Kornimate/medical-research-clean huggingface dataset:
laser-1st vs drops-1st for glaucoma and ocular hypertension

Conditions: Primary Open Angle Glaucoma; Ocular Hypertension

Summary: this is a randomized study with two treatment arms: 'initial selective laser trabeculoplasty (slt) followed by conventional medical therapy as required' ('laser-1st') and 'medical therapy without laser ('medicine-1st'). it compares quality of life in the two arms at three years, while also examining the incremental cost and cost-effectiveness of laser-1st versus medicine-1st.

subjects are randomly allocated to one of two treatment arms that examine treatment pathways, rather than comparing single treatments alone: 'initial selective laser trabeculoplasty (slt) followed by conventional medical therapy as required' ('laser-1st') and 'medical therapy without laser ('medicine-1st'). we compare quality of life in the two pathways (arms) over three years, while also examining the incremental cost and cost-effectiveness of laser-1st versus medicine-1st. a 'treat in pursuit of control' design (tpc) compares two different routes to a pre-defined target intraocular pressure (iop) (pathways). it is a pragmatic study that uses published guidelines to make the complex clinical treatment choices faced in managing glaucoma, standardised between treatment arms by use of computer treatment algorithms. a uk national institute for health and care excellence (nice)-compliant evidence-based iop treatment target 1 is set for each patient, according to the study treatment algorithms. they then proceed through stepped increments of treatment intensity (up to and including surgery) until a predetermined target iop is reached. target iop is reassessed in the light of objective clinical evidence of stability of glaucomatous optic neuropathy (gon) and visual function using visual field tests and automated optic nerve evaluation. health related quality of life (hrql) and secondary outcomes are compared for patients in each pathway.

Eligibility criteria:
inclusion criteria: * diagnosis of open angle glaucoma (defined as an open drainage angle and reproducible glaucomatous visual field defects as tested by the swedish interactive threshold algorithm (sita) algorithm on the humphrey visual field or glaucomatous optic neuropathy) * or * ocular hypertension (intra-ocular pressure above 21mmhg and requiring treatment as per national institute of health and care excellence (nice) guidelines). * able to provide informed consent. exclusion criteria: * advanced glaucoma in the potentially eligible eye as determined by early manifest treatment guidelines (emgt) criteria 77: visual field loss mean deviation worse than -12db in the better or -15db in the worse eye. * secondary glaucoma (e.g. pigment dispersion syndrome, rubeosis, trauma etc) or any angle closure. * any contra-indication to selective laser trabeculoplasty (e.g. unable to sit at the laser-mounted slit-lamp; past history of uveitis). * unable to use topical medical therapy due to e.g. physical infirmity and a lack of carers able to administer daily eye-drops.

Keywords: primary open angle glaucoma glaucoma ocular hypertension poag slt laser
lgcp (laparoscopic greater curvature plication)

Conditions: Obesity

Summary: the aim of this study is to find out the safety and efficacy of laparoscopic greater curvature plication (lgcp) procedure. this study procedure is an alternative restrictive weight loss surgery that has the potential to reduce the complications associated with gastric banding and sleeve gastrectomy by creating a small sized stomach without the use of an implant and without cutting stomach.

study objectives: to demonstrate the safety and efficacy of laparoscopic greater curvature plication (lgcp) design: prospective, open-label, and single center

Eligibility criteria:
inclusion criteria: * subject is at least 18 years of age at the time of enrollment into the study; * have a bmi of at least 30; * subject is willing to give consent and comply with protocol evaluation and treatment schedules; * subject agrees to refrain from any type of weight-loss drug (prescription or oct) or elective procedure that affect body weight for the duration of the trial; and * hba1c\<11% exclusion criteria: * history of previous malabsorptive bariatric procedures; * women of childbearing potential who are pregnant or lactating at the time of screening or at the time of surgery; * any condition which precludes compliance with the study; * history or presence of pre-existing autoimmune connective tissue disease; and * use of prescription or over the counter weight reduction medications or supplements within 30 days of the screening visit or the duration of study participation. this study is a local study (ny, within 50 miles). this study is not a sponsored trial. therefore, the procedure is not free.

Keywords: obesity surgery
dark chocolate, coconut water, and ibuprofen in managing primary dysmenorrhea

Conditions: Dysmenorrhea Primary; Menstrual Pain; Ibuprofen

Summary: dysmenorrhea, the painful condition experienced by women during menstruation, affects a significant proportion of women worldwide and often leads to decreased productivity. various pharmacological and non-pharmacological treatments are available for pain relief, but information on their effectiveness, particularly regarding green coconut water, dark chocolate, and ibuprofen, remains limited. this study aimed to compare the effectiveness of green coconut water, dark chocolate bars, and ibuprofen in reducing the intensity of primary dysmenorrhea. a randomized controlled trial with a quantitative design was conducted, involving 45 participants randomly assigned to receive either 330 ml of green coconut water, 35 grams of 70% dark chocolate, or 400 mg ibuprofen. pain intensity was measured before and after treatment.

dysmenorrhea, commonly known as period pain, is a prevalent condition that affects a large number of women during menstruation, causing discomfort and often leading to reduced productivity. while several treatments are available to alleviate the pain, there is limited information on the comparative effectiveness of different interventions, including green coconut water, dark chocolate, and ibuprofen. this research aimed to conduct a randomized controlled trial to compare the effectiveness of green coconut water, dark chocolate bars, and ibuprofen in managing primary dysmenorrhea. a total of 45 participants were enrolled in the study and randomly assigned to one of three intervention groups: green coconut water, dark chocolate bars, or ibuprofen. the green coconut water group received 330 ml of pure green coconut water, which is known for its potential health benefits and natural electrolyte content. the dark chocolate group received 35 grams of 70% dark chocolate, as some studies have suggested its potential role in pain relief due to the presence of bioactive compounds. the ibuprofen group received 400 mg of the common over-the-counter nonsteroidal anti-inflammatory drug (nsaid) known for its analgesic properties. to assess the effectiveness of each intervention, pain intensity was measured before and after treatment using validated pain scales. the kruskal-wallis test, a non-parametric statistical method, was used to analyze the data and compare the effectiveness of the three interventions.

Eligibility criteria:
inclusion criteria: * women aged between 17 and 24 years * diagnosed with primary dysmenorrhea based on specific characteristics and assessment * willing to refrain from using any pharmacological or non-pharmacological therapies other than the interventions provided by the researcher * willing to participate as respondents exclusion criteria: * allergies to dark chocolate or young coconut water or contraindications to ibuprofen consumption * diagnosed with specific gynecological conditions.

Keywords: dark chocolate young coconut water ibuprofen pain intensity
hepzero:heparin free dialysis with evodial

Conditions: Chronic Kidney Disease; Patients Requiring Heparin Free Dialysis Treatments

Summary: the study hypothesis is that with evodial in patients requiring heparin free dialysis, the heparin free treatment can be performed easily (without saline flushes or blood predilution) and is at least not inferior and maybe superior to the standard care heparin free treatment in terms of clotting.


Eligibility criteria:
inclusion criteria: * patients requiring heparin free dialysis treatments on nephrologists' prescription, * chronic esrd patients treated by maintenance hemodialysis for at least 3 months, * patients with a well functioning blood access that can allow a blood flow of at least 250 ml/min, * patients aged 18 years or more, * written consent to participate in the study (informed consent). exclusion criteria: * patients in icu settings, * aki patients, * patients dialyzed in self care, satellite hd units, * patients treated in single needle mode, * known heparin contraindication (hit type ii), * patients requiring blood and other labile blood products (i.e. fresh frozen plasma, platelets, etc ...) transfusion during hemodialysis treatment, * patients receiving oral anticoagulants (including anti vitamin k), * patients receiving a combination of anti-platelets agents, * patients treated with unfractionated or low molecular weight heparin beside the dialysis treatment to prevent deep vein thrombosis, * pregnant/ planning pregnancy and lactating women during study period, * adult patients protected by the law, * patients are not affiliated to health insurance system (beneficiary or dependant) * participation in other interventional studies during the study period, * patients that have already been included in this study.
expanded access protocol of troriluzole in patients with spinocerebellar ataxia (sca)

Conditions: SCA; Spinocerebellar Ataxias

Summary: the purpose of this expanded access protocol is to provide access to the investigational drug troriluzole in patients with spinocerebellar ataxia (sca).

this is an intermediate-size patient population expanded access protocol designed to provide treatment use of troriluzole to patients with spinocerebellar ataxia (sca) who are considered to be eligible in the clinical judgement of the investigator/treating physician. the population includes both troriluzole naive patients and patients participating in previous clinical trials with troriluzole (bhv4157-201 and bhv4157-206) who have a confirmed diagnosis of spinocerebellar ataxia.

Eligibility criteria:
key inclusion criteria: * patient has a confirmed diagnosis of spinocerebellar ataxia (sca), defined as either clinical evidence supporting diagnosis or confirmed genotypic diagnosis. * adequate hepatic function. key exclusion criteria: * patient is known to have acute or chronic liver disease that is clinically significant in the judgement of the physician. * patient has a history of a clinically significant medical condition that would interfere with the patients ability to comply with the expanded access protocol or would place the patient at increased risk.
vr solace for pain and anxiety using survey and biodata

Conditions: Chronic Pain

Summary: the purpose of this study is to assess the therapeutic response to vr solace in patients with chronic pain and anxiety using real-time clinical and survey data. regression analysis of demographic characteristics, lab and survey data will be conducted to better understand the efficacy of vr solace in treating chronic pain and anxiety. the investigator also aims to explore the possible association between the patient-reported changes in pain or anxiety levels with real-time physiological changes observed during vr solace use.


Eligibility criteria:
inclusion criteria: * age 18+ * endorsing pain/anxiety with objective measurement of 3 or greater on 10-point scale on validated survey * diagnosis with chronic pain/anxiety exclusion criteria: * exclusion of patients that are followed by cl psychiatry team at cedars-sinai medical center to avoid overlap with another ongoing vr study * no active diagnosis of medical conditions that may cause physiological variations in vital signs (i.e. sepsis, cardiogenic shock/arrhythmia) * no active diagnosis of seizures, migraines, severe nausea, severe propensity for motion sickness, or facial/head deformities that would allow for comfortable placement of headset * exclusions of patient currently taking beta blockers * unable to communicate/read english for survey items * unable to use vr independently - patients will be expected to maneuver through questions/steps of the vr system during the session
a nurse-led, advance care planning intervention in the emergency department

Conditions: Emergency Department; Motivational Interviewing; Advance Care Planning

Summary: ed goal is a 6-minute, motivational interviewing, advance care planning intervention. in this study, the investigators will pilot test (part i) ed goal by training research nurses to demonstrate its intervention fidelity and acceptability on older adults with serious illness in the emergency department (ed). upon demonstrating the intervention fidelity of this intervention in part i, the investigators will collect patient-centered outcomes (part ii) of 100 older adults with serious illness after leaving the ed. further in part iii, the investigators will conduct a survey to the participants' outpatient clinicians to find out how to optimize the care coordination from the ed to the outpatient office to facilitate advance care planning conversations.


Eligibility criteria:
part 1. inclusion criteria: * ≥50 years of age and ≥1 serious illness\* or ed clinician would not be surprised if patient died in the next 12 months * english-speaking * capacity to consent exclusion criteria: * acute physical or emotional distress * determined by em physician not to be appropriate * clearly documented goals for medical care\*\* (unless the treating clinician recommends that the patient needs the intervention) * delirium (assessed using 3d-cam) * mild cognitive impairment or dementia (assessed using minicog or sbt) * already enrolled in this study * unable/unwilling to schedule the follow-up outcomes assessment on the calendar. part 2. inclusion criteria: * ≥50 years of age and ≥1 serious illness\* or ed clinician would not be surprised if patient died in the next 12 months * english-speaking * patient with mild cognitive impairment or mild dementia with caregiver has a capacity to consent * caregivers of patients with moderate/severe dementia has a capacity to consent exclusion criteria: * acute physical or emotional distress * determined by em physician not to be appropriate * clearly documented goals for medical care\*\* (unless the treating clinician recommends that the patient needs the intervention) * delirium (assessed using 3d-cam) * already enrolled in this study * unable/unwilling to schedule the follow-up outcomes assessment on the calendar. (\*nyha stage iii/iv congestive heart failure, chronic obstructive lung disease on home oxygen, chronic kidney disease on dialysis, or metastatic solid tumor cancer. in addition, patients with nyha stage i/ii congestive heart failure, chronic obstructive lung disease not on home oxygen, chronic kidney disease not on dialysis, solid tumor cancer without metastasis will be included if recent hospitalization in the last 12 months exists.) (\*\*molst, medical order for life-sustaining treatment.)
impact of intensive outpatient rehabilitation on non-motor patient-reported outcomes in parkinson's disease (intenso)

Conditions: Parkinson Disease

Summary: this historical cohort study aims to evaluate the impact of different intensity rehabilitation protocols on the short and medium-term severity of non-motor symptoms in patients with parkinson's disease. one of the principal strengths of this study is that it is a real-life study, so it has a high external validity necessary to test the clinical effectiveness of these two types of training, which could have significant practical implications for rehabilitation in parkinson's disease.


Eligibility criteria:
inclusion criteria: * adults diagnosed with idiopathic pd, hoehn \& yahr stage ≥ 1 \< 5, consecutive referral to the rehabilitation facility between 1 january 2014 and 31 december 2019 to receive outpatient physiotherapy treatment for the management of motor disability, specifically targeting gait, balance, or posture disorders; * completion of the course of rehabilitation treatment; * availability of non-motor symptom scale and unified parkinson's disease rating scale, recorded before and after treatment and 6 plus or minus 1 months later exclusion criteria: * diagnosis of any primary or secondary parkinsonism rather than pd * symptom onset since less than three years * any concomitant neurological disease (e.g. polyneuropathy, stroke, etc) * any other chronically disabling disease (e.g. severe heart, liver or kidney failure, cancer, psychiatric disorders, limb amputation, severe musculoskeletal or neuropathic pain) * changes in antiparkinsonian drug therapy during the whole study period * exposure to a course of physiotherapy during the 6 months preceding the study

Keywords: parkinson&#39;s disease rehabilitation non-motor symptoms multimodal exercise intensity
selfcare management intervention in heart failure

Conditions: Heart Failure

Summary: a novel tool for self-care enhancement for heart failure (hf) patients has been developed. in this randomized controlled trial, patients will be randomized 1:1 to either receive the home-based tool (optilogg) or standard care. the intervention will go on for 8 months, and outcomes are self-care, cardiovascular events (including emergency visits, admissions, number of in-hospital days).

patients will be recruited using continuous sampling, and will be approached either in connection with being discharged after a heart failure (hf) related event or upon visiting an out-patient hf clinic if the patient has been admitted for hf at least once the last year. after written consent has been given, demographical data will be noted, and the patient will complete forms: the european heart failure self-care behaviour scale 9-item questionnaire (ehfscb-9) and self-assessment of symtoms (nyhaclass). expected time for this is 20 minutes. the baseline demographical data will include age, gender, ejection-fraction, new york heart association (nyha)-class, blood pressure, heart rate, hf aetiology, and other routine tests for hf visits as outlined in the european guidelines for hf treatment. after the patient has filled out the forms, the patient will be randomized to the control group (cg) meaning standard care, or the intervention group (ig). patients allocated to the ig will be equipped with the home based self-care enhancement tool optilogg. optilogg assists the patient with symptom monitoring and flexible diuretics regimen, as well as education about living with hf. it consists of a specialized tablet computer wirelessly connected to a weight scale. optilogg is ce-marked. the intervention will be deployed for eight months. after the eight months, the patients will be called to a follow-up visit. during the visit all data that was collected at baseline/recruitment will be collected again. all cardiovascular events for each patient will be retrieved, for the eight months during which the intervention was deployed, but also for the following 12 months. these events include hospital admissions, er-visits and number of in-hospital days. based off of previous findings in the literature, target for enrollment was set at 70 + 70 patients, to achieve statistical significance with 80% power.

Eligibility criteria:
inclusion criteria: * diagnosed heart failure, international classification of diseases (icd): i50, existing or de-novo, in nyha-class ii-iv * admission for hf within the last 12 months * filled out consent form * expected to be able to use the tool, if allocated to the intervention group exclusion criteria: * decline to participate * more than mild cognitive impairment * expectancy of life \< 8 months * for other reasons deemed inappropriate to be enrolled, e.g. participating in another study affecting standard care
albion "assessment of the best loading dose of clopidogrel to blunt platelet activation, inflammation and ongoing necrosis"

Conditions: Ischemia

Summary: * to compare the kinetics of inhibition of platelet aggregation (aggregometry) and platelet activation (flow cytometry) with different loading doses of clopidogrel * to evaluate the effect on various parameters of inflammation and necrosis and the safety of these loading doses


Eligibility criteria:
inclusion criteria: 1. patient hospitalised with ischemic symptoms (onset \< 48 hours) and at least one of the following characteristics of nstemi: * ecg st or t changes * positive troponin 2. patient treated on admission with 250-500 mg aspirin (oral or iv) and who will receive low dose aspirin (\< or = 100 mg daily) from the next day on 3. patient treated with bid lmwh (indicated dosage for this indication) exclusion criteria: 1. catheterization scheduled within 24 hours after randomisation 2. patient presenting an absolute contra-indication to the use of clopidogrel and/or asa: - history of drug allergy to thienopyridine derivatives or asa 3. severe uncontrolled hypertension (bp \> 180 / 100 despite therapy) 4. platelet count \< 100 000 / mm3 5. neutrophil count \< 1800 / mm3 6. patient with increased risk of bleeding, such as severe hepatic insufficiency, current peptic ulceration, proliferative diabetic retinopathy 7. history of severe systemic bleeding 8. patient with any contraindication to lmwh 9. patient treated with clopidogrel within the last 10 days 10. patient treated with oral anticoagulants or hirudin or planned to receive these products during the hospitalisation period 11. patient treated with ticlopidine, dipyridamol, nsaids (including cox1 and cox2 inhibitors), cilostazol, gpiib iiia antagonists or planned to receive any of these products within the next 24 hours following randomisation. 12. patient whose arm venous status is incompatible with an indwelling catheter 13. patient presenting an evolving cancer 14. patient with nyha class iv heart failure 15. intubated and ventilated patient