Kornimate/medical-research-clean huggingface dataset:
a study on ca blocker versus aii antagonists in hypertension with type 2 diabetes

Conditions: Hypertension; Diabetes Mellitus, Type 2

Summary: the antihypertensive effect of the increased dose of angiotensin ii receptor blocker (aii antagonist) is compared with that of the additional combined use of amlodipine in hypertensive patients with type 2 diabetes mellitus, who have been treated with aii antagonist, the antihypertensive effect of which has been inadequate.


Eligibility criteria:
inclusion criteria: * patients with type 2 diabetes mellitus. * patients who have been treated by the single use of aii antagonist at usual for at least 8 weeks or patients who have been treated by the combined use of aii antagonist at usual doses and calcium channel blocker or a antihypertensive drug other than ace inhibitors for at least 8 weeks. * patients who show a systolic blood pressure (blood pressure) \> 135 mm hg or a diastolic blood pressure \> 85 mm hg, which is measured (in a sitting position) on an outpatient basis at the time of start of the observation period, and show the mean (blood pressure level measured at home after getting up before the start of study) of systolic blood pressure \> 130 mm hg or diastolic blood pressure \> 80 mm hg measured at home after getting up for last 5 days during the last 2-week observation period. * patients whose consent is obtained at age 20 years or over. * patients whose consent is obtained from themselves in written form. with regard to 2) and 3), however, the case, in which the mean of the systolic blood pressure levels measured at home after getting up for last 5 days during the first 1-week observation period is \> 180 mm hg or the mean diastolic blood pressure level is \> 110 mm hg, is included in the present study. exclusion criteria: * patients with secondary hypertension. * patients who show a systolic blood pressure \> 180 mm hg or diastolic blood pressure \> 110 mm hg on the measurement (in a sitting position) on an outpatient basis at the time of start of the observation period. * patients with severe hepatic dysfunction. * patients with severe renal dysfunction. * patients with a past history of hypersensitiveness to study drugs. * pregnant, lactating, and probably pregnant patients, and patients who want to become pregnant during the study period. * patients who have participated in the trial within 3 months before the start of the observation period or who attend the trial simultaneously with the present study. * other patients judged as being inappropriate for the subjects of the study by investigators.

Keywords: hypertension diabetes mellitus, type 2 calcium channel blocker angiotensin ii type 1 receptor blocker
antimicrobial revision in persistent febrile neutropenia

Conditions: Febrile Neutropenia

Summary: febrile neutropenia is often seen in patients with hematologic malignancies who receive cytotoxic chemotherapy. these patients are usually placed on posaconazole prophylaxis upon starting chemotherapy. if an episode of febrile neutropenia occurs, generally an anti-pseudomonal beta lactam, like cefepime or piperacillin-tazobactam, is initiated. in patients who continue to fever on these agents, the optimal method of antimicrobial revision has yet to be determined.

in this prospective, randomized, open-label, single-center trial, the primary objective is to compare the clinical efficacy of two approaches to antimicrobial revision among patients with persistent febrile neutropenia. neutropenic patients on cefepime or piperacillin-tazobactam who continue to fever for greater than 96 hours will be randomized to receive either meropenem or micafungin dosed according to local guidelines. the primary outcome is a global success rate including a composite of defervescence within 72 hours of meropenem or micafungin initiation, absence of signs or symptoms of infection, and no modification to antimicrobial regimen after initiation of meropenem or micafungin. the secondary outcomes to be collected include in-hospital mortality or discharge to hospice, hospital length of stay, time to defervescence, days of therapy of meropenem or micafungin, rate of clostridioides difficile infection on meropenem or micafungin, and cause of any proven breakthrough infection while on meropenem or micafungin.

Eligibility criteria:
inclusion criteria: * ≥ 18 years of age * diagnosis of hematologic malignancy * receiving chemotherapy as treatment of hematologic malignancy * neutropenia defined as an absolute neutrophil count (anc) ≤ 500 cells/mm3 or an anc ≤ 1000 cells/mm3 with a predicted decline to \< 500 cells/mm3 within 48 hours * prescribed cefepime or piperacillin-tazobactam as initial treatment for febrile neutropenia * persistent fever for ≥ 96 hours since initiation of cefepime or piperacillin-tazobactam or recurrent fever that occurs ≥ 96 hours since initiation of cefepime or piperacillin-tazobactam (fever defined as single temperature of ≥ 38.3°c (101°f) or a temperature of ≥ 38°c (100.4°f) on two consecutive measures separated by at least one hour) * receipt of posaconazole as neutropenia prophylaxis for at least 3 calendar days exclusion criteria: * clinically or microbiologically confirmed infection at time of enrollment, for example, a positive culture or rapid diagnostic test, positive imaging (x-ray, ct, mri) or biomarker, such as galactomannan, that is consistent with infection * history of infection with organism known to be resistant to meropenem or micafungin * documented allergy to carbapenems or echinocandins * concomitant use of valproic acid * uncontrolled seizure disorder * pregnancy * previous enrollment in this study

Keywords: acute myeloid leukemia acute lymphocytic leukemia
single-breath measurement underestimates ventilatory volume according to emphysema severity

Conditions: Emphysema

Summary: although single breath helium (he) dilution measurement (vasb) is currently used in pulmonary function laboratories to assess functional alveolar volume and diffusing capacity for carbon monoxide, the extent to which vasb reflects ventilatory and thoracic volume has not been prospectively determined in emphysema. we hypothesized that vasb underestimates rebreathe helium dilution volume (varb), and plethysmographic volume (vapleth) as clinical and physiologic severity of emphysema increases.

vasb, varb, and vapleth were measured in 52 consecutive stable outpatients with clinical and radiographic emphysema. thirteen patients with an obstructive ventilatory defect without emphysema (ovd) and 18 normal controls were similarly studied. all subjects underwent spirometry followed by whole body plethysmography and he dilution volume measurements; vasb and varb order was randomized.

Eligibility criteria:
inclusion criteria: * all outpatients between the ages of 18 and 81 years referred to the columbia university medical center pulmonary diagnostic unit between 1/18/06 and 7/30/07 for full pulmonary function evaluation, and with an obstructive ventilatory defect on spirometry, were considered eligible. exclusion criteria: * patients who did not want to undergo the re-breathe diffusing capacity testing * patients who could not give informed consent;and * patients who were too physically compromised to undergo full testing including the re-breathe maneuver as deemed by our technicians.

Keywords: alveolar volume pulmonary function testing emphysema
direct comparison of altered states of consciousness induced by lsd and psilocybin

Conditions: Healthy

Summary: lsd (lysergic acid diethylamide) and psilocybin (the active substance in "magic mushrooms") are widely used for recreational purposes. both substances are also increasingly used in psychiatric and psychological research to induce and investigate alterations in waking consciousness and associated brain functions (functional brain imaging, "model psychosis") . however, it has never been studied whether there are differences in the alterations in mind produced by these two substances. both lsd and psilocybin are thought to induce hallucinations primarily via stimulation of the 5-ht2a receptor. however, there are differences in the receptor activation profiles between the two substances that may also induce different subjective effects. lsd potently stimulates the 5-ht2a receptor but also 5-ht2b/c, 5-ht1 and d1-3 receptors . psilocin (the active metabolite of the prodrug psilocybin) also stimulates the 5-ht2a receptor but additionally inhibits the 5-ht transporter. in contrast to lsd, psilocybin has no affinity for d2 receptors. both substances are used in neuroscience as pharmacological tools. however, there are no modern studies comparing these two substances directly within the same clinical study and research subjects and using validated psychometric tools. therefore, the investigators will compare the acute effects of lsd, psilocybin and placebo.


Eligibility criteria:
inclusion criteria: 1. age between 25 and 65 years. 2. understanding of the german language. 3. understanding the procedures and the risks that are associated with the study. 4. participants must be willing to adhere to the protocol and sign the consent form. 5. participants must be willing to refrain from taking illicit psychoactive substances during the study. 6. participants must be willing to drink only alcohol-free liquids and no coffee, black or green tea, or energy drink after midnight of the evening before the study session, as well as during the study day. 7. participants must be willing not to drive a traffic vehicle or to operate machines within 48 h after substance administration. 8. women of childbearing potential must have a negative pregnancy test at the beginning of the study. pregnancy tests are repeated before each study session. 9. women of childbearing potential must be willing to use double-barrier birth control 10. body mass index 18-29 kg/m2. exclusion criteria: 1. chronic or acute medical condition 2. current or previous major psychiatric disorder 3. psychotic disorder in first-degree relatives 4. illicit substance use (with the exception of cannabis) more than 10 times or any time within the previous two months. 5. pregnant or nursing women. 6. participation in another clinical trial (currently or within the last 30 days) 7. use of medications that may interfere with the effects of the study medications (any psychiatric medications) 8. tobacco smoking (\>10 cigarettes/day) 9. consumption of alcoholic drinks (\>10/week) 10. bodyweight \< 50 kg
spinal anesthesia - intraocular pressure

Conditions: Intraocular Pressure

Summary: we aim to investigate the effect of spinal anesthesia on intraocular pressure.

spinal anesthesia provides adequate anesthetic conditions for many operations. these operations include orthopedic, urological, gynecological and many general surgery operations. although few, side effects of the procedure and its effects on body are well known. however, there is inadequate knowledge about the effects of spinal anesthesia on pressure changes in the eyes. these pressure changes in eyes can result in some detriments. elevated pressures in the eyes can result in disease known as glaucoma, that makes hazard to eyes. decreased eye pressures can also result in some eye detriments. we aimed to investigate the effects of spinal anesthesia procedure on eye (intraocular) pressure changes.

Eligibility criteria:
inclusion criteria: * patients having general surgery operations under umbilicus * patients of american society of anesthesiologists (asa) status i-ii exclusion criteria: * patients denying spinal anesthesia * contraindications for spinal anesthesia * eye diseases * hypertension * asa status iii or more
diagnostic yield of 20-gauge procore needle for eus-guided fna biopsy in solid pancreatic lesions

Conditions: Pancreatic Neoplasms

Summary: this study aims to examine technical feasibility and diagnostic yield of new 20-gauge procore needle for eus-guided fine needle biopsy in solid lesions by comparing with 22-gauge procore needle. the study design is prospective, randomized study.


Eligibility criteria:
inclusion criteria: * patients older than 20 years referred to our medical center for eus-fnb with diagnosed or suspected solid pancreatic masses according to clinical evaluation and imaging studies. exclusion criteria: * cystic pancreatic lesions, patients haemodynamically unstable or with severe coagulopathy (international normalized ratio \[inr\] \> 1.5 or platelet count \< 50,000 cells/cubic millimeter \[cmm3\]), patients unable to suspend anticoagulant/anti-platelet therapy, pregnancy, inability or refusal to give informed consent, and refusal to participate in the study.
brain-computer interface (bci) based intervention for attention deficit hyperactivity disorder (adhd)

Conditions: Attention Deficit Hyperactivity Disorder

Summary: this study aims to examine the efficacy of a brain-computer interface system for the treatment of inattentive symptoms of attention deficit hyperactivity disorder (adhd). the investigators hypothesis is that children with adhd receiving treatment with the bci-based training will improve to a greater extent than the control group. additionally, the investigators are also conducting an fmri study involving interested participants, to elucidate the neural mechanisms underlying any behavioural improvement. this is necessary to help the investigators gain a better picture of brain correlates related to adhd and understand how the intervention can affect the brain.

this bci study will involve 2 phases. the first phase is a preliminary study to test the safety and effectiveness of the novel bci device which involves newly developed dry electrode sensors and intervention game. twenty children, aged 6-12 and diagnosed with inattentive or combined subtype of adhd will be recruited for the study. this open-label, experimental arm will go through 8 weeks of bci intervention. the second phase will be a randomized controlled trial involving 160 children. they will be randomized into the treatment or control arm. the treatment arm will receive 8 weeks of bci intervention, similar to the experimental arm. the other group will serve as wait-list controls. the fmri trial aims to examine the underlying neural processes explaining any therapeutic effects that may be seen. the study will enroll 70 children with adhd, aged 6-12, who are participating in the main randomized controlled trial: 40 from the brainpaltm intervention group and 30 from the control group; participants will undergo fmri scan at week 0 and 8 or week 8 and 16. the study will recruit another 30 children aged 6-12 from the community as the healthy control group, who will undergo the same imaging procedure once. the scans will involve both functional and structural imaging.

Eligibility criteria:
inclusion criteria: * dsm-iv-tr criteria for adhd, either the combined or inattentive subtype, based on the diagnostic interview schedule for children (cdisc; schaffer et al., 2000) exclusion criteria: * present or history of medical treatment with stimulant medication and atomoxetine * co-morbid severe psychiatric condition or known sensori-neural deficit e.g. complete blindness or deafness (such that they cannot play computer games) * history of epileptic seizures * known developmental delay (i.e. iq 70 and below) * predominantly hyperactive/impulsive subtype of adhd (i.e. no predominant inattentive symptoms) * present/history polyunsaturated fatty acids supplement intake (e.g. omega-3 oil, flax seed oil, cod liver oil) in the past 3 months * present/history of traditional chinese medicine (tcm) prescribed for treatment of attention problems in the past 1 month

Keywords: brain-computer interface
intralesional injection of levofloxacin for the management of cutaneous leishmaniasis

Conditions: Cutaneous Leishmaniasis

Summary: aim of the study to evaluate the effectiveness of intralesional levofloxacin 0.5% solution as a local injection in treating cutaneous leishmaniasis. in an open-label single-arm clinical trial, all patients were given intralesional levofloxacin injections; the patients had cutaneous leishmaniasis lesions. each lesion was considered a case in the final analysis. each lesion will be followed up for 90 days (censor endpoint) or until the lesions are cured. intralesional levofloxacin (5 mg/ml, 100 ml, tavanic®, sanofi, france) will be injected into each lesion based on its size (5 mg/cm2). the infiltration of intralesional dose will be given once weekly for up to 6 weeks. treatment will be stopped in patients cured before 6 weeks of treatment. a fine insulin needle will be used to infiltrate the lesion.

local therapies have been recommended by the world health organization (who), the pan american health organization, and other experts as an alternative to systemic drugs in patients with at least four lesions smaller than 4 cm in diameter, especially when the face or joints are not affected. usually, they are easy to use and have a lower risk, toxicity, and cost compared to traditional therapies. local treatment includes thermotherapy, cryotherapy, and topical and intralesional drugs. the last approach is effective and safe in localized forms

Eligibility criteria:
inclusion criteria: * patients with single or multiple (less than seven lesions) lesions of cutaneous leishmaniasis and patients ranging in age from 20 to 75 years old. exclusion criteria: * patients who received anti-leishmaniasis treatment locally or systemically for the last month before this study and patients on prolonged corticosteroid therapy.
cleansing device for the treatment of scalp and hair conditions

Conditions: Dandruff; Seborrheic Dermatitis; Hair Loss

Summary: the objective of this study is to evaluate an improvement of scalp health after the use of an investigational off-label waterpik and brush device aimed to massage and cleanse the scalp.

seborrheic dermatitis and dandruff are skin conditions that present with common features and respond similarly to treatments. dandruff involves flaking skin that can cause irritation and itching. dandruff only involves the scalp, whereas seborrheic dermatitis can occur on the scalp, face, chest, and retro-auricular areas. seborrheic dermatitis can also result in itching and flaking, as well as inflammation and erythema. both dandruff and seborrheic dermatitis are known to be harmful to the scalp. despite shampoo and washing, one may still continue to have flaking and scale present on the scalp. there are numerous scalp massages and brushes on the consumer market. waterpik® was fda approved in 2018 to provide pressured water combined with a powered toothbrush for optimal plaque and particle removal when cleaning the mouth and teeth. waterpik® now has several products on the market designed for oral health, pet care, and washing in the shower. the off-label design utilizes the waterpik® device, but with adjustments optimized for scalp health. through the investigational use of the off-label waterpik® and brush device, the investigators propose the technique of massage and gentle water pressure will reduce seborrheic dermatitis and dandruff on the scalp.

Eligibility criteria:
inclusion criteria: * participants must qualify for one of the following scalp conditions based on clinical opinion of a board-certified dermatologist: healthy scalp, dandruff, seborrheic dermatitis, or hair loss disease * all women of child bearing potential must indicate use of two of the following contraceptive methods. the waterpik device uses an ultrasonic technology which includes ultrasound. unnecessary ultrasound is not recommended for pregnant women. * combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, or transdermal) * progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, or implantable) * intrauterine device (iud) * intraurerine hormone-releasing system (ius) * vasectomized partner * sexual abstinence * barrier method, such as a condom exclusion criteria: * non-english speaking * exclusion related to pregnancy, lactation, or plans to become pregnant over the course of the study (based on self-report from the participant) * current clinical condition that, in the opinion of the site investigator, would interfere with adherence to study requirements
haploidentical cd34+ selected cells combined with single unit umbilical cord blood transplant for treatment of high-risk hematologic disorders

Conditions: Hematologic Disorders

Summary: this is a study to evaluate the safety and efficacy of miltenyi clinimacs® cd34 reagent system to promote engraftment of haploidentical cd34+ selected cells combined with single unit umbilical cord blood transplant for treatment of high-risk hematologic disorders.

in this clinical protocol, the clinimacs® cd34 reagent system will be used for processing hematopoietic progenitor cells collected by apheresis (hpc, apheresis) from an allogeneic, hla-haploidentical, related donor to obtain a cd34+ cell-enriched population for hematopoietic reconstitution. the haploidentical donor will be mobilized by g-csf and undergo one apheresis to collect cd34+ stem cells. the products will be cryopreserved until the time of transplantation. recipients with hematologic disorders who require transplant will receive a standard conditioning regimen and will receive an allograft on day 0 containing donor cd34+ cells that have been positively selected and t-cell depleted following g-csf mobilization combined with a single ucb unit.

Eligibility criteria:
inclusion criteria - recipient * ages 18-80 years inclusive * diagnosed with high risk hematologic disorders warranting stem cell transplant per institutional standard of care * lack hla-identical related donor * availability of at least one hla- haploidentical (i.e. =\> 5/10 and \<= 8/10 hla match) related donor (hla-a, b, c, dr, and dq loci) who is available to donate cd34+ cells. * availability of at least one 4/6 hla-matched (hla-a, b, and dr loci) cord blood unit from the national marrow donor program (nmdp). the cord blood unit must contain a minimum tnc (prior to thawing) of at least 2x107 cells per kilogram of recipient body weight * ability to comprehend the nature of the treatment 6.2. exclusion criteria - recipient (any of the following) * hla identical (6/6) related donor available and readily accessible at time of transplantation evaluation * any patient not meeting institutional standard guidelines for transplant eligibility

Keywords: stem cell transplant umbilical cord blood transplant haploidentical cd34+ selected cells
effects of sensory motor training and kinesthetic exercises in knee osteoarthritis.

Conditions: Knee Osteoarthritis

Summary: in this study i will see the effects of kinesthetic exercises and sensory motor training on pain and range of motion in patients with knee oa.

in 2022 a a pilot randomized trial of different weekly applications of kinesthesia, balance and agility exercise program for individuals with knee osteoarthritis was conducted.in 2023 a critically appraised research was conducted on sensorimotor or balance training to increase knee-extensor and knee-flexor maximal strength in patients with knee osteoarthritis. in past there is no study that compares the effects of smt and kinesthetic exercises in knee oa.

Eligibility criteria:
inclusion criteria: * patients having osteophytes and definite joint space reduction confirmed by radiographs * patients having age 40-60 years or both gender are included exclusion criteria: rheumatoid arthritis. hip or ankle instability hip or knee replacement unresolved balance disorder patients with active synovitis

Keywords: osteoarthritis pain smt