Kornimate/medical-research-clean huggingface dataset:
evaluation of the online chronic disease self-management project at group health

Conditions: Chronic Conditions

Summary: the purpose of this study is to learn if group health members who participate in the online chronic disease self-management program will experience improved health outcomes, improved health care utilization, and lower costs.

we will pilot an evidence-based online program for chronic disease self-management that is modeled after the widely-replicated in-person chronic disease self-management program (cdsmp) developed at stanford university. the online cdsmp is an internet-based intervention for people with one or more chronic conditions. it is built on self-efficacy theory and is structured around a formal curriculum that emphasizes problem solving, decision making, and confidence building in weekly sessions over six weeks. the curriculum addresses generic topics and skills that are relevant to managing any chronic condition. the program is structured around three components: 1) password-protected, interactive web-based instruction; 2) web-based bulletin board discussion groups to enable participatory learning and interaction; 3) and a reference book, living a healthy life with chronic conditions, that contains the program content and supplemental information. it is facilitated by two trained lay moderators, at least one of whom has a chronic condition. piloting the online cdsmp allows group health to learn about and maximize the program's impact in the group health system before launching a full-scale program. since web-based interventions are increasingly recognized as holding promise in health care, our learnings and recommendations will likely be applicable beyond this innovation. the pilot provides gh the opportunity to explore the following about the online cdsmp and web-based tools, in general: 1. impact of the online cdsmp on participants' psychosocial and health status, health behaviors, and health service utilization 2. efficient processes for incorporating the online cdsmp into existing operations through use of pdca cycles 3. an understanding of demographic characteristics of members who are more likely to participate in an online self-management program than an in-person program 4. effective recruitment and retention strategies 5. feasibility of sustaining the program without external funding 6. recommendations for successful implementation of future innovations that utilize web-based media, social networking technology, etc.

Eligibility criteria:
inclusion criteria: * group health member * have access to group health enhanced online services * one or more chronic conditions or a caregiver of someone who fits that criteria * 18 years of age or older exclusion criteria: * not a group health member * no access to group health enhanced online services * no chronic conditions and not a caregiver of someone with a chronic condition * under 18 years of age

Keywords: chronic disease self-management program (cdsmp)
azithromycin as a quorum-sensing inhibitor for the prevention of pseudomonas aeruginosa ventilator-associated pneumonia

Conditions: Pneumonia, Ventilator-Associated; Pseudomonas Infections

Summary: the purpose of this study is to assess the clinical efficacy of azithromycin, used as a quorum-sensing blocker, when compared to placebo for preventing or delaying the occurrence of pneumonia in ventilated patients colonized with pseudomonas aeruginosa.


Eligibility criteria:
inclusion criteria: * male and non pregnant female aged 18 to 75 years * patients hospitalized in icu, under mechanically assisted ventilation expected to be mandatory for 3 days or more * reasonable survival chance within next few days with an apache score 10-25 * tracheal aspirate found positive for p. aeruginosa * the subject (or a close family member in case of incompetence) understands the procedure, agrees to participate, and is willing to give written informed consent * informed consent must be obtained for all subjects before enrollment in the study, by patient or by a close family member exclusion criteria: * poor prognosis as judged by apache score ii score \>25 * pregnant female * grossly under-or overweight (bmi\ 29) * ongoing therapy with a macrolide * known allergy to any macrolide * proven p. aeruginosa pneumonia * ongoing anti-pseudomonal therapy with a proven susceptible colonizing strain * anticipated short duration of mechanical ventilation (\<3 days) * known drug interaction that could either decrease efficacy or raise safety concerns * severe hepatic failure (type c, score \>10 on child pugh scale) * sick sinus syndrome or long qt syndrome * recent donation of blood or participation in another clinical trial within 3 months * any situation exposing the patient to higher risk or possibly confounding results

Keywords: pseudomonas aeruginosa pneumonia ventilator-associated quorum sensing
hypoxia and exercise in the elderly

Conditions: Elderly Persons

Summary: ageing is the primary risk factor for most chronic diseases including type 2 diabetes mellitus. sarcopenia and muscular mitochondrial dysfunction with aging are crucial mechanisms leading to decreased exercise tolerance and worsened insulin sensitivity. thus, metabolic disease and frailty, which limits physical mobility as well as quality of life, share common cellular mechanisms. the investigators will test the hypothesis that a combination of normobaric hypoxia and exercise training elicits a synergistic effect on age-associated metabolic skeletal muscle dysfunction and the investigators will address the molecular mechanisms. in a randomized clinical study, the investigators will compare normoxic and hypoxic training conditions in elderly subjects. outcome measures will focus on whole body insulin sensitivity and mitochondrial responses in skeletal muscle before and after the 8-week training intervention.


Eligibility criteria:
inclusion criteria: * 55 to 75 years of age * body mass index: 20 - 35 kg/m2 * weight stable during last 6 months before screening (weight change \< 2% body weight) * homa-index of insulin resistance ≥ 2 to 4 units exclusion criteria: * more than 1 hour of scheduled exercise training per week * known diagnosis of type 2 diabetes or measured hba1c \> 6,5% * known drug or alcohol abuse * any contraindication to perform exercise training * acute or chronic infections * increased bleeding risk by history, inr \> 1,3, use of anticoagulants
combined use of er:yag and nd:yag laser

Conditions: Chronic Periodontitis

Summary: the aim of the present study was to compare the effectiveness of combined er:yag and nd:yag laser therapy to that of scaling and root planning with hand instruments in nonsurgical treatment of chronic periodontitis.

the aim of the present study was to compare the effectiveness of combined er:yag and nd:yag laser therapy to that of scaling and root planning with hand instruments in nonsurgical treatment of chronic periodontitis.twenty-ﬁve systemically healthy patients with moderate-to-advanced periodontal destruction were selected for this study. the quadrants were randomly allocated in a split-mouth design to either combined er:yag (160 mj/pulse, and 10 hz) and nd:yag laser (100 mj/pulse, and 20 hz) therapy (test group) or scaling root planning using hand instruments (control group). at baseline, 1 month, and 3 months after treatment, clinical measurements, including plaque index (pi), gingival index (gi), probing depth (pd), clinical attachment level (cal), and bleeding on probing (%) (bop), were performed and gingival crevicular fluid and subgingival plaque samples were taken. the gingival crevicular fluid levels of interleukin-1β (il-1β) and tumor necrosis factor-α (tnf-α) were analyzed by enzyme-linked immunosorbent assay. total antioxidant status (tas)/total oxidant status (tos) were analyzed by high-performance liquid chromatography and a novel automatic colorimetric method. quantitative analysis of porphyromonas gingivalis (pg), tannerella forsythia (tf), and treponema denticola (td) was performed using real-time polymerase chain reaction (pcr) procedures.

Eligibility criteria:
inclusion criteria: * the patients had ≥4 teeth per quadrant with probing depth (pd) of ≥5 mm, clinical attachment level (cal) of ≥4 mm, and radiographic signs of alveolar bone loss. these individuals also had bleeding on probing (bop) at \>80% of the proximal sites. exclusion criteria: * periodontal treatment received for the last 1 year; systemic diseases that could influence the outcome of the therapy, pregnancy, smoking, immunosuppressive chemotherapy; and use of antibiotics and anti-inflammatory drugs for the last 6 months.

Keywords: er-yag lasers nd-yag lasers chronic periodontitis nonsurgical periodontal debridement
autologous stem cell transplantation in acute myocardial infarction

Conditions: Acute Anterior Wall Myocardial Infarction

Summary: objectives intracoronary transplantation of different cell populations have been used in acute myocardial infarction (ami) with promising results. the primary objective of the astami study is to test whether intracoronary transplantation of autologous mononuclear bone marrow cells (mbmc) improve left ventricular ejection fraction (lvef) after anterior wall ami. design the astami study is a randomized, controlled, prospective study. one hundred patients with acute anterior wall st-elevation myocardial infarction (stemi) treated with acute pci are randomized in a 1:1 way to either intracoronary transplantation of autologous mbmc 5-8 days after pci or to control. left ventricular function, exercise capacity, biochemical status, functional class, quality of life and complications are validated at baseline and during a 12-month follow up.


Eligibility criteria:
inclusion criteria: * age 40-75 years * anterior wall ami with 120-720 minutes from onset of symptoms to pci * st elevation on ecg according to who criteria * angiographically significant stenosis on lad proximal to the second diagonal branch * successful pci with stenting of culprit lesion * hypokinetic, akinetic or dyskinetic segments assessed by echocardiography in a standard 16 segment model and * ck-mb above 3 times upper reference value. exclusion criteria: * previous mi with established significant q-waves on ecg * cardiogenic shock * permanent pacemaker or other contraindication to mri * stroke with significant sequela * short life expectancy due to extra cardiac reason * uncontrolled endocrinological disturbance * hiv and/or hbv/hcv positive serology * mental disorder or other condition which interferes with patient possibility to comply with the protocol.

Keywords: myocardial infarction bone marrow cells cell transplantation
the effect of taping in addition to self-stretching exercise in the elderly people with hyperkyphosis

Conditions: Physical Performance

Summary: aim: the aim of the study is to investigate the effectiveness of kinesio taping and sham taping in addition to self-stretching exercise on hyperkyphosis angle, neck pain and quality of life in elderly individuals with hyperkyphosis. method: 60 elderly individuals with hyperkyphosis aged 60-85 years will be included in the study. subjects will be divided inti three groups. kinesio taping, sham taping and self-stretching exercise. the kinesio taping group will be given kinesio taping in addition to self stretching exercises. the second sham taping group will be given sham kinesio taping in addition to self stretching exercises. the third self-stretching group will be given a program consisting of stretching exercises for pectoral, erector spinae, latismus dorsi, multifidus, rhomboid and trapezius muscles. individuals will be asked to do these exercises on their own for 15-20 minutes at home or in the office every day for four weeks. before and after the study, the subjects will be test for the kyphosis angle will be evaluated with a flexible ruler and scoliosis research society outcome questionnaire (srs22) will be used to evaluate spinal curvatures.the neck disability questionnaire will be used to evaluate neck pain. the occiput-neck distance and mini mental test will be used in this srudy.


Eligibility criteria:
inclusion criteria: * volunteer female and male individuals between the aged of 60-85 years, * kyphosis angle is greater than 56 degrees in women and 62 degrees in men, * individuals who have not physiotherapy in the last 6 months, * individuals who have not phsical activity in the last 6 months. exclusion criteria: * individuals with any thoracic scoliosis and scheuermann's disease, * individuals who having a kinesio tape allergy or developing an allergy while working.

Keywords: exercise kinesiotape kyphosis elderly
clopidogrel and atorvastatin treatment during carotid artery stenting

Conditions: Carotid Stenosis

Summary: the purpose of this study is to evaluate the efficacy and safety of two different loading doses of clopidogrel and a reloading of atorvastatin in the prevention of periprocedural ischemic brain damage in patients undergoing carotid angioplasty.


Eligibility criteria:
inclusion criteria: * symptomatic and asymptomatic patients with finding of significant carotid stenosis exclusion criteria: * patients with acute injuries to the baseline mri of the brain, * patients with active bleeding, * contraindications to statin therapy and mri contraindications (pacemaker/claustrophobic).

Keywords: therapeutic strategies for carotid artery stenting
effectiveness of a dietary counseling to prevent early consumption of added sugar and ultra-processed foods

Conditions: Infant Nutrition Disorders; Feeding Patterns; Health Knowledge, Attitudes, Practice

Summary: the purpose of the study is to prevent the early introduction of added sugar and ultra-processed foods and evaluate the impact on breastfeeding duration, complementary feeding quality, growth and prevalence of caries during the first year of life.

this randomized field trial will be performed at the maternity wards of friendly hospitals initiative in three regions of brazil: north, northeast and south. after delivery, mothers who accepted to participate in the study will be randomized into control and intervention groups.it will be performed a weekly block randomization to prevent the contamination of information among mothers of different groups in the same facility. the intervention mothers will be advised not to give added sugar and ultra-processed foods during the first year of life, including a leaflet with colored images as a reminder for mothers. the control group mothers will not receive the study intervention but will be have all the routine health assistance of the maternity. at 6 months and 12 months, mothers of both groups will be visited in their homes and dietary evaluation and anthropometric measurements of their babies will be assessed. at 12 months of age the infants will have dental examinations and hemoglobin concentration through a capillary blood test. .

Eligibility criteria:
inclusion criteria: * newborns with gestational age ≥ 37 weeks * single birth * mother with at least 18 years old exclusion criteria: * mothers with hiv or htlv1 positive * infants with clinical occurrences or other conditions that prohibit breastfeeding or requires specific dietary treatment.

Keywords: complementary feeding added sugar ultra-processed foods intervention infants
a study of the effect of syn-010 on subjects with ibs-c

Conditions: Irritable Bowel Syndrome With Constipation (IBS-C)

Summary: a randomized, double-blind, parallel-group, placebo-controlled, multi-dose study of the effect of two dosage strengths of syn-010 compared with placebo on breath methane production in breath methane-positive subjects with irritable bowel syndrome with constipation (ibs-c)

this is a phase 2, randomized, multi-center, multi-dose study. sixty subjects with irritable bowel syndrome with constipation who are between the ages of 18 and 65, inclusive, will be enrolled. the entire duration of the study may be up to 43 days (from screening to the post end-of-study \[eos\] visit telephone call).

Eligibility criteria:
inclusion criteria: * subjects must have ibs-c and have a positive breath ch4 test result (\> 10 ppm) at screening. * subject must meet the modified rome iii criteria for ibs-c. * subject must have an average abdominal pain intensity score of ≥ 3 (scale 0-10) reported at screening and baseline. * subject must have an average of fewer than 3 complete spontaneous bowel movement (csbms) per week. * subject must agree to refrain from making any lifestyle changes that may affect ibs-c symptoms from the time of screening to the end of the study. exclusion criteria: * subject has taken ibs treatments (prescription or over-the-counter), proton pump inhibitors, laxatives, antibiotics. * subject currently has any structural abnormality of the gastrointestinal (gi) tract or a disease or condition that can affect gi motility, or any unexplained and clinically significant symptoms such as lower gi bleeding, rectal bleeding, heme-positive stool, iron-deficiency anemia, weight loss, or systemic signs of infection. * subject has been diagnosed with or has a family history of familial adenomatous polyposis, hereditary nonpolyposis colorectal cancer, or any other form of familial colorectal cancer. * subject reports loose (mushy) or watery stools (bristol stool form scale \[bsfs\] score of 6 or 7).
safety and efficacy study of pyridostigmine on patients with spinal muscular atrophy type 3

Conditions: Spinal Muscular Atrophy Type 3

Summary: the purpose of this study is to evaluate safety and efficacy of anti-cholinesterase therapy on the motor function in sma type 3 patients with impaired neuromuscular junction (nmj).

spinal muscular atrophy (sma) is the second neuromuscular disease meet in children. sma is a genetically transmitted disease inducing muscular weakness predominating on shoulders and hips. currently, there is no effective therapy to slow the progression of the disease. sma is due to a neuron motor attempt of the spinal cord and recently it has been demonstrated a neuromuscular junction (nmj) involvement, according to recent studies. emotas study aim to understand if nmj abnormalities could have an impact on motor performance and fatigue in sma type 3 ambulatory patients by electromyogram and to improve by non-invasive therapy quality of life of patients.

Eligibility criteria:
inclusion criteria: * spinal muscular atrophy type 3, genetically confirmed * age higher than 6 years old * ambulatory patient * informed consent signed * more than 100 meters of walking at 6-minute walk test at screening * value at screening and baseline in a range of 20% of the highest value at 6-minute walk test exclusion criteria: * patient who had surgical intervention or suffer from a recent traumatism (less than 6 months) * associated pathology such as endocrinopathy, infectious disease, allergy, myopathy, chronic or acute inflammatory pathology, during 3 weeks preceding the inclusion. * other therapeutics than food supplements or those frequently prescribed in spinal muscular atrophy or its complications * non tolerance of electromyography * limited collaboration due to trouble in information comprehension * pathology inducing contra-indication for pyridostigmine treatment (allergy at molecule, asthma, parkinson disease, mechanic obstruction of urinary or digestive tracts)

Keywords: spinal muscular atrophy type 3 electromyography fatigability decrement
effect of administration of rifaximin on the portal pressure of patients with liver cirrhosis and esophageal varices

Conditions: Liver Cirrhosis; Portal Hypertension

Summary: the purpose of this study is to assess whether the add of rifaximin in patients with liver cirrhosis and esophageal varices treated with a standard therapy with beta blockers, leads to a significant reduction of portal hypertension.

it is well recognized that the gut flora may play an important role in the development of complications of liver cirrhosis, such as hepatic encephalopathy (he), spontaneous bacterial peritonitis (sbp) and variceal bleeding, which are are directly caused or aggravated by the translocation of enteric bacteria or their products into the blood of cirrhotic patients.preliminary studies have shown that selective intestinal decontamination appears to ameliorate the hyperdynamic circulatory state of cirrhosis. the investigators hypothesize that a modulation of gut microbiota by administering a non-adsorbable antibiotic, in addition to beta-blockers, can be a safe strategy to reduce the portal pressure, influencing favorably hemodynamics of portal circulation. thus, the purpose of this study is to evaluate if in patients with liver cirrhosis and esophageal varices at high risk of bleeding, rifaximin, administered in addition to standard therapy with beta - blockers (propranolol), for a time of 60 days: leads to a significant reduction of hepatic venous pressure gradient (it will be assessed by hepatic vein catheterization), 2) modify the intestinal flora in favor of specific families of bacteria (it will be assessed by fecal microbiota analysis), 3) change systemic inflammatory responses (it will be assessed by serum pro-inflammatory cytokines) 4) change in cognitive functions (it will be assessed by neuropsychological and electroencephalogram evaluations).

Eligibility criteria:
inclusion criteria: * diagnosis of liver cirrhosis (based on clinical, biochemical and radiological criteria with or without liver biopsy) * presence of esophageal varices at high risk of bleeding * hepatic venous pressure gradient \> 12 mmhg. * 19≤ age ≤75 * informed consent exclusion criteria: * patients already treated with beta blockers * treatment with systemic antibiotics and/or non-absorbable intestinal antibiotics in the previous two weeks * bacterial infection, spontaneous bacterial peritonitis * overt hepatic encephalopathy in the last week * active gastrointestinal bleeding, or in the last week * active alcoholism or drug abuse in last 3 weeks * acute alcoholic hepatitis * hepatocellular carcinoma or other neoplasm * significant coronary artery disease (angina nyha iii/iv), congestive heart failure (nyha iii/iv), relevant cardiomyopathy, history of myocardial infarct within the last 12 months * contraindications to the administration of beta blockers; allergy to rifaximin * pregnancy or breastfeeding * refusal to participate

Keywords: portal hypertension liver cirrhosis rifaximin
the phosphodiesterase inhibitor tadalafil as an adjunct to antidepressants in major depressive disorder patients

Conditions: Major Depressive Disorder

Summary: antidepressant-like effects of tadalafil to its ability to modulate transduction pathways responsible for neuroplasticity. treatment with tadalafil was shown to be pkg-dependent and lead to increased expression of cgmp, pcreb, bdnf and vgf in the hippocampus and prefrontal cortex (pfc), brain areas relevant to mood disorders pathophysiology. low-dose tadalafil improved both depressive symptoms in patients with erectile dysfunction.


Eligibility criteria:
inclusion criteria: eighty adult outpatients with the diagnostic and statistical manual of mental disorders-iv (dsm-iv) diagnosis of mdd based on a mini neuropsychiatric interview (mini) (american psychiatric association., 2000; sheehan et al., 1998), without psychotic features and a total 17 item ham-d score of at least 18 with item 1 (depressed mood) scored 2 or greater were eligible (hamilton, 1960). patients were requested to be free of all the psychotropic and anti-inflammatory medications for at least 4 weeks before participating in the study. exclusion criteria: patients with bipolar i or bipolar ii disorder patients with personality disorders patients with eating disorders patients with substance dependence or abuse patients with concurrent active medical condition patients with history of seizures patients with history of receiving electroconvulsive therapy (ect) patients with inflammatory disorders patients with allergy or contraindications to the used medications patients with finally pregnant or lactating females cardiovascular disorders severe renal impairment: creatinine clearance of ≤ 25 ml/min moderate or severe hepatic impairment