Kornimate/medical-research-clean huggingface dataset:
effect of transcranial magnetic stimulation on cognition and neural changes in parkinson's disease

Conditions: Parkinson's Disease; Mild Cognitive Impairment

Summary: parkinson's disease (pd) affects more than 100,000 canadians and results in symptoms affecting both motor and cognitive (thinking and memory) functions. parkinson's disease with mild cognitive impairment (mci) frequently results in development of dementia for which few treatment options exist. transcranial magnetic stimulation (tms) is used to alter activity in the outer regions of the brain and has been shown in previous studies to increase cognitive performance in patients with different disorders. this study will investigate the effectiveness of tms as a clinical treatment for the cognitive deficits associated with parkinson's disease. 64 male and female participants between the ages of 50 and 90 will attend eight study visits over a period of 63 to 66 days. this study is a double-blind randomized clinical trial meaning the participant will be assigned by chance to either the tms-treatment group or the sham-treatment group. additionally, a combination of memory and thinking tests and magnetic resonance imaging (mri) will be used to see if there are structural and functional changes within the brain. genotyping and blood analysis before and after treatment for different biomarkers will also be performed and these data will be compared to the tms data. initially, this research will increase knowledge about the effects of tms on various brain regions. ultimately, we will be able to determine if tms can be used as a complementary therapy for pd to improve cognitive performance and to reduce progression into dementia.

visit 1: informed consent neuropsychological battery visit 2: (1-2 days later) blood draw neuropsychiatric assessment questionnaires companion questionnaire to take home updrs visit 3: (up to a week after visit 2) mri scan while performing executive task visit 4: (1-3 days after visit 3) tms- or sham-treatment (two sessions , 20 min each, 1 hour apart) visit 5: (2-3 days after visit 4) same as visit 4 visit 6: (2-3 days after visit 5) same as visit 4 visit 7: (1 day after visit 6) neuropsychological battery updrs visit 8: (1 day after visit 7) mri scan while performing executive task blood draw visit 9: (1 month after visit 6) neuropsychological battery updrs

Eligibility criteria:
inclusion criteria: * diagnosis of idiopathic parkinson's disease any stage * mild cognitive behaviour confirmed through neuropsychological assessment * mri compatibility exclusion criteria: * alcohol-dependency * severe psychiatric disorder, neurological disorder, epilepsy or stroke * general anaesthesia in the past six months * history of cerebrovascular disorders * colour-blindness

Keywords: transcranial magnetic stimulation
pre-approval access single patient request for niraparib / abiraterone acetate combination (nira/aa combination)

Conditions: Metastatic Castration-resistant Prostate Cancer

Summary: the purpose of this pre-approval access is to provide niraparib plus abiraterone acetate (nira/aa combination) in the treatment of (a) participant(s) with first line metastatic castration-resistant prostate cancer with specific homologous recombination repair (hrr) gene alterations.


Eligibility criteria:
inclusion criteria: * diagnosed with metastatic castration-resistant prostate cancer (mcrpc) * a confirmed homologous recombination repair (hrr) gene alteration as identified by a genomic assay through use of a validated test * eastern cooperative oncology group performance score (ecog ps) grade of 0 or 1 * willing to receive concomitant prednisone/ prednisolone 10 milligrams (mg) (not provided by janssen) daily while receiving niraparib/abiraterone acetate (nira/aa) combination treatment * willing to continue treatment with gonadotropin-releasing hormone (gnrh) analogue if not surgically castrated exclusion criteria: * prior treatment with a poly adp-ribose polymerase (parp) inhibitor * prior systemic therapy for mcrpc (that is, taxane-based chemotherapy, androgen signaling inhibitors). ongoing androgen deprivation therapy (adt), prior systemic treatment (example, apalutamide, enzalutamide, darolutamide, docetaxel) for earlier disease settings (example, hormone sensitive disease, non-metastatic castration-resistant disease); and treatment recently initiated with abiraterone acetate for mcrpc less than or equal to (\<=) 60 days is permitted * other treatment options available or participant eligible or able to participate in a clinical trial for first line mcrpc with hrr gene alterations * moderate-severe pain * history or current diagnosis of myelodysplastic syndrome (mds)/acute myeloid leukemia (aml)
hepatitis e infection : emergence mechanisms in north-eastern france of polymorphic clinical forms.

Conditions: Hepatitis E Infection in Humans and in Environment

Summary: the present research aims to collect virological and clinical data on hepatitis e virus (hev) infections, either in acute or chronic forms of hev infection in north-eastern france, with liver- or non liver-related symptoms, plus data on hev circulation in the outside environment. the purpose of this study is to improve the diagnosis and care of hev-infected patients, as well as the preventive features to take into account in order to avoid food- and environment-borne infections. at last, we will investigate hev molecular characteristics, with the hypothesis that some advantageous hev strains coul be more pathogenic for some tissues and/or organs.


Eligibility criteria:
inclusion criteria: * hev-infected patients, with hepatitis and/or neurological and/or renal symptoms exclusion criteria: * patients, with hepatitis and/or neurological and/or renal symptoms, infected by other viruses leading to hepatitis (hepatitis b, hepatitis c, hepatitis a ...)
effect of resistance training on microvascular, hemodynamic and physical parameters in obese adolescents

Conditions: Obesity

Summary: the purpose of this study is to investigate the effect os resistance training on microvascular reactivity, endothelial functions, inflammatory markers, blood pressure, heart rate, body composition and physical fitness in obese adolescents.


Eligibility criteria:
inclusion criteria: * tanner pubertal stage of development between three and five * age between 13 up to 17 years old exclusion criteria: * presence of chronic diseases (diabetes mellitus, nephropathy and/or hypertension), * musculoskeletal injury, * smoking and * to be in use of any medication.

Keywords: endothelial function microvascular reactivity obesity adolescents
evaluation of an algorithm to detect sleep and wake in continuous positive airway pressure (cpap)

Conditions: Sleep Apnea, Obstructive

Summary: the purpose of this engineering trial is to develop and validate an algorithm that will deliver paced breathing as a ramp feature to obstructive sleep apnea (osa) subjects using continuous positive airway pressure (cpap) therapy. in this trial the investigators will be evaluating the algorithm's ability to correctly distinguish between sleep and wake.


Eligibility criteria:
inclusion criteria: * age 21-70 * diagnosis of obstructive sleep apnea (osa) * current adherent cpap user (has been using cpap nightly for at least 2 weeks). * on cpap pressures of 5-10cm. * subjects wishing to complete a day or evening appointment need to have significant daytime sleepiness (epworth sleepiness scale score of 8 or above) * able and willing to provide written informed consent * english speaking exclusion criteria: * participation in another interventional research study within the last 30 days * major controlled or uncontrolled medical condition such as congestive heart failure, neuromuscular disease, renal failure etc. * inability to tolerate nasal cpap mask due to problems breathing solely through their nose. * chronic respiratory failure or insufficiency with suspected or known neuromuscular disease, moderate or severe chronic obstructive pulmonary disease (copd), or any condition with an elevation of arterial carbon dioxide levels while awake (paco2≥55mmhg) * severe oxygen desaturation on the polysomnography (psg), i.e. sa02 \< 70% for 10% of the study. * surgery of the upper airway, nose, sinus or middle ear within the past 90 days * currently using supplemental oxygen * regular use of sleeping pills or stimulants (\> 3 nights a week) * currently working night shift or rotating day/night shift * drowsy driving or near miss accident in the past 6 months * inability to tolerate or track to paced breathing device during initial habituation session in lab * chronic insomnia, restless legs syndrome, or severe periodic limb movement disorder (plmd - plmai\>20/hr).

Keywords: paced breathing osa sleep/wake detection
cobb angle measurement of kyphosis and scoliosis

Conditions: Kyphosis; Scoliosis

Summary: measurement of bone length in subjects diagnosed with kyphosis and scoliosis using the lunar idxa x-ray scan.

to determine if bone density scanning (dexa) and the use of a computer software program can make accurate measurements of the curvature(s) of the spine (cobb angle)in patients with kyphosis and scoliosis compared to x-rays of the spine.

Eligibility criteria:
inclusion criteria: * 18 years of age * have kyphosis or scoliosis * have had an x-ray of the spine performed within 3 months time exclusion criteria: * are unwilling to read and sign this document * are pregnant or if you have not had a negative pregnancy test just prior to the idxa scan. * have severe deformities of your back * unable to lay on the scanning table for the scan

Keywords: spinal curvatures
pyridostigmine and its effects on autonomic modulation in diabetic patients

Conditions: Diabetes Complications

Summary: the purpose of the study is to determine if pyridostigmine bromide improves heart rate variability of type 2 diabetes mellitus subjects with cardiovascular autonomic neuropathy.

the reduced heart rate variability is associated with increased risk of death in patients with diabetes mellitus. cholinesterase inhibition with pyridostigmine bromide increases heart rate variability in normal individuals and congestive heart failure subjects but its effects on patients with diabetes mellitus is unknown. based on those evidences, we will test if the short-term administration of pyridostigmine bromide increases heart rate variability in patients with diabetes mellitus.

Eligibility criteria:
inclusion criteria: * diabetes mellitus exclusion criteria: * myocardial infarction * acute ischemic syndromes * second or third degree atrioventricular block * active alcoholism * thyroid dysfunction * chronic obstructive pulmonary disease * history of intolerance to pyridostigmine.

Keywords: pyridostigmine autonomic modulation diabetes mellitus heart rate variability
safety and efficacy of tofacitinib in patients with refractory myasthenia gravis: a pilot study

Conditions: Myasthenia Gravis, Generalized

Summary: this is a 6 month study that will evaluate the efficacy of 5mg tofacitinib tablet taken twice a day in patients with refractory myasthenia gravis. twenty adult participants will receive a four month treatment of tofacitinib followed by elution for one month.


Eligibility criteria:
inclusion criteria: * fluctuating muscle weakness and fatigability classified as the myasthenia gravis foundation of america (mgfa) clinical classification type iia-iva; * more than 10% amplitude decrement in low frequency repetitive nerve stimulation, and less than 10% amplitude increment in high frequency repetitive nerve stimulation; * understanding and assigning the informed consent form, and having a good compliance with treatment. meet all of the criteria in above as well as at least one of the below: * refractory: insufficient response to full dose- and course- steroids treatment (0.75-1mg per kg per day for at least 3-6 months), failure to respond adequately to tacrolimus (no less than 3mg per day) for 3 months; * severe or intolerable adverse effects from conventional immunosuppressive therapy. exclusion criteria: * positive for muscle-specific kinase (musk) antibodies; * a tumor history except for thymoma; * a history of type b and type c hepatitis; * a history of tuberculosis or t-spot.tb tset positivity; * hepatic, renal and cardial insufficiency (baseline: alt/ast\>50u/l;bnp\>200pg/ml）; * severe allergy or infection, or chronic or recurrent infection; * pregnancy; * hyperlipidemia; * participating other clinical trials

Keywords: myasthenia gravis tofacitinib
effectiveness and cost-effectiveness of vcst and online dementia carer support

Conditions: Dementia

Summary: a multicentre single-blind cluster randomised trial to evaluate the effectiveness and cost-effectiveness of virtually delivered versus in-person cognitive stimulation therapy (cst) and carer support in people living with dementia and carers

this is a multicentre, single-blind cluster randomised trial with an aim to evaluate the effectiveness and cost-effectiveness of virtual delivery of cst and carer support in comparison with in-person cst and carer support in hong kong chinese. a total of 156 dyads of people living with dementia and carers will be randomly assigned to one of the four groups: (a) vcst (7 weeks) followed by in-person carer support programme (6 months); (b) in-person cst (7 weeks) followed by in-person carer support programme (6 months); (c) vcst (7 weeks) followed by online carer support programme (6 months); and (d) in-person cst (7 weeks) followed by online carer support programme (6 months). the investigators will measure outcomes at baseline, 7 weeks, and 6 months.

Eligibility criteria:
inclusion criteria: * having a clinical diagnosis of mild to moderate dementia; * having a family carer; * living in the community in hong kong; * able to communicate and understand communication; * able to see and hear well enough to participate in a meaningful assessment; * the person with dementia and/or his/her carer can provide informed consent exclusion criteria: * unable to communicate; * unable to participate in intervention due to significant hearing or visual impairment, or other physical or psychiatric conditions

Keywords: cognitive stimulation therapy (cst) virtually delivered cognitive stimulation therapy (vcst) carer support programme information and communication technology (ict) cluster randomised trial effectiveness cost-effectiveness chinese
randomized controlled clinical trial of weight loss programs in obese persons

Conditions: Obesity

Summary: the purpose of this study is to compare two approaches to a diet and exercise-based weight loss program.

the high prevalence of obesity and its medical consequences make it one of the most important public health issues in the united states today. few interventions have been consistently successful at reducing obesity. this trial will test an intervention program that lasts 22 weeks, with 16 evening sessions and one weekend day. participants will be randomized to one of two arms. both arms will receive diet and exercise intervention elements. the study aims for gradual weight loss, with a calorie target that will maintain ideal body weight, rather than a more calorie restricted diet. the exercise component is based around increasing walking. the arms will compare methods for producing long-lasting behavior change.

Eligibility criteria:
inclusion criteria: * age 18+ years old * bmi \> 30-45 * waist circumference \> 102 cm (men) or \> 88 cm (women) * live in san francisco bay area and able to attend more than 16 classes and up to 12 assessment visits in san francisco over an 18 month period exclusion criteria: * inability to provide informed consent * age \< 18 * a substance abuse, mental health, or medical condition that, in the opinion of investigators, will make it difficult for the potential participant to participate in the group intervention * type i or ii diabetes or fasting glucose ≥ 126 mg/dl or hemoglobin a1c ≥ 6.5; those with hba1c between 6-6.5% may complete an ogtt to rule out diabetes (glucose \<200 mg/dl) * use of systemic (oral or iv) corticosteroids in the 6 months prior to enrollment or severe autoimmune disorders or other conditions (e.g. rheumatoid arthritis, lupus), that are likely to require these medications * use of immunosuppressive or immunomodulating drugs or chronic or acute conditions that would require the use of such medications * a history of known coronary artery disease (cad), or typical or atypical anginal chest pain requires a letter from the participant's physician that he or she has been adequately evaluated and that a moderate exercise program is appropriate * non english speaker * pregnant or planning to get pregnant in the next 12 months, breastfeeding or less than 6 months post-partum * initiation of new class of psychiatric medications in past 2 months * currently on a specific weight loss diet * for influenza vaccine administration: a prior allergic reaction to the influenza vaccine or eggs. these participants can be included in the trial but will be excluded from participation in influenza vaccination. * active bulimia or strong history of bulimia * current use of weight loss medications or supplements such as amphetamine-based drugs that are believed to have some effect on weight * history of or planned weight loss surgery * untreated hypothyroidism: tsh \> 4mu/ml (or the upper limit of normal reference defined by the lab doing the assay)

Keywords: obesity randomized controlled trial weight loss metabolic syndrome
reinfusion drains vs tranexamic acid in total joint arthroplasty

Conditions: Total Joint Arthroplasty

Summary: it is widely reported that a large percentage of total joint replacement patients receive allogeneic (human donor blood) blood transfusions due to perioperative blood loss with numbers ranging from 30% to 80%. the risks of allogenic blood transfusion are well documented in the literature. in addition, they are time-consuming: often lengthening hospital stay and decreasing the availability for postoperative physical therapy. moreover, they are costly at several hundred dollars per unit, and allogeneic transfusions are linked with immunosuppression and increased postoperative infection rates and wound healing problems, which are devastating complications in this elective, joint replacement population. several options are available for diminishing the need for allogenic blood transfusion following elective total joint replacement. these include the use of perioperative blood salvage devices (orthopat) and tranexamic acid. while there is data to support the use of both orthopat and tranexamic acid in primary total joint arthroplasty, there is little information comparing one versus the other in terms of efficacy and economics. the purpose of this study is to compare the safety, effectiveness and cost benefit of hemovac drain, orthopat and tranexamic acid to manage blood loss during total hip and total knee replacement surgery.


Eligibility criteria:
inclusion criteria: 1. patients presenting for primary unilateral hip or knee arthroplasty 2. \> 18 years of age 3. preoperative hemoglobin on day of surgery \> 10mg/dl exclusion criteria: 1. patients with a preoperative hgb \< 10mg/dl 2. patients who are unwilling to consent to blood transfusions 3. patients with a history of bleeding disorder 4. patients on anticoagulation therapy preoperatively (asa 325mg, plavix or coumadin) 5. patients with a history of thromboembolic events ( dvt, pe, cva mi) 6. patients with platelet counts \< 100,000 7. patients with kidney disease (serum cr \> 1.2) 8. patients with end stage renal disease or on hemodialysis 9. patients with renal transplant 10. patients presenting for bilateral total hip or knee arthroplasty 11. patients presenting for conversion or revision total hip or knee procedures 12. patients donating pre-autologous blood 13. patients with primary hematologic disease or malignancy 14. patients with allergy to tranexamic acid 15. patients with hepatic disease 16. patients not discontinuing steroid use prior to surgery 17. patients with religious beliefs/practices prohibiting blood transfusions 18. patients with cognitive impairment 19. patients who are terminally ill

Keywords: total joint arthroplasty, blood loss
analgesic effect of intravenous patient-controlled analgesia (iv pca) versus paravertebral block after video assisted thoracic surgery (vats)

Conditions: Postoperative Pain After Video Assisted Thoracic Surgery

Summary: the purpose of this study is to compare the analgesic effect of paravertebral block with that of intravenous patient-controlled analgesia after video assisted thoracic surgery.


Eligibility criteria:
inclusion criteria: * patients receiving video assisted thoracic surgery exclusion criteria: * patients with cardiovascular disease * patients with neurologic disease * patients with contraindications to paravertebral block or epidural block * patients with history of previous vats * patients with pain at the expected incision site
liposomal bupivacaine in ambulatory hand surgery

Conditions: Pain

Summary: this study is being done to evaluate pain management regimens following ambulatory hand surgery. improved pain control may be associated with decreased complications, decreased pain scores, decreased opioid dependence, improved patient comfort and satisfaction, and reduced healthcare costs. liposomal bupivacaine is an fda-approved local anesthetic. there will be two groups. one group will receive liposomal bupivacaine. one group will not. the results will be compared. patients will be over the age of 18 ambulatory hand surgery. approximately 40 subjects will participate in this study at llu.


Eligibility criteria:
inclusion criteria: * patients 18 years of age and over undergoing ambulatory hand surgery involving soft tissue and subfascial structures, including: cmc arthritis, flexor and extensor tendon injury, symptomatic ganglia, hand and finger fractures exclusion criteria: * patients who are unable to give informed consent to participate in this study * patients with a documented history of hypersensitivity reactions to local anesthetic agents * patients with a diagnosis of chronic pain disorders such as fibromyalgia, chronic migraine headaches, or psychiatric disorders other than depression or anxiety * patients who are currently pregnant * patients with impaired hepatic function * patients with underlying nerve damage or impairment * patients with renal impairment/failure * patients whose career/livelihood require a great deal of hand dexterity, in whom a complication could cause a significant impact on life and career (ex: musician, dentist)