Kornimate/medical-research-clean huggingface dataset:
effects of an osteopathic treatment protocol on sleep quality

Conditions: Sleep Disorder

Summary: single-centre interventional single-blinded randomized controlled trial, with random assignment of the subjects in two groups (intervention and control, 1: 1 ratio) and to be carried out with volunteers that present alterations in the quality of sleep. eligible and accepting subjects participating in the study will be assigned to receive an osteopathic treatment protocol or a placebo technique

intervention protocol in the intervention group: the intervention protocol consists of 4 techniques that will be performed according to the following order: 1. inhibition of the suboccipital muscles. 2. parietal lift. 3. sutherland technique of sphenobasilar synchondrosis. 4. compression technique of the fourth ventricle (cv4). intervention protocol in the control group: placebo technique that consists of placing the hands on top of the skull without any therapeutic intention for five minutes.

Eligibility criteria:
inclusion criteria: * adults ranging from 18 to 80 years old and with a score greater than 5 on the pittsburgh sleep quality index exclusion criteria: 1. recent head injuries or fractures. 2. having suffered a stroke or intracranial hemorrhage. 3. tumors. 4. epilepsy. 5. bradycardia. 6. hypotension. 7. heart disease 8. neurological problems 9. psychiatric problems

Keywords: sleep quality heart rate variability stress osteopathic manipulative treatment manual therapy
12 weeks of hemodialysis with medium cut-off filter compared to hemodiafiltration with standard high-flux filter.

Conditions: Chronic Kidney Diseases; Uremia

Summary: the medium cut-off dialysis (mco) membrane has been developed to improve middle molecule removal compared to standard high-flux dialysis filters. the aim of this study is to compare levels of middle molecules after 12 weeks of mco hemodialysis, compared to 12 weeks of hemodiafiltration using standard high-flux filter.


Eligibility criteria:
inclusion criteria: * ongoing hdf treatment (\>3 months) * oliguric * albumin ≥ 30 * crp \<15 * no acute myocardial infarction within 3 months. * swedish or english speaking. exclusion criteria: - not able to understand the study information.

Keywords: dialysis mco middle molecules
metformin for the treatment of mcrc patients undergoing folfiri plus target therapy

Conditions: Progression-Free Survival

Summary: to investigate progression-free survival (pfs) in patients with metastatic colorectal cancer treated with chemotherapy folfiri monotherapy or chemotherapy folfiri combined with metformin

objectives: 1. main purpose • to investigate progression-free survival (pfs) in patients with metastatic colorectal cancer treated with chemotherapy folfiri monotherapy or chemotherapy folfiri combined with metformin 2. secondary purpose (1) to investigate the survival (os) of patients with metastatic colorectal cancer treated with chemotherapy folfiri monotherapy or chemotherapy folfiri combined with metformin (2) to investigate the disease control rate (dcr) of patients with metastatic colorectal cancer treated with chemotherapy folfiri monotherapy or chemotherapy folfiri combined with metformin

Eligibility criteria:
inclusion criteria: 1. aged between 20 and 90 years old 2. patients diagnosed with metastatic colorectal cancer who is going to receive folfiri chemotherapy 3. female must not be planning to become pregnant or breastfeeding, and not pregnant at any point during treatment. (contraception is required to participate in this trial) 4. those without major physiological diseases (example of major cardiovascular disease is acute myocardial infarction; example of major cerebrovascular disease is acute stroke, malignant hypertension, acute kidney failure, acute liver failure) 5. those who are not allergic to the relevant drugs required for the test 6. those who can follow the doctor's order to take the medicine 7. subjects must be willing to sign the consent form 8. blood sugar level above 80 mg/dl exclusion criteria: subjects who meet any of the following exclusion conditions are not allowed to join the trial 1. patients other than the above-mentioned main inclusion criteria. 2. non-native speakers 3. known allergy to metformin or any of its components. 4. severe instability in diabetes (ketoacidosis). 5. blood sugar level lower than 80 mg/dl 6. heart failure, respiratory insufficiency. 7. inadequate hematopoietic function defined as below: * hemoglobin \< 9 g/dl; * absolute neutrophil count (anc) \< 1,500/mm3; * platelet count \< 100,000/mm3; 8. inadequate organ functions defined as below: * total bilirubin \> 2 times upper limit of normal (uln); * hepatic transaminases (alt and ast) \> 2.5 x uln; * creatinine \> 1.5 x uln;
rapid administration of carnitine in sepsis

Conditions: Septic Shock

Summary: prior work has shown that exogenous l-carnitine administration enhances glucose and lactate oxidation, attenuates fatty acid toxicity, and improves endothelial-smooth muscle coupling and cardiac mechanical efficiency. the overall goal of this proposal is to investigate l-carnitine as a novel adjunctive treatment of septic shock. in this study the investigators will test our primary hypothesis: early adjunctive l-carnitine administration in vasopressor dependent septic shock will significantly reduce cumulative organ failure at 48 hours with an associated decrease in 28-day mortality suggesting the need for further phase iii study. to accomplish this the investigators will conduct a phase ii, double blinded, placebo controlled, adaptive randomized trial of 250 eligible patients with vasopressor-dependent septic shock. study subjects will be assigned to one of four arms: low (6g), medium (12g) or high (18g) dose intravenous l-carnitine or placebo for 12 hours as a part of early resuscitative care.


Eligibility criteria:
inclusion criteria: 1. suspected or confirmed infection (examples include but are not limited to: white cells in a normally sterile body fluid; perforated viscus; radiographic evidence of pneumonia in clinical symptoms; a syndrome associated with a high risk of infection e.g. cellulitis, cutaneous abscess, ascending cholangitis, toxic shock syndrome, fever of unknown origin with high suspicion of infectious etiology) 2. any two of four criteria of systemic inflammatory response as defined by the 2001 accp/sccm consensus conference committee; 3. recognition of septic shock and initiation of quantitative resuscitation within 24 hours of enrollment; 4. requirement of high dose vasopressors for ≥4 hours to treat shock: norepinephrine \> 0.05mcg/kg/min; dopamine \>10mcg/kg/min; phenylephrine \>0.4 mcg/kg/min; epinephrine \> 0.05 mcg/kg/min; 5. cumulative sequential organ failure assessment (sofa) score of ≥ 6; 6. blood lactate level of \>2.0 mmol/l. exclusion criteria: 1. age \<18 years; 2. pregnancy or breastfeeding; 3. any primary diagnosis other than sepsis; 4. established do not resuscitate status or advanced directives restricting aggressive care or treating physician deems aggressive care unsuitable; 5. any history of seizures or a known seizure disorder; 6. any known inborn error of metabolism; 7. anticipated requirement for surgery that would interfere with the 12 hour infusion time; 8. active participation in another interventional study; 9. cardiopulmonary resuscitation (chest compression or defibrillation) prior to enrollment; 10. known systemic allergy to l-carnitine. 11. severe immunocompromised state (e.g. subject has neutropenia \[receiving cytotoxic chemotherapy with absolute neutrophil count \<500/ul or expected to decline to \< 500 ul within the next three days). 12. active treatment with coumadin
intermittent oral-esophageal tube feeding in alzheimer's patients with dysphagia

Conditions: Alzheimer Disease

Summary: this is a prospective multicenter study with alzheimer's patients with dysphagia. patients enrolled are randomly divided equally into the observation group and the control group. all patients receive conventional care, and the observation group received intermittent oral-esophageal tube feeding while the control group received nasogastric tube feeding for enteral nutrition support. baseline information (demographics, medical history, etc.), nutritional status at admission and after treatment, depression, dysphagia, and quality of life after treatment are compared.

the alzheimer's disease in the elderly exhibits the high prevalence.this is a prospective multicenter study with alzheimer's patients with dysphagia. patients enrolled are randomly divided equally into the observation group and the control group. all patients receive conventional care, and the observation group received intermittent oral-esophageal tube feeding while the control group received nasogastric tube feeding for enteral nutrition support. baseline information (demographics, medical history, etc.), nutritional status at admission and after treatment, depression, dysphagia, and quality of life after treatment are compared.

Eligibility criteria:
inclusion criteria: * age between 18 years and 85 years, meeting the diagnosis of alzheimer's disease. * presence of no contraindication for enteral nutrition. * with dysphagia verified by imaging materials. * with stable vital signs and no severe liver or kidney dysfunction, metabolic disorders, cardiovascular diseases, or multiple complications * minimum mental state examination ranging from 10-26 exclusion criteria: * unable to cooperate in completing treatment and assessment due to personal reasons or other disorders. * complicated with other intracranial lesions, such as stroke. * abnormal structure of swallowing-related organ and tissue.
correlation of endothelial function and early coronary artery disease in humans

Conditions: Endothelial Dysfunction

Summary: qualifying patients who are scheduled for angiogram with endothelial function testing are approached to participate in this protocol (consent form reviewed with patient). those who are willing to participate will have additional measurements taken during their angiogram as part of this protocol. patients who are diagnosed with endothelial dysfunction as a result of a clinically indicated angiogram will be eligible to participate in a 6 month medication trial (atrasentan vs. placebo - randomized, blinded trial). patients are monitored closely during the 6 month trial via phone calls and blood testing for assessment. at the end of the 6 months they return to mayo for a repeat angiogram to assess endothelial function for any changes or improvements.

aim i: to determine the activity of the endogenous endothelin system in the coronary circulation in humans with coronary endothelial dysfunction and atherosclerosis risk factors. aim ii: to assess the potential of chronic endothelin receptor antagonists to improve preexisting coronary endothelial dysfunction and myocardial perfusion in humans and aim iii: to assess the effect of chronic endothelin receptor antagonism on the endogenous nitric oxide system in association with oxidative stress in humans with early coronary disease risk factors.

Eligibility criteria:
inclusion criteria: * age \> 18 years and \< 85 years * male or female exclusion criteria: * left dominant circulation * heart failure with ef \<40% * unstable angina * mi or angioplasty of the lad or circumflex with 6 months prior to entry into the study * use of radiographic contrast agent within 12 hours of entry into the study * use of investigational agents within one month of entry into the study * patients who require treatment with positive inotropic agents other than digoxin during the study * patients with cerebrovascular accident within 6 months prior to entry into the study * significant endocrine, hepatic, renal disorders; local or systemic infectious disease within 4 weeks prior to entry into study * pregnancy or lactation * mental instability * federal medical center patients
ibutilide administration during pulmonary vein ablation

Conditions: Atrial Fibrillation; Pulmonary Vein Ablation

Summary: to test the hypothesis that localized functional reentry maintains afib in humans, ibutilide will be administered intravenously in patients undergoing an afib ablation. the hypothesis of this study is that ibutilide will decrease the high frequency signals observed in afib suggesting the presence of micro reentrant circuits as the basic mechanism of afib, especially for the paroxysmal afib group. the potential difference in response to the ibutilide in patients with paroxysmal versus persistent afib may show the difference in the underlying mechanism of afib between these two groups.


Eligibility criteria:
inclusion criteria: * patients to be scheduled for atrial fibrillation radio frequency ablation * paroxysmal, permanent symptomatic atrial fibrillation refractory to conventional treatment * symptomatic atrial fibrillation that do not want or desire to take medication or undergo cardioversion * patients on antiarrhythmics that can be discontinued 5 half lifes prior to the procedure except for amiodarone exclusion criteria: * patients with recent major hemorrhage (within 6 months) * patients with a coagulopathy * patients who are pregnant or breast feeding * patients with acute congestive heart failure * patients with hypokalemia or hyperkalemia * patients with a prolonged qtc \> 440mms * patients with polymorphic ventricular tachycardia secondary to antiarrhythmic class iii and class i * patients with left ventricular dysfunction \< 40% * patients with a history of recent mi (\< 1 month) * patients with a history of an angioplasty of \< 1 month * patients with a history of coronary artery bypass grafting surgery of \< 3 months. * patients with a history of chronic renal failure or a creatinine clearance of \< 30ml/m * patients with a history of stroke of \< 6 months
functional electrical stimulation for facial muscles

Conditions: Facial Nerve Paresis

Summary: partial or complete facial paralysis is the weakness of muscles of facial expression. facial paralysis causes physical, social and emotional problems. functional electrical stimulation (fes) for facial paralysis is a technique in which muscles are electrically stimulated, causing them to contract this study is designed to help patients with facial nerve weakness.


Eligibility criteria:
inclusion criteria: * patients experiencing unilateral facial nerve paralysis brackmann 5/6 or 6/6. exclusion criteria: * history of epilepsy or seizures. * individuals with metal orthopedic implants in the mouth (e.g. plates or screws). * individuals suffering from fibromyalgia. * individuals currently receiving any form of transcranial brain stimulation (e.g. rtms, ect, or mst).

Keywords: facial nerve paralysis functional electrical stimulation rehabilitation
tamoxifen for the treatment of unfavorable bleeding in contraceptive implant users

Conditions: Menstruation Disturbances

Summary: the purpose of this study is to study whether a drug called tamoxifen can reduce vaginal bleeding in women who are using the etonogestrel contraceptive implant.

nearly all of the 3 million unintended pregnancies in the united states each year result from inconsistent or non-use of contraception. increasing use of the most effective methods of contraception will reduce unintended pregnancies and their social, medical and economic consequences. the contraceptive etonogestrel implant (eng implant) is 20 times more effective at pregnancy prevention than oral contraceptive pills, but it has bleeding side effects that make it unappealing for many women. tamoxifen, a selective estrogen receptor modulator (serm) used most commonly for adjuvant treatment of breast cancer, has previously been shown to dramatically reduce bleeding in users of an older levonorgestrel-based contraceptive implant (norplant tm). it has not been studied in newer progestin-based methods such as the eng implant. if tamoxifen could stop bleeding in users of the eng implant, it would give patients and physicians a valuable option for management of progestin-induced irregular bleeding. this research project will test the effectiveness of tamoxifen taken on an as-needed basis to treat abnormal bleeding in eng implant users. if tamoxifen can be established as an effective treatment for frequent or prolonged bleeding, it will increase the acceptability of the eng implant, increase its use and reduce unintended pregnancies. this is the first project to evaluate tamoxifen for treatment of unfavorable bleeding in users of the eng contraceptive implant.

Eligibility criteria:
inclusion criteria: * current user of the etonogestrel implant (nexplanon, implanon) for at least one month * experiencing bleeding episodes more frequently than every 24 days, or a single episode of bleeding lasting longer than 14 days * english or spanish speaking * planning to continue implant use for six months * access to a cell phone that can accept and send text messages exclusion criteria: * postpartum within six months * post-abortion within six weeks * pregnant * breast-feeding * undiagnosed abnormal uterine bleeding pre-dating placement of contraceptive implant * bleeding dyscrasia * anticoagulation use * active cervicitis * allergy to tamoxifen * history of venous thromboembolism * current or past breast or uterine malignancy * use of medication contraindicated with tamoxifen (coumadin, letrozole, bromocriptine, rifampicin, aminoglutethimide, phenobarbital)

Keywords: contraceptive implant irregular vaginal bleeding etonogestrel implant
cerebrovascular reactivity in american football players

Conditions: Traumatic Brain Injury; Mild Traumatic Brain Injury; Post-Concussion Syndrome

Summary: investigators will measure cerebrovascular reactivity (cvr) using functional near-infrared spectroscopy (fnirs) and magnetic resonance imaging (mri) during the chronic phase after repetitive mild traumatic brain injury (rmtbi) as a biomarker of traumatic cerebrovascular injury (tcvi). we hypothesize that cvr will be decreased in patients with rmtbi and that these decreases will correlate with clinical outcomes. furthermore, we predict that 5 week administration of a phosphodiesterase 5 (pde5) inhibitor, sildenafil citrate, will augment cvr in patients with a history rmtbi.


Eligibility criteria:
inclusion criteria: 1. age 40-65 years 2. former national football league (nfl) players or former varsity college football players 3. ability to undergo mri scanning 4. ability to read, write, and speak english 5. stable doses of concomitant medications for last 2 weeks prior to enrollment 6. diagnosis of post-concussive syndrome according to diagnostic and statistical manual 5 (dsm-5) criteria exclusion criteria: 1. contraindication to sildenafil 2. past medical history or evidence of penetrating brain injury 3. daily therapy with a pde5 inhibitor within the past 2 months, or taken as needed within past 4 weeks 4. history or evidence of pre-existing disabling neurological or psychiatric disorder not related to previous head injuries 5. history of melanoma 6. history of diagnosed obstructive/ restrictive pulmonary disease 7 .) contraindication to mri

Keywords: tbi cvr hypercapnia fnirs functional magnetic resonance imaging (fmri) american football
the research for new clinical diagnostic strategy of specific biomarkers for traumatic brain injury

Conditions: Traumatic Brain Injury

Summary: traumatic brain injury (tbi) is the most common type of nerve injury and it severely endangers the public health. it is necessary to accurately measure the early neurological function of brain injury for monitoring its prognosis and therapeutic interventions. glasgow coma score (gcs) and computed tomography (ct) are often used to diagnose the severity of tbi. however, gcs has its drawbacks in the observation of prognosis, because it is interfered by analgesics, sedatives and relaxants in the evaluation of neurological function. ct may miss the diagnosis of diffuse axonal injury (dai) and the monitoring of intracranial pressure (icp). secondary injuries after tbi, such as oxidative stress, inflammatory damage, and abnormal metabolism, can destroy cerebral blood vessels and structures, which also affect the diagnosis of injury. therefore, there is an urgent need for new methods to quickly identify which patients are likely to suffer brain injury or even cause persistent disability. detection of brain injury biomarkers based on blood and brain tissue has long been used to assess the severity of tbi, but no biomarkers have been found for early diagnosis of mtbi and prognosis of different degrees of brain injury. protein and metabolic product differences were detected from blood or the lesion samples of normal population, patients with traumatic brain injury and/or non-brain injury using mass spectrometry proteomics and metabolomics analysis platform, and diagnostic markers of potential traumatic brain injury were found, and their differential and diagnostic values were discussed.


Eligibility criteria:
inclusion criteria: 1. male and female, aged from 18 to 65. 2. patients with brain injury within 24 hours after injury 3. non-brain injury group refers to patients with limb injury or systemic injury except brain injury. 4. the subject reads and fully understands the instructions of the patients and signs the informed consent. exclusion criteria: 1. male or female, aged below 18. 2. patients with definite history of central nervous system or cardiovascular system or taking drugs affecting the central nervous system. 3. patients with severe metabolic diseases. 4. pregnancy.