Kornimate/medical-research-clean huggingface dataset:
effects of different exercise training programs in ckd 4-5

Conditions: Chronic Kidney Disease

Summary: the investigators' purpose is to study which exercise training modality: aerobic physical activity in conjunction with either resistance training or balance training, is most beneficial in patients with chronic kidney disease (ckd 4-5: gfr \< 30 ml/min/1.73mup\[2\]). furthermore, our purpose is to evaluate the long-term effects of exercise training on functional status, cardiovascular morbidity, blood pressure control, heart rate variability, cardiac function, inflammation, body composition, nutritional status, progression of uraemia and health related quality of life. this interventional study is prospective, randomized and controlled comprising 150 prevalent and incident patients from our outpatient clinic. patients are invited to participate in the study consecutively, irrespective of basic functional status. at start patients are randomised either to resistance or balance training and the programme is adapted and individualised to each patient's actual physical status and ability. the exercise prescription is to exercise for 30 minutes/day, 5 days/week, keeping the intensity constant at a level of "somewhat strenuous" to "strenuous" on the borg scale rate of perceived exertion. the total observation period is 12 months with checks every four months. although exercise training is a recommended therapy in ckd, there is a lack of medical and scientific evidence on optimal prescription. we hope that this study will provide evidence-based knowledge on exercise prescription and its effects on various risk factors in ckd patients. finally, if patients achieve a higher degree of physical functional capacity they should be able to maintain an autonomous lifestyle, resulting in considerable reductions in societal costs for care and transportation.


Eligibility criteria:
inclusion criteria: * ckd 4 and 5 * over 18 years of age * no neurological or orthopedic impairments * stable cardiac status exclusion criteria: * not on renal replacement therapy * no severe electrolyte disturbances
studying genes in samples from younger patients with adrenocortical tumor

Conditions: Adrenocortical Carcinoma

Summary: rationale: studying samples of blood and tumor tissue from patients with cancer in the laboratory may help doctors learn more about changes that occur in dna and identify biomarkers related to cancer. purpose: this research trial studies genes in samples from younger patients with adrenocortical tumor.

objectives: * to perform whole-genome sequencing, deep sequencing, micro rna analysis, methylation status, copy number variation analysis, and single-nucleotide polymorphisms (snps) analysis in pediatric adrenocortical tumors and compare those results to those of the same patient's normal cells. outline: archived tumor and blood samples are analyzed for whole-genome sequencing, deep sequencing, micro rna , methylation status, copy variation, and single-nucleotide polymorphisms. results are then compared with patients' normal cells.

Eligibility criteria:
disease characteristics: * banked tumor and blood samples obtained from patients enrolled on cog-arar0332 in north america and brazil patient characteristics: * not specified prior concurrent therapy: * not specified

Keywords: adrenocortical carcinoma
treatment outcomes and quality of life after imrt treatments of head and neck cancers

Conditions: Head and Neck Cancer

Summary: the purpose of the research study is to evaluate effectiveness and the quality of life, specifically the risk of dry mouth, after radiation treatment for head and neck cancers.


Eligibility criteria:
inclusion criteria:patients who complete radiation therapy for h\&n cancers at stanford university
latent toxoplasmosis in females with borderline personality disorder

Conditions: Borderline Personality Disorder; Toxoplasmosis

Summary: borderline personality disorder is a common mental disorder with core features of affective dysregulation, impulsivity, and identity disturbance. although this disorder is mostly understood as a result of a combination of biological factors (genes, temperament) and early aversive experiences (often of traumatic nature), recent data suggest that other factors may be important in its development and course. preliminary findings show that patients with borderline personality disorder have higher prevalence of toxoplasma seropositivity. this infection may manifest in symptoms such as affective dysregulation, aggression, suicidality, or anxiousness. as such, it may play a role in the psychopathology of the borderline personality disorder. the aim of this study is to explore the prevalence of toxoplasma seropositivity in a sample of females with borderline personality disorder, its clinical correlates, and a potential impact on outcomes of an intensive six-week inpatient schema-therapeutic treatment. results may enrich our understanding of this disorder and lead to improvements of the therapeutic approaches.


Eligibility criteria:
inclusion criteria: * adult * female * borderline personality disorder diagnosis according to the diagnostic and statistical manual of mental disorders-5 criteria * signed informed consent exclusion criteria: * current substance abuse disorder * psychotic disorder, bipolar disorder, organic mental disorder current or past * severe suicidal risk * severe somatic illness (e.g., endocrinopathy, oncologic, hematologic, cardiologic, or neurologic illness)

Keywords: borderline personality disorder latent toxoplasmosis toxoplasma gondii pharmacotherapy psychotherapy clinical features
preoperative and postoperative ctdna comparison in early stage lung cancer

Conditions: Preoperative and Postoperative ctDNA Comparison in Early Stage Lung Cnacer

Summary: mutation-positive peripheral blood ctdna became mutation-negative after surgical removal of the cancer tissue. all subjects in the control group were negative for ctdna mutations。


Eligibility criteria:
inclusion criteria:patients with pulmonary nodules who underwent curative-intent resection were able to enter the study - exclusion criteria:patients who received any invasive examination or treatment prior to resection or had a history of malignancy; patients who do not attend follow up after surgery; blood samples that were contaminated; and biopsies that exhibited advanced lung cancer in pathology。 -
eadi as a predictor of successful extubation in patients with traumatic cervical spinal cord injury

Conditions: Traumatic Cervical Spinal Cord Injury (CSCI)

Summary: esophageal recordings of diaphragm electrical activity (eadi) made it possible to monitor respiratory drive and the subsequent phrenic nerve conduction and respiratory neuromuscular function continuously. thus, we designed a "spontaneous breathing challenge" test to monitor the change in eadi after a maximal inspiration. we hypothesized that the absolute change (δeadi) and the percentage changes change (δeadi%) in eadi after a "spontaneous breathing challenge" predict successful extubation in traumatic csci patients during acute hospitalization.

a retrospective cohort study enrolled adult traumatic csci patients who underwent mechanical ventilation and admitted to the intensive care unit (icu) of zhongda hospital form june 2014 to july 2018. the following inclusion criteria were used: age 18 years or older, traumatic csci patients with a neurologic level of injury of c1 to c8 by the american spinal injury association (asia) standard impairment scale grade a-d patients with mechanical ventilation due to acute respiratory failure and admite to icu, dedicated nasogastric tube with nine electrodes that allow to continuously measure diaphragm electrical activity (eadi catheter, maquet, solna, sweden) in postion. csci was defined as radiologically-confirmed injury to the cervical spinal column, combined with clinical signs and symptoms consistent with csci at that level. the exclusion criteria were: tracheostomy at time of addmition to icu, withhold or withdraw life sustaining treatment due to other serious organ injury, can't complete instructional actions, death occurred within 7 days after injury, or postoperative mv was a direct result of surgery and had duration of less than 24 hours postoperatively. extubation or tracheostomy was decided by the physician in charge according to the local protocol of weaning.

Eligibility criteria:
inclusion criteria: 1. age 18 years or older 2. traumatic csci patients with a neurologic level of injury of c1 to c8 by the american spinal injury association (asia) standard impairment scale grade a to d 3. patients with mechanical ventilation due to acute respiratory failure and admit to icu 4. with dedicated nasogastric tube with nine electrodes that allow to continuously measure diaphragm electrical activity (eadi catheter, maquet, solna, sweden) in position. exclusion criteria: 1. tracheostomy before icu admission 2. withhold or withdraw life sustaining treatment due to other serious organ injury 3. can't complete instructional actions, 4. death occurred within 7 days after injury 5. postoperative mv was a direct result of surgery and had duration of less than 24 hours postoperatively. 6. eadi data not available

Keywords: spinal cord injury weaning
cognitive determinants of psychoeducation and information in psychoses

Conditions: Schizophrenia; Delusional Disorders (ICD-10)

Summary: the aim of the study is to examine whether the efficacy of psychoeducation in patients with schizophrenia or schizoaffective disorders is dependent on their cognitive performance level and if a preceding cognitive training can enhance the therapeutic effects of psychoeducation

schizophrenic inpatients are examined shortly after admission with a broad battery of clinical and neurological rating scales and neuropsychological tests. they are then randomized to either standard treatment (including antipsychotic medications, art and occupational therapy, psychotherapy) or to standard treatment plus daily computerbased cognitive training (cogpack; ten 1-hour sessions over two weeks). after repetition of the broad assessment battery all patients (and some of their family members) take part in a bifocal psychoeducation group program (eight 1-hour sessions over four weeks). specific pre-post measures are illness knowledge, self and expert ratings of adherence to treatment, insight to the illness, treatment satisfaction. the study also includes a 9-month follow-up, with number of rehospitalizations, days in hospital and psychopathology as the primary outcome measures.

Eligibility criteria:
inclusion criteria: * inpatients * informed consent * german as first language or very good knowledge of german exclusion criteria: * mental retardation * any serious somatic illness

Keywords: schizoaffective schizotypal
population health approach to optimizing medications in older adults

Conditions: Medication Adverse Effects; Older Adults (65 Years and Older); Polypharmacy; Polypharmacy Patients; Deprescribing

Summary: this randomized controlled pragmatic pilot study examines the feasibility and acceptability of a population health-based deprescribing intervention that leverages a polypharmacy risk prediction model. it includes four arms (2 intervention and 2 control arms) and uses a parallel arm study design.

this pilot clinical trial will examine the feasibility and acceptability of a medication management intervention that uses risk stratification to identify older adults (including older adults with mild cognitive impairment or alzheimer's disease and related dementias) at greatest risk for polypharmacy-related adverse events. the intervention will use a risk prediction model to identify potential study participants for inclusion and enroll them and their care partners into a polypharmacy clinic. the study will stratify patients by cognitive impairment status. the risk prediction model includes variables such as: age, sex, recent healthcare encounters, current and past medications, current and past lab tests, current and past diagnoses.

Eligibility criteria:
inclusion criteria: * patients will be invited to enroll in the study if they are in the top decile of risk selected by a risk prediction model of polypharmacy-related adverse events. the risk prediction model includes variables such as: age, sex, recent healthcare encounters, current and past medications, current and past lab tests, current and past diagnoses. * 65 years of age or older * have a primary care clinician within the cedars-sinai health system who uses mycslink (electronic health record used by cedars-sinai). * part of a cedars-sinai health system population health registry (e.g., enrolled in an accountable care organization, medicare advantage plan, or primary care first program) * diagnosis of mild cognitive impairment or dementia at baseline (for one intervention group) on the problem list exclusion criteria include: * patients for whom there is an active substance use disorder (defined by a physician) and thus for whom the intervention may not be appropriate * patients with an organ transplant * visits with a cedars-sinai medical center pharmacist for a polypharmacy consult within the last 6 months * patients who previously indicated in the ehr that they wish to opt out of participating in research studies. * patients enrolled in cs360, a program for highly complex medical patients, who already receive polypharmacy services.

Keywords: older adults polypharmacy deprescribing
renal hemodynamics, energetics and insulin resistance: a follow-up study

Conditions: Type 2 Diabetes; Diabetes Type 2; Diabetic Nephropathies; Nephropathy; Obesity; Adolescent Obesity; Diabetic Kidney Disease

Summary: the current protocol plans to enroll participants with youth-onset type 2 diabetes (t2d) as well as obese and lean controls from the renal-heir - renal hemodynamics, energetics and insulin resistance in youth onset type 2 diabetes study (n=100) \[comirb #16-1752\] in a prospective investigation that seeks to 1) define the changes in kidney function by gold standard techniques and energetics by functional magnetic resonance imaging (mri) in adolescents with and without t2d as they transition to young adulthood; 2) quantify kidney oxidative metabolism by 11c-acetate positron emission tomography (pet) in a subset of participants who are ≥18 years of age with youth-onset t2d and/or obesity; 3) determine peripheral arterial stiffness by sphygmocor. mechanistic insight will be provided by transcriptomic analyses of repeat biopsies 3-years after their initial biopsy for eligible participants with youth-onset t2d, as well as molecular analysis of tissue obtained from j-wire endovascular biopsies. this study will also leverage this well-characterized cohort of youths to define youth-onset t2d-related changes in brain morphology and function by structural mri and resting-state functional mri and through the assessment of cognitive function (fluid and crystallized intelligence) using the nih toolbox cognitive battery (nihtb-cb), as an exploratory objective. all enrollees in renal-heir have consented to be contacted for future research opportunities.


Eligibility criteria:
inclusion criteria: * obese youth with and without type 2 diabetes + lean controls who were previously enrolled in the renal heir study * participants who will undergo a pet scan: ≥ 18 years exclusion criteria: * anemia * seafood, iodine, or penicillin allergy * pregnancy * mri scanning contraindications (claustrophobia, implantable devices, \>550 lbs) * history of bleeding or clotting disorders, thrombocytopenia, warfarin and/or heparin use * taking sulfonamides, procaine, thiazolsulfone or probenecid
treatment of temporomandibular dysfunction with hypertonic dextrose injection

Conditions: Temporomandibular Joint Disorders

Summary: dysfunction of the jaw, associated with pain in the jaw or about the jaw in the face can be quite long lasting and debilitating. dextrose injection with a small needle has be notably helpful in preliminary studies in reducing pain and improving jaw function. this randomized trial will compare dextrose injection with saline injection for temporomandibular(jaw) dysfunction, also known as tmd.

longitudinal studies of subjects with temporomandibular dysfunction show a general pattern of symptom diminishment, especially in the elderly. however studies out to 2-8 years show residual symptoms in many and nearly 25% with unabated symptoms. dextrose injection has been utilized empirically for many years and a marked reduction in pain and luxation after intraarticular and pericapsular dextrose injection has been reported in a recent rct. however, small study size and lack of a non injection control have prevented any definitive conclusions as the additional efficacy of including dextrose in the injectate. the mechanism of action of dextrose injection was originally thought to be via a brief stimulation of the inflammatory cascade with resultant production of growth factors. however, non-inflammatory dextrose effects on growth factor production have been demonstrated, and, more recently, dextrose has been found to treat neurogenic inflammation (pain from upregulation of the trpv1 receptor on peptidergic nerves). this has the theoretical benefit of reducing pain, regardless of the status and position of the intraarticular cartilage or degree of degenerative change of the tmd. the primary goal of this study is to evaluate the ability of dextrose injection versus saline injection to reduce pain and improve functional complaints referable to the temporomandibular joint.

Eligibility criteria:
inclusion criteria: * facial pain nrs rating \> 5/10 * jaw symptom rating \> 5/10 * jaw function issues seen on examination exclusion criteria: * any potential acute dental issue * rheumatic inflammatory disease * chronic intake of nsaids or corticosteroids. * pain in other body location worse than jaw pain * pain 10/10 in other body location.

Keywords: tmd temporomandibular dextrose prolotherapy
efficacy and safety study of shr-1819 injection in adult patients with severe atopic dermatitis

Conditions: Moderate to Severe Atopic Dermatitis

Summary: this trial was designed to evaluate the efficacy and safety of shr-1819 injection in patients with atopic dermatitis.


Eligibility criteria:
inclusion criteria: 1. subjects voluntarily sign informed consent forms prior to the commencement of any proceedings related to the study, are able to communicate smoothly with the investigator, understand and are willing to complete the study in strict compliance with the requirements of this clinical research protocol； 2. the age was ≥18 at the time of signing the informed consent and gender is unlimited; 3. atopic dermatitis at screening (according to the 2014 american society of dermatology guideline criteria, see annex 1) and disease duration for at least 1 year before screening as judged by the investigator; 4. easi ≥ 16, iga ≥ 3, bsa ≥ 10% during the screening and baseline periods; 5. tcs was not optimal or not tolerated by the investigator. exclusion criteria: 1. pregnant or lactating women; 2. major surgeries are planned for the duration of the study; 3. history of previous atopic corneal conjunctivitis involving the cornea; 4. history of clinically significant diseases (e.g., circulatory system abnormalities, endocrine system abnormalities, neurological disorders, hematologic disorders, immune system disorders, psychiatric disorders, and metabolic instability) that the researcher believes that participation in the study poses a risk to the safety of the subject or that the disease/illness worsens during the study period will affect the effectiveness or safety analysis; 5. subjects have had or are currently clinically significant diseases or abnormalities; 6. screening for people with a history of heavy alcohol consumption or substance abuse in the 3 months prior to screening; 7. the drug has been used in the previous 6 months; 8. screening of subjects with malignancy within the first 5 years (except completely cured cervical cancer in situ and non-metastatic cutaneous squamous cell carcinoma or basal cell carcinoma); 9. other comorbid (or co-occurring) skin disorders may be affected in the study evaluation; 10. any cause that the researchers believe would prevent the participants from participating in the study.
gm-csf in patients with pulmonary alveolar proteinosis

Conditions: Pulmonary Alveolar Proteinosis

Summary: this is a study to determine the efficacy and safety of granulocyte-macrophage colony-stimulating factor (gm-csf, sargramostim) administered subcutaneously to patients with pulmonary alveolar proteinosis (pap).

pap is a rare lung disease characterized by accumulation of surfactant phospholipids and proteins within the lungs. there is no specific pharmacologic therapy for pap and the current practice of lung lavage under general anesthesia is invasive and has limitations. although it is unknown if the anti gm-csf antibody is related to the disease pathogenesis, observations suggest a role for gm-csf in lung homeostasis as well as in the pathogenesis of pap. patients will receive subcutaneous gm-csf or placebo once a day and will be followed on an outpatient basis at 2 weeks, and 1, 2, 3, 4, 5 and 6 months after initiation of therapy. clinical response will determine dosing schedule and will be evaluated by symptom scores, gas exchange data, and chest radiographs. completion date provided represents the completion date of the grant per oopd records

Eligibility criteria:
inclusion criteria: * diagnosis of primary or idiopathic pap * creatinine no greater than 2 mg/dl * bilirubin no greater than 2 mg/dl * liver enzymes no greater than 3 times normal * women must use an effective method of contraception, be post menopausal, or be surgically sterilized exclusion criteria: * active respiratory infection * active cardiovascular disease (e.g., cardiogenic pulmonary edema) * underlying myeloproliferative disorder or leukemia * other secondary cause of pap (e.g., occupational exposure to silica or hiv with pcp) * at increased risk of side effects from gm-csf therapy (i.e., rheumatoid arthritis, immune thrombocytopenia, or autoimmune thyroiditis) * previous therapy with gm-csf * pregnant or nursing * significant renal or liver disease

Keywords: sargramostim injections, subcutaneous
the effect of hydrotherapy and land-based rehabilitation program combined with ankle taping in athletes with chronic ankle instability

Conditions: Sports Rehabilitation Program; Hydrotherapy; Ankle Instability

Summary: there will be a difference in ankle functional ability between athletes with chronic ankle instability in the intervention group and in the control group.


Eligibility criteria:
inclusion criteria: * recurrent ankle sprain in one year * sustain at least one repeated injury or have the experience of ankle instability feelings or "giving way" * not undergoing formal or informal rehabilitation for the unstable ankle in the last three months * have residual symptoms after recurrent sprain of the ankle exclusion criteria: * have the history of fracture or surgical procedures in the lower extremity * have the history of neurological disorders affecting the lower extremities vestibular dysfunction or balance disorder * allergic to the zinc oxide compound in the adhesive tape

Keywords: hydrotherapy chronic ankle instability ankle taping