Kornimate/medical-research-clean huggingface dataset:
action observation therapy in hemiparetic cp: impact on balance & lower limb function

Conditions: Hemiparetic Cerebral Palsy Children

Summary: background: action observation therapy (aot) leverages the mirror neuron system to enhance motor learning and is anticipated to improve upper extremity function in children with cerebral palsy. however, its effects on balance, lower extremity function, and gait performance in children with hemiparetic cerebral palsy remain underexplored. the planned study aims to evaluate whether the addition of aot to conventional physiotherapy will positively influence balance, lower extremity function, and gait performance in this population. objective: the study is designed to assess the efficacy of incorporating aot as an adjunct to conventional physiotherapy in improving balance, lower extremity function, and gait performance in children with hemiparetic cerebral palsy. methods: a patient cohort consisting of children with hemiparetic cerebral palsy (gmfcs levels i and ii) is planned to be assembled. it is expected that a total of 20 patients will be recruited and then randomly allocated into an experimental group and a control group. the experimental group is scheduled to receive conventional physiotherapy in addition to aot sessions, while the control group is planned to receive conventional physiotherapy only. the intervention period is planned for 6 weeks, during which both groups will participate in 12 physiotherapy sessions. additionally, the experimental group is scheduled to undergo aot sessions twice weekly, with each session lasting 30 minutes. outcome measures to be employed will include the timed up and go (tug) test, pediatric balance scale, five-step stair climbing and descending test, and the 6-minute walk test (6mwt). this study is expected to systematically evaluate the potential benefits of adding aot to standard physiotherapy regimens for enhancing balance, lower extremity function, and gait performance in children with hemiparetic cerebral palsy.


Eligibility criteria:
inclusion criteria: * diagnosed hemiparetic type of cerebral palsy exclusion criteria: * any other types of cerebral palsy

Keywords: action observation therapy hemiparetic cerebral palsy balance lower extremity function rehabilitation
transfusion requirements during spinal surgery for severe scoliosis

Conditions: Scoliosis

Summary: corrective surgery for scoliosis can result in prolonged operating room time and significant blood loss. the investigators goal is to determine what the transfusion requirements are for young adults undergoing spinal surgery for scoliosis and what other intra-operative factors influence the amount of blood and blood products used. the investigators will used the information obtained to improve the management of patients undergoing corrective surgery for scoliosis.

data collected prior to surgery will include patients' past medical history, hemoglobin concentration, inr, mcv, gender, age and weight. immediately prior to surgery, but after induction of anesthesia, subjects will have another complete blood count drawn to assess preoperative hemoglobin/hematocrit concentrations. this is customarily done to establish a baseline. during surgery patient's core temperature, hemoglobin, hematocrit levels, estimated blood loss, central venous pressure, blood pressure, heart rate, cell saver, the amount of irrigation fluid, colloid, crystalloid, blood and blood products will be recorded hourly throughout surgery. all of the data collection described is standard in these types of cases. patients will be transfused allogenic blood if hemoglobin levels fall below 8.0 g/dl or patients present with clinical signs/symptoms of hypovolemia (hypotension, tachycardia). data collection concerning allogenic blood transfusion will include intraoperative transfusion rate, volume of transfused units per patient and transfusion index. surgical intervention data regarding the extent of the surgical procedure will be collected: the number of curves, the curve magnitude, type of instrumentation required, the number of levels fused and the fluoroscopy time. the placement and type of wound drains and their .respective outputs will be noted. preoperative and postoperative curve magnitude will be documented as well as instrumentation used to facilitate curve correction. the number of levels fused will be documented. hemoglobin and hematocrit levels will be noted at several intervals post operatively (24 hours, 48 hours and last result prior to discharge) and further transfusion requirement will be recorded. the length of intensive care unit stay and the length of hospital stay will be noted. regarding surgical procedure all patients will be operated on by the same surgical team, under standardized anesthesia, total intravenous anesthesia (tiva), and postoperative analgesia. data will be expressed as percentages or as a mean +/- sd. t-test analysis will be used for comparison for quantitative variables and a p value \< 0.05 will be considered statistically significant

Eligibility criteria:
inclusion criteria: * all patients undergoing surgical correction of scoliosis
functional outcomes following shoulder surgery: a prospective database

Conditions: Rotator Cuff Tear

Summary: the purpose of this prospective database is to investigate the long-term functional status of patients who have undergone various types of rotator cuff repair surgery. patients are asked to respond to questionnaires prior to surgery and at various post-operative visits in an attempt to quantify their functional outcomes. responses are then linked to other data such as symptoms, prior treatments, previous surgery, complications, radiographic results, etc. these data may then be used as a basis for devising guidelines for future patients and surgeons. this particular project is interested in investigating long term results of arthroscopic rotator cuff repair techniques.

the purpose of the prospective database is to initiate data collection for a group of patients undergoing surgery of the shoulder. long-term data collection will include information on the functional status of the patients' shoulder as well as quality of life information and radiographic results. for the purposes of this study, we are interested in the long-term outcomes of participants who underwent a double row versus single row fixation in arthroscopic rotator cuff repair procedures.

Eligibility criteria:
inclusion criteria: * arthroscopic rotator cuff repairs that occurred between 2007-2009 * enrolled in previous study comparing single vs double-row fixation exclusion criteria: * withdrew from original study * unable or unwilling to provide written informed consent * excluded from original study

Keywords: shoulder surgery prospective database long term outcome
vitamin d metabolism in patients with endocrine disorders

Conditions: Pituitary ACTH Hypersecretion; Acromegaly; Diabetes Mellitus, Type 1; Primary Hyperparathyroidism

Summary: this prospective controlled interventional study aims to reveal the diversity of vitamin d metabolism in patients with certain endocrine disorders (cushing's disease, acromegaly, primary hyperparathyroidism, diabetes mellitus type 1) compared to healthy adults. all patients will receive a single dose (150,000 iu) of cholecalciferol aqueous solution orally. laboratory assessments including serum vitamin d metabolites (25(oh)d3, 25(oh)d2, 1,25(oh)2d3, 3-epi-25(oh)d3, 24,25(oh)2d3 and d3), free 25(oh)d, vitamin d-binding protein (dbp) and parathyroid hormone (pth) as well as serum and urine biochemical parameters will be performed before the intake and on days 1, 3 and 7 after the administration.


Eligibility criteria:
inclusion criteria: * confirmed diagnosis (arms "cushing's disease", "acromegaly", "diabetes mellitus type 1", "primary hyperparathyroidism") * active phase of the disease (arms "cushing's disease", "acromegaly") * no history of surgical and specific pharmacological treatment (arm "primary hyperparathyroidism") * hba1c \<8.0% (arm "diabetes mellitus type 1") * absence of the specified endocrine disorders (arm "control group") exclusion criteria: * factors associated with vitamin d level * intake of the following drugs during the 3 months preceding the study: vitamin d medications; glucocorticosteroids; antiretroviral drugs; antifungal drugs; cholestyramine, orlistat; antiepileptic drugs; antidepressants (fluoxetine); diuretics (spironolactone); antimicrobial agents (macrolides, tetracyclines, isoniazid, rifampin, primaquine); chemotherapy (cyclophosphamide, tamoxifen, paclitaxel, ifosfamide, irinotecan, etoposide, vinblastine); immunosuppressants (cyclosporin a, tacrolimus, sirolimus); h2 receptor antagonists. * bmi \>35 kg/m2 * pregnancy * granulomatous disease (sarcoidosis, tuberculosis, histoplasmosis, berylliosis, coccidiomycosis) * disease with malabsorption syndrome (crohn's disease, ulcerative colitis, celiac disease, post-bariatric surgery condition, decompensation of chronic pancreatitis) * reduced renal function (egfr \<60 ml/min/1.73m2) * laboratory signs of liver failure (hypoalbuminemia, hypoprothrombinemia) * hypercalcemia or risk factors for hypercalcemia * serum total calcium \>3.0 mmol/l * myeloma * immobilization * thiazide diuretics intake * allergy to vitamin d drugs * total 25(он)d \>60 ng/ml (determined by chemiluminescent immunoanalysis)

Keywords: vitamin d vitamin d deficiency chromatography, liquid tandem mass spectrometry cholecalciferol
antiplatelet therapy in acute coronary syndrome(acs). safety and efficacy of switching antiplatelet

Conditions: Acute Coronary Syndrome

Summary: this study aims to describe antiplatelet therapy in acs in andalusia and make an assessment of efficacy and safety of hospital use prasugrel / ticagrelor vs. clopidogrel and prasugrel switching to / ticagrelor patients pretreated with clopidogrel.

the management of acute coronary syndrome has changed in recent years as reflected in the new clinical practice guidelines of the european society of cardiology for the management of acs with or without st segment elevation, with the development and increased accessibility of the angiography and percutaneous coronary intervention and the arrival of the new antiplatelet (prasugrel and ticagrelor). the acs encompasses several clinical entities where dual antiplatelet therapy remains the basis of antiplatelet therapy and one of the mainstays of treatment. but the emergence of prasugrel and ticagrelor have changed the classical management with aspirin plus clopidogre

Eligibility criteria:
inclusion criteria: * patients admitted to the coronary care unit at the time defined with an initial diagnosis of acs. exclusion criteria: * myocarditis, takotsubo syndrome, pulmonary thromboembolism. * secondary mi or type 2, caused by an increase in demand or decrease oxygen (anemia, tachycardia, hypotension, heart failure, etc.). 11 * patients under 18 years.

Keywords: acs
the prespg4 study - studying the prodromal and early phase of spg4

Conditions: Hereditary Spastic Paraplegia; Hereditary, Spastic Paraplegia, Autosomal Dominant

Summary: study goals 1. prospective longitudinal data on progression in the natural course of spg4 in presymptomatic mutation carriers prior to clinical disease onset and in early stages of disease 2. biomarkers providing objective measures of disease activity


Eligibility criteria:
inclusion criteria: * first degree relatives (parents, offspring, and sibs) of spg4 patients or symptomatic individuals with known spast mutation * age 18 to 70 years * written, informed consent (patient) exclusion criteria: * no known spast-mutation within the family * manifest spastic gait (subclinical signs like increased deep tendon reflexes, positive babinski sign are allowed) * participation in interventional trials

Keywords: spg4 presymptomatic at risk mutation carriers biomarkers longitudinal progression
the effect of new-style vaginal repair mesh in the treatment of female stress urinary incontinence

Conditions: Stress Urinary Incontinence

Summary: the study is to explore the effectiveness of a new-style anterior vaginal wall mesh in the treatment of female stress urinary incontinence(sui). meshes were made by gynemech tm ps, (johnson \& johnson shanghai medical equipment co. china food and drug administration (cfda) registration no. 3460365, size 10 × 15cm). meshes were cut to appropriate size. the incontinence questionnaire summary table (iciq-sf), pad test, urodynamic and other diagnostic tests were used for preoperative assessment and the evaluation of postoperative surgical outcome and complication. the results were compared with the one-year cure rates of burch and trans vaginal taping (tvt) surgeries. the analysis indicated that the surgery using the new-style anterior vaginal mesh, as a minimally invasive procedure, not only achieved its expectation with similar cure rate to burch, tvt/ trans vaginal taping obturator (tvt-o) surgeries, but also has lower economic cost and complication rate than the tvt /tvt-o approach. the evaluation of long-term treatment effect needs further follow-up of the patients.


Eligibility criteria:
inclusion criteria: * patients with clinically and biopsy confirmed non-neoplastic lesions of genital skin and mucous membrane (non-neoplasia epithelial disorders of skin and mucosa of vulva). symptoms include repeated itching, discoloration, rhagades, loss of skin elasticity and dyspareunia that affect the patients' quality of life. exclusion criteria: * atypical hyperplasia or vulvar cancer confirmed by biopsy of genital lesions; * vulvovaginal or other gynecological trauma, acute inflammatory diseases and other acute illness in need of urgent care; * combined with other serious gynecological diseases (symptomatic hysteromyoma, ovarian tumor, etc.), and/or severe organ diseases (such as heart, lung, brain and renal disease/failure) that need immediate treatment; * other type of cancers that require urgent care.
ct-ffr-guided strategy for in-stent restenosis

Conditions: Coronary Artery Disease; In-stent Restenosis

Summary: this study will be a prospective, randomized clinical trial to compare standard practice guided by usual care testing to ct-ffr-guided management in patients with in-stent restenosis.

this trial will randomize 294 patients with in-stent restenosis to receive either ct-ffr or routine clinical assessment. in all subjects, the investigators will review all diagnostic test results and determine a treatment strategy. the primary end point will be 12-month major adverse coronary event (mace) rates, defined as all cause death, non-fatal myocardial infarction (mi), ischemia-driven target vessel revascularization (tvr). secondary end points will include total medical costs, and quality of life (qol), medical radiation exposure, etc. we will test noninferiority of current ffr-guided strategy compared with standard care strategy.

Eligibility criteria:
inclusion criteria: * (1) \>18 years old; * (2) ability to provide informed consent; * (3) previous pci who underwent ccta and have at least 1 lesion with a percent diameter in-stent stenosis between 30% and 90% in a coronary artery with a ≥2.25 mm reference vessel diameter by visual assessment; * (4) accepted further clinically indicated coronary testing, coronary arteriography, or ffr, or ivus, or pci, etc. exclusion criteria: * (1) prior coronary artery bypass surgery (cabg), heart valve surgery, cardiac pacemaker, or implanted cardiac defibrillator; * (2) target vascular stents were evaluated for implantation within one month; * (3) unstable clinical conditions including acute chest pain, cardiogenic shock, congestive heart failure (nyha grade iii or iv), unstable blood pressure (systolic blood pressure \< 90mmhg) or acute pulmonary edema; * (4) acute myocardial infarction occurred within 7 days before enrollment, and left ventricular ejection fraction ≤40%; * (5) other severe cases are not suitable for clinical trials including complex congenital heart disease, sick sinus syndrome, long qt syndrome, severe arrhythmia, tachycardia, severe asthma, severe or very severe chronic obstructive pulmonary disease (copd) and severe chronic renal damage; * (6) contraindication to beta blockers, nitroglycerin, adenosine, or allergy to iodine contrast agents; * (7) pregnancy or pregnancy status unknown; * (8) life expectancy \<1 years; * (9)repeated enrollment; * (10) any other factors that other researchers consider not suitable for inclusion or completion of this study.

Keywords: coronary ct angiography-derived fractional flow reserve in-stent restenosis major adverse coronary events
bladder neck surgery in children with neurogenic bladder

Conditions: Incontinence; Bladder Dysfunction; Spina Bifida; Neurogenic Bladder Disorder; Child, Only

Summary: surgical outcomes of bladder neck surgery in children with neurogenic bladder. consequences on bladder voiding.

surgical outcomes of bladder neck surgery in children with neurogenic bladder: quality of voiding: spontaneous, need for catheterization, or incontinence. other surgical complications.

Eligibility criteria:
inclusion criteria: * patients with neurogenic bladder and younger than 18 years old , who underwent a bladder neck procedure exclusion criteria: * patients, with neurogenic bladder and older than 18 years old ,who underwent a bladder neck procedure

Keywords: bladder neck surgery surgical outcomes child retrospective study
parks & pediatrics fit together

Conditions: Pediatric Obesity; Implementation

Summary: the proposed project will test an implementation strategy (the "trailguide") for delivering an existing model of pediatric obesity treatment ("fit together") that has demonstrated ability to meet published recommendations for improving health outcomes of children with obesity.

evidence-based treatment for childhood obesity exists, yet a fundamental knowledge-to-action gap has significantly limited the uptake of recommendations into clinical practice, particularly in low-income settings. persistence of this gap represents a large-scale public health threat, as the earliest generation of children living through the obesity epidemic now enters adulthood, they are the first in us history to have a shorter life expectancy than their parents, mainly due to rising rates of obesity-related cancers and cardiovascular disease. a central challenge in delivering recommended treatment is the intensity; ≥26 hours of face-to-face contact are necessary to achieve health benefits and risk reduction. the objective of the proposed project is to develop and test an implementation strategy that pairs primary care pediatric clinics with the municipal parks and recreation (p\&r) centers to deliver the current treatment recommendations with high fidelity, while allowing

Eligibility criteria:
inclusion criteria: * child receives primary care at one of the participating clinics * child age 6-11 years old at the time of enrollment in the study * bmi greater than or equal to 95th percentile for age and sex * english- or spanish-speaking exclusion criteria: * injuries or disabilities preventing physical activity. inclusion criteria for caregivers: * age 18 or older * english or spanish-speaking * caregiver has smartphone and is willing to download app(s) used in the study * anticipates bringing the child to the program the majority of the time and spends significant time with the child outside of program hours (necessary in order to accurately answer survey questions about child behavior and child participation in the program, and provide feedback about the program) * does not have plans to leave the area during the next 12 months

Keywords: physical activity pediatrics
usg brachial plexus block for upper extremity surgery

Conditions: Fracture at Wrist and/or Hand Level; Rupture of Tendon of Wrist and Hand; Injuries to the Wrist, Hand and Fingers (S60-S69); Ganglion Cysts; Carpal Tunnel Syndrome

Summary: ultrasound-guided (usg) brachial plexus (bp) block efficacy at the supraclavicular (scl), lateral- infraclavicular (lic) and axillary (ax) level: randomized, observer-blinded study of the single-penetration multiple-injection-technique.

the investigators will compare the bp block efficacy (for surgical anaesthesia) with the usg single-penetration multiple-injection-technique at the scl, lic and ax level for upper-extremity surgery (elbow, forearm, wrist, hand). the investigators want to investigate whether the single-penetration multiple-injection-technique would provide for safe surgical anaesthesia with lower volumes of local anaesthetics than has previously been described in a comparative study at the three different levels. 120 patients will prospectively be randomized to an usg bp block administered as a single-penetration multiple-injection-technique at one of three different levels: (1) scl (2) lic (3) ax. ropivacaine 0.75% (20 ml) will be used for all blocks prior to surgery.

Eligibility criteria:
inclusion criteria: * age above 18 years * american society of anaesthesiology class 1-3 * patients undergoing upper extremity surgery exclusion criteria: * inability to cooperate * inability to understand and talk danish * allergic to ropivacaine * infection at site of surgery * neurological dysfunction at site of surgery * severe coagulopathy * drug and alcohol abuse * patients, who can not get a nerve block due to technical difficulty * pregnancy or nursing * body mass index \>35
effect of vitamin d on the honeymoon period in children and adolescents with type 1 diabetes

Conditions: Type 1 Diabetes

Summary: the purpose of this study is to determine if supplementation with vitamin d in children and adolescents with newly diagnosed type 1 diabetes increases the number of patients who enter the honeymoon period.

type 1 diabetes is an autoimmune disease characterized by destruction of the insulin secreting beta-cells of the pancreas. there is evidence that vitamin d may play a role in the initial risk of development of autoimmune disease, including type 1 diabetes. however, vitamin d may also play a role the natural progression of type 1 diabetes by altering innate insulin secretion and sensitivity and by influencing systemic inflammation, directly at the level of the beta-cell. studies have shown that vitamin d insufficiency or deficiency is frequently reported in children and adolescents with type 1 diabetes. a majority of newly diagnosed patients with type 1 diabetes enter a period of partial clinical remission, characterized by low or even absent insulin requirements, also known as a honeymoon period. this honeymoon period is associated with improved metabolic control, near normal insulin sensitivity, and recovery of beta-cell function leading to preservation of endogenous insulin secretion. we hypothesize that supplementation with vitamin d in children and adolescents with newly diagnosed type 1 diabetes will halt the destructive process within the beta cell and improve beta-cell function by increasing endogenous insulin secretion and decreasing systemic inflammation, thereby increasing the rate of partial clinical remission.

Eligibility criteria:
inclusion criteria: * children and adolescents ages 4-18 years old with newly diagnosed type 1 diabetes. exclusion criteria: * age less than 4 years * pregnant females * previous or known history of vitamin d deficiency or insufficiency * current use of vitamin d supplementation or multi-vitamin containing \>800 iu daily * or concurrent development and/or history of other significant systemic illness or non-endocrine autoimmune disorder.

Keywords: type 1 diabetes vitamin d clinical remission