Kornimate/medical-research-clean huggingface dataset:
intrapartum glycemic control in gdma2

Conditions: Pregnancy; Gestational Diabetes Mellitus, Class A2; Neonatal Hypoglycemia

Summary: this is a randomized, parallel, controlled, non-inferiority trial to assess the impact of a tight versus a more liberalized intrapartum glycemic control in gestational diabetic mothers on neonatal glycemia. national guidelines for the management of intrapartum glucose in women with gdm are lacking. this is likely due to the scarcity of high-quality data on the topic.

gestational diabetes mellitus (gdm) remains a common pregnancy complication, affecting 6-15% of pregnancies worldwide. the incidence of gdm is expected to continue its global upward trend in light of the growing obesity epidemic and delayed childbearing. gdm is associated with adverse short- and long-term maternal and offspring outcomes. neonatal hypoglycemia, as a result of fetal hyperinsulinemia, occurs in up to 35% of pregnancies complicated by gdm with potential long-term neurodevelopmental sequelae. in that regard, significant emphasis has been placed on the prevention of neonatal hypoglycemia through optimal maternal glycemic control. available data are conflicting as to the contribution of intrapartum glycemia to neonatal glycemia. moreover, national guidelines for the management of intrapartum glucose in women with gdm are lacking. this is likely due to a lack of high-quality data on the topic. as far as we are aware, only one single center randomized controlled trial has been published on the topic. that study's findings suggest that an approach to a more liberalized intrapartum glycemic management was not associated with a higher rate of neonatal hypoglycemia compared to a tight glycemic control regimen. we propose to replicate these findings in a different population at our institution. if this more relaxed approach to intrapartum glycemic management is confirmed to be safe to women and their babies, its clinical application has the potential to decrease the inconvenience of frequent finger pricks for our patients during labor and allow more efficient allocation of resources for the nursing staff on an already labor-intensive unit.

Eligibility criteria:
inclusion criteria: * women 18 years or older * non-anomalous singleton gestation * gestational diabetes type a2 diagnosed at 24 weeks' gestation or beyond * planned vaginal delivery at term at inova fairfax women's hospital exclusion criteria: * women \< 18 years * fetus with major congenital malformations * twin or higher order gestation * pre-existing diabetes mellitus * exposure to antenatal or any systemic steroids 14 days or less prior to delivery * preterm delivery * scheduled cesarean birth * intrapartum cesarean birth prior to 4-5 cm of cervical dilatation

Keywords: intrapartum glycemia labor
creation of an ecological tool assessing episodic memory in geriatrics

Conditions: Memory Disorders; Neurocognitive Disorders

Summary: in this study the participants can be recruited via scheduled consultation and external institutions (associations, senior club..). neuropsychological assessment will be realize to determine presence or absence of neurodegenerative disease. study test is ecological mai. this test are assigned in two groups (with or without neurocognitive disorders).

in this study the participants can be recruited via scheduled consultation and external institutions (associations, senior club..). neuropsychological assessment will be realize to determine presence or absence of neurodegenerative disease. study test is ecological mai. participation will be 30 minutes for patients see in case of routine care and 2h30 for those accompanying the patients and participants recruited in external institutions. participants are assigned in two groups. group 1 : with neurocognitive disorders group 2 : without neurocognitive disorders benefits : for participants without neurodegenerative disorder, study enables to take control early if anomaly will be detected. the study permit to have cognitive assessment. risk : it's possible that participants feel tired. no constraints for participants seen during scheduled consultation.

Eligibility criteria:
inclusion criteria: * male or female ≥ 70 ans * person have good locomotion, move independently * personne agree to participate groupe 1 : 17≤mmse≤24 (greco) diagnosis of neurodegenerative diseases (major neurocognitive disorders: alzheimer, mixed dementia, lobar frontotemporal degeneration, vascular dementia). groupe 2 : mmse ≥ à 25 (greco) without neurodegenerative disease exclusion criteria: * person with legal protective measures * person deprived of liberty * mental retardation or mmse≤ 16 * understanding verbal disorders * visual major disturbances * person with disease causing increased fatigue * person with psychiatric pathology excepted anxiety disorder or depression with mild episodes. * person not covered by french national health insurance

Keywords: geriatrics
cd180 overexpression in follicular lymphoma

Conditions: Follicular Lymphoma

Summary: background:altered toll-like receptor (tlr) expression levels and/or mutations in its signaling pathway (such as myd88 mutation) contribute to the pathogenesis of lymphoproliferative disorders (lpd). cd180 is an orphan member of the tlr family that modulates the signaling of several tlrs, but only limited studies have evaluated its expression by flow cytometry (fcm) in lpd. methods: using a multiparameter fcm approach, biologists have assessed cd180 mean fluorescence intensity (mfi) in lymph nodes (lns) and peripheral blood (pb) samples obtained from patients with follicular lymphoma (fl; ln/pb, n=44/n=15), chronic lymphocytic leukemia (cll, n=26/n=21), mantle cell lymphoma (mcl, n=13/n=17), and marginal zone lymphoma (mzl, n=16/n=12). specimens from non-tumoral pb and ln (n=8/n=12) were used as controls.


Eligibility criteria:
inclusion criteria: * samples from patients with: * lf: follicular lymphoma * mcl: mantle cell lymphoma * cll/sll: chronic lymphocytic leukemia/small lymphocytic leukemia * mzl : splenic marginal zone * clt :control b-cells exclusion criteria: * patient \<18 years old

Keywords: follicular lymphoma flow cytometry cd180 toll-like receptor lymphoproliferative disease
video-based intervention to address disparities in blood pressure control after stroke

Conditions: Stroke

Summary: the purpose of this study is to examine the impact of a multidisciplinary telehealth-based model of outpatient stroke care on blood pressure control following stroke, and further, to evaluate its impact on racial disparities in post-stroke blood pressure control.

blood pressure is poorly controlled for many stroke survivors and racial disparities in blood pressure control and stroke recurrence exist. the purpose of this study is to examine the impact of a multidisciplinary, telehealth based, outpatient model of care on outcomes after stroke with a focus on blood pressure control. the video-based intervention to reduce treatment and outcome disparities in adults livings with stroke and transient ischemic attack (virtual) has several components including early follow-up via telehealth with a multidisciplinary team, remote blood pressure monitoring, and medication adjustment by a pharmacist.

Eligibility criteria:
inclusion criteria: * ischemic stroke, hemorrhagic stroke (intracerebral hemorrhage),or transient ischemic attack (tia * presence of hypertension (by clinical history or hospital bp ≥140/90 mmhg on two occasions) * plan to discharge home after stroke * ability to provide consent (patient or caregiver) in english or spanish. patients with cognitive impairment or aphasia limiting participation will be included if they have a caregiver to assist with monitoring and telehealth visits. * two neurologists must agree on tia diagnosis exclusion criteria: * modified rankin scale (mrs) \> 4 (severe disability) at time of discharge * life expectancy \< 1 year or terminal illness * stroke unrelated to vascular risk factors (rfs) (drug use, trauma, vasculitis) * pregnancy * symptomatic flow limiting carotid stenosis without plan for intervention * long-term bp goal ≥ 130/80 mmhg according to clinical team
implementation of physical therapy protocol in management of chronic maxillary sinusitis

Conditions: Chronic Maxillary Sinusitis

Summary: this study will be conducted to investigate the effect of physical therapy protocol and medication on pain, pressure pain threshold and dysfunction in patients with chronic maxillary sinusitis

rhino sinusitis is one of the most common health-care problems worldwide and its prevalence and incidence is increasing. chronic sinusitis is a big health problem worldwide that affects almost 15% of humans. the most affected sinus is the maxillary sinus as its drainage orifice through the hiatus semilunaris is badly placed near the roof of the sinus. the first line of treatment for sinusitis is mostly medical drugs including antimicrobial drugs, decongestants, nasal sprays, corticosteroids, and antihistamine drugs which can effectively dry the mucus. physical therapy also offers a variety of treatment approaches for sinusitis. it includes various electrotherapy modalities, manual drainage techniques, suboccipital release for sinus headaches, needling, and rhino flow therapy. in spite of many studies and treatment approaches done on sinusitis, there are limitations faced in evidence of which approval is most effective, the objective of our study is to investigate the effect of physical therapy protocol in people with chronic maxillary sinusitis.sixty six patients with chronic maxillary sinusitis will be allocated randomly to three groups; one group will receive physical therapy protocol, second one will receive medication only and the third one will receive physical therapy protocol and medication for four weeks.

Eligibility criteria:
inclusion criteria: * patients clinically diagnosed by ent physician with chronic maxillary sinusitis with a history of 3 months or longer. * age group from 18 to 50 years exclusion criteria: * local contraindications for face mobilization or massage. (abrasions, skin conditions, broken bones) medical contraindications. (bacterial infections, conjunctivitis, styes) * duration of onset less than 2 months headache due to reasons other than chronic sinusitis (tmjd, cervicogenic headache, underlying neurological diseases, anxiety-related, etc) * patients with surgery performed in the past 1 year for maxillary sinusitis cognition level impairment * metal implants in the face region

Keywords: physical therapy protocol chronic maxillary sinusitis
effect of different anesthetic techniques for isolated systolic hypertensive patients of abdominal surgery on postoperative hospital stay and morbidity

Conditions: Postoperative Complications

Summary: in general anesthesia, two main ways of pain control are used intra-operatively, one is opioids, the other is epidural. many colleges prefer using epidural analgesia because it is potent and more effective , and also the benefits of stress block, less depression of breath. however, the epidural technique often causes more drop of blood pressure, especially in dehydrated patients. the investigators designed the trial to see if the benefit weigh out the potential risk of epidural in isolated hypertensive patients.


Eligibility criteria:
inclusion criteria: - adults aged 50-70 with isolated systolic hypertension . exclusion criteria: * age \ 50% or liver enzymes \> 50% upper limit of normal values)

Keywords: remifentanil isolated systolic hypertension morbidity epidural combined general anesthesia
effects of high voltage electrical stimulation, shortwave diathermy and kinesiotherapy on arterial blood flow in the lower limbs of diabetic women

Conditions: Diabetes; Peripheral Arterial Disease

Summary: peripheral arterial disease (pad) is a pathological condition limiting, resulting from a narrowing or occlusion of the artery diameter due to aneurysms, inflammation, atherosclerosis and thromboembolic events. one of the main risk factors for the development of dap is diabetes mellitus due to its relation to the process of atherogenesis. thus, the objective of this study is to evaluate the effects of three treatment modalities for pad on the blood flow velocity. it is a crossover study. fifteen women with diabetes receive three types of treatment, the order defined according draw: high voltage electrical stimulation, shortwave diathermy and kinesiotherapy. the blood flow of the lower limb will be assessed by doppler ultrasound. the hypothesis of this study is that physical therapy resources increase the circulation of the lower limb.


Eligibility criteria:
inclusion criteria: * women * diagnosis of diabetes * diagnosis of peripheral arterial disease exclusion criteria: * regular physical activity * smokers * thrombosis active * severe peripheral arterial disease

Keywords: physical therapy modalities electric stimulation therapy hyperthermia, induced diabetes mellitus
exploring cerebellar inhibition of the motor cortex in stroke patients

Conditions: Stroke

Summary: the past 10 years of research in post stroke patients have shown certain types of rehabilitation can help neuronal plasticity of the brain. transcranial magnetic stimulation (tms) can be used to monitor this plasticity by mapping the brain's function (measuring brain activity). recent research suggests that tms can be used for both prognosis (determining future function) and to determine what type of rehabilitation therapy will work best after stroke. the purposes of this research study are to: 1) determine changes in cerebellar activity after motor cortical stroke 2) compare changes in recovery of motor function with changes in cerebellar - motor cortex connections; 3) determine the ability of tms to "predict" functional outcome after stroke. the primary hypotheses are: 1) functional recovery will be correlated with tms changes (as measure of motor threshold (mt), intracortical inhibition, cerebellar cerebral inhibition (cbi), motor evoked potentials (meps) and recruitment curves; 2) baseline tms will predict future functional outcomes.

transcranial magnetic stimulation (tms) can be used to monitor this plasticity by mapping the brain's function (measuring brain activity). recent research suggests that tms can be used for both prognosis (determining future function) and to determine what type of rehabilitation therapy will work best after stroke. the purposes of this research study are to: 1) determine changes in cerebellar activity after motor cortical stroke 2) compare changes in recovery of motor function with changes in cerebellar - motor cortex connections; 3) determine the ability of tms to "predict" functional outcome after stroke. the primary hypotheses are: 1) functional recovery will be correlated with tms changes (as measure of motor threshold (mt), intracortical inhibition, cerebellar cerebral inhibition (cbi), motor evoked potentials (meps) and recruitment curves; 2) baseline tms will predict future functional outcomes.

Eligibility criteria:
inclusion criteria: * one sided ischemic stroke confirmed by radiology * adults exclusion criteria: * brainstem stroke * cerebellar stroke * seizure with the recent stroke * any history of uncontrolled seizure * pregnancy or planning on getting pregnant during the next year * recent history (past year) of alcohol and drug abuse (due to lack of follow up) other criteria include tms exclusions: aneurysm clips, previous surgery over motor cortex, open craniotomy.

Keywords: stroke transcranial magnetic stimulation neuronal plasticity rehabilitation
comparing water vapour thermal therapy (rezūm) and turp

Conditions: Prostate Cancer

Summary: this is a randomized controlled trial using a non-inferiority design with the subjects randomized 1:1 to either water vapour thermal treatment (rezum) arm or transurethral resection of prostate (turp) arm.


Eligibility criteria:
inclusion criteria: * men 50-80 years * refractory urinary retention related to benign prostatic hyperplasia (bph) * on urethral foley's catheter before treatment * prostate size 30-80ml on ultrasound exclusion criteria: * prior prostate operation * past or current history of prostate cancer * strong suspicion of prostate cancer (e.g. elevated psa before urinary retention or abnormal prostate on dre without workup for prostate cancer) * known urethral stricture / bladder stone / hypocontractile bladder * known neurological diseases which may affect bladder function (e.g. parkinsonism, stroke) * contraindicated to undergo turp or rezum (e.g. not fit for ga/sa, active urinary tract infection, fail to be placed in lithotomy position, uncorrectable coagulopathy, antiplatelet or anticoagulant which cannot be stopped)
an international trial to evaluate the efficacy and safety of saber®-bupivacaine for postoperative pain control in patients following arthroscopic shoulder surgery

Conditions: Postoperative Pain

Summary: the objective is to identify the optimal dose of saber-bupivacaine for postoperative pain control in patients undergoing elective arthroscopic shoulder surgery on the basis of pharmacokinetics, efficacy and safety evaluations. the study duration consists of a screening period up to 14 days and a treatment period 14 days with a long term follow up visit at 6 months. the study will provide further data on safety.


Eligibility criteria:
inclusion criteria: * subacromial impingement syndrome * mri with intact rotator cuff * patients suitable for general anaesthesia exclusion criteria: * known major joint trauma, infection, avascular necrosis, chronic dislocation, inflammatory or degenerative glenohumeral arthropathy, glenohumeral arthritis, frozen shoulder or previous surgery of the affected shoulder * abnormal ecg * prolonged qt syndrome * current or regular use of analgesic medication for other indication(s)

Keywords: post operative pain local anaesthesia postoperative pain after arthroscopic shoulder surgery
primary hiv prevention in pregnant and lactating ugandan women

Conditions: Primary Prevention of HIV Acquisition

Summary: this study aims to test the effectiveness of a behavioral intervention aimed at preventing the primary acquisition of hiv by uninfected pregnant and lactating women in uganda, east africa where hiv transmission is high. women who acquire hiv during pregnancy or lactation are at higher risk of adverse health and pregnancy outcomes and their baby is at high risk of acquiring hiv and dying. keeping hiv-uninfected women uninfected during pregnancy and lactation is an important component of the global world health organization (who) strategy to eliminate mother-to-child transmission of hiv but there has been no study to date to assess interventions that can effectively keep these women uninfected. in this study, the investigators will test the hypotheses that: 1. extended repeat hiv testing and enhanced counseling (erhtec) during late pregnancy (\>36 weeks) and breastfeeding can increase and sustain risk reduction behaviors and prevent incident sti and hiv infections among hiv-uninfected pregnant women, and 2. that couple hiv testing and counseling (htc) can further enhance this effect through improved couple communication and emotional and economic support from male partners.

the specific aims of the study are: * aim 1: to assess the effect of an extended repeat hiv testing and enhanced counseling (erhtec) intervention on sexual risk behavior and sexually transmitted infections (sti) and hiv acquisition in hiv-uninfected pregnant and lactating women enrolled individually * aim 2: to assess the effect of erhtec on sexual risk behavior and the incidence of sti and hiv in uninfected pregnant and lactating women enrolled with their partner, and * aim 3: to assess the costs and estimate the cost-effectiveness of the intervention. we will conduct a stratified randomized trial of 410 hiv-negative pregnant ugandan women enrolled individually and 410 hiv-negative pregnant women enrolled with their male partners in mulago hospital, kampala and st joseph hospital, kitgum, northern uganda. in each site, 205 women enrolled individually and 205 couples will be randomized to be either retested and counseled for hiv in late pregnancy only (\>36 weeks) as per the who/ministry of health (moh) recommendation, or to receive erhtec throughout pregnancy and breastfeeding. individual women and couples randomized to the intervention arm will receive the erhtec intervention at 3, 6, 12, and 18 months postpartum. follow-up will end at 24 months postpartum or 6 weeks after the end of breastfeeding, whichever occurs first.

Eligibility criteria:
inclusion criteria: * women: 15-49 years old, confirmed hiv negative, confirmed pregnant, living within 30kms /19 miles of hospital, willingness to sign informed consent * men: \> or = 15 years old, being an established partner of a woman participant, living within 30kms /19 miles of hospital, willingness to sign informed consent exclusion criteria: * condition requiring hospitalization

Keywords: hiv and pregnancy hiv and breastfeeding mother-to-child transmission of hiv africa uganda
use of mobile-based technologies to improve diabetes self-management and postprandial glucose control

Conditions: Type 1 Diabetes

Summary: the project involve evaluation of a web-based nutrition education program and pilot-testing of a new smartphone app for real-time data logging to identify factors causing glycemic variability.

the intervention will be three (3) months in duration and will entail use of a smart phone app for real-time data logging to identify factors causing glycemic variability, as well as use of a web-based nutrition education program. the investigators postulate that the interactive nutrition education curriculum - which will provide feedback to patients about the inter-relationship between their food intake and postprandial glucose profiles, as well as practical guidance for improvements - will lead to a change in food choices and improved post-prandial glucose control.

Eligibility criteria:
inclusion criteria individuals that satisfy all of the following conditions will be considered for participation: 1. must be between the ages of 25 - 75 years of age (inclusive) 2. type 1 diabetes diagnosis at least 1 year, treated with multiple daily injections or insulin pump. 3. a1c 7.5-9.0% exclusion criteria 1. current or past use of real-time cgm for more than 2 months. 2. pregnancy (self-reported) or planning conception in next 6 months. 3. history of disordered eating, actively trying to lose weight or planning to do so, bmi \> 30 kg/m2 (to limit participation by individuals who are actively trying to lose weight), 4. medical conditions or medications that would affect gastric emptying such as gastroparesis, bariatric surgery, medications such as pramlinitide, liraglutide or exenatide.