Kornimate/medical-research-clean huggingface dataset:
treatment of muscle cramps in patients with liver cirrhosis

Conditions: Liver Cirrhosis; Muscle Cramps

Summary: this is a pilot study to see if hydroxychloroquine (hcq) if safe and effective to use with patients having cramps due to their cirrhotic liver disease.

this project is proposed as a pilot study to gather preliminary data for a full-scale randomized trial to assess the efficacy and safety of hydroxychloroquine (hcq) in the treatment of muscle cramps in patients with cirrhosis.

Eligibility criteria:
inclusion criteria: * previous diagnosis of cirrhosis * adult (\>21 years) * able to complete a written questionnaire in english * stable and ambulatory * meld score \ 25,000 exclusion criteria: * people allergic to hydroxychloroquine, 4-aminoquinolone derivatives or any component of the formulation * previous diagnosis of retinal or visual field changes attributable to 4-aminoquinolone * previous diagnosis of porphyria * previous diagnosis of psoriasis * fulminant hepatic failure * pregnant women

Keywords: liver cirrhosis muscle cramps
exercise intervention in heart failure

Conditions: Heart Failure

Summary: this is a pragmatic, non-inferiority clinical trial, enrolling heart failure patients who will be randomized to a 12-week exercise training program either centre-based or home-based with telemonitoring. the impact of this intervention will be assessed on established surrogate markers in hf such as maximal exercise capacity, plasma biomarkers and quality of life. the cost-effectiveness and overall satisfaction with the treatment will also be studied. in addition to measure the clinical and economic impact of this innovative way of delivering exercise, it is intended to unravel new molecular pathways and assess a pool of biomarkers that provide a wide mechanistic picture underlying the clinical effects of exercise.


Eligibility criteria:
inclusion criteria: 1. diagnosis of hfref and hfpef according to criteria of the european society of cardiology (2016) 2. clinical stability for ≥ 6 weeks 3. optimal medical treatment for ≥ 6 weeks 4. patients that are able to understand and follow the exercise prescription 5. written informed consent exclusion criteria: 1. patients who have undertaken cardiac rehabilitation within the past 12 months 2. patients who have received an intracardiac defibrillator (icd), cardiac 3. resynchronisation therapy (crt) or combined crt/icd device implanted in the last 6 weeks 3. inability to exercise or conditions that may interfere with exercise intervention 4. signs of ischemia during cardiopulmonary exercise test 5. comorbidity that may influence one-year prognosis 6. symptomatic and/or exercise induced cardiac arrhythmia or conduction disturbances 7. currently pregnant or intend to become pregnant in the next year 8. expectation of receiving a cardiac transplant in the next 6 months 9. participation in another clinical trial 10. patients who are unable to understand the study information or unable to complete the outcome questionnaires

Keywords: heart failure home-based exercise maximal oxygen consumption cost-effectiveness
fulvestrant in treating patients with recurrent, persistent, or metastatic endometrial cancer

Conditions: Recurrent Uterine Corpus Carcinoma; Stage III Uterine Corpus Cancer AJCC v7; Stage IV Uterine Corpus Cancer AJCC v7

Summary: this phase ii trial is studying fulvestrant to see how well it works in treating patients with recurrent, persistent, or metastatic endometrial cancer. estrogen can stimulate the growth of cancer cells. hormone therapy using fulvestrant may fight cancer by blocking the uptake of estrogen by the tumor cells.

primary objectives: i. compare the probability of clinical response in estrogen receptor (er)-positive vs er-negative patients with recurrent, persistent, or metastatic endometrial cancer treated with fulvestrant. ii. compare the relationship between response rate and intensity of receptor expression in patients treated with this drug. iii. determine the frequency and intensity of toxicity of this drug in these patients. outline: patients receive fulvestrant intramuscularly on day 1. treatment repeats every 28 days for at least 2 courses in the absence of disease progression or unacceptable toxicity. patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

Eligibility criteria:
criteria: * histologically confirmed recurrent, persistent, or metastatic endometrial cancer that is not curable with surgery or radiotherapy * estrogen receptor (er) and progesterone receptor status known by immunohistochemistry * er positive or negative allowed * measurable disease: * at least 1 target lesion not within a previously irradiated field or irradiated target lesion with clear disease progression * at least 20 mm by conventional techniques, including palpation, x-ray, ct scan, mri, or at least 10 mm by spiral ct scan * performance status: * gog 0-1 * hematopoietic: * absolute neutrophil count \>= 1,500/mm\^3 * platelet count \>= 100,000/mm\^3 * no prior bleeding diathesis (disseminated intravascular coagulation, clotting factor deficiency, or requirement for anticoagulants) * hepatic: * bilirubin =\< 1.5 times upper limit of normal (uln) * sgot =\< 3 times uln * alkaline phosphatase =\< 3 times uln * renal: * creatinine =\< 2 mg/dl * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception * no hypersensitivity to castor oil * no other concurrent malignancy except nonmelanoma skin cancer * no other prior malignancy within past 5 years * no prior chemotherapy for persistent, recurrent, or metastatic endometrial cancer * no more than 1 prior chemotherapy regimen for newly diagnosed endometrial cancer that has subsequently recurred * at least 3 weeks since prior hormonal therapy and recovered * at least 3 weeks since prior radiotherapy and recovered * at least 3 weeks since prior surgery and recovered
a study about modified rna vaccines against influenza in healthy adults

Conditions: Influenza, Human

Summary: the purpose of this study is to learn if modified rna (modrna) vaccines for the prevention of influenza are: * safe; and * how these vaccines produce an immune response in generally healthy adults. immune response is the way the body protects itself against things it sees as harmful or foreign. rna (also called ribonucleic acid) is one of two types of nucleic acid made by cells. rna contains information that has been copied from dna (the other type of nucleic acid). cells make several different forms of rna, and each form has a specific job in the cell. many forms of rna have functions related to making proteins. rna is also the genetic material of some viruses instead of dna. rna can be made in the laboratory and used in research studies. also called ribonucleic acid. influenza is term used for flu illness. it is an infection caused by a virus that affects your mouth, nose, and throat. the study is seeking for participants who: * are at least 18 years of age * have not received an influenza vaccine within the last 6 months * are generally healthy this study will be divided into three sub-studies: substudy a (ssa), substudy b (ssb), and substudy c (ssc). all participants, regardless of sub-study, will receive 1 dose of either of the following vaccines as an injection into their arm: * 1 of the modrna influenza vaccines that is being studied; or * an approved influenza vaccine approved for use in their respective age group. participants will be involved in this study for about 6 months. during this time, participants will have at least 3 clinic visits.


Eligibility criteria:
key inclusion criteria applies to all 3 substudies: * participants ≥18 years of age. * generally healthy participants. substudy c only: - receipt of licensed influenza vaccination for the 2023-2024 flu season at least 6 months ago. key exclusion criteria all 3 substudies: * diagnosis of influenza (by clinical testing) in the last 6 months. * immunocompromised individuals with known or suspected immunodeficiency * receipt of any investigational or licensed influenza vaccines within 6 months.
the succeed trial of secondary stroke prevention

Conditions: Stroke; Secondary Stroke Prevention

Summary: the purpose of this study is to test a newly-developed outpatient clinic and community-based care intervention called succeed (secondary stroke prevention by uniting community and chronic care model teams early to end disparities) for improving control of stroke risk factors among stroke patients in the los angeles county "safety net", and to measure the costs of running such an intervention, relative to usual care.

individuals randomized to the intervention arm will receive care from a team that consists of a care manager(cm) who is either a nurse practitioner (np) or physician assistant (pa), supervised by the site pi, and a community health worker (chw). the cm will follow care protocols developed by the research team. the chw will serve as a liaison between the patient and the health care system, and mobilize resources and system support to reduce social isolation and improve stroke risk factor control self-management, through a series of workshops and home visits. intervention participants will receive home blood pressure monitors. subjects in either arm are eligible to receive their usual source of care. five hundred participants who have had a stroke or tia will be enrolled, randomized to the intervention or to usual care in a 1:1 ratio, and followed for 12 months. the impact of the intervention on systolic blood pressure is the primary study outcome; secondary outcomes are other stroke risk factors. enrollment will occur at four sites in los angeles county, and the study sample is projected to include over 90% socioeconomically disadvantaged individuals from minority groups.

Eligibility criteria:
inclusion criteria: * patients of los angeles county+university of southern california (lac-usc), rancho los amigos, olive view-university of california, los angeles (ucla), or harbor-ucla * transient ischemic attack (tia), ischemic stroke or hemorrhagic stroke within the prior 90 days * english, spanish, korean, mandarin or cantonese-speaking * 40 years of age or older * capable of giving informed consent (no proxies will be used to obtain consent) * systolic blood pressure is 130 mm hg or greater or systolic blood pressure is between 120 mm hg and 130 mm hg and there is diagnosed/treated hypertension prior to the stroke or tia exclusion criteria: * younger than 40 years * systolic blood pressure less than 120 mm hg or systolic blood pressure is between 120 mm hg and 130 mm hg and there is no known history of hypertension prior to the stroke or tia * speaks language other than english, spanish, korean, mandarin, and cantonese * inability to comprehend the study because of communication or cognitive impairments

Keywords: self-management chronic care model community health worker
ear acupressure for reducing anxiety and pain during heart surgery

Conditions: Elective Heart Surgery

Summary: acupuncture and acupressure, rooted in traditional chinese medicine, are used to treat a variety of symptoms. one specific and easy-to-apply method is ear acupuncture/acupressure following the nada protocol (developed by the national acupuncture detoxification association in 1985 in new york). this technique has been used successfully in germany since 1995. it is known for its balancing and stabilizing effects on both body and mind, helping to reduce symptoms such as anxiety and stress, and promoting relaxation and inner calm. open-heart surgery can be emotionally overwhelming for patients, often triggering intense existential fears. preoperative anxiety may worsen physical and psychological symptoms and negatively affect surgery outcomes. therefore, non-pharmacological interventions like acupuncture are gaining importance alongside medication. several studies have demonstrated the effectiveness of preoperative acupuncture in reducing pain, anxiety, and nausea across various surgeries. randomized trials show significant anxiety reduction through both body and ear acupuncture. one study found that ear acupuncture can rapidly improve psychological well-being, with effects noticeable within five minutes. this suggests its potential use not only the day before surgery but also immediately beforehand. in contrast, research on ear acupressure before heart surgery is limited. however, one study reported improvements in sleep quality and reduced anxiety. a recent review highlighted the positive effects of ear stimulation on stress, blood pressure, and heart rate, and even suggested that acupressure may be more effective than acupuncture.


Eligibility criteria:
inclusion criteria: * all adult patients who are capable of giving consent or willing to do so and who are undergoing elective heart surgery at the robert bosch krankenhaus study center are included. exclusion criteria: * under 18 years old * emergency or urgent surgery * patients who are incapable of giving consent or unwilling to do so * patients who have received acupuncture treatment (including nada ear acupuncture or acupressure) in the last three months
changes in the t-wave alternans in patients with heart failure treated wih sacubitril-valsartan

Conditions: Heart Failure

Summary: the aim of this study is to know if the sacubitril-valsartan treatment improves the t-wave alternans in those patients that begin its treatment, which would indirectly show a lower risk of malignant ventricular arrythmias.

sacubitril-valsartan has shown to reduce sudden death in its principal clinical trial, paradigm-hf. a t wave alternans (twa) is an electrophysiological phenomenon that acts as an independent predictor of sudden death and ventricular arrhythmias in postinfarct myocardial. twa is measured by using a special software and electrodes during a treadmill test, that analyse small changes in the microvolt of the t wave consecutive with a complex algorithm in three dimensions. the twa could be negative (normal), positive (pathological) or indeterminate. if a twa is pathological it reflects an electric instability in depolarization. our hypothesis is that the treatment with sacubitril-valsartan in heart failure patients with reduced ejection fraction, could improved the twa.

Eligibility criteria:
inclusion criteria: * adults from 18 to 80 years old. * patients with grade ii heart failure according to the new york heart association (nyha). * left systolic disfunction: left ventricle ejection fraction\<40% * nt-probnp \> 600 pg/ml (or \> 100 pg/ml in the case the patients has been hospitalised during the last year. * treated with ace or ara ii+betablocker at stable doses during the prior 4 weeks to the beginning of the study. exclusion criteria: * previously treated with sacubitril-valsartan. * allergy or intolerance to ara ii. * systolic blood pressure \< 100 mmhg at inclusion. * glomerular filtration \<35 ml / min / 1.73 m2 of body surface. * level of potassium \> 5,4 meq/l. * impossibility to walk on a treadmill. * record of recovered sudden death or documented ventricular tachycardia. * carrier of an automatic implantable defibrillator.

Keywords: heart failure sacubitril-valsartan t-wave changes alternans
airsense 10 ahi validation study

Conditions: Sleep Apnea

Summary: the airsense 10 platform is able to detect respiratory events at night and report these data via telemonitoring. the accuracy of the airsense 10 will be compared with scoring with polysomnography (psg). 100 patients will be observed in a sleep facility under psg and airsense treatment.

sleep disordered breathing is commonly assessed by calculating an apnea-hypopnea-index ahi and a hypopnea-index hi to define how frequent breathing or breathing efforts stop during the night. the severity of sleep apnea (sa) is determined by the number of occurring apneas and hypopneas. the respiratory disturbance index (rdi) captures these events and is calculated comprising an ahi but also reras via the flow signal. polysomnography (psg) is being used in the sleep laboratory as the gold standard method to document a patient's sleep behavior by tracking air flow, respiratory effort, blood oxygen and electrocardiac as well as electromyographic signals. this way a comprehensive sleep pattern analysis can be created and different forms of sa can be detected. however, the method is laborious and cost-intensive, so it could save time and costs to have events accurately scored by the device itself. device data become important when tracking a patient's sleep night by night and not only once. reliable sleep data can be a valuable tool for tailoring sleep therapy to specific patient's needs. accurate device data also build the foundation for analysis of large amounts of data, which can help us understanding how sleep disorders develop.

Eligibility criteria:
inclusion criteria: 1. patients aged ≥18 years who are able to understand and follow the instructions of the study personnel 2. patients with an indication for pap therapy or currently adherent to pap therapy (device usage ≥4 h/ night) for moderate to severe sleep apnoea and diagnostic ahi ˃15/h and/or a residual cai ˃5/h 3. patients with currently titrated fixed cpap pressure ≥8 cmh2o; or 95th percentile apap pressure ≥8 cmh2o; or asv therapy with a 95th percentile ipap of ≥8 cmh2o 4. patients who are established pap users (pap use duration ≥6 weeks) 5. dated and signed written informed consent exclusion criteria: 1. patients with moderate to severe obstructive airway disease and/or respiratory insufficiency 2. patients with heart failure in nyha class iii or iv, unstable hypertension, paroxysmal/persistent atrial fibrillation, unstable angina pectoris, cardiac or cerebral ischemic events within the last 6 months before screening 3. patients with current primary or secondary insomnia 4. patients who are pregnant or breastfeeding 5. patients who are physically unable to comply with the protocol
home-based longitudinal investigation of the multidisciplinary team integrated care

Conditions: Health Care Utilization; Caregiver Burnout

Summary: some research found the effectiveness of implementation of home health care on patients' physical function, quality of life (qol) and decreased the risk of hospitalization and medical costs. however, little was known about the longitudinal change of comprehensive assessments of physical and mental health, qol, well-being, and medical resource utilization of patients receiving home health care and their caregivers. furthermore, the evaluation of advance care planning, palliative care need, and the quality of dying and death were also insufficient among the aforementioned population. therefore, this cohort study aims to investigate the longitudinal change of health-related outcomes and utilization of resource utilization, and explore their trajectories in two years for patients who receive home health care and their caregivers in taiwan.

this is a prospective longitudinal cohort study in taiwan. data will be collected by trained interviewers at the baseline (t0), 3-month follow-up (t1), 6-month follow-up (t2), 12-month follow-up (t3), 18-month follow-up (t4), and 24-month follow-up (t5). via home visits, interviewer-administered questionnaires (informed consent, contact/follow-up information, background information, health condition, physical functioning, cognitive function, etc.) will be used. it estimates that the home visit will take up to 2 hours. the investigators will recruit at least 1200 eligible patients and caregivers (600 dyads) from at least 15 institutions (e.g., home clinics and hospitals) which provide home health care. trained research assistants will touch based with eligible participants recommended by institution staff and invite them to take part in the study. to ensure the study are achieving the target sample the investigators will examine the distribution of living area and number of participants in each type of home health care unit during recruiting. moreover, the investigators have estimated an attrition rate of 20% over the study. higher drop-off rates in certain sub-groups may be problematic, so the investigators will monitor participants' attrition. in addition, the cohort the investigators enrolled will be linked to their data in taiwan's national health insurance research database to analyze the medical resource utilization of participants in our study. the results will show the health status and resource utilization as well as quality of home health care in taiwan for clinical practices, research and future policy making.

Eligibility criteria:
inclusion criteria: * aged 20 years or older * receiving home health care services at least two months * either the patient or caregiver can express clearly exclusion criteria: * reject to sign the informed consent * both the patient and caregiver cannot complete the interview * both the patient and caregiver cannot communicate with an interviewer in a familiar language

Keywords: home health care super-aged society
laser acupuncture for traumatic facial paralysis

Conditions: Traumatic Facial Paralysis

Summary: objective: the objective of this study was to determine whether laser acupuncture therapy could relieve symptoms in patients with traumatic facial paralysis. methods: this study was retrospective study including 174 patients that undergoing traumatic facial paralysis. all the patients received laser acupuncture (la). patients were assigned to the la 1 month group, la 3 month group and la 6 month group, with 58 patients in each group. clinical outcome measure comprised the house-brackmann grading system, facial clinimetric evaluation scale (face), sunnybrook facial grading scale (sbfg), facial disability index (fdi), electroneuronography (enog), electromyography (emg) and blink reflex


Eligibility criteria:
inclusion criteria: * 1, patients diagnosed with traumatic facial paralysis 2, patients were eligible if they were graded at house-brackmann grade (hb) 3 or higher. exclusion criteria: - 1.serious mental illness or social problems, and neurological disorders, and systemic diseases, such as malignant tumors, and other serious consumptive diseases. 2. planning for pregnancy, those in pregnancy, or those who were lactating. 3. neurotmesis by trauma.

Keywords: traumatic facial paralysis laser acupuncture photobiomodulation retrospective study