Kornimate/medical-research-clean huggingface dataset:
feasibility and effectiveness of concurrent exercise training on frail older adults living in nursing homes

Conditions: Frailty

Summary: the present study is a crossover randomized controlled trial that aims to investigate the effects of concurrent exercise training over usual care on physical performance, muscle strength, and myokines concentrations in frail older adults living in nursing homes.the main questions it aims to answer is: can a 12-week exercise intervention provide beneficial effects on physical performance, muscle strength and myokines among the most frail participants? researchers will compare this intervention to usual care. nursing homes (comprising participants) will be randomly assigned to a sequence of interventions (ab or ba), being a -exercise and b usual care. participants will be assessed before and after each intervention.

the present study is a crossover randomized controlled trial that aims to investigate the effectiveness of a concurrent exercise training over usual care on physical performance, muscle strength, and myokines concentrations in frail older adults living in nursing homes. nursing homes will be randomly assigned to receive a sequence of interventions (ab or ba), being a -exercise and b usual care. participants will receive a 12-weeks of either exercise intervention or usual care. a 4-week washout period will be conducted between interventions. participants will assessed before and after each intervention.

Eligibility criteria:
inclusion criteria: * classified as frail according to the fried criteria (e.g., frailty phenotype ≥ 3 criteria); * not having participated in any exercise intervention for the last 3 months; * being able to ambulate (with/without assistance). exclusion criteria: * any contraindication that could affect physical exercise performance or testing procedures, including terminal illness, uncontrolled disease or other unstable medical condition; * bone fracture in the past three months; * having a short physical performance battery score (sppb) \< 3.

Keywords: frail exercise concurrent training long-term care myokines
rct for sslf vs. isff with conventional surgical instruments in chinese apical prolapse female patients

Conditions: Apical Prolapse

Summary: this trial is designed to investigate the efficacy and safety of two native tissue repair procedure with conventional surgical instruments in chinese apical prolapse female patients (pop-q ii-iv) and compare the outcome in prolapse women randomized to sacrospinous ligament fixation (sslf) and ischial spinous fascia fixation (isff).

the population will include chinese female patients with advanced apical prolapse (stage ii-iii) and who are undergoing sacrospinous ligament fixation (sslf) and ischial spinous fascia fixation (isff) procedure using conventional surgical instruments without special instrument. after enrollment, standardized baseline data including demographics, popq evaluation, series of validated questionaires via interviews( pfdi-20, pfiq-7, pisq-12) will be collected by study personnel at the baseline visit. eligible consenting patients will proceed to randomizations with equal probability of assignment to sslf or isff. randomization to either sslf or isff will take place preoperatively by each clinical site using a random permutated block design. after index surgical intervention, scheduled follow-up will occur at 3, 6, 12, 24 and 36 months after the index surgery. at the follow-up visits, popq examination will be performed and an update of current medications, an assessment of new or continuing pelvic floor disorders, adverse events that occurred since the previous evaluation, and an assessment of health care costs. a series of validated instruments will be administered via interviews to including pfdi-20, pfiq-7, pisq-12, pgi-c.

Eligibility criteria:
inclusion criteria: 1. women with apical prolapse with pop-q ii-iv (but no anterior wall prolapse stage iv) 2. sslf or isff is proceeded as described before，while ancillary procedures like vaginal hysterectomy, anterior/posterior vaginal wall repair without mesh or mid-urethral suspension could be performed simultaneously. 3. women who have been eligible for long-term follow-up. 4. women who agreed to participate in the study and signed informed consent. exclusion criteria: 1. women who have surgical history for prolapse with mesh. 2. women who have contraindication for surgical procedure 3. women who are unable to comply with the study procedures
a study to compare the bioavailability intranasal administration of 200 and 400 µg or 400 µg alone of optinose™ fluticasone with 440 µg of flovent® hfa (fluticasone propionate) inhalation aerosol (part 2)

Conditions: Mild to Moderate Asthma

Summary: to compare the systemic exposure of a single dose of 400 µg of optinose fluticasone with 440 µg of flovent® hfa (fluticasone propionate) inhalation aerosol in asthmatic subjects.


Eligibility criteria:
inclusion criteria: 1. male or female subjects' ages 18 to 55 years, inclusive, at screening. 2. have a body mass index of 18 to 32 kg/m2, inclusive, and a body weight of not less than 52 kg for males and 45 kg for females. 3. otherwise healthy mild to moderate asthmatic (part 2) with no clinically relevant abnormalities in the opinion of the investigator as determined by medical history, physical examination, blood chemistry, hematology (including complete blood count), serology, urinalysis, vital signs, and ecg performed at screening. 4. history of mild to moderate asthma, diagnosed by a physician, which is well controlled at the present time (no history of sudden or severe asthma exacerbation in the past 12 months). 5. are unlikely to exacerbate during the study due to seasonal allergen exposure. 6. able to tolerate withdrawal of their medication for a required period of time. exclusion criteria: 1. currently have or have a history of disease or dysfunction of the cardiovascular, endocrine, hematologic, neurological, immune, gastrointestinal, genitourinary, musculoskeletal, or other body system that is clinically significant in the opinion of the investigator. 2. history of smoking or use of nicotine-containing substances within the previous 3 months before screening. 3. hypersensitivity to fluticasone propionate or any of the excipients found in optinosetm fluticasone or flovent® hfa (for part 2). 4. history of extensive nasal and/or sinus surgery. 5. known nasal obstruction including allergic rhinitis, nasal septal deviations, polyposis, severe mucosal swelling, nasal ulcers, nasal trauma or any other reason. 6. history of acute severe asthma attacks. 7. history of seasonal asthma exacerbation, in which case subjects should be outside the relevant allergen season. 8. have evidence of any chronic medical conditions other than asthma requiring prescription medications (e.g., hypertension or diabetes). 9. have used inhaled, intranasal, oral, or injectable corticosteroids within 4 weeks prior to dosing. subjects should be on stable treatment for at least 1 month prior to withdrawal.
cost-effectiveness of tele-expertise for premature infants for retinopathy

Conditions: Retinopathy of Prematurity

Summary: the purpose of this study is to determine whether telemedicine would be as effective as having a pediatrics ophthalmologist on site for screening examination of retinopathy in premature infants and would be cost-effective.


Eligibility criteria:
inclusion criteria: * born before 32 wa or having a birth weight under 1500g exclusion criteria: * brain malformations
programmed intermittent epidural bolus compared with continuous infusion in multiparous women

Conditions: Breakthrough Pain

Summary: the goal of this randomized controlled trial is to examine the impact of programmed intermittent bolus epidural analgesia technique on the incidence of breakthrough pain during labor in multiparous women compared to continuous epidural infusion. multiparous women will randomly be divided during labor into two groups; study group will receive mix of bupivacaine and fentanyl once (bolus) every 60 minutes; the control group will receive continuously the same dose during an hour, until delivery.

there are several pharmacological and non-pharmacological techniques for pain relief during labor. epidural analgesia is considered the most effective modality for intrapartum pain relief. maintenance of epidural analgesia is achieved by different techniques; continuous epidural infusion (cei), intermittent epidural analgesia (iea), patient control epidural analgesia (pcea) and combination between the techniques. another technique, the programmed intermittent bolus epidural analgesia (pibea). the advantage of this technique is that boluses are given all the time at planned intervals, so laboring women do not depend on the medical staff to receive the bolus when there is a breakthrough pain. this method has been reported to be associated with less motor block, lower incidence of instrumental vaginal deliveries, and less consumption of anesthetic agents when compared to cei. there are no conclusive data regarding the use of pibea in combination with pcea compared to cei and pcea on the effect of pain relief during labor and birth outcomes. the hypothesis of the current trial is that pibea and pcea will decrease the incidence of breakthrough pain, and probably shorten the second stage of labor, lead to fewer instrumental deliveries and higher women's satisfaction compared to cei and pcea.

Eligibility criteria:
inclusion criteria: 1. multiparous women 2. term pregnancy 3. singleton 4. vertex presentation 5. latent phase (cervical dilatation less than 6 cm) 6. epidural analgesia request 7. visual analogue scale score greater than 40 exclusion criteria: 1. estimated fetal weight greater than 4.0 kg 2. intra uterine fetal death 3. drug sensitivity 5. anomalous fetus 6. contraindication for epidural analgesia

Keywords: multipara term pregnancy singleton vertex presentation latent phase maternal request for epidural visual analogue scale > 4
mobilition with movement and soft tissue mobiiztion in tennis elbow

Conditions: Tennis Elbow

Summary: lateral epicondylitis or tennis elbow is one of the most common lesions of the arm. this injury is a major challenge, as it is difficult to treat, prone to recurrence and may last for several weeks or months, with an average duration of a typical episode which has been reported to be between six months to two years. this is an rct study. subjects who fulfilled inclusion criteria will be taken for the study. before conducting the actual method for subjects, lateral epicondylitis evaluation is done. first day before treatment, pain evaluation were done by using numeric pain rating scale. muscle power was assessed by mmt (manual muscle testing) and the function level are tested by patient-related tennis elbow evaluation (prtee) questionnaire and asked to mark the results. subjects will be divided into 2 groups randomly by lottery method. each group consists of 15 patients. group a will be given mwm; group b will be given soft tissue mobilization. both groups will be given with the above said methods for alternative days in a week as per 3 sessions per week for 4 weeks. at the end of program subjects will be reassessed by recording muscle strength, pain intensity and functional level. finally pre and post recordings will be compared and analyzed statistically.


Eligibility criteria:
inclusion criteria: * tennis players. * age group between 15-30 years. * positive specific tests.(cozen and mills test) * subjects having lateral epicondylitis pain for at least 4 weeks, muscle power for wrist muscle should be increase with activity against resistance, average pain level of 3-cm or more on a 10-cm numerical pain rating scale exclusion criteria: * any neurological disorder. * other elbow deformity or joint pathology. fracture of upper limb
uniportal vats resection for pulmonary aspergilloma : evaluation of prognostic factors in a single center experience

Conditions: Pulmonary Aspergillosis; Surgery-Complications; Thoracic Diseases

Summary: the objective of this study was to report our experience with u-vats resection and to evaluate our surgical outcomes with an analysis of postoperative complications. the investigators also estimate the prognostic factors that influence the morbidity and the conversion.

evaluation of prognostic factors tuberculosis hemoptysis type of aspergilloma presence of complete adherence procedure

Eligibility criteria:
inclusion criteria: - treatment using uniportal vats exclusion criteria: - resection using thoracotomy
spa therapy in the treatment of sleep apnea syndrome

Conditions: Obstructive Sleep Apnea Syndrome; Chronic Venous Insufficiency

Summary: the purpose of this study is to determine whether 3-week of spa therapy improves sleep apnea in patients with chronic venous insufficiency and concomitant obstructive sleep apnea syndrome (osas).

obstructive sleep apnea syndrome (osas), characterized by repetitive episodes of partial or complete upper airway (ua) obstruction, is highly prevalent in the general population (2% in women, 4% in men). osas is associated with hypersomnolence and it increases the risk of cardiovascular morbidity and mortality. its pathogenesis is largely multifactorial. in patients with chronic venous insufficiency, fluid retention contributes to this pathogenesis: during the day, fluid accumulates in the legs due to gravity ; during sleep in recumbent position, this accumulated fluid redistributes rostrally in the neck and causes upper airway narrowing and predisposes to osas. the hypothesis is that a comprehensive treatment program for chronic venous insufficiency (spa therapy) would reduce sleep apnea in patients with chronic venous insufficiency and concomitant sleep apnea syndrome. the objective is to assess the efficacy of a 3-week spa therapy on attenuation of sleep apnea in this population of patients.

Eligibility criteria:
inclusion criteria: * patient with chronic venous insufficiency with oedema (ceap clinical classes c3 to c5) and concomitant sleep apnea syndrome (ahi \> 15 events/hour) * patient in stable state (no change in medical treatment and no hospitalization for respiratory, cardiac or metabolic event in the 2 months preceding inclusion) * patient available for a program of 3-week spa therapy exclusion criteria: * patient with no social insurance * pregnant and nursing woman * patient detained by judicial order * patient with contra-indication to spa therapy * patient with chronic venous insufficiency \< ceap c3 or ceap c6 * patient already treated by class iv compression stockings for severe veinolymphatic insufficiency * patient already treated for sleep apnea * patient who have already benefited of spa therapy (any type) within 9 months before the enrollment * patient with severe comorbidities * patient who could not respect the constraints related to the study

Keywords: sleep apnea venous insufficiency spa treatment
investigating health impacts of exposure to harmful algal blooms

Conditions: Red Tide; Neurologic Disorder; Florida

Summary: the goals of this project are to study the biological effects of environmental toxins (et), in particular aquatic toxins such as brevetoxins (pbtx) and microcystin or their metabolites. this study is designed to examine the effects of the body from harmful algae blooms (hab) as well as possibility of an association between exposure to the marine toxin, brevetoxin (pbtx), which is released from k. brevis during the red tide bloom, and the prevalence of neurological illnesses.

exposure to environmental toxins present in local waters, such as brevetoxins released by karenia brevis (k. brevis) or microcystin produced by cyanobacteria, is known to cause skin and eye irritation, gastrointestinal and respiratory distress. the ingestion of high levels of brevetoxins from eating contaminated shellfish can result in neurotoxic shellfish poisoning (nsp), an acute gastroenteritis with accompanying neurologic symptoms. people are often exposed by direct skin contact with contaminated waters, drinking contaminated water, breathing in airborne droplets of the toxins, or eating contaminated shellfish. this condition usually resolves itself within 3 days as the brevetoxins are excreted from the body. aerosolized brevetoxins are also known to cause a reversible upper respiratory syndrome, characterized by coughing, sneezing, and feelings of irritation to the airways. once the exposure to the brevetoxin-laden air has ceased, symptoms usually go away within 15 minutes. the main objective of this study is to determine if exposure to marine or similar environmental toxins can adversely affect cns health, immune system, respiratory system and other biological processes which contribute to long-term cognitive dysfunction or illnesses in individuals exposed to these toxins. sponsor will be examining whether general health signs and symptoms that are reported are as associated with the exposure to harmful algal bloom toxins. known symptoms of exposure to harmful algae bloom/red tide /shellfish include the following: skin and eye irritation, gastrointestinal and respiratory distress, acute gastroenteritis with accompanying neurologic symptoms, respiratory distress, such as reversible upper respiratory syndrome with symptoms of coughing, sneezing, and feelings of irritation to the airways.

Eligibility criteria:
inclusion criteria: 1. subject should be able to provide written informed consent. 2. adult aged 18 or older. 3. resident (temporary or permanent) of one of the following five southwest florida counties (lee, collier, charlotte, sarasota, or manatee). 4. any race or ethnicity. 5. willing to return for at least a total of four study visits and participate in all required procedures for the duration of the study. exclusion criteria: 1. inability to speak or write in english. 2. any medical condition for which the study investigator believes enrollment is medically inappropriate. 3. unwilling/unable to provide biological samples or poor venous access.

Keywords: brain fog red tide respiratory coughing neurotoxin beach florida
risk of umbilical trocar-site hernia after silc cholecystectomy versus conventional cholecystectomy

Conditions: Cholecystolithiasis; Incisional Hernia

Summary: background laparoscopic cholecystectomy is a very common procedure. postoperative pain, especially around the umbilical port is dominating the first postoperative week. single incision laparoscopic cholecystectomy (silc) has been proposed to diminish postoperative incisional pain and improve cosmetic results, but results are not convincing and the risk of formation of an umbilical trocar-site hernia is not properly investigated. this study aimed to investigate the risk of umbilical trocar-site hernia formation after silc vs. conventional 4-port laparoscopic cholesystectomy. methods this is a cohort registry study with prospective questionnaire and clinical follow-up on 239 patients having a silc from 1/1 2009 to 1/6 2011 vs. 478 mathed patients having a conventional laparoscopic cholecystectomy (consecutively from one month before and after silc. they are matched for age, gender, date of operation, and surgeons skills (database from intraoperatively registered data). primary endpoint is umbilical trocar-site hernia formation (operation for a umbilical hernia or clinical hernia). the h0 hypothesis is that there is not difference between silc and conventional. exclusion criteria are: death, operation for acute cholecystitis. the included patients will be sent a questionnaire asking for operation for a hernia in the area, suspicion of a hernia, and perioperative data that we do not have in the database. futhermore those patients who suspect a hernia will be invited to aclinical exam by a medic to state the diagnosis. furthermore we patients are asked to report if they have chronic pain and/or discomfort.


Eligibility criteria:
inclusion criteria: * silc 1/1-2009-1/6-2011 and matched controls consecutively from the cholecystectomy-database having a lap. chol. one month before and one month after the silc group. exclusion criteria: * death in the follow-up time * an abdominal operation before la.chol/silc with midline incision * an abdominal operation after la.chol/silc with midline incision * primary operation for acute cholecystitis

Keywords: silc lap. cholecystectomy trocar-site hernia
effectiveness of anti-inflammatory drugs for preventing pain versus treating pain during medical abortion from 13 to 22 weeks at hung vuong hospital

Conditions: Pain Management; Anti-Inflammatory Agents, Non-Steroidal; Abortion, Spontaneous

Summary: the goal of this clinical trial is to assess the effectiveness of non-steroidal anti-inflammatory drugs (nsaids) for prophylactic pain relief compared to on-demand pain relief during medical abortion for pregnancies between 13 and 22 weeks at hung vuong hospital in ho chi minh city. the main questions it aims to answer are: 1. does prophylactic use of nsaids reduce pain compared to on-demand use during medical abortion? 2. what are the potential adverse effects of nsaids in this context? researchers will compare a group receiving prophylactic nsaids to a control group receiving on-demand pain relief to determine if the prophylactic approach leads to improved pain management outcomes. participants will: * be given nsaids either as a preventative measure or upon the onset of pain. * be monitored for pain levels using validated pain scales, any side effects, and outcomes of the abortion procedure.


Eligibility criteria:
inclusion criteria: * pregnant women aged 18 years or older. * no mental illness. * gestational age between 13 and 22 weeks (based on the last menstrual period with a regular menstrual cycle and accurate recall of the last menstrual period, or based on a first-trimester ultrasound) with an indication of stillbirth, fetal malformation requiring termination, or voluntary abortion with counseling and understanding of the abortion procedure. * willing to participate in the study. * capable of reading and signing the informed consent form. * able to provide personal information independently. exclusion criteria: * medical conditions contraindicating medical abortion: bleeding disorders, anticoagulant use, moderate to severe anemia. * cardiovascular conditions: heart failure, mitral valve stenosis, embolism, uncontrolled hypertension. * other medical conditions: renal failure, adrenal gland disorders, severe asthma, liver and biliary diseases, glaucoma. * active pelvic inflammatory disease or acute genital infections. * previous uterine surgery. * placenta previa or central placenta previa. * uterine malformations. * history of allergy to nsaids, mifepristone, or misoprostol. * unwillingness to participate in the study.