Kornimate/medical-research-clean huggingface dataset:
sildenafil to reduce vascular remodeling during left ventricular assist device support

Conditions: Vascular Diseases

Summary: contemporary left ventricular assist device (lvad) therapy improves survival during advanced heart failure but vascular aging develops rapidly leading to major adverse events including stroke and bleeding in nearly half of patients. in this study, the study team aims to investigate whether sildenafil pharmacotherapy, which has anti-fibrotic effects, can reduce vascular aging during lvad support. an aim of this study is to compare changes in small blood vessels in the gastrointestinal tract between participants receiving sildenafil or placebo. video capsule endoscopy (vce) will be used to assess these changes in small blood vessels.

over 6.5 million individuals in the united states suffer from heart failure (hf), with the burden of this disease expected to grow over the next decade. approximately 300,000 of these patients have advanced hf and may benefit from durable left ventricular assist device (lvad) therapy, which can improve outcomes during advanced hf. however, despite advancements in device design that have increased survival rates, large registries of real- world cases reveal that nearly half of patients experience severe vascular adverse events, including stroke and bleeding, during prolonged contemporary lvad support. this elevated adverse-event rate remains a major barrier to safely expanding the use and durability of lvad therapy. vascular remodeling or aging of the large and small blood vessels is known to promote stroke and bleeding within the general population. critically, such remodeling is rapidly accelerated under conditions of reduced pulsatility produced by lvads, evidenced by large vessel stiffening and fibrosis, small vessel angiodysplasia, and endothelial dysfunction. phosphodiesterase-5 inhibitors (pde5i), such as sildenafil, are prescribed to select lvad patients with pulmonary hypertension and right heart failure. however, given that these agents enhance nitric oxide-cgmp signaling in platelets and vascular smooth muscle cells, leading to anti-thrombotic and anti-fibrotic effects, they may also reduce vascular remodeling and related adverse events. here, based on preliminary findings, a double-blind, randomized, placebo-controlled trial will be conducted to determine the effects of chronic sildenafil administration on vascular remodeling during lvad support.

Eligibility criteria:
inclusion criteria: * over 18 years of age * supported by a durable lvad or planned to undergo placement of a durable lvad * be able to give informed consent exclusion criteria: * history of pre-existing aortic valve prosthesis or an aortic graft * allergy to sildenafil * taking any nitric oxide (no) donor medications * history of complete carotid occlusion
influence of transmission season on outcome of treatment of schistosoma haematobium infection in mozambique

Conditions: Hematuria; Hydronephrosis

Summary: to assess the influence of seasonal variations in schistosoma haematobium transmission on treatment outcome (morbidity and re-infection)

general objective to provide knowledge about the influence of transmission season (high and low) on the outcome of treatment assessed by cure rate, re-infection rate, regression and reappearance of urinary tract morbidity rate after treatment in order to optimise praziquantel treatment strategies for morbidity control in urinary schistosomiasis. specific objectives to determine the prevalence and intensity of schistosoma haematobium infection before chemotherapy and compare cure rates and levels of re-infection after chemotherapy administered during high and low transmission seasons. to assess urinary tract morbidity due to schistosoma haematobium by ultrasonography and compare the regression and reappearance of urinary tract pathology chemotherapy administered during high and low transmission seasons. to correlate morbidity determined by ultrasound with infection and morbidity parameters such as intensity of infection, micro- and macrohematuria, circulating cathodic antigen (cca) in urine, proteinuria and leucocyturia and determine sensitivity, specificity and positive predictive values in relation to urinary tract morbidity. study design the main research question concerning the influence of transmission season on treatment outcome will be addressed in a consecutive cohort study with two separate but comparable cohorts. the first cohort will be examined and treated with praziquantel during the season with high transmission, february/mach (group a) and the second cohort will be examined and treated during the low transmission season, in july approximately 5 months later (group b). each cohort will be examined before treatment and 2, 6 and 18 months after treatment. the study will be carried out in 4 primary schools; two from machava j area and two from costa do sol area. the schools will be selected based on the following criteria: similar prevalence (\> 50%) and intensity of s. haematobium infection; absence or very low levels of s. mansoni infection; a minimum of 2 classes (\>35 pupils per class) at each level (3rd and 4th level) and similar distribution of boys and girls.examinations will include urine for parasitology and haematuria and ultrasonography of upper and lower urinary tract

Eligibility criteria:
inclusion criteria: * children aged 8-12 years exclusion criteria: * all children presenting with macro-haematuria or severe pathology detected by ultrasonography (large masses, pseudo-polyps or hydronephrosis/hydroureter) at the 6 months follow-up examination will be treated with praziquantel and excluded in the data analysis.

Keywords: schistosoma haematobium haematuria ultrasonography uganda vesical polyps
interrupted subdermal suture spacing during linear wound closures and the effect on wound cosmesis

Conditions: Interrupted Subdermal Suture

Summary: this study aims to investigate whether the spacing of the interrupted deep (subdermal) sutures affects surgical wound cosmesis on the trunk and extremities. in other words, the investigator would like to determine which of the following yields a more cosmetically appealing scar: many closely approximated subdermal sutures or fewer, more widely spaced subdermal sutures. the investigator wishes to compare the effects of one versus two centimeter spacing between sutures.

sutures are the standard of care in repairing cutaneous wounds. the majority of surgical reconstructions following a mohs micrographic surgery and standard surgical excisions require two layers of sutures: a deep layer and a top layer. the deep layer dissolves naturally whereas the top layer must be removed. this study aims to investigate whether the spacing of the interrupted deep (subdermal) sutures affects surgical wound cosmesis on the trunk and extremities. in other words, the investigator would like to determine which of the following yields a more cosmetically appealing scar: many closely approximated subdermal sutures or fewer, more widely spaced subdermal sutures. the investigator wishes to compare the effects of one versus two centimeter spacing between sutures. it is possible that fewer, more widely spaced sutures may leave more open space in the wound, leaving more tension to pull on those few sutures, possibly encouraging the wound to dehisce and make it harder to approximate the wound edges yielding a less cosmetically appealing scar compared to placing many closely approximated sutures which would decrease the tension and likely better approximate the wound edges yielding a more cosmetically appealing scar. on the other hand, we may find that suture spacing has no effect on wound cosmesis and that placing fewer, more widely spaced sutures is much more time efficient. the investigator may also find that the effect of suture spacing on wound cosmesis is dependent on wound tension. for example, perhaps the suture pacing would have no effect on the cosmesis of a wound under no tension, however, for a wound under high tension, it is possible that many closely approximated sutures would yield better cosmetic results for the reasons listed above.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * able to give informed consent themselves * patient scheduled for cutaneous surgical procedure on the trunk and extremities with predicted primary closure * willing to return for follow up visit. exclusion criteria: * mentally handicapped * unable to understand written and oral english * incarceration * under 18 years of age * pregnant women * wounds with predicted closure length less than 4 cm

Keywords: subdermal suture wound closure wound cosmesis
the role of congenital mucosal immune system in the airways of patients with chronic obstructive pulmonary disease

Conditions: COPD Exacerbation; Smoking, Tobacco

Summary: the purpose of the study is to explore the role of congenital mucosal immune system in the airways of patients with copd including the impact of ilcs (innate lymphoid cells) on metabolism of epithelial cells.during the research the following methods will be applied: measurement of volatile organic compounds (vocs), airway epithelial cytology and culture.

ilcs profiles, epithelium metabolism measured by vocs and microbiome profiling (specific 16s rrna-16s ribosomal rna gene-targeted qpcr) will by determined in the airways of patients with copd after the exacerbation. microbiome profiling will be based on next generation sequencing (ngs) of the 16s rrna encoding region.

Eligibility criteria:
exclusion criteria: * neoplasm * diabetes * astma * acute airway infection in last 2 weeks
study to compare the safety and efficacy of idp-123 lotion to tazorac cream in the treatment of acne vulgaris

Conditions: Acne Vulgaris

Summary: the primary objective of this study is to compare the safety and efficacy of once daily application of idp-123 lotion to tazorac cream, 0.1%, vehicle lotion, and vehicle cream in subjects with moderate to severe acne vulgaris.

this is a multi-center, randomized, double-blind, vehicle-controlled, 12-week study designed to assess the safety, tolerability, and efficacy of idp-123 lotion in comparison with tazorac cream, vehicle lotion, and vehicle cream in subjects with moderate to severe acne. treatment success will be evaluated by changes in inflammatory and non-inflammatory lesion counts, as well as treatment success using an evaluator's global severity score. idp-123 is a lotion for the topical treatment of acne.

Eligibility criteria:
inclusion criteria: * male or female at least 12 years of age and older * written and verbal informed consent must be obtained * subject must have a score of moderate or severe on the evaluator's global severity assessment * pre-menses females and women of childbearing potential must have a negative urine pregnancy test at the screening and baseline visits * subjects must be willing to comply with study instructions and return to the clinic for required visits exclusion criteria: * any dermatological conditions on the face that could interfere with clinical evaluations * any underlying disease(s) or some other dermatological condition of the face that requires the use of interfering topical or systemic therapy or makes evaluations and lesion count inconclusive * subjects with a facial beard or mustache that could interfere with the study assessments * subjects who are unable to communicate or cooperate with the investigator * subjects with any underlying disease that the investigator deems uncontrolled, and poses a concern for the subjects safety while participating in the study
the effects of 8-week resistance and aerobic exercise on anxiety, depression, sleep, inhibitory control in young adults with smartphone overdependence

Conditions: Exercise; Smartphone Addiction; Sleep; Inhibition; Mood

Summary: the purpose of this study is to identify the effects of the resistance exercise and aerobic exercise on depression, anxiety, sleep, inhibitory control in young adult with smartphone overdependence


Eligibility criteria:
inclusion criteria: * smartphone overdependent scale score of 24 ≥ * no regular exercise in the past 3 months exclusion criteria: * unable to perform exercise * patients with musculoskeletal disorders * patients with cardiovascular diseases.
effects of iv-administered ca-dtpa and zn-dtpa to treat patients with gadolinium deposition disease

Conditions: Headache; Cognitive Disturbance; Skin Hyperpigmentation; Arthralgia

Summary: purpose: there are two goals we have for this prospective single arm study; to see an increase in the amount of gadolinium in 24 hour urine collection following each infusion treatment with calcium and zinc dtpa, and to see a reduction or elimination of gadolinium deposition disease (gdd) symptoms. participants: twenty (20) patients who are suffering from gadolinium deposition disease (gdd) procedures: over a series of three (3) treatment time-points patients will be treated with iv ca-dtpa on day one, and zn-dtpa on day two.


Eligibility criteria:
inclusion criteria: exhibiting 3 or greater of the following symptoms which must be present after having been administered a gbca: * cognitive disturbance * extremity pain * headache * chest wall pain * skin induration * skin hyperpigmentation * skin pain * arthralgia exclusion criteria: * pregnant or lactating * less than 18 years old * no evidence of gadolinium (has to have shown previous demonstration of gd by urine analysis or bone biopsy) * known connective tissue disease such as systemic lupus erythematosus or scleroderma * severe hemochromatosis or wilson's disease * glomerular filtration rate (gfr) ≤ 60 * have had an investigational drug within last 30 days * unable to give written consent * multiple sclerosis * chronic heart failure * cirrhosis of the liver

Keywords: gadolinium deposition gbca extremity pain skin pain chest wall pain
n-acetylcysteine to prevent renal failure

Conditions: Kidney Failure, Acute; Oxidative Stress Induction

Summary: the purpose of this study is to determine the possible effect nephroprotective of n-acetylcysteine in patients with chronic kidney disease undergoing elective coronary artery bypass grafting by serial evaluation of renal function and to evaluate whether treatment reduces cardiac mortality, cardiac events and global mortality, if it interferes with oxidative stress and inflammation and the need for dialysis.

renal failure is a serious and relatively frequent complication of cardiac surgery was observed, especially in diabetics and those with pre-existing renal dysfunction. given that oxidative stress is elevated in diabetics and in renal and heart, it is reasonable to speculate on its involvement in the pathophysiology of this complication. it is unknown whether the incidence of postoperative renal failure can be reduced by antioxidants. n-acetylcysteine (nac) is an antioxidant that prevents nephropathy induced by contrast medium and aminoglycosides and increases intracellular levels of cyclic guanosine monophosphate, acting as a vasodilator and platelet inhibitor. based on a knowledge of the pathophysiology of arf, several interventions have been attempted over the past decades. however, various measures employed successfully in the prevention of experimental arf did not result in success in clinical practice. much of this failure is probably due to the difference between the experimental models of arf that encountered in the clinic. other factors that should be considered, and that may explain the poor results in clinical trials are: the time of use of the drug, dosage and route of administration, are not always adequate. from the data in the literature, it remains doubtful whether the protective role of nac is limited only to contrast nephropathy or whether it could have application in other clinical situations in which oxidative stress and vasoconstriction are determinants of injury, as occurs, for example, in cabg surgeries. nac is a drug of low cost and low toxicity, this paper intend to assess its role as prophylaxis of renal dysfunction in the postoperative period of cabg in patients with chronic kidney disease stages 3 and 4 (gfr between 15 and 59 ml/min/1, 73 m2 of body surface).

Eligibility criteria:
inclusion criteria: * adult patients aged 30 to 80 years old of both sexes * indicated for elective cabg * with glomerular filtration rate, assessed with the mdrd \ 15 ml / min / 1.73 m2 body surface exclusion criteria: * patients on chronic dialysis or with creatinine\> 5 mg / dl preoperatively; individuals allergic or intolerant to n-acetylcysteine * pregnant women * patients with cancer * patients underwent re-surgery within the first 72 hours postoperatively

Keywords: n-acetylcysteine myocardial revascularization acute renal failure oxidative stress
sensory-motor integration for sensory processing and balance in asd

Conditions: Autism Spectrum Disorder (ASD)

Summary: this randomized controlled trial evaluates the effectiveness of a 16-week structured sensory-motor integration exercise program compared to conventional therapy (applied behavior analysis and massage therapy) in improving sensory processing abilities and balance in children aged 6-12 years diagnosed with autism spectrum disorder (asd). outcomes are measured using the short sensory profile and berg balance scale at baseline and after 16 weeks of intervention. findings aim to demonstrate the clinical utility of sensory-motor integration exercises in enhancing functional outcomes for children with asd.

children with autism spectrum disorder often experience significant sensory processing issues and motor coordination challenges, particularly balance deficits. this study evaluates a sensory-motor integration intervention aimed at improving sensory modulation and motor abilities. participants aged 6 to 12 years are randomized into two groups: an intervention group participating in structured sensory-motor exercises (64 sessions, 4 times weekly, 45 minutes per session), and a control group receiving conventional therapy (primarily applied behavior analysis and massage therapy). outcomes are assessed using standardized measures: the short sensory profile (ssp) for sensory processing and the berg balance scale (bbs) for balance, at baseline and immediately following the intervention period.

Eligibility criteria:
inclusion criteria: * age 6-12 years * diagnosed with autism spectrum disorder (dsm-5 criteria) * mild-to-moderate asd severity (cars score ≤ 39.5) * ability to participate in structured sessions exclusion criteria: * significant physical impairments or medical conditions affecting participation * recent (within 6 months) participation in sensory integration therapy
functional outcome after minimally invasive pyeloplasty for adult patients with upjo

Conditions: Ureteropelvic Junction Obstruction

Summary: an intervention study on adult patients with uretero-pelvic junction obstruction (upjo) due to crossing vessels would be managed either through classic dismembered pyeloplasty or vascular hitch.

in recent studies, some patients with crossing vessels upjo could be managed by vascular displacement of these vessels, what is named as vascular hitch or vasculopexy in a way to avoid classic dismembered technique. this newer technique is supposed to provide comparable results to the classic technique but with lesser operative time and shorter hospital stay. in the era of minimally invasive procedures, robotic assisted or laparoscopic vascular hitch could provide many advantages over the classic open technique.

Eligibility criteria:
inclusion criteria: * all patients with upjo above 18 years * upjo caused by crossing vessels confirmed by ct angiography * symptomatic upjo exclusion criteria: * recurrent upjo after a previous trial of open repair , * secondary upjo after open renal surgery. * upjo in non functioning kidney
expanded access program using imm-101 for patients with advanced pancreatic cancer

Conditions: Pancreas Cancer; Pancreatic Cancer; Pancreatic Cancer Stage IV; Pancreatic Cancer Stage III

Summary: an expanded access program for imm-101 for patients with advanced pancreatic cancer.

imm-101 is a suspension of heat-killed whole cell mycobacterium obuense. since it is a heat-killed preparation, treatment is not associated with the potential side-effects of delivering live or attenuated organisms. five studies with imm-101 have been completed including a 110-patient randomised phase ii study in pancreatic cancer and exploratory studies in other solid tumours (melanoma, colorectal cancer and advanced melanoma).

Eligibility criteria:
inclusion criteria: this expanded access program is available for patients of 18 years or older with advanced pancreatic cancer for whom, in the opinion of their treating physician, other treatment options or clinical trials in this indication are unsuitable. exclusion criteria: female patient of child-bearing potential who is not, in the opinion of the physician, using an approved method of birth control (e.g., physical barrier \[patient and partner\], contraceptive pill or patch, spermicide and barrier, or intrauterine device \[iud\]).
changes in motor cortex following exercises for chronic low back pain

Conditions: Chronic Low Back Pain

Summary: the motor cortex of the brain changes following chronic pain and injury, and this is linked to pain-associated changes in motor behaviour. this study aimed to investigate whether therapeutic exercises in patients with chronic pain can induce reorganisation of the motor cortex and restore normal motor behaviour. the investigators hypothesised that motor training can induce reorganisation of the motor cortex and that these changes are related to improved motor behaviour.

the sensory and motor systems can reorganize following injury and learning of new motor skills. recently we observed adaptive changes in motor cortical organization in patients with chronic back pain, which are closely linked to changes in motor behavior. although pain-related alterations in behavior can be trained and are associated with improved symptoms, it remains unclear whether these meaningful functional outcomes are related to motor cortical reorganization. here we investigate the effects of two interventions in people with chronic back pain: skilled motor training and a control intervention of self-paced walking exercise. we measured motor cortical excitability (motor threshold (mt)) and organization (center of gravity (cog) and map volume) of the deep abdominal muscle, transversus abdominis (tra), using transcranial magnetic stimulation (tms). in addition, motor behavior of tra was assessed during single rapid arm movements. the study helps to elucidate the mechanisms of specific motor exercises in chronic back pain management.

Eligibility criteria:
inclusion criteria: * sustained or episodic non-specific low back pain lasting longer than 3 months exclusion criteria: * orthopaedic, neurological, circulatory or respiratory conditions * history or family history of epilepsy * recent or current pregnancies * previous surgery to the abdomen or back * abdominal or back exercises in the preceding 12 months

Keywords: low back pain motor training motor cortex brain plasticity