Kornimate/medical-research-clean huggingface dataset:
abnormal pain processing in copd patients

Conditions: Pulmonary Disease, Chronic Obstructive; Pain

Summary: dyspnea, cough, and fatigue are the symptoms characteristic of moderate-severe copd. within the progression of disease was also reported a prevalence of 34-77% of pain symptoms in these patients. a review observed a higher score in pain intensity/interference associated with multiples pain locations of copd patients. pain in chronic diseases may appear to result from abnormalities in pain processing because of the damage and/or inflammation of peripheral structures.

dyspnea, cough, and fatigue are the symptoms characteristic of moderate-severe copd. within the progression of disease was also reported a prevalence of 34-77% of pain symptoms in these patients. a review observed a higher score in pain intensity/interference associated with multiples pain locations of copd patients. several studies reported that comorbidities, gold grade, and breathlessness may contribute to a higher pain prevalence in copd patients because of the systemic inflammatory process and lung hyperinflation. pain in chronic diseases may appear to result from abnormalities in pain processing and alteration of sensitization due to the damage and/or inflammation of peripheral structures.

Eligibility criteria:
inclusion criteria: * between 50 and older age * accepted to sign the informed consent exclusion criteria: * comorbidities with a course of chronic pain that interfered with evaluation * the presence of cognitive impairment to understand the questionnaire
back-on-track studying early quality care

Conditions: Musculoskeletal Diseases

Summary: this study is a randomized controlled trial conducted at two clinical sites. the purpose of this study is to determine whether patients with musculoskeletal injuries do better by seeing a primary care provider first versus seeing a physical therapist first. target enrollment is 150 subjects.

physical therapists have an important role as initial contact providers for individuals with musculoskeletal disorders. health care expenditures are on the rise each year in the u.s. and a large proportion is due to musculoskeletal disorders. despite the rise in spending, there has not been an improvement in outcomes for individuals with musculoskeletal disorders. furthermore, increased medical spending and utilization could expose patients to iatrogenic harm. comparative effectiveness studies of different portals of entry would help to determine the most effective pathways for individuals with musculoskeletal disorders to seek care. the purpose of this study is to determine whether patients with musculoskeletal injuries do better by seeing a primary care provider first versus seeing a physical therapist first. subjects will be enrolled from two sites (temple university, philadelphia, pa and brooke army medical center, san antonio, tx). patient self-reported outcomes measures will be collected at baseline and 6 weeks. at 6 months, healthcare utilization will be assessed. the investigators plan to enroll a target sample size of 75 subjects per site (150 total). descriptive statistics will be computed to characterize the 2 treatment groups with ancova being used to assess differences between treatment groups at 6 weeks, adjusting for baseline values, evaluating the assumption of parallel slopes. the investigators will further investigate sources of systematic differences in response to treatment using methods such as generalized estimating equations and linear mixed effects models. this research will be the first multi-site study to compare effectiveness of these two pathways for individuals with musculoskeletal pain in the u.s. with a growing older adult population, the percentage of individuals who have musculoskeletal pain in the u.s. will only increase over time. this research study is timely and could meet the need for identifying the most effective pathway for individuals with musculoskeletal pain to seek care.

Eligibility criteria:
inclusion criteria: 1. a patient at temple university employee health, or, brooke army medical center. 2. able to speak english sufficiently to understand informed consent 3. a patient with a musculoskeletal condition as their primary complaint 4. greater than 18 years old 5. within 90 days (3 months) of either initial musculoskeletal onset or repeat acute recurrence of a previous episode exclusion criteria: 1. patients have already sought care from provider for their presenting condition for this current episode 2. patients have an insurance plan that requires them to see an outside provider prior to seeing the study providers

Keywords: physical therapy modalities primary care health services research
the impact of the covid-19 pandemic on orthopedic trauma management

Conditions: Trauma; COVID-19 Pandemic

Summary: the aim of the study is to compare emergency orthopedic trauma admissions between the pre-pandemic period and the pandemic period and to detect changes in orthopedic trauma epidemiology.

the aim of the study is to compare emergency orthopedic trauma admissions between the pre-pandemic period and the pandemic period and to detect changes in orthopedic trauma epidemiology. for this purpose, an epidemiological study was conducted in our country, comparing trauma admissions to a level 1 trauma hospital during a one-year period before the pandemic with those in the year following the onset of the pandemic.demographic characteristics of the patients, such as age and gender, were recorded. in addition, the injury mechanisms of the patients, diagnosis, injured extremityor anatomical region, broken bone, fracture classification, multitrauma rates, trauma releated complications, hospitalization days, and treatment modalities were examined.

Eligibility criteria:
inclusion criteria: * the patients who were admitted between march 2019 and march 2021 * patients presenting due to trauma exclusion criteria: * patients admitted before the pandemic and outside the pandemic period * consultation or outpatient clinic patients * non-traumatic conditions * patients with incomplete records
nebulised heparin to reduce covid-19 induced acute lung injury

Conditions: Covid19; ARDS, Human; Lung Injury, Acute; Ventilation Perfusion Mismatch

Summary: the investigators present a randomised open label phase ib/iia trial of nebulised unfractionated heparin to evaluate the effect of nebulised unfractionated heparin on the procoagulant response in icu patients with sars-cov-2 requiring advanced respiratory support. as this is one of the first studies of nebulised heparin in covid 19 lung disease the investigators will assess safety as a co-primary outcome.


Eligibility criteria:
inclusion criteria: to be eligible, a patient must satisfy all these inclusion criteria: 1. confirmed or suspected covid-19. note, if 'suspected', results must be pending or testing intended 2. ability to obtain informed consent/assent to participate in study 3. age 18 years or older 4. requiring high flow nasal oxygen or positive pressure ventilator support or invasive mechanical ventilation for a time period of no greater than 48 hours 5. d-dimers \> 200 ng/ml 6. pao2 to fio2 ratio less than or equal to 300 7. acute opacities on chest imaging affecting at least one lung quadrant. note 'acute opacities' do not include effusions, lobar/lung collapse or nodules 8. currently in a higher level of care area designated for inpatient care of patients where therapies including non-positive pressure ventilatory support can be provided. exclusion criteria to be eligible, a patient must have none of these exclusion criteria: 1. enrolled in another clinical trial that is unapproved for co-enrolment 2. heparin allergy or heparin-induced thrombocytopaenia 3. aptt \> 100 seconds 4. platelet count \< 50 x 109 per l 5. pulmonary bleeding, which is frank bleeding in the trachea, bronchi or lungs with repeated haemoptysis or requiring repeated suctioning 6. uncontrolled bleeding 7. pregnant or suspected pregnancy (urine or serum hcg will be recorded) 8. receiving or about to commence ecmo or hfov 9. myopathy, spinal cord injury, or nerve injury or disease with a likely prolonged incapacity to breathe independently e.g. guillain-barre syndrome 10. usually receives home oxygen 11. dependent on others for personal care due to physical or cognitive decline (pre-morbid status) 12. death is imminent or inevitable within 24 hours 13. the clinical team would not be able to set up the study nebuliser and ventilator circuit as required including with active humidification 14. clinician objection. 15. the use or anticipated use of nebulised tobramycin during this clinical episode 16. any other specific contraindication to anticoagulation including prophylactic anticoagulation not otherwise listed here 17. relapse in clinical condition in patient that had fully weaned from advanced respiratory support 18. any systemic anticoagulation other than prophylactic anticoagulation
correlation study of family communication disorders and negative network use behavior among adolescents

Conditions: Adolescent

Summary: the entry point of this project is the social background of the post-epidemic era, with teenagers and parents as the research object, aims to explore the relationship between family communication disorders and adolescent negative network use behavior in the post-epidemic era. this project intends to investigate whether there are family communication disorders and negative internet use behaviors among 14-25 year old teenagers by issuing questionnaires (sample size: 140). in order to conclude whether there is some connection between family communication disorder and adolescent negative network use behavior.

this research project takes the "post-epidemic era" as the background entry point, and explores the relationship between teenagers' negative internet use behavior and family communication by using questionnaires. through literature review, it is obtained that family communication disorders may be related to adolescents' emotional changes with their parents, limited peer interaction, and changes in the structure of their lives. in order to avoid the negative feelings brought by family communication barriers, adolescents tend to turn to other areas such as virtual networks to compensate and regain happiness, which can easily lead to negative internet use behaviors if they are not careful. by studying the "loss of compensation" model proposed by chinese scholar gao wenbin, the application of the "loss of compensation" model to family communication disorders and adolescents' negative internet use behavior is derived. in this context, if we can study the correlation between family communication barriers and adolescents' negative internet use behaviors, it will be beneficial to ease the parent-child relationship, correct adolescents' negative internet use behaviors, and promote the healthy growth of adolescents.

Eligibility criteria:
inclusion criteria: * adolescents aged 14-25 (including 14,25 years old) and their parents; * agree to participate in the studies exclusion criteria: * persons of interest with a history of prior psychiatric illness, who are suffering from a serious acute illness, are unconscious, emotionally unstable, and unable to communicate normally

Keywords: adolescents family communication disorders negative network use behavior
physical activity counseling during pulmonary rehabilitation

Conditions: Chronic Obstructive Pulmonary Disease

Summary: this randomized controlled trial will assess the effect of adding intensive physical activity counseling to an outpatient pulmonary rehabilitation program. counseling including real-time feedback on daily activities from an activity monitor will be offered to improve participation in physical activities in daily life during and after an outpatient pulmonary rehabilitation program.


Eligibility criteria:
inclusion criteria: * spirometry-proven copd * referred for 6-month outpatient pulmonary rehabilitation program exclusion criteria: * orthopedic problems impairing daily activities * progressive neurological or neuromuscular disorders * psychiatric or cognitive disorders * patients on the waiting list for lung transplantation

Keywords: copd physical activity pulmonary rehabilitation counseling
macrolide mediates pulmonary infection of pseudomonas aeruginosa

Conditions: Bronchiectasis

Summary: it is acknowledged that il-18, as a product of the inflammasome, is involved in host defence against viral and bacterial stimuli by modulating the immune response. the aim of this study was to determine il-18 levels in serum of patients with bronchiectasis and to investigate whether macrolide attenuate its levels.

non-cystic fibrosis bronchiectasis is a respiratory disease characterized by persistent airway inflammation and dilation of bronchial wall driven by various causes. patients with bronchiectasis suffer from excessive sputum production, recurrent exacerbations, and progressive airway destruction. it was reported that 30%-40% patients were infected with pseudomonas aeruginosa. major therapy for bronchiectasis is focused on breaking the "vicious cycle" of mucus stasis, infection, inflammation, and airway destruction. currently a number of clinical trials have showed that macrolide effectively used in the treatment of non-cf bronchiectasis. evidence has indicated that 14- and 15-membered ring macrolides possess immunomodulation and anti-inflammatory functions beyond their antimicrobial properties. however, the underlying mechanisms that account for the anti-inflammatory actions of macrolides have not yet to be elucidated, and the activities do not appear to be controlled by a single mechanism.interleukin-18 (il-18), along with interleukin-1b (il-1b), is produced by inflammasomes when activated by a number of pathogen, environmental or host-derived danger signals. inflammasomes are innate immune regulatory protein complexes which seem to play a key role in the host immune response of patients with bronchiectasis. the aim of this study was to determine il-18 levels in serum of patients with bronchiectasis and to investigate whether macrolide could attenuate its levels.

Eligibility criteria:
inclusion criteria: 1. able to provide written informed consent. 2. confirmed diagnosis of bronchiectasis by hrct. 3. aged 18-85 years. exclusion criteria: 1. bronchiectasis as a result of cf or active tuberculosis or non-tuberculous mycobacterial (ntm) infection. 2. allergy to macrolide antibiotics 3. any history of severe cardiopulmonary dysfunction, eg. left heart failure, unstable cardiac arrhythmias 4. pregnant or nursing 5. hypogammaglobulinemia or other autoimmune disease 6. diagnosed with abpa
compare ceftazidime-avibactam + metronidazole vs meropenem for hospitalized adults with complicated intra-abd infections

Conditions: Complicated Intra-abdominal Infection

Summary: the purpose of this study is to evaluate the effects of ceftazidime avibactam plus metronidazole compared to meropenem for treating hospitalized patients with complicated intra-abdominal infections.

a phase iii, randomized, multicenter, double blind, double-dummy, parallel-group, comparative study to determine the efficacy, safety, and tolerability of ceftazidime avibactam plus metronidazole versus meropenem in the treatment of complicated intra-abdominal infections in hospitalized adults

Eligibility criteria:
inclusion criteria: * patient must be 18 to 90 years of age, inclusive, * female patients can participate if they are surgically sterilized or postmenopausal for at least 1 year or her sexual partner has had a vasectomy * female of childbearing potential has had normal menstrual periods for 3 months and negative serum pregnancy test and agree to practice highly effective methods of birth control during treatment and for at least 7 days after last dose * intraoperative/postoperative enrollment with visual confirmation (presence of pus within the abdominal cavity) of an intra-abdominal infection associated with peritonitis * confirmation of infection by surgical intervention within 24 hours of entry: evidence of systemic inflammatory indicators; physical findings consistent with intra-abdominal infection; supportive radiologic imaging findings of intra-abdominal infections exclusion criteria: * patient is diagnosed with traumatic bowel perforation undergoing surgery within 12 hours; perforation of gastroduodenal ulcers undergoing surgery within 24 hours. other intra-abdominal processes in which primary etiology is not likely to be infectious * patient has abdominal wall abscess or bowel obstruction without perforation or ischemic bowel without perforation * patients whose surgery will include staged abdominal repair, or "open abdomen" technique, or marsupialization * patient has suspected intra-abdominal infections due to fungus, parasites, virus or tuberculosis * patient is considered unlikely to survive the 6- to 8-week study period or has a rapidly progressive or terminal illness, including septic shock that is associated with a high risk of mortality

Keywords: ceftazidime-avibactam, metronidazole, meropenem, anti-bacterial agents, anti-infective agents, therapeutic uses, pharmacologic actions, physiological effects of drugs
pilot study of minocycline (npl-2003) in adults with obsessive-compulsive disorder (ocd)

Conditions: Obsessive Compulsive Disorder

Summary: obsessive-compulsive disorder (ocd) is a common psychiatric illness that affects up to 2-3% of the population. people with ocd experience anxiety-provoking, intrusive thoughts, known as obsessions, and feel compelled to perform repetitive behaviors, or compulsions. the only medications proven effective for ocd are serotonin reuptake inhibitors (sris), but even with sri treatment, most patients continue to experience significant ocd symptoms, impaired functioning, and diminished quality of life. recent evidence suggest that a different neurotransmitter, glutamate, may contribute to the symptoms in ocd. medications that target glutamate hold promise for ameliorating symptoms for those patients continuing to suffer from ocd. in this study we are recruiting patients to receive the drug npl-2003, which is thought to modulate the neurotransmitter glutamate, added to whatever other ocd medications they are taking in a 12-week open label study.


Eligibility criteria:
inclusion criteria: * primary dsm-iv diagnosis of ocd * currently on a stable and adequate dose of sri (or history of prior sri or cbt treatment meeting criteria for adequate trial) * patients not currently receiving an sri or cbt will be included if they have undergone a prior sri or cbt trial and they report no interest in pursuing another dri or cbt trial at this time. patients who have been on sris in the past must be free of sris for at least 6 weeks prior to participation * y-bocs score of greater or equal to 16 * physically health and females must be using effective contraception * sufficient severity of symptoms to warrant additional augmentation treatment * able to provide consent exclusion criteria: * ongoing treatment with other antibiotics and/or accutane. patients with lupus erythematosus * patients planning to start cbt during the study period or those who have begun cbt within the past 8 weeks * presence of psychotic symptoms or lifetime history of schizophrenia, bipolar disorder or other psychotic disorder * current major depressive disorder (patients must be free of the disorder for 3 months prior to enrollment). ham-d must be \<18. * judged clinically to be at risk of suicide (suicidal ideation, severe depression or other factors * current eating disorder * severe renal insufficiency * documented history of hypersensitivity or intolerance to tetracycline antibiotics * concomitant use of anti-coagulant drugs, antacids, iron, calcium, magnesium, aluminum, zinc sales. note:concomitant psychotropic medications such as antipsychotics and benzodiazepines will be permitted as long as they have been stable for at least 4 weeks and remain stable during the course of the study. * current etoh/drug abuse or dependence disorder of dependency in the past 3 months * female patients who are either pregnant or nursing

Keywords: ocd
study of topical abi-1968 in subjects with precancerous cervical lesions from human papillomavirus (hpv) infection

Conditions: HSIL; HSIL of Cervix; High-Grade Squamous Intraepithelial Lesions; High-grade Cervical Intraepithelial Neoplasia; Human Papilloma Virus; Cervical Cancer; Cervical Intraepithelial Neoplasia; Cervical Neoplasm; Cervical Dysplasia; CIN

Summary: this study evaluates the use of topical abi-1968 cream, in the treatment of cervical precancerous lesions in adult women.


Eligibility criteria:
inclusion criteria: * women, 25 to 50 years old. * cervical hsil diagnosis made within 2 months of enrollment and confirmed with biopsy with no evidence of invasive cancer in any specimen and must be p16+. * able and willing to abstain from sexual intercourse for 48 hours prior to first dose and 2 days after each dose. * generally experiencing regular menstrual cycles, unless using long-acting reversible contraception that induces amenorrhea (e.g., mirena iud, norplant). exclusion criteria: * women who are pregnant, plan to become pregnant in the next 4 months, or lactating females. * history of cancer, except basal cell or squamous cell carcinoma of the skin. * history of genital herpes with \> 3 outbreaks per year, or active non-hpv vaginal infection. * plan to have excision or ablation of the lesion(s) within 3 months of enrollment. * history of cervical cancer, colposcopy suspicious for cancer, any prior treatment of cin, or hysterectomy.
intra-parotid facial nerve tractography

Conditions: Parotid Tumor

Summary: the aim of the study is to evaluate concordance between the facial nerve's path in the parotid evaluated by radiologist in preoperatively and the facial nerve's path in the parotid evaluated by surgeon in peroperatively.

surgery is the main treatment for parotid tumol, benign or malignant pathologies. the procedure requires a trunk search and a facial nerve dissection along its intraparotid length. this intervention entails a risk of facial paralysis. mri tractography is a new imaging technique that can characterize nerve fibers and their path. the interest would be to allow the surgeon to best prepare the parotidectomy by locating the tumor in relation to the trunk and all the branches of the facial nerve.

Eligibility criteria:
inclusion criteria : * major patient * patient with initial parotid mass or recurrent * parotidian mass with surgical indication * benign or malignant * with or without preoperative facial paralysis * patients consenting the protocol exclusion criteria : * parotidian masses without surgical indication * patient with a classic contraindication to mri

Keywords: parotidetomy tractography facial nerve facial palsy tumor of parotid gland
use of videos to improve patient knowledge on prenatal genetics

Conditions: Aneuploidy; Birth Defect

Summary: this is a randomized controlled trial of a low income and low health literacy population of pregnant women from a diverse racial and ethnic background to assess the effectiveness of a pre-visit educational video on prenatal genetic screening and testing options.

during pregnancy, women are routinely counseled about the risks of their offspring to have a chromosomal abnormality or birth defects. both prenatal screening and diagnostic testing options to exclude aneuploidy should be offered to all pregnant women early in their pregnancy. a standardized educational video on prenatal screening may enhance a patient's understanding and knowledge of testing and support more informed decisions. the objective of this study is to evaluate and compare patient knowledge scores on prenatal genetic screening before and after a standard prenatal care visit compared to the addition of a pre-appointment educational video.

Eligibility criteria:
inclusion criteria: * pregnancy, english or spanish-speaking exclusion criteria: * minors \<18 years old, * \> 21 completed weeks of gestational age, * prior genetic counseling during current pregnancy * fetus with known ultrasound abnormality

Keywords: patient education genetic counseling