Kornimate/medical-research-clean huggingface dataset:
use of rituximab treatment in addition to standard care for newly presenting thrombotic thrombocytopenic purpura

Conditions: Thrombotic Thrombocytopenic Purpura

Summary: the purpose is to evaluate safety and feasibility of the use of rituximab as an adjunct to standard therapy (plasmapheresis + steroids) for patients with thrombotic thrombocytopenic purpura (ttp). this includes evaluating the rate and type of treatment failure.

with this study we hope to evaluate safety and feasibility of the use of rituximab as an adjunct to standard therapy (plasmapheresis + steroids) for patients with thrombotic thrombocytopenic purpura (ttp). this includes evaluating the rate and type of treatment failure.

Eligibility criteria:
inclusion criteria: patients will be included in the trial based on the following criteria: * patients must have ttp with platelet count \< 100,000/ml and microangiopathic hemolytic anemia which is defined as presence of at 3-10 fragmented red blood cells (schistocytes) per high power filed on the peripheral blood smear. * either gender, age 17 or older * men and women of reproductive potential must agree to use an acceptable method of birth control during treatment and for six months after completion of treatment. * ttp not related to underlying cancer, treatment of cancer or transplantation * new onset ttp, or previously diagnosed ttp with an unmaintained remission for \>12 months. * ldh \>2x upper limit of normal * prothrombin time (pt), partial thromboplastin time (ptt) normal * direct antiglobulin test (dat) negative * subject has provided written informed consent * patients who have received up to 3 plasmapheresis. exclusion criteria: patients will be excluded from the trial based on the following criteria: * a diagnosis of aids. patients with hiv infection with absolute cd4 counts \>200/ul and no active, significant opportunistic infection are eligible * patients with a known hepatitis c infection (hcv) and/or with hepatitis b * patients receiving pheresis more than once a day * recent (within 1 year) bone marrow or hematopoietic stem cell transplant * patient is on calcineurin inhibitors, or is unable to come off them * acute or chronic disseminated intravascular coagulation (dic), defined by d-dimers \>8mg/ml and fibrinogen \< 100 mg (0.1g)/dl * a diagnosis of metastatic or non-metastatic malignancy other than basal cell carcinoma. * malignant hypertension (systolic blood pressure \[bp\] \> 200 mm hg or a diastolic bp \> 130 mm hg) * pregnancy (a negative serum pregnancy test should be performed for all women of childbearing potential within 7 days of treatment). eligibility resumes 3 days after delivery * patients with family history of or a previous diagnosis of congenital ttp * patients with hemolytic uremic syndrome (hus) * patients with sepsis

Keywords: thrombotic thrombocytopenic purpura ttp hematology
show me how you move and i will tell you who you are

Conditions: Vestibular Disease; Vestibular Function Disorder

Summary: the aim of this experiment is to gain a better understanding of the body movement patterns of patients with balance disorders (following damage to the vestibular system), as well as their cognitive performance profile. to achieve this, we will need to assess the performance of both patients and healthy subjects with no balance disorders. we will be using a newly-developed artificial intelligence tool to analyze body movement patterns on the basis of participants' videos, and we will also be evaluating participants' performance in a few simple tests of reaction times to image presentations on computer and/or tablet/smartphone. if you agree to take part in this experiment, you will be asked to perform a simple walking exercise in a corridor (filmed and supervised by a physiotherapist) as well as a few objective cognitive measurement tests (reaction time to attentional and vigilance tasks on computer and/or tablet/smartphone) and subjective tests (self-reported questionnaires) requiring around 40 minutes of investigation in total. in the long term, the results of this research will make it easier to assess balance disorders in patients with vestibular pathology, and better quantify any cognitive difficulties they may have.


Eligibility criteria:
for patients : inclusion criteria: * age between 18 and 90 years old. * vestibular loss diagnosed by senior ent doctors with the gold standard ent measures (caloric testing, head impulse test and/or vestibular evoked myogenic potential, ocular and cervical). exclusion criteria: * previous neurological disorders (stroke, dementia, ...) * current medication interfering with the testing (reducing reaction time). * visual difficulties interfering with the testing (visual field reduction,...) * age below 18 years old. for healthy controls : inclusion criteria : - age between 18 and 90 years old. exclusion criteria: * previous neurological disorders (stroke, dementia, ...) * current medication interfering with the testing (reducing reaction time) * visual difficulties interfering with the testing (visual field reduction,...) * vertigo or balance complains or an history of previous vestibular disorder. * age below 18 years old. * not being able to understand the consigns of the task.
rehabilitation exercise using digital healthcare system in patients with rotator cuff repair

Conditions: Rotator Cuff Tears

Summary: the study aims to examine the effect of short-term rehabilitation exercise support using digital healthcare system (uincare homeplus) in the patients with rotator cuff repair surgery. the study is a two-arm prospective randomized controlled study comparing the effect of rehabilitation exercise digital healthcare system at home with conventional brochure-based home exercise. simple shoulder test (sst), pain (using numerical rating scale), shoulder range of motion (rom), disability of arm, shoulder and hand (dash), shoulder pain and disability index (spadi), quality of life using eq-5d will be evaluation on enrollment, 6-weeks, 12-weeks and 24-weeks after enrollment.

rotator cuff tear is one of the most common disorders affecting shoulder pain and disabilities of daily life. it is a disorder that can be caused by trauma, overuse, inappropriate usage of shoulder as well as degenerative change, which is increasing due to enlarged geriatric population. current method of post-operative rehabilitation is home-based self rehabilitation using brochure, combined with one or two times of education at the hospital before discharge. patients often find difficulty in doing rehabilitation by themselves at home without supervision which resulted in decreased compliance. with development of technologies using multi-motion sensor and ar(augmented-reality) system, the investigators have developed a digital healthcare system(uincare homeplus) which can supplement patients' rehabilitation at home by giving them proper instructions as well as feedback. in this prospective randomized controlled study, the investigators aimed to compare the efficacy of the newly-developed digital healthcare system with conventional rehabilitation program.

Eligibility criteria:
inclusion criteria: * patient who had rotator cuff repair surgery * patient who is discharged to home after surgery exclusion criteria: * patient who has previous history of shoulder surgery on the affected shoulder * patient who has severe neurological deficit or infection on the affected shoulder * patient who has severe comorbidities (ex: uncontrolled diabetes mellitus or rheumatoid arthritis) that inhibit affected shoulder rehabilitation * patient who cannot participate rehabilitation program

Keywords: rotator cuff repair post-operative rehabilitation digital healthcare system
fibromyalgia and naltrexone: the final study

Conditions: Fibromyalgia

Summary: this study evaluates the effect of low dose naltrexone (ldn) on pain in women with fibromyalgia (fm). the study is designed as a parallel randomized (1:1) double blind, placebo-controlled superiority trial. half of the participants will receive treatment with ldn while the other half will receive treatment with placebo.

low dose naltrexone (ldn) is used widely as off label treatment in patients with fibromyalgia, despite the lack of larger randomized controlled trials (rct) supporting an effect. ldn has antagonistic effect on both opioid receptors and on toll-like receptors in glia cells. mediated via those receptors, ldn can potentially reduce neuroinflammation and induce homeostasis in the endorphin system in patients with fibromyalgia. the aim of the trial is to investigate whether treatment with ldn has a superior effect compared to placebo on pain among female patients with fibromyalgia, evaluated after 12 weeks of treatment. the study is also exploring secondary aims regarding a possible improvement of other fibromyalgia core symptoms and a possible improvement of global assessment, daily functioning and health-related quality of life. among the exploratory secondary objectives are changes in muscle exhaustion, physical fitness, pain sensitivity, inhibition of pain, augmentation of pain, and pro-inflammatory cytokines.

Eligibility criteria:
inclusion criteria: * women aged 18-64 years * understands and writes danish * fulfills the american college of rheumatology 1990 criteria for fibromyalgia * a minimum score of 4 in self-reported average pain during the last 7 days on a 0-10 numeric rating scale at baseline * all fertile women have to use safe anti conception (spiral, birth control pills, contraceptive patch, contraceptive vaginal ring or gestagen injections) for 3 weeks before and 1 week after the trial. if the patients' normal lifestyle includes sexual abstinence, they do not have to use anti conception. instead they can give an oral informed consent, that they will be sexually abstinent during the trial. a woman is considered non-fertile if she is sterilized, hysterectomized, bilateral oophorectomized or is postmenopausal. a woman is considered postmenopausal when vaginal bleeding has been absent for 1 year and is confirmed by measurement of follicle-stimulating hormone. exclusion criteria: * known allergy against naltrexonehydroclorid * pregnancy or breastfeeding. a negative pregnancy test has to be available for all fertile subjects at baseline * use of opioids or nsaids during the 4 weeks before inclusion in the trial * abuse of alcohol or other substances * inflammatory rheumatic diseases * demyelinating diseases * active cancer * liver dysfunction * kidney dysfunction * psychotic diseases * history of suicide attempts * suicide ideation - evaluated using patient health questionnaire-9 (item 9 has to be answered "never")
edentulous sites augmented with collagen matrix or ctg

Conditions: Edentulous Alveolar Ridge

Summary: ridge deformities can complicate prosthetic rehabilitation, especially in situations where optimal esthetic outcomes are desired. simpler, less invasive and predictable treatments are needed in order to obtain soft tissue augmentation at edentulous ridges. autogenous subepithelial connective tissue graft (sctg) has always been regarded as the treatment of choice, but heterologous volume stable collagen matrix (vcmx) is emerging as a reliable alternative. the principal aim of the present rct will be to compare the volumetric buccal soft tissue changes at edentulous areas after augmentation procedure using vcmx or sctg. parameters related to periodontal health at adjacent teeth and patient reported outcomes (proms) will be also assessed as secondary outcomes. proving the non- inferiority of vcmx compared to sctg would provide the specialists and general clinicians with an easier, less invasive and better tolerated technique for soft tissue augmentation at edentulous ridges and for improving aesthetic and cleansability of the prosthetic rehabilitation.


Eligibility criteria:
inclusion criteria: * intercalated mono-edentulous area ridge defects to be rehabilitated with fixed partial bridge * at least 18 years old * at least 6 months from tooth extraction at the study area. exclusion criteria: * systemic diseases which could influence the outcome of the therapy (e.g. uncontrolled diabetes mellitus); * smoking ≥ 10 cigarettes a day; * pregnant or nursing women; * chronic use of corticosteroids or other anti-inflammatory or immune-modulator drugs; * patients who need use of medications affecting bone metabolism or oral mucosa; * presence of a congruous fdp at the edentulous area; * history of soft tissue augmentation surgery in the study area; * active periodontitis * uncompliant patients
project breathe: a culturally tailored mbsr intervention for young adult black men

Conditions: Alcohol Abuse; Substance Abuse; Post Traumatic Stress Disorder

Summary: the purpose of this study is to create a program focused on mindfulness and stress reduction specifically tailored to young adult black males.

project brothers reclaiming emotional awareness, tranquility, healing, and ex-istence (breathe) is a research study to create a program focused on mindfulness and stress reduction specifically tailored to young adult black males (18 to 29 years old) residing in durham, nc and in hartford, ct. the investigators plan to use a mobile app on a cell phone to better understand 'real-time' feedback of experiences of stress due to racism. the investigators are interested in learning about the recruitment and retention of black males participating in mindfulness based practices. the investigators are also interested in receiving feedback about options to modify and scale a mindfulness based stress reduction intervention and its preliminary effects on reducing physical and emotional stress reactions and poor coping mechanisms like marijuana and alcohol use linked to everyday racism and discrimination.

Eligibility criteria:
inclusion criteria: * age: 18-29 * ethnicity: non-hispanic black * gender: male * does not meet the dsm-v criteria for substance use disorder or dependence or severe post-traumatic stress disorder (ptsd); * neighborhood inclusion criteria: must live in a high vaod neighborhood in durham county, nc, or north hartford promise zone, ct and have resided in the selected neighborhood for at least 6 months. exclusion criteria: * non-english speakers, * meet the dsm-v criteria for substance use disorder or dependence or severe post-traumatic stress disorder (ptsd); * women; * men of other racial/ethnic groups; * neighborhood outside of high vaod neighborhood in durham county, nc or north hartford promise zone, ct.

Keywords: black men mindfulness-based stress reduction substance use alcohol use prevention ecological momentary assessment
short acting agents vs long acting in frequent excerbator copd patients

Conditions: Copd

Summary: chronic obstructive pulmonary disease is heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive ,airflow obstruction. there are network meta analysis to compare the efficacy and safety of short acting bronchodilators vs long acting agents in treatment of copd

aim of the work1.to compare efficacy of short acting beta 2 agonists ,short acting antimuscrinic agents and beclomethasone versus long acting beta 2 agonist,short acting antimuscurnic agents and fluticasone.- type of the study: this study is a randomized controlled trail 2.4. 2- study setting: present study will be conducted in chest outpatient clinic chest department assiut university hospital 2.4. 3- study subjects: frequent exacerbator copd patients based on determining the main outcome variable, the estimated minimum required sample size is 80 patients (40 in each group). main outcome variable is difference in dyspnoea scores in frequent exacerbator copd patients receiving long-acting steroids vs. short acting treatment. based on previous systematic review we expected to find significant improvement in long-acting treatment group (large effect size). data will be collected through: patients diagnosed copd by different investigations (history, examinations spirometry) have recurrent exacerbations, some patients receiving short acting beta 2 agonists, short acting anti-muscurnic agents and beclomethasone versus long acting agents and fluticasone then all patients followed using dyspnea scores, ccq, saint george questionnaire which assess heath related quality of life.

Eligibility criteria:
inclusion criteria: * all frequent exacerabator copd patients exclusion criteria: * patients less than 18
sedentary screen time activities on food intake

Conditions: Exogenous Obesity

Summary: the purpose is to investigate the effect of sedentary screen time activities on food intake and subjective appetite in 9- to 14-year old normal weight and overweight/obese girls. the investigators hypothesize that pre-meal exposure to screen time activities for 45 minutes increases subjective appetite and food intake at the next meal. food intake will be measured immediately following screen-time exposure, and subjective appetite measured throughout the study period at 0, 15, 30, 45 and 75 minutes.


Eligibility criteria:
inclusion criteria: * healthy girls with no emotional, behavioral or learning problems exclusion criteria: * boys
renal denervation in patients with chronic heart failure and resynchronization therapy

Conditions: Heart Failure

Summary: chronic heart failure is becoming more and more common disease and activation of sympathetic nervous system plays a crucial role in its development. there is some data allowing to suspect that one of the new treatment methods- renal denervation, also in patients with chronic heart failure may lead to decrease of systemic activity sympathetic nervous system and, as a consequence, to decrease of disease progression. the research hypothesis is whether renal denervation in case of symptomatic heart failure, even the optimal treatment therapy is used (including resynchronization therapy), is contributing to the improvement in parameters of neurohormonal activation, hemodynamics and clinical patient status. the aim of the study is to obtain a new knowledge concerning renal denervation in chronic heart failure, so far only very limited data- mostly case reports- are available in this study area.


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 year 2. heart failure patients nyha class ii - iv 3. implanted resynchronization pacemaker according to current european guidelines at least 6 months earlier 4. symptoms of heart failure even on optimal pharmacological therapy including resynchronization therapy (lack of improvement within dyspnoea and exercise tolerance after the procedure) 5. left ventricular ejection function ≤ 35% 6. glomerular filtration rate (egfr according to mdrd formula ≥ 30 ml/min/1.73m2) 7. patient informed consent for participation in the study exclusion criteria: 1. renal artery anatomy not eligible for denervation (at least 4 mm diameter, 20 mm in length) 2. history of prior renal artery intervention 3. single functioning kidney 4. clinic systolic bp \< 110mmhg 5. pregnancy 6. acute coronary syndrome or cerebrovascular event within last 3 months 7. serious medical conditions which may adversely affect safety- clinically significant peripheral vascular disease, abdominal aortic aneurysm, bleeding disorders (thrombocytopenia, hemophilia, or significant anemia)

Keywords: renal denervation
effectiveness of home programs after lumbar spinal decompression surgery

Conditions: Lumbar Spine Disease

Summary: the study will be conducted with volunteer patients who are followed up by bursa çekirge state hospital cekirge state hospital neurosurgery outpatient clinic and who have undergone lumbar decompression surgery and who meet the study criteria. the cases will be divided into 2 groups by randomization software. the control group will receive post-operative exercise training and will be encouraged to move. the study group will receive a core stabilization program in addition to education via telerehabilitation. the first evaluation will be performed 2 months post-operatively and the second evaluation will be performed 2 months after treatment.


Eligibility criteria:
inclusion criteria: * having undergone lumbar decompression surgery without fusion and 2 months of history * participate in all necessary follow-up assessments * being between 18-65 years old * understand simple commands * signing the consent form exclusion criteria: * presence of a previous spinal fusion surgery * presence of malignancy * having undergone spine surgery before * have any other orthopedic or neurological problem that may affect treatment and assessments * situations that prevent communication * lack of cooperation during the study
investigation of the effect of distention medium temperature on image quality, hyponatremia risk, and post-operative pain in operative hysteroscopy

Conditions: Post-operative Pain

Summary: minimally invasive applications are seen as the gold standard in today's gynecology practice and are frequently preferred by both patients and physicians. less pain, shorter hospital stays, and better cosmetic results brought about by minimally invasive applications further increase their preference. one of these approaches is hysteroscopic interventions. although hysteroscopy is a well-defined method, current research has focused on further reduction of pain. one of these methods is to warm the distention media at body temperature. thetaim of this study was to examine the effect of distention medium temperature on image quality, hyponatremia risk, and post-operative pain in operative hysteroscopy.

minimally invasive applications are seen as the gold standard in today's gynecology practice and are frequently preferred by both patients and physicians. less pain, shorter hospital stays, and better cosmetic results brought about by minimally invasive applications further increase their preference. one of these approaches is hysteroscopic interventions. although hysteroscopy is a well-defined method, current research has focused on further reduction of pain. one of these methods is to warm the distention media at body temperature. the optimum distention medium temperature has not been determined in the "best practice in outpatient hysteroscopy green top guideline" organized by the royal college of obstetricians and gynecologists and "guideline on management of fluid distension media in operative hysteroscopy" organized by the european society of gynecological endoscopy. in routine practice, some physicians use distention fluid at room temperature, while others use it by warming it at body temperature. it is known that colder fluids cause irregular contractions in the uterus. in prospective studies, the effects of heating distention media at body temperature on pain were reported inconsistently. as clear data could not be obtained, the risk of further intravasation and hyponatremia that may occur with the image quality and, more importantly, the heating of the fluid was ignored. but; freitas fonseca et al. in his in vitro study in brazil, it was shown by theoretical calculations that heating hysteroscopy irrigation fluids from 270c to 370c increased intravasation by 53%. in light of the literature, and based on the ideas and possible risks in question, the aim of this study was to examine the effect of distention medium temperature on image quality, hyponatremia risk, and post-operative pain in operative hysteroscopy.

Eligibility criteria:
inclusion criteria: * to be planned for operative hysteroscopy due to an endometrial polyp or type 0-1 myoma in the range of 2-3 cm * having a vaginal delivery at least once before * ability to communicate adequately in turkish or english exclusion criteria: * pregnancy * active vaginal, and cervical infection

Keywords: hysteroscopy