Kornimate/medical-research-clean huggingface dataset:
diagnosis and treatment of sleep apnea in the acute exacerbation of heart failure

Conditions: Sleep Apnea; Heart Failure

Summary: congestive heart failure affects 2.3 percent of the population (approximately 4,900,000) with an incidence of 10 per 1,000 of the population after the age of 65 (1). the admission rate for patients with heart failure is on the rise, so is the mortality associated with it and its national annual bill, now exceeding $21 billion (1). obstructive sleep apnea (osa) is present in 11-37 percent of patients with heart failure (2,3), and tends to increase in severity when the heart failure is less controlled (4, 5). therefore, the actual prevalence of osa in patients hospitalized with acute heart failure is likely higher. there is now evidence that treatment of osa with nasal continuous positive pressure (ncpap) in outpatients with stable heart failure improves left ventricular ejection fraction, and quality of life (6), and confers a reduction in fatal and non-fatal cardiovascular events (7). however, there has not been any evaluation of the role of diagnosis and treatment of osa in patients hospitalized with acute heart failure. this uncertainty about the true prevalence and role of osa in exacerbations of heart failure, and the role of its treatment in the acute setting may explain why aggressive diagnostic and therapeutic strategy for osa in patients admitted to the hospital with acute heart failure is not part of the standard clinical practice in acute care centers. given the rising admission rate, and mortality associated with heart failure, an evaluation of the role of osa and its treatment in this patient population is highly significant.

osa is associated with large negative swings in the intrathoracic pressure, significant increase in the sympathetic nerve activity and repetitive surges in blood pressure, along with episodic hypoxia and hypercapnea (8, 9). these autonomic and respiratory changes may increase the cardiac muscle workload, cardiac dysrrhythmia, and exacerbate ischemia (10,11,12). treatment with continuous positive airway pressure (cpap) is the most successful therapeutic modality available for obstructive sleep apnea. it is still not clear whether establishing the diagnosis of osa and initiating treatment with cpap while still in the hospital carries any benefit in the management of patients with acute heart failure. this study will evaluate the effect of work up and treatment of osa on the outcome of patients hospitalized with acute congestive heart failure (chf).

Eligibility criteria:
.inclusion criteria: * able to provide an informed consent * speaks english * older than 21 * heart failure * positive for osa exclusion criteria: * csa * already on cpap * hemodynamic instability * acute respiratory failure * neurological defect * dialysis

Keywords: sleep apnea, obstructive sleep apnea, heart failure, chf
does the diacutaneous fibrolysis change ultrasonographic measurements in patients with carpal tunnel syndrome?

Conditions: Carpal Tunnel Syndrome; Physical Therapy Modalities; Ultrasonography

Summary: the carpal tunnel syndrome (cts) is a common entrapment neuropathy caused by compression of the median nerve at the wrist.clinically electroneuphysiological assessment is not accessible to all clinicians. in this way ultrasounds (us) is a more accessible and economical tool and many studies have reported that us has high sensitivity and specificity in the diagnosis of cts.diacutaneous fibrolysis (df) is a physiotherapeutic technique derived from cyriax deep friction massage principles.df technique could assist in improving changes in the connective tissues adjacent to the median nerve, especially the thickness of tcl and this could be reflected in a decreasing of tcl. moreover, the neurophysiological and mechanical effect described by this technique may improve the nerve compression decreasing the csa of the median nerve. the purpose of this study is to quantify changes in the cross-sectional area of the median nerve in the carpal tunnel and the thickness of transversal carpal ligament measured by us and the changes in the intensity of the numbness and the subjective assessment of clinical change after df treatment in forearm, wrist and hand area compared to placebo.


Eligibility criteria:
inclusion criteria: - diagnosed medically with neurophysiological test of carpal tunnel syndrome (low and moderate intensity) exclusion criteria: * severe carpal tunnel syndrome * previous surgery on the hand * hormonal factors: diabetes, thyroids pathologies, pregnant * cervical disfunctions * ulcerations or skins disorders
study of safety and effects of mdma-assisted therapy for treatment of ptsd

Conditions: Posttraumatic Stress Disorder

Summary: the purpose of this clinical trial is to learn if mdma-assisted therapy is safe and effective in people with ptsd. the main question it aims to answer is: do two open-label sessions of mdma-assisted therapy reduce ptsd symptoms? participants will undergo three non-drug preparatory therapy sessions followed by two open-label mdma-assisted therapy sessions. after, participants will undergo three non-drug integrative therapy sessions.

this phase 2, open-label study will provide supportive data on the safety and effectiveness of mdma-assisted therapy in participants with ptsd. this study will be conducted at a single study site in vancouver, bc. there will be at least 2 co-therapy pairs. the study will enroll up to 20 participants. the preparatory period will consist of three 90-minute non-drug preparatory therapy sessions. a flexible divided dose of mdma will be administered during the treatment period with manualized therapy in up to two open-label experimental sessions. during the treatment period, each experimental session is followed by three 90-minute non-drug integrative therapy sessions. the experimental sessions are scheduled roughly 3 to 5 weeks apart.

Eligibility criteria:
inclusion criteria: * are at least 18 years old. * are fluent in speaking and reading a recognized language of the study site. * are able to swallow pills. * agree to have study visits recorded, including study drug sessions and non-drug therapy sessions. * must provide a contact (relative, spouse, close friend, or other support person) who is willing and able to be reached by the investigators in the event of a participant becoming suicidal or unreachable. * must agree to inform the investigators within 48 hours of any medical conditions and procedures. * if of childbearing potential, must have a negative pregnancy test at study entry and prior to each experimental session, and must agree to use adequate birth control through 10 days after the last experimental session. * must not participate in any other interventional clinical trials during the duration of the study, and commit to medication dosing, therapy, and study procedures. * at baseline, have moderate ptsd diagnosis. exclusion criteria: * are not able to give adequate informed consent. * have uncontrolled hypertension. * have a marked baseline prolongation of qt/qtc interval (e.g., repeated demonstration of a qtc interval \>450 milliseconds \[ms\] in males and\>460 ms in females corrected by friderica's formula). * have a history of additional risk factors for torsade de pointes (e.g., heart failure, hypokalemia, family history of long qt syndrome). * have evidence or history of significant medical disorders. * have symptomatic liver disease. * have history of hyponatremia or hyperthermia. * weigh less than 48 kilograms (kg). * are pregnant or nursing, or are of childbearing potential and are not practicing an effective means of birth control. * have current alcohol or substance use disorders.
the effects of dietary supplements on glycemic control, body composition and hepatic fat content in people with prediabetes

Conditions: PreDiabetes

Summary: this clinical study aims to explore the effects of 3 dietary supplements on metabolic parameters, liver fat content, and body composition in individuals with prediabetes. prediabetes refers to a condition where blood sugar levels are higher than normal but not high enough for a diabetes diagnosis. the study will last for three months, during which participants will either take a dietary supplement or a placebo. five groups will be studied, including placebo groups. blood tests will assess glucose and lipid metabolism parameters, adipokines, and liver and kidney function. liver stiffness and fat content will also be measured using elastography. additionally, body composition will be assessed, and participants' psychological state, quality of life, eating habits and sports habits will be evaluated using questionnaires.


Eligibility criteria:
inclusion criteria: * willingness and ability to provide written informed consent and comply with all study requirements, * age between 40 and 80 years * prediabetes with a hba1c level between 5,7-6,4% * no antidiabetic treatment prior to the inclusion in the study * bmi between 25 and 35 kg/m2 * fasting glucose of 100-125mg/dl * in the case of women of childbearing potential, providing a negative pregnancy test at inclusion and once a month until the end of the study exclusion criteria: * failure to provide written informed consent and/or failure to comply with the study requirements * age \<40 years * hba1c outside of the set range * significant impairments of hepatic and/or renal function * clinically significant abnormalities in medical history, routine laboratory screening, or in physical examination * allergies against any of the components of the dietary supplements or the placebo * type 1 diabetes mellitus, latent autoimmune diabetes in adults, maturity-onset diabetes of the young, gestational diabetes * pregnancy, lactation * concurrent treatment with any antidiabetic drug * concurrent treatment with drugs/dietary supplements that have proven interactions with dietary supplements included in our study

Keywords: prediabetes dietary supplements
therapeutic research in multiple myeloma

Conditions: Multiple Myeloma

Summary: the purpose of this study is to learn how myeloma cells grow and become a cancer, how to distinguish them from normal cells and how to eliminate these cells selectively.

participating in this study will require that blood and bone marrow samples be obtained as a part of the diagnostic work-up or follow-up of your multiple myeloma. bone marrow/peripheral blood/tissue samples will be collected for research purposes, as well as testing for genetic traits of castleman's disease if you consent to this study. in addition, data will be collected including demographic information gathered from your medical record, including gender, date of birth, ethnicity, date of diagnosis, laboratory and pathology results, treatment protocols, dates of relapses, subsequent treatment protocols, and current treatments and medications.

Eligibility criteria:
inclusion criteria: * any subject evaluated for a mirt protocol exclusion criteria: * subjects who have not been evaluated for a mirt protocol
optimizing engagement in services for first-episode psychosis

Conditions: Engagement, Patient; First Episode Psychosis

Summary: this study will compare a 12-session behavioral activation (ba) intervention modified for first-episode psychosis (fep) to usual community mental health care (i.e., treatment-as-usual; tau) delivered over 6 months with a sample of latinos with fep and their families. comparable family group sessions will also be delivered to participants in both conditions. it is expected that ba participants will show better engagement than tau participants.

after an initial pre-screen, screening, and pre-intervention assessment, enrolled participants will be randomized to either ba or tau. the study intervention phase will last up to 6 months, during which time ba participants will receive up to 12 one-on-one ba sessions and tau participants will receive the usual care (e.g., medication management and any other service \[e.g., group counseling\]). participants will be assessed at post-intervention, 1-month-post-intervention, and 6-month-post-intervention. the primary objective of aim 1 is to examine whether ba for fep improves engagement in services better than tau among latinos with fep and their families. secondary objectives of aim 1 are to examine whether ba participants show greater improvements in quality of life, symptoms (e.g., psychosis, depression), functioning, and recovery compared to tau participants, and whether ba participants have greater remission rates than the tau group at 1- and 6-month post-intervention. additionally, the association between potential ba mediators and engagement will be examined to identify mechanisms of engagement. potential predictors of engagement will also be examined.

Eligibility criteria:
inclusion criteria: * self-identification as latino * age 15 to 35 * diagnostic \& statistical manual of mental disorders-5 diagnosis of schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, other specified schizophrenia spectrum, affective psychosis, and other psychotic disorder criteria * ability to speak english or spanish * caregiver willing to consent to participate in the study and care * ability to provide fully informed consent exclusion criteria: * diagnosis of psychotic disorder due to another medical condition or substance/medication-induced psychotic disorder * presence of a serious medical condition * 3≤ years after the onset

Keywords: first episode psychosis behavioral activation engagement latinx
assessment of vascular health after niacin therapy (avant)

Conditions: Coronary Artery Disease; Carotid Artery Disease; Peripheral Artery Disease

Summary: this study is looking to see if niacin will lessen atherosclerotic plaque inflammation and favorably affect circulating levels of endothelial progenitor cells and microparticles in people with atherosclerotic disease on chronic statin therapy.


Eligibility criteria:
inclusion criteria: * men age 55 years and above with coronary artery disease or women age 65 years and above with coronary artery disease or men age 45 years and above with both coronary artery disease and carotid or lower extremity peripheral artery disease or women age 55 years and above with both coronary artery disease and carotid or lower extremity peripheral artery disease. * subjects must be on statin monotherapy, defined as a stable statin dose for at least 12 weeks, with no anticipated need for further titration during the study period exclusion criteria: * anxiety or claustrophobia prohibiting imaging * history of allergy to intravenous contrast, iodine, or shellfish * renal insufficiency * history of allergy or severe intolerance to niacin * history of diabetes mellitus or elevated fasting glucose * moderate to severe gout * peptic ulcer disease * acute coronary syndrome, transient ischemic attack or cerebrovascular accident, or acute limb ischemia in the preceding 12 months * heart failure or unstable angina pectoris * use of daily non-statin lipid-altering therapy prior to the initiation of study medication
enzalutamide vs. abiraterone in chemotherapy-naïve metastatic castration-resistant prostate cancer (mcrpc)

Conditions: Prostatic Neoplasms, Castration-Resistant

Summary: this study will be a retrospective data analysis to compare outcomes between patients with chemotherapy-naïve metastatic castration-resistant prostate cancer (mcrpc) who initiated enzalutamide and those who initiated abiraterone using the 100% fee-for-service medicare claims data. the study will address the following objectives: primary objective: to compare overall survival (os) in patients with chemotherapy-naïve mcrpc who initiated enzalutamide vs. abiraterone secondary objectives: * to compare os in patients with chemotherapy-naïve mcrpc who received only enzalutamide without any subsequent therapy vs. abiraterone without any subsequent therapy * to compare treatment duration and time to subsequent therapy in chemotherapy-naïve mcrpc patients initiating enzalutamide vs. abiraterone


Eligibility criteria:
inclusion criteria: * male with ≥ 1 diagnosis claim for prostate cancer * have documented secondary metastasis code on or after the initial prostate cancer diagnosis * have initiated enzalutamide or abiraterone within 90 days prior to the metastasis date or on or after the metastasis date. the initiation date of enzalutamide or abiraterone will be defined as the index date. * have evidence of surgical or medical castration before the index date * at least 18 years old at the index date * continuous eligibility for ≥ 12 months prior to the index date exclusion criteria: * received chemotherapy, novel hormonal therapy, radium-223, or immunotherapy prior to the index date * had a prior history of other cancers

Keywords: metastatic castration-resistant prostate cancer mcrpc enzalutamide abiraterone overall survival os treatment duration
study to evaluate the safety and pharmacokinetics of inhaled ciprofloxacin in patients with moderate to severe chronic obstructive pulmonary disease (copd)

Conditions: Pulmonary Disease, Chronic Obstructive

Summary: objectives of the study are to investigate the safety, tolerability and levels of ciprofloxacin in the lung after single and multiple inhalative administration to patients with moderate to severe copd (stage ii-iii according to gold criteria)


Eligibility criteria:
inclusion criteria: * adult patients with copd, 40 to 75 years of age * diagnosis of copd * airway obstruction with a post-bronchodilator forced expiratory volume (fev1) of \>/=30% and \</=65% of predicted and a post-bronchodilator fev1 / forced vital capacity (fvc) of \</=70% * current or ex-smokers with a smoking history of more than 10 pack-years * patients must be able to produce acceptable induced sputum samples (as defined in the study procedure manual) * normal body weight: body mass index (bmi) between 19 and 35 kg/m2 exclusion criteria: * significant respiratory disease other than copd as bronchial asthma, cystic fibrosis or clinically evident bronchiectasis * more than one copd exacerbation within 12 months and within 8 weeks prior to screening * total blood eosinophil count \>/=600/mm3 * thoracotomy with pulmonary resection * regularly use of daytime oxygen therapy for more than one hour per day and in the investigator's opinion will be unable to abstain from the use of oxygen therapy during clinic visits * hypersensitivity to the investigational drug or to other quinolones and/or to inactive constituents of the inhalation powder * hypersensitivity of the bronchial system to inhalation of nebulized drugs or saline solution * patients with a history of severe allergies, non-allergic drug reactions, or multiple drug allergies * concomitant use of medication which could interfere with the investigational drug. before study drug administration a wash out period of more than 5 half lives has to be considered * concomitant inhalative therapy with antibiotics and/or concomitant systemic therapy with * fluoroquinolones * oral beta-andrenergics, beta blockers * oral steroids * methylxanthines: 24-hour washout of short-acting theophylline and 48-hour washout of long-acting theophylline prior to pre-study examination * antihistamines, antileukotrienes prescribed for asthma * oral cromolyn sodium or oral nedocromil sodium

Keywords: ciprofloxacin inhalation pharmacokinetics safety tolerability copd
artificial intelligence-assisted vs surgeon-directed screw planning in robotic femoral neck fracture surgery

Conditions: Femoral Neck Fractures

Summary: the goal of this clinical trial is to compare two different methods of screw path planning-ai-assisted versus surgeon-directed-in robotic-assisted femoral neck fracture fixation surgery. the study will include adult patients diagnosed with femoral neck fractures who are eligible for surgical fixation using a robotic system. the main questions it aims to answer are: does ai-assisted screw path planning improve the radiographic accuracy of screw placement? does ai-assisted planning reduceoperative time, number of intraoperative fluoroscopy exposures, intraoperative blood loss (ml)? does ai-assisted planning reduce postoperative complications and improve functional outcomes compared to surgeon-directed planning? researchers will compare the ai-assisted planning group to the surgeon-directed planning group to determine whether ai guidance contributes to enhanced surgical precision, reduced operative risk, and improved recovery outcomes. participants will: undergo robotic-assisted internal fixation of femoral neck fractures with either ai-assisted or surgeon-directed screw path planning, receive standardized perioperative care and follow-up at defined intervals, be evaluated through clinical assessments, imaging studies, and documentation of intraoperative and postoperative metrics over a 6-month follow-up period.

femoral neck fractures, occurring between the femoral head and neck base, are among the most common hip injuries, particularly in the elderly population. while surgical fixation with closed reduction and cannulated screws is a widely accepted standard, challenges such as suboptimal screw placement, prolonged fluoroscopy exposure, and increased risk of complications like nonunion or avascular necrosis persist-largely influenced by surgeon experience and intraoperative variability. to address these limitations, this trial investigates the effectiveness and safety of artificial intelligence (ai)-assisted versus surgeon-directed screw path planning in robotic-assisted internal fixation of femoral neck fractures.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * radiologically confirmed diagnosis of femoral neck fracture (displaced or non-displaced); * scheduled to undergo robotic-assisted internal fixation with cannulated screws as the initial treatment strategy during the study period; * capable of understanding the study procedures and providing informed consent; * willing and able to adhere to the prescribed postoperative follow-up schedule and rehabilitation instructions. exclusion criteria: * evidence of avascular necrosis of the femoral head on the affected side prior to surgery; * inability to tolerate the surgical intervention; * severe physical illnesses, cognitive problems (such as memory loss), or mental health conditions that may impair the ability to comply with medical instructions or attending scheduled follow-up appointments.

Keywords: robotic-assisted orthopedic surgery screw placement accuracy artificial intelligence in surgical planning