Kornimate/medical-research-clean huggingface dataset:
low or high botox dilution for the hemiplegic gait?

Conditions: Post Stroke Spastic Hemiplegia

Summary: there is debate regarding the efficiency of different dilutions of botulin toxin type a (btx-a) injections. some authors believe that highly diluted btx-a injections achieve greater neuromuscular blockade resulting in higher spasticity reduction. on the other hand, other researchers suggest that there is no difference in spasticity decrease if either high or low volume toxin is being injected. studies on this subject lack either the design or the power of study was low. therefore, there is no clear guideline for an optimal botulinum toxin dilution protocol. in an attempt to have a better understanding, a cross over study was designed. the material will be patients with spastic hemiparesis which will be treated with botulin toxin at different dilutions. gait analysis will be used for the evaluation of the botulin toxin injection on gait improvement. to the best of our knowledge such a trial hasn't been performed yet.

there is an ongoing controversy regarding the effect of different dilutions in the efficacy of botulin toxin type a (btx-a) injections. some authors believe that highly diluted btx-a injections achieve greater neuromuscular blockade resulting in higher spasticity reduction. they are arguing that btx-a in high dilution is the optimal choice especially when bigger muscles are injected, for the large volume of fluid administered into the muscle will carry the btx-a molecules to endplates remote from the injection site. two animal studies suggest that increasing the volume of diluents is a potential strategy in order to achieve a more efficient and cost-effective manner of btx-a treatment. an attempt to quantify how the location of btx-a injection affects the drug effect was made, which revealed that injecting only 0.5 cm away from the motor endplates yielded a 50% decrease in paralysis2. a newer double-blinded study by jm gracies et al performed on humans comes to the same conclusion, that high volume dilution provides greater neuromuscular block and spasticity reduction than a low volume dilution. on the other hand, other researchers suggest that there is no difference in spasticity decrease if either high or low volume toxin is being injected. previous studies lack either the design or the power of study was low. therefore, there is no clear guideline for an optimal botulinum toxin dilution protocol.

Eligibility criteria:
inclusion criteria: * equinovarus deformity * with an average 3 on ashworth spasticity scale * able to walk indoors either freely or with a cane. exclusion criteria: * patients suffering from any mental illness that would disturb the gait pattern * patients suffering from musculoskeletal diseases that overtly interfere with the gait

Keywords: stroke hemiplegia
the target bp off-med trial

Conditions: Hypertension; Hypertension,Essential

Summary: to obtain an assessment of the efficacy and safety of renal denervation by alcohol-mediated neurolysis using the peregrine kit in hypertensive subjects in the absence of antihypertensive medications.


Eligibility criteria:
inclusion criteria: 1. has 3 office blood pressure measurements with a mean office systolic blood pressure (sbp) of ≥140 mmhg and ≤180 mmhg, and a mean office diastolic blood pressure (dbp) of ≥90 mmhg. 2. subject is willing to discontinue any current antihypertensive medications during the run-in period and the post-treatment period. 3. has a mean 24-hour ambulatory sbp of ≥135 mmhg and ≤170 mmhg with ≥70% valid readings exclusion criteria: 1. subject has renal artery anatomy abnormalities. 2. subject has an estimated glomerular filtration rate (egfr) of ≤45 ml/min/1.73 m2, based on the chronic kidney disease epidemiology collaboration (ckd-epi) equation; or is on chronic renal replacement therapy. 3. subject has documented sleep apnea. 4. subject has any of the following conditions: severe cardiac valve stenosis, heart failure (new york heart association \[nyha\] class iii or iv), chronic atrial fibrillation, and known primary pulmonary hypertension (\>60 mmhg pulmonary artery or right ventricular systolic pressure). 5. subject is pregnant or lactating at the time of enrollment or planning to become pregnant during the trial time period (female subjects only). 6. subject is being treated chronically (e.g. daily use) with nsaids, immunosuppressive medications, or immunosuppressive doses of steroids. aspirin therapy and nasal pulmonary inhalants are allowed. 7. subject has a history of myocardial infarction, unstable angina pectoris, or stroke/tia within 6 months prior to the planned procedure.

Keywords: renal denervation neurolysis
tolerance and acceptability evaluation of stockholm

Conditions: Malnutrition

Summary: tolerance and acceptability of new oral nutritional supplement - stockholm.

to evaluate tolerance and acceptability of 'stockholm' in patients requiring supplementary oral nutritional support compared with currently available alternatives. to obtain data to support an acbs submissions for 'stockholm' (to allow for prescription in the community at nhs expense).

Eligibility criteria:
inclusion criteria: * patients who are able to communicate their views regarding acceptability. * patients established on an oral nutritional supplement, being prescribed ons providing approximately 300 kcal/day * patients expected to require oral nutritional supplementation for at least 2 further weeks. * informed consent obtained. exclusion criteria: * participation in any other studies involving investigational or marketed products concomitantly or within two weeks prior to entry into the study * patients requiring a milk free diet * patients with medical or dietary contraindication to any feed ingredients (see appendix 2 of protocol for full list) * patients with significant renal or hepatic impairment * patients with dysphagia requiring stage 1,2 or 3 thickened fluids * patients with uncontrolled inflammatory bowel disease or previous bowel resection with ongoing gastrointestinal symptoms.
effect of mindfulness on pain after total knee arthroplasty

Conditions: Total Knee Replacement; Post Operative Pain; Opioid Use

Summary: this study will be a prospective randomized controlled trial evaluating the effectiveness of using headspace before and after undergoing total knee replacement surgery. the purpose of this study will be to determine whether using headspace will help to improve functional outcome scores, decrease pain, and decrease opioid medication use after total knee replacement in patients with depression and/or anxiety. headspace is a smartphone-based application that guides individuals through various mindfulness sessions and has been shown to reduce symptoms of depression, anxiety, and pain.


Eligibility criteria:
inclusion criteria: * patients undergoing unilateral primary tka and * patients with mdd who take medication for mdd and/or patients with gad who take medication for gad * patients with mdd and/or patients with gad who are being treated for those conditions with psychotherapy by a psychologist or psychiatrist * patients with an sf-12 mental health score less than 45.6 * owning a smartphone (apple or android) to be able to download the mindfulness application exclusion criteria: * patients undergoing bilateral tka * patients undergoing revision tka * patients with mental health conditions other than mdd and/or gad * patients currently utilizing a mindfulness application
effects of nordic walking and exercise on glucose metabolism in type 2 diabetes mellitus: a randomized controlled trial

Conditions: Type 2 Diabetes; Exercise

Summary: the objective of this randomized controlled trial was to evaluate the effects of two different physical exercise programs aimed at long-term lifestyle changes in physical activity in patients with type 2 diabetes, with glucose metabolism evaluated by hba1c as the primary outcome.

physical training and exercise is considered a cornerstone in the treatment of type 2 diabetes mellitus. programs which include physical activity as a component in the treatment of type 2 diabetes as well as other chronic diseases have in denmark and other countries been based on "exercise on prescription schemes". in denmark, these schemes have focused on individual behavioral change and an exercise program for 16 weeks. no studies have documented whether "exercise on prescription" helps patients with type 2 diabetes to change their lifestyle behavior or whether it has a positive impact on measurements for physical capacity and glucose metabolism. nordic walking is a fitness type of walking; incorporating the use of specially designed walking sticks. nordic walking focuses on aerobic training where the additional activity of the arms increases a person's oxygen uptake and energy expenditure. in denmark, many activity programs and concepts such as exercise on prescription and nordic walking are recommended to patients with type 2 diabetes but their efficacy has not been demonstrated. it is unknown whether one specific type of physical training program is more suitable than another, when comparing the physical effects as well as the ability to induce good compliance and change in lifestyle. the aim of this randomized, controlled trial was to evaluate the effect of two different physical exercise programs lasting 4 months aiming at introducing long term life style changes in physical activity with a follow-up period of 8 months in patients with type 2 diabetes.

Eligibility criteria:
inclusion criteria: * type 2 diabetes for more than one year, * hba1c in the range of 7-10 %, * bmi \> 25 kg/m2, * age 25-80 years * stable antidiabetic treatment for at least 3 month before inclusion. exclusion criteria: * participants with symptomatic heart disease (nyha 2-4) * ischemia in lower extremities, * myocardial infarction within the previous 3 months * lung disease

Keywords: hba1c type 2 diabetes lifestyle changes exercise
chemotherapy and liver cirrhosis in frequently-associated cancers

Conditions: Cirrhosis; Neoplasms

Summary: cirrhosis and cancers of the upper digestive tract, colorectal and ent share common risk factors. liver cirrhosis can change the elimination of cancer drugs. precise data on management and outcome of patients with liver cirrhosis undergoing chemotherapy are lacking. most patients have been excluded from clinical trials evaluating conventional therapies. the study of tolerance, side effects, and outcome in patients with cirrhosis could help improve chemotherapy management for better tolerance and efficacy. the main objective is to estimate the frequency of liver cirrhosis among patients evaluated in cpr for ent, upper digestive or colorectal cancer. secondary objective includes the evaluation ofthe impact of cirrhosis on the management of chemotherapy by comparing cirrhotic patients' outcomes with a control group of matched non-cirrhotic patients.


Eligibility criteria:
inclusion criteria: * follow-up for the following cancers: upper digestive sphere (stomach, esophagus, pancreas, bile ducts), colorectal, ent * theoretical indication of conventional chemotherapy based on 5fu, anthracyclins, platinum salts, gemcitabin, taxans, irinotecan or antiangiogenic drugs, anti-egfr or anti-her 2 therapies, according to management guidelines * beneficiary of a social security system * dated and signed non-opposition consent exclusion criteria: * other concomitant primary cancer * pregnant women * patients under guardianship, curatorship or justice protection

Keywords: liver cirrhosis chemotherapy ent cancers upper-digestive tract cancers colorectal cancers
universal exercise unit therapy with sling exercise therapy on lower limb kinematics in chronic stroke patients

Conditions: Chronic Stroke

Summary: stroke occurred when blood supply to brain or a part of brain is disturbed due to clot (ischaemic stroke) or due rupture of small vessels (hemorrhagic stroke) in brain and causes bleeding in brain cells. the prevalence of stroke was 1.2 % (1200/100,000) in pakistan, 3.1% in china and it is 44.29 to 559/100,000 in different parts of the world. leading cause of stroke is hypertension. the aim of study will be to compare universal exercise unit therapy with sling exercise therapy on lower limb kinematics, disability, balance and quality of life in chronic stroke patients.

this will be randomized controlled trial. study will be conducted at khawaja arshed hospital sargodha. duration of intervention will be 08 weeks, 5 sessions in a week, total 40 sessions. duration of single session will be one hour. a convenient sample of n patients fulfilling the inclusion and exclusion criteria will be selected from in-patient settings of various hospitals from the city sargodha and will be allocated randomly into three groups equally after taking informed consent. group a will obtain universal exercise unit therapy. group b will obtain sling exercise therapy and group c will be control and will receive routine physical therapy. outcome will be measured at baseline, 04 weeks and 08 weeks. outcome measurement tools will be berg balance scale, barthel index, short form 12 (sf-12), trunk impairment scale, functional reach test and smart phone motion analysis for lower limb kinematics. scores will be measure in mean and sd. results of intervention will be comparing by using one way anova by using ibm spss version 21.0

Eligibility criteria:
inclusion criteria: * patient with chronic (course of disease at least six month) * recently discharge from in-patients setting with in 06 month of onset * hemiplegia (either right or left) * both gender * age between 30 to 70 * medically stable * no balance disorders before this stroke. * history of mental * illness or severe cognitive impairment (mini-mental scale score \> 25) exclusion criteria: * stroke patient with complication like shoulder hand syndrome, adhesive capsulitis or shoulder partial dislocation * stroke patients with behavioral issue, significant cognitive deficit * patients with arthritis and fracture * chronic stroke with deformities * serious viscera dysfunction, such as cardiovascular system, * lung, liver and kidney * history of mental * illness or severe cognitive impairment (mini-mental scale score \> 25) * audio-visual understanding * obstacle, unable to cooperate with instructions; * infection and ulcer skin

Keywords: motion analysis universal exercise unit sling exercise therapy stroke
biologics and sublingual immunotherapy

Conditions: Asthma, Allergic

Summary: most current studies involve using a biological drug to increase the safety of allergen immunotherapy (ait) especially in the treatment of food allergies, to avoid the risk of anaphylaxis. however, adding xolair® to ait may improve the therapy's effectiveness. there are still few observations on this topic, especially in patients with house dust mite (hdm)-driven asthma.

assess the effectiveness of combined therapy actair® plus xolair compared to monotherapy with actair® or xolair® or standard symptomatic therapy in patients with mild or moderate allergic asthma to hdm. treatment duration: 24 months follow-up duration:12 months total duration: 36 months (not including screening and randomization period) may 2024 - march 2028 consisting of a 4 to 5 months screening phase (with 1 month observation period prior to randomization) a treatment phase of 24 months and post-treatment follow-up phase 12 months

Eligibility criteria:
inclusion criteria:• \>18 years old * a total ige between 30-700 iu/ml * moderate asthma with perennial symptoms confirmed as hdm-driven asthma based on medical history and positive nasal provocation tests, partially controlled asthma; * fev1 \>70% at baseline; * positive skin prick test results for d. pteronyssinus, d. farinae exclusion criteria: * sensitisation to other allergens with clinical signs not related to hdm * uncontrolled asthma, * other serious diseases or chronic unstable diseases * allergen immunotherapy during the past 5 years * contraindicating allergen immunotherapy and omalizumab treatment.

Keywords: ige asthma omalizumab immunotherapy
response and remission to treatment with anti-il5/il5r antagonists

Conditions: Asthma

Summary: the aim of this retrospective observational study is to compare the response and remission rate after treatment with il5/il5-r antagonists in asthmatics who would and would have not met the inclusion criteria of the original randomized clinical trials. this study will be performed using the charts of the patients.

objective to compare the response and remission rate after treatment with il5/il5-r antagonists in asthmatics who would and would have not met the inclusion criteria of the original rcts. after having obtained authorization from the ethics committee of the ciusss du nord de l'île de montréal and from the director of the professional services, all the charts of patients who received anti il5/il-5r at the tertiary asthma clinic of the hôpital du sacré-coeur de montréal will be reviewed. patients aged 75 years or younger, with a smoking history of less than 10 pack-year, and a fev1 \<80% predicted with reversibility in the previous year will be considered to fulfill the rcts criteria. response to treatment was defined by at least a 50% reduction in asthma exacerbations or in oral corticosteroids (ocs) doses in the year following the initiation of il5/il5r antagonists. clinical remission on treatment at one year was defined as no exacerbation, no ocs and la 10% or less decrease in pre-bronchodilator fev1 compared with baseline value.

Eligibility criteria:
inclusion criteria: patients 18 years and older who were followed at the outpatient asthma clinic of sacre-cœur hospital and have been treated with anti-il5/il5r between 2016 and 2020. exclusion criteria: none
effect of photobiomodulation on the treatment of soft tissue traumatic injuries

Conditions: Soft Tissue Injuries

Summary: soft tissue injuries are directly related to the energy of the trauma and its repair is the main factor for bone healing and the recovery of the function of the affected limb. photobiomodulation (pbm) is indicated as an adjuvant treatment to accelerate wound healing, however, there is still a lack of evidence regarding its effect on traumatic soft tissue injuries. this project aims to evaluate the effects of the application of pbm in the resolution of complex soft tissue injuries of traumatic origin associated with tibial fractures. 84 adult individuals, aged between 18 and 60 years, hospitalized with tibial fractures awaiting resolution of soft tissue injuries will be included to undergo definitive surgery. the subjects will be randomized in two groups: pbm (treated with a device with 144 led emitting diodes at wavelengths of 420, 660 and 850nm, 3j per point for 10 minutes) and sham (simulation of the led application, with a device with characteristics identical to that of the pbm group, for the same period of time). subjects will be treated daily until release for surgery. the primary outcome will be the assessment of the wound healing process using the bates-jensen scale. secondary outcomes will be: pain intensity; consumption of analgesic drugs; serum evolution of inflammatory markers c-reactive protein and creatine kinase, measurement of the lesion area, time needed for release for definitive surgery, presence of infection, and the cost-effectiveness of pbm. the evaluations will be carried out before the beginning of the intervention and daily until the participant is considered ready for surgery (which will be considered the end of the experimental period). data will be analyzed statistically considering a significance level of 5%.


Eligibility criteria:
inclusion criteria: * adult individuals of both sexes, aged between 18 and 60 years; * interned in the orthopedics and infirmary emergency room of the surgical clinic of conjunto hospitalar do mandaqui; * victims of high-energy trauma in the lower limbs with sufficient soft tissue injury to make primary closure unfeasible or definitive treatment of injuries in the initial care associated with tibial fracture. exclusion criteria: * diagnosis of chronic systemic diseases (renal failure, diabetes mellitus, hypertension, peripheral vascular insufficiency); * allergy to cefazolin and gentamicin; * uncontrollable active bleeding; * occlusive arteriopathies; * compartmental syndrome; * necrosis in the area of neurovascular injury with sensory deficit at the injury site; * history of previous surgeries on the affected limb; * local or systemic changes that contraindicate surgical intervention or hinder the postoperative period; * smoking; * photo sensitivity history; * neurological and psychiatric disorders; * use of anti-inflammatory drugs in the last 15 days prior to the trauma; * pregnant women.
study evaluating the timing of intrauterine insemination in relation to positive home ovulation prediction kit

Conditions: Infertility

Summary: the aim of this study is to assess the impact of the timing of intrauterine insemination (iui) in relation to the natural surge of luteinizing hormone (lh), as detected by home ovulation predictor kits, on pregnancy rates per treatment cycle. the study will take place at the offices of midwest fertility specialists and include patients who have been independently recommended by their primary physician to undergo ovulation induction with clomiphene citrate (cc) or letrozole and iui as therapy for infertility.

intrauterine insemination is a procedure that is performed in the physician's office. during the procedure the sperm from the male partner are placed directly into the female partner's uterus around the time of ovulation (release of oocyte or egg). ovulation predictor kits, available over the counter at pharmacies, test for the presence of luteinizing hormone in the urine. when the test result is a positive, it means the hormone is present in the urine. this is a sign of ovulation. physicians typically choose to perform intrauterine insemination either the day of a positive ovulation test or the day after a positive ovulation test. the purpose of this study is to determine if the day when intrauterine insemination is performed influences the chance of becoming pregnant.

Eligibility criteria:
inclusion criteria: * all couples consisting of male and female partner undergoing cc or letrozole cycle plus iui at a single infertility center (midwest fertility specialists) * the female partner must be aged 21-39 * infertile couples include those with a diagnosis(s) of unexplained infertility, mild male factor, ovulatory dysfunction, or anovulation * evidence of a normal uterus and at least unilateral tubal patency on saline infusion sonogram or hysterosalpingogram within the last 2 years * semen analysis for male partner must have minimal sperm concentration of 10 million per milliliter exclusion criteria: * recurrent miscarriages * nursing mothers * diagnoses of primary ovarian failure, diminishing ovarian reserve (as indicated by blood follicle stimulating hormone \>10 milliinternationalunits/ml and/or anti-mullerian hormone level \<0.5), abnormal uterine bleeding of undetermined origin, ovarian cyst of undetermined origin, stage iv endometriosis, or sex-hormone dependent tumors * documented bilateral tubal obstruction or other uncorrected uterine anomalies (e.g. uterine septum) * previous gonadotropin use and/or previous treatment with in vitro fertilization * abnormal semen analysis (sperm concentration less than 10 million per ml) or ejaculatory dysfunction in male partner * other uncorrected medical condition in female partner that would be a contraindication to attempting elective ovulation induction (e.g., uncontrolled diabetes, intracranial lesion, thyroid or adrenal disease)

Keywords: infertility intrauterine insemination luteinizing hormone surge