Kornimate/medical-research-clean huggingface dataset:
exercise therapy and ultrasound guided injections in painful shoulder

Conditions: Shoulder Bursitis

Summary: many patients experience an effect of steroid injection, however the effect is often short lasting and recurrence of symptoms is common. the short term effect of injection has been shown to be much better than exercise therapy; however over time the superior effect of injection compared to exercise does not last. injection in combination with exercise therapy might be a more sufficient therapy than injection alone. the aim of this study is to investigate a combination of steroid injection and a 10 week exercise program. in addition, the study tests the validity of clinical impingement tests using ultrasound verified impingement as gold standard.

for many patients unspecific pain and reduced motion in the shoulder is a common complaint. it is believed that the main reason for shoulder pain comes from inflammation of the bursa. many patients experience an effect of steroid injection, however the effect is often short lasting and recurrence of symptoms is common. exercise therapy for the muscles around the shoulder joint is also common treatment for shoulder pain. the short term effect of injection has been shown to be much better than exercise therapy; however over time the superior effect of injection compared to exercise does not last. the anti-inflammatory and pain releasing effect of steroid injection in combination with exercise therapy increasing the strength and control of the muscles around the shoulder joint, might be a more sufficient therapy than injection alone. thus, the aim of this study is to investigate a combination of steroid injection and a 10 week exercise program in patients with a painful shoulder. many different clinical tests are used to examine the pathological compression of the bursa during motion in the shoulder joint (impingement). however, it is actually not known if the pain in motion is caused by compression of the bursa. part of this study therefore is to test the validity of clinical impingement tests using ultrasound verified impingement as gold standard. studies comparing injection given guided by ultrasound to blind injections have shown that the ultrasound guided injections are more likely to place the active stuff correctly in the swollen bursa. in this study all injections will be given ultrasound guided. in the ultrasound examination the thickness of the bursa will be measured in all patients in order to investigate if swollenness of the bursa can explained the pain and dysfunction of the shoulder joint

Eligibility criteria:
inclusion criteria: * pain and reduced motion in the shoulder for more than four weeks * ultrasound verified swollenness of the bursa. exclusion criteria: * bilateral pain in the shoulder joints * rupture of the rotator cuff or biceps tendons * generalised disease which can explain the shoulder pain * oa in the shoulder joint * diabetes * positive compression test of the cervical spine

Keywords: shoulder impingement ultrasound injection of glucocorticosteroid exercise
a rollover study to evaluate the long-term safety and efficacy of ocrelizumab in patients with multiple sclerosis

Conditions: Multiple Sclerosis

Summary: this is a phase iiib, single-arm, multicenter, ole study. participants receiving ocrelizumab as an investigational medicinal product (imp) in a roche sponsored parent study who continue to receive ocrelizumab or are in safety follow-up at the time of the closure of their respective parent study (wa21092, wa21093 or wa25046) are eligible for enrollment in this extension study. participants who will continue ocrelizumab treatment will receive imp based on the dosage and administration received at the time of rollover from the parent study.


Eligibility criteria:
inclusion criteria * prior eligibility for and previous participation in 1 of the roche-sponsored parent studies wa21092, wa21093, or wa25046 with the participant either receiving ocrelizumab as an investigational medicinal product (imp) or being in safety follow-up after treatment discontinuation * for female participants of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use adequate acceptable contraception during the treatment period and for at least 6 months or longer if the local label is more stringent after the final dose of ocrelizumab, as applicable in the ocrelizumab package leaflet exclusion criteria * concurrent participation in any clinical trial (other than the parent study) * unable or unwilling to comply with the requirements of the protocol
evaluation of point-of-care (epoc) for covid-19

Conditions: COVID-19; SARS CoV 2 Infection

Summary: epoc is designed to examine the feasibility of conducting two point-of-care (poc) tests the lumiradx sars-cov-2 antibody test and the rightsign covid-19 igg/igm rapid test for sars-cov-2 antibodies and compare the reproducibility of these tests to tests run at a central laboratory on specimens obtained from the same study participants at the same time.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years. * informed consent by the patient or the patient's legally authorized representative (lar) for up to 4 fingersticks for poc testing and a blood draw for stored blood samples. * sars-cov-2 infection, documented by a nucleic acid test (nat) or equivalent testing within 3 days prior to consent or documented by nat or equivalent testing more than 3 days prior to consent and progressive disease suggestive of ongoing sars-cov-2 infection per the responsible investigator. (for non-nat tests, only those deemed with equivalent specificity to nat by the protocol team will be allowed. a central list of allowed non-nat tests is maintained for tico and that list will also be used for this protocol.) * duration of symptoms attributable to covid-19 ≤ 12 days per the responsible investigator. * requiring admission for inpatient hospital acute medical care for clinical manifestations of covid-19, per the responsible investigator, and not for purely public health or quarantine purposes. exclusion criteria: * prior receipt of sars-cov-2 hivig, convalescent plasma from a person who recovered from covid-19, or sars-cov-2 nmab within 6 months of the blood draws for testing as part of this protocol. * disease severity beyond that of stratum 1 in the tico trial. this includes the following conditions: 1. stroke 2. meningitis 3. encephalitis 4. myelitis 5. myocardial infarction 6. myocarditis 7. pericarditis 8. symptomatic congestive heart failure (chf; new york heart association \[nyha\] class iii-iv) 9. arterial or deep venous thrombosis or pulmonary embolism * current requirement for any of the following: 1. high-flow supplemental oxygen 2. non-invasive ventilation 3. invasive mechanical ventilation 4. extracorporeal membrane oxygenation 5. mechanical circulatory support 6. vasopressor therapy 7. commencement of renal replacement therapy at this admission (i.e., not patients on chronic renal replacement therapy). * in the opinion of the responsible investigator, any condition for which, participation would not be in the best interest of the participant or that could limit protocol specified assessments.

Keywords: covid-19 sars cov 2 covid19 testing
bg00010 (neublastin) phase 2 multiple dose adaptive design in participants with painful lumbar radiculopathy

Conditions: Painful Lumbar Radiculopathy; Sciatica; Radiculopathy

Summary: the primary objective of the study is to assess the efficacy of intravenous (iv) bg00010 (neublastin) in improving pain in painful lumbar radiculopathy participants when administered 3 times per week for 1 week. the secondary objectives of this study in this study population are as follows: to explore the duration of the effect of bg00010 in improving pain; to explore the dose response curve on pain reduction; to assess the safety and tolerability of bg00010; to assess the serum exposure to bg00010.

during the study, frequent assessment of allocation probability will be conducted to guide subsequent randomization of participants into dose groups.

Eligibility criteria:
key inclusion criteria: * body weight ≤133 kg. * leg pain radiating, diagnosed as being due to painful lumbar radiculopathy or lumbosacral radiculopathy, the diagnosis of which occurred within ≥6 months and ≤5 years of the time of randomization. * objective, documented evidence of painful lumbar radiculopathy involvement * lower back pain * leg pain * male and female subjects of childbearing potential must practice effective contraception during the study and be willing and able to continue contraception for 3 months after their last dose of study treatment. key exclusion criteria: * history of or positive test result at screening for human immunodeficiency virus, or for hepatitis c virus antibody, or current hepatitis b infection. * clinically significant diseases or conditions as determined by the investigator. * major surgery within 30 days prior to the screening visit or that is scheduled to occur during the study. * previous participation in a study with neurotrophic factors (e.g., nerve growth factor). * participation in a study with another investigational drug or approved therapy for investigational use within 3 months prior to day 1. * other unspecified reasons that, in the opinion of the investigator or biogen idec inc. (biogen idec), make the subject unsuitable for enrollment note: other protocol-defined inclusion/exclusion criteria may apply
pelvic organ prolapse repair with or without concomitant burch colposuspension in patients with urinary incontinence

Conditions: Pelvic Organ Prolapse; Urinary Incontinence

Summary: to evaluate the impact of burch colposuspension (bc), as an anti-incontinence measure, in patients with urinary incontinence (ui) undergoing abdominal surgery for pelvic organ prolapse (pop) repair

forty-seven women suffering from pop and ui were randomly assigned to abdominal pop repair and concomitant bc ( 24 patients; group a) or pop repair alone without any anti-incontinence procedure ( 23 patients.; group b). they were followed-up at 3, 6, and 9 months after surgery and then annually. the primary outcome measures were anatomical outcome and changes in incontinence status as indicated by a bladder diary, the number of daily pads and the stress test. secondary endpoints were changes in subjective symptoms and quality of life (qol) as measured by the urogenital distress inventory (udi-6) and the impact incontinence quality of life (iiq-7) questionnaires.

Eligibility criteria:
inclusion criteria: * study inclusion criteria were pop \> 2, ui as was defined by ics \[2\], age ≥ 18 and ≤ 75 yrs. exclusion criteria: * benign or malignant uterus lesion (leiomyoma, fibromyoma, cervical or endometrial carcinoma) * active pelvic inflammatory disease, * known hypersensitivity to synthetic materials (polypropylene, polythetrafloroethilene, polyethileneterephtalate, polyglactil acid or polyglycolic acid) * pregnancy or lactation * evidence of clinically significant cardiovascular, renal, hepatic or respiratory diseases; and * any condition that in the judgment of the investigators would interfere with the subject's ability to provide informed consent, comply with study instructions, place the subject at increased risk, or which might confound interpretation of study results.

Keywords: pelvic organ prolapse, urinary incontinence, burch colposuspension, surgery
trial of ceramic water filters to reduce cryptosporidium infection in kenya

Conditions: Cryptosporidium; Diarrhea; Cryptosporidiosis; Communicable Diseases; Diarrheal Disease

Summary: the aim of the study is to examine the efficacy of ceramic water filters to reduce the burden of waterborne diarrheal illness among infants in selected villages in kenya. in kenya very young children are given drinking water or water is used in reconstitution of their food. we hypothesize that ceramic water filters will remove cryptosporidium from drinking water reducing infection in infants.

diarrhea is a major cause of illness among children in africa. cryptosporidium is a protozoan waterborne diarrheal pathogen resistant to chlorine. ceramic filters are effective at improving drinking water quality, including removal of protozoa. in a recent preliminary analysis of \>22,000 children \<5 years enrolled in the global enterics multi-center study (gems) case-control study of moderate-to-severe diarrhea, cryptosporidium was identified as a leading cause of diarrhea in infants across all four participating african sites. this pilot is the first cryptosporidium specific intervention trial of household ceramic water filters to reduce the burden of cryptosporidiosis acquired through drinking water in rural kenya.

Eligibility criteria:
inclusion criteria: children 4-10 months old living in selected villages in the asembo health and demographic surveillance system (hdss) study area in kenya whose primary caretakers consent on their behalf to be visited weekly for 6 months to carry out weekly illness surveillance, and have a follow up home visit one year after initial enrollment into the trial. the household in which the child resides must be a consenting participant in the hdss. as the children included in the trial are infants, the child's primary caretaker will be invited to participate and be administered questionnaires. random selection will be at the compound level. only one household per compound will be eligible for selection. exclusion criteria: children 4-10 months old whose households are not active consenting participants in the hdss will not be eligible for inclusion. only the subset of children 4-10 months old who are randomly selected in the sample will be eligible for participation. -

Keywords: cryptosporidiosis waterborne disease diarrheal disease ceramic water filters infants young children drinking water kenya
a technology-based intervention with retired people

Conditions: Aging; Retirement

Summary: the main objective of the study is to understand retired people's perception of retirement, to know their personal experience and to jointly seek solutions to the needs and problems encountered. secondarily, the aim is to understand the impact that an active aging program intervention implemented in retired people, based on the use of technology and considering the basis for the adaptation of the prochaska and diclemente trans-theoretical model, can have in their quality of life.

the present study has been approached from a mixed-methods research. mainly, the study is focused on a research-action-participation method in order for empowering and to people having more control over their lives. this approach was used taking into account the many changes caused by leaving working life to begin the stage of retirement. in reference to participatory methods, techniques such as brainstorming, and consensus-building and visual techniques have been included. the quantitative approach is a complementary method to the qualitative approach based on a quasi-experimental study, as no control group has been introduced. from this approach, a descriptive and comparative study has been carried out on quality of life and the behavior adopted in the adaptation to retirement, both measured before and after the intervention. the intervention program developed consists of a brief-intervention about 5 sessions lasting between 45-60 minutes. it was intended to address the concerns and needs that emerge from the participants' interviews. the intervention is based on the principles of the process of adaptation to retirement defined by atchley and the prochaska and diclemente model on the phases of preparation for retirement. the material to be used will be based on existing resources for retired people, awareness through multimedia material and knowledge of possible contributions of different technological devices to healthy-lifestyle.

Eligibility criteria:
inclusion criteria: * people retired recently (since 10 years maximum) * people who attend regularly the institution selected for recruitment, which is attended by retired people over the age of 60 years old. exclusion criteria: * people who present cognitive and psychological alterations that may interfere in the interview * people who have not had paid employment * people who have completed previously a preparation for retirement's program.

Keywords: older adults technological devices technology healthy lifestyle quality of life
"cytotoxic t lymphocyte-associated antigen-4 (ctla-4) gene single-nucleotide polymorphism in primary immune thrombocytopenic purpura in children"

Conditions: ITP - Immune Thrombocytopenia

Summary: the investigators aim in this study to investigate the potential association of single gene polymorphisms of ctla-4 (snps; rs: 3087243) using real-time pcr in children with primary itp.

primary immune thrombocytopenia (itp) is an acquired autoimmune bleeding disorder characterized by isolated thrombocytopenia (platelet count \< 100 × 109/l) in the absence of other etiologies. the incidence of the disease is approximately 2-10 per 100,000 adults each year, with a prevalence of 9-20 per 100,000 adults auto antibody-mediated platelet destruction is the canonical mechanism of platelet destruction in itp. platelets coated by anti-glycoprotein (gp) autoantibodies are prematurely destroyed by macrophages via fcγ receptors (fcγrs) in the reticuloendothelial system. autoantibodies also accelerate platelet destruction through the induction of complement-dependent cytotoxicity (cdc) and platelet apoptosis many studies have demonstrated that cd8+ cytotoxic t lymphocytes (ctls) from peripheral blood or spleen of itp patients can directly lyse platelets or induce platelet apoptosis through granzyme b and perforin. ctls and anti-gp autoantibodies can induce the desialylation of platelet surface glycans, leading to premature platelet clearance. the immune checkpoint pathways are critical modulators of the immune system, allowing immune response initiation and preventing autoimmunity onset. immune checkpoints, including co-stimulation and co-inhibition signal pathways, are among the central mechanisms that regulate t-cell-mediated immune responses ctla-4 production is strongly influenced by genetic factors. single-nucleotide polymorphisms (snps) of the ctla-4-encoding genes are involved in the pathogenesis of many autoimmune diseases such as systemic lupus erythematosus (sle) and rheumatoid arthritis (ra) in recent years, it had been shown that thrombocytopenia was associated with the transcription level of ctla4 and regulation of t-cell activation

Eligibility criteria:
inclusion criteria: approval to sign an informed written consent, patient with newly diagnosed itp, patient age \> 1 year and \< 18 years and both sexes are included. exclusion criteria: refusal to sign an informed written consent, patient with persistent itp, patient with chronic itp, patient with secondary immune thrombocytopenia and patient age \ 18 years
effects of family status of osteopathic medical students on their perceived level of stress.

Conditions: Stress, Psychological

Summary: the investigators are interested in studying the effects of familial obligations, including marriage, parenthood, familial caregiving, on stress levels in osteopathic medical students (oms). the investigators expect to find that having a family may increase the stress level of oms in comparison with oms who don't have familial obligations.


Eligibility criteria:
inclusion criteria: * medical students exclusion criteria: * not current medical students
penicillin de-labeling in the pediatric primary care setting

Conditions: Penicillin Allergy; Penicillin Reaction

Summary: while reported adverse reactions to penicillins are common, most patients with a penicillin allergy label can safely tolerate penicillins, and elective evaluation for penicillin allergy has been recommended. for low-risk patients, direct oral challenge may be an optimal approach as a delabeling strategy. however, there is a vast disparity between the number of patients with a penicillin allergy label and practicing allergists in the united states, and implementing outpatient primary care-based delabeling strategies in low-risk patients may increase access to delabeling assessments. however, a recent survey of pediatricians identified perceived barriers to implementing penicillin allergy evaluations into their routine care. significant gaps in knowledge exist regarding the feasibility of this approach involving risk stratification evaluation of reported penicillin adverse reactions and direct amoxicillin challenge procedures in low-risk patients in the pediatric primary care setting. with this, the primary aim of this study is to evaluate the number of patients for which risk-stratification and direct amoxicillin challenge are successfully completed in an outpatient pediatric primary care clinic.


Eligibility criteria:
inclusion criteria: * children from ages 2-18 years with a history of parent-reported penicillin allergy. exclusion criteria: * children with a history of reaction consistent with a severe cutaneous adverse reaction to penicillin as defined as a history of oral blisters, diffuse skin peeling or blisters after taking a penicillin, or having the diagnosis of stevens johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms will be excluded. pregnant and breastfeeding female subjects will be excluded

Keywords: penicillin allergy
eccentric resistance training with blood flow restriction on muscle function

Conditions: Blood Flow Restriction

Summary: the study will determine the effects of adding blood flow restriction to eccentric training to assess whether this increases the improvements of muscle strength and size.

subjects will be randomly assigned to two groups: an eccentric only resistance training group or an eccentric training plus blood flow restriction group. subjects will train at a moderately low intensity on a multiple-joint eccentric device. those in the blood flow restriction will wear blood flow restriction cuffs on their upper thighs to reduce blood flow during the brief protocol. the training session will occur twice per week and will last \~5 minutes, including a one minute warm up, a one minute cool down and a three minute workout phase. the training program will last 7 weeks. testing will be conducted at baseline (following a one session familiarization), 4 weeks and after the end of the 7 week training period. assessments will focus on muscle strength, function, and morphology (size).

Eligibility criteria:
inclusion criteria: * 18-30 years of age * currently engaged in some form of resistance training between 1-3 times per week * must have been training aerobically, but no more than 3 hours a week for the past six months exclusion criteria: * must not have had any surgery of the lower limbs within the past 1 year period * must not have any neuromuscular disorder (e.g., muscular dystrophy etc.) * \< 76 inches tall (in order to fit on the training machine) * maximal strength of \< 725 lbs for the eccentric training device * if any of the subjects are pregnant or plan to be pregnant in the duration of the protocol. for those randomized to the bfr group, if any of the subject's thighs are too large for the bfr cuffs (greater than 68 cm).

Keywords: resistance training muscle function quadriceps eccentric strength vertical jump muscle quality muscle hypertrophy eccentric training