Kornimate/medical-research-clean huggingface dataset:
comparison study between two techniques for correction of upper lid retraction in patients with grave's orbitopathy

Conditions: Graves Ophthalmopathy

Summary: grave's ophthalmopathy is the most common cause of orbital disease in adults. the clinical presentation may vary between sub clinic symptoms to severe ones. the eyelid retraction is one of the most important signs of grave's ophthalmopathy and can lead to cosmetic and functional problems. the eyelid retraction can be found in the inflammatory stage and in the chronic disease, when it is stable. it can be described when the upper lid is contouring the superior limbus or positioned above that. this condition can lead to dry eye symptoms, exposure keratitis and cosmetic issues. the treatment can may be surgical or medical. the medical treatment are usually based on controlling thyroid function and in the use of steroids, both are not specific for the lid retraction, but for the inflammation that is common in the disease. in the longstanding disease, surgery is the most efficient treatment. there are several described techniques, they are based on the concept of weakening the muscles that act on lid elevation (levator and muller muscle). basically the techniques can be divided in two groups: the first with an anterior approach (with skin scar in the lid sulcus) and the second using a posterior approach (through the conjunctiva). in the literature there is no consensus in deciding the best technique, regarding cosmetic results, incidence of complications, hypo or hypercorrection. in this trial we propose to compare two distinct techniques that are already in clinical use. the blepharotomy uses a cutaneous approach and the other a conjunctival approach. the patients will be divided in two randomized groups and surgical expected outcomes, cosmetics outcomes and complications occurrence will be compared.

after a complete ophthalmic evaluation the recruited patients with inactive graves orbitopathy and upper eyelid retraction eligible for the study will be randomly separated in two groups. the evaluation also includes a face photography in primary position of gaze, a osdi questionnaire, a quality of life questionnaire, schirmmer test, lissamine green evaluation and eyelid position measurements. in the first group the patients will be submitted to blepharotomy for surgical correction of their upper eyelid retraction. in the second group the patients will be submitted to a posterior mullerectomy and gradual recession of the elevator muscle aponeurosis for surgical correction of their upper eyelid retraction. the outcomes will be compared between the two groups after a 6 month followup.

Eligibility criteria:
inclusion criteria: * \> 21 years old * controlled thyroid function * absence of strabismus * absence of other ocular pathology, such as high myopia * understanding the protocol and according the terms exclusion criteria: * pregnancy * history of previous upper lid surgery * myasthenia gravis

Keywords: upper lid exophthalmos grave's orbitopathy
dose escalation of icotinib in advanced non-small cell lung carcinoma (nsclc) patients evaluated as stable disease

Conditions: NSCLC

Summary: the primary purposes of this study are to assess the safety and efficacy of using high doses of the drug icotinib (conmana) as a way to treat patients with non-small cell lung cancer that achieve stable disease after 8 weeks routine therapy.

this is a multi-center phase ii randomized controlled study to assess the safety and efficacy of using high doses of the drug icotinib (conmana) as a way to treat patients with non-small cell lung cancer that achieve stable disease after 8 weeks routine therapy by pfs, as well as os and dcr. the adverse events and adverse reaction are evaluated as well.

Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed stage iiib/iv lung cancer(exclude patients confirmed by sputum cytology) * no previous targeted treatment such as gefitinib, erlotinib. * with a measurable disease(longest diameters \>=10mm with spiral computed tomography (ct)and \>=20mm with conventional ct) at least according to recist criteria * who performance status(ps)\<= 2 * n\>=1.5×109/l, plt\>=1.0×109/l,hb\>=10g/dl;ast\&alt should \<3uln(without liver metastasis) or \<5uln(with liver metastasis).tbil\<=1.5uln. * signed and dated informed consent before the start of specific protocol procedures. exclusion criteria: * allergic to icotinib * patients with metastatic brain tumors with symptoms. * experience of anti-egfr(the epidermal growth factor receptor) monoclonal antibody or small molecular compounds therapy such as gefitinib, erlotinib or cetuximab. * severe systemic disease out of control such as unstable or uncompensated respiratory,cardiac,liver,renal diseases.
bicalutamide and goserelin in treating patients with cancer of the ovary, fallopian tube, or peritoneum

Conditions: Fallopian Tube Cancer; Ovarian Cancer; Primary Peritoneal Cavity Cancer

Summary: rationale: some tumors need growth factors produced by the body's white blood cells to keep growing. goserelin may interfere with the growth factor and may stop the tumor from growing. bicalutamide may prevent androgens from stimulating the growth of cancer cells. purpose: phase ii trial to study the effectiveness of goserelin plus bicalutamide in treating patients who have refractory or recurrent cancer of the ovary, fallopian tube, or peritoneum.

objectives: i. determine the time-to-treatment failure in patients with ovarian epithelial, fallopian tube, or peritoneal carcinoma, in second or greater remission, treated with bicalutamide and goserelin. ii. assess luteinizing hormone and follicle-stimulating hormone suppression in correlation with serum vascular endothelial growth factor levels, and determine if these levels are related to time to treatment failure in these patients. iii. correlate the presence or absence of androgen receptor tissue expression by immunohistochemistry and androgen receptor gene trinucleotide repeat length to time to treatment failure in these patients. outline: patients receive oral bicalutamide once daily and goserelin subcutaneously once every 4 weeks. treatment continues in the absence of unacceptable toxicity until disease recurrence. projected accrual: a total of 35 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: histologically confirmed epithelial carcinoma arising in the ovary, fallopian tube, or peritoneum, in second or greater remission failed initial therapy with persistent or recurrent disease cytoreductive surgery and at least 1 platinum-based chemotherapy regimen no evidence of disease within 4 months of salvage chemotherapy ca-125 less than 35 u negative physical exam no abdominal or pelvic disease by ct patient characteristics: age: adult performance status: karnofsky 60-100% life expectancy: not specified hematopoietic: absolute neutrophil count at least 1,000/mm3 platelet count at least 100,000/mm3 hepatic: bilirubin less than 2 times upper limit of normal (uln) sgot less than 2 times uln alkaline phosphatase less than 2 times uln renal: not specified other: no other active invasive malignancy no inability to receive subcutaneous injection no inability to tolerate oral medication prior concurrent therapy: biologic therapy: not specified chemotherapy: see disease characteristics endocrine therapy: not specified radiotherapy: not specified surgery: see disease characteristics other: no concurrent oral anticoagulants

Keywords: recurrent ovarian epithelial cancer fallopian tube cancer primary peritoneal cavity cancer
effects of post-isometric relaxation versus static stretching in patients with levator scapulae syndrome.

Conditions: Levator Scapulae Syndrome

Summary: group a will be treated with postisometric relaxation technique and group b will be treated with static stretching technique. postisometric relaxation will be performed with the frequency of 5 times, such that it includes (30 isometric contraction of the muscle to be stretched for 10 seconds, followed by rest period of 5 seconds and then a stretch of 10 seconds hold. stretching exercise will be performed with 30 second hold and with 5 repetitions. all exercises will be performed 3 times per week for total of 4 weeks. outcome measures will be conducted through pain, range of motion, disability and muscle length after 4 weeks.

a randomized clinical trial will be conducted at tehsil head quarter hospital daska through consecutive sampling technique on 42 patients which will be allocated using computer generated sampling (random number table) into group a and group b. group a will be treated with postisometric relaxation technique and group b will be treated with static stretching technique. postisometric relaxation will be performed with the frequency of 5 times, such that it includes (30 isometric contraction of the muscle to be stretched for 10 seconds, followed by rest period of 5 seconds and then a stretch of 10 seconds hold. stretching exercise will be performed with 30 second hold and with 5 repetitions. all exercises will be performed 3 times per week for total of 4 weeks. outcome measures will be conducted through pain, range of motion, disability and muscle length after 4 weeks. data will be analyzed during spss software version 25. the normality of data will be assessed by shapiro-wilk test after which it will be decided either parametric or non-parametric test will be used within a group or between two groups.

Eligibility criteria:
inclusion criteria: * both males and females. * age range of 24-59 years. * neck and medial border scapular pain for at least 3 months. * nprs score greater than 3. * reduced side flexion and rotation of neck. * symptoms persisted for at least 3 months. * positive levator scapulae length test. * have suffered from myofascial pain exclusion criteria: * neuropathies. * vertebral fractures. * pregnancy. * fibromyalgia. * cancer. * traumatic neck injury. * previous cognitive and functional disorders. * coagulopathy(

Keywords: disability range of motion muscle length pain
to evaluate the incidence of acute otitis media in children in five east european countries

Conditions: Infections, Streptococcal

Summary: the aim of this study is to provide baseline acute otitis media data in east european countries.

each subject's involvement in this study will include a retrospective and prospective part.

Eligibility criteria:
inclusion criteria: * subjects who the investigator believes that parent(s)/ legally acceptable representative(s) can and will comply with the requirements of the protocol. * a male or female subject aged \< 6 years at the time of enrolment. * the investigator has access to the medical records that contain the medical history of the subjects for one year prior to enrolment (for subjects aged 1 to \< 6 years) or from birth (for subjects aged \< 1 year). * written informed consent obtained from either both parents/ lars or from one parent/ lar of the subject with the declaration of cooperation for one year after enrolment. exclusion criteria: * acute otitis media episode at the time of enrolment. * upper respiratory tract infection at the time of enrolment.

Keywords: prospective incidence otitis observational epidemiological retrospective
auditory nerve monitoring using intra-cochlear stimulation in subjects with acoustic neuroma

Conditions: Hearing Loss, Cochlear; Neurinoma of the Acoustic Nerve

Summary: the aim of this study is to assess the auditory nerve functionality with an intraoperative approach following a surgical removal of acoustic neuroma in patients with severe to profound sensorineural hearing disabilities.

whatever the acoustic neuroma treatments, the patient risks a hearing loss. the global strategy of hearing care aims to preserve the quality of life and patient hearing. for severe to profound hearing loss and anatomical auditory nerve preservation, the cochlear implant is put forward compared to the auditory brainstem implant. indeed, cochlear implant provides better speech outcomes. if cochlear implantation is not possible or no benefit for the patient, the brainstem implant is the most widely used. the neuristim device is used to investigate the auditory nerve integrity following neuroma surgery or on an affected auditory nerve. the neuristim is an intra-cochlear stimulator used in an intraoperative way. the intra-cochlear electrodes provide an electrical stimulation to auditory nerve fibers, and auditory nerve response measurements to these electrical stimulation are recorded and evaluated to determine the auditory nerve functionality. the neuristim is a device for helping surgeons to choose the most appropriate implantable solution. 2 groups of patients will be involved in this study: * a group of 17 patients with an acoustic neuroma or a past neuroma surgically removed or acoustic neuroma not requiring a surgery and with severe to profound hearing loss candidate for a cochlear implant or a auditory brainstem depending on the auditory nerve functionality, * a group of 17 patients with severe to profound hearing loss candidate for a cochlear implant.

Eligibility criteria:
inclusion criteria: * must be 18 years or older * patient with an acoustic neuroma already surgically removed with associated hearing loss (experimental group), * patient with an acoustic neuroma programmed to be surgically removed and candidates for an implantable hearing rehabilitation solution (experimental group), * patient with an acoustic neuroma that not need to be removed and candidate for an implantable hearing rehabilitation solution (experimental group), or * typical patient candidate for a cochlear implant (control group) exclusion criteria: * cochlea malformation, cochlea ossification * vulnerable subject
efficacy, safety, and dose-response of a live biotherapeutic product in women with acute vaginal infection

Conditions: Bacterial Vaginosis; Vulvovaginal Candidiasis

Summary: the purpose of this clinical trial is to investigate the clinical efficacy and safety of a live biotherapeutic product (bgy-1601-vt) intended as a first line of treatment in cases of acute vaginal infection without upfront microbiological confirmed diagnosis


Eligibility criteria:
inclusion criteria: * post-menarche woman aged 18 to 50 years old (inclusive), * with suspected bacterial vaginosis (bv) and/or vulvovaginal candidiasis (vvc), presenting symptoms of acute vaginal infection * no clinically significant and relevant abnormalities of medical history (including mental disorders) or physical examination, * able and willing to participate to the trial by complying with the protocol procedures as evidenced by her dated and signed informed consent form, exclusion criteria: * other already diagnosed or suspected infectious causes of bacterial vaginal infection (e.g., trichomonas vaginalis, chlamydia trachomatis, neisseria gonorrhoeae) within 1 month * current herpes simplex flare-up in the genital area, * vulvar condyloma due to the human papilloma virus; * vulvar dermatoses (e.g.: psoriasis or lichenification); * clinical diagnosis of bv or vvc within 4 months; * treatment with any antibiotic or antifungal therapy (local or systemic) within 2 months, regardless of the indication; * treatment with any local treatment (probiotics, antiseptic, etc.) within 1 month, regardless of the indication; * participant using any intravaginal product (local contraceptive \[spermicide, hormonal ring\], moisturizer, tampon, intimate hygiene product, etc.); * participant with a chronic disease or condition or treatment known to impact the immune system, including auto-immune disease, diabetes, cancer, renal failure, etc. * pregnant or breastfeeding patient or intending to become pregnant within 1 month ahead, or having given birth within 3 months; * participant in perimenopause, i.e. aged 45 years or more, with irregular menstrual cycles that could lead to a suspicion of menopause; * with a known or suspected food allergy or intolerance or hypersensitivity to any of the trial intervention ingredient;

Keywords: vaginal infection bacterial vaginosis (bv) vulvovaginal candidiasis (vvc) anaerobic bacteria prevotella gardnerella vaginalis candida albicans acute vaginitis
vascular function on the first day after cardiac surgery

Conditions: Coronary Artery Disease

Summary: this study examines the flow mediated dilation (fmd) of the brachial artery before and after cardiac surgery. fmd is measured with ultrasound technique. increased flow is achieved trough obstructing blood flow with a cuff around the forearm for five minutes. fmd is measured before surgery and on the first morning after the operation.


Eligibility criteria:
inclusion criteria: * admitted for coronary artery bypass surgery exclusion criteria: * ongoing treatment with nitrates or raas inhibiting drugs * unstable coronary syndrome * unstable circulation/shock * renal failure * hepatic failure * autoimmune or inflammatory disease * untreated hypertension.

Keywords: cardiac surgical procedures heart-lung machine coronary artery bypass brachial artery vasodilation regional blood flow ultrasonography
a pilot rct on the effect of exat on teacher burnout and stress

Conditions: Burnout; Stress

Summary: the objective of this pilot randomized controlled trial is to evaluate the effects of expressive art therapy on reducing burnout and stress symptoms among hong kong's primary and secondary school teachers. the proposed study is a pilot randomized controlled trial. prior to all study procedures, 90 participants (i.e., primary and secondary school teachers) will be recruited to complete an online informed consent with telephone support. eligible participants will be randomly assigned to either the expressive arts therapy group (exat group) or the waitlist control group (wl group) in a ratio of 1:1. the exat group will receive the expressive arts intervention via face-to-face workshops for 2 consecutive weeks (2 hours per session). there are a total of 3 batches (around 15 participants per batch) for the intervention. participants in this group will be in touch with their inner selves and inner resources via body movement, writing and music. there will be visual art creation as a conclusion for integrating the body and mind. the art products would be placed in their workplace for stress regulation. the wl control group will not receive any intervention during the study, but they will receive self-help art therapy materials after the whole study procedure. the outcome measures include burnout, stress, depressive, and anxiety symptoms, as well as insomnia symptoms, physical activity, health-related quality of life, and the intervention acceptability at baseline, immediate post-treatment, and 4-week follow-up assessments by completing the same questionnaire set.


Eligibility criteria:
inclusion criteria: 1. hong kong residents aged \>/=18 2. able to read chinese (verbal expression in chinese or english) 3. with qualified teaching cert. (degree holder) 4. willing to provide informed consent and comply with the trial protocol 5. teacher work in primary or secondary school in hong kong exclusion criteria: 1. current involvement in psychological treatment program for stress and / or burnout reduction 2. a change in psychotropic drugs or over-the-counter medications that target mood within 2 weeks before the baseline assessment 3. a patient health questionnair-9 (phq-9) item 9 score \> 2 indicating a serious level of suicidal risk

Keywords: expressive arts therapy teachers randomized controlled trial
an internet-administered, mindfulness training program for the treatment of anxiety

Conditions: Anxiety; Depression; Insomnia

Summary: the purpose of this study is to examine the effects of a 10 week mindfulness training program -- without therapist-support -- as treatment of anxiety. effects on depression, quality of life, and insomnia symptoms will also be studied.

previous research has provided evidence for the thesis that training in mindfulness can decrease symptoms of anxiety and depression. this study will examine the effects of a 10 week mindfulness training program -- without therapist-support -- as treatment of anxiety. effects on depression, quality of life, and insomnia symptoms will also be studied.

Eligibility criteria:
inclusion criteria: * satisfy dsm-iv criteria for an anxiety disorder * living in sweden and being able to read swedish * access to computer with internet connection exclusion criteria: * currently receiving other psychological treatment * non-stable use of psychoactive medication * deemed suicidal * deemed to suffer from other psychological disorder, e.g. psychosis, bipolarity etc.

Keywords: anxiety depression insomnia mindfulness internet
optimizing chronic pain care with mindfulness and chronic pain management visits

Conditions: Chronic Pain; Prescription Opioid Misuse; Substance-Related Disorders; Pain; Narcotic-Related Disorders; Chemically-Induced Disorders; Mental Disorders; Opioid-Related Disorders; Neurologic Manifestations

Summary: the primary aim of this implementation-effectiveness trial is to examine the effectiveness of mindfulness-oriented recovery enhancement (more) and patient-centered chronic pain management visits in primary care as interventions to reduce chronic pain, improve quality of life, and reduce opioid-related harms among chronic pain patients on long-term opioid therapy.


Eligibility criteria:
inclusion criteria: * age 18 + * current chronic pain diagnosis (pain for ≥3 months) determined by physician assessment * current use of opioids for ≥3 months * score \>=3 on the pain enjoyment general activity scale * score \>=9 on the current opioid misuse measure or lifetime psychiatric or substance use disorder diagnosis or benzodiazepine use or history of overdose or physician determination that risks of opioid use may outweigh the benefits of opioid use exclusion criteria: * chronic pain due to a cancer diagnosis * active suicidal intent, schizophrenia, psychotic disorder * prior experience with mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness-based relapse prevention, or mindfulness-oriented recovery enhancement
apixaban versus warfarin in patients with left ventricular thrombus

Conditions: Left Ventricular Thrombosis

Summary: the purpose of this study is to compare the novel oral anticoagulant apixaban with the standard therapy of warfarin on the size reduction or resolution of left ventricular thrombus over 3 months.

current treatment for left ventricular thrombus is anti-coagulant or blood thinning agent known as warfarin. recently at least three novel oral anticoagulant agents were used in the treatment of atrial fibrillation, pulmonary embolism and deep vein thrombosis (dvt). novel oral anticoagulant drugs will require no blood taking for inr monitoring, hence less visit and more convenience to patients. latest studies also showed lesser rate of bleeding as compared to warfarin and hence relatively safer.

Eligibility criteria:
inclusion criteria: 1. age 18 - 80 years old 2. presence of lv thrombus or spontaneous echo contrast (sec) grade 3 or 4 (patel vg 1996), with regional wall motion abnormalities 3. hasbled score less than 3 4. no episodes of major bleeding in the past 6 months a) major bleeding defined as i. episodes of bleeding with significant drop in haemoglobin(hb)level of at least 2gm/dl - includes upper and lower gastrointestinal bleed ii. the need for blood transfusion (pack cell) of at least 2 unit iii. recent surgery with bleeding complications and lost of hb as in (i) or (ii) iv. any intracranial bleeds with neurological deficits exclusion criteria: 1. patient with unstable arrhythmias and/or recurrent cardiogenic shock 2. patient with large ischemic stroke on recruitment-defined as involving \>1/3 of cerebral hemisphere or deemed to have high chance of haemorrhagic transformation 3. patient with permanent pacemaker 4. patient who is post valve replacement therapy 5. patient who is pregnant. 6. patient with advanced kidney disease at stage v and not on dialysis (crcl \<15 ml/min) 7. patient with advanced liver disease with coagulopathy 8. patient with organized and old left ventricular thrombus