Kornimate/medical-research-clean huggingface dataset:
hiv testing in pregnant women: evaluating an opt-out testing strategy

Conditions: HIV; AIDS Virus; Pregnancy

Summary: mother-to-child transmission of hiv is an important but preventable mode of infection. prevention depends on identifying pregnant women infected with hiv and offering medications during pregnancy which can dramatically decrease the chances of transmission. currently universal screening of all pregnant women for hiv is recommended in the province of ontario. unfortunately the rates of screening are still low: estimates place the average rate at 50% -60%. we believe that rates in our clinic at the women's health care centre are significantly higher in part because all our patients have a first obstetrical visit. this is an unhurried visit with a trained obstetrical nurse who offers pre-test counselling and explores reasons why patients refuse testing. we hypothesize that with this system, acceptance rates for hiv screening are significantly higher than the provincial average.

we hypothesize that by having a dedicated and unhurried intake visit with a trained obstetrical nurse, pregnant women will be more likely to accept antenatal hiv testing. we further hypothesize that in our obstetrical clinic at the women's health care centre, the application of a universal opt-out screening policy will result in a testing rate that is higher than the provincial average. this is a two part study. the first part will be a retrospective chart review while the second part will be a prospective cohort study. all antenatal patients with first visits at our clinic will be included. for the retrospective portion, 537 charts will be reviewed. for the prospective portion, 537 patients will be enrolled prospectively using a data sheet which will be included in all charts starting when the study begins. for both portions, the following information will be obtained: * presence of hiv test * result of test * if test not performed, the reason documented, in any * if testing refused, the reason for refusal additional information that will be obtained includes: * number of hiv positive pregnant women cared for in our clinic during the study period * percentage of positive cases * difference in testing (acceptance) rates between the retrospective and prospective (when data sheet in use) portions of the study.

Eligibility criteria:
inclusion criteria: * all pregnant women attending antenatal intake appointments at the women's health care centre at st. michael's hospital in toronto, canada between september 2003 and february 2005. exclusion criteria: * any pregnant women obtaining antenatal care at other health care facilities.

Keywords: hiv testing in pregnant women
effects of reverse natural apophyseal glides as compared to ventro-cranial translatoric glides in the management of upper thoracic spine hypomobility.

Conditions: Upper Thoracic Spine Hypomobility

Summary: this study is a randomized controlled trial and the purpose of the study is to determine the effects of reverse nags as compared to ventro-cranial translatoric glides in upper thoracic spine hypomobility in terms of pain and range of motion.

objectives: the objectives of this study are : 1. to determine the effects of reverse nags as compared to ventrocranial translatoric glide on upper back pain in upper thoracic spine hypomobility. 2. to determine the effects of reverse nags as compared to ventrocranial translatoric glide on thoracic rom in upper thoracic spine hypomobility. hypothesis: alternate hypothesis: 1. there will be a statistically significant difference in the effects of reverse nags as compared to ventrocranial translatoric glides in terms of upper back pain in persons with upper thoracic hypo mobility (p\<0.05). 2. there will be a statistically significant difference in the effects of reverse nags as compared to ventrocranial translatoric glides in terms of thoracic rom in persons with upper thoracic hypo mobility (p\<0.05). null hypothsis : 1. there will be no statistically significant difference in the effects of reverse nags as compared to ventrocranial translatoric glides in terms of upper back pain in persons with upper thoracic hypo mobility (p\>0.05). 2. there will be no statistically significant difference in the effects of reverse nags as compared to ventrocranial translatoric glides in terms of thoracic rom in persons with upper thoracic hypo mobility (p\>0.05). research design : experimental study .randomized control trail.

Eligibility criteria:
inclusion criteria: * 1. both male and females 2. adults (18-39 years) 3. upper thoracic hypomobility (flexion \<20° or extension \<25° or side bending \<20° or rotation \<35°) exclusion criteria: * 1-ankylosing spondylitis 2-history of spinal fusion or spinal surgery (discectomy/laminectomy etc.) 3-degenerative disc disorders 4-cervical radiculopathy, scoliosis 5-spinal stenosis or myelopathy 6-recent fracture or surgery 7-tb of spine, spondylolisthesis 8-not able to attend regular therapy appointments 9-fibromyalgia/myofascial pain syndrome
low-dose risperidone treatment for subjects suffering from borderline personality disorder

Conditions: Borderlone Personality Disorder

Summary: personality disorders are life-long maladaptive behavioral patterns. borderline personality disorder (bpd) is the leading personality disorder encountered in clinical settings, often associated with tremendous distress. it is characterized by impulsivity, emotional lability, unstable interpersonal relationships, with particular sensitivity to abandonment. bpd patients are prone to self destructive behaviors and all too frequently attempt suicide. when in emotional turmoil, persons with bpd may also develop brief, transient psychotic states. psychotherapy for bpd is a common treatment option, but it requires considerable time and specific personnel training, and is therefore not always feasible. medical treatment is an efficacious alternative, however there is no concensus on drug selection. some experts have suggested that medical treatment should be selected individually according to the subject's dominant clinical symptom. several psychopharmacological groups have been proposed: antidepressants, mood stabilizers, and several novel antipsychotic drugs. the latter are particularly promising since they may produce symptomaic improvement with fewer adverse effects. risperidone has been shown in a few preliminary studies to be promising in the treatment of various bpd symptoms, but no controlled study has tested it yet. we propose to test the efficacy of risperidone in the treatment of bpd in a double-blind crossover design using both clinical and phsysiological measure.the main hypothesis is that risperidone will be efficient in alleviating bpd core and secondary symptoms.


Eligibility criteria:
inclusion criteria: 1. women with borderline pd according to dsm-iv 2. signed informed consent. 3. age 18-45. exclusion criteria: 1. psychotic disorders (past or present). 2. substance or alcohol related disorders (past or present). 3. current major depressive episode. 4. suicidal risk. 5. history of head trauma, which caused loss of consciousness or peritraumatic amnesia or necessitated hospitalization. 6. any known psychiatric or general medical condition currently requiring specific medical attention. 7. current treatment with any antipsychotic, antidepressant drugs or mood stabilizers.

Keywords: risperidone borderlone personality disorder
natural progesterone and preterm birth in twins

Conditions: Preterm Birth

Summary: to assess the effectiveness of natural progesterone supplementation in preventing preterm births in twins.

objective: to assess the effectiveness of natural progesterone supplementation in preventing preterm births in twins. study design: national multicenter randomized double blind controlled clinical trial. setting: six tertiary hospitals in the east of spain (communities of valencia and murcia): instituto universitario ivi valencia, hospital universitario la fe (valencia), hospital universitario dr. peset (valencia), hospital general universitario (alicante), hospital vega baja de orihuela (alicante) y hospital virgen de la arrixaca (murcia). population: 246 bichorionic biamniotic twin pregnant women divided in three groups according to the allocated randomized treatment: (i) placebo (n=82); (ii) 200 mg progesterone (n=82); and (iii) 400 mg progesterone (n=82). methods: all participant women will self-administer two vaginal pessaries at bedtime containing the allocated treatment. vaginal pessaries will be identical externally but will contain either placebo or 200 mg of natural progesterone (laboratorios effik, madrid, spain). the treatment will be applied from the 20th week until the 34th week (or until delivery if it occurred earlier). control visits will be performed at 24, 28, 32 and 34 weeks. pregnancies will be managed according to each local protocol. an external statistical analysis will be performed on intention to treat basis. main outcome measure: preterm birth rate (\<37 weeks). secondary outcome measures: very preterm birth rate (\<32 weeks); cervical length measured by vaginal ultrasound at each control visit; need for tocolytic treatments; rate of preterm premature rupture of membranes; and perinatal morbidity and mortality. estimated period of study: 2006-2008.

Eligibility criteria:
inclusion criteria: * bichorionic biamniotic twin pregnant women * = or \> 18 years old exclusion criteria: * single pregnancy or monochorionic twin pregnancy or triplets * chronic hepatic pathology, previous alterations in hepatic analysis during anti-contraceptive treatment; or gestational cholestasis in in previous pregnancies.basal alterations in hepatic analysis profile. * profylactic cerclage until week 14. * basal alterations in renal analysis profile * local allergy to micronized natural progesterone * genital pathology not allowing for correct absorption of medication * fetal anomoly diagnosed after sonograph week 12 and/or 20. * smokers of more than 10 cigarettes/day * consumers of illegal substances

Keywords: preterm birth progesterone twins preterm birth in twin gestations
14/21 diet-walking in the park

Conditions: Overweight: 25 <BMI <30

Summary: the scientific literature shows a quantitative relationship between diet combined with physical activity as a long term weight reduction modality and an important factor in weight maintenance. primary assumption - the 14/21 diet will have an impact on bmi values, and their long-term maintenance. secondary assumption - the 14/21 diet will have a positive impact on anthropomorphic and biochemical markers, on blood pressure, resting heart rate, rmr, and life quality.

an interventional part for a duration of 56 days and a follow-up period including monitoring of different parameters. follow up session are set to 3, 6, 12 and 24 months from the end of the interventional period. participants will be recruited in several rounds, each including up to 25 participants. diet program is divided into 3 periods: 1. low carb diet for 14 days; 2. low carb and regular diet in alternating days for 21 days; 3. individual carbohydrate-rich diet for 21 days. the diet consists of a free choice of food ingredients from a detailed list of foods in each category (proteins, carbohydrates, vegetables, fat etc.). the participants are free to choose the types of food as long as they are within the specified allowance (quantity) for each food group.during the intervention period subjects will meet for walking. in addition, 30 minutes of aerobic exercise will be recommended 3 times/week.

Eligibility criteria:
inclusion criteria: hebrew speaking 25\<bmi\<30 18 years old or older signed an informed consent exclusion criteria: subjects who have a physical disability preventing them from exercise, subjects who are pregnant or lactating, subjects who are currently involved in another lifestyle intervention program, subjects who had undergone bariatric surgery in the past, subjects with: cancer, liver/kidney disease, organ transplantation, alcohol/drug addiction, subjects that have cognitive deterioration or psychosis, vegetarians who does't eat fish/sea food or vegans -

Keywords: 14/21 diet bmi biochemical blood markers quality of life
comparision of pvc ablation techniques

Conditions: Premature Ventricular Contraction

Summary: several reports have shown the utility of pvc ablation with cryo catheters. the aim of this study is to compare the outcomes and safety of cryo vs. rf for pvcs.

background: radiofrequency (rf) catheter ablation (ca) is an effective therapeutic strategy in eliminating refractory idiopathic ventricular outflow tract (ot) ventricular arrhythmias (va). however, early and late recurrences occur commonly. rfca has also been reported to be associated with collateral damage and pain. the use of cryo ablation as a safer alternative energy source been previously described. in several reports cryo was reported to successfully treat va originating from the ot in the absence of ablation related pain and collateral damage to adjacent structures such as the coronaries. when comparing outcomes and complications of catheter ablation of va from the papillary muscles of the left ventricle with either cryo or rf, cryo was found to be associated with significantly higher success rates and lower recurrence rates than rfca. aim: to compare the outcomes and safety of cryo vs. rf for pvcs. methods: patients with pvc va will be randomized in a 1:1 fashion to rfca or cryo ablation. all procedures will be done using a 3-dimensional mapping system (ensite™ navx™ system, st. jude medical). ablation will be performed at sites with earliest activation or at least pacemap exhibiting qrs morphology match of \>11/12. endpoint of procedure will be elimination and non inducibility of the clinical va. all patients will undergo continuous monitoring for at least 12 hours post procedure and 12 lead holter and exercise testing 1 month post procedure. successful ablation will be defined as absence of clinical va or \> 50% reduction in arrhythmia burden on holter in the absence of anti-arrhythmic medications.

Eligibility criteria:
inclusion criteria: 1. patients referred for pvc ablation. 2. age ≥ 18 years on a date of consent. exclusion criteria: 1. contraindications for ablation 2. serious known concomitant disease with a life expectancy of \< 1 year 3. elderly patients \>80 years of age 4. pregnancy or nursing 5. unwilling or unable to give informed consent

Keywords: ablation; cryo energy; radofrequency ablation
investigation of arm swings characteristics in patient with chronic obstructive pulmonary disease

Conditions: Chronic Obstructive Pulmonary Disease; Postural; Defect; Gait, Unsteady; Dyspnea

Summary: the former aim of this study is to determine whether the arm swings change in patients with chronic obstructive pulmonary disease (copd) according to healthy subjects. the latter purposes to investigate the correlation between balance parameters and arm swing, how to change arm swing according to severity of the disease, and to determine the relationship between balance and the severity of disease, the relationship of posture both arm swing and severity of disease in patients with copd. in accordance with this purposes, 20 patients with copd who have global initiative for chronic obstruction lung disease (gold) stage 1-2-3 and 20 healthy controls will be included between the ages of 40 and 65, respectively. tests and questionnaires will be used in order to determine the severity of copd and to evaluate posture. berg balance scale, time up and go test, 6 minute pegboard and ring test, 6 minute walk test and gait analysis will be performed. it is expected that by determining the parameters that can be affected by severity of copd. it is estimate to have information about severity of the disease by means of observational analysis. it will guide professional working in the field.


Eligibility criteria:
inclusion criteria: * who has been clinically stable for the last 4 weeks, * who will be able to walk independently for 6 minutes, * according to the classification of airflow limitation in copd (gold) system, the stage is 1-2-3, * who declares that he has not taken part in any other research exclusion criteria: * walking assistive devices, * receiving chronic oxygen therapy, * with central and peripheral vestibular disease, * with orthopedic, neuromuscular, neurological and cardiac diseases that may affect gait and balance, * with a history of lung cancer, sarcoidosis, tuberculosis and/or lung surgery, * who has communication problems, * with mental and cognitive problems
suicide gene therapy trial

Conditions: Haploidentical Stem Cell Transplantation

Summary: bone marrow or blood stem cell transplantation is used to treat a wide range of life-threatening conditions. t lymphocytes carried in the graft have powerful beneficial effects and play a vital role in the eradication of leukaemia and in fighting infection, but can also damage healthy tissues and cause graft-versus-host disease (gvhd). to safeguard against gvhd, the investigators propose modifying t cells to encode a 'switch' so that they can be eliminated if problems arise. children receiving half-matched (haploidentical) transplants from a parent are most likely to benefit from this strategy. at present these patients receive blood stem cells from a parent, but the t cells are removed because the risk of serious gvhd is unacceptable. this means that they are much more likely to suffer from life threatening infections or experience a relapse of leukaemia. the investigators want to use gene therapy to produce "safe" t cells which can be used to strengthen the transplant and prevent these serious complications.


Eligibility criteria:
inclusion criteria: 1. patients with primary immunodeficiencies, haematological malignancies or metabolic disorders at gosh (children of both sexes, aged 0 to 16 years) undergoing haploidentical transplant 2. both patient and donor must give informed consent in writing. 3. the donor must be willing, able and available for donation of t cells by collection of whole blood or leukapheresis. 4. the patient should be free of serious intercurrent illness. exclusion criteria: 1. donor unfit or unavailable 2. donor positive for hepatitis b or c, or htlv-1, or hiv 3. patient receiving ganciclovir, aciclovir, cidofovir a result of active cmv, adenovirus, varicella zoster or herpes simplex infection infection 4. gvhd ≥ grade ii before infusion of gene modified t cells 5. serious intercurrent illness

Keywords: gene therapy haploidentical bone marrow transplant graft versus host disease haploidentical stem cell transplantation t-cell suicide gene therapy
natural history study of infantile and juvenile gm1 gangliosidosis (gm1) patients

Conditions: GM1 Gangliosidosis

Summary: owing to the rarity, severity, speed of progression and fatal prognosis of infantile and juvenile gm1, there is a limited understanding of overall disease progression and meaningful outcome measures. this study aims to build a natural history data set through collection of a number of clinical, imaging, and laboratory assessments that may be specific predictors of gm1 disease progression and clinical outcome. having a gm1 natural history data set can inform potential efficacy endpoints and biomarkers for future clinical trials. this natural history study will follow up to 40 subjects diagnosed with gm1 gangliosidosis (up to 20 infantile (type 1) and 20 late infantile/juvenile (type 2)) for up to 3 years. visits will be conducted every 6 months, during which several procedures will be performed and the data recorded in order to learn about the natural course of the disease, including changes in clinical and neurological assessments and electrophysiologic, imaging and biofluid biomarkers. study procedures include: physical \& neurological exam, blood \& urine sample collection, questionnaires \& assessments of development, seizure diary, echo, ecg, x-ray and ultrasound (if mri not performed), eeg and genetic testing (if not already done). the following procedures are subject to local/institutional policies and the medical discretion of the study physician: mri, lumbar puncture (spinal tap) and general anesthesia/sedation (for mri and lp).


Eligibility criteria:
inclusion criteria: 1. documentation/ confirmation of reduced beta-galactosidase enzyme activity in leukocytes 2. confirmed diagnosis of infantile or juvenile gm1 gangliosidosis with documentation of glb1 mutations 3. parent/caregiver capable of providing informed consent (if cognitively able, child to provide assent as well) 4. infantile (type 1) gm1 subjects: documented symptom onset by 6 months of age with significant hypotonia on exam or history elicited from parent(s)/ caregiver(s) 5. juvenile (type 2) gm1 subjects: documented symptom onset after 6 months of age or documented symptom onset prior to 6 months of age without significant hypotonia on exam or elicited from parent(s)/ caregiver(s) exclusion criteria: 1. enrollment in any other clinical study with an investigational product/ therapy (patients receiving miglustat off-label will be eligible) 2. any clinically significant neurocognitive deficit not attributable to gm1 gangliosidosis or a secondary cause that may, in the opinion of the investigator, confound interpretation of study results 3. any condition that, in the opinion of the investigator, would put the subject at undue risk or make it unsafe for the subject to participate

Keywords: gm1 gm1 gangliosidosis gm1 type 1 gm1 type 2 gm1 gangliosidosis type 1 gm1 gangliosidosis type 2 gm1 natural history study gm1 gangliosidosis natural history study lysosomal storage disorders lysosomal disorders
combination of neck muscle vibration and tdcs with conventional rehabilitation in neglect patients

Conditions: Unilateral Spatial Neglect

Summary: background: unilateral spatial neglect (usn) rehabilitation remains a challenge and requires the development of new methods that can be easily integrated into conventional practice. the aim of the hemistim protocol is to assess immediate and long-term functional outcomes and neuropsychological aspects of recovery, induced by an innovative association of left-side neck-muscle vibration (nmv) and anodal transcranial direct current stimulation (tdcs) on the ipsilesional posterior parietal cortex during occupational therapy sessions in patients with left usn. methods: participants will be randomly assigned to 4 groups: control, left-nmv, left-nmv + sham-tdcs or left-nmv + anodal-tdcs. nmv will be applied during the first 15 minutes of occupational therapy and tdcs will be applied for 20 minutes, starting 5 minutes before, three days a week for three weeks. usn will be assessed at baseline, just at the end of the first experimental session, after the first and third weeks of the protocol and three weeks after its ending. discussion: left nmv, by activating multisensory integration neuronal networks, might enhance beneficial effects obtained by conventional occupational therapy sessions since interesting post-effects were shown when it was combined with voluntary upper limb movements. the investigators expect to reinforce lasting intermodal recalibration through ltp-like plasticity induced by anodal tdcs. the hemistim protocol represents a therapeutic innovation associated to conventional practice that could provide a partial solution to the rehabilitation challenges of the usn syndrome and some insights to its underlying mechanisms.


Eligibility criteria:
inclusion criteria: * admitted in a post-stroke rehabilitation unit in the sub-acute phase (15 days to 6 months from the onset of stroke symptoms) * at least 18 years old * a first unilateral right hemispheric stroke * diagnosis of stroke confirmed by computed tomography (ct) or magnetic resonance imaging (mri) * behavioral inattention test (c-bit), inferior or equal to 129 exclusion criteria: * unable to give informed consent * pregnant women * patients with skin lesions on the areas for electrode placement * having history of metal-in-cranial injury * epilepsy * vestibulo-cochlear illness * cardiac pacemaker

Keywords: neck muscle vibration tdcs conventional rehabilitation neglect