Kornimate/medical-research-clean huggingface dataset:
role of nitazoxanide and escitalopram in patients with rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: this study aims at evaluating the therapeutic effects of both nitazoxanide and escitalopram as adjuvant therapies in patients with rheumatoid arthritis and to evaluate their impact on stat3/ jak2, tlr /il -1β signaling pathways.

this study is a randomized, controlled prospective study to evaluate the potential therapeutic effects of the broad -spectrum antimicrobial (nitazoxanide) and selective serotonin reuptake inhibitor (escitalopram) on synovial inflammation and angiogenesis when administered as add-on treatments to the current dmards treatments for rheumatoid arthritis patients. a total of 90 ra patients recruited from outpatient clinic of physical medicine, rheumatology and rehabilitation at mansoura university hospitals, mansoura, egypt will be included in the study. they will be diagnosed with ra according to the american college of rheumatology/european league against rheumatism criteria 2010 (the acr/eular 2010 criteria). ra patients who will meet the inclusion criteria will be enrolled in the study. they will be classified into three groups: group 1: 30 ra patients who will receive the traditional therapy of rheumatoid arthritis for 12 weeks and serve as the control group. group 2: 30 ra patients who will receive traditional therapy plus nitazoxanide 1 gm/day for 12 weeks. group 3: 30 ra patients who will receive traditional therapy plus escitalopram 10 mg/day for 12 weeks. clinical examinations and laboratory parameters will be performed and measured at the beginning of the study and 3 months after randomization to evaluate the efficacy of nitazoxanide and escitalopram in the treatment of rheumatoid arthritis.

Eligibility criteria:
inclusion criteria: * diagnosed with rheumatoid arthritis according to the acr/eular 2010 criteria. * receiving conventional disease modified anti rheumatic drugs (dmards). * having active disease (the 28-joint disease activity score \[das28\] according to the crp formula \> 2.6). * age between 18 and 75 years. * conscious and cooperative. * male or female. * sign an informed consent for the clinical study exclusion criteria: 1. pregnant or planning to be pregnant and breast-feeding women. 2. chronic disease. 3. other autoimmune diseases, such as systemic lupus erythematosus, sjogren's syndrome and mixed connective tissue disease. 4. patients treated with biological tnf-α, il6 or il-1β antagonists. 5. infectious or inflammatory diseases, endocrine disorders, any past or current psychiatric or neurological diseases. 6. clinically significant hepatic and renal dysfunction or impairment. 7. alcohol abuse 8. receiving therapy that interact with nitazoxanide and escitalopram. 9. hypersensitivity to nitazoxanide and escitalopram.

Keywords: nitazoxanide escitalopram stat3/ jak2 signaling pathway tlr-4 /il -1β signaling pathway
doraya-hf ous assessment of the doraya catheter for the treatment of adhf patients with insufficient response to diuretics

Conditions: Acute Decompensated Heart Failure

Summary: the study objective is to evaluate the feasibility of the doraya catheter and measure clinical performance and safety endpoints, in adhf patients deemed to have insufficient diuretic response.


Eligibility criteria:
inclusion criteria: 1. subject is hospitalized with primary diagnosis of adhf. 2. n-terminal-pro-brain natriuretic peptide (nt-probnp) ≥1,000 pg/m orvbnp≥250 pg/ml. 3. evidence of fluid overload. 4. subject insufficiently responds to iv diuretic therapy exclusion criteria: systolic blood pressure \< 80 mmhg at the time of screening. 2. acute myocardial infarction or acute coronary syndrome or cardiogenic shock or pleurocentesis within past 14 days or cardiovascular intervention within past 14 days. 3. complex congenital heart disease (e.g., tetralogy of fallot subjects, single ventricle physiology). 4. known active myocarditis, hypertrophic obstructive cardiomyopathy, infiltrative cardiomyopathy (e.g., amyloidosis), constrictive pericarditis or cardiac tamponade. 5. severe aortic valvular disorder (i.e., hemodynamically relevant valvular diseases such as severe stenosis \\severe regurgitation) or severe mitral disease with planned intervention. 6. evidence of active systemic infection documented by either one of the following: fever \>38°c/100°f, or ongoing uncontrolled infection (i.e., inflammatory parameters not decreasing despite \> 48 hours of antibiotic treatment). 7. moribund subject or subject with severe or deteriorating damage in more than 3 critical body systems, based on investigator's clinical judgement.

Keywords: adhf
ghb poisoning and poisoning induced by others

Conditions: Drug Toxicity

Summary: patients with suspected ghb poisoning presenting to oslo accident and emergency outpatient clinic (oslo legevakt) or a hospital in oslo (oslo university hospital ullevål, diakonhjemmet, lovisenberg) will be included. oral fluid and blood tests will be analyzed for recreational drugs. clinical course will be charted, as well as treatment in the ambulance, emergency outpatient clinic and hospital to find predictors for when hospitalization is required. in the second part of the study the investigators will analyze urine and blood samples from patients presenting to the oslo accident and emergency outpatient clinic (oslo legevakt) with suspected substance poisoning induced by others, for toxic agents.

gammahydroxybutyrate (ghb) causes severe poisoning that requires emergency medical and hospital care. in addition, it is used as an anesthetic for planned sexual assault. laboratory analyses will help assess whether today's clinical diagnostics of ghb poisoning are precise enough, possibly being a supplement to improve it. can ghb poisoned patients be treated safely by emergency medical services or do these patients need hospitalization? in case of substance poisoning induced by others, sampling could identify substances that are quickly excreted from the body. today patients are referred to private laboratories the following day, delaying the diagnosis and missing short-term drugs. method: prospective study. oral fluid and blood samples will be collected from patients over 16 years of age where there is a clinical suspicion of ghb poisoning on arrival at oslo accident and emergency outpasient clinic (oslo legevakt) or hospital (ouh ullevål, lovisenberg and diakonhjemmet). blood and urine samples will be collected from patients over the age of 16 who present at the oslo accident and emergency outpasient clinic (oslo legevakt) with suspected substance poisoning induced by others. in both pasient groups the investigators will also register age, gender, clinically suspected toxic agents, vital signs, clinical features and treatment. the aims of this study are to see if the clinical diagnosis of ghb poisoning is precise enough, and whether more patients can be handled at an emergency outpatient level. furthermore, analysis of blood and urine samples from patients who suspect they have been poisoned by substances induced by others, will be done to identify toxic agents.

Eligibility criteria:
inclusion criteria: clinically suspected ghb poisoning means patients * who are comatose or have varying level of consciousness, * where there is absence of signs of opioid poisoning or poisoning with other agents, * where there is no effect of naloxone, * where there is information from a patient or companion about the intake of ghb * or where there is a finding of ghb in the patient's belongings. exclusion criteria: * patients under 16 years of age

Keywords: ghb gamma-hydroxybutyric acid substances of abuse poisoning induced by others recreational drugs poisoning intoxication
clinical evaluation of a myopia control lens in slowing myopia progression

Conditions: Myopia, Progressive; Myopia

Summary: this is a monocenter, randomized, controlled, parallel-group, double-masked clinical trial to evaluate the effectiveness of test lens in slowing myopia progression with respect to axial length elongation at baseline compared to a single vision spectacle lens (control). a total of 80 children will be recruited where 40 subjects will be allocated either to wear test lenses (group 1) or control lenses (group 2) for 1 year through randomization.

as myopia is a growing worldwide problem, it is important to better understand the range of possible treatments to slow the progression of myopia. spectacle lenses with aspherical lenslets were shown to be effective in reducing myopia progression and axial length elongation in children in the previous clinical trial. a dose-dependent effect was demonstrated, with higher lenslet asphericity having greater myopia control efficacy. this double masked parallel group study will test the safety and effectiveness of a test lens designed to modify the area and amount of myopic defocus on the retina without compromising vision. the study population includes children in singapore aged 8 to 13 years (80 subjects) at the time of commencing treatment. as age of myopia onset is known to be an important factor in rate of myopia progression, subject age at the time of enrollment will be used to balance randomization. axial length and spherical equivalent refraction will be the primary measure for myopia progression. visual acuity will also be compared between test lenses and control lenses to determine the quality of vision using test lenses.

Eligibility criteria:
inclusion criteria: * volunteer subject and guardian, fluent english spoken, willing to follow protocol and able to read, comprehend and sign the informed consent \& assent form. * equal to or greater than 8 years and not older than 13 years at time of informed consent and assent. * spherical equivalent refractive error (ser) by manifest refraction between -0.75 and -4.75 d in each eye. * astigmatism, if present, of not more than 1.50 d. * difference in ser between the two eyes (anisometropia) by manifest refraction not more than 1.00 d. * best corrected visual acuity in each eye equal to or better than +0.10 logmar (≥ 20/25 as snellen) * be in good general health based on his/her and parent's/guardian's knowledge. absence of ocular disease with full ophthalmic examination. without any ocular or systemic condition known to affect refractive status. * history of myopia control intervention * absence of strabismus by cover test at near or distance wearing correction. * absence of amblyopia * without ocular or systemic medications which, in the investigator's opinion, may significantly affect pupil size, accommodation or refractive state. exclusion criteria * vulnerability of subject * participation in any clinical study within 30 days of the baseline visit. * sibling of existing participant of this study

Keywords: refractive error eye disease short-sightedness children myopia myopia progression
clinical and radiographic success of pulpotomy using neoputty mineral trioxide aggregate versus pulpectomy using endoflas in primary molars with irreversible pulpitis: a randomized controlled trial

Conditions: Pulpitis - Irreversible

Summary: the goal of this randomized clinical trial is to evaluate the clinical and radiographic success of pulpotomy using neoputty mta vital primary molars diagnosed with symptomatic irreversible pulpitis. the main question it aims to answer is: will neoputty mta pulpotomy have higher clinical and radiographic success in comparison to endoflas pulpectomy in primary molars with irreversible pulpitis?


Eligibility criteria:
inclusion criteria: * children with spontaneous pain lasting a few seconds to several hours. * pain is intensified by thermal stimulus and persists after its removal. * pulp hemorrhage after performing access cavity and deroofing of pulp chamber showing reddish pink healthy pulp tissue. * radicular pulp health is verified by achieving hemostasis within six minutes of compression using a cotton pellet with 2% sodium hypochlorite. * absence of peri-apical or inter-radicular radiolucency, widening of periodontal ligament space, internal or external root resorption. exclusion criteria: * unrestorable primary molars. * primary molars with uncontrolled pulp hemorrhage or pulp necrosis. * medically compromised patients who have systemic disease. * uncooperative children who refuse treatment.
berlin beat of running study

Conditions: Cardiac Arrhythmia; Brain Lesion; Stroke

Summary: this prospective observational study will investigate the frequency of new onset atrial fibrillation (af) and of further cardiac arrhythmias as well as of (clinically silent) cerebral lesions in endurance runners before, during and after the bmw-berlin marathon 2011.

up to 120 experienced marathon runners will participate in the "berlin beat of running study" and will wear a transportable electrocardiogram (ecg) recorder at least 24 hours before, during and 24 hours after the bmw-berlin marathon. all participants will undergo brain mri examinations to detect cerebral lesions within days before and after the marathon race, respectively. moreover, serial blood samples will be taken a few days before, immediately after as well as a few days after the bmw-berlin marathon.

Eligibility criteria:
inclusion criteria: * age 35-65 years * at least 2 marathon runs within the last 5 years * weekly running of at least 40 km exclusion criteria: * known cardiac arrhythmia or prior stroke * contraindication for mri.

Keywords: marathon running brain mri ecg recording blood tests
efficiency of an optimized care organization for fatigue management for patients with covid-19.

Conditions: COVID-19; Fatigue

Summary: length of hospitalization for covid-19 infection may be increased due to the persistence of fatigue in 29-46% of cases. its management is essential to prevent the chronic fatigue . chronic fatigue syndrome affected between 30 and 40% of patients with sars in 2003 or mers in 2005 and persisted beyond 3 years. there is currently no specific treatment for acute or \<4 months asthenia. to avoid the transition to chronicity, some authors recommend respecting a long rest period. however, a program combining adapted physical activity and therapeutic patient education has already shown significant benefits for combating recent or semi-recent fatigue following a cardiovascular pathology and even during cancer treatments. therefore, the existing care pathway for hospitalized patients with covid-19 was adapted, combining exercise training and therapeutic patient education workshops.


Eligibility criteria:
inclusion criteria: * patient living in the loire region, france * patient showing post covid-19 fatigue (rt pcr positive \<1 month) * non-intubated patient if hospitalization in intensive care (\<72h) * patient hospitalized in a covid unit at the saint etienne hospital exclusion criteria: * patient hospitalized in intensive care \>72h * intubated and ventilated patient in intensive care * non-hospitalized patient and community-based medical follow-up

Keywords: covid-19 fatigue training therapeutic education physical activity
pocus for small bowel obstruction in the ed: a retrospective study

Conditions: Small Bowel Obstruction; Point of Care Ultrasound

Summary: this study protocol aims to evaluate the impact of point-of-care ultrasound (pocus) on the diagnosis and management of small bowel obstruction (sbo) in the emergency department (ed). sbo is a potentially life-threatening condition that requires prompt diagnosis and management. currently, the diagnosis of sbo is based on clinical evaluation and imaging tests, including plain abdominal radiography and computed tomography (ct) scan. pocus is a bedside imaging technique that is rapid, non-invasive, repeatable, cost-effective and radiation-free, and can provide valuable information for the diagnosis and management of sbo. the primary objective of this study is to compare the time to diagnosis of sbo between patients who undergo pocus intestinal loops examination and those who do not undergo pocus in the ed. the secondary objectives include comparing the hospital length of stay, the rate of surgical intervention, the rate of complications, and the mortality rate between the two groups. this is a monocentric retrospective cohort study that will include all adult patients (\> 18 years old) who presented to the ed with suspected sbo. the study population will be divided into two groups: the pocus group and the non-pocus group. the sample size calculation will be based on the assumption of a 30% reduction in the time to diagnosis of sbo in the pocus group compared to the non-pocus group, with a power of 80%. the results of this study may provide more robust evidence on the diagnostic accuracy and impact of pocus for sbo in the ed.


Eligibility criteria:
inclusion criteria: * age \> 18 years old * clinical suspicion of sbo based on history and physical examination * plain abdominal radiography (axr) or ct scan performed in the ed exclusion criteria: * pregnancy * known bowel obstruction * previous abdominal surgery within 30 days * refusal or inability to consent

Keywords: pocus sbo
respiratory training intervention

Conditions: Elders

Summary: this study aims to examine the effect of abdominal diaphragmatic breathing combined with incentive spirometer breathing training on the lung capacity of elderly community residents.

the research will be conducted in a community in central taiwan. inclusion criteria are people over the age of 65 in the community. all participants will be randomly assigned to either the experimental group or the control group. the experimental group will receive the breathing training of abdominal diaphragmatic breathing method combined with incentive spiromete. the control group is only taught the breathing training of abdominal diaphragmatic breathing. four assessment tools will be used, including the demographic questionnaire, respiratory capacity indicators, modified medical research council (mmrc) dyspnea scale, and the world health organization quality of life-bref taiwan version (whoqol-bref; whoqol-bref). data analysis will be performed by independent sample t test, paired t test, and repeated measures analysis. all data analysis will be performed by spss version 22.0.

Eligibility criteria:
inclusion criteria: 1. over 65 years old 2. a person who is conscious and can communicate in mandarin or hokkien, and can cooperate with breathing exercises. 3. agree to interview or fill out the questionnaire, and complete the consent form. exclusion criteria: 1. hemoptysis, pneumothorax, unstable cardiovascular status, chronic respiratory diseases (asthma, chronic obstructive pulmonary disease). 2. recent myocardial infarction or pulmonary embolism, thoracic aortic aneurysm, abdominal aortic aneurysm or cerebral aneurysm, recent eye surgery, nausea or vomiting, recent chest or abdominal surgery. 3. suffering from infectious diseases: airborne such as: chickenpox, measles, tuberculosis, severe special infectious pneumonia influenza. droplet transmission such as: pneumonia, influenza.

Keywords: breathing training abdominal diaphragmatic breathing respiratory capacity quality of life-
aripiprazole augmentation therapy in treatment-resistant depression

Conditions: Therapy-resistant Depression

Summary: 20 therapy-refractory patients with major depression will be treated for 3 weeks with aripiprazole 10 mg/d. effectivity will be assessed using a pre-post comparison of different psychopathological rating scales and patient adherence.

this will be an open pilot study using pre-post comparison. 20 treatment-refractory patients with major depression diagnosed by dsm-iv will be included. psychotic features of depression will be excluded by a score of 2 or less in the panss subscales p1, p3 and p6. treatment resistance as defined by history of non-response to two antidepressants from different classes at an acceptable dose and period is confirmed retrospectively. if possible, treatment compliance should be confirmed by plasma level examination. after informed consent, visit 1 is performed on day 0 (inclusion criteria, history, demographics, physical examination, vital signs, hamd, madrs, cgi, bdi, lab). study medication is started on day 1, the antidepressive therapy is continued at stable dose until the end of the study. patients will receive an adjunctive augmentation therapy of 10 mg/d aripiprazole. study visits will be performed on days 3, 7, 14 and 21 (visits 2-5: vital signs, hamd, madrs, cgi, bdi, lab). in addition to the ham-d and madrs scores, patients will perform a self-rating (bdi). aripiprazole plasma levels will be measured at the end of the treatment period to assess compliance and to detect a putative correlation between drug plasma levels and efficacy.

Eligibility criteria:
inclusion criteria: * major depression without psychotic features (dsm-iv definition) * therapy resistance (two courses of antidepressants from different classes for more than 3 weeks in adequate dose) * ham-d score greater/equal than 17 * age 18-70 exclusion criteria: * bipolar disorder * active alcohol or illicit drug use * female without effective contraception * severe medical conditions * psychotic features

Keywords: therapy-resistant depression add-on therapy depression
laser versus cryotherapy for the treatment of recalcitrant warts

Conditions: Warts

Summary: to evaluate whether laser was superior to cryotherapy for recalcitrant warts

patients with recalcitrant warts were randomized equally to receive laser or cryotherapy every 3 to 4 weeks, for a maximum of 4 sessions.the primary outcomes were the cure rate at 16 weeks; secondary outcomes included time to clearance of warts, patient satisfaction with the treatment and treatment-related adverse effects.

Eligibility criteria:
inclusion criteria: * patients with hpv2/27/57-induced recalcitrant warts, including periungualor mosaic warts, common or plantar warts with a duration of longer than 1 year, and common or plantar warts previously received no more than two sessions of cryotherapy * total number of warts is ≤10 . * aged 18 years or older. exclusion criteria: * patients are currently participating in another trial for the treatment of cutaneous warts. * patients have taken immunosuppressant drugs (such as oral corticosteroids) during the past three months. * patients have impaired healing eg due to diabetes, vitamin a deficiency, hyperthyroidism and hypothyroidism. * patients have autoimmune diseases (such as systemic lupus erythematosus, dermatomyositis, scleroderma or other diseases). * patients are pregnant or ready for pregnancies or breast-feeding. * patients have cold intolerance (such as cold urticaria, cryoglobulinaemia, cold agglutinin syndrome or raynaud's syndrome). * patients have local pain intolerance. * patients have local hypoesthesia. * patients are unable to tolerate laser or cryotherapy.