Kornimate/medical-research-clean huggingface dataset:
intervention to improve inhalative adherence

Conditions: Chronic Asthma; COPD

Summary: despite progress in pharmacological and non-pharmacological treatment in recent years, the burden of disease among asthma and copd patients is high and patients may be frequently hospitalized due to exacerbations. reasons for uncontrolled disease are manifold, but are frequently associated with poor inhalation technique and non-adherence to the prescribed treatment plan which may cause substantial mortality, morbidity, and cost to the healthcare system. in this respect, the study of causes for non-adherence and the development of measures to increase respectively maintain treatment adherence, particularly in chronic diseases, is of major clinical importance. the aim of this study was to investigate the impact of an acoustic reminder and a close supervision on adherence to inhaled medication and on course of disease and quality of life (qol) in asthma and copd patients. in this single-blinded trial, asthma and/or copd patients were randomly assigned either to the intervention or the control group. adherence to inhaled medication was monitored using electronic data capture devices, recording date and time of each inhalation device actuation. follow-up was six months. primary outcome was defined as "time to next exacerbation". secondary outcomes included number of exacerbations, number of exacerbations with hospitalization, taking/timing adherence, and qol during follow-up. adherence was measured using electronic data capture devices which saved date and time of each inhalative device actuation. patients are randomly assigned to an intervention, respectively control group. patients assigned to the intervention group will receive audio reminder and support calls in case medication is not been taken as prescribed or if rescue medication is used more frequently than prespecified in the study protocol. during the study, participants are assessed every two months.


Eligibility criteria:
inclusion: * aged 18 years or older * have an established asthma-diagnosis according to the global initiative for asthma (gina) guidelines and/or * have an established copd diagnosis according to the global initiative for chronic obstructive lung disease (gold) guidelines (severity gold i-iv based on the international gold-criteria) \[46\] and * are prescribed daily inhaled medication (controller medication for a daily maintenance treatment) * had at least one exacerbation in the previous 12 months before study start * with a metered dose inhaler (e.g. ventolin®), diskus (e.g.seretide®), turbohaler (e.g.symbicort®), aerolizer/breezhaler (e.g.onbrez®), handihaler (e.g. spiriva®) or ellipta (e.g relvar®) exclusion: * suffering from malignancies and/or other severe diseases * insufficient in the german language * pregnant or lactating

Keywords: adherence of inhaled medication pharmaceutical intervention
epigenetic contribution to the pathogenesis of diabetic nephropathy in qatari population

Conditions: Type 2 Diabetes

Summary: the main objective is to study the epigenetic contribution to the pathophysiology of diabetic nephropathy in qatari population.

diabetic nephropathy (dn) is a common vascular complication of type 2 diabetes (t2d) that is associated with increased mortality and poor quality of life.in industrialized countries, dn ranges first among other etiologies of end-stage renal disease (esrd).diabetes in qatar is a serious health issue for the qatari population since approximately 1/5 of the population has t2d, which is 2-3 times higher than the world average. as observed in other gulf cooperation council (gcc) countries, obesity and sedentary lifestyle are cornerstones in the development of t2d. additionally, consanguineous marriages in qatar contribute to this high prevalence. as a consequence, dn has an enormous burden in terms of management, treatment and especially in renal replacement therapy (rrt) in esrd in qatari population.dn is a glomerular disease defined by increased urinary albumin excretion (uae), hypertension and decline in the glomerular filtration rate (gfr), all induced by chronic hyperglycemia. however, there are other contributing factors such as genetic predisposition, systemic and intra-renal hemodynamic disturbances, all leading to glomerulosclerosis. all of the known pathways do not explain the complex pathophysiology behind dn. even different variants of genes described in major gwas studies have little impact in terms of risk prevention or prognosis of dn. over the last decade, epigenetics have initiated a new era in genetic medicine capable of giving a different approach to human disease.

Eligibility criteria:
inclusion criteria: * males and females, at least 18 years old * provide informed consent * willingness to participate in the study * in patients with diabetes, no concomitant diseases except for micro and macrovascular complications of diabetes (nephropathy, retinopathy, peripheral arterial disease, coronary artery disease, neuropathy) or symptoms of the metabolic syndrome ( hypertension, dyslipidemia and obesity) * not taking any chronic medications (except of the diabetes and the cardiovascular related drugs) * consent to having peripheral blood and urine collection for dna extraction and micro-rnas as well as routine laboratory evaluation, including general hematologic studies, general biochemical analyses. exclusion criteria: * type i diabetes or other form of diabetes (mody, secondary diabetes) * unable to meet the inclusion criteria * pregnancy * active infection or acute illness of any kind * chronic inflammation (auto-immune diseases) or infections (hiv, chronic viral hepatitis, chronic urinary tract infections ...) * evidence of malignancy within the past 5 years * chronic hematological disorders known to affect glycated hemoglobin results such as hemoglobinopathies and pathologies with high red-cell turnover
optimized tdcs for the treatment of migraine

Conditions: Migraine Disorders

Summary: the aim of this study is to establish an optimized protocol of tdcs that normalize the lack of habituation and efficiency of inhibitory cortical circuits in migraine patients and determine tdcs polarity and the best cortical areas to stimulate which could normalize the lack of habituation and efficiency of inhibitory cortical circuits. for this, migraineurs volunteers will undergo to some tdcs protocols or sham tdcs.

a crossover trial to establish an optimized tdcs protocol will be accomplished. anodal and cathodal tdcs will be applied over the primary motor cortex (c3 - active and contralateral supra-orbital region - reference) and visual cortex (oz - active and cz - reference). dual tdcs (anodal and cathodal - optimized protocol) will be applied on c3 - active and oz - active. electrical cortical activity will be assessed on 14 migraineurs through: (i) mep; (ii) mt; (iii) sici; (iv) icf; (v) pt and (vi) visual evoked-potential (vep-habituation). an interval of 48hs between sessions will be taken. the order of the sessions will be randomized and counterbalanced among volunteers by site www.randomization.com.

Eligibility criteria:
inclusion criteria: * ages: 18-55 years * gender: both * presented diagnostic of episodic migraine with or without aura or probably migraine with or without aura according to the criteria for diagnosis of ichd-iii * disease duration of at least 12 months * without preventive medication for at least 6 months prior to initiation of treatment exclusion criteria: * pregnant women; * pacemaker; * history of seizures; * metallic implants in the head; * patients with clinical evidence of brain injuries; * chronic pain associated to others diseases; * use of neuroleptic medications

Keywords: migraine disorders transcranial direct current stimulation electric stimulation therapy pain rehabilitation
the effect of the glycemic load of meals on the cognition and mood of older adults

Conditions: Dementia

Summary: a lower rather than a higher glycemic load (gl) meal has been shown to benefit cognition and mood, however, the data in older adults and those most prone to cognitive dysfunction, is limited and conflicting. one explanation is that the gl of a meal may interact with a person's pre-existing glucose tolerance (gt). as older adults have a higher incidence of glucose tolerance and are more likely to experience memory problems the present study considers the interaction between the gl of meal in those with better or poorer gt. the population studied will not have a history of diabetes or dementia. a battery of cognitive tests will be administered after meals sweetened with one of three sugars known to vary in the rate that they release glucose into the blood stream.

on day one subjects will take an oral glucose tolerance test and will then be divided into four groups depending on their glucose tolerance (how long values remain raised) and the tendency for values to subsequently fall to low values. on a second occasion 155 healthy older adults, aged 45-80 years, will be randomly assigned to receive either a glucose, sucrose or isomaltulose based meal. all meals are matched on macronutrient composition and differ only in glycemic load. cognitive performance and mood will be assessed 30, 105 and 180 minutes after breakfast. measures of memory, attention, reaction times and mood will be taken. the response to the three meals will be contrasted in those with different glucose profiles on day one

Eligibility criteria:
inclusion criteria: * healthy adults of 45 to 80 years exclusion criteria: * type 1 or type 2 diabetes * dementia * liver disease * gastro-intestinal problems

Keywords: glycemic load memory mood
ketogenic diet compliance in patients affected by locally advanced rectal cancer patients who undergo to radiotherapy

Conditions: Rectal Cancer

Summary: patients with locally advanced non-metastatic adenocarcinoma of the rectum undergoing chemoradiation therapy will be assigned to 2 groups: * the intervention group will be prescribed an individualized ketogenic eating plan to be followed throughout the treatment period * the control group will be prescribed a diet therapy plan treatment following the international guidelines of clinical nutrition, also to be followed during treatment

some days before the start of radiotherapy there will be the first visit in which patients will be enrolled and placed in one of the following two groups: * the intervention group (kd) will be prescribed a ketogenic diet therapy plan characterized by the following composition: carbohydrates \ 65%. * the control group (sd) will be prescribed a nutrition plan based on the mediterranean diet model according to espen guidelines (carbohydrates 45-55%, protein 15-20% and lipids 30-35%) there will then be two additional follow-ups for patients: one during the period of therapy and one at the end of therapy. compliance with diet therapy treatment (sd vs. kd) will be assessed by analysis of a food diary that the patient will be asked to complete. during follow-ups it will be assessed: * bmi and body composition (by bioimpedance analysis) * muscle strength and physical performance (by hand grip test and sit-to-stand test) compliance with and toxicity of radiochemotherapy treatment will be assessed at the radiochemotherapy visits (3 visits during treatment)

Eligibility criteria:
inclusion criteria: * histologic confirmation of rectal adenocarcinoma * locally advanced rectal cancer * patients undergoing neoadjuvant radiotherapy treatment * signature of informed consent to the processing of personal data exclusion criteria: * severely malnourished patients according to glim (global leadership initiative on malnutrition) criteria * patients treated for palliative purposes * patients with metastatic disease * diabetes mellitus * pregnancy or lactation * significant food allergies that would make the person unable to consume the food provided * refusal to participate in the proposed clinical trial

Keywords: rectal cancer ketogenic diet
safety, tolerability, and pharmacokinetics of dapsone in acne vulgaris

Conditions: Acne Vulgaris

Summary: this study will evaluate the safety, tolerability, and pharmacokinetics (pk) of dapsone in subjects with acne vulgaris following 28 days of dosing.


Eligibility criteria:
inclusion criteria: * diagnosis of acne vulgaris * willing to avoid excessive or prolonged exposure to ultraviolet light (e.g., sunlight, tanning beds) throughout the study * if male, the subject must agree to shave the facial treatment area and agree to maintain his routine shaving regimen for the duration of the study * willing to avoid applying moisturizers, sunscreens, cosmetics (except eye and lip makeup), and chemical peels throughout the study exclusion criteria: * oral acne treatments within 6 months
burst crossover trial

Conditions: Back Pain with Radiation; Pain, Postoperative

Summary: spinal cord stimulation (scs) is a widely applied therapy to treat chronic neuropathic pain, and one of the most common indications is persisting radicular neuropathic pain following lumbar spine surgery. in traditional scs therapies, the objective has been to replace the pain sensation with paresthesia. the anticipation is that the electrical current alters pain processing by masking the sensation of pain with a comfortable tingling or paresthesia. although patients mostly cope with paresthesia, a significant proportion reports that the sensation is unpleasant. 'burst' scs utilizes complex programming to deliver high-frequency stimuli. this scs technique seems to provide paresthesia-free stimulation, resulting in better pain relief of low back and leg pain then traditional tonic stimulation. the widespread use of scs has not been backed by solid evidence. the absence of placebo-controlled trials has long been an important point of criticism, but due to the nature of the intervention with sensation of paresthesia, studies with placebo control have so far not been considered possible. when 'burst' scs is used the stimulation is often unnoticed by the patient, allowing comparison with placebo stimulation. the aim of this randomized double-blind sham-controlled crossover trial is to evaluate the efficacy of 'burst' spinal cord stimulation for chronic radicular pain following spine surgery.


Eligibility criteria:
inclusion criteria: * have undergone ≥1 back surgeries and developed chronic radicular pain that has remained refractory to non-surgical treatment for ≥6 months * minimum pain intensity of 5/10 on the leg pain nrs at baseline * successful two-week scs testing period with tonic stimulation (≥2 points reduction in leg pain nrs from baseline). this means patients will experience paresthesia during the scs trial period * mandatory assessment at the multidisciplinary outpatient clinic for back-, neck- and shoulder rehabilitation, st. olavs university hospital * successful two-week scs testing period with tonic stimulation (≥50% reduction in leg pain nrs from baseline). this means patients will experience paresthesia during the scs trial period exclusion criteria: * coexisting conditions that would increase procedural risk (e.g., sepsis, coagulopathy) * history of laminectomy or posterior fusion at the thoracolumbar junction, where percutaneous electrode end tips are routinely placed. * abnormal pain behavior and/or unresolved psychiatric illness. * unresolved issues of secondary gain or inappropriate medication use.

Keywords: lumbar vertebrae surgery postoperational complications spinal cord stimulation
the epidemiologic study of human cytomegalovirus（cmv） in female students of xiamen university

Conditions: Cytomegalovirus Infections

Summary: in this study, 100 female students aged 18 to 30 years old in xiamen university will be enrolled. on the first visit, blood, saliva and urine samples of all participants will be collected. then saliva and urine samples will be collected at two-week interval until 6 months. serum samples will be tested the pp150-igg titer. saliva and urine samples will be used to test cmv dna by pcr. the primary purpose of this study is to identify the relationship between baseline pp150-igg titer and cmv infection.


Eligibility criteria:
inclusion criteria: * 18-30 years old * female students of xiamen university exclusion criteria: * students who have the serious diseases

Keywords: cytomegalovirus
a safety and tolerability study of denufosol in 2-4 year olds

Conditions: Cystic Fibrosis

Summary: the purpose of this study is to evaluate the safety and tolerability of denufosol 60 mg tid in pediatric cf patients 2 to 4 years of age


Eligibility criteria:
inclusion criteria: * have a confirmed diagnosis of cf * have oxyhemoglobin saturation ≥ 95% prior to randomization exclusion criteria: * have acute intercurrent respiratory infection (cough, wheezing, or new rhinorrhea or nasal congestion) * have any significant medical condition not related to cf * unable to discontinue use of hypertonic saline
prediction of intraoperative adhesions before cs

Conditions: Abdominal Adhesion

Summary: to predict the presence of intra-abdominal adhesions among women undergoing repeated cesarean section using several parameters.

one of the most frequently performed surgical procedures globally is cesarean delivery (cd). cesarean delivery rate is increasing, which raises the prevalence of intra-abdominal adhesions . the rate of intra-abdominal adhesions is 24-83% . adhesions cause various postoperative complications, including intestinal obstruction, pelvic pain, dyspareunia, infertility, visceral injury, delayed delivery of the newborn , prolong surgical duration, increase bleeding amount and the incidence of hysterectomy . for these reasons, obstetricians always want to identify the possible extent of adhesions before cesarean section. although to date there was no reliable technique to predict adhesions in women undergoing repeat cd . methods used in the evaluation of adhesions include the previous cesarean scar features, pigmentation, width and length , ultrasound sliding sign has been used in predicting pelvic endometriosis ,baron et al. ,used the sliding sign in predicting adhesions in women undergoing repeat cd, also stretch marks are a type of skin alteration that occur during pregnancy. to ensure better surgical outcomes and reduce morbidities, the accurate prediction of adhesion formations before cesarean section is important. this study aims to investigate the integration of multiple parameters, such as evaluating cesarean scars, ultrasound sliding sign, and striae gravidarum, to assess intra-abdominal adhesions. we hypothesize that employing a combination of these parameters will yield superior predictive capabilities compared to relying on a single parameter alone. by exploring a comprehensive approach to adhesion prediction, we endeavor to enhance the safety and efficacy of cesarean section procedures, ultimately improving maternal and fetal well-being.

Eligibility criteria:
inclusion criteria: 1. pregnant women aged from 18 to 35 years 2. women with at least one previous c-section 3. gestational age (≥36 weeks) 4. planned elective cesarean section exclusion criteria: 1. primigravida 2. gestational age (\<36 weeks) 3. pregnant woman who had developed wound site infections following prior cesarean section
normobaric hyperoxia combined with endovascular treatment for acute ischemic stroke

Conditions: Stroke; Endovascular Treatment; Neuroprotection

Summary: the purpose of this study is to evaluate the safety and efficiency of normobaric hyperoxia combined with endovascular treatment for acute ischemic stroke patients with stroke onset 6-24 hours.


Eligibility criteria:
inclusion criteria: * age≥18; * suspected lage vessel occlusion of acute anterior circulation occlusion; i.e. either the ica or the m1/m2-segment of the mca; * stroke symptom onset has been more than 6 hours but not more than 24 hours,and imaging confirmed the existenceof ischemic penumbra; * nihss score≥6; * alberta stroke program early ct score (aspects) of 6-10 on non- contrast ct; * (level of consciousness) nihss score of 0 or 1 * mrs score was 0-1 before stroke; * informed consent obtained; exclusion criteria: * rapid improvement in neurological status to an nihss \< 6 or evidence of vessel recanalization prior to randomization; * seizures at stroke onset; * intracranial hemorrhage; * systolic pressure greater than 185 mm hg or diastolic pressure greater than 110 mm hg, or aggressive treatment intravenous medication)necessary to reduce blood pressure to these limits; * symptoms rapidly improving; * symptoms suggestive of subarachnoid hemorrhage, even if ct scan was normal; * platelet count of less than 100,000 per cubic millimeter; * ct showed a multiple infarction (low density area greater than 1/3 cerebral hemisphere); * severe hepatic or renal dysfunction; * active and chronic obstructive pulmonary disease or acute respiratory distress syndrome; * \>3 l/min oxygen required to maintain peripheral arterial oxygen saturation (sao2)#95% as per current stroke management guidelines; * medically unstable; * inability to obtain informed consent; * life expectancy\<90 days; * pregnant or breast-feeding women; * unwilling to be followed up or poor compliance for treatment; * patients being enrolled or having been enrolled in other clinical trial within 3 months prior to this clinical trial; * evidence of intracranial tumor; * baseline blood glucose of \ 400 mg/dl (22.20 mmol); * patients with upper gastrointestinal bleeding or nausea and vomiting who cannot use oxygen masks; * other circumstances requiring emergency oxygen inhalation;
quality of life in patients with alcohol use disorder

Conditions: Alcohol Use Disorder

Summary: the primary purpose of this study is to investigate the factors associated with quality of life of patients with alcohol use disorder (aud) undergoing a detoxification program (cross-sectional analysis). the secondary purpose is (1) to identify the factors associated with change in quality of life between baseline and 6-month follow-up, and (2) to identify the factors associated with alcohol relapse at 6 months (longitudinal analyses).

the standard dsm-5-based clinical assessment of aud includes the number of aud criteria (between 2 and 11) as well as various parameters related to the patterns of alcohol use (e.g., frequency of use, frequency of heavy use). in the contemporary clinical practice, more "functional" assessment tools are emerging such as quality of life, autonomy, cognitive functioning, but also other non-specific lifestyle habits, such as sleep quality and sexual functioning. these indicators are important because they define the broad impact of aud on individual's life, and they are part of the overall rehabilitation, beyond the mere question of the relationship to alcohol. however, the determinants of quality of life of patients with aud patients undergoing a detoxification program, and the factors associated with change in quality of life are not well identified. this prospective cohort study will recruit 200 patients undergoing a detoxification program (home-based or in addiction services). patients' demographic data, socioeconomic status, physical diseases, medication use, clinical features of aud, psychiatric variables, impulsivity, autonomy, sexual functioning, sleep quality, and cognitive functioning will be measured at baseline. the alcohol quality of life scale (aqols) will be completed at baseline and at 6-month follow-up. alcohol status (relapse/abstinence) will be assessed at 6 months.

Eligibility criteria:
inclusion criteria: * dsm-5 aud criteria * at least 18 years of age * within the 10th and 21st day of a detoxification program. exclusion criteria: * communication difficulties (insufficient level of french, major hearing or visual impairment, major cognitive deficit) * under guardianship * under justice control * cannot be reached by phone