Kornimate/medical-research-clean huggingface dataset:
lifestyle interventions for seniors with apnea

Conditions: Obstructive Sleep Apnea

Summary: the overall goal of this study is to determine the efficacy of a lifestyle intervention, consisting of a weight loss diet and exercise on sleep apnea in older adults. the investigators will conduct a 3-month intervention in men and women who are sedentary with suspected sleep apnea. the investigators hypothesize that the intervention will lead to marked improvements in sleep apnea severity and cardiovascular risk markers.

frailty, a condition characterized by a decrease in physiological reserve and increased risk for adverse health-related outcomes, is an increased risk of aging, especially in the presence of co-morbid conditions. sleep apnea is also highly prevalent with increasing age. both conditions share common pathologies, suggesting that sleep apnea may increase the risk of developing or exacerbate the consequences of frailty. lifestyle interventions as strategies for treating sleep apnea and associated co-morbidities, thereby highlighting a feasible approach by which to reduce the incidence or progression of frailty. the specific aims of this study are to: 1) determine the effectiveness of a lifestyle intervention (li), consisting of a weight loss diet and supervised exercise, on reducing sleep apnea in older adults, and 2) determine whether this intervention is effective at improving parameters that are common to both sleep apnea and frailty, such as poor physical functional capacity and body composition, impaired or abnormal cardiometabolic function and increased levels of inflammation.

Eligibility criteria:
inclusion criteria: * aged 60-75 * bmi between 30-42 * apnea-hypopnea index above 10 events per hour (verified at baseline testing) exclusion criteria: * currently following a weight loss diet * history of substance abuse * participating in moderate to vigorous activity most days of the week * history of cardiovascular disease * currently being treated for sleep apnea * current cigarette smoking

Keywords: weight loss exercise diet sleep apnea aging
epidemiological study on community acquired pneumonia

Conditions: Community Acquired Pneumonia

Summary: long-term objectives of the basic research part are improvement of cap-management with respect to therapy, diagnosis and prevention to contribute to a better care of patients with pneumonia.

long-term objectives of the basic research part are improvement of cap-management with respect to therapy, diagnosis and prevention to contribute to a better care of patients with pneumonia. the aim of the study capnetz is to improve diagnosis, treatment and patient care.

Eligibility criteria:
inclusion criteria: * age ≥ 18 * infiltrate on chest x-ray * further inclusion criteria: cough or production of purulent sputum or pathologic lung auscultation (crackles) or fever exclusion criteria: * hospital inpatient treatment within the last 28 days * immune suppressed patients

Keywords: community acquired pneumonia cap capnetz age ≥18 infiltrate on chest x-ray cough or production of purulent sputum pathologic lung auscultation fever
single dose study of n1539 in the treatment of pain secondary to dental impaction surgery

Conditions: Dental Pain

Summary: to evaluate the safety and efficacy of single iv doses of n1539 after dental impaction surgery.

this is a randomized, double-blind, placebo-controlled, single center study in subjects who have undergone third molar extraction surgery. eligible subjects will have surgical removal of \>2 third molars, of which at least 1 must be a complete or partial mandibular impaction. each subject's study participation will consist of a screening visit (1-21 days prior to surgery), an inpatient evaluation period of 24 hours following dosing, and a follow-up phone call 3-5 days postdose.

Eligibility criteria:
inclusion criteria: * surgical extraction of \> 2 third molars with at least 1 complete or partial mandibular bony extraction exclusion criteria: * allergic response to aspirin, nsaids, acetaminophen or hydrocodone * use of aspirin or other analgesics within 48 hours prior to surgery * current or recent history of drug or alcohol abuse * any medication for treatment of chronic pain * clinically significant abnormality on screening laboratory test active or recent history of peptic ulcer disease or gi bleeding * prior abdominal surgery, except uncomplicated appendectomy * any other surgical procedure within 30 days before administration of study drug * pregnancy or breastfeeding * untreated hypertension; sbp \> 140 mmhg or dbp \> 95 mmhg

Keywords: dental pain
effect of distal needling on knee pain using acupuncture techniques

Conditions: Patellar Tendonitis; Complete Tear, Knee, Anterior Cruciate Ligament

Summary: the purpose of this study is to test if specific therapeutic benefits of acupuncture are mostly attributable to contextual and psychosocial factors, such as patients' beliefs and expectations.the investigators propose using the 2 acupuncture methods, which refrains from inserting needles in the affected area, in order to evaluate the short-term and long-term efficacy of acupuncture in a clinical setting compared with placebo and compared with invasive needling that does not adhere to "correct" acupuncture rules.

the main novel features of this study: 1. first aim to assess the effect of distal needling on knee pain 2. second aim to directly compare two acupuncture techniques, placebo, needling at "wrong" places and "correct" needling for knee pain advantages of the study compared to published data: 1. distal needling - enables assessment of range of motion (rom) and pain level during needling. 2. both acupuncture systems rely on minimal questioning, which simplifies the patient-practitioner interactions. 3. exploratory studies in the clinic of dp show that it is possible to distinguish between "correct" and "incorrect" needling, at least in the short term. long term effects have not been assessed yet.

Eligibility criteria:
inclusion criteria: * adult patients (\> 18 years old), suffering chronic stable pain score \>40 mm on 100 mm vas of the knee due to patellar tendonitis. * patients have had x-rays or other tests confirming they are not candidates for surgery nor are scheduled for steroid injections or hyaluronic acid injections within 8 weeks from the beginning of the study. * adult patients (\> 18 years old), two weeks after acl reconstruction surgery (with or without meniscal involvement), with pain score \>40 mm on 100 mm vas of the knee (all patients at this stage have significant rom limitation). exclusion criteria: * patient refusal * soldiers * pregnancy * morbid obesity * diabetes * peripheral vascular disease * lower limb neurological deficit (such as multiple sclerosis, nerve palsy), other serious co-morbidity (including severe back pain or hip pain) * a history of prolonged or current steroid use * received hyaluronic acid injections within the previous 3 months * have needle phobia or allergy to sticking plaster.

Keywords: knee pain acupuncture sham acupuncture
creation of a biobank of biological samples from patients with malignant hypertension

Conditions: Malignant Hypertension

Summary: the hama bank is an initiative aimed at collecting, preparing, and storing biological samples from patients treated for malignant hypertension and included in the hama cohort. conducted under crb (iso20387) conditions, this biobank serves as an essential resource for understanding the disease's pathophysiology, as well as for identifying novel biomarkers and therapeutic targets

malignant hypertension (mh) is an acute and severe form of hypertension that can lead to rapid target organ damage and potentially be fatal within months if not treated. despite the severity, mh manifests in various phenotypes, suggesting multiple underlying pathophysiological pathways. the hama bank aims to address this by collecting biological samples at two distinct time-points: for " pre-existing patients " in the hama cohort: a one-time collection focused on genetic analysis. a full sample (equivalent to sample 1 below) may be collected in option. for newly diagnosed patients (incident patients): sample 1 "acute phase": collected between day 0 and day 7 post-admission to any hama recruiting centers. this will be used for initial multi-omics analysis. sample 2 "chronic phase": collected between the 1st and 6th months during a follow-up visit at the investigating center. these samples will be cross-referenced with clinical and biological data from the hama cohort. the cohort follow-up schedule is: 1, 3, 6, 12 months after mh diagnosis and annually for a total of 5 years.

Eligibility criteria:
inclusion criteria: * patients included in the hama cohort with the following critera : * malignant hypertension according to the classic definition (severe hypertension associated with severe hypertensive retinopathy) * severe hypertension associated with acute target organ damage due to high blood pressure exclusion criteria: * refusal to participate to the substudy " hama bank " * patient on chronic dialysis

Keywords: malignant hypertension severe hypertension hypertensive emergency target organ damage pathophysiology biomarkers
coaches activating reaching and engaging patients

Conditions: Cancer; End-of-Life

Summary: the purpose of the team based advance care planning careplan program is to understand if a trained lay navigator who engages with patients with advanced stages of cancer can help patients in advance care planning, improve patient activation, satisfaction, quality of life, and the quality of end of life cancer care while also ensuring goal concordant cancer care at the end of life.

stanford cancer institute plans to implement and evaluate several critical elements to be in alignment with the mission of the organization to provide high value care to their patients. the careplan (coaches activating, reaching, and engaging patients in their end of life care plan) intervention is an innovative program aimed to strengthen provider-patient relationships and facilitate whole person care about matters important to patients diagnosed with advanced stages of cancer and important to patients' support network and family. the project is intended to help establish patients' goals of care plan with appropriate documentation, develop, deploy, and evaluate a model of care for patients with cancer that is intended to improve clinical outcomes and their experiences with their cancer care. the intervention provides patients with lay navigators who assist them and their families in formulating and discussing their goals of care with their health care teams in hopes to engage in shared-decision making for goal concordant care. the goal of the project is to demonstrate that there is improved documentation of goals of care, patient experiences, patient activation, quality of life, and quality of care and communication and that the program helps to improve goal concordant care receipt at the end of life.

Eligibility criteria:
inclusion criteria: * all patients who receive care at stanford cancer institute and have genitourinary cancers and have received greater than 2 prior courses of chemotherapy treatment exclusion criteria: * patients without capacity to consent

Keywords: end of life quality of care cancer care delivery
evaluation of clinical outcomes of scaffold treatment of partial meniscal injuries of the knee

Conditions: Knee Osteoarthritis; Knee Injuries; Meniscus Lesion

Summary: the study consists of 3 phases (identification of includable patients, telephone follow-up evaluation and the collection of study-specific clinical data in medical records of enrolled patients): * identification by trained medical personnel of subjects who meet the study's inclusion criteria. * once the patient's informed consent has been obtained, the study-specific questionnaires will be submitted by telephone. * study-specific clinical score data will be collected from the medical records of patients enrolled in the study. these data will be used, together with the data collected during the telephone follow-up, to evaluate the trend in outcomes over time after implantation of this scaffold.


Eligibility criteria:
inclusion criteria: * acute irreparable meniscal injuries requiring partial meniscectomy or chronic meniscal tissue loss (traumatic or degenerative) greater than 25%; intact anterior and posterior meniscal horn respectively; * peripheral meniscal rim (1 mm or more) along the entire circumference of the involved meniscus; * knee stability or anterior cruciate ligament injury stabilized at the time of surgery; * male or female patients between the ages of 18 and 65 years; * healthy contralateral knee; * normal axial alignment of the knee (mechanical tibio-femoral angle \< 3°) * patients treated surgically with scaffolds (actifit) for partial meniscal defects from january 01, 2009 to december 31, 2019 exclusion criteria: * patients no longer available; * concomitant posterior cruciate ligament (pcl) injury; * advanced cartilage injuries according to outerbridge classification (iv); * incorrect axial alignment of the lower limb; * documented allergy to polyurethane; * local or systemic infection; * history of previous anaphylactoid reaction; * systemic administration of corticosteroids or immunosuppressive drugs within 30 days prior to surgery; * evidence of osteonecrosis in the involved knee; * positive history of rheumatoid arthritis, inflammatory arthritis and autoimmune diseases; * neurological disorders or conditions that may affect the rehabilitation protocol; * pregnancy.
evaluating the efficacy of dry eye (de) disease treatment using novel tear film imager (tfi)

Conditions: Dry Eye Disease

Summary: dry eye disease signs and symptoms are reduced in patients who receive topical steroids and topical hyaluronic acid. adom's tear film imager measurements are reproducible and it can diagnose the dry eye disease state in a single, non-invasive measurement. the tear film imager can provide objective accurate measurements of the dry eye treatment effectiveness.

80 subjects will be enrolled , 40 of which with positive signs and symptoms of dry eye and 40 healthy subjects without sign and no symptoms of dry eye. healthy and dry eye groups will be age- matched. over a period of 4 weeks, the subjects diagnosed with dry eye will be treated and as follows: 1. hylo-comod artificial tears (0.1 % sodium hyaluronate) 8 times a day for 4 weeks 2. coll sterodex (dexamethasone sodium phosphate 0.1% eye drops) 3 times a day for 2 weeks healthy subjects will not receive any treatment. both groups will be examined at baseline and 4 weeks after baseline measurement. treatment results will be measured by both traditional methods and by tear film imager.

Eligibility criteria:
inclusion criteria: 1. signed informed consent form. 2. be at least 18 years of age at the time of enrollment of either sex or any race. 3. best corrected visual acuity (bcva) of 0.7 logmar (ie, 20/100 vision) or better in each eye as measured using a snellen chart 4. intraocular pressure (iop) in the range of 5 to 22 mmhg in both eyes. 5. de subjects will be enrolled if they manifest symptoms (osdi \>=13) and signs of clinically active dry eye disease in either eye, by at least one of: 1. corneal fluorescein staining - at least severe in one section or moderate at two 2. tbut =\< 10 sec 3. schirmer wetting of less than 10 mm in 5 min (with anesthesia). 6. control will be enrolled if they manifest no symptoms (osdi \<13) and no signs of clinically active dry eye disease in either eye, by meeting all the following criteria's: 1. corneal fluorescein staining - negative 2. tbut \> 10 3. schirmer wetting of more than 10 mm in 5 min (with anesthesia). 7. a negative urine pregnancy test if female of childbearing potential. exclusion criteria: 1. any ocular condition that could affect study parameters (glaucoma, nystagmus, keratoconus, follicular conjunctivitis, iritis or post lasik, lasek or prk). 2. have had any ocular infection within the last 30 days and/or have preauricular lymphadenopathy. 3. any significant illness that could be expected to interfere with study parameters. 4. use of any investigational product or device within one month prior to visit 1 or during the study period. 5. concomitant use of any prohibited medication (antihistamines, corticosteroids, all ocular medications or anti-allergic therapies) during the trial. 6. any history of, positive hiv, hepatitis b, c, or evidence of acute active hepatitis a (anti hav igm), any known history of iritis/uveitis, glaucoma, or other chronic ophthalmologic disorder other than allergic conjunctivitis. 7. history of any ocular surgical procedure within 3 months prior to visit 1.
efficacy and safety of losartan in pediatric chronic kidney disease with tubular proteinuria

Conditions: Proteinuria

Summary: the investigators hypothesize that using losartan would help decrease proteinuria in pediatric chronic kidney disease with tubular proteinuria.

children with tubular proteinuria (urine protein to creatinine ratio \> 0.3 mg/mg) were randomly assigned in 1:1 ratio to losartan or placebo treatment for 12 weeks, then crossed over to the opposite intervention for another three months after a washout period of 2 weeks. the primary outcome is the change in urinary protein-creatinine ratio from baseline to the end of 12 weeks. efficacy of losartan in children with ckd with tubular proteinuria was also investigated with additional retrospective review of medical record.

Eligibility criteria:
inclusion criteria: * age: 2years or older and younger than 18 years * estimated gfr ≥ 30ml/min/m\^2 * mean urinary protein-creatinine ratio \> 0.3 g/g from three first-morning spot urine collections * renal hypoplasia/dysplasia, reflux nephropathy, polycystic kidney disease, lowe syndrome, dent disease, tubulointerstitial nephritis, nephronophthisis/medullary cystic disease, obstructive uropathy(including puv, upj obstruction, uvj obstruction) exclusion criteria: * hypertension * under dialysis or organ transplanted * bilateral renal artery stenosis or primary hyperaldosteronism * pregnant or nursing

Keywords: losartan children proteinuria
mobile message intervention for stroke caregivers' psychological support

Conditions: Stroke; Caregiver Burnout; Mobile Phone Use; Depressive Symptoms; Psychological Distress

Summary: the proposed trial aims to test the feasibility of ecological momentary intervention on stroke caregivers' psychological distress.

75% of stroke caregivers report severe caregiver burdens, with 60% of stroke caregivers reporting at least one depressive symptom in hong kong. however, caregivers can experience difficulties in accessing and fully utilising existing services due to the varying types of care needs and its intensities amongst stroke survivors. ecological momentary intervention (emi) as an innovative and personalised intervention has shown great potential in supporting psychological well-being; yet, there are no studies on using emi for the caregivers' psychological support. the proposed trial aims to reduce stroke caregivers' psychological distress by delivering emi through instant messaging applications to provide personalised and real-time support led by healthcare professionals. stroke caregivers screened by patient health questionnaire-9 (phq-9) with scores ranging from 5 to 19 will be recruited from multiple sites including community centres, rehabilitation centres and outpatient clinics in public hospitals in hong kong, and individually randomised into the intervention group (n=20) or control group (n=20). the intervention group will receive the personalised instant messages for 4 weeks. the control group will receive general health information and regular messages reminding them to participate in follow-up surveys. the primary outcome will be the score of phq-9 at 4 weeks. secondary outcomes will include anxiety, perceived stress, and caregiver burden.

Eligibility criteria:
inclusion criteria: * primary family caregiver of stroke survivor * able to read and communicate in chinese * able to use mobile phone text messaging function * phq-9 ranged from 5 to 19 exclusion criteria: * professional medical personnel and care assistants * has provided care for \<1 month prior to recruitment * has diagnosis of psychiatric disease or is currently taking psychotropic drug * phq-9 ≥ 20 (i.e., severe depressive symptom) * currently participating in any type of psychological support intervention
obesity and asthma:a specific phenotype

Conditions: Obesity; Asthma

Summary: clinicians frequently observed that obese women referred for severe asthma do not respond to treatment. these patients, despite the presence of wheezing, often have normal expiratory flows and normal or "borderline" airway responsiveness. it is therefore possible that this mode of presentation reflect a pseudo-asthmatic state for which clinical definition and characteristics and optimal management remain to be determined. the aim of this study was to study the pulmonary physiological and airway inflammatory characteristics and response to treatment of obese women considered to have clinically severe asthma in order to demonstrate that some of these patients have a phenotype that is not that of asthma.

twenty-five obese women (bmi over 30) and 25 non-obese women (18\>bmi\<25) considered to have severe asthma by their physician and requiring corticosteroids to control their asthma will have the following investigation: * respiratory questionnaires focussing on the nature and time-course of symptoms, asthma control criteria, medication use. * physical examination, including measures of bmi, waist, hips and ratio waist/hips * blood test for complete blood count, blood glucose, total ige levels and markers of systemic inflammation (c-reactive protein, fibrinogen...) * spirometry and bronchodilator response. * induced sputum analysis and exhaled breath condensate ph to assess airway inflammation. * skin prick tests with a battery of common airborne allergens * measurement of lung volumes and airway resistance + mip and mep. * methacholine challenge (up to 16 mg/ml) with borg scores for breathlessness and chest tightness.

Eligibility criteria:
inclusion criteria: * will be women aged 18 years and over * will be in good health apart from asthma or obesity as determined by history and physical examination (no other condition that could influence the proposed tests). * all will be non smokers or ex-smokers for more than six months with a smoking history of no more than 10 pack- years (i.e., one pack per day or its equivalent for 10 years.) * subjects will have a physician's made diagnosis of severe asthma and treated with corticosteroids. exclusion criteria: * subjects who are, in the opinion of the investigator, mentally or legally incapacitated thus preventing informed consent from being obtained. * subjects having a co-existing illness that precludes them from the trial. * pregnancy or lactation * contraindication to the prednisone treatment.