Kornimate/medical-research-clean huggingface dataset:
psychology and physiotherapy approach of chronic pain in patients with hemophilia

Conditions: Haemophilia

Summary: this study evaluates the clinical impact of a combined protocol with cognitive-behavioral intervention and physiotherapy adjuvant to the standard medical treatment in patients with haemophilia that suffer from chronic pain

the purpose of this study is to improve the perception of the experience of chronic pain, as well as functionality and quality of life in hemophilic patients with chronic pain secondary objectives are: * to change the perception that the patient has of their pain, to improve the coping strategies and to increase the perception of self-efficacy of patients in pain management. * to increase the resources that allow a better self-regulatory of emotional, cognitive and competential of the pain experience, reverting in the emotional state of patients, particularly in levels of anxiety and depression. * to improve functional capacity and musculoskeletal status. * to improve quality of life. * to determine whether changes / improvements are maintained over time 3 months after finishing the program

Eligibility criteria:
inclusion criteria: * diagnosis of haemophilia a or b. * age between 18 and 60 years. * informed consent signed. * signs of arthropathy according to clinical criteria (score gilbert) and / or radiological criteria (score pettersson) in at least one of the six joints most commonly affected (ankles, knees or elbows) * chronic pain (cp) defined as persistent pain lasting at least six months and resistant to conventional medical therapy. it differs from the acute pain not only in its longer duration, but also sometimes persists even after the cause that produced it has disappeared. * absence of active coping strategies, understanding the concept of coping as those cognitive and behavioral efforts made by the individual in order to manage internal and external demands generated by their chronic pain condition and that involve a challenge to their potential individual resources. exclusion criteria: * presence of inhibitor to fviii or fix. * another haemostatic defect. * patients with severe cognitive deficits with which it is not possible a cognitive psychological intervention. * the inability to attend physiotherapy sessions for 12 consecutive weeks (7 supervised and 31 self-monitored) * surgical procedures performed 6 weeks prior or during the intervention protocol. * not acceptance or withdrawal of informed consent
prevention of fetal alcohol spectrum disorder (fasd) by the use of technology

Conditions: Alcoholism; Pregnancy

Summary: the institute of health economics is conducting a study to determine how a breathalyzer linked to a cloud based alcohol monitoring system changes alcohol consumption during pregnancy in women with alcohol dependency issues. ihe posits that the ability to self-monitor blood alcohol concentration and the ability to share sobriety via email or text with loved ones and counselors may reduce alcohol consumption and thus reduce the possibility of delivering a child with fasd. the study will provide useful evidence for tailoring future optimal maternal and child healthcare for women, with the potential of decreasing healthcare utilization by prevention of fasd. breathalyzer device usage plus secure document sobriety should improve patient monitoring convenience and demonstrate reductions in alcohol use outside of traditional office visits and patient self-reports.


Eligibility criteria:
inclusion criteria: * pregnant, alcoholic, actively in treatment for alcoholism addiction exclusion criteria: * not pregnant, not in treatment/therapy for addiction
comparison between mini monaka,perforated plugs and 3-snip punctoplasty in punctal stenosis

Conditions: Punctal Stenosis

Summary: to compare the result of mini monaka to perforated plug and 3 snip punctoplasty in management of punctal stenosis.

punctal stenosis is a common disorder of the punctum. it is an important cause of epiphora and accounted for 8% of all patients presenting with epiphora and 3% of all lacrimal drainage disorders. although numerous factors have been implicated as causative agents, the exact pathogenesis is still elusive. the widely believed hypothesis that histological studies have supported is a common mechanism involving inflammation leading to fibrosis and subsequent stenosis .a stenotic punctum can be easily diagnosed by slit-lamp examination, while probing and irrigation of the lacrimal pathway is usually required to exclude a more distal obstruction there are no uniformly acceptable guidelines for the management of punctal stenosis. several modalities described include punctal dilatation, 1-snip punctoplasty, 2-snip punctoplasty, 3-snip punctoplasty, rectangular 3-snip punctoplasty, 4-snip punctoplasty, punctal punching with kelly's or rsess punch, punctoplasty with mitomycin c, balloon punctoplasty, balloon puncta-canaliculoplasty, and inserting perforated punctal plugs, self-retaining bicanaliculata stents, or mini-monaka . the mini-monaka is a silicone post canalicular stent designed to repair canalicular lacerations. it is designed to fit snugly into the punctum and ampulla without any suturing .a perforated punctal plug can be put into the opening of the tear canal to allow drainage of tears. these are very small silicone arrowhead shaped tubes it is important to note that there is increasing evidence about the benefits of minimally invasive modalities like mini-monaka. the non-surgical dilation can be performed as an office procedure .

Eligibility criteria:
inclusion criteria: * o confirmed unilateral or bilateral cases of punctal stenosis based on slit-lamp examination. exclusion criteria: * o epiphora due to distal obstruction * active ocular infection or inflammation. * anatomic abnormalities * ocular cicatricial pemphigoid
two different cataract surgical procedures to prevent posterior capsule opacification

Conditions: Cataract; Posterior Capsule Opacification

Summary: in this study, the investigators introduce a new "capsule-reserved" cataract surgical procedure in which anterior lens capsule is reserved and attached onto posterior lens capsule in the purpose of preventing posterior capsule opacification (pco). a prospective randomized controlled study is reported to compare the new "capsule-reserved" surgical procedure with conventional one on the effectiveness to prevent posterior capsule opacification in age-related cataract patients.

a prospective, randomized controlled study of 240 eligible patients will been enrolled. two eyes of each patient were assigned randomly to two groups respectively: group i; anterior lens capsule is conventionally not reserved after continuous curvilinear capsulorhexis, while in group ii, anterior lens capsule is innovatively reserved and attached onto posterior lens capsule. this novel adjusted surgical procedure, featured by using the reserved anterior lens capsule to protect the peri-capsule microenvironment and prevent pco, is conceptual different from the traditional cataract surgical procedure. clinical examinations including posterior capsule opacification grading score, central posterior capsule thickness, central posterior capsule density, best corrected visual acuity, contrast sensitivity were carried out preoperatively and at each postoperative visit.

Eligibility criteria:
inclusion criteria: 1. aged 50 years or above 2. both eyes were diagnosed with age-related cataract 3. both eyes were planed to undergo the "phacoemulsification and iol implantation" surgery with 1 month 4. biocular bcva improvement post surgery was feasible judged by the ophthalmologists. exclusion criteria: 1. other ocular diseases 2. acd\<3ct 3. combined cataract surgery (trabeculoplasty, keratoplasty) 4. lens pseudoexfoliation syndrome combined with glaucoma or zonular abnormalities 5. previous intraocular surgery or trauma (laser not included) 6. uveitis 7. recent ocular infection 8. proliferative diabetic retinopathy 9. diabetes mellitus 10. congenital ocular abnormalities (aniridia, congenital cataract) 11. atrophy of iris 12. participants with previous clinical trials 30 days before surgery 13. using prostanoid eye drops 14. uncontrolled systematic diseases
structural and functional impairment of multiple organs in patients with systemic sclerosis: a mr imaging study

Conditions: Systemic Sclerosis; Multisystem Disorder

Summary: this study intends to carry out a prospective, multi-center cohort study based on mri to explore the incidence of structural and functional damage of central, brain and kidney in patiant with ssc and its clinical relevance, and to search for the characteristics of serological markers of structural and functional damage of heart, brain and kidney.

systemic sclerosis (ssc) is a autoimmune disease of unknown etiology with an estimated global incidence of 0.1‰. ssc characterized by abnormal immune activation, neovascularization, vascular remodeling in pathology, and eventually leads to fibrosis of tissues, skin, and organs \[2\]. in addition to skin sclerosis, ssc often involved multiple organ involvement, such as finger ulcer, gastroesophageal reflux, interstitial lung disease, pulmonary hypertension, cardiomyopathy, kidney damage, etc. neuropsychiatric manifestations such as anxiety and depression may also occur in ssc patients. a long-term follow-up study indicated that cardiomyopathy (14%), cardiovascular disease (12%), and kidney injury (4%) were important causes of death in ssc patients. therefore, early diagnosis and early intervention for multi-organ complications of ssc can significantly prolong the survival time of ssc patients.magnetic resonance imaging (mri) is a non-invasive, radiation-free imaging examination method with excellent soft tissue contrast, which can achieve one-stop multi-parameter imaging. at present, mri has been widely used to accurately diagnose and evaluate the structure and function of organs such as heart, brain and kidney. previous literature has shown that cardiac mri can identify cardiac injury in patients with ssc earlier than echocardiography even in the early stage. meanwhile it can find the abnormalities before clinical symptoms. therefore, mri is an effective noninvasive imaging method to evaluate the structural and functional damage of heart, brain and kidney in ssc patients.

Eligibility criteria:
inclusion criteria: clinical diagnosis of systemic sclerosis exclusion criteria: complicated with other immune disease claustrophobia contraindications for mr examination heart or respiratory failure diseases that affect mr findings (e.g. rapid atrial fibrillation) complicated with heart, brain and kidney diseases not caused by ssc（such as diabetic nephropathy and congenital heart disease） pregnant disturbance of consciousness
rimag study: trial of rituximab versus placebo in polyneuropathy associated with anti-mag igm monoclonal gammopathy

Conditions: Polyneuropathy

Summary: polyneuropathy associated with anti-mag monoclonal igm gammopathy is responsive of mainly a sensory deficit in predominantly males ,aged 40-70 years. significantly high serum anti-mag antibodies are linked with demyelinating features of the peripheral nerves.rituximab, an anti-cd 20 monoclonal antibody is a new drug which reduces b-lymphocytes. this study will test the safety and efficacy of rituximab in the treatment of patients with anti-mag polyneuropathy.

acting of a polyneuropathy for which there is not any treatment of reference today (see supra), a test of double-knowledge versus placebo is justified. acting of a chronic polyneuropathy, the clinical evaluation must be led over one one year period. acting of a sensitive polyneuropathy and the awaited benefit being the improvement of the clinical signs, the principal criterion is a sensitive score in addition validated in chronic sensitive polyneuropathies immunodeficiency syndrome. the patients answering the criteria of inclusion and none inclusion (see v-2) will be randomized in 2 groups: the first group will receive a perfusion iv of rituximab to the amount of 375 mg/m2 of body surface, once per week, during 4 weeks (see vii-3); the second group will receive 4 perfusions iv of placebo according to same methods'. the evaluation (see vi-1) will be carried out at the time of the randomization, then repeated in 3 months, 6 months, 9 months and 1 year.

Eligibility criteria:
inclusion criteria: * igm monoclonal gammopathy * anti-mag antibody titers \> 1.1000 btu (elisa) * worsening polyneuropathy with incat score \> 4 * informed consent exclusion criteria: * severe comorbidity * other concurrent causes of polyneuropathy * concurrent immunosuppressive therapies (wash-out \> 3 months) * previous treatment with rituximab * lymphoproliferative disease indicating other immunosuppressive treatment * unability to follow-up * previous documented side-effects with components involved in the tested drug * white cell count \< 1500/mm3 or platelet count \< 75.000/mm3 * patient under law

Keywords: anti-mag monoclonal gammopathy polyneuropathy rituximab
telerehabilitation based on aerobic exercise in fibromyalgia

Conditions: Fibromyalgia

Summary: fibromyalgia syndrome is the most common cause of chronic generalized musculoskeletal pain and is characterized by pain associated with generalizad sensitivity, fatigue, sleep disturbances and psychological problems. due to the chronic nature of the pathology and the great dependence on analgesic drugs that it often entails, in these patients it is considered necessary to provide an individualized approach and provide strategies that allow symptoms to be controlled conservatively and non-pharmacologically. the objective of this trial is to analyse the immediate effects on pain, mechanical pain sensitivity, impact of fibromyalgia, pain catastrophizing, psychological distress and physical function when a telerehabilitation program based on aerobic exercise is applied in women with fibromyalgia. for this purpose the investigators conduct a randomized controlled trial single-blind (examiner). the investigators included female patients diagnosed of fibromyalgia according to the american college of rheumatology (acr). thirty-four women with fibromyalgia are included and randomized into 2 groups: telerehabilitation program group based on aerobic exercise and control group. exercise group receive 2 treatment sessions a week over 15 weeks. all the variables are measured at the beginning of intervention and after the intervention.


Eligibility criteria:
inclusion criteria: * women diagnosed medically with fibromyalgia * diagnosed according to the american college of rheumatology criteria * age between 30 and 75 years old * telerehabilitation equipment including a laptop computer and access to internet exclusion criteria: * any kind of contraindications for physical activity * other physical or psychological therapies in the last 3 months. * medication modifications in the last 3 months

Keywords: exercise aerobic exercise telerehabilitation
a cohort study on thrombectomy for stroke

Conditions: Ischemic Stroke

Summary: the cerebral collateral circulation refers to the subsidiary network of vascular channels that stabilize cerebral blood flow when principal conduits fail. collateral status differs among patients with acute ischemic stroke. relatively sparse attention has been devoted to the role of baseline collateral circulation in patients with acute ischemic stroke who are candidates for revascularization. this study aim to investigate the correlation between baseline collateral circulation and the likelihood of opening of an arterial occlusion, the extent of reperfusion, tissue injury and clinical impairment.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years. * mechanical thrombectomy initiated within 24 hours after onset * ct perfusion can be performed before the initiation of thrombectomy and 24h after thrombectomy exclusion criteria: * contraindication to imaging with contrast agents * delay between imaging and beginning of thrombectomy \> 90 minutes
randomized clinical trial comparing conventional laparoscopic and robot-assisted laparoscopic hysterectomy

Conditions: Menorrhagia; Pelvic Pain; Hysterectomy

Summary: robotic-assisted surgery is becoming more prominent within the specialty of gynecologic surgery with little direct evidence that it is if not better than traditional laparoscopic surgery, at least equivalent. we designed a randomized-controlled trial to compare operative times, length of hospital stay, estimated blood loss, and post-operative complications associated with these two methods of minimally invasive hysterectomy.

the proposed study will be a non-blinded randomized control trial. patients will be randomized into each group conventional laparoscopic hysterectomy (group #1) and robot-assisted laparoscopic hysterectomy (group #2) using a random number generator. data collection will occur during the following points of patient interaction: pre-operative appointment, the surgical procedure, the patient's hospitalization, first post-operative appointment, and final post-operative appointment. the care for the patients enrolled in this study will not deviate from the standard care of patients who are currently undergoing laparoscopic and robot-assisted laparoscopic hysterectomy. the patients who present to the office for pre-operative history and physical examination for laparoscopic hysterectomy will be counseled about participation in this study. basic data collection will commence at the pre-operative visiting, including: patient demographics, past medical history, past surgical history, physical exam findings, and imaging results. the pre-operative appointment will occur between one to thirty days prior to surgery. intra-operative and immediate post-operative data will be collected by the surgical assistant (resident or fellow) and will include surgical procedure (conventional laparoscopic or robot-assisted), operative time, hematocrit, estimated blood loss, length of stay, and complications.

Eligibility criteria:
inclusion criteria: * undergoing hysterectomy * able to consent to the procedure exclusion criteria: 1. medical conditions not allowing for pneumoperitoneum 2. medical conditions not allowing proper ventilation during anesthesia 3. pelvic organ prolapse amendable to a vaginal approach 4. pregnant women 5. patients undergoing planned combined procedures including bowel resection (other than coincidental appendectomy) or major urologic procedures.

Keywords: hysterectomy robot-assisted laparoscopy
idiopathic generalized epilepsy cognitive and emotional profile

Conditions: Epilepsy; Quality of Life; Neuropathology; Emotional Problem; Executive Dysfunction

Summary: the primary goal of the study is to explore the neurocognitive, emotional-behavioral functioning, and quality of life of adolescents with ige, identifying key factors that affect their overall well-being. the study involves participants and their caregivers completing standardized questionnaires. additionally, clinical and anamnesic information will be collected to investigate the role of these variables on the emotional and executive functioning of the enrolled subjects

the 2022 ilae classification includes several types of idiopathic generalized epilepsy (ige), including childhood absence epilepsy (cae), adolescent absence epilepsy (jae), juvenile myoclonic epilepsy (jme), and generalized tonic-clonic seizure epilepsy (gtca). while neurocognitive development is generally normal, these conditions are often associated with mood disorders, adhd, and learning disabilities. prognostically, patients with ige tend to experience negative social outcomes such as poor academic performance, increased risk of unintended pregnancies, and psychiatric or emotional problems. these conditions may involve a range of seizure types, including absence, myoclonic, and tonic-clonic seizures, with eeg showing generalized spikes of 2.5-5.5 hz. these epilepsy syndromes are typically responsive to medication, but polytherapy is often required for optimal seizure control. the likelihood of remission and the age of remission can vary between syndromes, and patients may transition from one ige syndrome to another. in recent years, the focus of epilepsy treatment has shifted beyond seizure control to include psychological factors, aiming to improve the patient's overall health-related quality of life (hrqol). studies have shown that children with epilepsy have lower hrqol compared to healthy controls or children with other chronic conditions. factors influencing hrqol include psychiatric comorbidities, psychosocial challenges, cognitive and executive functioning, as well as epilepsy-specific variables such as seizure frequency, duration, and medication side effects. the primary goal of the study is to explore the neurocognitive, emotional-behavioral functioning, and quality of life of adolescents with ige, identifying key factors that affect their overall well-being.

Eligibility criteria:
inclusion criteria: age between 11 and 18 years diagnosis of idiopathic generalized epilepsy exclusion criteria: age under 11 years or over 18 years structural or cryptogenic epilepsy intellectual disability or borderline cognitive level refusal to participate in the study failure to obtain informed consent
multicenter registry for assessment of markers of early neurological deterioration in primary intracerebral hemorrhage

Conditions: Intracerebral Hemorrhage; Neurologic Deficits; Hemorrhagic Stroke; Hemorrhage

Summary: this multicenter observational study will explore the risk factors of early neurological deterioration(end) in patients with primary and to investigate the association between end and outcome.

neurological deterioration affects approximately one-third of patients with primary intracerebral hemorrhage (ich) and increases the risk of death and dependency. however, the risk factors of early neurological deterioration (end), such as biochemical parameters, neuroimaging, and systemic complications, are not well documented in primary ich, and the effective predictors of end is unknown. this multicenter observational study aims to seek out the risk factors of end in patients with primary ich and to investigate the association between end and outcome.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of primary intracerebral hemorrhage exclusion criteria: * patients with secondary * undergo surgical evacuation of hematoma； * presenting contraindications or refusal to mri * is pregnant * patients refuse to be followed up for any reasons.

Keywords: intracerebral hemorrhage neurological deterioration neuroimaging prognosis