Kornimate/medical-research-clean huggingface dataset:
hd21 for advanced stages

Conditions: Classical Hodgkin Lymphoma

Summary: primary objective of the trial is to demonstrate non-inferior efficacy of six cycles of brecadd compared to six cycles of escalated beacopp, each followed by radiotherapy to pet-positive residual lesions ≥2.5 cm, in terms of progression free survival (efficacy objective). if non-inferior efficacy can be shown, the co-primary objective is to further demonstrate reduced toxicity of the brecadd treatment compared to the escalated beacopp treatment measured by treatment related morbidity (trmorbidity objective).


Eligibility criteria:
inclusion criteria: * histologically proven classical hodgkin lymphoma * first diagnosis, no previous treatment, 18 to 60 years of age * stage iib with large mediastinal mass and/or extranodal lesions, stage iii or iv exclusion criteria: * composite lymphoma or nodular lymphocyte-predominant hodgkin lymphoma * previous malignancy (exceptions: basalioma, carcinoma in situ of the cervix uteri, completely resected melanoma tnmpt1) * prior chemotherapy or radiotherapy
comfort score during ultrasound guided supraclavicular brachial plexus block placement in elderly patients

Conditions: Arm Injuries; Wounds and Injuries

Summary: results from our preliminary study accepted as e-poster presentation on esra (bordeaux, september 2012.) showed significant difference in comfort score during ultrasound guided supraclavicular brachial plexus block (us-scb) between young and elderly population. however, it is unknown whether the difference in comfort score (1) was associated with reduction of local anesthetic (la) volume in elderly or it is attributed to elderly population by itself. the aim of the study is to compare the comfort score during us-scb placement in elderly patients undergoing upper limb surgery performed with two different volumes of local anesthetics (20 ml vs 32 ml).

involutional changes of brachial plexus in elderly, assessed by measuring the cross-sectional area (csa) of brachial plexus at the first rib, allowed a 35% reduction of la volume for an effective us-scb in comparison with the younger patients (2). ultrasound-guided regional anesthesia becomes an increasingly popular technique and its performance must be as comfortable as possible. therefore, comfort score during block placement is extremely important. comfort score is consisted of maximum pain intensity (vas), the satisfaction of the patient and the number of unpleasant events declared by the patients. it is calculated as the sum of each criterion, which was attributed a value of 0 or 1: vas(\ 30/100, 0), number of unpleasant events (0, 1; \>or=1, 0) and satisfaction (satisfied or very satisfied, 1; acceptable or unsatisfied, 0). comfort score of 3 or 2 is considered as comfortable while score 1 or 0 as uncomfortable block placement.

Eligibility criteria:
inclusion criteria: * age over 65 years (elderly group) * upper limb surgery exclusion criteria: * refusal of regional anesthesia * any neurologic or neuromuscular disease * clinical signs of cutaneous infection at the site of needle insertion

Keywords: arm injuries wounds and injuries lidocaine levobupivacaine bupivacaine anesthetics central nervous system depressants physiological effects of drugs
epidemiology of cardiac development in youth

Conditions: Cardiovascular Diseases; Heart Diseases

Summary: to document normal developmental changes in cardiac structure and function during late childhood and adolescence.

design narrative: the investigators documented the nature and extent of changes in cardiac structure based on m-mode measurements and developed corresponding reference values. they documented the nature and extent of changes in cardiac function based on pulse doppler measures and indices and developed corresponding reference values. they also investigated clinical findings based on m-mode and doppler measurements as well as changes in body size and composition, sexual maturation, and other covariates. they used existing data from project heartbeat! 's 12 four-monthly examinations over the age range from 8 to 17 years. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
no eligibility criteria
comparison between low fodmap and ssrd in ibs

Conditions: IBS - Irritable Bowel Syndrome

Summary: the aim of the present study is to compare the efficiency of low fodmap and ssrd to reduce symptoms in ibs, and to study the mechanisms and consequences of the two diets.

the investigator will perform a study on 200 subjects with verified irritable bowel syndrome (ibs). participants will be recruited from the clinic of gastroenterology or internal medicine as well as primary health care centers. at the start of the study, participants will complete protocols concerning rom iv criteria (to validate that the ibs criteria are ful-filled) as well as ibs symptom rating scales irritable bowel syndrome-symptoms severity scores (ibs-sss) and visual analog scale for irritable bowel syndrome (vas-ibs). the item health survey 1.0 (distributed by rand), rand-36, includes the same items as those in the short-form health survey (sf-36), and evaluates the quality of life. scoff is a brief questionnaire that asks the five questions about eating disturbances (do you make yourself sick because you feel uncomfortably full? do you worry you have lost control over how much you eat? have you recently lost more than one stone in a 3 month period? do you believe yourself to be fat when others say you are too thin? would you say that food dominates your life?). participants will be examined by an investigator who will complete protocols of clinical data. blood and fecal samples will be collected by the investigator. study participants will thereafter be randomized to receive either low fodmap (fermentable, oligo-, di-, mono-saccharides and polyols) diet (n=100), or a ssrd diet (starch ans sucrose-reduced diet) (n=100). after 4 weeks of dietary intervention, there will be a follow-up where blood and fecal samples are once again collected. at this point in time, participants will also fill in ibs symptom rating scales again. the participants are then free to eat whatever they want to, and another 5 months later, they will be examined again, the same protocols will be completed, and blood and fecal samples are collected. the investigator will use samples from baseline, 4 weeks and 6 months, for genetic/epigenetic (including genomic-wide association studies), metabolomics, proteomics, nutritional data, gut microbiota, and inflammatory parameter analyses. statistics the investigator will use mann-whitney u-test and wilcoxon test to study differences in the above-mentioned parameters between the two treatment groups, as well as before and after dietary intervention, respectively. for analyses of genetic/epigenetics, metabolomics, proteomics, and microbiota, the investigator will use bioinformatics and biostatistics.

Eligibility criteria:
inclusion criteria: * verified ibs according to rom iv criteria. exclusion criteria: * serious mental disease * serious somatic disease * abuse * inability to understand the swedish language * already on a diet

Keywords: ibs low fodmap ssrd
estrogen (gel)transdermal vs oral estrogen for endometrial preparation

Conditions: Frozen Embryo Transfer; Infertility, Female

Summary: the goal of this randomized study trial is to comparing transdermal estradiol gel and oral estradiol for endometrial preparation in the frozen embryo transfer cycle. the main question\[s\] it aims to answer is: • can transdermal estrogen (gel) can be equally efficacious as compared to oral estrogen in hormone replacement fet (hrt- fet) cycles ? the transdermal gel would have the added benefit of a higher patient comfort with fewer side effects and a better safety profile. participants planned for frozen embryo transfer will undergo h-p-o axis suppression on previous cycle d21 of menses with gonadotropin-releasing hormone(gnrh) agonist depot preparation (inj. decapeptyl 3.75 mg) im . the study will compare transdermal e2 gel with oral e2 tabs. the patients will be randomized into an oral and gel group, and all patients will participate only once in the study.

estrogen priming is essential for the induction of progesterone receptors and to build endometrial thickness, both of which play an important role in regulating endometrial receptivity . different routes of estrogen administration are oral (tablets), transdermal (patch/gel), and vaginal (tablets).

Eligibility criteria:
inclusion criteria: * infertile patients aged 23-35 years. * bmi 18.5 to 29.9 kg/m2. * a normal uterine cavity assessed by 3d ultrasound (usg)/hysteroscopy. * patients who underwent ivf/icsi and who have cryopreserved their embryos. * those receiving donor oocytes or donor embryos. * patients undergoing hormonal replacement frozen embryo transfer (hrt-fet) cycles with gnrh agonist suppression. * embryo transfers of good quality embryos -2/3/4/5 aa, ab, ba(as per gardner grading system). exclusion criteria: * preimplantation genetic testing for aneuploidies (pgt-a) cycles. * patients who had a fet performed in natural or stimulated cycles. * patients who had more than 2 failed transfers due to thin endometrium. * patients having uterine anomalies. * known cases of adenomyosis and endometriosis. * underlying cardiac/renal/hepatic/thromboembolic disorders, h/o anxiety or depression. * e2 \>50 pg./ml, p4 \> 1 ng/ml and on d2 of menses. * on d2 scan presence of a cyst or a dominant follicle. * patients with a history of recurrent 1st-trimester abortions.

Keywords: transdermal estrogen fet oral estrogen ivf/icsi
the effects of manual therapy in hemophilic patients

Conditions: Hemophilia; Arthropathy Hemophilic

Summary: uncertainty about how to treat existing hemophilic arthropathy (ha) is the most important issue that will increase functionality and joint health. recent studies have shown that mt can be used safely for improving joint health, pain and rom with no bleedings in pwh with elbow and ankle ha. unlike mt studies in hemophilia, we investigated the effects of mt on important parameters such as muscle strength (ms), functional level, joint health, functional independence score in hemophilia (fish) and kinesiophobia. these parameters are closely related to functional level and quality of life of pwh. therefore, evaluation of these parameters and determining the effects of the mt on these parameters are very important for both pwh and also clinicians.

the aim of this study was to investigate the effects of manual therapy in addition to home exercise program on hemophilia functional independence level, joint health, kinesiophobia, functional level, range of motion, muscle strength and pain level in hemophilic individuals with lower extremity joint arthropathy. hemophilic arthropathy was developed in at least one of the lower extremity joints and aged between 18-30 years 17 severe type hemophilic men were participated in the study. the participants were divided into two groups as home exercise group (heg) and manual therapy group (mtg) by randomization method. while the heg was performed the exercise program at home, in addition to the same heg manual therapy were applied to the mtg by the same physiotherapist 3 days a week for 1 hour. both groups were followed for a total of 5 weeks and pre-treatment evaluations were repeated post-treatment. the joint health of the hemophilics in both groups were evaluated with hemophilia joint health score (hjhs), their kinesiophobia level were evaluated with tampa kinesophobia scale, their functionality with the functional independence score in hemophilia (fish). in addition, functional reach, timed up and go and 5 times sit-to- stand tests were used for functional level. the range of motion was evaluated with a goniometer, muscle strength was measured with a digital dynamometer and pain level was assessed with a visual analogue scale (vas). number of hemarthrosis decreased in both groups.

Eligibility criteria:
inclusion criteria: * patients with hemophilia who have arthropathy developed in any of the lower extremity joints due to severe hemophilia and to be receiving regular prophylaxis (3\*1500 iu/ per week), but not having regular physical activity and sports. exclusion criteria: * patients with hemophilia who had any disease related to connective tissue, any surgery that affects lower limb function (joint debridement, fracture, prosthesis), any neurological disease or cognitive impairment that may affect functional level, any sensorial loss of peripheral nerve injury and did not attend their sessions and evaluations regularly.

Keywords: hemophilia arthropathy physiotherapy manual therapy joint health
achilles tendon rupture, conservative vs. operative treatment: prospective randomized controlled trial

Conditions: Achilles Tendon Rupture

Summary: the intention is to compare prospectively operative and conservative early functional rehabilitation protocol in treatment of total achilles tendon rupture. to compare these treatments, the investigators use 1998 published leppilahti-score, rand-36 quality of life-questionnaire and mri. the leppilahti-score includes both subjective and objective items (pain, stiffness, subjective calf muscle weakness, footwear restrictions, active range of motion between ankles, subjective result, isokinetic calf muscle strength). the investigators also study mri-imaging for both legs and compare including achilles tendon elongation and muscle volume correlations to leppilahti-score results between these two treatments. follow-up time is 18 months. hypothesis is that operative treatment offers no benefit in comparison conservative treatment, with identical rehabilitation protocol.


Eligibility criteria:
inclusion criteria: * 18-65 years, clinical diagnosis of total achilles tendon rupture, ultrasonography controlled tendon ends reposition when ankle is in equinus/ plantar flexion. exclusion criteria: * earlier achilles tendon disorders, corticosteroid injections in achilles tendon, fluorokinolol-antibiotics in 2 years earlier, systemic corticosteroid medication, diabetes, peripheral arterial disease, more than 7 days old rupture, patient lives abroad or patient refused to participate.

Keywords: achilles tendon rupture treatment, elongation operative treatment of achilles tendon rupture conservative treatment of achilles tendon rupture
tak-954 in critically ill participants with enteral feeding intolerance (efi)

Conditions: Critical Illness; Enteral Nutrition; Enteral Feeding Intolerance

Summary: the purpose of this study is to assess the treatment effect of intravenous tak-954 in improving the average daily protein adequacy received through enteral nutrition in critically-ill participants developing efi.

the drug being tested in this study is called tak-954. the study will assess the treatment effect of intravenous tak-954 in improving average daily protein adequacy received through enteral nutrition in critically ill participants with efi. the study will enroll approximately 200 participants. participants will be randomly assigned (by chance, like flipping a coin) to one of the 4 treatment groups -which will remain undisclosed to the participant and study doctor during the study (unless there is an urgent medical need): * group a: tak-954 0.1 mg * group b: tak-954 0.3 mg * group c: tak-954 1 mg * group d: metoclopramide 10 mg this multi-center trial will be conducted in the united states, united kingdom, australia and canada. the overall duration of treatment in this study is maximum of 14 days while in hospital. participants will be contacted by telephone 30 and 90 days after receiving their last dose of study drug for a follow-up assessment.

Eligibility criteria:
inclusion criteria: 1. has at least a size 12-(french size) fr nasogastric or orogastric tube with its tip at least 10 centimeter (cm) below the esophagogastric junction confirmed radiologically (the tip of the tube must be in the body or the antrum of the stomach and not in the fundus). 2. is intubated and mechanically ventilated in the icu. 3. is expected to remain alive, mechanically ventilated, and receive continuous enteral feeding for \>=48 hours following randomization. 4. have efi, defined as a single grv measurement of \>=250 ml with vomiting/retching within the last 24 hours, or a single grv measurement of \>=500 ml with or without vomiting/retching within the last 24 hours. exclusion criteria: 1. is under consideration for withdrawal of life-sustaining treatments within the next 72 hours. 2. has had major esophageal or gastric surgery or direct luminal trauma on this admission (participants with lower abdominal surgery are not excluded unless enteral feeding is contraindicated). 3. has mechanical bowel obstruction, short bowel syndrome, or the presence of an active gastric pacemaker. 4. have pre-existing hepatic disease that meets child-pugh class b (moderate; total score 7 to 9 points) or c (severe; total score 10 to 15 points). 5. has been admitted primarily for treatment of a drug overdose. 6. has a presence of a post-pyloric tube in place at randomization that may be used for enteral nutrition. 7. is receiving parenteral nutrition (pn) at screening. 8. is in diabetic ketoacidosis or non-ketotic hyperosmolar coma. 9. has a different nutrient requirement than allowed in feeding protocol.(outside a range of 1.2 to 2 gram per kilogram per day \[g/kg/day\] of proteins and up to 1.5 kilocalorie per milliliter \[kcal/ml\]).

Keywords: drug therapy
youth mayo clinic anxiety coach randomized controlled trial

Conditions: Anxiety

Summary: this research study aims to test the feasibility and effectiveness of using the mayo clinic anxiety coach smartphone app as an addition to traditional therapy for the treatment of anxiety disorders in youth, particularly those youth who may have limited access to mental health treatment in the traditional clinical setting.

60 therapists in underserved areas will treat children with anxiety disorders in one of three conditions (treatment as usual, anxiety coach with face-to-face therapy, or anxiety coach with minimal direct contact) to determine the feasibility of using of anxiety coach to increase the frequency of exposure and improve outcomes with varying degrees of face-to-face contact (n = 60 patients).

Eligibility criteria:
inclusion criteria: 1. age 7 to 17 2. primary diagnosis of: 1. social phobia, 2. separation anxiety disorder, 3. panic disorder with and without agoraphobia, 4. specific phobia, or 5. obsessive compulsive disorder 3. a parent or other primary care giver available to participate with the child in all assessment and treatment activities 4. estimated average intelligence 5. english speaking exclusion criteria: 1. history of and/or current diagnosis of: 1. psychosis, 2. autism, 3. bipolar disorder, 4. mental retardation, 5. oppositional defiant disorder, 6. ptsd, 7. selective mutism, or 8. major depressive disorder 2. current suicidality or recent suicidal behavior 3. parent to be involved in study who is unable to adequately participate due to intellectual or psychiatric difficulties 4. starting or changing the dosage of a psychiatric medication in the last two months

Keywords: anxiety social anxiety social phobia separation anxiety generalized anxiety gad phobia panic agoraphobia obsessive compulsive disorder ocd child adolescent smartphone teen youth
sleep enhancing tools: pilot study

Conditions: Sleep; Pain

Summary: to demonstrate whether use of sleep enhancing aids (face mask, ear plugs or white noise machine) in hospitalized patients can positively affect subjective symptoms of sleep quality, fatigue and pain.

a randomized, clinical pilot to trial the effect of sleep tools on patients' perception of sleep within the hospital setting. we propose to conduct this pilot study to improve subjective symptoms of sleep deprivation in non-icu hospitalized subjects by performing a brief intervention, easily performed at the point of care. given the heterogeneity of hospitalized patients with varying ages, co-morbidities and other factors (such as pain and fatigue), we felt that an initial pilot study should focus on acceptability of three sleep aids (ear plugs, eye masks and white noise machine) among hospitalized non-icu patients. patients will be able to choose which aid they use and will be allowed to change aids during their hospital stay. the primary outcomes of this study will be 1) improvement in perceived sleep quality as measured by promis, a validated patient-reported outcome information system and 2) quality of care measures (length of stay, medication use and participation in therapy sessions). promis (patient reported outcomes measurement information system) is an nih sponsored health survey tool. information on characteristics (both patient and environment) including demographics, illness severity, number of medications, specific medications (such as sedatives and pain medications) will be collected to examine which predictors of improved perception of sleep quality correlate with use of sleep aids. this study is intended to focus on modifying the environment at the patient level rather than addressing the sources of environmental hospital noise. our study has the potential to impact this field with a preventative education based intervention, using simple tools in the non-icu setting. it is important to understand this is not a study measuring sleep objectively but whether hospitalized patients perceive they sleep better if sleep aids are used.

Eligibility criteria:
inclusion criteria: * admitted to a private room in the hospital * speak and read english * expected length of stay \> 2 days exclusion criteria: * hearing aids * sleep apnea using positive airway pressure therapy * medically or behaviorally unstable

Keywords: survey
depression ,anxiety and stress disorders among diabetic patients in assuit university hospitals

Conditions: Diabetes Mellitus

Summary: 1. assessment the prevalence of psychiatric disorders in diabetic patient in assuit university hospital. 2. determine the associated factors with the psychiatric disorders.

across the world, both diabetes and psychiatric disorders are on rise. diabetes strongly affects disability, mortality, and global health expenditure. diabetes mellitus is a disabling long-term health condition that is common and growing. globally, it affects 10.5% of the population and is the leading cause of lost disability-adjusted life years type 1 diabetes is a lifelong autoimmune disease characterized by insulin deficiency and resultant hyperglycemia. it constitutes around 10% of all diagnosed cases of diabetes and its incidence is increasing globally. type 2 diabetes mellitus (dm2) is a chronic metabolic disease characterized by an increase in normal serum glucose levels (hyperglycemia). psychological disorders can occur in people with diabetes of all ages. type 1 diabetes seems to have a higher prevalence of psychological disorders than type 2 diabetes. about 15%-20% of people with diabetes are suffering from depression. the exact cause of depression in people with diabetes is unknown, it is likely complex due to a combination of genetic, physiological, and psychological factors. depression and anxiety could worsen the prognosis of diabetes by reducing the patients' ability to self-care and increasing non-compliance to treatments while increasing the risk of serious short-term and long-term complications such as blindness, amputations, stroke, and even premature death.

Eligibility criteria:
inclusion criteria: age between 18 and 70 years diagnosed according to criteria of the american diabetes association fasting plasma glucose (fpg) level of 126 mg/dl (7.0 mmol/l) or higher or a 2-hour plasma glucose level of 200 mg/dl (11.1 mmol/l) or higher during a 75-g oral glucose tolerance test (ogtt). exclusion criteria: * patient with cognitive difficulties * to be very sick and unable to give consent * women who were pregnant or had given birth in the last 6 months

Keywords: depression anxiety stress