Kornimate/medical-research-clean huggingface dataset:
transcutaneous electrical stimulation & sinoatrial node function

Conditions: Electricity; Effects; Heart Arrhythmia

Summary: transcutaneous electrical stimulation (tes) is used in clinical practice to diagnose or treat a diverse range of medical conditions for over a century. although the benefits of tes are well known, its potential side effects on the heart have not been convincingly clarified. this study will test whether tes has any effect on the sinoatrial node (san).

it was hypothesized that: 1) tes has effects indirectly via peripheral afferents or directly on the san, and 2) tes causes a change in the r-r interval (hrv). the aim of this study was to test these hypotheses. this research protocol will have three phases: first, the effect of a single electrical pulse on heart rate variability (hrv) will be examined in experiment i. the effects of conventional tens and acupuncture-like tens on hrv will be also investigated in experiment ii. finally, the effect of time and rest on the hrv will be tested in experiment iii. subjects will be in a sitting position with 90-degree flexion at the elbow and supination of the hand during electrical stimulation. a pair of square (4 x 4 cm), self-adhesive, pre-gelled skin electrodes will be used for stimulation. the electrodes will be placed over the flexor aspect of the right forearm. three-lead electrocardiogram (ecg) recording will be obtained to determine the change of hrv during rest and electrical stimulation sessions. the participant's ecg data will be continuously captured by noninvasive sensors \[self-adhesive pre-gelled ag/agcl surface electromyography (semg) electrodes, redline® istanbul, türkiye\] transmitted through a data acquisition system. the main outcome variable is the heart rhythm. in this context, electrical stimulus-related qrs wave and rr interval change (heart rate variability) will be examined. the possible direct effect of an electrical stimulus on the appearance of the qrs wave will be investigated in the time domain using the peristimulus time histogram and the waveform average technique. ecg data will be analyzed using a software package (cambridge electronic designs, cambridge, uk).

Eligibility criteria:
inclusion criteria: * healthy young adult volunteer exclusion criteria: * pregnancy * alcohol or drug abuse, * any medication with potential effects on the cardiovascular system

Keywords: transcutaneous electrical nerve stimulation neuromuscular electrical stimulation heart rhythm heart rate variability
combined effects of autogenic drainage and segmental breathing techniques in chronic obstructive pulmonary disease

Conditions: Chronic Obstructive Pulmonary Disease

Summary: chronic obstructive pulmonary disease is one of the most common life threatening disease affecting population. it is a preventable and treatable lung disease. people with copd must work harder to breathe, which can lead to shortness of breath and/or feeling tired. autogenic drainage (ad) works by adapting your breathing and maximizing airflow within the airways to improve ventilation and clear sputum. segmental breathing, also referred to as localized expansion breathing, is the exercise used to improve ventilation and oxygenation. this research of randomized controlled trial will check the combined effects of segmental breathing technique and autogenic drainage technique in chronic obstructive pulmonary disease by taking sample of 40 patients through non probability convenient sampling and randomly allocating them into two groups a and b out of which a will receive both autogenic drainage and segmental breathing technique, b will receive autogenic drainage only for upto the duration of 3 days per week(20-45 min) for upto 4 weeks.pre and post training outcomes will be measured through pulse oximeter,spirometer and bcss.the data will be analyzed through spss 25.


Eligibility criteria:
inclusion criteria: * age between 40 - 60 years. * diagnosed moderate copd patients according to gold criteria. * fev / fvc ratio \< 70 years * stable patients can understand written and oral english,urdu trial information. exclusion criteria: * pregnancy, due to the pressure on pelvic and abdomen muscles. * malignant disease * severe (ra) * diagnosis of asthma and major diseases, functionally limiting diseases, life expectancy \< 3 months. * neurological disorders

Keywords: autogenic drainage, segmental breathing technique chronic obstructive pulmonary disease.
breath test for biomarkers in humans receiving total body irradiation

Conditions: Radiation Injury

Summary: the effect of radiation on normal tissue varies widely between individuals. consequently, a test to measure tissue response to radiation could be clinically useful by permitting more accurate titration of dosage in patients undergoing radiotherapy. also, in view of emerging concerns about possible nuclear terrorism a test for exposure to radiation might also be useful in evaluating victims of a "dirty bomb" explosion. a number of different techniques have been previously reported in epidemiological studies for the estimation of prior radiation exposure. this study explores one approach to estimating radiation exposure by measurement of increased oxidative stress which can be detected by a breath test. in this study subjects undergoing significant exposure to therapeutic radiation will provide breath samples for analysis in a central laboratory. the hypothesis of the study is that the analysis of these samples will lead to the identification of a set of markers of radiation exposure.


Eligibility criteria:
inclusion criteria: 1. age 18 years or older 2. subject is willing and able to cooperate with study and give signed informed consent to participate 3. subject has been diagnosed with a condition that requires treatment with a tbi protocol of daily irradiation for one to five days 4. actively smoking subjects, as well as never smokers and former smokers are eligible for the study so long as a complete smoking consumption history can be recorded 5. subject will be available for follow-up breath tests following each session of tbi. subjects receiving only one day of tbi will be available for a follow-up 24-36 hours following tbi 6. subject is an in-patient at the hospital exclusion criteria: 1. subject has had chemotherapy within preceding 21 days

Keywords: breath test volatile organic compounds voc oxidative stress radiation biodosimetry metabolomics gcxgc tof-ms
routine early vs delayed amniotomy for preterm pregnancies: a randomized open label trial

Conditions: Labor, Premature

Summary: to compare the duration of preterm induction of labor in women undergoing early vs. late or no artificial rupture of membranes (arom). maternal and neonatal outcomes will also be compared between the two groups.

women presenting with a preterm singleton pregnancy between 28.0 and 36.6 weeks of gestation with cephalic lie and a medical indication for induction of labor will be approached for this study. the patient/provider must be attempting induction with the goal of vaginal delivery. women with ruptured membranes, suspected intrauterine infection, prior uterine scar, fetal demise, or a fetal anomaly will be excluded. women that agree to the study will be randomized to 2 groups: the "early amniotomy" group and the "late amniotomy" group. women in the early amniotomy group will undergo artificial rupture of membranes (arom) prior to reaching cervical dilation of 4 cm. women in the late amniotomy group may not undergo arom until they reach cervical dilation of greater than 4 cm or they have been on an oxytocin drip for greater than 10 hours with no cervical change. it is possible that a woman in the late amniotomy group will not undergo arom at all. the primary outcome under consideration is time in labor. secondary outcomes include rates of chorioamnionitis, postpartum endometritis, mode of delivery, and neonatal outcomes.

Eligibility criteria:
inclusion criteria: * preterm singleton pregnancy between 28.0 and 36.6 completed weeks of gestation * fetus in the cephalic position * intent to induce labor for vaginal delivery * if cervical ripening is planned, patient must be enrolled within an hour of initiation of ripening. if no ripening is planned, enrollment must be complete prior to starting induction. exclusion criteria: * preterm premature rupture of membranes (pprom) * fever or suspected chorioamnionitis prior to start of iol * prior uterine scar * infection with hiv/hepatitis b virus (hbv)/hepatitis c virus (hcv) or an active herpes simplex virus (hsv) infection * intrauterine fetal demise * major fetal anomaly * cervical dilation \> 4 cm

Keywords: pregnancy labor induction preterm
oxaliplatin, 5-fu and leucovorin in combination with oral capecitabine for metastatic colorectal cancer

Conditions: Metastatic Colorectal Cancer

Summary: the combination of oxaliplatin, 5-fu, leucovorin, and capecitabine is hypothesized to retain and potentially improve upon the activity of the folfox regimens. additionally, the use of an oral rather than an infusional 5-fu regimen represents a clear advantage in terms of both patient convenience and lack of associated catheter-related complications.


Eligibility criteria:
inclusion criteria: * no prior treatment for metastatic disease * ps 0-2 * measurable disease exclusion criteria: * neuropathy \> or equal to grade 2 * concomitant radiation therapy or other systemic cancer therapies * brain mets
50% nitrous oxide and 50% oxygen (meopa) conscious sedation versus placebo in fiberoptic bronchoscopy

Conditions: Fiberoptic Bronchoscopy

Summary: fiberoptic bronchoscopy may generate pain, anxiety or cough and dyspnea. it may then induce discomfort and then run down its yield. systematic local anaesthesia does not always suffice and fob may be conducted under general anaesthesia. premixed nitrous oxide and oxygen (meopa) could be efficient to avoid general anesthesia risks and to reduce organizational costs. nitrous oxide induces anaelgesia and anxiolysis when administered in oxygen at a 50% concentration. meopa is being delivered in france for every short painful medical in-patients procedure since 2001. at a concentration of 50% in oxygen, and delivered through a facial mask, it produces a conscious sedation useful during endoscopy. meopa safety is due to its short term effect, which ends 5 minutes after cessation of inhalation. it therefore allows ambulatory medicine. two randomized double blind controlled studies were driven in fiberoptic bronchoscopy (fauroux 2004, atassi 2005) and showed its efficacy on pain control and sedation. we will perform our study to estimate meopa efficacy in term of pain control (visual analogic scale (vas)), anxiety control (covi scale), cough and number of general anaesthesias, comparing fob under meopa and oxygen (double blind, randomized, placebo-controlled study.


Eligibility criteria:
inclusion criteria: * man or woman over 18 who should undergo a fiberoptic bronchoscopy (inpatient and outpatient) exclusion criteria: * child under 18 * pneumothorax * ocular surgery in the previous 3 months, * intracranial overpressure * lucidity impairment * emphysema bullae * face trauma * angina pectoris * hemodynamic instability * acute respiratory distress * hypercapnia \> 45 mm hg * pregnancy * lidocaine allergia * lack of approuval from the patient to perform the study will of the patient to undergo fob with premixed nitrous oxide-oxygen

Keywords: anxiety cough number of general anaesthesias (due to procedure failure) patients satisfaction chest physician satisfaction
effectiveness of night administration of low dose aspirin in hypertensive patients

Conditions: Hypertension

Summary: the goal is to investigate in patients with high blood pressure, bp, namely, those with systolic blood pressure and diastolic blood pressure, sbp/dbp higher than or equal to 140/90 mmhg, and high cardiovascular risk, under treatment with low-dose acetylsalicylic acid, asa, whether changing the time they take the drug (same dose) to bedtime (from taking it at some point during the active part of the day) produces a drop in their blood pressure (mean systolic and diastolic over 24 hours) of at least 2.5 mm hg; and also whether among non-dippers, under secondary treatment with low-dose asa, there is be a greater decrease in their night bp when the drug is taken in the evening.


Eligibility criteria:
inclusion criteria: * hypertensive patients (≥140/90) * patients from 18 to 80 years old * patients are currently taking low doses of asa during the day, for secondary prevention of cardiovascular events * patients have been stable for at least one month with their current antihypertensive and antiplatelet therapy. exclusion criteria: * severe and/or terminal illness * moderate/severe congestive heart failure (chf), new york heart association, nyha stage ≥ iii * moderate/severe chronic renal failure glomerular filtration rate \<45ml/min. * physical or mental illness that prevents the patient´s collaboration * being a heavy drinker, consuming more than 280 g of alcohol per week in the case of men or 170 g for women31 * concomitant treatment with other antiplatelets or anticoagulants * taking nonsteroidal antiinflammatory drugs, nsaids, on a regular basis * treatment with asa at doses outside those established in the inclusion criteria (above) * asa already being taken in the evening * being a shift worker or having a very intensive work schedule * hospital admission during the clinical trial * changes being made in the antihypertensive and antiplatelet therapy taken by the patient during the seven months of the trial * patients with unstable treatment or clinical condition requiring frequent adjustments thereof. * compliance with less than 90% of the doses, both those for daytime and those for evening administration

Keywords: low dose aspirin asa hypertension blood pressure
art - alveolar recruitment for acute respiratory distress syndrome trial

Conditions: Respiratory Distress Syndrome, Adult

Summary: acute respiratory distress syndrome (ards) is a common scenario in intensive care unit. discussions about it is exponentially growing up due its high mortality rates all over the world and low quality of life among survivors. mechanical ventilation is recognized to play an important role in treatment of patients with ards. however, mechanical ventilation itself has the potential to produce or worsen alveolar injury if inadequate strategies are chosen. several studies compared different mechanical ventilation strategies in ards but the results remain uncertain regarding their influence on survival in patients with ards. thus, this is a multicentric randomized controlled trial, with allocation concealment and intention to treat analysis to investigate if maximum alveolar recruitment maneuver in association to positive end-expiratory pressure (peep) titrated by static compliance of respiratory system (art strategy) is able to increase 28 days survival in patients with moderate to severe ards compared to conventional strategy proposed by the ards clinical network (ardsnet strategy). patients considered to this trial are those in mechanical ventilation with diagnosis of moderate to severe ards less than 72hours. patients included will be randomized to receive art strategy or ardsnet strategy and will be followed until hospital discharge, 28 days and 6 months.


Eligibility criteria:
inclusion criteria: * intubated, mechanically ventilated patients with diagnosis of moderate to severe ards less than 72 hours exclusion criteria: * age less than 18 years * use of vasopressor drugs in increasing doses over the last 2 hours or mean arterial blood pressure less than 65mmhg * presence of any contraindication to hypercapnia as intracranial hypertension or acute coronary syndrome * pneumothorax, pneumomediastinum, subcutaneous emphysema or pneumatocele * patient with no therapeutic perspective, candidates for palliative care exclusively * patient previously randomized in the art

Keywords: respiratory distress syndrome, adult randomized controlled trial respiration, artificial
design and verification of individualized smart assistive devices for stroke rehabilitation

Conditions: Stroke

Summary: this study aims to design and verify a multi-mode smart assistive device system for stroke rehabilitation by using eeg, fmri, imu and questioners


Eligibility criteria:
inclusion criteria: * the first time hemiparetic stroke; * diagnosis confirmed by a physician on the basis of the findings of neurological examinations and brain imaging (magnetic resonance imaging or computed tomography scan); * aged between 20 and 85 years; * brunnstrom's stage ii to v over the proximal and distal part of the upper extremity on the affected side; * no cognitive dysfunction, measured by the mini-mental state exam (≧24; suggested by 36 with respect to age and educational level) * willing/able to participate and having signed an informed consent form. exclusion criteria: * unstable vital sign * irreversible contracture over any of the joints of the affected upper extremity * history of surgery, fracture, arthritis, pain, or any other complications that might influence the recovery of upper extremity function like aphasia, apraxia and neglect; * having spasticity, as measured using the modified ashworth scale (score \> 2); * poststroke seizure; * heart attack within 3 months poststroke; cortical lesions in any of the five core motor areas of interest, including the bilateral m1, the bilateral pm, and the sma.

Keywords: stroke rehabilitation
strategies of therapy with the exoskeleton robot armin

Conditions: Stroke

Summary: neurological patients (e.g., after stroke) need long-term neurorehabilitation therapy of the arm with often limited, unsatisfactory outcome. robots became a promising supplement or even alternative for neurorehabilitation training.

the exoskeleton robot armin was further developed and software components adapted accordingly to offer a unique intensified and patient-tailored robot-aided training of the arm. the goal is to enhance treatment efficacy to an extent that the improvement in motor function is meaningful for the individual patient. the study objective is to compare armin therapy and a form of conventional occupational therapy that involves both arms regarding change in motor function.

Eligibility criteria:
inclusion criteria: * - aged ≥18 years * ischemic cerebral vascular accident (cva, stroke) in the sub-acute phase (one to twelve weeks post-stroke) as verified by brain imaging (ct or mri) * inpatient at rehaklinik zihlschlacht, switzerland * decreased arm motor function in one arm with a fma of 8 to 20 points (out of 66) * no excessive spasticity of the affected arm (modified ashworth scale mas ≤3) as assessed by the physician * no serious medical or psychiatric disorder as assessed by the physician * no serious orthopaedic, rheumatologic or other disease restricting movements of the paretic arm as assessed by the physician * no clinically significant shoulder subluxation (palpation \<2 fingers) as assessed by the physician * no skin ulcerations at the paretic arm as assessed by the physician * ability to communicate effectively with the examiner such that the validity of the patient's data could not be compromised as assessed by the physician * no history of cyber sickness (e.g., nausea when looking at a screen or playing computer games) as assessed by the physician * no pacemaker or other implanted electric device as verified by patient record * bodyweight \<120 kg * no serious cognitive defects or aphasia preventing effective use of armin as assessed by the physician
vouchers vs. prizes for methadone patients - 1

Conditions: Substance Abuse

Summary: the purpose of this study is to compare voucher-based contingency management (cm) procedures to a lower-cost cm system that provides opportunities to win prizes. cocaine-dependent outpatients are randomly assigned to (a) standard treatment, (b) standard treatment plus voucher cm for abstinence, defined by negative breath and urinalysis test results, or (c) standard treatment plus prize cm for abstinence, defined by negative breath and urinalysis test results. urine and breath samples are collected 3x/week during weeks 1-3, 2x/week during weeks 4-6 and 1x/week during weeks 7-12. follow-up interviews are conducted 1,3,6 and 9 months following intake during which substance use and psychosocial functioning are assessed.


Eligibility criteria:
inclusion criteria: * age \> 18 years * current dsm-iv diagnosis of cocaine dependence * maintained on a stable dose of methadone for \>1 month * willing to sign informed consent * english speaking exclusion criteria: * serious, uncontrolled psychiatric illness (e.g., acute schizophrenia, bipolar disorder, or substantial suicide risk) on the basis of history or medical examination * dementia (\<23 on the mini mental state exam) * in recovery from pathological gambling as determined by dsm-iv criteria

Keywords: contingency management substance abuse treatment
preventing perinatal depression

Conditions: Perinatal Depression

Summary: the goal of this pilot study is to evaluate the acceptability, feasibility, mechanisms of action, and efficacy of center m. center m is a group-based, mindfulness-based cognitive behavioral therapy (cbt) intervention to treat perinatal depression (pd).

the goal of this pilot study is to evaluate the acceptability, feasibility, mechanisms of action, and efficacy of center m. center m is a group-based, mindfulness-based cognitive behavioral therapy (cbt) intervention to treat perinatal depression (pd). pregnant participants will be surveyed at three time points: pre-intervention, post-intervention, and 6-weeks postpartum. surveys will include self-report measures evaluating depressive symptoms, mindfulness skills, emotion regulation, and participant satisfaction.

Eligibility criteria:
inclusion criteria: * gestational age at intervention onset between 12 and 30 weeks * english fluency * no previous experience in a mindfulness-based intervention group * ability and willingness to participate in a telehealth intervention exclusion criteria: -

Keywords: prenatal care mindfulness-based cognitive behavioral therapy for perinatal depression maternal morbidity maternal mortality
increasing the number of patients receiving information about transition to end-of-life care

Conditions: Palliative Care; Disclosure

Summary: introduction: honest prognostication and information for patients are important parts of end-of-life care. this study examined whether an educational intervention could increase the proportion of patients who received information about the transition to end-of-life care (iteol). method: two municipalities (in charge of nursing homes) and two hospitals were randomized to receive an interactive half-day course about iteol for physicians and nurses. the proportion of patients who received iteol was measured with data from the swedish register of palliative care (srpc). patients were only included if they died an expected death and maintained their ability to express their will until days or hours before their death. four hospitals and four municipalities were assigned controls, matched by hospital size, population, and proportion of patients receiving iteol at baseline.


Eligibility criteria:
inclusion criteria: * hospitals and municipalities: participation in the swedish register of palliative care. * patients: reported from an included hospital or municipality during six months before to six months after intervention. exclusion criteria: * hospitals and municipalities: exclusion criteria were more than 40% patients receiving iteol at start of study, too large for an intervention due to practical reasons (university hospitals or municipalities with over 100 000 inhabitants), and hospitals not containing both internal medicine and surgery departments. * patients were excluded when death was unexpected, when a forensic post mortem examination was performed, or when the patients had lost their ability to express their will and take part in decisions concerning the content of medical care one week or more before death.