Kornimate/medical-research-clean huggingface dataset:
assessment of human diaphragm strength by magnetic and electric stimulation after ultrasonography phrenic nerve tracking

Conditions: Intensive Care Unit; Invasive Mechanical Ventilation

Summary: development and validation of a new affordable and easy-to-use phrenic nerve stimulation tool for diaphragm strength assessment in intensive care unit

in intensive care unit, various forms of sepsis, undernutrition, surgery, global inflammation, iatrogeny, and mechanical ventilation, contribute to the overall muscular involvement including the diaphragm. assessment of diaphragm dysfunction is a critical issue for patients under mechanical ventilation, providing prognosis information and leading to the best therapeutic choices. up to now, for sedated ventilated critical care patient, expensive magnetic phrenic nerve stimulation equipment is needed to evaluate diaphragm strength. in this study, the investigators aim to develop an affordable easy-to-use phrenic nerve stimulation tool, with ultrasonography and a nerve stimulator usually used for neuromuscular transmission monitoring. hypothesis is that phrenic pacing using this new method is equivalent to the gold standard.

Eligibility criteria:
inclusion criteria: * icu patient with invasive mechanical ventilation * sedated patient with a richmond agitation-sedation scale of -4 or -5 exclusion criteria: * contraindication for magnetic stimulation (pacemaker) * hemodynamic or respiratory instability : pao2/fio2 \ 0,3 µg/kg/min, dobutamine \> 10 µg/kg/min * neuromuscular disease or recent use of neuromuscular blocking agents (2h30) with a tof ratio below 4/4 95%. * refusal of study participation or to pursue the study by the patient, no consent * pregnancy or breastfeeding * absence of coverage by the french statutory healthcare insurance system

Keywords: intensive care unit invasive mechanical ventilation diaphragm weakness assessment rehabilitation
osteopathic support evaluation of fibromyalgia patients

Conditions: Fibromyalgia

Summary: at present, the literature does not account for much of scientific data on the assessment of osteopathic intervention for patients with (fibromyalgia) fm. the investigators propose a pilot study evaluating the efficacy of osteopathic care, consists of several osteopathic interventions in the treatment of fm, in order to improve the painful experiences of fm patients. this study must include 44 patients with fm according to (american college of rheumatology) acr criteria and followed the university hospital of caen. the osteopathic care will last eight months and will be followed by a report three months after the end of osteopathic interventions. this in order to evaluate the effect in the short term and long term, of osteopathic care in patients with fm.


Eligibility criteria:
inclusion criteria: * fm patient diagnosed according to the acr criteria. * patient having realized biological balances excluding any underlying pathology that may be causing the pain. * patient over 18 years followed at caen university hospital. * patient treated with drugs to its fm. * patient being informed and having signed his consent. * patient affiliated to the social security system. * french-patient. exclusion criteria: * fm undiagnosed according to the acr criteria. * patient showing against -indications to the osteopathic surgery. * patient treated by manual therapy ( physiotherapy, osteopathy, acupuncture... ) during the trial and during the three months preceding the study. * concomitant maladie (type cancers, cardiovascular diseases, rheumatic diseases ) or all diseases causing bone pain and myalgia. * important surgery of less than 3 months. * inability to submit to medical monitoring study for geographical or social reasons. * inclusion the subject in another biomedical research protocol for this study. * women pregnant or nursing.

Keywords: osteopathy support treatment pain quality of life
gait profile and variables in pediatric rheumatic disease using a smart insole system

Conditions: Juvenile Idiopathic Arthritis (JIA); Familial Mediterranean Fever (FMF ); Healthy Controls

Summary: in pediatric rheumatic diseases, joint swelling, effusion, tenderness, and painful restriction of joint movement, particularly in weight-bearing joints, frequently alter walking function. these changes affect temporal and spatial parameters of gait, as well as kinematic and kinetic characteristics, leading to functional limitations. comprehensive physical assessments in patients may not always predict changes in gait parameters. therefore, incorporating objective methods related to gait and balance into physical evaluations is essential for functional insights and clinical decision-making, aiming to prevent adaptive mechanisms that could negatively affect gait function in the long term. in this context, smart insoles have emerged as a new tool for gait analysis, offering an alternative to high-cost, lab-based equipment. the digitsole pro® system can measure gait profile and variables in real-life conditions. a review of the literature reveals no studies utilizing smart insole-based gait assessments in pediatric rheumatic patients. the aim of our study is to investigate the gait profile and variables of children and adolescents with pediatric rheumatic disease using the next-generation digitsole pro® smart insole system, and to compare the results with those of healthy peers.


Eligibility criteria:
inclusion criteria: children and adolescents with pediatric rheumatic disease: * aged 6-18 years * diagnosed with jia or fmf at least 6 months ago at the istanbul medical faculty pediatric rheumatology clinic healthy children and adolescents: * aged 6-18 years * willing to participate in the study exclusion criteria: exclusion criteria for children and adolescents with pediatric rheumatic disease: * history of trauma or surgery affecting the musculoskeletal system in the last 6 months * presence of a chronic disease other than jia or fmf * acute pain for any reason * visual or hearing problems * cognitive impairment that prevents understanding of given instructions exclusion criteria for healthy children and adolescents: * history of trauma or surgery affecting the musculoskeletal system in the last 6 months * hearing or visual problems * acute pain for any reason

Keywords: juvenile idıopathic arthritis familial mediterranean fever gait profile smart insole system gait analysis
renal denervation for uncontrolled hypertension

Conditions: Hypertension

Summary: this is a study investigating the safety and usefulness of the renal denervation procedure in reducing high blood pressure in people whose blood pressure is not adequately controlled despite already being treated with 2 blood pressure lowering drugs. this study is designed to compare the effects renal denervation to a usual care group.

this is a phase 4 randomised control trial of renal denervation for the treatment of uncontrolled hypertension. previous studies have shown that the renal denervation procedure is safe and effective in reducing blood pressure. a total of 100 participants with uncontrolled blood pressure, treated with two blood pressure lowering medications will be recruited into the study. patients will be assigned to one of two groups. participants in group 1 will be assigned to undergo the renal denervation procedure. participants in group 2 will undergo usual care, receiving additional antihypertensive medication in an attempt to reach blood pressure targets. the duration of this study is 36 months.

Eligibility criteria:
inclusion criteria: * bp ≥140/90 mmhg (or ≥130/80 mmhg for patients with diabetes) * concurrent treatment with 2 anti-hypertensive drugs exclusion criteria: * renal artery anatomy ineligible for treatment * egfr \<15ml/min/1.73m2 (using mdrd formula) * individual has had myocardial infarction, unstable angina or cerebrovascular accident within 6 months of screening visit * female participants of child bearing potential must have negative pregnancy test prior to treatment

Keywords: renal denervation blood pressure cardiovascular risk target organ damage sympathetic activity
effect of epi-off technique corneal cxl on endothelial count by specular microscopy in keratoconus patients

Conditions: Keratoconus, Collagen

Summary: determine safety of epi-off cxl on corneal endothelium by using specular specular microscopy to assess endothelial count.

specular microscopy is a noninvasive photographic technique that analyze the corneal endothelium. using computer-assisted morphometry, modern specular microscopes analyze the size, shape and population of the endothelial cells. the instrument projects light onto the cornea and captures the image that is reflected from the optical interface between the corneal endothelium and the aqueous humor. the reflected image is analyzed by the instrument and displayed as a specular photomicrograph corneal collagen cross-linking (cxl) is a therapeutic procedure aiming at increasing the corneal stiffness in the keratoconus eyes by induction of cross-links within the extracellular matrix. it is achieved by ultraviolet-a (370 nm) irradiation of the cornea after saturation with the photosensitizer riboflavin. in the conventional cxl protocol, a minimum (manual) de-epithelialized corneal thickness of 400 μm is recommended to avoid potential irradiation damage to the corneal endothelium. in advanced keratoconus, however, stromal thickness is often lower than 400 μm, which limits the application of cxl in that category. efforts have been undertaken to modify the conventional cxl procedure to be applicable in thin corneas. the current review discusses different techniques employed to achieve this end and their results. the overall safety and efficacy of the modified cxl protocols are good, as most of them managed to halt the progression of keratectasia without postoperative complications. however, the evidence of safety and efficacy in the use of modified cxl protocols is still limited to few studies with few patients involved. controlled studies with long-term follow-up are required to confirm the safety and efficacy of it.

Eligibility criteria:
inclusion criteria: * patients with corneal diseases that treated by collagen cross linking such as keratokonus and post lasic ectesia with corneal thickness above 400um at its thinnest location. exclusion criteria: 1. prior herpetic infection 2. autoimmune disorders 3. corneal thickness below 400um at its thinnest location 4. corneal opacity
hong kong cohort of abnormal sleep in ageing population (hk-asap): focusing on brain health and sleep quality

Conditions: Sleep Disturbance; Aging; Cognitive Decline; Brain Disease

Summary: poor sleep quality can significantly jeopardize the brain health, cognitive functions, daily activities, quality of life, and even be implicated as a key potential contributing factor in the development of accelerated cognitive decline and prodromal dementia. consequently, research efforts to understand, and therefore potentially model, the effects of sleep quality on cognition and brain health are of great pragmatic values.

objectives: this study aims to investigate the cognitive changes in older adults with sleep disturbances, examine the neuroimaging contributors to poor sleep quality and cognitive deficits.

Eligibility criteria:
inclusion criteria: * chinese old adults are the ones who are over 60 years of chronological age. * sleep disturbance: individual's subjective sleep quality is assessed using the pittsburgh sleep quality index (psqi) with a total score \>5. exclusion criteria: * history of bipolar disorders or psychosis. * history of major neurological deﬁcits, including stroke, transient ischemic attack or brain tumor. * unable to participant magnetic resonance imaging (mri) scanning.

Keywords: ageing sleep disturbances cognition brain health longevity
a study utilizing escitalopram in glioma patients

Conditions: Glioma of Brain; Glioma

Summary: this pilot study will include grade iv glioma patients treated with ssris during approximately a 17 week study period. changes in cognition and evaluation of psychosocial factors from baseline to after 17 weeks of treatment with ssri study drug will be calculated.

as many as 85% of glioma patients experience cognitive impairment. this is not only from direct tumor involvement, but also worsens with therapy such as cranial radiation and chemotherapy, which further degrade neuronal function. commonly, impairments in visuospatial skills and executive function are seen. there is evidence that serotonin selective reuptake inhibitors (ssris) such as escitalopram improve modulation and function of resting state networks, contribute to neuroplastic changes in brain regions subserving these abilities, and provide general functional support to neuronal cells. in addition to either improving cognition or preventing cognitive decline, treatment with an ssri may also improve outcomes critical to overall survival in this vulnerable population, including functional independence, psychosocial stability, and quality of life. we hypothesize that following treatment with escitalopram patients will experience improved cognitive and mood function over time. we will also correlate changes in mood structural mri and electrophysiological correlates of visual pathway function. the addition of escitalopram has the potential to enhance cognitive function and hence functional independence thereby improving quality of life in these patients.

Eligibility criteria:
inclusion criteria: * patient with pathologically proven diagnosis of grade iv glioma * patients planning to receive chemotherapy and/or radiation for newly diagnosed disease * performance status ecog 0-2 or equivalent * patients must be age ≥19 years * life expectancy greater than 6 months * written informed consent to participate in the study. exclusion criteria: * hemifield defects (as this obscures visual field necessary to participate in all tests) * inability to undergo mri * severe renal impairment defined as gfr\<30 ml/minute * screen positive for depression or anxiety * already taking an anti-depressant (ssri or nsri) * have problems tolerating past treatment with ssri or nsris * females of childbearing potential must have a negative urine pregnancy test at the study enrollment. * female patients must be either postmenopausal, free from menses for ≥2 years, surgically sterilized, or willing to use two adequate barrier forms of contraception

Keywords: serotonin selective reuptake inhibitor cognition escitalopram
ms and nmosd in african-americans

Conditions: Multiple Sclerosis; Neuromyelitis Optica

Summary: this is a prospective study that aims to collect and review neuromyelitis optica spectrum disorder (nmosd) data from african american patients with a known diagnosis of multiple sclerosis (ms). it is an investigational study, prospective in nature. no randomization of patients will be done. information collected includes: age, gender, age at diagnosis, mri data (access to images), clinical presentation, findings on clinical examination, lab (blood and evoked potentials) and lp test results, eye exam findings if any and treatment, if started. additional details may include other neurological diseases which are also diagnosed (if any).

african-americans with ms are high risk for ambulatory difficulty given aggressive disease phenotype. disease responsiveness to fda-approved drugs is also marginal at best. a positive correlation between the presence of oligoclonal bands (ocbs) and progressive course of ms has been established even when adjusted for ethnicity. it is well documented that the csf humoral immune response, including a higher igg index is higher in african-american ms patients. although mri lesions, specifically cord and infra-tentorial regions, contribute to disability, the phenotype in african-american populations is also probably linked to hla-antigen complex. no study has ever collected data as it relates to ethnic background and ms. the university of kentucky would be the first institution to collect such data. this is a prospective study that will collect data from patients with the known diagnosis of ms who were later classified as nmosd from the university of kentucky's multiple sclerosis clinic. researchers will use redcap to store data.

Eligibility criteria:
inclusion criteria: * between the ages of 18 and 80 * are african-american * have a diagnosis of ms and later diagnosis of nmosd * have been seen at the university of kentucky's kentucky neuroscience institute

Keywords: multiple sclerosis ms neuromyelitis optica spectrum disorder nmosd african americans
imagine to remember: improving medication adherence in pre- and type 2 diabetes

Conditions: Medication Adherence

Summary: determine if an intervention consisting of future-thinking improves different facets of memory/executive function and/or decision-making.

the aim of this study is to determine if a cognitive intervention is an efficacious method for improving medication adherence in adults with prediabetes or type 2 diabetes. participants in this study will complete assessment sessions, as well as intervention sessions over a 15 week period. during this time, medication adherence will be monitored using a mems cap. the investigators hypothesize that, following the cognitive intervention, there will be improvements in participants' medication adherence, as well as in facets of memory.

Eligibility criteria:
inclusion criteria: adults over the age of 18 with prediabetes or type 2 diabetes currently prescribed at least one oral medication for blood glucose regulation, or for related comorbidities e.g., hypertension, hyperlipidemia, and are relatively non-adherent to taking them (\< 80% of prescribed doses taken), but are motivated and/or have the intent to better comply with their medication regimen, will be studied. prediabetes and type 2 diabetes: participants must have a diagnosis of prediabetes or type 2 diabetes within the last 2 years or meet criteria for prediabetes or type 2 diabetes. the american diabetes association guidelines (group, 2003) defines prediabetes and type 2 diabetes as fasting plasma glucose (fpg) 100mg/dl or greater, 2h glucose 140mg/dl or greater after oral glucose tolerance test (ogtt), or hemoglobin a1c (hba1c) of approximately 5.4% or greater. exclusion criteria: pregnancy: women who are pregnant or lactating will be excluded from participation. substance use, abuse, or dependence: individuals that currently have problems with substance dependence, addiction, or problematic substance use that would limit participation (e.g., binge drinkers, alcoholics, daily stimulant/opiate users) will be excluded. conditions that affect adherence: participants should not have a condition that would limit participation which include medical conditions that would affect individuals' ability to use the computer for prolonged period of time; leave the individual unable to ambulate; unmanaged psychiatric disorder (e.g., depression, anxiety, attention deficit hyperactivity disorder, schizophrenia), cognitive impairment that would impact memory (e.g., symptomatic concussion), or an intellectual impairment that would impact study adherence. additionally, participants should be able to attend to all intervention sessions. if a participant is not able to make most sessions (e.g. participant is out of town during most of the study for work or vacation travel), they may be excluded from the study prior participation in similar studies: individuals who have recently participated in a laboratory study using similar methods may also be excluded. use of medication adherence aids: individuals who currently use aids to assist with medication adherence (e.g., pill organizers, reminder apps)may be excluded
role of depression in blood pressure control. study

Conditions: Hypertension; Depression

Summary: our study aims to evaluate the role of depression in blood pressure control in ambulatory hypertensive patients.

research problem: hypertension is a multifactorial disease that affects approximately one quarter of the adult population. it is a major risk factor for stroke and cardiovascular disease. environmental and psychosocial factors play an important role in hypertension onset and control. the prevalence of depression among hypertensive patients is 26, 8% and its presence is associated with increased risk of cardiovascular-related morbi-mortality. our study aims to evaluate the role of depression in blood pressure control in ambulatory hypertensive patients. investigative process: this study is a cross-sectional, multicentric and descriptive study. the investigators intend to include three hundred and two patients. after obtaining their consent, a 24 hour ambulatory blood pressure monitor will be used to evaluate blood pressure control. depression was assessed by the 9-item-patient health questionnaire (phq-9) in tunisian dialect. clinical, socio-environmental, psychosocial and therapeutic and prognosis data will be collected from medical records.

Eligibility criteria:
inclusion criteria: * patients consulting for high blood pressure * patients older than 18 years. * patients able to give informed consent. non inclusion criteria : * patients followed for depression under treatment. * hospitalized patients exclusion criteria: * a white coat hypertension

Keywords: patient health questionnaire blood pressure monitoring, ambulatory hypertension depression
internal iliac artery ligation before cesarean hysterectomy in morbidly adherent placenta

Conditions: Blood Loss

Summary: 40 pregnant females at term diagnosed with morbidly adherent placenta and planned for elective cesarean section were recruited and randomized to 2 groups. group a: internal iliac ligation followed by cesarean hysterectomy. group b: cesarean hysterectomy.


Eligibility criteria:
inclusion criteria: * placenta previa accreta * previous 2 cesarean section * completed her family * hemoglobin \> 11 gm/dl * elective cesarean hysterectomy exclusion criteria: * anemia ( hemoglobin \< 11 gm/dl) * not completed her family * bmi \> 35 kg/m2 * bleeding tendency * emergengy cesarean section * thrombophilia

Keywords: internal iliac artery internal iliac artery ligation placenta previa placenta accreta cesarean hysterectomy
laser therapy for the management of radiation dermatitis

Conditions: Radiation Dermatitis

Summary: low level laser therapy (lllt) is a form of phototherapy which involves the application of light to injuries and lesions to promote tissue regeneration. it is a noninvasive treatment modality based on the photochemical effect of light on tissues, which modulates various metabolic processes. lllt has been used for a wide range of conditions, in particular in dermatology, to promote wound healing, reduce inflammation and oedema, and relieve pain. in this study, we intend to assess the efficacy of lllt to manage radiotherapy-induced skin reactions (or radiation dermatitis), a very common and distressing side effect of cancer treatment.


Eligibility criteria:
inclusion criteria: * diagnosis of noninvasive (stage 0) or invasive (stages 1, 2 or 3a) breast adenocarcinoma * treatment with primary breast-sparing surgery (lumpectomy) and/ or neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy or hormonal treatment * scheduled for postoperative radiotherapy with standard technique (isocentric) and fractionation regime (i.e., 25 daily fractions to the whole breast followed by a boost of 8 fractions to the tumor bed, 2 gy per fraction, five times per week) * provide signed informed consent exclusion criteria: * previous irradiation to the same breast * metastatic disease * mastectomy surgery * concurrent chemo-radiotherapy * required use of bolus material to deliver radiation therapy (i.e., material placed on the to-be-irradiated zone to modulate the delivered dose in order to ensure an optimal distribution of the radiation dose)

Keywords: radiation dermatitis radiodermatitis radiotherapy induced skin reactions low level laser therapy breast cancer