Kornimate/medical-research-clean huggingface dataset:
the impact of light, electrical, and magnetic neuroregulation interventions on sleep-wake disorders

Conditions: Insomnia Chronic; Narcolepsy; REM Sleep Behavior Disorder

Summary: carry out precise and effective neuromodulation interventions, and develop new neuromodulation technologies for sleep disorders. use phototherapy, transcranial electrical/magnetic stimulation and other therapies to conduct self-controlled intervention studies on insomnia, narcolepsy, and rapid eye movement sleep behavior disorder .


Eligibility criteria:
inclusion criteria: - patients with insomnia, narcolepsy,and rbd that have been clearly diagnosed by specialists should sign the informed consent form. exclusion criteria: 1. patients with major neurological diseases such as multi-infarct dementia, huntington\&#39;s disease, normal pressure hydrocephalus, brain tumors, progressive supranuclear palsy, epilepsy, subdural hematoma, multiple sclerosis, or those who have sustained neurological dysfunction or known structural brain abnormalities after significant head trauma are excluded. 2. a history of major depressive disorder or bipolar disorder within the past year, as defined in dsm-iv criteria. a history of schizophrenia (meeting dsm-iv criteria). 3. history of severe drug or alcohol abuse within the past year; 4. any significant systemic illness or unstable medical condition that may make it difficult to comply with the protocol, such as severe autoimmune diseases or a history of cancer. 5. have significant hearing, visual, or cognitive impairments, or are unable to participate in interviews in a meaningful way.
pilot randomized-controlled trial of integrated palliative and nephrology care versus usual nephrology care.

Conditions: Chronic Kidney Diseases

Summary: the objective of this application is to conduct a pilot study testing the impact of integrated nephrology and palliative care versus standard nephrology care on patient-reported outcomes. this study is a preliminary study designed to determine feasibility of a palliative care study inclusive of kidney disease patients and to look for trends in impact over a 12-week follow-up period. measurements will be taken at time one (time of enrollment) and time two (12 weeks). our central hypothesis is that integration of palliative care with standard nephrology care in the ambulatory care of patients with a glomerular filtration rate (egfr) ≤15ml/min/1.73m2 will trend towards improved symptom control, quality of life, and increased documentation of advance care planning when compared to usual nephrology care. we expect 10-15 patients per arm.


Eligibility criteria:
inclusion criteria: in order to be eligible to participate in this study, an individual must meet all of the following criteria: 1. age ≥18 2. fluent english speaker 3. egfr≤15 ml/min/1.73m2 (diagnosis of ckd stage v) 4. able to give consent 5. must be followed by a faculty group practice nephrologist exclusion criteria: an individual who meets any of the following criteria will be excluded from participation in this study: 1. diagnosis of dementia 2. non-english speaker 3. have been seen by a palliative care provider prior to study entry 4. pregnant women 5. on dialysis or have received a kidney transplant
stages trial: study of adiposity, growth and endocrine stages

Conditions: Obesity

Summary: the investigators propose to conduct a cross-sectional study of 60 participants who are 18-30 years of age to undergo research pet/ct. the purpose of this study is to investigate the relationships between brown adipose tissue (bat), the adiponectin/leptin (a/l) ratio, and components of the metabolic syndrome in young adults.

we propose to conduct a cross-sectional study of 60 participants who are 18-30 years of age to undergo research pet/ct. the purpose of this study is to investigate the relationships between brown adipose tissue (bat), the adiponectin/leptin (a/l) ratio, and components of the metabolic syndrome in young adults. this study is part of a larger study aimed at understanding the mechanism of brown adipose tissue as a potential protective factor against metabolic dysfunction.

Eligibility criteria:
inclusion criteria: * males and females, 18-30 years of age at enrollment, who are obese (bmi greater or equal to 30 kg/m2, weight less than 159 kg) and healthy * without medications and endocrine/genetic disorders known to affect weight. * participants may have insulin resistance, impaired glucose tolerance, dyslipidemia, or hypertension. exclusion criteria: * anyone who refuses participation. * a genetic syndrome or other endocrine disorder known to cause obesity (prader-willi, cushing syndrome, leptin deficiency, etc.). * use of the following medications: psychotropics, sulphonylurea, thiazolidinediones, insulin, glucocorticoids, anti-neoplastic agents, angiotensin receptor blocker, angiotensin-converting enzyme inhibitors. * pregnancy or history of pregnancy. * active infectious disease * history of cvd or stroke during the previous 36 months * total cholesterol 300 mg/dl, triglycerides 400 mg/dl * blood pressure 140/90 mmhg * fasting plasma glucose 126 mg/dl. * diabetes mellitus, type 1 or 2.

Keywords: metabolic dysfunction insulin resistance brown adipose tissue dyslipidemia
effect of auditory stimulation by family voices in preventing delirium: a randomized controlled trial

Conditions: Delirium

Summary: delirium is an acute cerebral dysfunction syndrome characterized by acute fluctuating changes in consciousness, cognitive dysfunction, and disorientation. it's especially common in critically ill patients of emergency intensive care units and seriously threatens the survival and prognosis of patients and causes heavy economic burdens to the family, society, and medical service system. impaired verbal communication, unfamiliar medical personnel, physical restraint, spatial-temporal disorientation, mechanical ventilation and sedation medication use can lead to a lack of adequate sensory stimulation and a high risk of delirium. acoustic stimulation as a non-invasive non-pharmacological intervention can provide some sensory stimulation as a surrogate for critically ill patients. this research designs the content scripts from the needs of icu patients and families for sound stimulation. the goal of this randomized controlled study is to test the effect of auditory stimulation by family voices in preventing delirium among sedative patients in emergency intensive care units.

patients are separated from their families and society under the closed management of the intensive care unit, the use of sedative drugs, mechanical ventilation, impaired verbal communication, physical restraint, environmental noise, and prolonged light exposure, which lead to a lack of adequate sensory stimulation, causing sensory deprivation in patients to some extent. in turn, sensory deprivation may cause multisensory perceptual confusion and hallucinations, affecting patients' orientation and thinking and triggering delirium, so providing appropriate sensory stimulation to critically ill patients may help to improve patients' orientation and attention, correct patients' thinking confusion and prevent delirium, and in clinical practice, sensory stimulation is considered as an important part of multicomponent delirium prevention programs.

Eligibility criteria:
inclusion criteria: * transferred to the eicu from emergency admission * no other history of emergency, surgery, or icu admission history within 30 days * no delirium in the first screening of emergency intensive care unit(eicu) admission * with an expected length of stay in eicu longer than 24h and use of sedation medication exclusion criteria * presence of hearing impairment, severe dementia, psychiatric disorder, or other severe brain dysfunction that hinders delirium assessment * persistent coma or deep sedation (rass score of -4 to -5) * patients without a family member who can cooperate with the recording * external ear disease or surgery that hinders earphone wearing

Keywords: delirium intensive care units auditory stimulation
interscalene block versus supraclavicular block for shoulder surgery

Conditions: Pain, Postoperative; Shoulder Pain; Surgical Procedure, Unspecified; Diaphragmatic Paralysis

Summary: interscalene brachial plexus block constitutes the analgesic criterion standard for shoulder surgery. however it is associated with a high incidence of hemidiaphragmatic paralysis (hdp) that may not be tolerated by patients with chronic pulmonary disease. this randomized controlled trial will compare ultrasound-guided interscalene block (isb) and supraclavicular block in patients undergoing arthroscopic shoulder surgery. the main outcome is static pain at 30 minutes after arrival in the post anesthesia care unit (pacu) as measured by a numerical rate scale (nrs) from 0 to 10. our research hypothesis is that interscalene and supraclavicular blocks will result in equivalent postoperative analgesia at 30 minutes in the pacu. the equivalence margin is set at 2 points


Eligibility criteria:
inclusion criteria: * patients undergoing arthroscopic shoulder surgery * american society of anesthesiologists classification 1-3 * body mass index between 20 and 35 exclusion criteria: * adults who are unable to give their own consent * pre-existing neuropathy * coagulopathy * obstructive or restrictive pulmonary disease * renal failure * hepatic failure * allergy to local anesthetics * pregnancy * prior surgery in the corresponding side of the neck or supraclavicular fossa * chronic pain syndromes requiring opioid intake at home
effectiveness of a therapeutic education program in improving quality of life of children with adhd and their parents

Conditions: Attention Deficit Disorder

Summary: attention deficit hyperactivity disorder (adhd) is a neurodevelopmental disorder characterized by attention deficit, impulsivity and hyperactivity. it's one of the most frequently encoutered disorder in child psychiatry. adhd has a significant impact on the quality of life of children and their parents. in the child psychiatry department of the mpea peyre plantade, a therapeutic education program specific to adhd has been set up for children and their parents. this program consists of different workshops whose aim is to reduce the adhd repercussions on the daily life of children and their families and thus improve their quality of life. the principal aim of our study is to evaluate the effectiveness of this program in improving the quality of life of children with adhd and their parents.


Eligibility criteria:
inclusion criteria: * aged 8 to 13 * with a diagnosis of adhd * living in the herault department * participatinf in the therapeutic education program " living well with adhd " exclusion criteria: * parent's objection to the use of data collected * parent unable to complete questionnaires

Keywords: therapeutic education quality of life
chemoradiotherapy for recurrent t1g3 bladder cancer

Conditions: Bladder Cancer

Summary: to evaluate the short term results of chemoradiation in case of t1g3 bc after bcg failure.

non- muscle invasive bladder cancer (nmibc) is a heterogeneous group of cancers. for most urologists the treatment of t1g3 tumor poses a dilemma of management.the spectrum of clinical behavior includes; t1 lesions that will not progress however t1g3 may be potentially lethal, associated with metastatic disease at the time of presentation. the major goal of treatment for t1g3 bc should be bladder preservation whenever possible. intravesical therapy with bacille calmette guerin (bcg) may decrease the recurrence rate by compared with transurethral resection of bladder tumor (turbt) alone.

Eligibility criteria:
inclusion criteria: * all patients with recurrent t1g3 bladder cancer after 6 doses of bcg consenting for chemoradiation and refusing radical cystectomy exclusion criteria: * any patients with distant metastasis or positive ln on ct or mri. * patients unfit for chemoradiation

Keywords: chemoradiation for t1g3 bc
effect of electronic monitoring and feedback on adherence to easyhaler controller medication in patients with asthma

Conditions: Asthma

Summary: effect of electronic monitoring and feedback on adherence to easyhaler controller medication in patients with asthma


Eligibility criteria:
main inclusion criteria: * written informed consent * male and female subjects with documented diagnosis of asthma * age 18 to 65 years * act score 19 or less at screening * treatment wih oral corticosteroids or hospital or emergency department admission due to asthma exacerbation within the past year * subject's able to use easyhaler inhalers and comply with study requirements main exclusion criteria: * recent (within 1 month) asthma exacerbation * concomitant major respiratory disease which may complicate the measurement of asthma control * \>20 pack-year history of smoking * recent upper or lower respiratory tract infection * pregnant or lactating female subjects
treatment of obsessive-compulsive disorder (ocd) in children

Conditions: Obsessive-Compulsive Disorder

Summary: the purpose of this study is to compare 3 treatments for children with ocd: medication (sertraline, ser) alone vs ocd-specific therapy (cognitive behavior therapy, cbt) vs medication plus therapy. some patients will receive an inactive placebo (pbo) instead of medication and/or educational support (es, non-psychological treatment) instead of therapy. one in 200 children suffer from ocd, but few receive appropriate treatment. both cbt and medication seem to be effective, but their effectiveness, alone and in combination, has not been evaluated. there are 2 phases to this trial. in phase i the child will receive 1 of the following 6 treatments for 12 weeks: 1) ser alone; 2) pill pbo alone; 3) cbt alone; 4) ser plus cbt; 5) ser plus es; 6) pill pbo plus es. if the child responds to treatment, he/she will go on to phase ii in which the treatment will be slowly reduced, then stopped (discontinued), over time to test the treatment's durability. the child will be evaluated at weeks 1, 4, 8, 12 (phase i treatment), and weeks 16, 20, 24, and 28 (phase ii discontinuation) to see how effective and durable the treatment is in treating your child's ocd. a child may be eligible for this study if he/she: has obsessive-compulsive disorder (ocd) and is 8 - 16 years old.

to contrast the degree and durability of improvement in pediatric obsessive-compulsive disorder (ocd), patients will be treated with 1 of 6 conditions (3 active treatments and 3 control treatments): sertraline alone (ser), ocd-specific cognitive behavior therapy (cbt), both ser and cbt (ser plus cbt), pill placebo (pbo), pill pbo plus educational support (es), and ser plus es. one in 200 youth suffers from ocd, yet relatively few receive appropriate treatment. both cbt and medication appear beneficial in controlled studies; however, the relative efficacy of cbt and medication, alone and in combination (comb) is unknown. thus, well-designed treatment outcome studies are necessary to improve care for youth with ocd. the experimental design covers 2 phases. phase i is a 2 (site) x 2 (ser or pill pbo) x 3 (cbt, es or non- psychosocial treatment) x 5 (repeated measures) factorial 12-week comparison of ser, cbt, comb and the control conditions. in phase ii, responders advance to a 16-week discontinuation study to assess treatment durability. the primary outcome measure is the yale-brown obsessive-compulsive scale. assessments blind to treatment status take place at week 0 (pretreatment); weeks 1, 4, 8, 12 (phase i treatment); and weeks 16, 20, 24 and 28 (phase ii discontinuation). besides addressing comparative efficacy and durability of the specified treatments, the investigators also examine time-action effects, differential effects on specific aspects of ocd, including functional impairment, and predictors of response to treatment.

Eligibility criteria:
inclusion criteria: - patients must have: dsm-iv diagnosed ocd.

Keywords: adolescence child cognitive therapy combined modality therapy obsessive-compulsive disorder placebos sertraline patient education psychotherapy
insulin initiation and adherence behaviours: a cross sectional survey of indian hcps & patients with type 2 diabetes

Conditions: Type 2 Diabetes

Summary: this is a cross-sectional study planned among patients with type 2 diabetes (t2d) and health care providers (hcps) who treat t2d patients. study participants will be recruited through existing databases/panels to complete a 30-minute self-administered online survey. the purpose of the study is to understand the insulinization barriers and the insulin adherence behaviours of both hcps and patients.


Eligibility criteria:
inclusion criteria: for patients 1. informed consent obtained before any study-related activities (study-related activities are any procedure related to recording of data according to the protocol). 2. male or female, age above or equal to 18 years at the time of signing informed consent. 3. diagnosed with t2d 4. currently seeing an hcp for t2d 5. initiated on insulin within the past 12 months 6. prescribed insulin on a permanent basis 7. currently taking insulin via a vial and syringe or insulin pen for hcp 1. informed consent obtained before any study-related activities (study-related activities are any procedure related to recording of data according to the protocol). 2. male or female, age above or equal to 18 years at the time of signing informed consent. 3. primary care physician (pcp) with degree in internal medicine or general medicine, diabetologist with degree in internal medicine or general medicine plus diploma in diabetology, or endocrinologist 4. has been in practice a minimum of 2 years 5. diabetologist/endocrinologist: treats at least 50 t2d patients per month 6. pcp: treats at least 40 t2d patients per month 7. currently initiates t2d patients on insulin 8. treats 20 percent or more of t2d patients with insulin exclusion criteria: 1. previous participation in this study. participation is defined as having given informed consent in this study 2. mental incapacity, unwillingness or language barriers precluding adequate understanding or cooperation
trial applying policy to eliminate or reduce inappropriate narcotics in the general-population

Conditions: Inappropriate Dose of Drug Administered; Pain, Chronic; Health Behavior

Summary: to assess the effectiveness of a government-led population-based opioid intervention on discontinuation of opioid medication in community-dwelling adults with chronic non-cancer pain.


Eligibility criteria:
inclusion criteria: * adults registered to receive pharmaceutical benefits in manitoba, who are aged 18 years and over and who have received ≥90 days supply of opioids in the 6 months prior to the trial will be included. this will ensure chronic use and episodic use of opioids will be included. exclusion criteria: * people receiving palliative care, people with cancer, and people who receive opioids in hospital. people with dementia (identified by having received a prescription for memantine or a cholinersterase inhibitor in the previous 12 months) will be excluded.

Keywords: deprescribing
diclofenac vs. placebo in a randomized double blind controlled trial in post ercp pancreatitis

Conditions: Post-ERCP Acute Pancreatitis.

Summary: 1. the most common complication of endoscopic retrograde cholangio-pancreaticography (ercp) is pancreatitis. 2. several studies showed that non-steroidal anti-inflammatory drugs (nsaids) can prevent the post ercp pancreatitis, the investigators used diclofenac vs placebo. 3. the effect of diclofenac in prevention of that complication, was measured by the number of patients who developed pancreatitis, and compare it with the placebo. 4. the investigators collected 199 patients, 17 excluded, 182 completed the study, all of them underwent the intervention called "ercp", and randomized to have either diclofenac or placebo before the procedure.

* all patients signed informed consents for the procedure, and the participation in the study. * between june 2012 and june 2013, 199 patients fulfilled the inclusion criteria, 182 of whom were included in the final analysis. * patients were excluded from study participation if they had a contraindication for diclofenac, including patients with recently diagnosed peptic ulcer disease, renal failure, those who developed acute pancreatitis during the two weeks before ercp, those with a history of chronic pancreatitis, and those who did not agree to participate in the study. * a placebo-controlled trial was conducted in 182 patients who underwent ercp. * preoperative, the patients received 75 mg intramuscular(im) diclofenac or im normal saline as placebo. at the end of each procedure, the investigators recorded the details of the maneuvers performed, including: 1. the total time of the procedure, 2. the number of attempts at cannulation, 3. the number of pancreatic duct cannulation, 4. the final diagnosis by ercp, 5. whether a sphincterotomy, a needle-knife papillotomy, or stent placement were performed. * serum amylase was determined 12 hours after ercp. * if the 12-hours serum amylase level was \> 3 times the upper normal limit and the patient exhibited pain or nausea and vomiting, then the patient had pancreatitis. * acute pancreatitis was defined as serum amylase \> 3 times the upper limit of normal and associated with epigastric pain, back pain, and epigastric tenderness. * statistical analysis: 1. randomization was done by the gi nurse, concealed envelop 2. data were summarized by descriptive statistics. 3. the chi square was used to compare categorical patient data. 4. the student's t test was used to compare continuous variables. 5. two-tailed p \< 0.05 was considered to indicate significance.

Eligibility criteria:
inclusion criteria: * any patient above the age of 16, referred for ercp exclusion criteria: * 1.could not reach the ampulla due to: a. pyloric stenosis b. ampullary tumor c. diverticula 2. ercp done recently 3. stent replacement 4. congestive heart failure(chf) 5. asthma

Keywords: diclofenac, ercp and pancreatitis