Kornimate/medical-research-clean huggingface dataset:
exclusion of venous thrombo-embolism with a new clinical decision support

Conditions: Venous Thromboembolism; Pulmonary Embolism; Deep Vein Thrombosis

Summary: the goal of this non interventional study is to demonstrate the diagnostic performances on fresh plasmas in comparison with the performances on frozen plasmas in any patients with vte suspicion, whatever the pre-test probability. the main question it aims to answer is : are the performances equivalent on fresh plasmas in comparison with frozen plasmas or is it necessary to determine a new algorithm of the clinical decision support with a new cut-off? participants will be diagnosed and treated in accordance with routine standard of care.

establish the diagnostic performance of the clinical decision support tool on fresh plasma, in pe and in dvt, in comparison with that on frozen plasma, and in comparison with the current diagnostic strategy, on the entire population and on the following different subpopulations: * patients eligible for d-dimer assay, with low or moderate clinical probability, compared to the reference diagnosis (imaging and d-dimer adjusted and not adjusted for age) * patients with high clinical probability, compared to the reference diagnosis (imaging) * patients not eligible for d-dimer assay: either with a condition associated with increased d-dimer levels in the absence of vte, or with a history of pe or dvt for less than 3 months or suspected thrombotic events * patients with known and active cancer * patients with covid-19. the assays will be conducted on a fresh and frozen plasma aliquots.

Eligibility criteria:
inclusion criteria: * pe and/or dvt suspicion * no opposition after informing the patient for his participation in research and processing of their data for this purpose, * benefiting from the social security system exclusion criteria: * preventive or curative anticoagulant treatment, or fibrinolytic treatment, * legal protection (e.g. guardianship or curatorship), * pregnant or breastfeeding women.
sildenafil citrate in early unexplained recurrent pregnancy loss

Conditions: Miscarriage, Recurrent

Summary: recurrent unexplained spontaneous miscarriage (rsm) is defined as three consecutive pregnancy loss prior to 20 weeks from the last menstrual period. 1% to 2% of women experience rsm. treatment of ursm is a challenging issue. the currently available lines of treatment according to simplicity of use, reliability and degree of invasiveness include corticosteroids, sildenafil citrate, aspirin, heparin and immunoglobulins (besides good antenatal care), but up to now there are no prospective randomized studies, powerful enough, to determine a significant difference between these therapeutic protocols, with any of the above mentioned pharmacological agents. sildenafil citrate (viagra®), a vasodilator, is also described as an anti-inflammatory agent. while improving uterine blood flow in the proliferative phase, no may have detrimental effects at the level of the endometrium during the implantation window. the no- mediated release of cytokines such as tumour necrosis factor- from activated natural killer cells has been implicated as a cause of implantation failure. based on these observations, this study attempts was made to study uterine arteries and sub-endometrial blood flow during the luteal phase in normal fertile women and in patients with unexplained recurrent miscarriage


Eligibility criteria:
inclusion criteria: * age: 20-35 years. * bmi (20-30) * history of three or more successive unexplained recurrent miscarriage. * normal uterine cavity by hystrography or hysteroscopy. * no luteal phase defects by progesterone \> 10 ng. * normal thyroid function (tsh, t3, t4) * normal lupus anticoagulant measured by activated partial throbmoplastine time (32-43 seconds). * normal anticardolipin (igg \< 20 gpl and igm \< 15 mpl measured by elisa). * normal anti thyroid antibodies. * normal glucouse tolerance test. * normal parental karyotyping. exclusion criteria: * age\ 35 year * bmi\ 30 * systemic diseases that might affect pregnancy such as diabetes or thyroid disorders or hypertension. * history of consanguinity. * family history of chromosomal abnormalities (e.g. trisomy 21, trisomy 13, turner's disease ...etc.). * history of autoimmune diseases, eg: systemic lupus. * congenital anomaly in uterine cavity as bicornate or septate uterus. * luteal phase defect and corpus luteum insufficiency. * uterine masses as fibroid or polyps. * patient with patuoles os. * patient with antiphosphlipid syndrome. * cigarette smoking and alcohol.
effectiveness of laser therapy on proximal hamstring tendinopathy

Conditions: Tendinopathy; Lasers

Summary: proximal hamstring tendinopathy (pht) is tendinopathy of the semimembranosus and/or biceps femoris/semitendinosus complex. previous studies have shown the efficacy of laser therapy in the treatment of tendinopathy. to the best of the investigator's knowledge, no study has compared the effects of high-power laser therapy with conventional physiotherapy programs in proximal hamstring tendinopathy patients. therefore, this study aimed to assess the effects of high-power laser therapy on pain and muscle power in proximal hamstring tendinopathy patients.

2 arms comparative pretest-posttest experimental research design with random allocation of subjects into groups (experimental and control group) using the lottery method. a total of thirty-six participants aged between 18-35 (mean age) years, were recruited in the present study. the selected participants were randomly allocated into experimental and control groups using the lottery method and website randomization.com with eighteen participants in each group. the participants and outcome assessor were kept blinded to the allocation. in the experimental group, the high-power laser was given whereas in the control group conventional physiotherapy treatment was given for 4 weeks. conventional physiotherapy treatment included the us, moist heat pack, and home exercises. home exercises include nordic hamstring exercises - 2 sets of 5 repetitions, 3 days/week for 3 weeks.

Eligibility criteria:
inclusion criteria: * athletes * pain located deep in the buttock/posterior thigh region * tenderness of ischial tuberosity * hamstring muscle tightness. exclusion criteria: * recent trauma to the posterior thigh * musculoskeletal disorder of ipsilateral lower extremity * taking pain medication daily * hypertension, malignancy, autoimmune disease, phlebitis, blood disorder.

Keywords: proximal hamstring tendinopathy laser therapy pain muscle power
alternative medicine approaches for women with temporomandibular disorders

Conditions: Temporomandibular Joint Disorders

Summary: temporomandibular disorders (tmd) are characterized by pain and tenderness in the muscles of mastication and/or the temporomandibular joint (tmj), limitations of jaw opening often accompanied by deviations in mandibular path, and clicking, popping or grating tmj sounds. tmd is often found in association with other problems: depression, anxiety, sleep disturbances, gastrointestinal symptoms, frequent infections, etc. this project proposes to holistically address patient symptoms through three different approaches, naturopathic medicine (nm), traditional chinese medicine (tcm), and usual care at kpnw. we will conduct a pilot test and phase ii trial to evaluate the two alternative healing approaches, tcm (n=50) and nm (n=50) delivered by tcm and nm practitioners, are as effective as usual tmd care (n=50) provided by dental clinicians in the kpnw tmd clinic. subjects will be females 25-55 years of age with multiple health problems (defined as patients who have had at least 4 organ system-grouped diagnoses in the past year, not including tmd). subjects will be evaluated at baseline, 6 and 12 months after start of treatment. the primary endpoint is change from baseline in the axis ii pain related disability and psychological status scale. clinical examinations, saliva samples to assess salivary cortisol levels, and responses to a series of questionnaires to assess pain, chronic pain, psychosocial functioning, and other physical symptoms will be used to assess outcomes. we will passively monitor health care utilization within kpnw using clinical, research, and administrative databases to determine whether the interventions have an impact on overall health care utilization. if either of these alternative interventions is shown to merit phase iii trial, our goal is to design and implement such a clinical trial to further evaluate the health consequences and costs of these alternative healing paradigms.

see brief summary

Eligibility criteria:
- patients who have had at least 4 organ system-grouped diagnoses in the past year, not including tmd
benefit of bovine or marine collagen vs. placebo on skin, hair, nails and whole body health in healthy adults

Conditions: Skin Laxity; Hair Thinning; Nails

Summary: the become study (bovine and marine collagen efficacy for skin, hair, nails and whole body health markers evaluation) is a randomized controlled trial designed to compare the effects of bovine and marine collagen supplements versus a placebo on skin, hair, nails and whole body health markers. the trial aims to determine the most efficacious collagen source for improving health outcomes and to establish if both types of collagen are equally effective. participants will be assessed on various health parameters, including skin elasticity, joint health, digestive health, and overall well-being, over a specified period.


Eligibility criteria:
inclusion criteria: females aged 35-55 years. participants must be comfortable with bovine or marine collagen (non-vegan/vegetarian). must provide informed consent and be willing to comply with study requirements. exclusion criteria: pregnant or breastfeeding women. history of chronic skin conditions (e.g., eczema, psoriasis) that might interfere with study outcomes. any active skin infections or severe acne. currently taking collagen supplements or have taken them within the last 6 months. use of medications or topical agents that can affect skin, hair, nails, or gastrointestinal health (e.g., corticosteroids, retinoids). excessive alcohol consumption or current smokers. regular use of sunbeds. recent cosmetic procedures (e.g., botox, fillers, chemical peels, laser treatments) on skin, hair, or nails within the last 3 months. any condition or situation that, in the opinion of the investigator, may interfere with the participant's ability to comply with the study requirements or give informed consent. poor adherence to previous study protocols

Keywords: collagen skin health skin density
gene therapy with modified autologous hematopoietic stem cells for the treatment of patients with mucopolysaccharidosis type i, hurler variant

Conditions: Mucopolysaccharidosis IH

Summary: this is a phase i/ii study evaluating safety and efficacy of autologous hematopoietic stem and progenitor cells genetically modified with idua lentiviral vector encoding for the human α-l-iduronidase gene for the treatment of patients affected by mucopolysaccharidosis type i, hurler variant

pediatric patients with mucopolysaccharidosis type i will be treated with genetically modified autologous hematopoietic stem cells collected from mobilized peripheral blood (or bone marrow if mobilization is not feasible) and transduced with idua lentiviral vector encoding for the human α-l-iduronidase gene. patients will be followed for 5 years after gene therapy. after completing participation in this study, subjects will be offered enrollment into an approved long term follow-up (ltfu) study which will enable continued follow-up for up to 15 years post-treatment (per regulatory guidelines for follow up of patients treated with atmps).

Eligibility criteria:
inclusion criteria: * written informed consent by parent/legal guardian * sex: males and females * age: ≥ 28 days and ≤ 11 years old * biochemically and molecularly proven mps ih * lansky index \>80% * indication to hematopoietic stem cell transplant * lack of a non-heterozygous (for mutated idua) hla-matched sibling donor or a ≥7/8 (4 digits high-resolution typing) hla-matched cord blood donor with a cellularity ≥5 x 10\^7 total nucleated cells (tnc)/kg after 1-month search.(this criterion will not apply to patients whose country of origin does not offer unrelated donor cord blood transplantion). * adequate cardiac, renal, hepatic and pulmonary functions exclusion criteria: * use of other investigational agents within 4 weeks prior to study enrolment (within 6 weeks if use of long-acting agents) * severe, active viral, bacterial or fungal infection at eligibility evaluation * patients affected by neoplasia or family history of familial cancer syndromes * cytogenetic alterations associated with high risk of developing hematological malignancies * history of uncontrolled seizures * patients with end-organ damage or any other severe disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study * positivity for hiv (serology or rna), and/or hbsag and/or hbv dna and/or hcv rna and/or treponema pallidum or mycoplasma active infection * patients with dq/iq \<70 * previous allogeneic hematopoietic stem cells transplantation or gene therapy with a different product * contraindications to peimp (g-csf, plerixafor, busulfan, fludarabine, rituximab)

Keywords: mucopolysaccharidosis ih gene therapy transplantation, autologous lentiviral vector
radiofrequency ablation of atrial fibrillation under apnea

Conditions: Atrial Fibrillation

Summary: this study seeks to assess the effect of apnea (breath hold) during atrial fibrillation (af) ablation by having all ablations performed under apnea. by prospectively studying the effects of apnea on af ablation, the investigators wish to demonstrate its feasibility, safety and impact on patient outcomes. this is a prospective study that includes both an apnea arm and a control arm. the subjects who consent to the apnea arm will undergo an atrial fibrillation ablation with periods of apnea. the subjects who consent to the control arm will agree to have their data from their standard of care atrial fibrillation be collected for comparison.


Eligibility criteria:
inclusion criteria: * age 18 - 80 years old. * symptomatic paroxysmal atrial fibrillation. exclusion criteria: * patients with persistent or permanent atrial fibrillation or prior atrial fibrillation ablation. * significant chronic obstructive pulmonary disease (such as those requiring home oxygen). * severe pulmonary hypertension. * other intrinsic lung pathology such as interstitial lung disease. * severe systolic dysfunction defined as left ventricular ejection fraction \< 30%.

Keywords: atrial fibrillation radiofrequency ablation ablation arrhythmia
clinical pharmacists role in the management of hypertension in jordan

Conditions: Hypertension

Summary: background: studies have demonstrated the crucial role of clinical pharmacists as integrated part of heath care team. not only in jordan but also in the middle east region, clinical pharmacy practice is not well established. this current study is the first to evaluate physicians - pharmacists' collaborative approach to uncontrolled blood pressure in jordan and the middle east.

objective: this study aimed to evaluate clinical pharmacists' role in the management of uncontrolled hypertensive patients in jordan. design: single blinded randomized controlled clinical trial. patients: 253 patients with uncontrolled hypertension specified as higher blood pressure readings than the recommended goals by the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure (jnc vii) at the time of enrollment. interventions: patients were randomly allocated to an intervention or control group: 130 and 123 patients, respectively. patients in both arms were followed up for 6 months. in the intervention group, patients were managed by physician-clinical pharmacist team. in the control group, patients were managed by physician(s) only and were not provided pharmaceutical care services.

Eligibility criteria:
inclusion criteria: * patients with uncontrolled bp, receiving 0-3 antihypertensive drugs with no change in the regimen or dose within the past 3 month. exclusion criteria: * patients with hypertensive urgency or emergency with bp more than (180/110). * patients with recent stroke or myocardial infraction (within past 6 months). * patients with class iii or iv chronic heart failure (chf). * patients with unstable angina. * patients with serious renal or hepatic disease. * pregnant patients. * patients with dementia or cognitive impairment. * if the patient is unable to provide informed written consent.

Keywords: uncontrolled blood pressure
evaluation of immune function in biliary atresia children with prolonged jaundice

Conditions: Biliary Atresia

Summary: null hypothesis of this study: biliary atresia patients with cholestatic jaundice do not have systemic immunity defect.

biliary atresia patients with cholestatic jaundice were noted to have increased incidence of infectious complications. previous animal models of bile duct ligation with acute jaundice ever demonstrated impairment of both humoral and cellular immune function. we performed the immunity study in biliary atresia patients due to the lack of comprehensive systemic immunity study in pediatric cholestatic model. systemic humoral immunity (total serum igg, iga, igm, c3 and c4), specific cellular immunity (lymphocyte classification, mitogen response, cytokines level after pha stimulation test), and non-specific cellular immunity (absolute neutrophil count, pmn cd11b/cd18 expression level, pmn superoxide release function, and pmn phagocytosis function) were tested. association with serum bilirubin level, nutritional status and blood biochemical values were tested to see the relation between systemic immune function and cholestatic jaundice.

Eligibility criteria:
inclusion criteria: biliary patients older than 1-year-old status post kasai operation. exclusion criteria: received liver transplantation, immunosuppresant, systemic immunoglobulin (within 6 months) and obvious infectious episode (within 2 weeks).
improving dietary behavior through tailored messages

Conditions: Cardiovascular Disease

Summary: the aim of this study is to compare a web-based system and a computer telephone system to determine their effectiveness in improving diet behaviors compared to each other and a control group.

the aim of this study is to compare a web-based system (web-diet) and a computer telephone system (tlc \[telephone linked communications\]-diet) for affecting dietary behavior change. these interventions will target the same dietary behaviors (consumption of fat and fruits and vegetables). the behavior change strategies and content will be derived from the same behavior change theory (the transtheoretical model \[ttm\]). a representative sample of \~1200 adults from a large urban area will be recruited through a list-assisted telephone list which will be bought by the university of rhode island so that subjects can be randomized into one of three groups: a web-based system (web- diet), a computer telephone system (tlc \[telephone linked communications\]-diet), or assessment only control. the study hypotheses, which will be evaluated both at the end of the 6-month intervention period and at the end of 18-month follow-up (post-baseline) observation period, are: 1. tlc-diet\> control 2. web-diet\> control 3. web-diet\> tlc-diet.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * be at risk with regard to saturated fat * have access to basic computer hardware and software * use the internet regularly (defined as 1 times per week) and with basic proficiency * read and speak english at a fifth grade level * have access to a telephone and be able to use it independently. exclusion criteria: * prescribed a diet that would conflict with a low saturated fat (e.g., a colectomy diet) * have a serious medical, psychiatric, or cognitive disease that would interfere with participation (e.g., cancer undergoing chemotherapy, psychotic disorder, alzheimer's disease, etc.) * if the individual does not use the internet at least once a week

Keywords: behavioral research diet health information systems
a de-escalating strategy for antibiotic treatment of pneumonia in the medical intensive care unit (0787b-092)

Conditions: Infection; Pneumonia

Summary: the primary objective of this study is a comparison between mk0787b and standard therapy.


Eligibility criteria:
inclusion criteria: * greater than 18 years of age * patient is diagnosed with nosocomial pneumonia exclusion criteria: * immunological deficient patients * pregnant women and nursing mothers * a fungus is identified before the study enrollment * received vancomycin or imipenem for more than 5 days before icu admission
long-term effectiveness of non-ablative er: yag laser for treatment of stress urinary incontinence (sui)

Conditions: Stress Urinary Incontinence

Summary: study is designed to assess the long-term clinical effects and safety profile of non-ablative er:yag (incontilase®) laser treatment, the durability of the results and the optimal treatment regimen for mild-to-severe stages of genuine female stress urinary incontinence (sui).

all patients with urodynamically proven sui, who have failed/declined conservative therapies will be informed about the study. they will be invited to attend a screening/baseline visit. at this visit, they will be asked to perform a standardised 1 hour pad test. their medical history will be checked and they will undergo a clinical and vaginal examination, pregnancy test and dip stick urinalysis. if their 1 hour pad weight is \>2g and they meet all other inclusion / exclusion criteria, they will be eligible for inclusion. they will receive detailed instructions for performing a 24 hour pad test, and will be asked to keep a 3 day voiding diary. they will be given the international consultation on incontinence questionnaire short form (iciq-ui sf). patients will then undergo 3 outpatient treatment visits. the timing of visits will be approximately 1 month apart. at each of their 3 outpatient appointments, they will be asked about any deleterious effects since their last appointment. patients will receive 3 treatments in total. patients will be invited to attend a follow-up visits 3, 6, 12 and 18 months after the 3rd treatment and asked to complete the 1 hour pad test, 24 hour pad test, 3 day voiding diary and iciq-sf questionnaire. at the 18-, 24- and 30-month follow up, they will be given an option to receive additional single session of non-ablative er:yag laser treatment. at each visit, and during additional visit after 36 months, they will be asked to complete all of the tests (1 hour pad test, 24 h hour pad test, 3 day voiding diary and iciq-ui sf).

Eligibility criteria:
inclusion criteria: * adult female, 18 years of age or older * clinical and urodynamic study (uds) diagnosis of stress urinary incontinence * no significant improvement in urinary incontinence from at least one previous conservative treatment, such as pelvic floor muscle training exclusion criteria: * pre-existing bladder pathology including prior radiation treatment * pregnancy * bmi\>35 * radical pelvic surgery or previous incontinence surgery * urinary tract infection or other active infections of urinary tract or bladder * sui iii (vlpp \> 60 cm h2o) * any form of pelvic organ prolapse (pop) stage 2 or greater, according to pop-q * diagnosis of urge incontinence * diagnosis of collagen disorders eg.benign joint hypermobility / elhers-danlos / marfans etc. * incomplete bladder emptying * vesicovaginal fistula * faecal incontinence * unwillingness or inability to complete follow-up schedule * unwillingness or inability to give informed consent * failure to comply with diary requirements during extended baseline period

Keywords: stress urinary incontinence non-ablative er:yag laser