Kornimate/medical-research-clean huggingface dataset:
genetics of uveitis

Conditions: Uveitis; Infectious Uveitis

Summary: in order to improve the investigators knowledge about uveitis and the underlying mechanism of disease, the investigators propose collecting blood from patients with uveitis, isolating dna and sequencing the dna to identify genetic mutations or associations in these patients.


Eligibility criteria:
inclusion criteria: * any patient above with the diagnosis of uveitis. * any patient with a diagnosis of infectious uveitis such as toxoplasmosis retinochoroiditis, herpes associated retinitis. exclusion criteria: * patients who are unable to give consent * patients in whom an adequated blood sample can not be obtained.

Keywords: uveitis infectious
piloting a multi-component technology-based care intervention to address patient symptoms in home hospice

Conditions: Hospice

Summary: with the growth of hospice, older adults have the opportunity to receive home-based care aimed at reducing suffering and focusing on quality of life at the end of life. while use of technology and educational videos has yet to be fully developed, structured, and evaluated in home hospice care, it has shown promise to improve care in other settings. therefore, this study aims to develop and evaluate a multi-component technology-based care intervention, i.e., improving home hospice management of end of life issues through technology (i-home).

the study intervention focuses on assessing and addressing patient symptoms in the home hospice setting through weekly telehealth visits (for up to 6 weeks) and educational videos that are geared for the patient's informal caregiver. the aim of this phase of the project is two fold. one is that the study team will conduct a single armed (n=6 dyads) pilot study with a focus on optimizing data collection protocols and the intervention. after this step, a randomized pilot study evaluating the feasibility and potential efficacy of i-home (n=50 dyads) compared to usual care (n=50 dyads) will be conducted. phase i of the study to assess feasibility of the intervention was registered on clinicaltrials.gov as nct04074304.

Eligibility criteria:
inclusion criteria: home hospice caregivers must be: * english speaking * 18 years of age or older * not blind * having a family member receiving home hospice care home hospice patients must be: * english speaking * 65 years of age or older * not blind * enrolled in home hospice care. exclusion criteria: * patients with a terminal diagnosis of dementia or patients who have cognitive impairment and unable to sign a written informed consent will be excluded.
protocol-guided rapid evaluation of veterans experiencing new transient neurological symptoms

Conditions: Transient Ischemic Attack; Stroke

Summary: this program will seek to implement a quality improvement program to improve the care of veterans with tia or minor stroke at 6 veteran health administration hospitals. the investigators will evaluate the implementation and effectiveness of the quality improvement program.

aim 1. to develop a quality improvement program to improve the care of veterans with tia or minor stroke that can be deployed nationwide. the program will include multiple components: a reporting system that is based on validated electronic quality measures (ecqms) that will allow staff to monitor the time-sensitive processes of care and outcomes of their population of veterans with tia or minor stroke; clinical protocols to improve the timeliness and completeness of care; professional education materials; and clinical note templates for use by nursing and pharmacy staff. lessons learned at the individual sites engaged in the quality improvement program will be shared across sites by use of a web-based platform and a virtual collaborative. we will assess end user's assessment of the program and its core elements. aim 2. to evaluate the effectiveness of the aim 1 qi intervention program for veterans with tia or minor stroke against usual care. teams at the 6 intervention sites will be given the quality improvement program components. the primary effectiveness outcome is the proportion of veterans who received all of the guideline-concordant processes of care for which they are eligible referred to as the "without-fail" care rate. aim 3. to evaluate the implementation of the qi intervention program across the 6 participating sites. the two primary implementation outcomes will be the number of implementation activities completed during the one-year active implementation period and the final level of team organization (defined as the group organization (go score)) for improving tia care at the end of the 12-month active implementation period. secondary aim to evaluate the sustainability of the program. sustainability will be evaluated over a one-year period that begins immediately after the one-year active implementation period. we will compare the without-fail rate in the sustainability period to the baseline period and the post-implementation period.

Eligibility criteria:
inclusion criteria: * this program will seek va hospitals that are self-designated as either a vha primary stroke center or a limited hours stroke facility or supporting stroke center. * eligibility for staff interviews is based on involvement in the qi intervention and willingness to participate. exclusion criteria: * unwilling to participate

Keywords: implementation quality improvement stroke transient ischemic attack tia systems redesign qi intervention
controlled exposures to air pollution in patients with coronary heart disease

Conditions: Coronary Heart Disease

Summary: air pollution is a major cause of cardiovascular morbidity and mortality. the components of air pollution responsible and the mechanisms through which they might mediate these harmful effects remain only partially understood. we hypothesise that these adverse effects are mediated by combustion derived air pollutants and that even a brief exposure will effect heart and blood vessel function. we assess the effect of dilute diesel exhaust inhalation at levels encountered in urban road traffic on heart and blood vessel function in patients with stable coronary heart disease.

observational studies suggest that exposure to air pollution may worsen symptoms of angina and trigger acute myocardial infarction. these findings are limited by imprecision in the measurement of pollution exposure, the effect of potential confounding environmental and social factors, and the lack of mechanistic data. controlled exposures of air pollutants can help to address these shortcomings by providing a precisely defined exposure in a regulated environment that facilitates investigation with validated biomarkers and surrogate measures of cardiovascular health. using a carefully characterised exposure system, we have previously shown in healthy volunteers that exposure to dilute diesel exhaust causes lung inflammation, depletion of airway antioxidant defences, and impairment of vascular and fibrinolytic function. to date, there have been no controlled exposures in patients with coronary heart disease: an important population who may be particularly susceptible to the adverse cardiovascular effects of air pollution. in a double blind randomized cross-over study, 20 patients with prior myocardial infarction will be exposed to dilute diesel exhaust (300µg/m3) or filtered air during periods of rest and moderate exercise in a controlled exposure facility. during the exposure, myocardial ischemia will be quantified by st-segment analysis using continuous 12-lead electrocardiography. six hours following exposure, vascular vasomotor and fibrinolytic function will be assessed by means of intra-arterial agonist infusions.

Eligibility criteria:
inclusion criteria: * previous myocardial infarction (\>6 months previously) treated by primary angioplasty and stenting * on standard secondary preventative therapy exclusion criteria: * angina pectoris (canadian cardiovascular society grade ≥2) * history of arrhythmia * diabetes mellitus * uncontrolled hypertension * renal or hepatic failure * unstable coronary disease (acute coronary syndrome or unstable symptoms within 3 months) * occupational exposure to air pollution * current smokers * asthma * inter-current illness

Keywords: air pollution myocardial ischemia endothelium fibrinolysis pathophysiology diesel exhaust
rituximab for idiopathic nephrotic syndrome

Conditions: Idiopathic Nephrotic Syndrome

Summary: open-label, randomized, controlled trial due to value whether the monoclonal antibody rituximab is non-inferior to steroids in maintaining remission in juvenile forms of sdns. the investigators will enroll 30 pediatric patients affected by idiopathic nephrotic syndrome, who have been in treatment with steroids for at least one year. the lowest dose of drug required to maintain a stable remission will be between 0.4 and 0.7 mg/ kg/ day. this trial provides an initial run-in phase of one month during wich remission will be achieved by means of a standard oral prednisone course. once remission has been achieved children will be randomized in a parallel arm open label rct to continue prednisone alone for one month (control) or to add a single intravenous infusion of rituximab (375 mg/m2 - intervention). prednisone will be tapered in both arms after one month.


Eligibility criteria:
inclusion criteria: * age between 1 and 16 years. * steroid-dependent idiopatic nephrotic syndrome for a minimum of 6 to a maximum of 12 months at the time of study entry, regardless of disease duration. * low-dose steroid dependence (between 0.4 and 0.7 mg/ kg/ day) exclusion criteria: * positivity of autoimmunity tests (ana, ndna, anca) or reduced c3 levels * histological pattern suggestive for congenital anomalies (diffuse mesangial sclerosis without igm deposits, cystic-like tubular dilations, evidence of mithocondrial damage on electronic microscopy. * histological pattern not correlated with idiopathic nephrotic syndrome in the pediatric age (membranous glomerulonephritis, lupus nephritis, diffuse and/or localized vasculitis, amyloidosis). * evidence of homozygous or heterozygous mutations in podocitary genes commonly involved in the pathology (nphs1, nphs2, wt1). * estimated glomerula filtration rate (egfr) \< 60ml/min. * presence of circulating igm against hcv, hbv, parvovirus or mycoplasm.

Keywords: nephrotic syndrome proteinuria rituximab
cobalamin status in young children with developmental delay

Conditions: Vitamin B 12 Deficiency

Summary: during fetal life and infancy, an adequate cobalamin status is important for normal growth and central nervous system development. during the last years we have detected cobalamin deficiency in a number of infants admitted to the pediatric department with various symptoms, including neurological symptoms and feeding problems. cobalamin treatment is given to the infants with biochemical cobalamin deficiency, and leads to loss of symptoms and in improved physical condition. in this study we want to establish the prevalence of cobalamin deficiency in infants with developmental delay and regression and other vague neurological symptoms. cobalamin status will be investigated in all children aged 8 months and younger, admitted to the pediatric department with these symptoms. in a randomised intervention trial we will evaluate the effect of cobalamin supplementation in children with these symptoms and metabolic evidence of impaired cobalamin status. study hypothesis: cobalamin treatment given to the infants with biochemical cobalamin deficiency, will lead to loss of symptoms and in improved physical condition.


Eligibility criteria:
inclusion criteria: * children below 8 months of age * clinical diagnosis or symptoms: developmental delay and regression and other vague neurological symptoms exclusion criteria: * children with syndromic disease

Keywords: cobalamin deficiency infant nutrition cobalamin supplementation neurodevelopment neurological symptoms
irbesartan, ciprofibrate and their combination onto the endothelial functions

Conditions: Hypertension; Dyslipidemia

Summary: the rationale of the study is to clarify whether the supplementation of irbesartan with ciprofibrate could increase the antihypertensive effect, could improve the endothelial functions, and/or could affect the atherogenic small-dense ldl-, oxydized ldl concentrations, onto the paraoxinase activity and on the crp and insulin levels.


Eligibility criteria:
inclusion criteria: * hypertensive + dyslipidemic + damaged endothelial function exclusion criteria: * hepatic and kidney damage, * iddm (insulin dependent diabetes mellitus) * freckson v type hyperlipoproteinaemia the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
combining cognitive and treadmill training on cognition and walking performance in stroke with cognitive impairment

Conditions: Stroke; Cognitive Impairment

Summary: post-stroke cognitive impairment is common in stroke survivors. cognitive function is related to walking ability. the dual task walking is required for daily activities, however, such ability is even more challenging than single walking for people with stroke. the purpose of present study is to investigate the effects of combining cognitive and treadmill training on cognitive function and dual task walking performance in chronic stroke patients with cognitive impairment.

this is a single-blinded, randomized controlled trial with pre- and post-measurements. 24 subjects will be recruited, and randomly assigned to one of two groups: cognitive training during treadmill training group (experimental group) and treadmill training group (control group). the intervention for both group will be 30 minutes per session, 3 sessions per week for a total of 4 weeks. statistical data analysis will use the spss 25.0. baseline characteristics will be analyzed using independent t-test or chi-square test. repeated measures two-way analysis of variance (anova) with tukey's post-hoc analysis will be used to compare between time and groups. the significant level is set at 0.05.

Eligibility criteria:
inclusion criteria: * age over 50 years old * chronic stroke (onset \>6 months) * with mini-mental state examination (mmse) score≧24 * montreal cognitive assessment (moca) score\<26 (impaired cognition) * ability to walk independently for at least 10 meters without assistive devices or support * ability to read and write cognitive tests exclusion criteria: * diagnosis of dementia * unstable physical condition * any neurological, psychiatric disorder, or diagnosed with learning disability which may affect participation in this study * visual or auditory disturbances

Keywords: stroke cognitive impairment cognitive and treadmill training
a study to evaluate the efficacy, safety, and immunogenicity of an ev71 vaccine

Conditions: Enterovirus 71 Infection

Summary: subjects will receive the first im injection of study vaccine on day 1 and will receive a second dose 56 days later. a booster vaccine will be given 365 days after the first dose in subjects 2 months to \< 2 years of age. the last study visit is on day 422 when subjects will be contacted via telephone / home visit system to assess for adverse events and concomitant medications.


Eligibility criteria:
inclusion criteria: 1. healthy children and infants aged from 2 months to less than 6 years as established by medical history and clinical examination. 2. the subjects' parents/guardians are able to understand and sign the icf. exclusion criteria: 1. age \< 2 months or ≥ 6 years. 2. for subjects \< 1 year, gestational age \< 34 weeks or birth weight \< 2200 grams. 3. has poor venous access (for subjects in sub-study only). 4. currently has a fever defined as ear/rectal temperature ≥ 38°c or axillary temperature ≥ 37.5 °c within 2 days before the time of planned vaccination. 5. has had previous known exposure to ev71 or has received ev71 vaccine. 6. has a history of herpangina or hfmd associated with enterovirus infection in the past 30 days before the date of the planned study drug vaccination. 7. has been diagnosed with a significant neurological, pulmonary, cardiovascular, hematological, hepatic, or renal disorder. 8. has a history of hypersensitivity to vaccines, or a history of allergic disease or reactions likely to be exacerbated by any component of the vaccine. 9. has used any investigational/non-registered product (including drug, vaccine, or invasive medical device) within 28 days before vaccination or plan to use during the study period. 10. has confirmed or suspected autoimmune disorder, or immunodeficiency. 11. administration of any licensed live attenuated vaccine within 14 days before or after each study vaccination (with the exceptions of live attenuated rotavirus vaccine via oral route). 12. has used immunoglobulins or any blood products within 11 months before vaccination or plan to use during the whole study period. 13. has had immunosuppressants, cytotoxic drugs, corticosteroids (including prednisolone ≥ 0.5 mg/kg/day or equivalent), or immunomodulators taken for \> 14 days within 6 months before first vaccination or plan to use before the last scheduled study visit. (inhaled and topical steroids are allowed). 14. has any medical or psychiatric condition, that is a contraindication to protocol participation based on the judgment of the investigator.
effects of oxygen on lung tissue during anesthesia

Conditions: Lung Injury, Acute

Summary: collect exhaled breath condensates from patients scheduled for a routine surgical procedure before, during, and after surgery for measurements of isofs draw blood from patients scheduled for a routine surgical procedure before, during, and after surgery for measurements of serum thrombomodulin.

high concentrations of oxygen are routinely administered to patients undergoing routine surgical procedures even though it is highly likely, at least in patients with normal lung function, that this is unnecessary and in fact may be doing unnecessary harm. therefore, we plan to assess whether there is any evidence of lung injury during surgery resulted from administration of high concentrations of oxygen by measuring isofurans (isofs) in exhaled breath condensate. in our studies in mice that were exposed to high concentrations of oxygen we also found that circulating levels of thrombomodulin were increased. thrombomodulin is present in endothelial cells and upon injury they release thrombomodulin into the circulation. endothelial cell injury is known to occur in hyperoxic-induced lung injury. therefore, in addition to measuring isofs in exhaled breath condensate we will also measure plasma concentrations of thrombomodulin as an indicator of endothelial injury.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) class i-iii. * patient is undergoing elective surgery requiring mechanical ventilation * patient is an adult, 18 - 80 years old. * subject has voluntarily signed and dated the informed consent document approved by the institutional review board (irb). exclusion criteria: * surgical procedures boarded for less than 2 hours * current smoker * all cardiac, thoracic and/or vascular surgeries involving the chest * patient unable to cooperate. * chronic airway diseases * asthma * medical contraindication to anesthetic technique (allergy, cardiac condition, neurologic condition, localized infection, bleeding disorder). * subjects who are pregnant.

Keywords: exhaled breath condensate elective surgery mechanical ventilation isofurans thrombomodulin requiring mechanical ventilation
the efficacy of continuous cold-therapy on postoperative pain and narcotics use following spinal fusion

Conditions: Radiculopathy; Central Spinal Stenosis; Foraminal Stenosis; Herniated Nucleus Pulposus; Degenerative Disc Disease; Isthmic Spondylolisthesis; Degenerative Spondylolisthesis

Summary: patient outcomes and satisfaction are an ever-increasing priority in surgical specialties. cryotherapy has been utilized following spine surgery as an adjunct therapy to reduce postoperative inflammation and improve patient outcomes. however, limited studies have investigated the effect of cryotherapy on postoperative pain and narcotics use. fountas et al. performed a randomized controlled trial to assess the impact of postoperative cryotherapy following single-level lumbar microdiscectomy. the authors reported patients receiving cryotherapy required significantly less pain medication (0.058 mg/kg/hr versus 0.067 mg/kg/hr, p\<0.001) and had shorter hospital stays (1.71 days versus 2.65 days, p\<0.001) as compared to the control group. in another randomized trial of single-level lumbar discectomy patients, murata et al. demonstrated cryotherapy to have no significant effect on vas inpatient pain scores or postoperative blood loss.

the purpose of this study is to determine if postoperative cryotherapy with a cold-therapy system reduces postoperative pain and narcotic consumption following single and multi-level spinal fusion. the investigators hypothesize that patients undergoing lumbar spinal fusion who receive postoperative cryotherapy treatment with a cold-therapy system will have reduced inpatient pain scores and require less narcotics as compared to patients that receive standard care (ice pack).

Eligibility criteria:
inclusion criteria: 1. single or multi-level lumbar spinal fusion for degenerative pathology, including: radiculopathy, central spinal stenosis, foraminal stenosis, herniated nucleus pulposus, degenerative disc disease, and isthmic or degenerative spondylolisthesis. 2. patient able to provide informed consent exclusion criteria: 1. chronic preoperative narcotic use defined as daily narcotic use for the past 6 months prior to surgery 2. workers' compensation insurance claim 3. active or history of malignancy 4. unable to speak, read, or comprehend english language
effects of sensory motor training on balance and proprioception among post-menopausal obese women

Conditions: Post Menopaused Female

Summary: postmenopausal obese women often have difficulties with balance and proprioception. sensorimotor training is an important part of physical therapy interventions, with emerging evidence that it could be beneficial for postmenopausal obese women. objective: to find the impact of sensorimotor training on balance and proprioception among postmenopausal obese women.

randomized clinical trial was conducted on postmenopausal obese women population with impaired balance and proprioception on inclusion \& exclusion criteria, sample size of 40, ages ranged from 45 to 65 years included. group a received smt and group b received ct. the interval of treatment was 6 weeks. data is collected from thq samundri. frt, tug, ols utilized to assess the pre-and post-estimations of postural strength.

Eligibility criteria:
inclusion criteria: * • post-menopausal obese women * bmi ≥30 * participants independent in adls * self-ambulatory * healthy (having no known condition in which sensorimotor exercises would be contraindicated.) exclusion criteria: * • history of ankle sprain * uncontrolled diabetes mullites * presence of orthopaedic problems. * neurological disorders. * psychological problems. * cognitive issues. * people with severe visual issues

Keywords: postmenopausal, obese, balance, proprioception