Kornimate/medical-research-clean huggingface dataset:
contingency management for the treatment of co-occurring alcohol and drug misuse

Conditions: Co-Occurring Alcohol and Drug Misuse

Summary: contingency management (cm) is a type of treatment used in the substance abuse field. patients' behaviors are rewarded for adherence to a treatment plan. as an approach to treatment, contingency management emerged from the behavior therapy traditions in mental health. by most evaluations, contingency management procedures produce one of the largest effect sizes out of all mental health and educational interventions. the purpose of this study is to perform a randomized, controlled trial to evaluate the ability of a culturally-tailored contingency management (cm) intervention to increase alcohol and drug abstinence among american indian (ai) tribal members from two rural reservations in the northwest.


Eligibility criteria:
inclusion criteria: 1. self-identify race as american indian (ai) 2. are seeking alcohol dependence and drug abuse treatment at a participating reservation 3. are age 18 or older 4. meet criteria of dsm-iv diagnosis of current alcohol dependence 5. current drug misuse 6. are not pregnant or planning to become pregnant for the duration of the study 7. are english speaking 8. have the ability to provide written informed consent exclusion criteria: 1. have significant risk of dangerous alcohol withdrawal, defined as a history of alcohol detoxification or seizure during the last 12 months and expression of concern by the patient and/or healthcare provider 2. meet criteria for dsm-iv diagnosis of drug dependence 3. have significant risk of dangerous drug withdrawal and/or self-reported or medically documented severe withdrawal from drugs in the last 6 months 4. have any medical or psychiatric condition, such as organic brain disorder, dementia, or psychotic disorder, that the principal investigator determines would compromise safe study participation 5. are receiving drugs under the direction of a physician for pain management or another medical condition for which drug abstinence is contraindicated
analysis of biopsies from the upper gastrointestinal tract

Conditions: Gastroesophageal Reflux Disease; Gastritis

Summary: multicenter study to correlate histological findings in the upper gastrointestinal tract with endoscopic and clinical data.

prospective multicenter study involving six clinical institutions (see collaborators) with recruitment of consecutive patients who undergo routine upper endoscopy for several (non-selected) reasons. the patients will have to fill out a questionnaire about their history of reflux symptoms, including questions regarding smoking and drinking habits. the treating physician will have to complete a clinical protocol which includes a questionnaire regarding the patient's drug history. the endoscopic examination is done in a routine, yet standardized fashion. in particular, biopsy material will be taken from the stomach, the gastroesophageal junction and from the duodenum. the samples will be routinely sent to the participating institutes of pathology (see collaborators) and will be assessed by independent histopathologists with special expertise in gastrointestinal pathology. endoscopic findings are documented in a standardized clinical protocol. likewise, the histopathological assessment of the samples is done following a standardized protocol following the who classification and the updated sydney classification, as appropriate.

Eligibility criteria:
inclusion criteria: * none exclusion criteria: * patients with abnormal anatomy at the gastroesophageal junction (e.g. post surgery)

Keywords: esophagus gastroesophageal reflux reflux esophagitis barrett's esophagus stomach intestinal metaplasia stomach helicobacter pylori infection proton pump inhibitor duodenum duodenal bulb celiac disease diagnosis
rivastigmine mini-tablet for alzheimer's disease

Conditions: Alzheimer&#39;s Disease

Summary: the objective of this study is to evaluate the efficacy and safety of rivastigmine mini-tablets in individuals diagnosed with mild to moderate alzheimer's disease (ad).

rivastigmine has received approval for the treatment of alzheimer's disease. the rivastigmine mini-tablet represents an innovative drug formulation designed to address swallowing difficulties by reducing the size of the dosage form, while also minimizing gastrointestinal side effects through an optimized drug release mechanism. this multi-center, observational study aims to evaluate the effectiveness, safety, and patient compliance associated with rivastigmine mini-tablets in individuals diagnosed with alzheimer's disease. assessments will be conducted at the 3rd, 6th, and 12th months of treatment.

Eligibility criteria:
inclusion criteria: * age 50 or older * meet the national institute of aging-alzheimer's association clinical criteria for probable alzheimer's disease * have a mini-mental state examination score of 10 to 24 at screening and baseline * geriatric depression scale score \<=7 at screening * hachinski ischemic scale \<=4 at screening * brain mri should meet: no infarcts in key areas (thalamus, hippocampus, entorhinal cortex, perirhinal cortex, angular gyrus, etc.), ≤ 2 stroke lesions \> 1.5 cm in diameter, and fazekas scale - assessed white matter lesion grade * 2. * patients whose caregivers are well-informed about the patients' condition and, if possible, live with them. * provide written informed consent exclusion criteria: * any systemic or neurological condition that could contribute to cognitive impairment above and beyond that caused by the participant's alzheimer's disease * any psychiatric diagnosis or symptoms (hallucinations, major depression, delusions, etc) interfering with study procedures * an advanced, severe or unstable disease of any type (cardiac, respiratory, gastrointestinal, renal disease, etc) that may interfere with efficacy evaluations * subjects treated with medication for dementia two weeks prior to baseline
effect of dexmedetomidine on renal function and delayed graft function after kidney transplantation

Conditions: Kidney Transplantation

Summary: the purpose of this study is to elucidate the effect of dexmedetomidine on renal function and delayed graft function after kidney transplantation


Eligibility criteria:
inclusion criteria: 1. adult (20-80 years old) 2. patients undergoing elective kidney transplantation exclusion criteria: 1. emergency surgery 2. severe sinus bradycardia (\<50 beats per min \[bpm\]) 3. second-degree or third-degree heart block 4. decreased heart function (ef \<30%) 5. acute myocardial ischemia 6. serious hepatic dysfunction (child-pugh class c) 7. patients with known or suspected severe adverse reactions to dex (or clonidine) 8. treatment with clonidine or dexmedetomidine in the past 30 days
fetoscopic neox cord 1k® spina bifida repair

Conditions: Spina Bifida; Myelomeningocele; Myeloschisis

Summary: to fetoscopically use cryopreserved human umbilical cord allografts, named neox cord 1k®, as a spinal cord cover of spina bifida defects. this procedure will be performed to create a watertight seal covering over the spinal cord in order to decrease the incidence rates of postnatal morbidities. for larger skin defects, neox cord 1k® may be used as a skin cover.


Eligibility criteria:
inclusion criteria: maternal inclusion criteria: * singleton pregnancy * gestational age at screening is 19 to 25 5/7 weeks and gestational age at surgery is 22 to 25 6/7 weeks * maternal age: 18 years and older * body mass index \< 40 kg/m2 * no preterm birth risk factors (short cervix, history of previous preterm delivery) * no previous uterine incision in the active uterine segment * willing to undergo an open fetal repair if the fetoscopic approach is unsuccessful fetal inclusion criteria: * spina bifida defect between t1 to s1 vertebral levels * chiari ii malformation * no evidence of kyphosis (curved spine) * no major life-threatening fetal anomaly unrelated to spina bifida * normal karyotype, or normal chromosomal microarray analysis (cma), or a cma with variants of unknown significance exclusion criteria: maternal exclusion criteria: * non-resident of the united states * multifetal pregnancy * poorly controlled insulin-dependent pregestational diabetes * poorly controlled a2 diabetes mellitus (a2dm) insulin-dependent diabetes * current or planned cerclage or documented history of an incompetent cervix * placenta previa or placental abruption * short cervix of \< 20 mm * obesity as defined by a body mass index of \> 40 kg/m2 * previous spontaneous singleton delivery prior to 37 weeks * maternal-fetal rh isoimmunization, kell sensitization, or a history of neonatal alloimmune thrombocytopenia * hiv or hepatitis-b positive status * known hepatitis-c positivity * uterine anomaly such as large or multiple fibroids or a mullerian duct abnormality that is diagnosed via imaging prior to surgery, which that are unavoidable during surgery * other medical conditions which are contraindication to surgery or general anesthesia * patient does not have a support person * inability to comply with the travel and follow-up requirements of the trial * patient does not meet psychosocial standardized assessment criteria * participation in this or another intervention study that influences maternal and fetal morbidity and mortality * maternal hypertension * zika virus positivity * allergy/history of drug reaction to amphotericin b fetal exclusion criteria: * major fetal anomaly not related to spina bifida * kyphosis in the fetus of 30 degrees or more * ventriculomegaly greater than 15 mm and no movements noted at hip and knee joints

Keywords: neox cord 1k fetoscopic repair cryopreserved human umbilical cord
role of magnesium sulphate as an adjuvant to bupivacaine in u.s guided quadratus lumborum block in lower abdominal cancer surgeries

Conditions: QLB in Lower Abdominal Cancer Surgeries as a Post Operative Analgesia

Summary: the aim of this study is to assess the efficacy of mg sulfate ( 10% ) as an adjuvant to bupivacain ( 0.25 % ) in an u.s guided qlb for postoperative analgesia and postoperative morphine consumption in lower abdominal cancer surgeries.

it is vital to apply adequate postoperative analgesia following lower abdominal surgeries of cancer because postoperative pain not only affects the patients' rest but also produces a series of pathological reactions. postoperative analgesia, including regional anesthesia, is very important which not only provides effective postoperative analgesia but also reduces the need for postoperative opioids.in recent years, various ultrasound-guided regional anethetic techniques have been extensively used. one of them is quadratus lumborum block which can provide postoperative analgesia of the segmental innervation from t6 to l1. in which the local anesthetics can spread through the thoracolumbar fascia to the paravertebral space, thereby blocking part of the sympathetic nerves . clinical studies have shown that compared with the current widely used transverse abdominal block, qlb provides longer analgesia and wider block levels when the same dose of local anesthetic is used unlike traditional trunk block, qlb cannot use the sense of falling during puncture and can only be performed under ultrasound guidance, which has the advantages of being real-time and dynamic. ultrasound-guided nerve block provides more accurate positioning and benefits for patients with less injury. magnesium sulfate plays an important role in the physiological function of the human body. a large number of studies have reported the safety and effectiveness of adding magnesium sulfate as an adjuvant in various regional anethetic techniques . therefore, we designed a prospective randomized controlled trial to compare the analgesic efficacy of combining magnesium sulfate with bupivacaine in qlb.

Eligibility criteria:
inclusion criteria: 1. age from 18 to 80 years old 2. both gender 3. weight from 55 to 85 kg 4. asa groups 2 and 3 5. lower abdominal cancer surgeries exclusion criteria: * 1. patient refusal 2. true local anesthetic allergy 3. coagulopathy 4. local infection at the procedure site 5. psychic patients 6. patient on chronic opioid use
comparing the efficacy of periarticular bone structure in patients treated with either tocilizumab or tumor necrosis factor blockers

Conditions: Rheumatoid Arthritis

Summary: comparing the structural effects of tnfi and tocilizumab on the periarticular bone by performing a comprehensive analysis of the periarticular bone changes in ra patients treated with either tnfi or tocilizumab in a longitudinal setting, using high-resolution peripheral quantitative computed tomography (hr-pqct), a very sensitive method for visualizing and quantifying bone microstructure in ra patients. quantitatively assessing the changes of erosions volume, osteophytes size and the area of cortical fenestration in a group of tnfi-treated and a group of tocilizumab- treated ra patients.

inhibition of tumor necrosis factor alpha (tnf-α) and of interleukin- 6 receptor (il-6r) emerged as highly effective cytokine blocking strategies in the treatment of rheumatoid arthritis (ra) in the last years. both, inhibition of tnf-α (tnfi) and of the interleukin-6 receptor by tocilizumab ameliorate the signs and symptoms, reverse the elevated acute phase response and inhibit the progression of bone erosion in ra patients (1). despite striking similarities with respect to their efficacy and safety in the treatment of ra, tnfi and tocilizumab are two entirely distinct approaches for targeting chronic inflammatory diseases in humans. this concept is highlighted by the differential response to tnfi and tocilizumab in other chronic inflammatory diseases such as psoriasis, psoriatic arthritis and spondyloarthritis, with clinical efficacy of the former but not the latter treatment modality (2). on the other hand, tocilizumab has a direct effect on the acute phase response and iron metabolism, which is not found with tnfi. therefore, subtle differences may exist between tnfi and tocilizumab, which are relevant for the long-term treatment of ra patients.

Eligibility criteria:
inclusion criteria: * females and males with ra erosions in the wrist and/or mcp joints * must be aged ≥ 18 years at time of consent * stable treatment with conventional dmards of at least 3 months exclusion criteria: * patients exposed to abatacept or rituximab in the last 12 months * patients receiving glucocorticoids over 5 mg prednisolone per day * patients who are younger than 18 years * pregnant or lactating females * patients having received an hr-pqct examination during the last 6 months before screening
questionnaires assessing the quality of life of patients treated for coronary heart disease

Conditions: Coronary Heart Disease

Summary: cardiovascular disease remains the leading cause of death in europe and worldwide. in 2014, they led to more than 4 million deaths in europe, and coronary heart disease alone accounts for nearly 1.8 million deaths, or 20% of all deaths in europe. however, mortality from cardiovascular disease and, especially, coronary heart disease has declined in recent decades. this has been made possible by improving the quality of care provided to patients. several studies have been conducted to demonstrate this improvement in the quality of care, but they mainly measure the functional results of treatment, morbidity and mortality, survival and prolongation of life. however, patient-centered outcomes such as health-related quality of life outcomes (such as mental function, ability to resume activities of daily living, social relationship) are also considered important outcomes in the management and monitoring of these diseases. some studies have shown that, even when other risks factors are controlled, a poor quality of life related to health is a prediction factor for morbidity and mortality in patients with coronary artery disease. some studies have suggested that health-related quality of life should be strongly associated with lifestyle, co-morbidities, and mental function. some factors have been identified as factors that may affect the quality of life in patients with coronary artery disease, including depression, anxiety, dyspnea and angina pectoris. depression and anxiety were negatively associated with health-related quality of life in patients with cardiovascular disease. as for dyspnea, it has been shown that in stable patients who have had a myocardial infarction, its increase at 1 month after initiation of treatment is strongly associated with a decrease in the quality of life and with an increased risk of re-hospitalization and death. it is therefore important to measure these factors when the quality of life is assessed in patients with coronary heart disease. the importance of assessing quality of life is that the clinician and the patient often have different concerns: what the clinician considers to be a "successful procedure" is not always considered as such by the patient. results related to quality of life (results rarely evaluated) are among the results that really interest the patient. indeed, many patients consider the quality of additional years of life acquired as important as the lifespan, so the goal of today's medicine is to improve the quantity and quality of life of the additional years of life acquired. to ensure this improvement, the assessment of health-related quality of life should be integrated into the daily clinical practice of coronary heart disease management. the objective of our study is to evaluate the feasibility of this practice throughout the traject of care, by using several standardized questionnaires.


Eligibility criteria:
inclusion criteria: confirmed coronary disease exclusion criteria: emergencies, patients lost to follow-up.
therapeutic exercise in cancer-related fatigue in women after breast cancer treatment

Conditions: Fatigue; Breast Cancer

Summary: the main objective of this study is to determine whether the proposed program of therapeutic exercise is effective in improving fatigue, more than the exercise unsupervised depending on their preferences, in women treated for breast cancer.

introduction: the prevalence of cancer-related fatigue in women treated for breast cancer is about 30% having significant effects in reducing their quality of life. there is evidence of the presence of sleep problems and immune response. several studies claim that physical exercise is effective during and after treatment of the disease as it improves the quality of life, cardiorespiratory function, physical functioning and symptoms of fatigue although not always found significant differences between intervention groups exercises compared with a control group. although the results of these studies are promising, generally present methodological biases as small sample size, absence of masking, heterogeneous groups, lack of monitoring short and long term and especially lack of specificity in relation to prescribed exercise ( frequency, intensity, time and type of exercise). subjects and methods: a randomized clinical trial, the examiner being blinded unaware of the intervention group to which subjects were assigned. participants will be randomly assigned to two groups: an experimental group, where the participants will be treated with therapeutic exercise; and a group where will be done physical exercise according their preferences. pre-intervention, immediate post-intervention, 3 and 6 months assessments will be made. the selection criteria will be: adult women treated for breast cancer, completed at least 6 months before, with persistent fatigue. all participants must understand and sign freely informed consent. sample size: 40 women for each group. data analysis: a descriptive analysis of all variables was performed. it establish for all cases a confidence level of 95% (p \<0.05). the effectiveness was assessed by comparing the experienced change of the two groups in outcome variables between physical therapy examinations.

Eligibility criteria:
inclusion criteria: * women treated for breast cancer, completed at least 6 months before, with persistent fatigue. * women who do not present contraindications for physiotherapy and physical exercise (infection, metastasis, loco regional recurrence, cardiopulmonary disorders). * women who have read, understood and signed informed consent freely. exclusion criteria: * women with cognitive limitations to understand the information provided, instructions for treatment and consent to their participation in the study.

Keywords: physical therapy modalities breast cancer treatment exercise therapy dyspnea
in vivo measurement of corneal epithelial changes in dry eye patients

Conditions: Dry Eye Syndrome

Summary: the purpose of this study is to measure corneal epithelial changes in dry eye subjects using a novel lubricant eye gel.

the purpose of this study is to measure corneal epithelial changes in dry eye (de) subjects using a novel lubricant eye gel.

Eligibility criteria:
inclusion criteria: subjects must have history of dry eye as determined by: 1. questionnaire 2. tear film break up time less than or equal to 10 seconds 3. schirmer's score of less than or equal to 5 mm 4. corneal staining greater than or equal to 3 in either eye, and 5. positive for conjunctival staining (greater than or equal to 1) exclusion criteria: * patients cannot wear contact lenses within 1 week prior nor during the study, and cannot have a history of hypersensitivity to any component of systane gel drops.

Keywords: dry eye epithelial changes
decision making, daily experiences, and brain activity in young adult women

Conditions: Binge-Eating Disorder

Summary: the investigators are doing a study of women with and without binge-eating disorder to learn more about what happens when people engage in everyday decision-making activities. the investigators are interested in learning more about brain activity during everyday decision-making and how everyday decision-making relates to a variety of daily experiences. examples of everyday decisions include deciding which product to buy, deciding what to eat for a snack, and deciding how to spend free time.


Eligibility criteria:
inclusion criteria: inclusion criteria for all participants: * normal or corrected to normal vision and hearing * verbal and written fluency in english * right-handed * body mass index of 20-35 kg/m\^2 additional inclusion criteria for participants with binge-eating disorder: • dsm-5 binge-eating disorder exclusion criteria: exclusion criteria for all participants: * impaired cognition or other neurological/cognitive problems * contraindications to mri (e.g., certain metal implants, claustrophobia) * currently/recently/potentially pregnant, seeking to become pregnant in the near future, or breastfeeding * serious and/or unstable medical diseases and conditions, and certain other medical diseases and conditions * recent low weight * certain medications (e.g., insulin) * current/recent frequent recreational drug use, or history of frequent recreational drug use in early adolescence * extreme dietary limitations (e.g., veganism), pervasive food allergies, or limited exposure to popular snack foods * current/recent suicidality * current/recent changes in treatment for mental illness * study-relevant research experience additional exclusion criteria for comparison participants: * personal history of eating disorders or recurrent binge eating * personal history of any other mental illness, including serious substance use problems * first-degree relative with current or past eating or psychotic disorder * significant recent change in weight additional exclusion criteria for participants with binge-eating disorder: * severe mental illness (e.g., psychotic disorder, severe agoraphobia) * certain other current/recent mental illness, including severe substance use problems, that would limit study participation or safety * recent anorexia nervosa spectrum disorder, avoidant-restrictive food intake disorder, or bulimia nervosa spectrum disorder

Keywords: binge-eating disorder decision-making brain activity