Kornimate/medical-research-clean huggingface dataset:
comparative effectiveness of prescribed adapted physical activity (apa), either practiced independently after training, or supervised by an apa teacher, on glycemic regulation in people with unbalanced type 2 diabetes.

Conditions: Diabetes, Type 2; Non-Insulin Dependent; Poorly Controlled Diabetes Mellitus

Summary: comparative effectiveness on glycemic balance of a non-pharmacological treatment, adapted physical activity (apa), either supervised by a qualified apa instructor or unsupervised in autonomy, in individuals with inadequately controlled type 2 diabetes, under diet alone or non-insulin treatment.


Eligibility criteria:
inclusion criteria: * patient who has given consent to participate in the study and has signed an informed consent form. * patient aged 18 to 67 years * patient diagnosed with type 2 diabetes * patient newly diagnosed or on non-insulin treatment (metformin +/- dpp4 inhibitor, glp1 analogue +/- sglt2 inhibitor) for whom it is considered to initiate or intensify antidiabetic treatment by introducing a new therapeutic class. * patient insufficiently controlled (\&gt; 1.30 g/l fasting blood glucose measured in the laboratory twice a few days apart in a city laboratory) * patient with good venous access. * patient capable of engaging in regular physical activity * patient who has undergone a coronary artery disease screening test in the year prior to inclusion according to the new recommendations of an expert consensus. * patient agrees to wear a fitbit charge 6 bracelet for the entire duration of the study, including the run-in period, and agrees to recharge it and transmit the data. exclusion criteria: * patient diagnosed with type 1 diabetes * patient treated with sulfonylureas * patient with a history of severe cardiovascular diseases (myocardial infarction, acute coronary syndrome, or stroke in the past year) * patient presenting a medical contraindication to performing a physical activity session (uncontrolled resting hypertension, i.e., systolic blood pressure \&gt; 160 mmhg and/or diastolic blood pressure \&gt; 100 mmhg, unstable coronary artery disease, heart failure, severe proliferative or non-proliferative evolving retinopathy (unstabilized), or having undergone recent surgical laser treatment of the eye, plantar perforating ulcer, disabling osteoarthritis of the lower limbs, respiratory failure, severe renal impairment, liver failure, severe dysautonomia, i.e., risk of chronotropic insufficiency during exercise, peripheral neuropathy) * patient with a history of severe hypoglycemia in the 6 months prior to entering the study and/or not feeling their hypoglycemia at all * patient with an ipaq score in the high category * patient with a known latex allergy * patient with morbid obesity (bmi \&gt; 40 kg/m²) * other conditions that may interfere with glycemic variation: particularly the use of corticosteroids during the study * patient treated with beta-blockers or calcium channel blockers with negative chronotropic action (such as isoptin) * breastfeeding woman * pregnant woman\* or wishing to become pregnant
efficacy of pea hull fiber - phase 2

Conditions: Healthy

Summary: the purpose of this randomized, cross-over study is to explore the effects of pea hull fiber on bowel movement frequency, transit time, appetite, gastrointestinal symptoms, microbiota composition and activity.

an 8-week randomized, cross-over study will be carried out to assess the efficacy of pea hull fiber. participants will complete a 2-week baseline period during which appetite, stool frequency, and stool consistency (transit time) will be collected by an online questionnaire, and participants will collect a single stool. dietary data (automated self-administered 24-hour diet recall) will be obtained at baseline and at each study visit. participants will be randomized on or about day 15 and consume snacks without pea hull fiber for a 2-week control period, and snacks with added pea hull fiber for a 2-week treatment period separated by a 2-week washout period. in both intervention periods, participants will complete daily questionnaires to assess stool frequency and consistency (transit time). an online questionnaire assessing appetite will be administered once per week. the gsrs will be competed at each study visit. during washout periods, the same data will be collected as will be done during the baseline and intervention periods. participants will be asked to collect one stool during baseline and during weeks 4, 6, and 8 for a total of 4 stools. stool samples will be analyzed for changes in the microbiota.

Eligibility criteria:
inclusion criteria: * are willing to have height and weight measured and provide demographic information (e.g. age, race, sex). * children age between 8-15 years old. * are occasionally constipated. * are willing to consume pea hull fiber and control snacks daily each for a 2-week period * are willing to complete a daily questionnaire throughout the entire 8-week study. * are willing to complete the appetite questionnaire two times per week. * are willing to complete the gastrointestinal symptom rating scale (gsrs) bi-weekly. * are willing to be interviewed for automated self-administered 24-hour-kids-2014 (asa24-kids-2014) one time per 2-week period throughout the study. * are willing and be able to provide a valid social security for study payment purposes. exclusion criteria: * have any known food allergies. * are currently taking medications for diarrhea. * have taken antibiotics within the past four weeks prior to randomization. * have ≥ 6 bowel movements per week * are currently taking probiotics supplements and do not want to discontinue a minimum of two weeks prior to the study. * have previously or are currently being treated for any gastrointestinal diseases such as (gastric ulcers, crohn's, celiac, ulcerative colitis, etc.).
use of iterative reconstruction method in ultralow-dose ct for follow-up of patients with intraabdominal abscess: comparison with standard dose ct

Conditions: Abdominal Abscess

Summary: increasing radiation exposure by medical examinations is getting more concerns. for optimal medical imaging, reducing radiation exposure with preservation image quality is important. one of the solutions is use of iterative recontruction of ct examination. in this study, the investigators aimed to investigate the clinical feasibility of ultralow dose abdominopelvic ct with iterative reconstruction in patients with intraabdominal abscess. patients with intrabdominal abscess usually undergo multiple ct examinations to evaluate treatment response. therefore, ultralow dose ct can reduce unnecessary radiation exposure in these patients.


Eligibility criteria:
inclusion criteria: 1. patients who underwent standard dose ct for suspected intraabdominal abscess 2. patients who need follow-up ct to evaluate treatment response of abscess 3) adult patient, 4) patients who agreed this study protocol exclusion criteria: 1. pregnancy 2. patients with poor renal function (gfr \< 30 ml/min/1/73m2) 3. patients who have allergy to ct contrast media 4. patients who are not cooperative (e.g., dementia)
research study to test carvedilol cr + lisinopril versus lisinopril + placebo in patients with high blood pressure

Conditions: Hypertension

Summary: randomized, double-blind, parallel group, multicenter study of subjects with stage 1 or 2 essential hypertension who are not at target blood pressure (\<140/90mmhg) at baseline. subjects will be randomized to receive either carvedilol cr + lisinopril or lisinopril + placebo. subjects will be uptitrated over a 6 week period until target blood pressure (\<140/90mmhg) is met. the primary objective of the study is to compare the proportion of subjects who achieve target blood pressure after 6 weeks of treatment.


Eligibility criteria:
inclusion criteria: * male or female age 18-80 years; stage 1 or 2 hypertension currently receiving 0 or 1 antihypertensive medication; mean sitting systolic blood pressure \>/=140mmhg to \ /=90 to \</=105mmhg. subjects taking one hypertensive medication had their medication withdrawn and entered a wash-out phase prior to randomization. exclusion criteria: * subject taking two or more antihypertensive medications, known contraindication to angiotensin-converting enzyme (ace) inhibitors or alpha- or beta-blocker therapy, subject has type 1 or type 2 diabetes

Keywords: target blood pressure hypertension coreg cr carvedilol cr stage 1 or 2 essential hypertension lisinopril
costs and effects of three modes for disease management of chronic obstructive pulmonary disease in general practice

Conditions: Lung Diseases, Obstructive

Summary: in this randomized controlled trial, three contemporary modes for chronic obstructive pulmonary disease (copd) management in dutch general practices are compared for costs and effects: * usual general practitioner (gp) care (at patient's initiative); * regular practice nurse review; and * integrated self-management education. all three interventions are based on existing guidelines, materials, and field experiences.

considering the ageing of the dutch population and the current and increasing shortage of general practitioners (gps), the capacity of primary healthcare is a major and growing concern. delegation of care normally provided by gps with care provided by trained practice nurses is now rapidly emerging for patients with chronic respiratory disease, i.e. asthma and chronic obstructive pulmonary disease (copd). however, most general practices still provide care at initiative of the patient self, because of the lack in scientific evidence and the costs of implementing a regular care structure. self-care by patients may be an alternative to alleviate the growing load on primary health care. the following two main research questions are addressed in this study. * does an integrated self-management education intervention for patients with copd in general practice contribute to attaining long-term treatment targets, compared to regular monitoring by a practice nurse and usual gp care? * what is the cost-effectiveness of an integrated self-management education intervention for patients with copd, compared to regular monitoring by a practice nurse and usual gp care?

Eligibility criteria:
inclusion criteria: * registered in one of the general practices participating in the study * diagnosis of copd, with global initiative for chronic obstructive lung diseases (gold) stage i, ii or iii * age ≥35 years * willing to provide written informed consent exclusion criteria: * very poor prognosis with regard to respiratory condition (gold stage iv) * severe co-morbid conditions with a reduced life expectancy * unable to communicate in the dutch language * objections to one or more of the disease management modes in the study

Keywords: chronic obstructive pulmonary disease (copd) self-management practice nurse cost-effectiveness randomized controlled trial
uterotonic prophylaxis trial

Conditions: Hemorrhage

Summary: excessive bleeding after dilation and evacuation (d\&e) requiring interventions is common, occurring in approximately 30% of cases at one large abortion-providing clinic. uterotonic prophylaxis at the time of d\&e, particularly with methylergonovine maleate (mm), is a common practice among d\&e providers despite nearly no evidence for its efficacy. finding ways to decrease excessive bleeding after d\&e has the potential both to improve patient safety and to reduce costs of provider-initiated interventions. the investigators propose a randomized, controlled trial to investigate the efficacy of mm prophylaxis versus placebo in decreasing excessive bleeding measured by a composite outcome among women undergoing d\&e at 20 to 24 weeks.


Eligibility criteria:
inclusion criteria: * between 20 wks 0 days gestation and 24 wks 0 days gestation * english or spanish speaking * bp before injection 140/90 or below * 18 years old or over exclusion criteria: * hypertension either on the preoperative or operative day (defined as systolic blood pressure greater than 140 mmhg or diastolic blood pressure greater than 90 mmhg) * d\&e procedures with more than one day of cervical preparation with dilators * use of protease inhibitors * known coagulopathy * known morbidly adherent placenta
the clostridioides difficile trial of rec-3964

Conditions: Recurrent Clostridioides Difficile Infection

Summary: this is a multi-center, open-label study to investigate the safety, tolerability, pharmacokinetics (pk) and efficacy of re-3964 (doses of either 250 mg or 500 mg po every 12 hours) for the reduction of clostridioides difficile infection (cdi).

the study was terminated due to business decision and there were no safety concerns.

Eligibility criteria:
key inclusion criteria: * be 18 years of age or older with clostridioides difficile infection (cdi) diarrhea associated with a positive stool test for c. difficile toxin\[s\] prior to the preceding curative treatment. * the cdi episode, severe or otherwise, must have resolved after receiving vancomycin with a standard duration of treatment. the participant must be randomized within 2 days of completing the preceding curative treatment. * have high risk for rcdi (a recurrent cdi episode within the last 6 months, age ≥65 years, immunocompromised state, or severe cdi with resolution prior to enrollment into the study). key exclusion criteria: * have an active, symptomatic, chronic diarrheal illness from other causes, such as ulcerative colitis or crohn's disease. * diarrhea that requires on-study treatment with agents that would confound the interpretation of the study results.

Keywords: cdiff infection clostridiodes difficile infection cdiff
pain: a project assessing the impact of a novel cannabinoid product

Conditions: Chronic Pain

Summary: this study is a clinical trial of a high-cannabidiol (cbd) sublingual product compared to placebo for 9 weeks in patients with chronic pain conditions. the study will assess the impact of cbd on chronic pain symptoms, conventional medication use, clinical state, quality of life, cognition, and biomarkers.

cannabis sativa has been used medicinally to treat a wide range of disorders for thousands of years. cannabis is comprised of more than 100 cannabinoids, including d9-tetrahydrocannabinol (thc), the major intoxicating constituent, and cannabidiol (cbd), the major non-intoxicating constituent that has a number of potential therapeutic properties. although a wide range of medical cannabis (mc) and hemp products (containing less than 0.3% thc) are used by consumers for a variety of medical indications, little is known about the direct impact of individual cannabinoids and constituent ratios on the symptoms that cause patients to seek treatment. chronic pain is one of the most common indications for mc use, and several studies have yielded compelling data suggesting that mc and its constituents may have analgesic and anti-inflammatory properties, suggesting that cannabinoids may have the potential to treat chronic pain. this investigation will involve a placebo-controlled crossover trial of a hemp-derived high-cbd, low-thc sublingual product in patients with chronic pain; patients will be assessed at baseline and over 69weeks of treatment with cbd or placebo on measures of clinical state, including pain and related symptoms, conventional medication use, and cognition, and provide samples for analysis of inflammatory markers.

Eligibility criteria:
inclusion criteria: * subject has provided informed consent * subject is 21 or older * subject is fluent in english * subject endorses a musculoskeletal chronic pain condition including, but not limited to, chronic pain due to injury, arthritis (including osteoarthritis and rheumatoid arthritis), bursitis, etc. exclusion criteria: * non-fluent english speakers * estimated iq \< 75 * a history of head injury or loss of consciousness greater than 5 minutes * currently uses cbd products regularly * female subjects will be excluded if they have a positive urine pregnancy test, are trying to become pregnant, or are currently breastfeeding * presence of a serious or unstable medical illness, including liver, kidney, or cardiovascular disease (hyper/hypotension, cardiac disorders), or neurological disorder (including seizure disorder) * primary neuropathic pain or cancer-related pain; patients experiencing neuropathic pain secondary to musculoskeletal pain will be allowed to enter the study * disclosure of a genetic polymorphism affecting cyp2c9 function

Keywords: cannabidiol medical cannabis industrial hemp
lid margin and conjunctival microbial flora following punctum occlusion

Conditions: Dry Eye Syndrome

Summary: to determine if the types and amount of bacteria or other germs change over time after the routine procedure of blockage of tear drainage duct in the treatment of dry eye condition or other condition benefiting from a tear drainage blockage

this study will investigate the impact of punctal occlusion on the ocular microbial flora. current thought is that punctal occlusion causes retention of inflammatory mediators on the ocular surface which may produce pathology, we hypothesize that blockage of the nasolacrimal drainage system may allow colonization of the ocular surface by potentially pathogenic ubiquitous organisms (which may produce exotoxins and other biologic products) that may be responsible for signs and symptoms seen in some patients. additionally, the presence of the silicone foreign body(punctal plug) may act as a nidus for bacterial adhesion with biofilm production (which is known to occur with pseudomonas sp and other organisms). there would thus be a paradigm shift of our current understanding of the pathophysiology of punctal occlusion. additionally, the choice of antimicrobials for the treatment of infections in patients with punctal occlusion may need to be modified if the microbial flora is found to be different in patients with punctal occlusion. the ocular flora may be different inpatients with severe dry eye or other chronic pathologic conditions, which are frequent indications for punctal occlusion. however, from our retrospective review, we could not determine if there was a change in the microbial flora following plug placement with colonization with these "unusual organisms" since baseline cultures prior to punctal plug placement were not obtained. we will try to differentiate any effect on the microbial flora caused by the silicone plug or acrylic plug(as a foreign body) versus the punctal closure by thermocautery. (punctal thermocauterization is an alternative method of punctal closure which is 1) the preferred choice by some ophthalmologists for all their cases, or 2) when the dry eye is severe and irreversible punctal occlusion is desired or 3) if punctal plugs can not be retained due to the large size of the patients punctal). the thermodynamic hydrophobic acrylic plug(smartplug) approved by the fda for punctal occlusion with the same indications as the traditional silicone plug.

Eligibility criteria:
inclusion criteria: * 18 years and older * able to sign informed consent * clinical indication for punctal plug insertion or punctal cautery or symptomatic patients who have previously had punctal occlusion * clinical indication for punctal plug removal(partial extrusion, discomfort) increased signs of ocular irritation with punctate keratopathy, punctal inflammation). * able to make follow up visit schedule exclusion criteria: * subjects without dry eye

Keywords: dry eye syndrome punctal occlusion punctal plugs tear drainage duct blockage
relaxin and placental volume in placenta accreta spectrum

Conditions: Placenta Accreta Spectrum; Placenta Accreta / Percreta

Summary: this retrospective case-control study investigated the potential role of circulating relaxin levels and estimated placental volumes (epv) in the pathogenesis and diagnosis of placenta accreta spectrum (pas) disorders. it compared these parameters in patients diagnosed with pas versus healthy controls.

this study aimed to compare relaxin levels in umbilical cord and peripheral blood and estimated placental volumes (epv) between pas cases and controls. additionally, subgroup analysis was conducted to evaluate relaxin levels and epv among pas subtypes (accreta, increta, and percreta).a retrospective case-control study was conducted at a tertiary referral center, analyzing data from january 2022 to december 2022.

Eligibility criteria:
inclusion criteria: women aged 18-45 years confirmed histopathological diagnosis of pas (case group) complete medical records healthy pregnant women undergoing cesarean delivery (control group) exclusion criteria: multifetal gestation emergency surgeries incomplete medical records

Keywords: biomarker pas placenta accreta spectrum placental volume relaxin rln2
pathways to advance targeted and helpful serious illness conversations (path-sic)

Conditions: Breast Cancer; Gastrointestinal Cancer; Gynecologic Cancer; Thoracic Cancer; Genitourinary Cancer

Summary: the purpose of this study is to increase serious illness conversations (sics) about patients goals and preferences regarding their healthcare between patients with cancer and their oncology clinicians and improved care provided near the end of life.

the objective of this study is to implement an intervention in a pragmatic randomized controlled trial that uses cancer treatment pathways data to identify patients appropriate for serious illness conversations (sics) and applies "nudges" to patients and their oncology clinicians to increase sics and improve end of life (eol) outcomes. identified participants and clinicians will be randomized into 1 or 4 groups. * nudge to patient and clinician * nudge to patient only * nudge to clinician only * no nudge. the expected enrollment is approximately 800 participants.

Eligibility criteria:
inclusion criteria: * patients who are aged 18 years or older, reach one of the poor prognosis nodes identified and have an upcoming appointment at one of the following dana farber cancer institute oncology clinics (including longwood and chestnut hill locations) * breast oncology clinic * gastrointestinal oncology clinic * genitourinary oncology clinic * gynecologic oncology clinic * thoracic oncology clinic exclusion criteria: * patients with an sic documented in the advance care planning module of the electronic health record in the 6 months prior to reaching a poor prognosis node * patients who have previously been randomized in this trial (e.g., the patient is encountering a poor-prognosis node for the second time during the trial period)

Keywords: breast cancer gastrointestinal cancer gynecologic cancer thoracic cancer genitourinary cancer serious illness communication