Kornimate/medical-research-clean huggingface dataset:
musculoskeletal ultrasound with elastography in the evaluation of muscle state in rheumatoid arthritis patients

Conditions: Rheumatoid Arthritis; Musculoskeletal Ultrasound

Summary: evaluation of muscle state in rheumatoid arthritis patients. application of elastography in the detection of muscle stiffness in rheumatoid arthritis

rheumatoid arthritis is a chronic debilitating disease. muscle weakness is a common symptom in patients with rheumatoid arthritis (ra). from a metabolic perspective, muscle mass is determined by the balance between protein synthesis and degradation. people with ra note tenderness, stiffness, and pain in affected muscles. in ra, chronic inflammation is a primary driver of muscle weakness. persistent synovitis leads to the release of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (tnf-α) and interleukin-6 (il-6), which contribute to muscle atrophy and dysfunction. joint damage and pain further limit physical activity, exacerbating muscle wasting through disuse atrophy. additionally, the systemic inflammation associated with ra can lead to metabolic disturbances, including insulin resistance, which negatively impacts muscle protein synthesis and overall muscle health. ra can cause a 25% to 70% reduction in muscular strength, typically caused by decreased skeletal muscle mass, ,reduced muscle strength is usually considered to be a result of decreased muscle mass due to disuse atrophy. rheumatoid cachexia, a term used in ra, is defined as a loss of skeletal muscle mass and with no, or little weight loss in fat mass muscle weakness not only reduces the quality of life for the affected patients, but since patients\&#39; ability to work decreases it will also dramatically increase the burden on society (e.g. increased costs for long-term sick leave). thus, ra severely affects both the individual and the society given the complexity of muscle affection in ra , accurate assessment is essential for effective management. conventional clinical methods, such as manual muscle testing and grip strength measurements, provide limited information on the underlying causes of muscle weakness. advanced imaging techniques, such as conventional ultrasound (us) and shear wave elastography (swe), offer a more comprehensive evaluation by providing detailed information on muscle morphology and stiffness.

Eligibility criteria:
inclusion criteria: * age 18:70 years * ra patients with positive rf and anti ccp exclusion criteria: * history of injury or operation of the lower limb and upper limbs . * history or clinical signs of neuromuscular disorders. * patients on drugs causing myopathy or myositis * history of chronic diseases : kidney and liver disease * diabetic patients .

Keywords: muscle state
a prospective study of post-operative opioid use in general surgery patients

Conditions: Pain

Summary: patients undergoing approximately 10 common outpatient general surgical operations will be given a narcotic prescription for a specified number of pills. inpatients who are about to be discharged after surgery or trauma will be given narcotic prescriptions for a specified number of pills. patients will be given a patient report form which they will use to record the number of pills they take each day and their daily pain score on a scale of 0-10.


Eligibility criteria:
inclusion criteria: * \>= 18 years of age * undergoing one of 9 elective outpatient operations: partial mastectomy, partial mastectomy and sentinel node biopsy, melanoma wide excision and sentinel node excision, thyroidectomy, parathyroidectomy, open inguinal hernia repair, laparoscopic inguinal hernia repair, laparoscopic cholecystectomy or * an inpatient on the general surgery service who took at least one oral narcotic exclusion criteria: * allergic to all narcotics * chronic opioid use * history of opioid or benzodiazepine abuse

Keywords: post-operative pain
smart ankle-foot orthosis to improve stroke outcomes: smart afo

Conditions: Stroke

Summary: the smart ankle-foot orthosis (smart afo) system is an investigational system that combines a diagnostic ankle-foot orthosis with a mobile application to assist clinicians in optimizing an afo user's gait by adjusting afo stiffness and range of motion settings, and quantifying functional walking improvements in post-stroke individuals. the purpose of the clinical testing is to evaluate the smart afo system with its target users: post-stroke afo users and orthotists. this may include, but is not limited to, identifying any aspects of the smart afo system that could be improved through clinical testing and evaluating the gait of post-stroke afo users walking with an afo adjusted using the smart afo system.


Eligibility criteria:
inclusion criteria: * age 18 years or older * mass less than 90 kg (200 lbs) * at least six months post-stroke * hemiplegia or hemiparesis as a result of stroke * foot drop during swing phase (often identified by a toe catch), on at least one side * current user of an afo * current user of an afo with a triple action joint is acceptable * has bilateral passive ankle range of motion within normal limits * able to walk safely on level ground for at least 100 feet without rest * able to communicate individual perceptions in the english language * able to provide written informed consent * participants that will use a treadmill during data collection must also be able to walk independently and safely on an instrumented treadmill exclusion criteria: * confounding injury, musculoskeletal issues, or cognitive issues that limit effective participation * pregnancy * not able to read and understand english * use of assistive device that requires bilateral upper extremities

Keywords: ankle-foot orthosis orthotist
fecal microbiota transplant (fmt) plus fidaxomicin for severe or fulminant clostridium difficile infection

Conditions: Clostridium Difficile

Summary: fecal microbiota transplantation (fmt) has been very effective for patients who suffer from mild c diff infection (cdi) which recurs but it is unclear how effective fmt alone is in treating severe and fulminant cdi. current evidence suggests that fmt in combination with vancomycin is required, and that multiple treatments are necessary. the investigators think fidaxomicin may be a better option in the context and may potentially reduce the number of fmt required. however, fidaxomicin has never been used to treat severe or fulminant cdi. in this pilot study, the investigators plan to use a combination of fmt plus fidaxomicin to determine efficacy and safety in treating patients with severe or fulminant cdi. the investigators want to see if this approach may reduce the number of fmt treatment required, and/or the length of hospital stay.

in this prospective, open -label, multi--center feasibility study, the investigators aim to determine the efficacy and safety of using combined serial fmt by enema plus fidaxomicin to treat patients who have severe or fulminant cdi not responding to maximal medical therapy. the hypothesis is the combination of fmt plus fidaxomicin can reduce the number of fmt required and/or hospital length of stay compared to fmt plus vancomycin. participants will receive fmt by enemas over 3 days which constitutes a single cycle with concurrent treatment with oral fidaxomicin. if participants do not show improvement biochemically or clinically, then a repeat fmt cycle will be administered to a maximum of 4 cycles.

Eligibility criteria:
inclusion criteria: * age \> 18 years with severe1 or fulminant2 cdi, without an adequate response to metronidazole iv 500 mg q8h and vancomycin 500 mg po q6h for at least 2 days or after fecal microbiota transplant (fmt). an adequate response is defined as a decrease in stool frequency or inflammatory markers (wbc or c reactive protein) by 10% over 48 hours * those with ability to provide informed consent or an alternative decision maker providing assent exclusion criteria: * those with bowel perforation * those taking chemotherapy or radiation treatment with absolute neutrophil count of \< 1000 cells/mm3 * those with known colonic strictures * those with subtotal colectomy or planning to have a colectomy * those with significant ileus

Keywords: fecal microbiota transplantation fidaxomicin
early anti-retroviral treatment in hiv- infected children

Conditions: HIV Infections

Summary: earth study is conducted as part of the epiical project. it is a prospective cohort study which aims to monitor clinical, virological and immunological features of hiv-positive, early treated children (≤90 days after diagnosis), in order to identify participants with excellent viral and immunological control, and also other without excellent control, in order to stratify potential participants in proof-of-concept trials directed to hiv cure.

the duration of the study is 4 years from the start of enrollment with at least 4 years of follow-up for each participant. the study is conducted in south africa, mali, and mozambique with an expected enrollment target of 200 participants (as a minimum). in this study, newly diagnosed hiv-infected children will start art as early as possible, following local standards of care, and will be followed up to 4 years of age. clinical and blood data for viral load, immunology, and serology will be collected at the 11 visits. hiv reservoir size and hiv-specific immune responses will be analyzed at visit 1 and at 1, 2, 3, and 4 years after enrollment. we will identify children with hiv infection eligible to participate in proof-of-concept treatment/remission studies. a predictive model developed from european participant data will help identify children with low reservoir. these predictions will then be compared with available data from participants already enrolled with an excellent control to refine the model.

Eligibility criteria:
inclusion criteria: 1. perinatally infected infants who start art at ≤90 days after diagnosis (hiv infection diagnosed and confirmed by molecular methods in 2 different samples, i.e., positive qualitative hiv dna/rna test). 2. breastfed-infected children found to be infected ≤ 90 days of age and who started art at \< 90 days after diagnosis. this group will be younger than six months of age at art initiation. 3. caregivers (mother, if alive and available) able to provide informed consent. 4. able to take art. exclusion criteria: 1. second and successive rna pcr negative 2. malignancy 3. current concomitant immunosuppressive therapy (including\>15 days and \>2 mg/kg/day of prednisone-equivalent). 4. caregivers withdraw consent 5. age \>180 days.

Keywords: hiv infection infants antiretroviral therapy
energy balance for prostate cancer survivorship

Conditions: Prostate Cancer

Summary: the purpose of this study is to evaluate the effectiveness of a weight management program for men undergoing a prostatectomy by seeing if the program is easy to follow, impacts weight gain, and reduces risk of cancer recurrence in the participants.

the weight management program is designed to help participants lose weight before their prostatectomy and to help them maintain that weight loss after surgery. there are four main components to the weight management program. the four components of the program are: 1. diet 2. physical activity 3. coaching 4. diet and exercise monitoring tool the program will be tailored to each individual participant. all participants will be ask to monitor their program using a tool provided by the study team. participants will be actively participating in the study activities for about 5 months. after that, the study team will review medical records for up to 10 years after enrollment to monitor weight changes and cancer status.

Eligibility criteria:
inclusion criteria: * men newly diagnosed with prostate cancer who are scheduled for prostatectomy (stage t1 or t2) * body mass index (bmi) 25-45 kg/m2 * have internet access * have an ipad/iphone/idevice exclusion criteria: * history of 5 alpha reductase inhibitors prior 3 months * history of radiation therapy * taking active cancer treatment * undergoing salvage therapy * castration-resistant prostate cancer * evidence of metastasis * evidence of biochemical recurrence * high risk medical condition (e.g. gout or kidney disease)

Keywords: prostate cancer prostatectomy weight loss prevent weight gain
brief integrative therapy for post-traumatic stress disorder

Conditions: Stress Disorders, Post-Traumatic

Summary: the purpose of this study is to refine brief integrative therapy (bit) and to evaluate its effectiveness in treating women with post-traumatic stress disorder (ptsd) following childhood sexual abuse. this study will also promote the development of skills that are necessary for increasing quality of life and improving self-esteem.

bit integrates interpersonal, problem solving, affect regulation, and psychoeducational components. in this study, bit is used to encourage women to focus on current issues and problems. the bit therapist will help patients identify the impact of ptsd on their functioning, help them identify effective coping strategies for dealing with trauma-related distress, and encourage them to establish and maintain a certain degree of independence from the therapist. patients receive 15 weekly sessions of bit. assessments occur pre-treatment, post-treatment, and at a 3-month follow-up, and include self-report measures, clinician administered ptsd scale questions, interviews, and evaluations of lifetime stressors.

Eligibility criteria:
inclusion criteria: * post-traumatic stress disorder (ptsd) diagnosis * childhood sexual abuse, defined as any sexual contact before the age of 16 with someone 5 or more years older * at least 1 clear, detailed memory of sexual abuse exclusion criteria: * substance abuse or dependence * psychotic disorder, bipolar disorder, or dissociative disorder * 2 or more suicidal or parasuicidal acts in the past year * domestic violence involvement * pregnancy or attempting to become pregnant

Keywords: child abuse, sexual
gram type infection-specific sepsis identification using machine learning

Conditions: Sepsis; Severe Sepsis; Septic Shock

Summary: the focus of this study will be to conduct a prospective, randomized controlled trial (rct) at cape regional medical center (crmc), oroville hospital (oh), and ucsf medical center (ucsf) in which a gram type infection-specific algorithm will be applied to ehr data for the detection of severe sepsis. for patients determined to have a high risk of severe sepsis, the algorithm will generate automated voice, telephone notification to nursing staff at crmc, oh, and ucsf. the algorithm's performance will be measured by analysis of the primary endpoint, time to antibiotic administration. the secondary endpoint will be reduction in the administration of unnecessary antibiotics, which includes reductions in secondary antibiotics and reductions in total time on antibiotics.


Eligibility criteria:
inclusion criteria: * all adults above age 18 who are a member of one of the three subpopulations studied in this trial (patients with gram-positive infection, patients with gram-negative infection, and patients with mixed gram-positive and gram-negative infection) are eligible to participate in the study. exclusion criteria: * under age 18 * no record of gram infection

Keywords: dascena gram infection antibiotic administration machine learning algorithm diagnostic
comparing mri to ct on pediatric craniosynostosis.

Conditions: Craniosynostosis

Summary: the purpose of this study is to develop and test the effectiveness and diagnostic quality of zero echo time magnetic resonance imaging (zte mri) in comparison to ct.


Eligibility criteria:
inclusion criteria: * pediatric patients 0-18 of age will be recruited by our surgical colleagues based on the clinical concern for craniosynostosis and possible need for calvarial reconstruction. exclusion criteria: * lack of consent * contraindication/inability to undergo both examinations within the designated time period and/or undiagnostic image quality.
study of 18f-dcfpyl pet/ct imaging in patients with suspected recurrence of prostate cancer

Conditions: Prostate Cancer; Prostate Adenocarcinoma; Prostate Cancer Recurrent; Prostate Cancer Metastatic

Summary: this study evaluates the diagnostic performance and safety of 18f-dcfpyl (pyl) pet/ct imaging in patients with suspected recurrence of prostate cancer who have negative or equivocal findings on conventional imaging.


Eligibility criteria:
inclusion criteria: * male \>/= 18 years of age * histopathologically confirmed prostate adenocarcinoma per original diagnosis, with subsequent definitive therapy * suspected recurrence of prostate cancer based on rising psa after definitive therapy on the basis of: 1. post-radical prostatectomy: detectable or rising psa that is ≥ 0.2 ng/ml with a confirmatory psa ≥ 0.2 ng/ml (american urological association \[aua\]); or 2. post-radiation therapy, cryotherapy, or brachytherapy: increase in psa level that is elevated by ≥ 2 ng/ml above the nadir (american society for therapeutic radiology and oncology \[astro\]-phoenix) * negative or equivocal findings for prostate cancer on conventional imaging performed as part of standard of care workup within 60 days prior to day 1 * life expectancy ≥6 months as determined by the investigator * able and willing to provide informed consent and comply with protocol requirements exclusion criteria: * subjects administered any high energy (\>300 kev) gamma-emitting radioisotope within five (5) physical half-lives prior to day 1 * ongoing treatment with any systemic therapy (e.g. adt, antiandrogen, gnrh, lhrh agonist or antagonist) for prostate cancer * treatment with adt in the past 3 months of day 1 * receipt of investigational therapy for prostate cancer within 60 days of day 1 * subjects with any medical condition or other circumstances that, in the opinion of the investigator, compromise the safety or compliance of the subject to produce reliable data or completing the study

Keywords: positron emission tomography biochemical recurrence rising psa pet/ct diagnostic imaging psma radical prostatectomy bcr
biomodulating rotator cuff healing - a proof of concept trial

Conditions: Rotator Cuff Tears

Summary: novel concepts in quantum biology of rotator cuff repair and author's novel findings on biomodulation inspired us to design a pragmatic non-pharmacological add-on rehabilitation protocol that may potentially decrease retear rates after arthroscopic repair using a knotted suturebridge technique. in this proof-of-concept trial, 146 patients will be randomized 1:1 to either a 6-weeks post-operative cryo-, photo- and electro-biomodulation protocol or a control group immobilized in a standard abduction sling for 6 weeks. healing will be evaluated using the sugaya classification on mri at 1 year post-operatively.


Eligibility criteria:
inclusion criteria * patient is over 18 years old * patient presents with a symptomatic full-thickness tear as diagnosed preoperatively on ultrasound, arthro-ct or mri. * absence of significant muscle atrophy or fatty infiltration of the affected tendon exceeding stage 2 of the goutallier classification exclusion criteria * partial rotator cuff tear or other shoulder injury * planned concomitant procedures other than subacromial decompression, acromioclavicular joint resection or biceps tenodesis/tenotomy * irreparable rotator cuff tear * patients who present with cartilage lesions greater than stage ii of the outerbridge classification (≥15mm diameter) on preoperative x-ray * patient presenting with a known comorbidity that could affect the outcome of surgery (cervical radiculopathy, polyarthritis, neurological disease of the upper limb) * patient not able to give informed consent
trial of nivolumab with folfox after chemoradiation in rectal cancer patients

Conditions: Rectal Cancer

Summary: this is a phase ii, prospective, open label, one-center study for evaluation of the addition of nivolumab to the chemotherapy phase of the neoadjuvant treatment for locally advanced rectal cancer patients. subjects must have received no prior treatment for rectal cancer (chemotherapy, radiotherapy or surgery) and no prior treatment with checkpoint inhibitors. eligible subjects will receive chemoradiation for a period of 5 weeks, 6 cycles of chemo-immunotherapy (mfolfox6 + nivolumab) for a period of 12 weeks, once every 2 weeks, and will undergo surgery after 4 weeks.


Eligibility criteria:
inclusion criteria: * signed written irb approved informed consent * age ≥ 18 years * ecog ps 0-1 * subjects with histologically confirmed primary (non-recurrent) locally advanced rectal adenocarcinoma * stage t3-4 n0 or tx n+ according to baseline rectal eus and pet-ct * patients who are planned for neoadjuvant chemoradiation and are surgical candidates * no prior chemotherapy, radiotherapy or surgery for rectal cancer * no prior radiotherapy to the pelvis, for any reason * presence of adequate contraception in fertile patients * women of childbearing potential must have a negative serum or urine pregnancy test within 24 hours prior to the start of study drug * women must not be breastfeeding * ability to swallow tablets * no previous (within the last 5 years) or concurrent malignancies, with the exception of adequately treated cone-biopsied in situ carcinoma of the cervix or basal cell carcinoma of the skin exclusion criteria: * active autoimmune disease. \[subjects with type i diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll\] * prior treatment with an anti-pd-1, anti-pd-l1, anti-pd-l2, anti-cd137, or anti-ctla-4 antibody, or any other antibody or drug specifically targeting t-cell co-stimulation or checkpoint pathways * known history of positive test for human immunodeficiency virus (hiv) or known acquired immunodeficiency syndrome (aids) * pregnancy or breastfeeding

Keywords: nivolumab chemoradiation mfolfox6 rectal cancer anti-pd-1 antibody