Kornimate/medical-research-clean huggingface dataset:
telephone psychotherapy for late-life generalized anxiety disorder (gad)

Conditions: Generalized Anxiety Disorder

Summary: the purpose of this study is to determine if cognitive-behavioral therapy (cbt)and supportive therapy delivered by telephone are effective for reducing worry and anxiety in rural older adults with generalized anxiety disorder (gad).

older adults in rural locations often face significant barriers to treatment, including stigma, transportation, lack of local appropriately trained service providers, and impaired mobility. the proposed treatment is delivered in a workbook format and by telephone, which maximizes its portability. treatment will be compared with nondirective supportive therapy, a very credible comparison condition equivalent to the intervention in therapist attention. we propose to randomize 88 adults ≥ 60 years with a diagnosis of gad to either cognitive behavioral therapy delivered by telephone, or nondirective supportive therapy. the 2 primary treatment outcomes are anxiety symptoms as assessed by the hamilton anxiety rating scale, and worry symptoms as assessed by the penn state worry questionnaire-abbreviated. the proposed secondary outcomes are depressive symptoms, sleep, disability, and quality of life. further, mediators and moderators of the treatment effect will also be examined. mediators include process variables (therapeutic alliance, adherence, participant satisfaction, and treatment credibility) and new psychotropic medication use; moderators include demographic information (age, education, gender, race, income), psychiatric variables (baseline anxiety severity, baseline depressive disorders, baseline psychotropic medication use), medical comorbidity, and therapist assignment. maintenance of response will be assessed over 6 months. this research has great public health significance, because it is a low-cost intervention with high potential for widespread dissemination, and it targets an underserved group - community-dwelling rural elders - who currently lack effective treatment interventions tailored to their needs.

Eligibility criteria:
inclusion criteria: * 60 years gad reside in rural county proficient in english exclusion criteria: current psychotherapy active alcohol or substance abuse with use within last month dementia or global cognitive impairment psychotic symptoms active suicidal ideation with plan and intent change in psychotropic medications within last 1 month significant hearing loss

Keywords: anxiety rural elderly
study on the trajectories of rehabilitation compliance in stroke patients

Conditions: Stroke, Acute

Summary: to describe the general trajectories of rehabilitation compliance in first-onset stroke patients within 6 months, and to identify the heterogeneous development trajectory of different subgroups based on the mixed model of latent growth.to explore the predictors of different change tracks of rehabilitation compliance of stroke patients from the perspectives of biological, psychological and social factors, so as to provide the basis for formulating precise nursing intervention measures.

to describe the general trajectories of rehabilitation compliance in first-onset stroke patients within 6 months. to recruit first-onset stroke patients undergoing rehabilitation and collect the general data. telephone follow-up at 2 weeks, 6 weeks, 8 weeks, 12 weeks and 24 weeks after the onset. based on the biological-psychosocial medical model and literature, biological, psychological and sociological factors were screened. the patient rehabilitation adherence level in different periods was measured. latent growth mixture model (lgmm) was used to investigate the general trend of rehabilitation compliance in patients with first-episode stroke within 6 months. latent class growth analysis (lcga) method in latent growth hybrid model was used to identify the track of heterogeneous change. multivariate logistic regression analysis was used to explore the predictors of different subgroups of change trajectories relative to other subgroups.

Eligibility criteria:
inclusion criteria: * patients diagnosed with stroke by ct or mr; * patients with first onset (within 14 days of onset); ③ limb dysfunction (muscle strength ≤4); ④ age: ≥18 years old; ⑤ awareness (nihss consciousness level ≤1 point); * informed consent of patients. exclusion criteria: * patients with deep vein thrombosis; * fracture patients; * a history of severe cardiopulmonary dysfunction and craniocerebral trauma; * recurrent stroke during the study; ⑤patients with severe mental disorders; ⑥ mixed aphasia patients.

Keywords: rehabilitation stroke medical adherence trajectory
the use of manual muscle relaxation techniques in the treatment of temporomandibular joint disorders

Conditions: Temporomandibular Disorder; Temporomandibular Joint Disorders

Summary: the aim of the study was to compare the degree of relaxation of the anterior part of the temporal muscles and the masseter muscles achieved with the use of post-isometric relaxation and myofascial release methods in patients requiring prosthetic treatment due to temporomandibular joint disorders (tmd) with a dominant muscular component. the study included 60 patients, both sexes, aged between 19 and 40. the patients who met the inclusion criteria were alternately assigned to one of the two study groups: i group consisted of the patients received post-isometric relaxation treatment (pir), ii group - patients received myofascial release treatment (mfr). each group consisted of 30 subjects. the series of ten treatments were performed in both groups. the comparative assessment was carried out based on the data obtained from the physical examination, physiotherapeutic examination of the masticatory system, surface electromyography (semg) of anterior temporal and masseter muscles and the data on the intensity of spontaneous masticatory muscle pain assessed using the visual analogue scale (vas).


Eligibility criteria:
inclusion criteria: * diagnosed functional disorders of the masticatory system with the accompanying excessive tension of the masseter muscles, * no clinical signs of displacement of the disc with a blockage in the temporomandibular joint, * spontaneous pain in the masticatory muscles, lasting at least one month before treatment, * good general health of the patient, * full dental arches * written consent to participate in the study exclusion criteria: * occurrence of a face or head injury during participation in the research project, * open wounds in the area where the therapy was carried out, * sudden illness of the patient preventing participation in the study, * the will to terminate participation in the study

Keywords: temporomandibular disorder physiotherapy
improved chest ct diagnostic and contrast medium administration

Conditions: Pulmonary Disease

Summary: investigation of impact of using different cm approaches on contrast enhancement in chest ct examinations - a prospective study

continuing advances in computed tomography (ct) in the past decades such as short scanning times with multi-detector ct (mdct) requires contrast medium (cm) administration to be precisely planned to ensure a diagnostically accurate ct scans. to improve the chest ct diagnostic, the contrast enhancement in the thoracic vessels shoulde be increased. the most important patient-related factors affecting the magnitude of vascular and parenchymal contrast enhancement are body weight. historical practice has been to use a fixed volume of cm independent of body weight. research has shown a clear relationship between vessel enhancement and patient weight, and that fixed cm volume technique is inappropriate, as smaller patients may receive excessive volume, and larger patients insufficient volume resulting in reduced image quality and poor diagnostic. in addition, excess cm can result in contrast induced adverse effects and nephropathy. to overcome these problems, it is essential to adjust the cm volume to the patient's total body weight and body composition. this adjustment can be done in different ways. the aim of this study is to identify which weight/body tailored cm administration is the best replacement for fixed cm administration in chest ct. the cost and procedure time will also be explored.

Eligibility criteria:
inclusion criteria: * patients undergoing chest ct examination between august 2019 and september 2021 * age \> 18 years exclusion criteria: * hemodynamic instability * cardiac failure * pacemaker * renal insufficiency (estimated glomerular filtration rate \<30 ml/min/1.73 m2) * contraindications to contrast enhanced ct * age \< 18 years
folic acid supplementation in phenytoin induced gingival overgrowth

Conditions: Gingival Overgrowth

Summary: phenytoin, a common anti-seizure drug, leads to cosmetically unacceptable side effect of gingival overgrowth in a significant number of patients. there is some evidence of therapeutic effect of folic acid in cases of established phenytoin induced gingival overgrowth. in this study, the aim is to study the prospective preventive effect of low dose oral folic acid supplementation on phenytoin induced gingival overgrowth in epileptic children.


Eligibility criteria:
inclusion criteria: * age: 6-15 yr * started on phenytoin within 1 mo of enrollment exclusion criteria: * not willing to participate * on other folic acid antagonists e.g. anti-neoplastic drugs for \>/= 2 wks during last 3 months * pre-existing gingival over-growth due to other cause

Keywords: phenytoin gum hyperplasia phenytoin induced gingival overgrowth plaque index gingival overgrowth grade
clinical characteristics of people with long-term type 1 diabetes

Conditions: Type 1 Diabetes

Summary: type 1 diabetes (t1d) is characterized by absolute insulin deficiency. although the discovery and application of exogenous insulin has prolonged the lifespan of t1d patients, the chronic diabetic complications caused by long-term poor glycemic control will still reduce patients' quality of life and the overall life expectancy. according to the studies focused on long-term t1d, part of the patients with long disease duration showed resistance to microvascular complications, and several protective factors have been identified. the prevalence of t1d in china is extremely low compared to that in the western world, and little is known about the characteristics of patients with long-term t1d in china. therefore, this study is designed to collect variable clinical and laboratory features of patients with long-term t1d, explore the risk and protective factors for the development of microvascular complications, and provide reference for the prediction and prevention of these complications.

this is a single-center, prospective, observational study. the investigators propose to enroll 400 patients with type 1 diabetes (t1d) ≥10 years. the patients will be followed up annually for 3 years. in order to ensure high quality data, two staff are responsible for the input of original data into the database to check and confirm the accuracy. when the data entered by two people is inconsistent, the auxiliary staff decides which data to use. missing data will be filled in with the multiple imputation method. the regression analysis will be used to explore the risk and protective factors for the development and progression of microvascular complications.

Eligibility criteria:
inclusion criteria: * individuals diagnosed with type 1 diabetes(t1d) according to the 1999 world health organization report * insulin dependence from disease onset * with t1d duration of ≥10 years * able to understand the procedures and methods of this study, voluntarily participate in the study, and agree to sign the informed consent form exclusion criteria: * patients with type 2 diabetes, gestational diabetes, or specific types of diabetes * patients with mental disability or have any other condition or disease that may hamper compliance with the protocol
randomised controlled treatment study of selective mutism

Conditions: Selective Mutism

Summary: selective mutism (sm) describes inhibited and withdrawn children who are persistently mute in central situations despite ability to talk. sm may cause great suffering and create problems, both socially and related to learning. sm is associated with social anxiety, neurodevelopmental delay and bilingualism. the prevalence is about .7-8 ‰. adequate assessment and treatment of sm is seldom provided in the mental health services. sm is considered hard to treat, and randomised treatment studies are lacking. this study will examine the effect of a manual based treatment for sm. the treatment consists of home- and kindergarten /school based interventions including behaviour techniques and psychoeducation. defocused communication is a general treatment principle. comorbidity, including neurodevelopmental delay /disorder, and predictors of outcome, will be examined. a pilot study was conducted to ensure the feasibility of the planned effectiveness study. seven children, aged 3-5 years were included. six has started treatment, and all talked in the kinder garden within the first 3 months. the present study will have a randomised controlled design with 1. manual based intervention for 6 months compared to 2. waiting list controls (3 months), and then manual based intervention. the sample: children aged 3-9 years consecutively referred to the school psychology- or the mental health services in oslo and eastern norway. expected n = 24 based on the pilot study, is a sufficient sample size to answer our primary research question. the treatment will be given by a therapist from the research group or by a local clinician under supervision. the study can add essential knowledge on treatment of sm and make effective treatment available to clinicians in the community.


Eligibility criteria:
inclusion criteria: * children from eastern \& southern norway will be included if they fulfill the diagnostic criteria for sm exclusion criteria: * children with sm and mental retardation with iq below 50. * children with sm and psychosis or pervasive developmental disorders with the exception of asperger syndrome and pdd nos (dsm-iv) * children with sm who receive an active treatment for sm in the camhs * children with sm who are medicated for social anxiety. * children with sm where the parents do not understand norwegian.

Keywords: selective mutism intervention
comparative pharmacokinetic trial of rgb-03 and mabthera

Conditions: Rheumatoid Arthritis

Summary: pharmacokinetic properties, efficacy, safety and tolerability of rgb-03 and mabthera will be compared in patients suffering from rheumatoid arthritis.


Eligibility criteria:
inclusion criteria: * active rheumatoid arthritis * inadequate response or intolerance to other dmards and anti-tnfs * treatment with methotrexate exclusion criteria: * previous treatment with rituximab * patients with systemic manifestations of rheumatoid arthritis * patients seropositive for hiv, hcv, hbv * female patients nursing other protocol-defined inclusion/exclusion criteria may apply.
therapeutic and dietary effects of the sublimated mare's milk supplement in patients with non-alcoholic steatohepatitis

Conditions: Non-alcoholic Steatohepatitis

Summary: this study evaluates the dietary and therapeutic effect of supplement consisting of sublimated mare milk among patients with non-alcoholic steatohepatitis.

nonalcoholic steatohepatitis (nash) is characterized by the liver damage in the form of fatty degeneration and hepatitis in people who do not abuse alcohol. the disease often develops in middle-aged women with excessive body weight, increased blood glucose and blood lipids, but can occur in all age groups and in both sexes. in most cases, the disease is asymptomatic. laboratory data indicate an increase in the level of aminotransaminases. ultrasound reveals hyperechoic tissue of the liver due to diffuse fatty infiltration. the degree of steatosis can also be estimated by a controlled attenuation parameter (cap - controlled attenuation parameter) in the fibroelastometry of liver tissue. it is also possible to verify the degree of fibrosis of liver tissue in its presence. given that the mare's milk has therapeutic and dietary properties for various diseases of the internal organs, including liver diseases, the investigators decided to study its therapeutic effectiveness in nash. in this clinical study, the effectiveness of mare's milk in nash will be studied in comparison with control groups taking monotherapy with ursodeoxycholic acid (udca) and combined therapy (mare's milk and udca). patients will receive a sublimated form of mare's milk in the appropriate dosage within 2 months, and the results of clinical laboratory and instrumental studies will be compared among themselves using statistical methods.

Eligibility criteria:
inclusion criteria: * patients with a verified diagnosis of non-alcoholic steatohepatitis; * aged 16 to 60 years; * absence of an allergic reaction to dairy products; * willingness to consent to participate in the study. * consent to adhere to treatment exclusion criteria: * taking antibiotics, cytostatics and steroids during the last 3 months; * taking alcohol hepatotoxic doses (no more than 30 g alcohol per day for men and not more than 20 g for women); * history of oncological diseases; * presence of diabetes mellitus, decompensated forms of diseases, intestinal dyspepsia, hypertension (blood pressure 140/90 mm hg and more at the time of the initial visit to the doctor), tuberculosis; * a positive result of screening for antibodies to viral hepatitis b, c and d, as well as hiv * presence of concomitant diseases of the kidneys, liver, cardiovascular, respiratory and other body systems, oncological, mental health and decompensated endocrine diseases, tuberculosis, and hiv infection; * pregnancy and/or lactation; * patient involvement in other clinical trials within the last 3 months; * refusal to participate in the study.

Keywords: non-alcoholic steatohepatitis mare milk immune markers
levetiracetam in post-traumatic stress disorder

Conditions: Post-Traumatic Stress Disorder

Summary: the purpose of this study is to evaluate the short-term efficacy and safety of levetiracetam in post-traumatic stress disorder (ptsd) and to evaluate continuation effects of levetiracetam in preventing ptsd relapse. the hypothesis is that levetiracetam will be safe and effective in preventing relapse of ptsd.

this is an investigator-initiated, single site study, consisting of two phases: 8 weeks of open label treatment with levetiracetam (500-2000 mg/day) in patients with ptsd, and in those who demonstrate at least minimal improvement, 12 weeks of randomized, double-blind treatment with either levetiracetam or matching placebo.

Eligibility criteria:
inclusion criteria: * ages 18-65 * primary diagnosis of ptsd based on dsm-iv criteria and assessed by the mini international neuropsychiatric interview (mini) * davidson trauma scale (dts) score of at least 40 on screening * ability to provide written informed consent exclusion criteria: * any primary dsm-iv axis i disorder other than ptsd * substance abuse during the last 6 months * a clinically unstable medical condition or clinically significant laboratory abnormalities * suicide risk or serious suicide attempt during the last year * concurrent use of psychotropic medications including benzodiazepines, barbiturates, antiepileptic drugs, antidepressants, buspirone, dietary supplements or herbal or homeopathic remedies with psychotropic effects * recent (within the last 3 months) initiation of cognitive behavioral therapy * failure of a previous trial of levetiracetam at 2000 mg/day * pregnancy or lactation * women of childbearing potential who are unwilling to practice an acceptable method of contraception

Keywords: ptsd anxiety pharmacotherapy levetiracetam relapse prevention
trivandrum breast cancer screening trial

Conditions: Breast Cancer

Summary: cluster-randomized controlled trial in trivandrum district, kerala, india to evaluate the effect of triennial screening for breast cancer using clinical breast examination on breast cancer mortality.

the study population consisted of 274 administrative regions (clusters) in trivandrum district, kerala, southern indian. 133 clusters were randomly assigned to the intervention arm (3 rounds of clinical breast examination conducted 3 years apart) and were compared to the remaining 141 clusters assigned to a control arm that received standard of care. the eligibility criteria were all healthy subjects aged 30 to 69, without a personal history of breast cancer. informed consent was signed by each participant. the intervention arm consisted of 55,843 participants and the control group consisted of 59,447 participants.

Eligibility criteria:
inclusion criteria: * residing in 274 study clusters in trivandrum city, kerala exclusion criteria: * diagnosis with breast cancer prior to study * bedridden subjects * subjects suffering from open tuberculosis or other debilitating diseases
optic nerve sheath diameter in hypertensive emergency

Conditions: Hypertensive Emergency; Papilledema; Hypertension

Summary: this prospective observational study investigates the potential of point-of-care ultrasonography of the optic nerve sheath diameter (onsd) to rule out papilledema in patients with suspected hypertensive emergency. the primary focus is on assessing onsd sensitivity in identifying papilledema (hypertensive retinopathy grade 4), while secondary endpoints include hypertensive retinopathy grade 3, hypertensive encephalopathy, and the need for intravenous rapid-acting medications to lower elevated blood pressure. this study aims to determine the diagnostic characteristics of this procedure for the diagnosis of hypertensive retinopathy, thus assessing its potential as a screening tool to rule out hypertensive retinopathy by the acute internal medicine doctor.


Eligibility criteria:
inclusion criteria: * ≥ 18 years old * any patient presenting to the emergency department (ed) with suspected hypertensive emergency i.e.: blood pressure of \> 200 millimetres of mercury (mmhg) systolic and/or \> 120 mmhg diastolic exclusion criteria: * patients with preexisting optic nerve head changes such as glaucoma, pre-existing retinal artery/vein occlusions or any other condition that makes assessment of the fundi impossible. * primary neurological cause of hypertension: ischemic cerebrovascular incident
ppi guided strategies for prevention and treatment of intraoperative hypotension

Conditions: Intraoperative Hypotension

Summary: intraoperative hypotension is closely related to the poor prognosis of surgery. the study is focused on the effectiveness of maintaining normal peripheral perfusion index (ppi) on time-weighted average of hypotension during anesthesia.

intraoperative hypotension is closely related to the poor prognosis of surgery. hypotension decreased blood flow perfusion of organs, which lead to dysfunction of multiple organs, especially increasing serious complications such as cardio-cerebrovascular events and acute renal injury within 30 days after surgery. the aim of this study is to establish a set of strategies that can effectively prevent and treat intraoperative hypotension, so as to alleviate possible harm to patients from perioperative hypotension. the study is focused on the effectiveness of maintaining normal peripheral perfusion index (ppi) on time-weighted average of hypotension during anesthesia. the lower target mean arterial pressure (map) was higher than 65 mmhg. map less than 65 mmhg was defined as intraoperative hypotension between induction and tracheal extubation.

Eligibility criteria:
inclusion criteria: 65 years and older asa physical status 1-3 general anesthesia arterial catheterization procedures last more than 2 hours communicate normally in mandarin exclusion criteria: abnormal allen's test higher target than 65 mmhg history of diabetes vascular diseases arrhythmia cardiac function class ii and above physical disability, unable to conduct ppi monitoring participated in other clinical studies in the past month

Keywords: intraoperative hypotension peripheral perfusion indexi general anesthesia non-cardiac surgery