Kornimate/medical-research-clean huggingface dataset:
study on the efficacy of infiltration of upper cluneal nerves in chronic pain related to cluneal syndrome

Conditions: Cluneal Syndrome; Nerve Entrapment Syndrome

Summary: lower back pain is a very common complaint in the chronic pain clinic. its etiology is nonspecific in 85% of the cases. in 1957, strong and davila reported that the superior cluneal nerves (scns) and middle cluneal nerves (mcns) can be entrapped around the iliac crest, suggesting a causal relationship between this entrapment (scn-entrapment, scn-e) and low back pain symptom. this is known today as "cluneal syndrome". cluneal syndrome remains poorly investigated and is currently a diagnostic challenge. various types of lumbar movements exacerbate its occurence. the most common theory regarding the origin of this pain evokes that is primarily due to a mechanical cause linked to stenosis or adhesions of fibrous tissue around the cluneal nerves causing distress. the hypothesis is that the investigator can reduce the pain related to the syndrome of superior cluneal origin thanks to a "volume effect" which aims to detach adhesions and/or aponeurotic stenoses that cause a distress of cluneal nerves. the aim of this study is to assess the effectiveness of the cluneal nerve block using thethomas dahl nielsen ultrasound based technique in patients with chronic low-back pain related to scn-e. to this end, the investigator will compare physiological serum injection versus local anaesthetic injection, with the aim of reducing short-term pain and improving quality of life.


Eligibility criteria:
inclusion criteria: 1. patient signed inform consent 2. patient diagnosed with unilateral or bilateral superior cluneal syndrome : diagnostic points will be : * a maximum pain at the trigger point on the back iliac crest, approximately 7 cm from the median line and 4.5 cm from the poster superior iliac crest. palpation on this point causes pain reminding the patient's long-term pain), * palpation "rolled-palpated" at the buttocks provokes either pain, paraesthesia, or discomfort. * the criteria of facial syndrome, sacro-iliac syndrome or radiculopathy are excluded. * low back pain during back movements. exclusion criteria: 1. pain not associated to superior cluneal syndrome. 2. infection at the puncture point. 3. pain of suspected neoplastic origin. 4. allergy to local anaesthetics. 5. refusal of the patient

Keywords: superior cluneal nerve entrapment chronic low-back pain injection site infiltration local anesthetic pain cluneal nerve block
virtually observed treatment (vot) for tuberculosis patients in moldova

Conditions: Tuberculosis

Summary: this trial aims to increase the wellbeing of tuberculosis patients and their adherence to medication in chisinau, the republic of moldova. the design is an individually randomised controlled trial (rct) and will involve 400 tb patients during their 'continuation phase' of treatment. the trial will have two arms; 200 patients will form the control group and receive the standard provision of directly observed treatment (dot) and 200 will receive virtually observed treatment (vot). vot differs from dot in that the daily observation of patients taking their medication will be observed via internet video messages rather than in-person. based on a small sample of patient interviews we think that for some patients dot may be a hindrance rather than a help. vot allows patients to take their treatment in the comfort of their home and means they don't have to travel to their polyclinic every day. there will be a central vot observation centre where vot observers will view and respond to video messages sent in by patients in the vot arm. the messages will be sent via an m-health app. the vot observers will also respond to the patients by sending feedback to the patients. the trial duration will depend on the recruitment rate of eligible patients but is expected to take 16 months.


Eligibility criteria:
inclusion criteria: 1. consent to being part of the trial 2. live in chisinau and no plans to move away from chisinau during the four months 3. aged 18 or over 4. at least four months of care remaining exclusion criteria: 1. having mdr-tb 2. homeless 3. is not homeless 4. suffer from alcoholism or drug misuse 5. in prison 6. has a treatment regimen with injections
technical modifications of appendicular stump closure during laparoscopic appendectomy

Conditions: Acute Appendicitis

Summary: laparoscopic appendectomy (l-appe) presents a golden standard in the treatment of acute appendicitis nowadays. however, there are ongoing controversies regarding the ideal technique of appendicular stump closure during l-appe in the published literature. several technical modifications of appendicular stump closure are available at the present - closure using endoloop, endostapler or hem-o-lock clips. the aim of the proposed project (cas study) is to compare medical and economic outcomes of patients undergoing l-appe with different methods of appendicular stump closure (endostapler, endoloop and hem-o-lock clips).

acute appendicitis presents one of the most common surgical illnesses which affect approximately 7% of the western population. in the czech republic, 11664 patients were hospitalized and operated for the diagnosis of acute appendicitis (k35-k38) during 2016. it might seem that the procedure of appendectomy will be guided by a clear algorithm for its frequency, but it is not so. because of acute appendicitis, appendectomy may be performed via laparotomy or laparoscopy (minimally invasive surgery). during laparoscopic appendectomy (l-appe), there are no clear recommendations regarding trocar placement, methods of dividing appendicular mesenteriolum, methods of appendicular stump closure or appendicular stump sinking. the proposed clinical study is focused on the issue of the appendicular base interruption during l-appe. at the present, there are several technical modifications of appendicular stump closure - by means of endoloop (the suture loop from absorbable fiber), endostapler or using hem-o-lock clips. the performed literature search revealed that evidence-based medicine data regarding the optimal way of appendicular stump closure are insufficient. that is why the investigators have decided to conduct a prospective randomized single-center clinical study aimed to compare different technical modifications of appendicular stump closure during l-appe. within a study period, all patients undergoing l-appe at the university hospital ostrava will be randomized to one of the technical modifications of appendicular stump closure. the aim of the project (cas study) is to compare medical and economic outcomes of patients undergoing l-appe with different methods of appendicular stump closure (endostapler, endoloop and hem-o-lock clips). the operative time, intraoperative and postoperative complications will be the primary outcome measures of the study, economic outcomes will be the secondary outcome measures.

Eligibility criteria:
inclusion criteria: * age ≥18 years * acute appendicitis * laparoscopic approach * signed informed content exclusion criteria: - necrosis or advanced inflammatory changes in the area of appendicular stump

Keywords: acute appendicitis laparoscopy closure of appendicular stump economical and medical outcomes
development and evaluation of rapid bacterial species identification for acid-fast bacilli smear using image analysis ai

Conditions: Bacterial Infections

Summary: the goal of this observational study is to develop ai that detects and classifies acid-fast bacilli from microscope images using anonymized and fixed glass slides.


Eligibility criteria:
inclusion criteria: * patients in whom acid-fast bacilli(afb) smear test was ordered exclusion criteria: * no exclusion criteria
islamic trauma healing: feasibility study

Conditions: Post Traumatic Stress Disorder

Summary: this study will examine the initial feasibility of a program called islamic trauma healing by conducting a small feasibility study (n = 26) of islamic trauma healing in somalia on key targets of ptsd, depression, somatic symptoms, and quality of life. the hypothesis is that those in islamic trauma healing will show a reduction of ptsd symptoms, depressive symptoms, and somatic symptoms and show improvement in quality of well-being. feasibility will also be examined by examining at retention, satisfaction, and community feedback.

islamic trauma healing is a lay-led, small-group intervention specifically targeting healing mental wounds of trauma within mosques. the six-session intervention combines empirically supported exposure-based and cognitive restructuring techniques with islamic principles. a lay-led, group program promotes community building, acknowledges trauma's impact in the community, and facilitates wider implementation. the program is not referred to as "therapy" or "treatment" for "mental illness." it incorporates community building (e.g., shared tea, supplication), integrated islamic principles that utilize cognitive restructuring through discussion of prophet narratives (e.g., faith during hard times, prophet job \[ayyub\]), and exposure therapy through individual prayer, talking to allah about the trauma. ultimately, the program will follow a self-sustaining train-the-trainer model, led by group leaders, empowering lay leaders to facilitate healing in their communities. further, training time is dramatically reduced to two, 4-hour training sessions, focusing on teaching skills of group discussion leading rather than training as a lay therapist or mental health counselor. preliminary data from a community sample and from initial men's and women's groups show a strong perceived need and match with the islamic faith, with large effects obtained for pre- to post-group across measures (g = 0.76-3.22). qualitative analysis identified the intervention as operating on potential mechanisms of connectedness to the community, faith integration, healing, and growth. the preliminary data point to the program being well-received and offering a promising model for delivery of a trauma-focused intervention to muslim communities. the next steps are examining islamic trauma healing in low and moderate-income muslim countries, examining the feasibility of implementing this lay-led program.

Eligibility criteria:
inclusion criteria: * experienced a dsm-5 trauma at least 12 weeks ago * report current re-experiencing or avoidance symptoms * islamic faith * 18-65 year of age exclusion criteria: * immediate suicide risk, with intent or plan * cannot understand consent/visible cognitive impairment
dosage effects of folic acid on blood folates of honduran women

Conditions: Spina Bifida and Anencephaly

Summary: cdc staff at the national center on birth defects and developmental disabilities have been working closely with a honduras-based organization, project healthy children (pns) and the ministry of health, on a folic acid supplementation study among female maquila workers. participants are divided into two groups. one group receives a 1.0 milligram pill daily while the other group receives a 5.0 milligram pill weekly. the aim of this study is to assess serum blood folate levels measured at baseline, midpoint, and endpoint of the study. hypothesis: folic acid (5mg)given once weekly is as effective as folic acid (1mg)given daily in raising blood folate levels.


Eligibility criteria:
inclusion criteria: minimum employment in factory 6 mths - exclusion criteria: * pregnant * currently consuming folic acid * prior birth-defect affected pregnancy * chronic disease * currently taking folic acid antagonist
pulse control using usg and manual palpation methods in cardiopulmonary resuscitation

Conditions: Cardiopulmonary Resuscitation

Summary: the final approach adopted in advanced cardiac life support (acls) guidelines as defined by the american heart association (aha) and the european resuscitation council (erc) is to minimize the time between chest compressions in cardiopulmonary resuscitation (cpr). pulse and rhythm checks are recommended between chest compressions and it is stated that this period should not exceed 10 seconds. all guidelines also state that in cases of low cardiac output or low blood pressure, even if electrocardiographic (ecg) rhythms can be obtained, pulse checks may still fail and an arterial pulse may not be felt during chest compressions. this difficulty in sensing the arterial pulse causes delays in the decision of cardiac arrest in the patient. for this reason, there are cases of cardiac arrest in which the initiation of cpr is delayed or not started at all. the most common method for checking the pulse is manual palpation. however, since it is an operator-dependent method, it is affected by the experience of the healthcare personnel, the vital values of the patient, and anatomical differences. therefore, more objective criteria are required to detect a pulse. a clinical study of the reliability of pulse checks showed that most healthcare professionals are unable to detect the presence or absence of a pulse. another study showed that pulse alone is not sufficient to initiate cpr, and 50% of decisions to initiate cpr based on heart rate are incorrect. therefore, more objective criteria have been sought to detect the presence of a pulse. for this purpose, evaluations were made regarding the presence of end-tidal carbon dioxide, cardiac echo, and organized rhythm.


Eligibility criteria:
inclusion criteria: * all adult patients (over 18 years of age) with in-hospital or out-of-hospital cardiac arrest exclusion criteria: * patients with traumatic arrest * conditions affecting carotid pulse palpation and/or usg application (patients with a history of carotid stenosis or dissection, patients undergoing neck surgery, patients with neck abscess hematoma) * pregnant arrest patients

Keywords: carotid artery pulse check cardiopulmonary arrest
effectiveness of relational touch in painful elderly

Conditions: Chronic Pain

Summary: the aim is to investigate the feasibility and efficacy of a relational touch / relational intervention on persistent pain in a long term geriatric hospital care ward population. the main issue is the pain reduction. the hypothesis is that this type of intervention is very useful on pain reduction in old people even with physical or mental disability.

the first 74 patients wanting to participate are randomly assigned to 2 groups: relational- touch or relational. inclusion criteria are : patients with chronic pain; age \>65y and informed consent. where patients had mental impairment the family's agreement is solicited. the regional ethics committee agreement was granted. the intervention consists of 6 relational versus relational- touch sessions (twice a week) .evaluation takes place after the second, 4th and 6th sessions and in the 4th week following the intervention. the main outcome is the pain reduction. the primary outcome measure is the pain reduction according to the doloplus scale and the vrs; the secondary outcomes measures are : patient's participation rate; pain related symptoms variation; overall benefit.

Eligibility criteria:
inclusion criteria: * age \>65 y * chronic pain \> 3 months * follow up 4 weeks * patient's speak french * patient's or representative's agreement to participate and to the informatics treatment of the data exclusion criteria: * acute pain * unstable clinical status

Keywords: chronic pain elderly relational touch
atrial fibrillation prediction trial.

Conditions: Atrial Fibrillation

Summary: atrial fibrillation (af) is a common arrhythmia with a prevalence of 1.5-2%. this prevalence increases significantly after 80 years of age. after the appearance of first episode(s) some of the patients will present frequent arrhythmia recurrences moving from the paroxysmal status to the persistent and the permanent status of the continuous spectrum of the natural time course of af. in contrast some other will not present further relapses. to study and predict the dynamic evolution of af is clinically important, furthermore, the detection of different sub populations risk for af relapses will determine and different therapeutic approaches.

atrial fibrillation (af) is a common arrhythmia with a prevalence of 1.5-2%. this prevalence increases significantly after 80 years of age. in the presence of the arrhythmia the risk of stroke increases five fold while the congestive heart failure and the mortality rates are increasing significantly also.after the appearance of first episode(s) some of the patients will present frequent arrhythmia recurrences moving from the paroxysmal status to the persistent and the permanent status of the continuous spectrum of the natural time course of af. in contrast some other will not present further relapses. to study and predict the dynamic evolution of af is clinically important, furthermore, the detection of different sub populations risk for af relapses will determine and different therapeutic approaches. the study will include \> 500 patients 30-80 years old. inclusion criteria is one up to five paroxysmal af (paf) episodes during the last three years. patients during screening must maintaining sinus rhythm. exclusion criteria are substrate of severe valvular diseases, congenital heart disease, previous heart surgery, hyperthyroidism, severe diseases of the autonomic nervous system, alcoholism, diseases affecting seriously the survival and absence of adequate cooperation for the study. screening will include 12 lead surface digital ecg, 30 min high resolution (1000 hz) ecg recording from 3 pseudo orthogonal x,y,z leads system, and complete echo study (2d, pwd, tdi, strain).among other indices will be analyzed: p duration, p index, p dispersion, p wave signal for late potentials, for wavelets, pq/rr dynamics, heart rate dynamics and various markers for the autonomic nervous system status.primary end point is one or more paf relapse(s) during a period of 12 months after recruitment in study.secondary end point is permanent af during a period of 36 months after recruitment in study.

Eligibility criteria:
inclusion criteria: * inclusion criteria is one up to five paroxysmal af (paf) episodes during the last three years. patients during screening must maintaining sinus rhythm. exclusion criteria: * previous heart surgery, hyperthyroidism, severe diseases of the autonomic nervous system, alcoholism, diseases affecting seriously the survival and absence of adequate cooperation for the study

Keywords: atrial fibrillation relapses prediction p wave signal averaged ecg p wave wavelets strain tissue doppler imaging
pivotal influence of obesity on body composition and ovarian doppler in different polycystic ovarian syndrome phenotypes

Conditions: Polycystic Ovary Syndrome; Obesity

Summary: the study aimed to explore the impact of obesity on both body composition and ovarian doppler parameters across various phenotypes of females diagnosed with polycystic ovarian syndrome (pcos). additionally, the investigation seeked to establish correlations between these parameters and their prevalence concerning the clinical criteria of pcos.

polycystic ovarian syndrome (pcos) is a complex and multifactorial condition characterized by endocrinological, reproductive, metabolic, and biochemical abnormalities, affecting 12% to 21% of reproductive-aged females. it has emerged as a significant global public health concern. however, variations in diagnostic criteria and patient selection have led to considerable discrepancies in the absolute prevalence of pcos and its temporal trends. previous studies have examined ovarian volume and blood flow indices in both obese and non-obese females with pcos, albeit employing different criteria for obesity classification. notably, none have compared these parameters across normal weight, overweight, and obese pcos females. therefore, the current study aims to explore the impact of obesity on body composition and ovarian doppler parameters within distinct pcos phenotypes. an additional objective is to assess correlations between anthropometric, body composition, and ovarian doppler parameters and the prevalence of pcos symptoms.

Eligibility criteria:
inclusion criteria: * age ranged from 18 to 40 years old. * individuals with polycystic ovary syndrome (pcos) should exhibit at least two of the three features outlined in the rotterdam criteria for diagnosis, encompassing oligo- or anovulation, clinical and/or biochemical indications of hyperandrogenism, and the presence of polycystic ovaries as identified through ultrasonography. exclusion criteria: * congenital adrenal hyperplasia * thyroid dysfunction * hyperprolactinemia * androgen-secreting tumors * cushing syndrome * undergoing any medical therapy for the treatment of pcos or for weight loss.

Keywords: polycystic ovary syndrome obesity body composition ovarian doppler
telemedically supported analgesia in the emergency medical service

Conditions: Indication for Analgesia; Emergency Medical Service; Teleconsultation

Summary: the aim of the study is to evaluate the safety and efficacy of telemedically supported and delegated pain therapy in the emergency medical service (ems).

six ambulances from five different emergency medical service (ems) districts are equipped with a portable telemedicine system. in cases of emergencies, where intravenous analgesia is necessary, the paramedics can use this system to contact a so called "tele-ems physician" after consent of the patient is obtained. the tele-ems physician has an audio-connection to the ems team and receives vital parameters (e.g., ecg, pulse oximetry, non-invasive blood pressure) in real-time. the transmission of still pictures - taken with a smartphone - and video streaming from the inside of the ambulance can be carried out, if meaningful. the tele-ems physician supports the ems team and can delegate the application of morphine and other analgesics. this can be carried out to bridge the time to the arrival of an ems physician or in less severe cases without an ems physician on-scene. all regular ambulances of the five districts are not allowed to administer analgesics without an physician on-scene. they have to call an advanced life support response unit, staffed with an ems physician, who carries out all kinds of als interventions. the safety, efficacy and the quality of analgesia should be compared with regular ems.

Eligibility criteria:
inclusion criteria: * verbal consent obtained or patient is unable to consent due to the severity of the emergency * indication for analgesia exclusion criteria: * refused consent * no indication for analgesia

Keywords: telemedicine teleconsultation analgesia emergency prehospital
implementation of cognitive stimulation therapy

Conditions: Dementia

Summary: this project aims to examine the feasibility of implementing cognitive stimulation therapy (cst) under real world circumstances in a more heterogenous population, with the ultimate goal of making the treatment broadly accessible. the effects of cst on the behavioral and psychological symptoms of dementia (bpsd) as a non-pharmacologic intervention will also be studied.


Eligibility criteria:
inclusion criteria: * established diagnosis of dementia or meets the criteria for dementia based on a positive screening test with clinical evidence of cognitive impairment affecting one or more adl * has a slums score greater than 10. exclusion criteria: * unable to hold a meaningful conversation, * unable to hear well enough to participate in a small group discussion * severe visual impairment that precludes ability to see most pictures * unable to remain in a group setting for 45 minutes