Kornimate/medical-research-clean huggingface dataset:
stem cells therapy for fecal incontinence in children after posterior sagittal ano-rectoplasty

Conditions: Fecal Incontinence

Summary: the problem of the incontinence imposes considerable strain on the child and their parents. these patients suffer from a long-life handicap and they need support and follow-up. the cost associated with these diseases has clearly been illustrated to be a major component in the healthcare spending picture, may be adding hundreds of thousands of dollars to healthcare cost, as well as loss of productivity in the work force. fecal incontinence treatment has been a difficult challenge for surgeons for several generations until now the current traditional surgical result is unsatisfactory. mesenchymal stem cells injection may represent a new attractive treatment option for anal sphincter lesions. moreover, experimental injury of muscle of anal sphincter in rats has been successfully treated with stem cells injections. in this study, the investigators will shed more light on the ability of mesenchymal stem cells to induce myogenesis and regenerate anal sphincter of patients with fecal incontinence. it will be very useful to many egyptian patients.

a stem cell is capable of forming various tissue under definite signals received from the body. stem cell research in animals has been an ongoing program in the west with fruitful results. current challenges with the use of stem cells in clinical practice will be solve the many unanswered queries. to study the potential therapeutic effects of local mesenchymal stem cell injection in children presenting with fecal incontinence (fi) after posterior sagittal ano-rectoplasty (psarp) operation for high imperforate anus. children whom suffering from fi after psarp for high imperforate anus will included in this study. autologous msc from the upper posterior iliac crest bone marrow sample will be extracted from patients under general anesthesia, in a suitable clean operation room. will be cultured and injected into the external anal sphincter defect using direct pena stimulator or ultra sound guidance. then followed up for 180 days post injection, to assess the ability of mesenchymal stem cells to induce myogenesis of the anal sphincter of patients with fi after psarp.

Eligibility criteria:
inclusion criteria: male childern ages: above 2 years old. patient with fi. after psarp repair of high imperforate anus. absence of parasitic and infective bacterial growth after stool analysis and stool culture. - exclusion criteria: any degree of spinal cord injury, systemic, neuronal paralysis or sacral agenesis. absence of muscle activity detected by emg. ano-rectal disorders such as tumors, fissures, anal or rectal prolapse, and rectocele. positive stool culture resistant to preoperative oral antibiotic therapy. previous injection of bulking agents at the level of sphincter. immunocompromise patient. previous adverse reaction to anesthesia.

Keywords: fecal incontinence posterior sagittal ano-rectoplasty mesenchymal stem cell
app-based diabetes management and community-based interventions

Conditions: Diabetes Mellitus Type 2

Summary: community-based health coaching interventions play a vital role in complementing the traditional chronic disease management model for type 2 diabetes patients. compared to conventional approaches that often focus on periodic clinical visits, community-based coaching could provide continuous, personalised support within patients in everyday environments. health coaches work directly with patients to set realistic goals, develop individualised action plans, and provide ongoing motivation and accountability. this personalised attention helps to improve self-management skills, such as medication adherence, dietary choices, and physical activity, which are crucial for chronic disease management and preventing complications. our mobile health app, empower+ has multiple logging features, gamified elements to help users set goals and provide rewards, educational resources, and personalised nudges generated based on real users; inputs and predictive modeling. it has demonstrated some preliminary effectiveness and acceptability within the clinical settings. this trial aims to assess its effectiveness, adoption, and sustainability in the less-controlled community settings, preparing for its large implementation in the future.


Eligibility criteria:
inclusion criteria: * aged 21 years and above * having been diagnosed with type 2 diabetes mellitus * having most recent hba1c ≥ 6.5% * physically able to exercise * able to read, write, and converse in english * able to comply with study procedures exclusion criteria: * requiring assistance with basic activities of daily living (badl) * have planned major operation or surgical procedure within 6 months from the time of recruitment * current pregnant or lactating
study of heat and intravenous fluids for exogenous rewarming

Conditions: Hypothermia

Summary: the purpose of this study is to compare two novel active rewarming techniques in mildly hypothermic people. volunteers will undergo 3 cooling trials in a circulating bath at 14 degrees celsius and will then be rewarmed with either shivering alone, warmed iv fluids (ivf), or water perfusion pads applied to the hands and feet. the investigators hypothesize that both heated ivf and water perfusion pads to the arteriovenous anastomoses (avas) will prove to provide significantly superior rewarming rates than shivering alone.


Eligibility criteria:
inclusion criteria: * any healthy male or female over 18 years of age exclusion criteria: * no heart/blood pressure/cholesterol medications. * no history of raynaud's disease or any other condition (including asthma) that could be aggravated by cold-water immersion

Keywords: arteriovenous anastomoses accidental hypothermia rewarming
effects of continuous airway pressure on the ability to heat and humidify air

Conditions: Healthy

Summary: we hypothesize that continuous positive pressure applied to the airway will decrease the ability of the nose to warm and humidify inspired air compared to zero or negative pressure. we will use continuous positive airway pressure (cpap), a device commonly used to treat patients with sleep apnea, to vary the pressure in the airway and determine if increased pressure decreases the ability to warm and humidify inspired air. if our hypothesis is correct, it may explain the reason why cpap is poorly tolerated in patients with sleep apnea; i.e., less ability to warm and humidify air leading to more nasal mucosal irritation.


Eligibility criteria:
inclusion criteria: 1. males and females between 18 and 55 years of age. 2. a clinical history suggestive of normal nose and upper airway, other than during a cold. 3. willingness of the subject to participate in and complete the study, and the ability to understand the purpose of the trial. exclusion criteria: 1. physical sign or symptoms suggestive of renal, hepatic or cardiovascular disease. 2. women of childbearing potential who are pregnant, trying to become pregnant or nursing a child. 3. subjects treated with systemic steroids during the previous 30 days. 4. subjects treated with topical (inhaled, intranasal or intraocular) steroids, nasalcrom or opticrom during the previous 15 days. 5. subjects treated with oral antihistamine/decongestants during the previous seven days. 6. subjects treated with topical (intranasal or intraocular) antihistamine/decongestants during the previous 3 days. 7. subjects treated with immunotherapy. 8. subjects on chronic anti-asthma medications. 9. subjects with polyps in the nose or a significantly displaced septum. 10. subjects who have incurred an upper respiratory tract infection within 14 days of the start of the study.

Keywords: cpap pressure of -5cm/water during cold, dry air exposure cpap pressure of 0cm/water during cold, dry air exposure cpap pressure of 5cm/water during cold, dry air exposure cpap pressure of 10cm/water during cold, dry air exposure
the learning curve of nbi with magnification in the diagnosis of colorectal lesions

Conditions: Colorectal Lesion

Summary: it exists a learning curve in using nbi with magnification to differentiating colorectal lesions.

it is very useful to use narrow-band imaging and sano cp analysis in the differential diagnosis of colorectal lesions. the endoscopists who had never used nbi or no knowledge of nbi can have effective and stable diagnostic accuracy after using nbi with magnification to diagnose 15 target and non-target lesions respectively.

Eligibility criteria:
inclusion criteria: * ages 16 to 85 * any patient undergoing nbi with magnification colonoscopy exam and found with colorectal lesions exclusion criteria: * unwilling to consent * had surgery of colorectal tumors * using nsaids * diagnosed or suspected ibd * familial adenomatous polyposis(fap) or hereditary non-polyposis colorectal(hnpcc) or other hereditary disease

Keywords: narrow band imaging learning curve colorectal differential diagnosis with colorectal lesion nbi with magnification
pharmacologic effects of darifenacin and tolterodine on cardiovascular parameters in healthy subjects

Conditions: Healthy

Summary: this study will evaluate the pharmacologic effects of exposure to darifenacin and tolterodine on cardiovascular parameters in healthy subjects 50 years of age and older


Eligibility criteria:
inclusion criteria: * healthy males and females ≥ 50 years * body mass index equal to or greater than 18.5 kg/m2 and less than 35.0 kg/m2 exclusion criteria: * known or suspected allergy to tolterodine er or darifenacin or their components * subjects with irregular day and night patterns such as night shift workers * significant medical problems know to affect heart rate (ie., hypertension, hypotension, history of heart failure, history of pulmonary disease, etc.) * medication with potential known to affect heart rate * history of any malignancy within the past 5 years, with the exception of localized basal cell carcinoma of the skin * pregnant or nursing women * subjects with diseases such as urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, severe renal insufficiency, etc. other protocol-defined inclusion/exclusion criteria may apply

Keywords: heart rate, overactive bladder
trunk extensor endurance training versus scapular mobilization in patient with thoracic kyphosis

Conditions: Thoracic Kyphosis

Summary: to compare the effect of trunk extensor endurance training and scapular mobilization on thoracic pain in patient with thoracic kyphosis. to compare the effect of trunk extensor endurance training and scapular mobilization on kyphotic angle in patient with thoracic kyphosis to compare the effect of trunk extensor endurance training and scapular mobilization on shoulder rom in patient with thoracic kyphosis


Eligibility criteria:
inclusion criteria: * both gender (male and female) * age 20-40 * postural kyphosis * kyphotic angle exceeds 40° * thoracic pain\>3 exclusion criteria: * thoracic, scapular and clavicle abnormalities * vertebral fractures, history of trauma or spinal surgery * history of prolonged use steroid (more than 6 months),rheumatologic conditions * cardiac, autoimmune diseases * structural kyphosis(x-ray findings) * scoliosis(x-ray findings) * cancer, neurological disorders, metastasis, or inflammatory * osteoporosis, pregnancy or any genetic conditions affecting their bones, muscles or cartilage.
healthy diet for healthy moms and babies

Conditions: Gestational Diabetes; Obesity; Pregnancy, High Risk

Summary: the purpose of this clinical study is to collect baseline information on dietary habits and metabolic risk factors, and to examine the effects of a dietary intervention focusing on fiber and antioxidant rich berries on the development of gestational diabetes, maternal glucose and lipid control and inflammation in obese pregnant women at risk of developing diabetes. with the ongoing epidemic of obesity, the prevalence of gestational diabetes is significantly increasing and the goal of this research is to identify optimal dietary strategies that can reverse this condition or control the rise in blood glucose among those with already developed diabetes.


Eligibility criteria:
inclusion criteria: * bmi \> or = 30, \<20 weeks gestation and singleton pregnancy with the following options: previous history of gestational diabetes and/or family history of diabetes exclusion criteria: * • twin or multiple pregnancy * chronic pre-pregnancy conditions (chd, cancer, diabetes) * gastrointestinal conditions * anemia * allergic to berries and fiber * vegetarian food habits or special diets * not proficient in english and/or unable to provide consent
antithymocyte globulin as a second line therapy in graves orbitopathy

Conditions: Graves Orbitopathy

Summary: the overall objective of the study is to evaluate the safety and efficacy of rabbit antithymocyte globulin in the treatment of graves orbitopathy (go) after ineffective treatment with moderate-to-high doses of glucocorticoids.

this is a prospective interventional, single-center study examining the safety and efficacy of rabbit antithymocyte globulin (ratg) in adult patients with active moderate-to-severe go after ineffective treatment with moderate-to-high doses of glucocorticoids. all enrolled participants will receive 0.8 - 1.0 mg/kg of ratg (cumulative dose of 150-200 mg given intravenously in two or three divided doses, 24 hours apart) after premedication with methylprednisolone i.v. (in total dose of 375 mg), 1 mg of antihistaminic agent clemastine and 1000 mg paracetamol i.v. in order to assess efficacy and safety of the treatment, patients will be evaluated at baseline and at 6, 12, 24 and 48 weeks. baseline and subsequent evaluation will involve medical history, physical examination, including detailed eye examination, laboratory assessment (thyroid-stimulating hormone \[tsh\], flow cytometry, tsh-receptor antibodies, cbc) and orbital magnetic resonance imaging (mri).

Eligibility criteria:
inclusion criteria: * clinical diagnosis of graves' disease associated with active thyroid eye disease and a clinical activity score of ≥ 3 * euthyroid or with mild hypo- or hyperthyroidism defined as free thyroxine (ft4) and free triiodothyronine (ft3) levels less than 50% above or below the normal limits * previous ineffective treatment (partial response, recurrence or progression of symptoms) with moderate-to-high doses of glucocorticoids (at least 4.5 g of methylprednisolone) exclusion criteria: * hypersensitivity to rabbit proteins or to any product excipients * active acute or chronic infections * latent tuberculosis * leucopenia below 3000/μl * lymphopenia below 400/μl * thrombocytopenia below 75000/μl * coagulation disorders * active malignancy and pregnancy

Keywords: graves disease proptosis antithymocyte globulin
outcome following vitamin c administration in sepsis

Conditions: Severe Sepsis

Summary: this study is designed to determine if vitamin c administration to septic patients will result in an improvement in organ dysfunction which occurs during a septic illness. hypothesis: 1. vitamin c in sepsis will reduce the injury to organs 2. vitamin c will reduce the length of time on a ventilator, length of stay in the intensive care unit and in hospital.

this study will measure biomarkers of inflammation, coagulation and oxidative stress. these biomarkers have been shown to be increased during periods of oxidative stress eg post-operative, trauma, sepsis. the investigators will determine if vitamin c administration decreases oxidative stress and as a result, a decrease in the markers of organ dysfunction eg sofa scores. ultimately, if the investigators show a decrease in injury to organs, will this result in a better outcome for patients.

Eligibility criteria:
inclusion criteria: * diagnosis of severe sepsis * admitted to the intensive care unit exclusion criteria: * allergy to vitamin c * history of kidney stones * glucose-6-phosphate dehydrogenase deficiency * history of iron overload/hemochromatosis

Keywords: severe sepsis
pre-sleep protein supplementation and load carriage recovery in british army recruits

Conditions: Protein-energy; Imbalance; Muscle Soreness

Summary: load carriage is a common military activity and has been shown to induce acute exercise-induced muscle damage (eimd) and impair muscle function. protein supplementation can accelerate muscle recovery by attenuating eimd and muscle function loss. this study investigated the impact of an additional daily bolus of protein prior to sleep throughout training on acute muscle recovery following a load carriage test in british army recruits. muscle function (maximal jump height), perceived muscle soreness and urinary markers of muscle damage were assessed before (pre), immediately post (post), 24-hours post (24h-post) and 40-hours post (40h-post) a load carriage test.

british army basic training (bt) is physically demanding with new recruits completing multiple bouts of physical activity each day with limited recovery. load carriage is one of the most physically demanding bt activities and has been shown to induce acute exercise-induced muscle damage (eimd) and impair muscle function. protein supplementation can accelerate muscle recovery by attenuating eimd and muscle function loss. this study investigated the impact of an additional daily bolus of protein prior to sleep throughout training on acute muscle recovery following a load carriage test in united kingdom (uk) british army recruits. a mixed group (men/women) over over 120 new recruits were randomised to dietary control (con), carbohydrate placebo (pla), moderate (20g; mod) or high (60g; high) protein supplementation. muscle function (maximal jump height), perceived muscle soreness and urinary markers of muscle damage were assessed before (pre), immediately post (post), 24-hours post (24h-post) and 40-hours post (40h-post) a load carriage test. the underlying aim of this study was to assess whether additional protein intake could attenuate aspects of muscle damage from an acute load carriage test including muscle function, muscle soreness and biomarkers of muscle damage during short term recovery.

Eligibility criteria:
inclusion criteria: * enrolled into british army basic training * medically fit to train and complete the load carriage test exclusion criteria: * not taking any other nutritional supplement * pregnant
a nomogram for evaluating significant liver fibrosis in patients with chronic hepatitis b virus infection

Conditions: Liver Fibrosis

Summary: liver fibrosis is the key step for progression to cirrhosis and liver cancer in patients with chronic hepatitis b (chb). it is crucial to identify significant liver fibrosis in the treatment of chb patients. hence, the investigators aim to construct and validate a new nomogram model for evaluating significant liver fibrosis in chb patients. the nomogram was based on a retrospective study of 259 chb patients, who underwent liver biopsy. through random grouping, 182 cases (70%) were included in the training set and 77 cases (30%) were included in the validation set. biopsy pathological stage was used as the gold standard to screen the factors included in the model. the receiver operating characteristic (roc), area under the roc curve (auc), calibration curve, and decision curve analysis were used to evaluate the diagnostic effect of this nomogram model. in addition, the investigators will compare the diagnostic efficiency of the new nomogram model with apri, fib-4, and gpr.


Eligibility criteria:
inclusion criteria: * meet the diagnostic standard presented in asian-pacific clinical practice guidelines on the management of hepatitis b. * hbsag-positive for over 6 months. * aged 18-65 years old. * no gender limitation. exclusion criteria: * co-infection with other types of hepatitis viruses, including types a, c, d, and e. * co-infection with human immunodeficiency virus (hiv). * autoimmune hepatitis (aih), primary biliary cholangitis (pbc), primary sclerosing cholangitis (psc), inherited metabolic liver disease, drug-induced liver injury (dili), alcoholic liver disease, and hepatocellular carcinoma (hcc). * with other malignant tumor and other major systemic diseases. * incomplete clinical data.
description of real world antiviral effectiveness and sustainability of the 2-drug regimen dolutegravir + lamivudine in untreated and pre-treated patients in routine clinical care in germany

Conditions: HIV Infections

Summary: this is a prospective, non-interventional, multi-center study, in subjects with clinical indication of human immunodeficiency virus (hiv)-1 infection. the aim of the study is to generate the real world evidence for the use of dtg+3tc in routine clinical care in germany to supplement data obtained from controlled clinical trials. approximately, 300 treatment naïve and pre-treated hiv-1 positive subjects will be enrolled in the study. the observation period for the study will be 3 years. data will be collected from routine clinical care via electronic data capture (edc) system.


Eligibility criteria:
inclusion criteria: * subjects with \>= 18 years of age. * subjects with documented hiv-1 infection. * prescription of dtg + 3tc was issued independently from entering this study. * subjects with the ability to understand informed consent form and other relevant regulatory documents. exclusion criteria: * any contraindication according to tivicay or lamivudine summaries of product characteristics (smpcs). * subjects with vl \> 500 c/ml. * any antiretroviral therapy for the treatment of hiv-1 in addition to dtg and 3tc or the dtg/3tc fixed dose combination (fdc). * subjects with hepatitis b virus (hbv)- coinfection. * subjects with current participation in the ongoing non-interventional study triumph (study number: 202033, nct number: nct02342769) or in any interventional clinical trial irrespective of indication. * subjects who had previously participated in clinical trials assessing dtg+ 3tc.

Keywords: dolutegravir two-drug regimen human immunodeficiency virus hiv symptom distress module lamivudine hiv treatment satisfaction questionnaire
determining when patients hospitalized with acute heart failure can be safely sent home (the decide study)

Conditions: Acute Heart Failure

Summary: the purpose of this study is to determine if certain findings (blood tests, symptom improvement, etc.) after acute heart failure treatment can identify a group of patients who are safe for early hospital discharge.

a fundamental question faced by physicians treating acute decompensated heart failure (adhf) is "when has treatment worked sufficiently for safe discharge, and who requires further treatment?" patients with adhf have a high incidence of morbidity and mortality. current guidelines for emergency department (ed) and hospital disposition of patients with adhf are based on limited empirical evidence. this creates clinical uncertainty regarding disposition leads to prolonged hospitalizations, higher costs and increased resource consumption. the specific aim of the study is to develop a prediction rule from readily available clinical data to help physicians identify adhf patients eligible for safe and early discharge from the ed and hospital after treatment is initiated.

Eligibility criteria:
inclusion criteria: * fulfill the modified framingham criteria * have baseline data available within 1 hour of initial ed therapy * have previously documented systolic dysfunction (ejection fraction less than 50%) by echocardiogram * willing and able to give informed consent the exclusion criteria are: * patients less than 18 years of age.