Kornimate/medical-research-clean huggingface dataset:
wii-fit for balance and gait in elderly veterans

Conditions: Gait, Unsteady; Postural Balance

Summary: falls are a major public health problem. they are the leading cause of injuries and injury-related deaths in those aged over 65 years. balance and gait abnormalities are major reasons for falls in elderly. exercise interventions improve gait and balance in the elderly. despite the many proven benefits of exercise, many older adults in the us remain sedentary. this study targets at improving balance and gait with use of wii-fit as an exercise program.

objectives/rationale falls are a major public health problem. they are the leading cause of injuries and injury-related deaths in those aged over 65 years. balance and gait abnormalities are major reasons for falls in elderly. exercise interventions improve gait and balance in the elderly. despite the many proven benefits of exercise, many older adults in the us remain sedentary. this study targets at improving balance and gait with use of wii-fit as an exercise program. specific aims 1. to establish the safety, feasibility, and efficacy of an 8-week wii-fit program to improve measures of balance, and gait in older adults, compared to a cognitive remediation program, brain fitness. 2. to compare the effect of an 8-week wii-fit program to brain fitness program, on measures of biomechanical assessment, adherence, safety, physical activity, fear of fall, enjoyment, functional status, cognition and quality of life. design 8-week, randomized, parallel group, active intervention study methods patients will be recruited via irb approved flyers posted in various locations of the little rock and north little rock cavhs campuses and via referrals from the cavhs providers. thirty elderly veterans will be randomly assigned to wii-fit arm or brain fitness arm. both groups will participate in the intervention for approximately 45 minutes 3 days a week for 8 weeks. outcome measures will be assessed at baseline, and approximately week 4 and after completion of week 8. balance and gait will be assessed by berg balance scale. secondary outcome measures include biomechanical testing for gait and balance, safety, adherence, measures of functional status, cognition, quality of life, fear of falling, physical activity and physical activity enjoyment.

Eligibility criteria:
inclusion criteria: * subjects age ≥ 60 years * fall risk as measured by berg balance scale (bbs) is ≤ 52 * normal cognition as measured by mini mental state exam (mmse ≥ 24) * able to consent exclusion criteria: * subjects using wheel chair or walkers for mobility * subjects with absolute contraindications per acsm guidelines * any medical condition (per the relative contraindications per acsm guidelines below) that in the opinion of the study physician is likely to compromise their ability to safely participate in the exercise program.

Keywords: balance gait wii-fit
epidemiology and determinants of outcomes of hospital acquired blood stream infections in the intensive care

Conditions: Bacteremia; Sepsis; Hospital Acquired Condition; Resistance Bacterial

Summary: eurobact ii will investigate the mortality and morbidity of hospital-acquired blood stream infections in patients treated in intensive care units (icu). it will investigate the effects of the micro-organism and its characteristics, such as type and resistance to antibiotics on the infection and its consequences. it will also investigate the effects of the antibiotics and other treatments on survival of patients. eurobact ii will include patients from multiple icus in multiple countries.

eurobact ii is a multinational multicentre cohort study that will include patients with hospital-acquired blood stream infections (ha-bsi) treated in icus around the globe. it will provide with an update of the epidemiology of ha-bsi since the eurobact i study. it is designed to investigate the effects of ha-bsi on mortality at day 28. to describe the determinants of outcomes of ha-bsi, specifically the effects of the source of infection, the microorganism, the characteristics of antimicrobial therapy and of source control. it will investigate patient specific and organizational factors and will describe the determinants of management of ha-bsi in icus.

Eligibility criteria:
inclusion criteria: * age \> 18 years. * hospital acquired bloodstream infection (ha-bsi). * treated in the icu. * icu acquired or * hospital acquired prior to icu admission exclusion criteria: * patients that had a positive blood culture in the hospital and transferred to icu for a different reason than specific treatment of the causes or consequences of ha-bsi. * previous inclusion in the study. * ha-bsi is defined as a positive blood culture (bc) sampled after 48 hours following hospital admission.

Keywords: hospital-acquired infection blood stream infection bacteremia intensive care
optimizing brain stimulation parameters

Conditions: Epilepsy; Seizure

Summary: a primary purpose of this study is to better understand what stimulation parameters work best for patients. for example, for deep brain stimulation (dbs) of the anterior nucleus of the thalamus (ant), it is not clear what stimulation frequency leads is most effective. this study will help assess the effectiveness of low frequency or high frequency stimulation.


Eligibility criteria:
inclusion criteria: * patients who are implanted with a brain stimulation device targeting the anterior nucleus of the thalamus per mayo clinic standard of care exclusion criteria: * patients for whom clinical follow-up is not expected during the initial 6-8 months following implant
quality of life in children and adolescents with chronic functional constipation: educational action effects

Conditions: Chronic Functional Constipation

Summary: the purpose of this study is to determine if the quality of life in children and adolescents diagnosed with chronic functional constipation improves after educational activity in focus group composed by these patients' mothers.

the present research will be conducted on the specific constipation clinic in hospital das clínicas at universidade federal de pernambuco.

Eligibility criteria:
inclusion criteria: * children (6 to 9 years-old) and adolescents * diagnostic of chronic functional constipation exclusion criteria: * patients using calcium and/or heme * patients with organic diseases that causes constipation

Keywords: quality of life constipation focus groups health education problem-based learning
clinical impact of pharmaceutical consultations in patients treated for chronic obstructive pulmonary disease at home

Conditions: Chronic Obstructive Pulmonary Disease

Summary: the implementation of pharmaceutical consultations in the city or at the hospital could modify the occurrence of exacerbations related to chronic obstructive pulmonary disease after return of the patient to his home.


Eligibility criteria:
inclusion criteria: * the patient has signed the consent form. * the patient is affiliated to a health insurance programme * the patient is at least 18 years old (≥). * the patient is admitted to complete hospitalization (for patients in the "hospital and control" groups). * the patient is diagnosed with stage 2 to 4 chronic obstructive pulmonary disease. the diagnosis as well as the stage of the disease are validated by a pulmonologist at the facility. * the patient has one or more inhaler devices to treat chronic obstructive pulmonary disease. * the patient returns to his / her home when discharged from hospital (for patients in the "hospital and control" groups). * the patient is available for a follow-up of 12 months. exclusion criteria: * the subject participates in another interventional study. * the subject is in an exclusion period determined by a previous study. * the patient is under safeguard of justice. * the subject refuses to sign the consent. * it is not possible to give the patient (or his/her trusted-person) informed information.
selenium supplementation of patients with cirrhosis

Conditions: Liver Disease

Summary: the purpose of this study is to determine whether patients with liver cirrhosis can improve their selenium nutritional status by taking supplemental selenium.

selenium is an essential nutrient. selenium carries out its biological functions through selenoproteins. the liver converts dietary selenium to a form that can be used to make selenoproteins. patients with cirrhosis have much lower selenium levels than healthy individuals. we hypothesize that patients with cirrhosis are unable to utilize dietary selenium for selenoprotein synthesis. these patients may benefit from another form of selenium: selenate. we will compare the effects of two supplemental forms of selenium on plasma selenium levels in patients with cirrhosis. patients will be randomized to receive either a placebo, 200 µg selenomethionine, 200 µg selenate or 400 µg selenate, daily, for 8 weeks. we will measure selenium levels in the blood at baseline, week 4 and week 8. we will determine which forms of selenium, if any, increased plasma selenium levels of the cirrhosis patients.

Eligibility criteria:
inclusion criteria: * liver disease * aged 18 or above exclusion criteria: * substance abuse * renal failure

Keywords: cirrhosis liver disease selenium selenoproteins selenoprotein p biomarkers
phase 2 study of safety, tolerability, and immunogenicity of three dose levels of acam3000 smallpox vaccine

Conditions: Smallpox

Summary: a phase 2 study to assess the mva smallpox vaccine in previously vaccinated and vaccine- naive subjects at three dose levels.

this study will be a randomized, double-blind, placebo-controlled out-patient study conducted in multiple centers in the united states (us). up to 700 healthy male and female adult subjects 18 to 55 years of age (inclusive), who have been previously vaccinated or subjects who are naïve to smallpox vaccine will be enrolled. subjects will be randomized to 1 of 8 treatment groups with 100 (or 50 placebo) subjects per group in which they will receive either acam3000 mva smallpox vaccine (1 of 3 dose levels) or placebo on study days 0 and 28. all personnel associated with the trial will be blinded as to treatment, with the exception of the study pharmacist who prepares the treatment for administration to each subject. there are 2 control groups in this study. a comparison of adverse events and other safety assessments between placebo and acam3000 mva smallpox vaccine will be performed. in addition to serving as a control for safety, the previously vaccinated subjects receiving placebo will serve as a control for antibody and t-cell responses in persons with preexisting immunity who receive acam3000 mva smallpox vaccine. safety, tolerability, and immunogenicity data for 110 subjects undergoing primary immunization with graded doses of acam3000 mva smallpox vaccine will be available following completion of acambis protocol h-249-001, an ongoing phase i clinical trial. the doses levels in this study may be changed following the availability of results from protocol h-249-001. statistical analysis will focus on comparisons among the dose levels of acam3000 mva smallpox vaccine and comparisons of acam3000 mva smallpox vaccine to placebo, as appropriate. a separate analysis will be performed for previously vaccinated and naïve subjects. descriptive statistics will be used to compare demographic and baseline clinical data between stratum.

Eligibility criteria:
inclusion criteria: * subjects must be in good general health, checked on toxicity grading table. * for previously vaccinated subjects- must be between the ages of 33 and 55 with a previous vaccine more than 10 years ago. * for vaccine naive subjects- must be between the ages of 18 and 32, and have never been vaccinated for smallpox. * female subjects must not be pregnant or lactating. exclusion criteria: * subjects who participated in a "first responder" program. * any history of immunodeficiency. * any autoimmune disease * any history of cardiac disease * any diagnosed risk factors for ischemic coronary disease * any history of heart palpitations or abnormalities in cardiac rhythm. * any current or history of eczema of any description. * known allergy to mva or any of its components, including eggs or egg products. * morbid obesity

Keywords: mva vaccine
the effect of slanted recession of horizontal muscle on horizontal strabismus with abnormal accommodative convergence /accommodation ratio (ac/a)

Conditions: Horizontal Strabismus With High AC/A Ratio

Summary: different methods was tried to treat high ac/a strabismus cases;such as prescription of bifocal glasses in esotropia,recession of horizontal muscles with posterior fixation sutures,more recession than needed for far deviation(augmented recession),recession and pulley fixation and slant recession. different results was reported for any type of above methods. in recent studies,slanted recession was applied for high ac/a in esotropic cases and success rate of 67% was reported.but there was no unanimity for procedure of choice. since slant recession method is simpler and has low side effect than the other methods,therefore in this study the investigators want to peruse the outcome of this method on high ac/a horizontal strabismus.


Eligibility criteria:
inclusion criteria: * all patients with horizontal strabismus that the different between far deviation and near deviation is more than 10 pd exclusion criteria: * all patients who had history of surgery on horizontal muscles and patients with pseudo high ac/a ratio.
breast lesions characterization on contrast enhanced ultrasound with histopathological correlation

Conditions: Malignant Neoplasm, Overlapping Lesion of Breast

Summary: breast lesions are a common condition, diagnosed by imaging and palpation. in order to reduce the number of biopsies performed to the definitive diagnosis of a breast lesion, an imaging method with a high degree of accuracy is needed. ultrasound imaging with microbubbles contrast media allows the diagnosis of vascularization of the lesion, according to timing. our hypothesis is that a highly vascularized lesion that enhances in an early timing is most likely to represent a malignant lesion and thus, deserves biopsy for a definitive diagnosis. females over 18 years age, with a focal lesion in breast will be suitable to perform this examination.


Eligibility criteria:
inclusion criteria: * female with a diagnosed breast focal lesion exclusion criteria: * allergic conditions to contrast media, * asthma, * r-l shunt
comparison of air and expansile gas in pneumatic retinopexy

Conditions: Retinal Detachment

Summary: the objective of the study is to evaluate the results of using air versus expansile gas (perfluoropropane) in the treatment of rhegmatogenous retinal detachment by pneumatic retinopexy, comparing the retinal reattachment rate and post-operative visual recovery.

to the best of the investigators' knowledge there have been no clinical trials to compare air and expansile gas in pneumatic retinopexy. the investigators hypothesize that both air and expansile gas have the same properties of gas and remain in the eye for 5-6 days which is long enough to have moderate chorioretinal adhesion to seal the retinal break. if the investigators can prove that air is equivalent to expansile gas in this procedure, it can save a lot of money for the country. therefore, the investigators are conducting a randomised controlled double-blind study to compare the results of using air and perfluoropropane in pneumatic retinopexy for treatment of rhegmatogenous retinal detachment.

Eligibility criteria:
inclusion criteria: * superior retinal break from 8 o'clock to 4 o'clock * single retinal break not greater than 2.5 clock hours in size * multiple breaks not greater than 3 clock hours away * no (or minimal) proliferative vitreoretinopathy * physically and mentally co-operated in post-operative head positioning * signed informed consent form for the study exclusion criteria: * ocular media opacities * advanced glaucoma * aphakia or pseudophakia * previous ocular surgeries * one-eyed patients * subject did not sign informed consent form

Keywords: retinal detachment pneumatic retinopexy
online psychology program for chronic pain after surgery

Conditions: Post-surgical Pain; Pain, Acute; Pain, Chronic; Post-Surgical Pain, Chronic

Summary: this project will evaluate the feasibility of a new fully self-guided online acceptance and commitment therapy (act) program entitled advancing online psychology tools for the transitional pain service (adopt-tps), developed on an online health application platform called manage my pain (mmp). the act program is designed to teach mindfulness skills and provide psychoeducation about post-surgical pain. the feasibility of the self-guided online program will be compared to a pre-existing psychologist-guided workshop that delivers the same program. it is anticipated that the self-guided online act program will be deemed feasible by participants.

the transitional pain service (tps) at toronto general hospital is a multidisciplinary treatment program that aims to prevent chronic post-surgical pain (cpsp) and persistent opioid use after surgery. cpsp is a major public health concern impacting from 10% up to 70% of patients, depending on the type of surgery. those experiencing cpsp are at higher risk for prolonged opioid use, which introduces challenges like addiction, misuse, and overdose. acceptance and commitment therapy (act) is an evidence-based psychology intervention that is effective in reducing patients' risk of cpsp and opioid use. however, access to this intervention is currently limited to predominantly in-person, specialized hospital-based clinic settings like the tps, which prioritize patients at highest risk for cpsp and often require physician referrals for quick access. there is a need for such treatment approaches to spread to other institutions and to be available for lower-risk post-surgery patients, yet the shortage of specialized pain psychologists creates a barrier to widespread dissemination. the current project will evaluate the feasibility of a novel fully self-guided online act intervention entitled advancing online psychology tools for the transitional pain service (adopt-tps), developed on a mobile health application platform called manage my pain (mmp). a randomized, controlled pilot feasibility trial will evaluate the efficacy of adopt-tps by comparing it to a pre-existing psychologist-guided workshop. once tested, this scalable, evidence-based online intervention can be easily implemented at institutions across canada and beyond to address cpsp and opioid use without the need for specialized pain psychologists on staff.

Eligibility criteria:
inclusion criteria: * patients who received a post-surgical referral to the tps * patients who have access to a device that can connect to the internet exclusion criteria: * patients who have received tps psychology treatment * patients with a known history of serious mental illness (e.g., psychosis and/or active mania) * patients who have limited comprehension of english or comprehension deficits due to dementia

Keywords: feasibility studies digital health acceptance and commitment therapy mindfulness internet-based intervention randomized controlled trial
botulinum toxin in patients with spastic lower limb paresis associated with multiple sclerosis

Conditions: Multiple Sclerosis

Summary: spastic paraparesis is one of the most disabling functional deficits in the population with multiple sclerosis between 18 and 80 years of age and at any functional level. infiltration with botulinum toxin is a clinical practice that has been carried out for years with clinical evidence of improvement in the patient's walking patterns and quality of life. we assume that the infiltration of this product can generate a direct benefit in the walking ability of these patients and secondarily improve their quality of life.


Eligibility criteria:
inclusion criteria: * acceptance and signature of informed consent. * age between 18 and 80 years old, both included. * patients with relapsing remitting multiple sclerosis (rrms), progressive secondary (sp) and primary progressive (pp), with spasticity resistant to usual treatment, either because of the severity of the spasticity or because of intolerance to side effects. * outpatients with spastic paraparesis that causes gait deficiency. * patients with an edss score between 2 and 6, both included. * patients with segmental involvement in mas \>1 in two or more muscle groups in the lower extremities. * absence of cognitive disability. score less than 5 on the spmsq scale of pfeiffer. * possibility of carrying out the treatment (method of administration, scheduled visits) and scales correctly. * women of childbearing potential should use an effective contraceptive method (hormonal contraceptives, intrauterine device, condom) or refrain from having sex in order not to get pregnant. a woman is considered to be fertile after menarche and to become postmenopausal, unless she has undergone a permanent sterilization procedure (hysterectomy, salpingectomy, bilateral oophorectomy). a postmenopausal state is defined as absence of menstruation for 12 months without an alternative medical cause. exclusion criteria: * psychiatric illness that hinders participation in the trial. * comorbidity that threatens the patient's life in the short term (severe liver disease, cardiovascular disease, etc.). * osteoarticular disorder that prevents physical activity. * pregnancy or lactation. * lack of primary or secondary response to any type of botulinum toxin for the treatment of ms previously detected. * sensitivity to botulinum toxin or to any excipient. * any medical condition that, in the opinion of the investigator, may compromise compliance with the objectives and / or procedures of this protocol or preclude the administration of botulinum toxin. * changes in the treatment regimen of any drug that directly or indirectly interferes with neuromuscular function within 4 weeks before the start of the study treatment.

Keywords: multiple sclerosis botulinum toxin type a
effects of smoking on placenta and lactation

Conditions: Smoking, Tobacco; Placenta Diseases; Breastfeeding; Fetal Conditions

Summary: maternal smoking during pregnancy although it is known to be associated with fetal growth restriction, it's effect on postpartum breastfeeding is not yet clear. the aim of the present study was to examine the impacts of smoking in pregnancy on breastfeeding as well as its impacts on placental immunoreactivity.

the study was conducted on 70 women who gave birth via spontaneous vaginal delivery. groups were classified as smokers (n=35) and non-smokers (n=35). the breastfeeding conditions of both groups were evaluated prior to discharge and after postpartum 10th day. cross-sections were taken from the placenta tissues after which their igf-1 (insulin like growth factor-1), leptin, hpl (human placental lactogen) immunoreactivities were examined.

Eligibility criteria:
inclusion criteria: * pregnant women who have started smoking at least 100 cigarettes in her lifetime and who now smokes every day, * pregnant women who have never smoked throughout their life, including pregnancy(16), * pregnant women who gave birth at term, * multiple pregnancy, preeclampsia, gestational diabetes, thyroid dysfunction, those who do not have a systemic disease and due to systemic disease during pregnancy those who do not use * pregnant women who had spontaneous vaginal delivery, * in order not to encounter communication barriers and because cultural differences may vary, the pregnant woman is not a foreign national, * pregnant women who do not have any barriers to communication by phone, * those who do not have any health problems that prevent breastfeeding exclusion criteria: * multiple pregnancy * insulin dependent diabetes * pregnant women who have had a cesarean section * preeclampsia * thyroid disease

Keywords: smoking cigarette placenta igf-1 leptin hpl breastfeeding