Kornimate/medical-research-clean huggingface dataset:
pain and autonomic symptoms in parkinson's disease and atypical parkinsonisms

Conditions: Parkinson Disease; Multiple System Atrophy

Summary: the goal of this observational study is to learn about the impact of the different types of pain and of the domains involved in the autonomic disorders of inpatients and outpatients diagnosed with parkinson disease (pd) and multiple system atrophy (msa) admitted to istituti clinici scientifici maugeri centers. the main aims are: evaluate the prevalence of pain and characterize it in parkinson's disease and atypical parkinsonisms (msa) evaluate the effect of rehabilitation on pain and autonomic symptoms evaluate the prevalence of autonomic symptoms in parkinson's disease and atypical parkinsonisms (msa) assess the impact of pain and autonomic symptoms on quality of life. participants will perform neurological examination, rehabilitation program and clinical scales. researchers will compare the two groups of patients (pd and msa) and the effect of the rehabilitation on pain, autonomic symptoms and quality of life.

2% of the population over 65 is affected by parkinson's disease (pd) or parkinsonism. this represents a significant burden on the health service in countries where the elderly represent 1/5 of the general population. in recent years there has been increased attention on the presence of non-motor disorders in pd patients. among these, pain and autonomic symptoms are more frequently present and contribute to the worsening of disability and quality of life of the affected patient. how much the presence of pain and autonomic symptoms can affect the rehabilitation outcome and how much the rehabilitation treatment itself can improve the painful or autonomic symptomatology is not known, but rehabilitation has an important role in the management of diseases where there are no real treatments capable of cure or slow down the neurodegenerative process. in the maugeri clinical scientific institutes, patients with parkinson's disease or parkinsonism are hospitalized or followed as outpatients and a personalized rehabilitation setting is ideal for being able to evaluate the patient in a sufficiently wide time frame to be able to appreciate significant changes in clinical parameters. the greater knowledge of the impact of the different types of pain and of the domains involved in the autonomic dysfunction will help the clinician to better manage the patient's disability and will contribute to the definition of specific rehabilitation strategies aimed to improve the patient's quality of life.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of parkinson's disease or multiple system atrophy according to current international criteria (gilman s et al, 2008; postuma rb et al. 2015). * mini-mental state examination score at least 10 exclusion criteria: * vascular or pharmacological parkinsonism * diabetes mellitus * hepatic or renal dysmetabolism, * hypothyroidism or hyperthyroidism * assumption of potentially neurotoxic drugs

Keywords: pain autonomic symptoms rehabilitation
dynamic measures of neurochemistry in mood disorders

Conditions: Depression

Summary: the purpose of this study is to understand changes in brain chemical signals when people take antidepressants called sertraline (zoloft®) and bupropion (wellbutrin sr, zyban ®). spinal fluid is used to measure chemical levels of dopamine, serotonin, and other chemicals thought to be involved in depression. the study has potential to help understand and treat depression.

the purpose of this study is to understand changes in brain chemical signals when people take antidepressants called sertraline (zoloft®) and bupropion (wellbutrin sr, zyban ®). spinal fluid is used to measure chemical levels of dopamine, serotonin, and other chemicals thought to be involved in depression. the study has potential to help understand and treat depression.

Eligibility criteria:
inclusion criteria: * age range: 18 to 50 years. * weight: within 20% of ideal weight, as specified in the 1983 metropolitan height and weight tables. patients who deviate from these ranges may be reviewed on an individual basis by the investigator. this criterion is necessary because of mechanical risks of poor access in overweight individuals, and because of physiologic risks in underweight individuals. * sex distribution: both men and women (self or partner surgically sterilized, or using double barrier method). to the extent possible, women will have csf sampling at the same point in their menstrual cycles, ideally during the follicular phase. * race: any * health: healthy, ambulatory depressed or healthy adults; must show clear capacity to form consent based on a strong understanding of the potential risks and benefits. exclusion criteria: * evidence of significant hepatic, gastrointestinal, renal, respiratory, endocrine, hematologic, neurologic, psychiatric, or cardiovascular system abnormalities, history of deep venous thrombosis (dvt), thrombophlebitis, coagulopathy. * pregnancy. * patients with a known or suspected history of alcohol or drug misuse and/or a positive urine drug screen. * patients who are unwilling or unable to abide by the requirements of the study or who violate the prohibitions and restrictions of the study. * any condition which would make the patient, in the opinion of the investigator, unsuitable for the study. * patients who have taken any unapproved prior or concomitant medications. * patients who have donated blood within one month of the study. * patients with serious medical illness, history or signs/symptoms of lumbar spine/disc disease or significant laboratory findings. * recent participation in other studies. * patients with histories of migraine will be considered individually, and warned of the risk of headache following spinal tap. * patients who smoke regularly, would experience withdrawal while hospitalized for 5 days, or who cannot abstain from tobacco for the entire duration of the study. * patients who present significant suicide risk, e.g. with a history of highly impulsive suicide attempts.

Keywords: depression antidepressant ssri
using cpap to improve menstruation in women with polycystic ovarian syndrome and obstructive sleep apnea

Conditions: Sleep Apnea, Obstructive; Anovulation; Polycystic Ovarian Syndrome

Summary: the purpose of this study is to determine if treatment of obstructive sleep apnea (osa) with continuous positive airway pressure in women with both osa and polycystic ovarian syndrome will improve the regularity of the women's menstrual cycles.

women seeking fertility treatment at the university of louisville will be screened for polycystic ovarian syndrome (pcos) based on history and then blood work if history suggests pcos. after establishing a diagnosis of pcos based on the national institute of health criteria, they will be screened for impaired glucose tolerance, class iii obesity, and obstructive sleep apnea \[using the epworth sleepiness scale (ess) as the initial screen\]. for those women that screen positive on the ess, they will be referred to the university of louisville physicians sleep center for a formal sleep study. only patients with pcos, severe obstructive sleep apnea, impaired glucose tolerance, and class iii obesity will qualify for enrollment in the study. once enrolled, patients will be encouraged to use continuous positive airway pressure (cpap, standard of care for treatment of obstructive sleep apnea) for at least six months. during those six months, patients will be asked to track their menstrual cycles and whether they took progesterone to induce a withdrawal bleed during that time period. the use of ovulation predictor kits to help determine ovulation status will be encouraged, but not required for the study. during initial evaluation, patients seeking fertility care having a clinical presentation concerning for pcos have their blood drawn for evaluation of thyroid stimulating hormone, free and total testosterone, antimullerian hormone, and 2 hour glucose tolerance test. at the conclusion of six months of cpap therapy, patients will be asked to repeat the above blood tests for comparison to baseline values. women can continue to attempt pregnancy during the study time period if they desire.

Eligibility criteria:
inclusion criteria: * age 18-35 * english speakers * polycystic ovarian syndrome by nih criteria * abnormal 2 hour glucose tolerance test * body mass index \>/= 40 kg/m2 * severe obstructive sleep apnea diagnosed with either a home or in-house sleep study exclusion criteria: * age \ 35 * non english speakers * no diagnosis of pcos * normal glucose tolerance test * no diagnosis of obstructive sleep apnea * body mass index \< 40 kg/m2 * using any form of hormonal contraception

Keywords: pcos, osa, cpap
the effect of propofol based total intravenous anesthesia on oxidative stress and nitric oxide

Conditions: Prostate Cancer

Summary: robot assisted laparoscopic radical prostatectomy(robot-lrp) requires pneumoperitoneum and trendelenburg position which result in oxidative stress and inflammatory response. propofol is well known to reduce those responses during anesthesia. therefore, we try to figure out the efficacy of propofol to reduce oxidative stress, inflammatory response and increase the nitric oxide activity during robot-lrp compared to that of desflurane. to investigate the oxidative stress, malondialdehyde will be measured. as inflammatory markers, interleukin-1β, interleukin-6, tumor necrosis factor-α will be measured. nitric oxide will be measured as well. secondarily, kidney protection effect of propofol over desflurane will be compared.


Eligibility criteria:
inclusion criteria: * patients undergoing robot-assisted laparoscopic radical prostatectomy under general anesthesia exclusion criteria: * chronic renal failure ( estimated glomerular filtration rate \<60 ml/min/1.73m2) * allergy to propofol, nuts * on diuretics, vitamin c or vitamin e within 5 days before surgery * body mass index \> 30 kg/m2 * older than 70 years * who cannot read the patient consent form
vitamin-d receptor activation (vdra) in chronic kidney disease

Conditions: Chronic Kidney Disease

Summary: to investigate whether treatment with a vitamin-d receptor activator is able to improve important markers of cardiovascular risk.

main question: may 12 weeks of vdra treatment reduce the pathological sympathetic overactivation associated with moderate kidney disease? secondary questions aim to thrown light on how vdras can reduce albuminuria and crp, i.e. does vdra treatment improve (prespecified statistical analyses): a) diastolic dysfunction? b) capillary microcirculation, and whether ameliorated disturbances relate to improved diastolic dysfunction? c) endothelial dysfunction and arterial stiffness? d) inflammatory activation? e) platelet function and haemostasis? f) levels of antibacterial peptides? g) levels of igfbp-1 and adiponectin? overall design the study is designed as a double-blind, randomised, placebo-controlled trial involving two groups (n=72) of patients: 1) chronic kidney failure (ckd, egfr 15-59 ml/m2) and 2) chronic kidney failure and concomitant diabetes mellitus (ckd+dm). it will start with a two-week placebo run-in, followed by randomisation to: 1. zemplar 1 μg (taken as 1 x 1 μg capsule and one placebo capsule), 2. zemplar 2 μg (taken as 2 x 1 μg capsules) and 3. placebo (taken as two placebo capsules).

Eligibility criteria:
inclusion criteria: egfr 15-59 ml/m2 exclusion criteria: current vitamin d treatment

Keywords: dysfunction in ckd
study of circulating multiple myeloma cells as a biomarker of mgus and smm

Conditions: a Diagnosis of MGUS or SMM by IMWG Criteria

Summary: this is a prospective study to collect blood and bone marrow samples from patients with sm and mgus. about 100 subjects will be enrolled at the university of pennsylvania and followed for 2 years. the primary objective of this study is to evaluate cmmcs as a biomarker to detect patients at high risk of progression to multiple myeloma in patients with mgus and smm.

the primary objective is to evaluate cmmcs as a biomarker to detect patients at high risk of progression to multiple myeloma in patients with mgus and smm. the secondary objective are to correlate cmmcs with the mayo clinic prognostic models in mgus/smm, to compare bone marrow genomic findings with genomic findings in cmmc (utilizing multiple myeloma fish panel), to perform immunophenotyping of bone marrow plasma cells, to perform gene expression profiling on cd138+bone marrow plasma cells and correlate with progression, to perform serum microrna profiling and correlate with progression, to correlate bone marrow immunohistochemical studies evaluating the microenvironment with cmmc, to perform proteomic profiling on peripheral blood to evaluate serum biomarkers of progression and to establish a biorepository of samples of peripheral blood for future studies.

Eligibility criteria:
inclusion criteria: * age 18 or greater * capable of informed consent * a monoclonal gammopathy detected in the serum, including intact immunoglobulin (igg and iga) and light chain only gammopathies. light chain only gammopathy is defined as an abnormal light chain ratio and increased involved light chain).44, 45 * absence of myeloma related organ or tissue impairment ("crab") as defined by: * hypercalcemia (calcium greater than or equal to 11) * renal failure (creatinine \>2.0) * anemia hemoglobin \<10 gm/dl) * bone disease (osteolytic lesions, fractures) exclusion criteria: * a secondary b-cell neoplasm or other active malignancy aside from non-melanoma skin cancer or localized prostate cancer. an active malignancy is any malignancy requiring therapy within the past 3 years. patients with monoclonal b-cell lymphocytosis are not excluded. * igm monoclonal gammopathy * inability to comply with follow-up
effect of lower extremity traction on the popliteal angle after percutaneous needle tenotomy of the knee flexor muscles.

Conditions: Disability or Chronic Disease Leading to Disablement

Summary: people with neuromotor disability (i.e. following an inborn or acquired spinal cord, cerebral or peripheral neurological lesion) are at risk of neuro-orthopaedic disorders. microinvasive percutaneous needle tenotomy is a frequent use alternative to open surgery to treat limb deformities. a lower extremity traction is performed in our unit during 2 to 7 days after surgery of the knee flexor muscles. the aim of this study is to describe the efficiency of lower extremity traction on the popliteal angle after percutaneous needle tenotomy of the knee flexor muscles.

this is a prospective, monocentric, cohort study of neurological disabled inpatients subjects treated in the perioperative disability unit (upoh) of our university hospital for limb deformities by percutaneous needle tenotomy of the knee flexor muscles. all eligible inpatient subjects with neuromotor disability and admitted for the treatment of limb deformities by percutaneous needle tenotomy of the knee flexor muscles will be consecutively included. data will be collected from the patients' medical records, in particular data related to their clinical, radiological, biological, and physiological examinations. this is a routine care study; no procedures are added for research purposes. it is an ancillary study to the no-aging study.

Eligibility criteria:
inclusion criteria: * patients \>= 18 years old ; * treated in the perioperative disability unit (upoh) of the physical medicine and rehabilitation department of our university hospital; * admitted for the treatment of limb deformities by percutaneous needle tenotomy of the knee flexor muscles ; * having a neuromotor disability; * no opposition to be enrolled in the study from the patient, or from a legally authorized close relative if the patient's state of health does not allow it; * affiliation to a social security scheme. exclusion criteria: * associated open surgery ; * associated bone surgery ; * under court protection.

Keywords: neuro-orthopaedics traction tenotomy disabled persons
the effect of the shoulder arthroscopic surgery on respiratory mechanics

Conditions: Shoulder Arthroscopic Surgery

Summary: during shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the shoulder and trachea, compressing the upper airway. although the extravasation is generally reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or life-threatening complications. furthermore, the soft tissue edema around the shoulder may extend to the thoracic cage, compress the chest and induce the respiratory distress immediately after surgery. the investigators attempt to determine the effect of shoulder arthroscopic surgery on respiratory mechanics. changes in respiratory mechanics and arterial blood gases were measured and compared before and after the shoulder arthroscopic surgery.

currently, most shoulder surgeries are performed with arthroscopy. the advantages of shoulder arthroscopic surgery are decreased blood loss due to minimal incision for scope, a reduced operation time, minimization of surgical stress, and rapid recovery time after surgery. during shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the shoulder and trachea, compressing the upper airway. although the extravasation is generally reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or life-threatening complications. furthermore, the soft tissue edema around the shoulder may extend to the thoracic cage, compress the chest and induce the respiratory distress immediately after surgery. from these facts, the mechanism of respiratory discomfort after shoulder arthroscopic surgery may be because the upper airway obstruction or restrictive pathology due to direct compression of thoracic cage by the soft tissue edema. there have been no studies on the respiratory effect of shoulder arthroscopic surgery. we have observed frequent and severe respiratory discomfort after the shoulder arthroscopic surgery. therefore, in this study we attempt to determine the effect of shoulder arthroscopic surgery on respiratory mechanics. changes in respiratory mechanics and arterial blood gases were measured and compared before and after the shoulder arthroscopic surgery.

Eligibility criteria:
inclusion criteria: * patients undergoing arthroscopic shoulder rotator cuff repair surgery * american society of anesthesiologist (asa) class i or ii * patients under 70 yrs. exclusion criteria: * patients older than 70 yrs, * patients with anatomical derangement of upper airway, * patients with pulmonary or cardiac disease, * patients with a history of laryngeal or tracheal surgery or hemodynamic instability

Keywords: shoulder arthroscopic surgery respiratory discomfort airway obstruction restrictive pathology diaphragm palsy
intestinal microbiome after gastrectomy

Conditions: Gastric Cancer

Summary: the gastric barrier plays a major role in the maintanance of the distal intestinal microbiome composition. it has been shown before that the use of gastric acid suppression medication, such as proton pump inhibitors, are associated with distinctive alterations of the intestinal microbiome. foremost, the invasion of predominantly oral bacteria, like veillonella and streptococcus species, were a resurring finding in previous reports. gastric cancer treatment includes the total or subtotal resection of the stomach which can influence the gastric acid production. however, the influence by alterations in gastric milieu after this treatment on the composition of the intestinal microbiome is not well studied. therefore, the intestinal microbiome of patients after total or subtotal gastrectomy and its influence on intestinal inflammation and gut permeability will be studied.


Eligibility criteria:
inclusion criteria: * age 18 years and above * history of radical removal of gastric cancer (test group and control group 1) or ppi (control group 3) * informed consent exclusion criteria: * chemotherapy or radiotherapy 12 months prior to inclusion * gastric stump cancer * usage of antibiotics, pro- pre or synbiotics, h2-blocker 1 month prior to inclusion * ppi use (except for control group 3) 1 month prior to inclusion * history of radical removal of gastric cancer (control group 2-3) * history of gastrointestinal tract resections (other than gastric) * recurrence of gastric cancer * current non-gastric malignancies
evaluation of a regional healthy skin program in remote aboriginal communities of australia's northern territory

Conditions: Scabies; Impetigo; Pyoderma; Streptococcal Infections

Summary: the purpose of this study is to determine whether a coordinated regional approach to healthy skin programs in six remote aboriginal communities can demonstrate, not only a reduction in the burden of scabies and streptococcal skin sores, but also broad health benefits, including primary prevention of some chronic diseases that occur at particularly high rates in australian aboriginal communities. the primary objectives of the program are: * demonstrate a reduction in scabies and skin sores on a regional basis * demonstrate the broader public health effects of healthy skin programs, particularly those relating to chronic diseases such as rheumatic fever and renal diseases * build on the existing indigenous capacity by assisting in the development of new knowledge and skills to improve the health and well being of indigenous communities * establish the feasibility of incorporating healthy skin programs into existing health service delivery

there are standard government recommendations for the conduct of healthy skin programs within the northern territory (nt), where the key component involves a single mass treatment for scabies of all residents in the region followed by regular monitoring of skin infections with treatment of individuals as new cases arise. the key features of the guidelines include: * community planning and collaborative effort; * development of local educational resources; * single whole community treatment day for scabies with permethrin (5%); * community "clean up" involving house cleaning, linen and rubbish collection; * emphasis on housing functionality and "washing kids" to maintain low rates of skin sores; and * regular monitoring of scabies and skin sores, usually in a target group such as children previous programs have been successful in controlling scabies and related skin infections in the nt but have been limited to single communities with varying levels of success. in collaboration with communities in the east arnhem region, we propose to conduct a coordinated healthy skin program. by concentrating on one region, the project has an increased likelihood of success because reinfection due to mobility between communities will be minimised, and because the project will be recognised as a collaboration between multiple communities. the program is structured into three distinct components: * implementation of the program within the participating communities; * evaluation of the program against specific outcomes; and * integration of the program into routine service delivery.

Eligibility criteria:
inclusion criteria: * all children aged \<15 years in the participating communities exclusion criteria: * none

Keywords: scabies impetigo pyoderma streptococcal infections