Kornimate/medical-research-clean huggingface dataset:
effects of electro dry needling versus dry needling in levator scapulae syndrome

Conditions: Neck Syndrome

Summary: mechanical neck pain is posteriorly occurring non-specific pain that originates from the superior nuchal line and extends to the first thoracic vertebrae. it is exacerbated by sustained neck postures, neck movements or cervical muscle palpation. the aim of study will be to compare the effects of electro dry needling and dry needling on pain, muscle strength, disability and range of motion in patients with levator scapulae syndrome.

a randomized clinical trial will be conducted at shalamar hospital, (sihs physiotherapy clinic lahore) through convenience sampling technique on 30 patients which will be allocated using simple random sampling through sealed opaque enveloped into group a and group b. group a will receive electro dry needling along with conventional physiotherapy in which parameters for electro dry needling will be needles of 30×0.25 mm, 50×0.25 mm sizes, frequency 80-100 hz, duration 10-20 minutes and intensity as tolerated and group b will receive dry needling along with conventional physiotherapy in which parameters will be dry needles will be 30×0.25 and 50×0.25 mm sizes. standard physiotherapy will include a hot pack (10 min), stretching of levator scapulae (3 times with 30 second hold), and scapular stabilization exercises (10 times with 5 second hold).there will be 3 sessions per week, needling in both groups will be for performed 2 times per week for total 3rd week of treatment comprising of 6 sessions, 3rd session will comprise of standard physical therapy. pre and post treatment measures will be recorded.outcome measures will be conducted through pain, \*muscle strength,\* disability and range of motion questionnaire. data will be analyzed during \*spss software version 25.after assessing the normality of data by the shapiro-wilk test, it will be decided whether a parametric or non-parametric test will be used within a group or between two groups.

Eligibility criteria:
inclusion criteria: * age ranges of 18-45 years * both genders, males and females * positive levator scapular length test (7) * positive simon's criteria for levator scapulae * neck pain -nprs \< 7 (8) * neck and upper back pain for at least 3months. * examination - increased muscle tone and tenderness at neck and upper back * reduced rom-side flexion and rotation of neck * non traumatic unilateral mechanical neck pain of three or more months of duration, presenting an latent mtrp in the levator scapulae muscle on the painful side exclusion criteria: * neuropathies * radiated pain towards the arm * vertebral fractures * traumatic neck injury * whiplash injury (9) * previous surgical procedures in the cervical spine * previous cognitive and functional disorders * psychological disorders (mood and psychotic disorders such as schizophrenia, depression,and anxiety disorders), * fibromyalgia

Keywords: neck pain disability muscle strength range of motion
phage therapy in prosthetic joint infection due to staphylococcus aureus treated with dair.

Conditions: Infection of Total Hip Joint Prosthesis; Infection of Total Knee Joint Prosthesis

Summary: pilot non comparative study assessing the clinical control of infection of dair + sat +nacl and dair + sat + phages anti-staphylococcus aureus in patients with staphylococcus aureus prosthetic joint infection with an indication of dair + sat.


Eligibility criteria:
inclusion criteria: 1. male or female ≥ 18 years 2. staphylococcus aureus monomicrobial knee or hip pji ˃3 months after prosthesis implantation with clinical signs of infection and with indication of dair with direct closure and suppressive antibiotics therapy (sat) 3. staphylococcus aureus only in joint fluid within 6 months before randomization or in case of relapse of infection under antibiotics therapy after a dair performed within 6 months before pre-inclusion visit 4. without preoperative diagnosis of superinfection due to another pathogen 5. phagogram displaying the susceptibility of the strain to at least one of the phages. 6. patient with a life expectancy of 2 years and more as determined by the principal investigator 7. females of childbearing potential/sexually active males with partner of childbearing potential: commitment to consistently and correctly use an acceptable method of birth control (oral, transdermal, systemic or implant contraception birth control, intrauterine devices) for 1 month after the last study drug administration 8. females of non-childbearing potential: either surgically sterilized or at least 1 year postmenopausal (amenorrhea duration at least 12 months) 9. negative pregnancy test exclusion criteria: 1. early staphylococcus aureus prosthesis joint infection (˂3months after the prosthesis implantation) 2. other germ found in culture of joint fluid sample 3. phagogram displaying no susceptibility of the strain to anti-staphylococcus aureus bacteriophages 4. patients with asa score ≥ 4 5. severe sepsis or septic shock or hemodynamic instability 6. patients with an indication to prosthesis replacement or amputation 7. immunosuppressed patients 8. alt or ast \> 5 x uln, creatinine \> 1.53 mg/dl in men and \> 1.24 mg/dl in women 9. known allergic reactions to components of phages products 10. medical history which in the opinion of the investigator would mean that the patient is unsuitable for participation in the study 11. patients who are pregnant or breastfeeding. patients should not be enrolled if they plan to become pregnant during the treatment period and 1 month after the last administration of study drug 12. women/men refusing to use an effective contraception during 1 month after the last administration of study drug.

Keywords: joint infection staphylococcus aureus phagotherapy
alternate day micafungin: a pk study in pediatric patients

Conditions: Fungal Infection

Summary: the purpose of this study is to examine the pharmacokinetics of micafungin when it is given on an every other day schedule. the study will determine if every other day micafungin will provide drug exposure equivalent to daily dosing while reducing administration costs and improving patient convenience. fifteen patients will be enrolled on this study. blood samples for pk measurements will be obtained for 48 hours following a single dose of micafungin (3 mg/kg).

disseminated fungal infection is a major cause of morbidity and mortality in immunocompromised children. many of the drugs used for fungal prophylaxis have been associated with kidney and liver toxicity. also, breakthrough infections have been reported with the use of some of the oral agents due to poor oral absorption. an alternative approach is the use of intravenous micafungin for fungal prophylaxis. micafungin has a distinct advantage due to its better safety profile, specifically in terms of liver and kidney toxicity. currently, children who receive micafungin are given daily dosing. this study will examine the pharmacokinetics of micafungin when it is given on an every other day schedule. it will examine whether every other day micafungin will provide drug exposure equivalent to daily dosing while reducing administration costs and improving patient convenience. both animal and adult human data support the use of this approach. fifteen patients will be enrolled on this study and will be given a single dose of micafungin (3 mg/kg). blood samples will be drawn for pharmacokinetic measurements after administration of micafungin.

Eligibility criteria:
inclusion criteria: * hospitalized patients who are at risk for fungal infection and require prophylaxis. * age ≤ 10 years excluding neonates * children must have an indwelling venous access device * patients with adequate organ function (documented within 2 weeks prior to start of micafungin): creatinine \< 2 times upper limit normal; alt, ast and total bilirubin ≤ 3 times upper limit normal exclusion criteria: * patients who are \ 10 years of age * patients who have history of past or evidence of active fungal disease (by either radiological studies or biopsy proven) or are being treated for presumed fungal infection. * patients who have history of allergy to micafungin or other echinocandin preparations, such as caspofungin or anidulafungin. * patients who have received micafungin or other echinocandin preparations in the previous two weeks. * patients receiving antifungal prophylaxis other than fluconazole at the time of enrollment. * failure to sign informed consent, or inability to undergo informed consent process. * not medically advisable to obtain the specimens necessary.

Keywords: anti-fungal immunocompromised pharmacokinetic prophylaxis pharmacokinetics
the effect of virtual reality glasses during endoscopy

Conditions: Pain; Anxiety; Gastro-Intestinal Disorder

Summary: upper gastrointestinal endoscopy is an invasive procedure used to diagnose and treat pathologies in the gastrointestinal mucosa. since it is an invasive procedure, it can cause anxiety in patients before and pain during the procedure. virtual reality glasses are an effective method used to reduce the pain and anxiety levels of patients during painful procedures. this study aimed to evaluate the effects of virtual reality glasses on pain, anxiety, and comfort in patients undergoing upper gastrointestinal endoscopy without sedation.

this single-center randomized controlled parallel group study was conducted with 60 patients who underwent upper gastrointestinal endoscopy at the endoscopy unit of a training and research hospital in istanbul. patients in the virtual reality glasses group (n=30) watched videos of their preferred relaxing nature settings or videos without any violent content during the procedure. patients in the control group (n=30) received no intervention. data were collected using the patient information form, visual analog scale (for pain and comfort) and state anxiety inventory. pain, comfort and anxiety levels of patients were assessed five minutes before and five minutes after the procedure.

Eligibility criteria:
inclusion criteria: * to have an upper gastrointestinal endoscopy for the first time * to be performed an upper gi endoscopy without sedation * to be between the ages of 18-75 * to be willing to participate in research exclusion criteria: * to use analgesic or anesthetic drugs before or during the procedure * to use antidepressants, anxiolytic and sedative drugs * to have communication difficulties and mental disability

Keywords: pain anxiety comfort endoscopy virtual reality glasses
improving metabolic & mental health in female healthcare shift workers

Conditions: Sleep, Inadequate; Overweight and Obesity; Work Related Stress; Healthy Lifestyle

Summary: circadian rhythm disruption caused by shift work alters metabolic and hormonal pathways, which accelerates chronic disease onset, leading to decreased quality and quantity of life. preclinical studies indicate that optimizing nutrient and sleep/rest timing can mitigate these effects. female nightshift healthcare workers will be recruited to participate in a randomized crossover trial in which participants will be expected to follow the prescribed lifestyle intervention for eight weeks during the first or second eight-week periods of the study.

clinical assessments will include dexa, phlebotomy, questionnaires, and stool collection, which will be completed at weeks 0, 8, and 16 to assess changes in metabolic health and quality of life. four days of 24-hour dietary recalls will be collected at baseline, and weeks 4, 8, 12, and 16. garmin vivofit4 activity trackers will be provided to all participants at baseline, and participants will be reminded to sync the devices once weekly at minimum. during the 8-week intervention phase, participants will receive guidance on when and what to eat and when to sleep and be physically active. additionally, participants will be provided with whey protein isolate powder and grain-based snack bars to be consumed primarily during work shifts. lean body mass (kg) will be used to prescribe total caloric (\~30kcal/kg lean mass) and protein (2g/kg lean mass) needs and sleep/rest goals will be 6-8 hours per 24 hour "day."

Eligibility criteria:
inclusion criteria: * female * 18-50 years old * bmi between 27 and 40 kg/m2 * \>6 months in current predominantly night shift (average 30+ hours/week) schedule * can read and speak english * willing to correspond with study staff using smartphone technologies exclusion criteria: * pregnant or undergoing hormonal treatment for fertility * major changes in any prescription medications within 3 months * major surgeries in last 3 months * diagnosis of type 2 diabetes or other major endocrine diseases * diagnosed food allergies or significant dietary limitations * currently engaged in intensive weight loss program * minimal medically necessary radiation exposure within the last year

Keywords: circadian rhythm protein shift work female sleep
a study to assess the efficacy, safety, and tolerability of imvt-1402 as treatment for adult participants with graves' disease

Conditions: Graves' Disease

Summary: this is a study to assess the efficacy, safety, and tolerability of imvt-1402 in adult participants with graves' disease (gd) who are hyperthyroid despite antithyroid drug (atd) treatment. the primary objective of this study is to evaluate the efficacy of imvt-1402 versus placebo as assessed by t3 (total triiodothyronine \[t3\] or free triiodothyronine \[ft3\]), free thyroxine (ft4), thyroid-stimulating hormone (tsh), and atd dose at week 26.


Eligibility criteria:
inclusion criteria: * have documented diagnosis of gd. * have a tsh value \< 0.1 miu/l as assessed by the local laboratory at the screening visit. * meet one of the following at the screening visit: * have been on atd for ≥ 3 months in the period immediately preceding the screening visit and both of the following: * are on atd at the screening visit with an atd dose of ≥ 20 mg/day methimazole or equivalent for the 4-week period immediately preceding the screening visit. * are anticipated to be on a stable dose of atd for the 4-week period immediately preceding randomization. * have been on atd for ≥ 6 months in the period immediately preceding the screening visit and all of the following: * have been treated with ≥ 15 mg/day methimazole or equivalent at any point during the participant's treatment history. * are on atd at the screening visit with an atd dose a specified amount of methimazole or equivalent for the 4-week period immediately preceding the screening visit. * are anticipated to be on a stable dose of atd for the 4-week period immediately preceding randomization. additional inclusion criteria are defined in the protocol. exclusion criteria: * have previously been treated with radioactive iodine (rai) therapy or have undergone total thyroidectomy. * have a t3 (total t3 or ft3, as available and per standard of care at local laboratory) or ft4 value \< lower limit of normal (lln) as assessed by the local laboratory at the screening visit. * have received levothyroxine, desiccated thyroid extract, or t3 at any dose within 6 weeks of the screening visit. * have a history of hyperthyroidism not caused by gd (e.g., toxic adenoma or toxic multinodular goiter) and/or history of thyroid storm within 6 months of the screening visit. * have an autoimmune disease other than gd requiring treatment that, in the investigator's judgment, puts the participant at undue risk. * have moderate-to-severe active thyroid eye disease (ted) and are expected to require immediate surgical intervention and/or are planning corrective surgery/irradiation or medical therapy for ted during study participation. additional exclusion criteria are defined in the protocol.

Keywords: imvt-1402 anti thyroid drug hyperthyroidism autoimmune thyroid disease
naf/fdg pet/mri in measuring response to radium ra 223 dichloride in patients with metastatic hormone-resistant prostate cancer

Conditions: Hormone-Resistant Prostate Cancer; Metastatic Malignant Neoplasm in the Bone; Metastatic Prostate Carcinoma

Summary: this pilot clinical trial studies combined fluorine f 18 sodium fluoride (naf)/ fludeoxyglucose f 18 (fdg) positron emission tomography (pet) and magnetic resonance imaging (mri) in measuring response to a drug, radium ra 223 dichloride (ra-223), in treating patients with prostate cancer that has not responded to hormone therapy and has spread to other parts of the body. combining naf/fdg in a simultaneous pet/mri scan may help doctors accurately measure how well patients respond to treatment with radium ra 223 dichloride.

primary objectives: i. estimate the performance of simultaneous naf/fdg pet/mri for the prediction of treatment response in patients with metastatic castrate resistant prostate cancer (mcrpc). ii. estimate the performance of simultaneous naf/fdg pet/mri for detection of extra-skeletal disease progression during treatment in mcrpc patients. outline: patients receive 18f naf and 18f fdg intravenously (iv) over 30 seconds-1 minute and then undergo pet/mri and contrast-enhanced mri after 45-60 minutes. patients undergo imaging at baseline, after course 3 (12 weeks), and after course 6 (24 weeks) of treatment with ra-223. after completion of study, patients are followed up for up to 12 months.

Eligibility criteria:
inclusion criteria: * provides written informed consent * diagnosed with mcrpc and painful bone metastases, referred for xofigo (radium ra 223 dichloride) * able to remain still for duration of the imaging procedure (about one hour) exclusion criteria: * metallic implants
comprehensive yoga therapy based lifestyle prehabilitation program for women with ovarian cancer

Conditions: Ovarian Cancer

Summary: to provide a comprehensive yoga therapy (cyt) program to patients with ovarian, fallopian tube, or primary peritoneal cancer who are scheduled to receive chemotherapy and then undergo surgery. researchers want to learn about the effects of the program on patients' quality of life and other outcomes described below.

primary objectives: to assess the feasibility of a cyt prehabilitation program in women with ovarian cancer scheduled to receive nact and ids. feasibility criteria will include consent (30% of those approached) and study retention (60%) rates. secondary objectives: examine the effects of the cyt program on physical conditioning as assessed by the 6 min walk test (6mwt) and sit to stand reps (30secsts) compared with wlc. examine group differences in surgical outcomes including post op stay, readmission rate, post op morbidity, surgical site infection rate, transfusions, and time to first chemotherapy post operatively. examine group differences in patient-reported outcomes including qol, fatigue, stress, sleep disturbances, mental health, social support, and mindfulness. examine if there are group differences in preoperative albumin level, vit d, magnesium levels. examine group differences and changes over time in microbiome biodiversity. examine group differences in body composition (sarcopenia) as measured by routine abdominal ct scans. explore the association between adherence to the components of cyt with ability to sustain behavior changes and between changes in lifestyle parameters with outcomes. this will be explored both within and across groups.

Eligibility criteria:
inclusion criteria: 1. women with stage iii-iv epithelial ovarian, fallopian tube, primary peritonal cancer with recommendations for nact/ids at recruitment. 2. able to read, write, and speak english. 3. 18 years of age or older. 4. oriented to person, place, and time. 5. access to internet connection. 6. access to a tablet, laptop or computer or smart phone. 7. plan for surgical intervention at md anderson cancer center 8. performance status 0-2. exclusion criteria: 1. have completed chemotherapy. 2. any major thought disorder (e.g., schizophrenia, dementia). 3. any major communication barriers that would preclude being able to complete the intervention (e.g., visually or hearing impaired). 4. extreme mobility issues (e.g., unable to get in and out of a chair unassisted).
non invasive dp/dt to detect an acute ischemic myocardial dysfunction in emergency department

Conditions: Acute Myocardial Ischemia

Summary: most patients presenting to the emergency department with chest discomfort have a nonischemic ecg and biomarkers of myocardial necrosis within normal limits. these patients are routinely admitted to hospital because of diagnostic uncertainty for occult mi or ischaemia. acute myocardial ischemia is associated with acute mycardial dysfunction we tested a non-invasive plethysmographic arterial pressure change index of myocardial performance (dp/dt) that could be added to the diagnostic triage of ischaemia in the er avoiding unnecessary admissions.

for patients with chest pain , the ecg remains the most important initial risk assessment tool. myocardial ischemia or infarction is highly likely in patients with significant st segment changes on the ecg or elevation in myocardial markers of necrosis. identification of high-risk patients is more difficult in those with non ischemic ecg and negative markers on presentation. one of the most sensitive indices of contractility is the rate of increase of intraventricular pressure during isovolumetric contraction, (left ventricular dp/dt and arterial dp/dt). dp/dt (dp/dt ejc ) represents the rate of change of pressure during ejection. it has been shown that cardiac contractility and dp/dt decreases during acute myocardial ischemia. we theorized that a higher value of dp/dt would be found for non ischemic chest pain than during ischemic chest pain because ischemia reduces myocardial contractility, whereas chest pain of non cardiac origin increases dp/dt by the stress of the pain itself. the current study describes a noninvasive plethysmographic dp/dt changes in patients presenting at the emergency department with acute chest pain, which could be added to the diagnostic triage of ischemia in the ed, thus decreasing the number of unnecessary admissions.

Eligibility criteria:
inclusion criteria: * age over 18 year old * chest pain that lasted less than 12 hours exclusion criteria: * traumatic chest pain * arrythmias * stemi

Keywords: chest pain myocardial ischemia acute myocardial dysfunction plethesmography non invasive dp/dt