Kornimate/medical-research-clean huggingface dataset:
timing of oral anticoagulant therapy in acute ischemic stroke with atrial fibrillation

Conditions: Ischemic Stroke; Atrial Fibrillation

Summary: this study will compare early with late start of treatment with non-vitamin k oral anticoagulation (noac) in adult patients with acute ischemic stroke and atrial fibrillation; it is a registry-based randomized clinical trial (r-rct) using the swedish stroke register (riksstroke). half of the patients will start noac early (within 4 days after stroke onset) while the other half will start late (5-10 days after stroke onset).

oral anticoagulation therapy is well established and highly recommended for the prevention of recurrent ischemic stroke in patients with atrial fibrillation, but the optimal time point to start after an acute ischemic stroke is not known. the intervention in this study will be timing of treatment onset. the choice of noac (i.e. apixaban, dabigatran, edoxaban or rivaroxaban) after the acute ischemic stroke is at the discretion of the treating physician. this study will use the swedish stroke register for enrolment, randomization and follow-up, with additional data linkage from other mandatory national registers. primary outcome will be assessed at 90 days and secondary outcomes (including all-cause mortality and health economic analyses) and will be assessed at 90 days and up to one year after the index ischemic stroke.

Eligibility criteria:
inclusion criteria: * adult patients (≥ 18 years) with acute ischemic stroke and atrial fibrillation * eligible and willing to start (or re-start) noac * registered in the swedish stroke register * signed informed consent exclusion criteria: * contraindication to noac (e.g. ongoing bleeding, mechanical heart valve prosthesis) * ongoing therapy with noac (without ≥2 days interruption at index stroke) * international normalized ratio (inr)\>1.7 * no second brain imaging (ct/mri) after thrombolysis/thrombectomy * previous randomization in the timing study

Keywords: oral anticoagulants (noac)
influence of resentment and forgivingness on quality of life in people living with hiv

Conditions: Forgiveness; Hiv; Stress; Stigma; Health

Summary: life stress is strongly associated with poor mental and physical health and its effects explain significant morbidity and mortality. forgiveness is one of the factors that can influence the effects of stress on health. by definition, forgiveness is the release of negative feelings, emotions, and behaviors - and possibly the release of positive feelings - toward an offender. numerous studies have shown that forgiveness is associated with several mental and physical health benefits. the literature argues that high levels of propensity to forgive (trait) predispose that person to experience forgiveness (state) more often. in other words, a stronger forgiving disposition is believed to increase the experience of forgiveness, which, in turn, mitigates the negative effects of stress. forgiveness is therefore a coping style that can play a beneficial role in the stress-health relationship. patients living with hiv (plhiv) are patients particularly exposed to stress, not only because of their chronic pathology but also because of the stigma attached to this disease. very few studies have studied the impact of forgiveness (state or trait) on the physical health of plhiv and even fewer the impact of an intervention promoting the disposition to forgive. the objective of this prospective observational monocentric study is to show in a very secular country that forgiveness has an effect on well-being as well as on other health parameters.


Eligibility criteria:
inclusion criteria: * belonging to the plhiv followed at the amiens university hospital, not likely to move within the year * possibility of follow-up in teleconsultation (usual support of the service) * benefiting from a social security scheme * consent to participate in the research exclusion criteria: * erratic follow-up (non-compliance, predictable move) or moribund patient * illiterate or not speaking french

Keywords: forgiveness forgivingness hiv stress stigma health
impact in quality of care of the "structural heart nurse" as new interventional cardiology nursing role in spain.

Conditions: Valvular Heart Disease; Nurse's Role; Competence; Cardiac Disease

Summary: the hypothesis is that patients with structural heart disease who are treated by structural heart nurses obtain better results in indicators of quality of care, compared with the usual practice (or not assisted) by this type of new interventional cardiology's nursing role.

valvular disease is the future epidemic structural heart disease of developed countries. to slow or alter the course of the disease, cardiac valve repair or replacement is necessary. transcatheter treatment has become a safe alternative to surgery. the united states and canada developed the tavi (transcather aortic valve implantation) program and tavi nurse is strongly supported by scientific societies as a key leadership role in the aortic stenosis care process. this nursing role is not implemented in spain. the objective of this study is to develop a new nursing role in interventional cardiology, similar to tavi nurse but including all the structural heart diseases, through conceptual definition and competencies, and evaluate its impact on the quality of care after of its implementation. the new nursing role of a hemodynamics and interventional cardiology unit in spain will be based on the model existing in other countries. this study consists of three phases: phase i) integrative review to explore and identify the definition and competencies of tavi nurse or another similar figure outside spain, as well as identify quality of care indicators. phase ii) the competences of these nurses will be contextualized in spain, and indicators of quality of care will be defined through the consensus of experts using a delphi methodology. phase iii) quasi-experimental pre / post study to assess the quality of care, through the indicators developed, of the implementation of the new nursing role.

Eligibility criteria:
inclusion criteria: * adult patients (\>18 years) who have been or will undergo any procedure of structural heart disease in the hemodynamic and interventional cardiology unit of the hospital de la santa creu i sant pau. * patients who accept to participate in the study. exclusion criteria: * patients with cognitive impairment, mental disability or other serious difficulty communicating. * patients with insufficient fluency of the main languages.

Keywords: quality of health care/organization & administration advanced practice nursing/trends quality improvement/organization & administration quality of health care/standards professional role structural heart disease nurse's role valvular heart disease nurse's competences
esophageal hypersensitivity study in healthy volunteers

Conditions: Pain; Esophageal Sensitivity

Summary: the purpose of the study is to compare sensitivity and sensitization of visceral pain in the esophagus using different pain stimuli


Eligibility criteria:
inclusion criteria: * provision of written consent * clinically normal physical findings * sensitization potential exclusion criteria: * clinically significant illness within 2 weeks prior to the first dose of investigational product * history of clinically significant disease * use of prescribed medication during the 2 weeks before administration of the first dose of investigational product

Keywords: gerd healthy volunteer esophagus pain
"comparing the plaque removal ability of two different toothbrushes among school going cp children

Conditions: Cerebral Palsy

Summary: it was an intervention utilizing two toothbrushes on school going cerebral palsy children age (6 -18 yrs). the triple head tooth brush and single head brush was provided to parents along with dental health education to their parent on brushing technique and oral care for their child. parents who give consent for their child were enrolled in the study. the plaque removal ability of toothbrush was assessed by turesky modified quigley hein index. the reading for plaque score was recorded at base line and after the follow up of 4 weeks. difficulties during brushing was also analyzed.

study design :single blinded randomized control trial study setting: the study was conducted in schools that have cerebral palsy children in karachi. study duration :from june 2021 to june 2022. sampling technique: non probability purposive sampling technique was used for selection of study population. sample size: total 58 individuals were recruited in the study. after including the 20% drop out rate 35 subjects were enrolled at each study group which make total sample size of 70 cerebral palsy participants. random allocation was made in two groups in order to keep the sizes of intervention groups similar. study instrument: * for study intervention two types of tooth brushes were used. the single head and triple head tooth brush. * for data collection a structured questionnaire was used that collect information on social demographic characteristics, oral hygiene behavior, dentition status, plaque status and difficulties associated with brushing. data collection method: * the study used a single-blind, parallel, and randomized controlled trial (rct) design. * a total 70 cerebral palsy children were recruited in the study which was stratified into two groups of 35 children each in intervention and control group. * intervention group was given triple head tooth brush with fluoridated toothpaste whereas control group was given single head tooth brush with fluoridated toothpaste. * dental health education on oral care was given to participant's parent along with brushing technique demonstrated on model as well on their child's teeth. * data was collected through structured questionnaire. oral health assessment was recorded through dmft/dmft index. plaque index was calculated by turesky modified quigley hein index by dyeing the plaque on tooth surface by plaque disclosing tablets. difficulties during brushing were also evaluated. * statistical analysis involved pair sample t test, repeated measure anova, chi-square and fisher's exact test.

Eligibility criteria:
inclusion criteria: * • parents who give consent to enrol in study and their children (age: 6-18yrs) who cooperate to allow to perform oral assessment. exclusion criteria: * • children unable to cooperate due to underlying systematic condition because of their motor and mental illness.

Keywords: plaque status difficulties assocaited with tooth brushing triple head tooth brush
virtual reality for phantom limb pain

Conditions: Phantom Limb Pain

Summary: this study will develop a virtual reality-based treatment for phantom limb pain among veterans and test it against the most established behavioral therapy for phantom limb pain, mirror therapy.

the va system performs more than 10% of all amputations in the u.s., a percentage translating into more than 50,000 upper and lower extremity amputations in the past decade. among veterans with amputations, research suggests that upwards of 70% experience phantom limb pain (plp), an often chronic and debilitating condition with adverse effects on quality of life and poor responsiveness to conventional pain treatments. the use of virtual reality technology for chronic pain management is a novel and rapidly advancing area of study, with existing research suggesting that virtual reality treatments are effective for acute pain management, promising for chronic pain management, and as yet untested for plp. in the current study, the investigators will develop a virtual reality environment that simulates mirror therapy - the gold standard behavioral treatment for plp - comparing the efficacy of this modality in a population of veterans with plp against a standard mirror therapy treatment validated by this research team in a previously supported clinical trial.

Eligibility criteria:
inclusion criteria: * ages 21-75 veteran receiving care at va san diego healthcare system * upper or lower extremity amputation with reported plp for at least six months * plp intensity \> 3/10 * english-speaking, literate, with stable residence * able to operate a vr headset as evidenced by direct observation exclusion criteria: * major medical illness that might confound effects of pain on function, e.g.: * advanced cardiac * pulmonary disease * current active alcohol or substance use disorder as evidenced from medical record * currently active suicidality * homicidality, or unstable psychiatric status in previous three months as measured by direct observation, patient self-report, or medical record * moderate or severe cognitive impairment as demonstrated by medical diagnosis or clinical observation * prior mirror therapy experience
immunogenicity of covid-19 vaccination in plwh

Conditions: HIV Infections

Summary: various facts support the study of covid-19 vaccine immunogenicity in people living with hiv (plwh) at this time: (1) many plwh in canada will be eligible to receive covid-19 vaccination as they are in a high priority risk group, such as residents or staff of shared living facilities for seniors, health care workers with direct patient contact, aged 70 years of age or older, or adults in indigenous communities; (2) as vaccines against many other pathogens, it is plausible that the current standard vaccination strategy of covid-19 is less effective in plwh; (3) the potential burden of significant covid-19 infection in plwh is likely large given many plwh are aging and have co-morbidities known to predispose to worse covid-19 outcomes; (4) the vaccine clinical trials which include plwh63, have stringent exclusion criteria, making results non-generalizable to many plwh such as those with lower cd4 counts. with the rapid roll-out of covid-19 vaccination, many plwh will be receiving the covid-19 vaccine. through vaccination, the provision of the same dosage of antigen stimulation to all individuals will result in a controlled method to measure immune response in plwh. therefore, we propose to develop a pan-canadian cohort of plwh receiving a covid-19 vaccine(s) to assess a spectrum of immune responses. we also aim to assess the safety and tolerability of the covid-19 vaccines in plwh. these data may provide support for the use of one vaccine product over another and for exploring alternate vaccination strategies in plwh (i.e., increased dose or double-dose vaccination and so forth).


Eligibility criteria:
inclusion criteria: * age \>/=16 years (sites may choose to only enrol adults based on their provincial age of majority) * hiv positive for hiv group; for hiv negative group, individuals should be immunocompetent and generally in good health (i.e. participants should not have a condition associated with immunodeficiency nor be receiving immunosuppressant medication) * receiving at least 1 dose of covid-19 vaccine, or have received 1 or 2 doses of a covid-19 vaccine * able to provide signed, informed consent * able to attend study visits exclusion criteria: * signs or symptoms of active covid-19 infection * for hiv-uninfected persons: immune-compromising conditions or on medication which suppresses the immune response
cardiometabolic disease risk factors in cameroon

Conditions: Cardiac Disease; Metabolic Disease

Summary: cardiometabolic diseases (cmds) are a major public health concern in sub-saharan africa, including cameroon. studies have shown a significant increase in the prevalence of hypertension, diabetes, and obesity in recent years. however, access to timely diagnosis and treatment remains limited, particularly in rural areas. community-based screening programs have been shown to be effective in identifying individuals with undiagnosed cmd risk factors and promoting early intervention. by leveraging the strengths of community-based approaches, the urbacam-d study aims to address the growing burden of cmds in urban cameroon.


Eligibility criteria:
inclusion criteria: * screening is open to any adult over the age of 18 years
effectiveness evaluation of a dengue self-monitoring system

Conditions: Dengue

Summary: the goal of this clinical trial is to compare the effectiveness of a dengue self-monitoring system with standard care in reducing treatment delay among dengue patients receiving outpatient care. the main question it aims to answer are: • is a dengue self-monitoring system effective in reducing treatment delay in dengue patients? participants will use the dengue monitoring system in addition to the standard care they are receiving for outpatient follow up for dengue. researchers will compare them with dengue patients receiving the usual standard care to see if the dengue monitoring system reduces delay in treatment seeking in patients.

dengue self-monitoring system (desmos) was developed to guide patients about warning signs and advise them to visit a doctor appropriately before their scheduled follow up on the next day, apart from motivating them to comply to the daily follow up visits at the clinic. desmos is hypothesised to effectively reduce delay in treatment seeking in dengue patients. the main aim of this system is to get dengue patients to key-in their symptoms regularly via the app when they are at home. reminders will appear on the phone to remind them to key in the symptoms thrice daily. the system is designed as a supportive tool for outpatient dengue management. it is not meant to replace to usual standard care for dengue care.

Eligibility criteria:
inclusion criteria: * age 18 years old and above * newly diagnosed with dengue fever * have a smartphone * receiving outpatient follow up for dengue exclusion criteria: * hearing and speech impairment * cognitive impairment

Keywords: dengue outpatient care self-monitoring system treatment delay warning symptoms
comparison of selective trunk and supraclavicular brachial plexus blocks

Conditions: Upper Extremity Problem

Summary: there are different methods in brachial plexus blocks for hand, wrist, forearm, and elbow operations. in this study, the anesthetic efficacy of the ultrasound-guided selective truncus methods and the supraclavicular methods for brachial plexus blocks in upper extremity surgeries will be compared.

currently, brachial plexus block performed with various approaches is preferred to general anesthesia due to its advantages in upper extremity surgeries. these advantages can be listed as protecting the patient's consciousness, minimum effect on breathing, reducing airway interventions, enabling long-term postoperative pain control, reducing opioid-related side effects, limiting metabolic and endocrine changes due to surgery, and early discharge of hospital. the supraclavicular approach has a rapid onset of block and a high success rate. close proximity to the pleura is the main disadvantage, but the widespread use of usg in peripheral blocks has also reduced the risk of complications related to this proximity. in the selective truncus approach defined by manoj kumar karmakar in 2020, three trunks of the brachial plexus can be identified separately and selectively blocked under ultrasound guidance. it has been suggested that sensory/motor block occurs in all ipsilateral upper extremity dermatomes except t2 by selective blocking of the upper, middle, and lower trunks. in this study, the selective trunk method and the supraclavicular method will be compared. patients who will undergo upper extremity elbow and below-elbow surgery in the orthopedics and traumatology operating room will be included in the study. the primary aim of the study is to compare the success rates of supraclavicular and selective truncus blocks in patients scheduled for hand, wrist, forearm, and elbow surgery. comparisons will be made by measuring the first analgesic time after surgery. secondary aims are sensory and motor block success rates between the two methods. the block application time, preparation time for surgery, number of needle insertions, tourniquet pain, diaphragmatic paralysis rate, complications (vascular puncture, paresthesia, horner's syndrome, hoarseness, local anesthetic toxicity, pneumothorax) patient satisfaction, surgeon satisfaction and total analgesic amount at the end of the postoperative 12 and 24 hours will be recorded.

Eligibility criteria:
inclusion criteria: - patients undergoing upper extremity elbow and below-elbow surgery in the orthopedics and traumatology operating room exclusion criteria: * patient's refusal * asa iv, * pregnancy, * neuromuscular disease, * peripheral neuropathy * bleeding disorders, * local anesthetic allergy, * infection in the block area * operations without using a tourniquet

Keywords: nerve block pain, postoperative anesthetics, local
prospan® hustenzäpfchen - investigation on efficacy and tolerability in children

Conditions: Symptoms of Acute Bronchitis Accompanied by Coughing

Summary: the aims of this study are * demonstrating superior efficacy of prospan® hustenzäpfchen compared to placebo in children suffering from acute bronchitis accompanied by coughing * characterisation of safety and tolerability of prospan® hustenzäpfchen in comparison with placebo.

after interim analysis of the first part the clinical study will be continued as follows: double blind, placebo controlled, randomised, multi-centre study with 2-parallel groups for the treatment of acute bronchitis accompanied by coughing in children aged 0 - 6 years to demonstrate efficacy and safety of prospan® hustenzäpfchen. for assessment of cough intensity and severity a specific symptom score has been developed, which gathers the child's frequency and severity of coughing and of cough productivity as well as the severity of rhonchi (each symptom will be assessed on a four-point likert scale ranging from 0 to 3; total score range: 0-12 points). considering the specificities of the study population and the disease, confirmatory evaluation will be based on the change in the symptom score after the first three consecutive days of treatment as assessed by the investigator.

Eligibility criteria:
inclusion criteria: 1. male or female children aged 0 to 6 years 2. acute bronchitis existing not longer than three days and accompanied by coughing 3. symptom rating score of ≥ 5 assessed by the investigator 4. symptom 'frequency of coughing' of ≥ 2 assessed by the investigator 5. the patient's legal representatives must give informed consent in accordance with the supposed will of the patient, after having been informed about benefits and potential risks of the trial, as well as details of the insurance taken out to cover the risk for patients participating in the study - exclusion criteria: 1. hypersensitivity to the active ingredient or to any further constituents of the pharmaceutical preparations 2. patients with severe allergies or multiple drug allergies 3. any other pulmonary disease within the last two weeks 4. chronic pulmonary diseases 5. exacerbation of chronic pulmonary disease 6. suspicion of bacterial pulmonary infection 7. fever above 39°c (rectal measurement) -

Keywords: bronchitis coughing children ivy hedera helix l.