Kornimate/medical-research-clean huggingface dataset:
dopaminergic loss and pain in parkinson's disease

Conditions: Parkinson's Disease; Pain

Summary: about 46% of patients suffering from parkinson's disease present pain disorders. parkinson disease is characterized by loss of dopaminergic neurons. the aim of this study is to assess the relationship between the loss of dopaminergic neurons and the existence of pain in parkinson's disease. using single photon emission computerized tomography (spect) imaging (123i fp-cit, which binds dopamine transporter) and the determination of subjective pain threshold, the investigators will establish correlations between dopaminergic degeneration and pain perception.

parkinson's disease is a frequent neurodegenerative disease leading to motor handicap, cognitive and pain disorders. these pain disorders could be correlated to dopaminergic loss. the clinical trial will be conducted in a single center (neurology department, purpan hospital, toulouse, france). the study is classified as a physiopathology one. twenty patients with parkinson's disease, presenting pain disorders or not, will be selected. this clinical trial will last one year. all the exams, including image acquisition will be done the same day. these will take about 6 hours for each patient. expected results: binding of 123i fp-cit to dopamine transporters should negatively correlate with pain intensity and also with thermal pain thresholds in patients suffering from parkinson's disease.

Eligibility criteria:
inclusion criteria: * patients with clinically established parkinson's disease according to the ukpdsbb (uk parkinson's disease society brain bank) (gibb et less, 1998; hugues et al, 1992). * male or female patients, aged from 30 to 70 years. * patients must benefit from the french social security system. * patients must give a written informed consent. * female fertile patients must use an efficient method of contraception. if patients suffer from chronic pain, pain must be related to parkinson's disease. exclusion criteria: * patients with a syndrome other than the idiopathic parkinson's disease. * patients suffering from important trembling during the off periods or abnormal involuntary movements (dyskinesia) during the on periods, not allowing the imagery exam to be performed. * patients suffering from another disease causing chronic pain. * patients suffering from cancer. * patients with cognitive dysfunction. * patients not able to complete the scales. * pregnant, breastfeeding or fertile female patients not using an efficient method of contraception. * patients not willing to participle in the trial.

Keywords: parkinson's disease pain dopamine transporters imaging
clown doctors and a sedative premedicant for children undergoing surgery

Conditions: Insomnia

Summary: the purpose of the present investigation will be to determine whether a combination of clown doctor and parental presence is more effective than a combination of sedative premedication and parental presence for reducing anxiety in children and their parents and for improving parental satisfaction.


Eligibility criteria:
inclusion criteria: * children aged 2 to 12 yr, scheduled for minor surgery under general anesthesia will be included in the present study. exclusion criteria: * children with prematurity, development delay, previous anesthetic experience will be excluded from this study

Keywords: children surgery anxiety
manual therapy in haemophilic arthropathy of the knee

Conditions: Patients With Haemophilia

Summary: this study aims to assess the effectiveness of two physiotherapy treatments: one with manual therapy using joint traction, passive muscle stretching, and isometric exercise, active resisted and proprioception exercises; and other treatment with educational sessions and home exercises to improve the rom, muscle strength and proprioception in patients with haemophilia and arthropathy of the knee.

randomized trial with two treatment groups: one using joint traction, passive muscle stretching and isometric exercises, active resisted and proprioception exercises (group mt); and another with educational sessions and home exercises (group e); and a control group (group c). the intervention was carried out during twelve weeks, performing evaluation before and after treatment, and six months of finalizing this. the treatment in mt group consisted of two sessions per week for one hour each, and the treatment in group e consisted of a session of 90 minute every two weeks, with exercises daily home. the control group (group c) did not receive any treatment. after the allocation to the groups, the composition was follows: mt group = 7; e group = 7; and control group = 7.

Eligibility criteria:
inclusion criteria: * patients must be over the age of 18 years * diagnosis of haemophilia a or b * patients with haemophilic arthropathy in one or both knees exclusion criteria: * patients who had a haemarthrosis of knee during intervention * patients with different medical diagnosis (eg, von willebrand's disease) * patients with antibodies to fviii or fix (inhibitors).

Keywords: knee joint disease haemophilia physiotherapy modalities
whitby: working towards better healthcare interventions for tinnitus: a brain stimulation study

Conditions: Tinnitus

Summary: tinnitus - the awareness of sound without any outside source - affects around 15% of people and can cause anxiety and depression. treatment options are limited and do not address tinnitus directly (e.g., reduce its loudness). to do that, we must change brain activity causing tinnitus. low-dose electrical stimulation, using a technique called transcranial direct current stimulation (tdcs), is a promising approach. the technique is safe and easy to administer. several small studies have tested tdcs for tinnitus showing some benefits. to assess whether these benefits will generalise to other patients, we need to conduct a randomised controlled trial - a large, rigorously controlled experiment based on prior agreed procedures. clinical trials are expensive and time-consuming to run and thus require meticulous pilot work to establish the most effective treatment regimens and the most sensitive measures of treatment outcome. the current study aims to provide such pilot information for a clinical trial of tdcs treatment of tinnitus. using a total of 40 patients, we will establish how to best to administer tdcs and measure resulting changes in tinnitus perception and associated brain activity. the current study is a crucial first step towards determining whether or not tdcs can effectively treat tinnitus.


Eligibility criteria:
inclusion criteria: * aged 18 or over * suffering from subjective idiopathic tinnitus * sufficient understanding of english to be able to provide informed consent * able to safely undergo tdcs exclusion criteria: * aged under 18 * not suffering from tinnitus or suffering from objective tinnitus * insufficient understanding of english to be able to provide informed consent * unable to safely undergo tdcs as assessed by tdcs safety questionnaire * having taken part in a research study in the last 3 months involving invasive procedures or an inconvenience allowance

Keywords: tinnitus brain stimulation neuromodulation transcranial direct current stimulation
brief cognitive behavioral therapy (cbt) for pediatric anxiety and depression in primary care

Conditions: Anxiety; Depression

Summary: the purpose of this study is to determine whether a brief (12 week) psychological treatment program, based in primary care, can help youths struggling with anxiety and/or depression. this brief cognitive behavioral therapy program will be compared to enhanced referral to specialty mental health care.

mood and anxiety disorders in childhood and adolescence are disabling, distressing, and prevalent and produce added costs to health systems. this two-site randomized controlled trial will test the effects of a brief cognitive behavioral therapy (bcbt) protocol (8-12 sessions) in a large sample (n=210) of children and adolescents (age 8-16) presenting with anxiety and/or depression in primary care. clinical and cost-effectiveness of bcbt will be compared to a plausible public health alternative - enhanced referral to specialty mental health care (smhc). this investigation is noteworthy in adopting a deployment-focused model and testing this intervention early in its development within a real world context (primary care) and against a plausible public health comparison condition (smhc) relevant for future treatment dissemination.

Eligibility criteria:
inclusion criteria: * meet full or probable diagnostic criteria for separation anxiety disorder, generalized anxiety disorder, social phobia, major depression, dysthymic disorder, or minor depression * age 8.0 to 16.9 * live with legal, consenting guardian for at least 6 months exclusion criteria: * youths requiring alternate intervention (e.g., youths with bipolar disorder, psychosis, active suicidal ideation with plan, ptsd, substance dependence, current physical or sexual abuse, or mental retardation * suffer from serious or unstable physical illness (e.g., uncontrolled diabetes) * currently in active, alternate intervention for anxiety or depression (e.g., antidepressant use)

Keywords: child adolescent anxiety depression internalizing cognitive behavioral therapy pediatric primary care
doppler-guided or non doppler-guided arterial ligation and mucopexy for third degree hemorrhoids: that is the question

Conditions: Hemorrhoids Prolapse

Summary: hemorrhoidal disease is one of the most common proctological disease affecting the general population from the mid-teens onward with considerable implications for the national health service (nhs) both from an economic point of view and from surgeon's workload.improved understanding of the pathogenesis of hemorrhoids and of the complications associated with excisional hemorrhoidectomy led to the invention of newer surgical procedures, including doppler guided hemorrhoidal artery ligation (dghal). this technique was introduced in 1995 by morinaga et al. and consists in the use of a proctoscope with a doppler transducer that detect the arterial structures. since dghal does not involve tissue excision, it is expected to be associated with reduced postoperative pain if compared with hemorrhoidectomy. in the last decade several devices (thd and ami/ hal-rar - hemorrhoidal artery ligation and recto anal repair) have been developed in order to improve and facilitate the execution of the technique, making easier the procedure. the hypothesis of the study is that a simple mucopexy procedure by suture-fixation of anal cushion without the aim of a doppler device, could be as effective as dghal and mucopexy to manage prolapsing grade iii hemorrhoids.

prospective, multi-centre, parallel-arm randomized controlled equivalence trial. eligible patients will be randomized to either mucopexy without doppler guided artery ligation or mucopexy with doppler guided hemorroidal artery ligation. primary aim of the hamlet trial is to demonstrate that mucopexy without dghal for grade iii haemorrhoids have equivalent recurrence rate at 1 year follow up of dghal with mucopexy procedure

Eligibility criteria:
inclusion criteria: * symptomatic grade iii hemorrhoids according to goligher * no other source of anal bleeding than hemorrhoids * written informed consent exclusion criteria: * any previous hemorrhoid surgery * participants expressing clear preference for one of the interventions * pregnancy * inability to understand the informed consent * oral anticoagulants of congenital defects of the coagulation * patients with immunodepression (i.e. hiv) * other proctological diseases (fissures, fistulas, condyloma, etc) * ibd involving the anus ore the rectum

Keywords: hemorrhoid doppler mucopexy
a phase 1b study to evaluate the safety and pk of mp-376 in chronic obstructive pulmonary disease (copd) patients

Conditions: Chronic Obstructive Pulmonary Disease

Summary: patients with chronic obstructive pulmonary disease (copd) suffer from frequent and recurrent acute exacerbations (aecb) which are associated with enormous healthcare expenditures and significant morbidity, specifically an increased risk of death, a decline in pulmonary function and a significant change in quality of life. bacteria appear to have an important role in acute exacerbations in chronic bronchitis and copd. studies of acute exacerbations in copd have shown a reduction in bacterial load with prolonged exacerbation-free interval. in addition, recent studies indicate that acquisition of a new strain of h. influenzae, m. catarrhalis, s. pneumoniae or p. aeruginosa are responsible for many of these exacerbations. chronic inflammation and bacterial infection predispose many patients to frequent and recurrent acute exacerbations. mpex, (the sponsor on record at time of the study's initial registration) believes that intermittent administration of inhaled mp-376 in high risk patients will decrease the incidence of acute exacerbations by both by lowering the organism burden, and resultant inflammation, as well as pre-emptive eradication of any newly acquired bacterial strains.

this study will be a phase 1b, multi-center, randomized, single-blind, placebo-controlled study to evaluate the safety, tolerability, and pharmacokinetics of mp-376 solution for inhalation given for 5 days to copd patients. study acquired from horizon in 2024.

Eligibility criteria:
inclusion criteria (selected): * \>/= 40 years of age * history of copd * fev1 \</= 65% of predicted and fev1/fvc \</= 0.7 value at screening * clinically stable with no changes in health status within the last 30 days * lifetime smoking history of at least 15 pack-years * willing and able to give informed consent exclusion criteria (selected): * use of any systemic or inhaled antibiotics within 30 days prior to baseline * history of hypersensitivity to fluoroquinolones or intolerance with aerosol medication * crcl \ /= 3 x uln at screening * significant or unstable medical conditions

Keywords: copd patients
effects of nutritional supplementation and dietary advice in elderly patients after hospital discharge.

Conditions: Malnutrition

Summary: the purpose of this study is to evaluate the effects of nutritional therapy in elderly malnourished patients. the hypothesises are that nutritional supplementation and dietary advice alone or in combination affects mortality, quality of life and health-care consumption after six month of treatment.


Eligibility criteria:
inclusion criteria: * ≥65 years old * admitted to one of the participating wards during the recruitment period exclusion criteria: * well-nourished * no consent to participate * not able to communicate * not able to understand swedish * presumed life-expectancy \<1 year * already receiving nutritional therapy including dietary advice, supplements, tube-feeding or parenteral nutrition * dietary restrictions due to illness or disease inconsistent with the intervention * impaired cognitive function or dementia * body mass index ≥35 * living in old peoples homes, sheltered housing, institution, service flats or nursing homes * participant in a study evaluating differences in 3-year mortality between well-nourished patients, patients at risk of malnutrition and malnourished patients

Keywords: randomized controlled trial malnutrition aged aged 80 and over nutrition therapy
the optimization of blood pressure and fluid status control with eight-polar bioelectrical impedance analysis

Conditions: Hypertension; Fluid Overload; Heart Diseases

Summary: peritoneal dialysis (pd) is a widely used modality of renal replacement therapy. due to its continuous nature of therapy, better control of fluid status and preservation of residual renal function were presumed by most nephrologists. however, recent evidences showed that it might not be the case. the severity of fluid overloading and the need for anti-hypertensive agents to control blood pressure seems to be more severe for pd patients. therefore, more aggressive strategy to control dry weight is mandatory in pd patients. however, over reduction of dry weight might affect residual renal function (rrf) and, probably, the survival of pd patients. a balance between reduction of dry weight and preservation of rrf is crucial for the care of pd patients. currently, only clinical measures like cardiothoracic ratio on chest x-ray and absence of pedal edema were used to evaluate pd patient's dry weight. there is no objective method to determine dry weight accurately. in this prospective and randomized study, the investigators will use multi-frequency bio-impedance (mf-bia) to detect intracellular and extracellular water (ecw) content of patients.


Eligibility criteria:
inclusion criteria: * age 18 to 80 exclusion criteria: * type i dm * severe heart failure * unstable angina

Keywords: bioimpedance ultrafiltration blood pressure pulse pressure
study evaluating pantoprazole in adolescents with gerd

Conditions: Gastroesophageal Reflux

Summary: the purpose of this study is characterize the pk profile of single and multiple doses of pantoprazole in adolescents aged 12 to 16 years with gastroesophageal reflux disease (gerd).


Eligibility criteria:
inclusion criteria: * 12-16 years old * clinical diagnosis of gerd * ability to swallow tablets exclusion criteria: * gi or malabsorption disorders * chronic use of warfarin * positive pregnancy test

Keywords: adolescents gerd
an evaluation of the team birth project

Conditions: Pregnancy Complications; Cesarean Section Complications; Maternal Complication of Pregnancy; Communication, Multidisciplinary

Summary: the purpose of this study is to evaluate the feasibility of a pilot project to improve communication and teamwork and to increase vaginal delivery rates at hospital in the united states

the purpose of this study is to evaluate the feasibility of a pilot project to improve communication and teamwork and to increase vaginal delivery rates at hospital in the united states. teambirth is a rigorously designed care process to improve care and sdm across the full care team, which includes the patient, their support person(s), nurse and physician or midwife, by ensuring reliability for best practices in communication and teamwork during labor and delivery. teambirth aims to operationalize best practices in communication and clinical care from the major professional organizations in obstetrics, including the american college of obstetricians \& gynecologists (acog), society for maternal-fetal medicine (smfm), american college of nurse-midwives (acnm), and association of women's health, obstetric, and neonatal nurses (awhonn), to ensure these practices are occurring consistently throughout labor. key teambirth practices include: 1. promoting the roles of the laboring patient, nurse, and delivering provider as members of the care team with equally valuable input for sdm, 2. eliciting the patient's preferences, symptoms, and subjective experiences and integrating them with clinical data to inform patient care plans, 3. distinguishing statuses and care plans for the mother, fetus, and labor progress, and 4. setting shared expectations for the next planned evaluation.

Eligibility criteria:
clinician participant inclusion criteria: * all clinicians who have practice privileges at a study site clinician participant exclusion criteria: * none implementation team participant inclusion criteria: * champions, super-users and others who have been involved in the implementation of "team birth project" at a study site implementation team participant exclusion criteria: * none patient participant inclusion criteria: * 18 years or older * live birth. includes: spontaneous or induction of labor; vaginally, with an instruments (forceps / vacuum), or unscheduled cesarean delivery * patient at a study site piloting "team birth project" patient participant exclusion criteria: * under 18 years old * scheduled cesarean delivery * experienced intrapartum, stillbirth, or neonatal death

Keywords: quality improvement program evaluation quality assurance feasibility acceptability
immediate versus delayed treatment of odontogenic infections

Conditions: Focal Infection, Dental

Summary: the objective of this study is to compare the physiologic resolution of dental infections between immediate tooth extraction (control group) and administration of systemic antibiotics and delayed extraction (study groups 1 and 2). a secondary objective is two compare two different antibiotic regimens in the delayed extraction groups (study group 1 and 2).

this is a prospective partially randomized clinical trial. patients 2-11 years old who have a vestibular swelling associated with an odontogenic infection are being studied. subjects will self-select into the control or study group. all subjects will be offered to have the tooth extracted on the day of diagnosis, and if this treatment is chosen they will join the control group (group 1). subjects who defer treatment will be placed on amoxicillin and will be placed into the study group. the study group will be randomized into two parallel study groups that either have average dose antibiotics for 10 days (group 2), or maximum dose antibiotics for 5 days (group 3).

Eligibility criteria:
inclusion criteria: * patients who present to the dental clinic or boston children's hospital emergency room * odontogenic origin associated with a primary tooth and limited to the buccal vestibule only * ages of 2-11 years old * primary caregiver present * english speaking * american society of anesthesiologists (asa) classification of i * none or current systemic antibiotic therapy regimen \< 24 hours * able to take medication orally * those patients who choose to participate in the study exclusion criteria: * infection that has spread beyond the buccal vestibule, or not detectable * infection is associated with a permanent adult tooth * ages of \ 11 years old * american society of anesthesiologists classification of ii or greater or poor general health. * renal impairment * immunosuppressive disease * recent antibiotic therapy in the last 1 to 30 days * allergy to penicillin * unable to take oral medications * decline participation

Keywords: dentistry antibiotic penicillin pediatrics