based regimen. * subjects may have up to 2 additional systemic regimens for advanced or metastatic disease. maintenance regimens (e.g., with a parp inhibitor or bevacizumab) are not considered separate regimens. * age greater than or equal to 18 years at the time of signing the informed consent form (icf). * has measurable disease per recist 1.1. * has provided written informed consent. * eastern cooperative oncology group (ecog) performance status of 0 or 1. * adequate liver, renal, hematologic, pulmonary and coagulation function. exclusion criteria: * cytotoxic chemotherapy, biologic agent, investigational agent, or radiation therapy within 3 weeks prior to the first dose of cbx-12. * subjects who are currently receiving any other anticancer or investigational agent(s). * clinically significant intercurrent disease. * active human immunodeficiency virus (hiv) infection. * active hepatitis b or c infection.
non invasive ventilation in acute asthma

Conditions: Asthma

Summary: the aim of this study is to compare the efficacy of noninvasive positive pressure ventilation versus best medical therapy in patients with acute severe asthma

in the past, the mainstay of treatment for patients progressing to respiratory failure from acute asthma was intubation and mechanical ventilation. newer strategies to prevent these intubations to prevent the inherent complications are being explored in form of various pharmacological means like heliox, magnesium sulfate etc. non pharmacological strategies among which non invasive positive pressure ventilation (nippv) is one of the most challenging after showing success in patients with chronic obstructive airway disease (copd) and cardiogenic pulmonary edema. data on efficacy of nippv in the management of aa is sparse but has the potential to improve the management of acute severe asthma. noninvasive ventilation merits further studies in patients with aa, and some consensus panels have suggested that its widespread application in patients with asthma await such trials.the role of nippv is not yet clear and needs further studies and keeping this in view we planned this study to study the role of nippv in the management of acute asthma.

Eligibility criteria:
inclusion criteria: 1. history of asthma of at least 1 year 2. fev1 \< 50% of predicted (by age, height, and gender) or fev1 \< 200 l/minute 3. respiratory rate \> 30 breaths/min 4. all patients judged by the attending physician as having an acute attack of asthma ( inability to speak in sentences in one breath, sao2 \ 10 mm of hg) - exclusion criteria: 1. smoking history of \> 10 years 2. chronic obstructive pulmonary disease 3. endotracheal intubation 4. room air saturation \< 88 % or arterial pao2 \< 55 mm of hg 5. hemodynamic instability defined as systolic bp \< 90 mm hg 6. altered state of consciousness 7. congestive heart failure 8. ischemic heart disease 9. upper airway obstruction 10. facial deformity 11. pregnancy 12. pulmonary infiltrates consistent with pulmonary edema or pneumonia

Keywords: asthma
il-6 regulation of substrate metabolism and influence of obesity

Conditions: Obesity; Healthy

Summary: the aim of the study is to investigate the effects of blocking il-6 signaling with tocilizumab on lipid, glucose and protein metabolism during rest and exercise in healthy and obese humans. interleukin-6 is a molecule produced by a variety of cells and impacts on energy metabolism during fasting and fed conditions. systemic il-6 levels are low but increase acutely in response to fasting, exercise and infection, and also chronically in response to obesity and other conditions of lowgrade inflammation.our recent human intervention study showed that il-6 receptor blockade prevents exercise training from reducing visceral fat mass. whether il-6 receptor blockade directly regulates lipolysis and/or lipid oxidation in humans is however unclear. therefore, this study will be performed to investigate the physiological role of il-6 on lipid, glucose and protein metabolism in humans.

the aim of the study is to assess changes in substrate kinetics, that is, lipolytic rate, rate of appearance and disappearance of free fatty acids, fatty acid oxidation, glucose rate of appearance and disappearance and protein synthesis and degradation during rest and exercise with and without il-6 receptor blockade. we will assess the acute effects of blocking il-6 as well as the long-term consequences of il-6 receptor blockade on all the above parameters. overall, we hypothesize that blocking il-6 changes substrate kinetics. more specifically we hypothesize that blocking il-6 reduces the appearance of free fatty acids, reduces the lipolytic rate and lipid oxidation. we hypothesize that the consequences of blocking il-6 will be observed during resting and exercising conditions and both immediately and longterm after il-6 receptor blockade. we hypothesize that il-6 receptor blockade results in an increased respiratory exchange ratio (rer) and thus increased reliance on glucose as substrate. in this study 10 healthy males and 10 obese males will be included. subjects will be infused with saline on 2 of the study days and tocilizumab on 1 of the study days. isotope dilution techniques with \[6,6-2h2\]glucose, \[1,1,2,3,3-d5\]glycerol, k-\[u-13c16\]palmitate, l-\[ring-d5\]phenylalanine, l-\[d2\]tyrosine will be applied to assess lipid, glucose and protein kinetics. respiratory exchange ratio will be measured by indirect calorimetry. the borg scale will be used to assess the perceived exertion during exercise.

Eligibility criteria:
inclusion criteria: * bmi \ 25 kg/m2 or ≥ 30 and ≤ 40 kg/m2 * healthy (based on screening) exclusion criteria: * smoking * severe thyroid or heart disease * inflammatory diseases * current infection * liver disease * kidney disease * immunosuppressive disease * corticosteroid use * regular nsaid usage * aspirin use \>100 mg/d * history of carcinoma * history of tuberculosis * anemia * neutropenia * low platelets * bleeding disorders * obstructive pulmonary disease

Keywords: interleukin-6 tocilizumab exercise substrate metabolism lipolysis
modifications of heart murmurs and cardiac output during fever

Conditions: Heart Murmurs; Fever

Summary: the combination of fever and auscultation of a heart murmur suggests the diagnosis of endocarditis. however, fever itself increases cardiac output and could therefore modify heart sounds. the aim of the femur study is to measure the modification of heart sounds during fever. heart sounds of 15 hospitalized febrile patients with a heart murmur will be recorded using an electronic stethoscope before and after resolution of fever. the records will be analyzed using a computerized application in order to quantify the intensity of heart murmurs.

fever is an frequently observed during acute illnesses, particularly infectious diseases. the hemodynamic consequences of fever have been extensively studied. fever leads to an acceleration of heart rate (approximately 8.5 bpm per degree celsius) and to a moderate drop in blood pressure. cardiac output increases in the context of heat stress as a result of complex physiological adaptations, including heart rate and systolic function increase while preload and after load decrease. however, there are no studies on the specific consequences of fever on heart sounds. the question is important since auscultation of a heart murmur in a febrile patient suggests the diagnosis of endocarditis. in endocarditis, the heart murmur, which is present in 85% of cases, is due to the mutilation of heart valves, which requires urgent diagnostic and therapeutic management. suspicion of endocarditis requires emergency cardiac ultrasonography. however, the proportion of patients with actual endocarditis among patients with heart murmur and fever is low. this could arise from the fact that fever itself may increase or trigger a heart murmur. indeed, any increase in cardiac output may generate audible turbulence when blood is pumped across a heart valve. functional or inorganic murmurs are murmurs triggered by changes in cardiac output or blood viscosity, as opposed to organic murmurs reflecting an anatomical abnormality in the heart. certain characteristics of the murmur and the context of occurrence can guide the clinical toward one of these two situations, but distinguishing functional from organic murmurs is most often difficult. the impact of fever on cardiac murmurs has not been experimentally demonstrated. this is the aim of the femur study. for this purpose, heart sounds of 15 patients will be recorded during a febrile ilness and after resolution of fever using an electronic stethoscope and analyzed using a computer application. the average intensity of heart murmurs will be compared between the two periods in order to determine the impact of fever.

Eligibility criteria:
inclusion criteria: * hospitalized febrile patients (body temperature \> 38.5°c) * aged 18 or older * agreement to participate to the study exclusion criteria: * patients treated with beta-blockers, verapamil, or diltiazem * patients with atrial fibrillation * pregnancy or breastfeeding * patients with severe psychiatric disorder * patients with diminished heart sounds
the effect of symbiotic beverage consumption on lipid profile

Conditions: Lipid Profile; Fasting Blood Sugar Above Normal; Body Mass Index

Summary: the goal of this clinical trial is to evaluate whether the synbiotic beverage "daygurt" can improve lipid profiles, blood sugar levels, blood pressure, and body weight in individuals diagnosed with dyslipidemia. the main questions it aims to answer are: does "daygurt" significantly reduce total cholesterol and ldl levels compared to nutrition counseling alone? does "daygurt" increase hdl levels and reduce triglycerides more effectively than nutrition counseling? does "daygurt" lead to greater improvements in fasting blood sugar, blood pressure, and body weight compared to nutrition counseling? the intervention group (receiving "daygurt" plus nutrition counseling) will be compared to the comparison group (receiving nutrition counseling without "daygurt") to see if "daygurt" provides additional benefits beyond standard dietary advice. participants will be divided into 2 groups: intervention group: consume "daygurt" daily for 8 weeks. comparison group: receive nutrition counseling sessions focused on managing dyslipidemia but will not consume "daygurt." both groups will undergo health parameter measurements before and after the intervention, including: total cholesterol, ldl, hdl, and triglyceride levels. fasting blood sugar. blood pressure. body mass index (bmi).


Eligibility criteria:
inclusion criteria: * cholesterol total above 200 mg/dl, or ldl cholesterol above 100, or bmi above 25 kg/m2 * agree to study protocols exclusion criteria: * has allergic to dairy product * having any drug lowering cholesterol

Keywords: symbiotic beverages lipid profile body mass index
rehabilitation nursing program in otolaryngology

Conditions: Rehabilitation; Neck Cancer; Otorhinolaryngologic Neoplasms

Summary: the european commission's current political guidelines demonstrate into a joint plan aimed at improving and controlling cancer disease. head and neck cancer (hnc) are the sixth most common cancer worldwide. the surgery is one of the most effective treatments, however it significantly compromises the self-care and functional capacity of the patients, so the intervention the rehabilitation nurse (rn) is essential. objective: compare the degree of dependence in discharge from patients undergoing hnc surgery with rn intervention versus general nursing care (not rn intervention). the specific objective is to analyze the role of confounders in the effect of the rn intervention on the patient dependence. seventy-nine patients with rn intervention who undergoing a different type of surgery (1-neck dissection, 2-total laryngectomy with neck dissection, 3-pelviglossomandibulectomy with neck dissection and tracheotomy, 4-pelviglossomandibulectomy with neck dissection, pectorals major flap and tracheotomy) and all patients who undergoing the same type of surgery without rn intervention (n=72).

seventy-nine patients with rn intervention who undergoing a different type of surgery (1-neck dissection, 2-total laryngectomy with neck dissection, 3-pelviglossomandibulectomy with neck dissection and tracheotomy, 4-pelviglossomandibulectomy with neck dissection, pectorals major flap and tracheotomy) and all patients who undergoing the same type of surgery without rn intervention (n=72). differences between groups were calculated using non-parametric tests chi-square for categorical variables and mann-whitney u for numeric variable. after correlation tests between variables, statistical analysis was carried out through poisson regression to a significance level of 5%.

Eligibility criteria:
inclusion criteria: * undergoing a different type of surgery: 1-neck dissection, 2-total laryngectomy with neck dissection, 3-pelviglossomandibulectomy with neck dissection and tracheotomy, 4-pelviglossomandibulectomy with neck dissection, pectorals major flap and tracheotomy. exclusion criteria: * participants will be excluded if not be possible access of the clinical information.

Keywords: maxillofacial surgery head and neck cancer otolaryngology
spasmodic dysphonia pain

Conditions: Spasmodic Dysphonia

Summary: this study aims to identify adjuvant methods to improve patient comfort during in-office laryngology procedures.

hypothesis: the use of local anesthetic or vibrating instrument will decrease overall pain experienced by a patient with spasmodic dysphonia undergoing botox injections. aims, purpose, or objectives: to identify adjuvant methods to improve patient comfort during in-office laryngology procedures. results demonstrated here should be transferrable to other transcutaneous in-office procedures in laryngology. background: spasmodic dysphonia is a vocal disorder characterized by uncontrollable voice breaks. injection of botulinum neurotoxin into the laryngeal muscles is the mainstay of treatment. patients require repeated treatments due to the temporary effect of botulinum neurotoxin. laryngeal injections are commonly performed through the skin of the neck and can be associated with pain and discomfort. local anesthetic administration prior to laryngeal injection is commonly performed in clinical practice, however its efficacy hasn't been evaluated and a third of surveyed otolaryngologists do not administer local anesthesia prior to the laryngeal injection of botulinum neurotoxin. vibratory anesthesia involves the application of a local vibratory stimulus and has been found to reduce pain during various needle-related procedures. vibratory anesthesia has not previous been evaluated for laryngeal injections. this study will utilize the need for spasmodic dysphonia patients to receive repeated injections to incorporate a crossover design where patients receive three consecutive laryngeal injections of botulinum toxin experiencing injection without additional anesthesia, with local anesthesia, and with vibration anesthesia in a randomized order.

Eligibility criteria:
inclusion criteria: * spasmodic dysphonia with or without tremor * receiving botox as treatment via a transcricothyroid approach exclusion criteria: - allergy to lidocaine

Keywords: pain
genicular artery embolization (gae) for osteoarthritic knee pain

Conditions: Knee Osteoarthritis; Knee Pain Chronic; Knee Pain Swelling; Knee Arthritis; Arterial Occlusion

Summary: the objective of this investigation is to evaluate the safety of the geniculate artery embolization (gae) procedure with hydropearl® microspheres in 30 patients with knee pain caused by osteoarthritis with 24 months follow-up. the gae procedure is an arterial embolization procedure that blocks abnormal blood vessels caused be knee arthritis in order to evaluate the effect on knee pain.


Eligibility criteria:
inclusion criteria: 1. provide informed consent 2. age ≥ 40 years 3. moderate to severe knee pain (vas \>40 mm) 4. pain refractory to 3 months of conservative treatments, including at least one of the following: * a. anti-inflammatory medications * b. physical therapy * c. intra-articular injections 5. kellgren-lawrence radiographic grade 1, 2, or 3 disease 6. mri features of active synovitis (synovial thickening and/or enhancement on mri). 7. ineligibility or refusal of surgical management. 8. local knee tenderness exclusion criteria: 1. rheumatoid or infectious arthritis 2. advanced lower extremity atherosclerosis that would limit selective angiography 3. local knee infection 4. prior knee surgery (excluding arthroscopic/meniscal interventions) 5. uncorrectable coagulopathy (inr\>1.8, platelets\<50,000/µl) 6. iodine allergy resulting in anaphylaxis 7. chronic renal insufficiency (serum creatinine \>2 mg/dl) 8. life expectancy less than 6 months

Keywords: knee osteoarthritis genicular artery embolization geniculate artery embolization
kaletra: therapy with double protease inhibitors

Conditions: Human Immunodeficiency Virus

Summary: therapy with lopinavir/ritonavir (kaletra) and one other protease inhibitor in human immunodeficiency virus participants

this study is intended to observe and collect data on the usage, dosing, tolerability, and effectiveness of lopinavir/ritonavir (kaletra) when used as part of a nucleoside reverse transcriptase inhibitors-free double protease regimen. enrollment in the study was independent of the decision to prescribe kaletra.

Eligibility criteria:
inclusion criteria: * participants with human immunodeficiency virus infection * participants on lopinavir/ritonavir (kaletra) and one other protease inhibitor exclusion criteria: * hypersensitivity against lopinavir, ritonavir or other ingredients * severe liver insufficiency * no concomitant astemizole, terfenadine, oral midazolam, triazolam, cisapride, pimozide, amiodarone, ergotamine, dihydroergotamine, ergometrine, methylergometrine, vardenafil and st. john's wort

Keywords: viral load resistance double protease inhibitors mutations immune system infection nucleoside reverse transcriptase inhibitors-free human immunodeficiency virus
endothelial cell loss after cataract surgery

Conditions: Cataracts

Summary: the purpose of this study is to compare two cataract surgical technique variations for removing the nucleus of the lens (central part of the lens) in terms of damage to the inner layer of the cornea which is called the endothelium. one variation uses more ultrasound energy and the other more mechanical force to break up the nucleus.


Eligibility criteria:
inclusion criteria: * visually significant moderate density cataract exclusion criteria: * corneal or retinal pathology limiting visual potential to worse than 20/40 * lens pathology including pseudoexfoliation or lens dislocation * prior intraocular surgery * age less than 40

Keywords: cataract corneal endothelial cell loss ultrasound power corneal endothelium
impact of psychology on life quality in chronic and cancer pain patients

Conditions: Chronic Pain Syndrome; Psychology, Social

Summary: this study is to compare the effect of pain management program. we compare life quality, pain scores, sleep, anxiety and depression scores, and self report measures before and after mindfulness based pain management workshops.

chronic pain is a growing problem in modern society. one in every five person in developed countries have this condition. chronic pain is pain that persists longer than six months. it lead to psychological disorders such as anxiety, depression, anger and chronic fatigue. it decreases life quality, lower self-esteem and decrease work force. because of these factors and the high cost of treatment, it impacts social economics highly. chronic pain is caused by wind-up effect of the nervous system which the inhibitory signals are impaired. the nervous systems is therefore tuned up. mindfulness based pain management helps lower this wind-up effect by noticing self, to observe and release stress. it has been proven to alter brain activity, enhance self control, improve attention and decrease secretion of stress hormones. it decreases pain and allow patients to regain control of life.

Eligibility criteria:
inclusion criteria: * pain condition for over six months, with diagnosis by pain physician to be of chronic pain or cancer pain. exclusion criteria: * patients unable to communicate in mandarin.

Keywords: chronic pain mindfulness based stress reduction psychology pain management program