Kornimate/medical-research-clean huggingface dataset:
email nudges to improve gdmt (mra) adherence in heart failure

Conditions: Heart Failure With Reduced Ejection Fraction

Summary: the email nudges to improve gdmt (mra) adherence in heart failure (enigma-hf) study is a pragmatic parallel-arm randomized control trial of a quality improvement (qi) intervention involving email nudges to cardiology clinic managers to schedule appointments specific to guideline directed medical therapy (gdmt) initiation, with the goal of optimizing mineralocorticoid-receptor antagonist (mra) use by patients with heart failure with reduced ejection fraction (hfref) cared for by cardiologists within the university of california, los angeles (ucla) health system.

importance: guideline directed medical therapy (gdmt) is a specific set of 4 medications proven to improve morbidity and mortality for patients with heart failure (hf) with reduced ejection fraction (hfref), yet they are underutilized nationally and internationally. various quality improvement (qi) interventions have had varying degrees of success at increasing gdmt prescription and titration. objective: the purpose of the study is to assess whether email nudges to ucla health cardiology clinic managers to schedule gdmt-specific appointments can lead to increased utilization of a specific medication within gdmt called a mineralocorticoid-receptor antagonist (mra). pertinent secondary objectives will include evaluating whether email nudges specific to mra would increase utilization of the other medications in gdmt and whether they would increase appointments specific to gdmt. design, setting, and participants: the basic design is a pragmatic parallel-arm randomized control trial of a qi intervention. the setting is cardiology outpatient clinics at a large university-based single integrated healthcare system (ucla health). participants are outpatients with hfref under the care of a ucla cardiologist, with an ejection fraction on file, and currently not prescribed an mra. hypothesis: the investigators hypothesize that the intervention will lead to an increased utilization of mra, compared to the control arm.

Eligibility criteria:
inclusion criteria: * facility: ucla health system * patient is 18 years of age or older * patient is under the care of a ucla cardiologist * patient has a primary diagnosis of hfref * patient is not currently prescribed an mra exclusion criteria: * hyperkalemia * chronic kidney disease stage 4 or higher * pregnant or breastfeeding patients * heart transplant or ventricular-assist device patients * hospice patients * patients without an lvef on file * patients with an ef \>35%

Keywords: ambulatory care learning health system quality improvement [qi] implementation science clinical decision support mineralocorticoid receptor antagonist [mra] guideline directed medical therapy [gdmt]
psychotherapy of anxiety disorders with noninvasive brain stimulation - using virtual reality

Conditions: Phobia

Summary: the aim of the study is to transfer the rtms stimulation protocol by raij et al. (2018) into a therapeutic setting to improve exposure therapy in acrophobic patients. the quasi-randomized, placebo-controlled and double-blinded study will include 88 patients with height phobia (according to dsm 5). all participants will perform two exposure sessions in virtual reality (vr). before exposure therapy, one group will receive verum rtms of the left frontal cortex, which is indirectly functionally linked to the ventromedial prefrontal cortex (raij et al., 2018). the control group will receive sham stimulation. a structural mri and a tms navigation system will be used for precise localization of the left fc. anxiety symptoms will be measured using subjective ratings (e.g. acrophobia questionnaire) and the behavioural approach task (bat) in vr and in real life before and after the treatment, and at 6 months follow-up. furthermore, blood samples will be collected before rtms and after exposure treatment to assess epigenetic and gene expression based changes.

the following hypotheses are derived: 1. patients with acrophobia, who receive an active rtms of the left fc before vret, show a significantly stronger reduction of phobic symptoms immediately after exposure therapy, compared to the sham stimulation group. 2. patients with acrophobia, who receive an active rtms of the left fc before vret, show a significantly greater increase in approach behavior and significantly less distress during the bat immediately after exposure therapy, compared to the sham stimulation group. 3. the postulated differences in hypotheses 1 and 2 are still detectable at follow-up after 6 months.

Eligibility criteria:
inclusion criteria: * acrophobia (according to dsm-5) * right handed * german native speaker * written informed consent exclusion criteria: * neurological and/or severe physical illnesses * comorbid axis i disorder (other than phobias) * pretreated phobia of heights * use of tricyclic antidepressants, antipsychotics, or other substances that increase cerebral seizure susceptibility * craniocerebral injuries, head surgery * epileptic seizures, or family history of epilepsy * metal parts in the head area * cardiac pacemakers * infusion pumps * heart diseases * increased intracranial pressure * pregnancy * cochlear implants * tattoos (done before the year 2000) * piercings (if not completely removable) * permanent make-up * nicotine or pain patches * other mri contraindications

Keywords: vr exposure therapy acrophobia rtms pfc
predicting postoperative ambulation following selective dorsal rhizotomy based on preoperative gross motor function score

Conditions: Spastic Cerebral Palsy; Walking, Difficulty; Ambulation Difficulty

Summary: cerebral palsy (cp) is a neurodevelopmental disorder characterized by abnormalities in muscle tone, movement, and motor skills resulting from permanent, nonprogressive damage to the developing brain before, during, or after birth (tedla \& reddy, 2021). the worldwide prevalence of cp is 2-3 per 1000 live births (paul et al., 2022). the most common type of cp is spastic, accounting for approximately 85% of all cp cases (paul et al., 2022). it is divided into 3 types: hemiparetic, diparetic, and quadriparetic. selective dorsal rhizotomy (sdr) is a surgical technique applied for spasticity management in children with bilateral spastic type cp (novak et al., 2014). one of the most important points in the decision-making process for sdr surgery is the compatibility of the family's expectations with the expectations of the healthcare professional. informing the family about the expectations is very important in the decision-making process for surgery (waite et al., 2023). no study has been found in the literature that provides objective predictive value before surgery in terms of postoperative ambulation. the aim of this study is to examine the predictability of postoperative ambulation status in patients with spastic cerebral palsy (scp) according to the gross motor function measure-88 (gmfm-88) score before sdr.

it is an observational study. purpose of the study: the aim of this study was to examine the predictability of postoperative ambulation status in patients with spastic cerebral palsy (scp) according to the gross motor function measure-88 (gmfm-88) score before sdr. 95 children with cp were included in the study. among scp cases, 71(74.7%) were diparetic, 18(18.9%) were quadriparetic, and 6 (6.3%) were triplegia. * can the total score of a gross motor function measure before sdr predict walking after sdr? * can the gross motor function measure total score before sdr surgery provide an indication of the family's postoperative walking expectations? the gross motor function measure-88 (gmfm-88) and the gross motor function classification system (gmfcs) were applied to the participants.

Eligibility criteria:
inclusion criteria: * age between 0-17, * diagnosis of spastic cp, * participants and parents willing to participate in the study voluntarily, * gross motor function classification system (gmfcs) level between ii-iv, * no history of orthopedic surgery before sdr surgery, * actively continuing the physiotherapy and rehabilitation (ptr) program for at least 2 months in the post-operative period. exclusion criteria: * having different types of cp such as dyskinetic, ataxic and mixed type * having hemiparetic type cp * having a history of any surgery on the musculoskeletal system before sdr surgery * having received botulinum toxin injection within the last 6 months.

Keywords: cerebral palsy ambulation selective dorsal rhizotomy gross motor function
prospective study of functional and quality of life outcomes in panniculectomy patients

Conditions: Panniculitis

Summary: patients with morbid obesity often develop a significant overhanging abdominal pannus. problems associated with an overhanging pannus can include difficulty performing routine daily activities as well as exercise due to the cumbersome nature of the excess tissue. in addition, the abdominal pannus tissue often becomes infected due to difficulty with hygiene and abnormal circulation and lymphatic flow. there may also be a significant contribution from the pannus to the patient's underlying cardiopulmonary status which is often compromised in morbid obesity patients. in addition to weight loss, one of the treatment strategies includes a panniculectomy. a panniculectomy involves resection of the excess abdominal skin and fat in a wedge shape from the lower abdomen. purported benefits include increased ability to exercise, better quality of life and improved cardiopulmonary function. however, there is a significant morbidity associated with panniculectomy surgery, with wound related complications occurring in as much as 50% of patients with this procedure. the investigators hypothesize that the panniculectomy procedure provides long term benefits to this patient population despite significant short term morbidity.

this is a prospective trial to determine what if any functional and quality of life benefits are achieved with a panniculectomy. patients will be evaluated preoperatively and postoperatively with specific interventions aimed at describing their functional status. these interventions will include: echocardiogram, pulmonary function testing, arterial blood gas, functional capacity evaluation by physical therapy, and a quality of life survey. the investigative interventions will be performed postoperatively at 6 months and again at 1 year post surgery. data will also be gathered on complications such as wound infection, dehiscence, and cardiopulmonary problems. there should be no additional risk to the patient as the surgery and procedures listed are already performed routinely on this patient population. study participants will have morbid obesity with significant overhanging pannus that requires surgical intervention. this study will compare the preoperative values to post operative values taken at 6 months and then at 1 year post operative. these values include echocardiograms, pulmonary function tests, arterial blood gases and a functional capacity evaluation.

Eligibility criteria:
inclusion criteria: * subjects must be between the ages of 18 - 80 years of age * bmi \> 35 * non-smoker exclusion criteria: * subjects under the age of 18 or older than 80 years of age * bmi \< 35 are not eligible for study inclusion * smokers are not eligible for inclusion in this study

Keywords: panniculitis panniculectomy
local and systemic changes in osteonecrosis of the jawbone

Conditions: Osteonecrosis of the Jaw

Summary: osteonecrosis of the jawbone (onj) is a serious complication of antiresorptive therapies (arts), for example with bisphosphonates or denosumab. especially long term treatment with intravenous antiresorptive agents causing lesions and, less frequent, also oral administration. this study aims at elucidating local and systemic changes in patients with onj.


Eligibility criteria:
inclusion criteria: * 18 years or older * with/without art * with/without mronj exclusion criteria: * smoker (\>10 cigarettes/day) * pregnancy
prevention of recurrence of atrial fibrillation

Conditions: Fibrillation, Atrial

Summary: the purpose of this study is to determine whether the study drug is effective in preventing the recurrence of atrial fibrillation (an abnormal heart rhythm).


Eligibility criteria:
inclusion criteria: * symptomatic persistent atrial fibrillation requiring dc cardioversion. * duration of af \>48 hrs. \<6 months exclusion criteria: * concomitant class i and/or iii anti-arrhythmic drugs. * amiodarone treatment within 3 months of the study. * other inclusion or exclusion criteria to be determined by the physician and study sponsor.

Keywords: symptomatic atrial fibrillation persistent atrial fibrillation
over active bladder patients having sling surgery

Conditions: Overactive Bladder

Summary: the purpose of this study is to determine whether treatment with anti-muscarinic medications following sub-urethral sling procedures improves overall subjective and objective outcomes in women with mixed incontinence with primary stress symptoms.

women with mixed incontinence with primary stress symptoms undergoing sub-urethral sling procedures will be randomized to peri-operative placebo or solifenacin. subjects in the placebo group will take orally once daily for 9 weeks. subjects in the solifenacin group will take orally once daily for 9 weeks.

Eligibility criteria:
inclusion criteria: * age \>/= 18 * patient is appropriate for sub-urethral sling procedure * mixed urinary incontinence * no antimuscarinic therapy for previous 30 days exclusion criteria: * uncontrolled narrow angle glaucoma * acute cystitis * unevaluated hematuria * currently using anti-muscarinic therapy * unable to complete pre-operative urodynamics * contraindication to anti-cholinergic therapy * unable or unwilling to complete diaries or quality of life questionaire * significant (exteriorized) pelvic organ prolapse

Keywords: overactive bladder incontinence solifenacin women postoperative
effects of viral reactivation on outcomes of brain-injured patients ( ibis-virus)

Conditions: Brain Injury

Summary: morbidity and mortality of icu patients is increased by the development of a "immunosuppression" systemic (is). this is develops in the early hours of hospitalization and is responsible for severe infections, including viral reactivations (cytomegalovirus or herpes simplex virus). viral reactivation was associated with increased morbidity and mortality in intensive care units. in clinical practice, they are searched at the onset of organ failure or unexplained fever. the investigators wish to conduct this research in the stroke patients to assess the predictive power of these viral reactivations on the duration of mechanical ventilation.

pcr for herpes simplex virus in blood and in tracheal aspirate (day-1, day-7 and day-15) - clinicians are blinded to the results pcr for cytomegalovirus in blood and in tracheal aspirate (day-1, day-7 and day-15) - clinicians are blinded to the results

Eligibility criteria:
inclusion criteria: * hospitalisation in intensive care unit * acute brain injury (trauma, subarachnoid haemorrhage, stroke, infection) with glasgow coma scale \<= 12 * age between 18 and 75 years * mechanical ventilation \> 24 hours exclusion criteria: * encephalopathy post anoxy * active cancer * immunosuppresseur treatment * pregnancy * history of autoimmune disease

Keywords: brain injury virus immunosuppression mechanical ventilation
effects of the sugar sucrose on bodyweight and energy intake over 28 days in obese women

Conditions: Obesity

Summary: this study partially replicates two previous studies with normal weight women, and overweight women. both found that women could compensate for sucrose added to the diet in carbonated soft drinks (4 x250ml total1800 kj per day) when it was given blind over a period of 4 weeks. the hypothesis is that this applies also to obese women, who will not gain weight, increase overall energy intake in the diet, or eat differently whilst consuming sucrose. 42 participants shall be randomly assigned to either be given carbonated drinks that contain sucrose, or drinks that are artificially sweetened.


Eligibility criteria:
inclusion criteria: * female * bmi 30-35 kg/m² * at least one period of dietary restriction of 4 weeks or more in the last 24 months exclusion criteria: * dislike of popular sweet carbonated drinks * dieting during the last month * history of diabetes * having an eating disorder * depression, * being a smoker * pregnant * lactating, * wearing a pacemaker * currently taking medication for mood or thyroid disorders
plasma ngal in apn patients

Conditions: Pyelonephritis

Summary: in recent years, novel biomarkers of renal dysfunction have attracted attention for the diagnosis of utis. ngal is a 25 kda protein that belongs to the lipocalin. it acts as a transporter for small hydrophobic molecules and is involved in many physiological processes, such as modulating inflammation, innate immune response, and maintaining metabolic homeostasis


Eligibility criteria:
inclusion criteria: * above 20 years suspected have pyelonphirtis exclusion criteria: * age below 20
inhaled treprostinil expanded access program in pulmonary hypertension associated with interstitial lung disease

Conditions: Pulmonary Hypertension; Interstitial Lung Disease; Combined Pulmonary Fibrosis and Emphysema

Summary: this is an expanded access program (eap) for eligible participants with pulmonary hypertension associated with interstitial lung disease (ph-ild) designed to provide access to inhaled treprostinil. availability will depend on territory elegibility.


Eligibility criteria:
inclusion criteria: 1. patient consent 2. males and females aged 18 years old or older 3. ph-ild diagnosis: * confirmed diagnosis of group 3 ph by right heart catheterization (rhc): - mpap \> 20 mmhg with pawp ≤ 15 mmhg and pvr ≥ 2 wu and * confirmed diagnosis of diffuse parenchymal lung disease based on imaging (any form of ild or cpfe) exclusion criteria: 1. diagnosis of pah or ph for reasons other than group 3 ph-ild 2. use of concomitant pah drugs contraindicated for ph-ild (ambrisentan and riociguat) 3. use of any concomitant investigational drug

Keywords: inhaled treprostinil tyvaso eap expanded access early access compassionate use named patient program npp ph-ild
short-term effects of thoracic manipulation in shoulder impingement

Conditions: Shoulder Impingement Syndrome

Summary: the hypothesis of this study is that thoracic spine manipulation would reduce pain in subjects with sis and cause changes in scapular kinematics and muscle activity in subjects with impingement symptoms and in asymptomatic subjects. with this study, the investigators want to answer if possible changes in scapular motion and muscle activity following a tsm depend on the symptoms or if it is generic to individuals without shoulder dysfunction and not specific to subjects with shoulder impingement.

subjects with shoulder impingement signs will be evaluated and will be compared with subjects asymptomatic for shoulder symptoms. both subjects will be randomly assigned to one of two intervention groups: thoracic spinal manipulation (tsm) or sham intervention. we want to know if possible changes in scapular motion and muscle activity following a tsm depend on the symptoms or if it is generic to everyone. also, we want to know if tsm reduces shoulder pain immediately and in a short-therm period.

Eligibility criteria:
inclusion criteria (symptomatic subjects): to present with at least 3 of the following findings: * positive neer impingement test, * positive hawkins impingement test, * positive jobe test, * pain with passive or isometric resisted shoulder lateral rotation, * pain with active shoulder elevation, * pain with palpation of rotator cuff tendons, * pain in the c5 or c6 dermatome region. exclusion criteria (symptomatic subjects): * signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process), * pregnancy * systemic illnesses * if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation * signs of complete rotator cuff tear or acute inflammation * cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis) * scoliosis * glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests) * previous upper extremity fracture or shoulder surgery. exclusion criteria (asymptomatic subjects): * any positive test for shoulder impingement * signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process), * pregnancy * systemic illnesses * if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation * signs of complete rotator cuff tear or acute inflammation * cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis) * scoliosis * glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests) * previous upper extremity fracture or shoulder surgery.

Keywords: manual therapy rehabilitation shoulder spine
tramadol versus lidocaine infiltration for tonsillectomy

Conditions: Peri-tonsillar Analgesic Infiltration; Tonsillectomy; Postoperative Pain; Inflammatory Response

Summary: the investigators postulate that the use of pre-incisional peritonsillar infiltration of tramadol or lidocaine reduces both the inflammatory response and postoperative analgesic consumption, without harmful effects. therefore, the present study is designed to evaluate the effects of infiltration of tramadol or lidocaine on the postoperative acute-phase serum protein, c-reactive protein, and analgesic consumption after tonsillectomy.


Eligibility criteria:
inclusion criteria: * asa i \& ii preschool children aged 2-6 years, undergoing elective tonsillectomy with or without adenoidectomy, under general anaesthesia. indications for tonsillectomy will be chronic recurrent tonsillitis or tonsillar hypertrophy exclusion criteria: * patients with a history of allergy to tramadol or amide local anaesthetics, epilepsy, or taking cardiovascular, antihypertensive, steroids, or anti-inflammatory medications, those with cardiac, liver, or kidney diseases, or any underlying systemic diseases or acute infectious processes will be excluded from the study. all operations will be performed, using an electro-dissection technique, by the same surgeon.

Keywords: anaesthesia tonsillectomy inflammatory response stress response tramadol lidocaine