Kornimate/medical-research-clean huggingface dataset:
a new decisional tree for the management of acetabular fractures : monocentric observational study

Conditions: Management of Acetabular Fractures

Summary: acetabular fractures are challenging fractures to treat. many fracture patterns occur, in a deep anatomical area surrounded by numerous vascular and nervous elements, generally in a polytraumatic context . a reduction with less than 2 mm of incongruence is generally considered acceptable, limiting post-operative osteoarthritis that could rapidly require total hip arthroplasty. due to the long learning curve, this surgery is limited to large reference centers . in the last twenty years, the main series published in the literature are small series due to the rarity of the fractures and their trauma context (loss of follow-up, polytrauma patients...). the large variety of fracture patterns according to the letournel classification creates a spread in patient distribution and decreases the power of statistical analysis. that is the reason why big series are rare and only a few of them allow significant conclusions . the other studies are meta-analyses with their limitations the lack of consensus makes it difficult to interpret the results between series, so the investigators developed a decision tree to address this knowledge gap. the aim of this study is to assess and compare the results of a decisional tree for acetabular fracture in a large cohort of patients from a well-known experimental trauma center.


Eligibility criteria:
inclusion criteria: * adult patient at the time of injury * acetabular fracture * pre-operative standard x-ray image * pre-operative ct image * post-operative x-ray standard image (ap-alar and obturator views) * post-operative ct scan. * willingness and ability to participate in the study exclusion criteria: * ipsilateral fracture femoral and/or associated pelvic ring fracture (floating hip c or b) * pregnant, lactating women * subject under administrative or judicial supervision
color doppler imaging of orbital venous flow in grave's orbitopathy

Conditions: Graves' Disease; Graves' Ophthalmopathy

Summary: orbital venous flow study in patients with grave's orbitopathy in different manifestation forms and stages, made with color doppler imaging

prospective study with grave's patients in active and fibrotic disease, myogenic and lipogenic forms, with muscle restriction and without muscle restriction and with or without optic compressive neuropathy. blood flow was studied with color doppler imaging (cdi) in the following orbital vessels: * superior ophthalmic vein (main target of the study protocol) * retinal central vein * retinal central artery * ophthalmic artery

Eligibility criteria:
inclusion criteria: * clinical diagnosis of grave's orbitopathy with well defined disease. exclusion criteria: * uncertain cases, with an undefined status of grave's ophthalmopathy.

Keywords: graves color doppler imaging graves' ophthalmopathy orbital venous flow
student stress levels and management through meditation

Conditions: Stress, Psychological

Summary: the professional program in physical therapy is rigorous and demanding on students, resulting in high levels of fatigue, stress, and sleep disturbance that can impact student performance and wellbeing. this project seeks to investigate ways to reduce student stress, monitor their quality of sleep and possibly enhance their learning through the practice of meditation.

utilizing a randomized controlled study design, a cohort of doctoral students in their first year of physical therapist education will undergo an 8 week intervention of a mantra-based meditation (twice daily 20 minutes) with pre and post measures of blood pressure, sleep hygiene via the pittsburgh sleep quality index (psqi) and stress surveys, including perceived stress scale (pss) and visual analogue scale for stress (vas), as well as daily logs of sleep to assess sleep quality. as many as 32 students (total number in cohort) per year may participate with 1/2 serving as controls and 1/2 undergoing the meditation practice for 8 weeks. baseline measurement details: questionnaires: each participant will be given a 1-item visual analogue scale for stress (vas), a 10 item perceived stress scale (pss), and a 9 item pittsburgh sleep quality index (psqi) questionnaire. the vas simply asks subjects to score how much stress they are feeling at that one moment in time on a 0-100 scale. the psqi scores and assesses sleep quality and disturbances over a 1-month time interval and will be administered at the 4 week mark 1/2 way into the study as well as at pre and post intervention data collection events. blood pressure: blood pressure will be measured individually in a separate room to ensure confidentiality. the bp measurements will be administered using an omron professional automatic blood pressure monitor (model number hem 907x) to ensure comfort/safety and the accuracy of the reading. also for accuracy of blood pressure measurements subjects will be asked to refrain from caffeine (coffee, tea or chocolate), cigarettes/nicotine, or exercise that morning until after measurements are taken and avoid alcohol the evening prior. one identified researcher will take all blood pressure reading and will be blinded to which subjects are part of the research or the control groups.

Eligibility criteria:
inclusion criteria: * graduate student in the first year of the doctorate of physical therapy (dpt) program at california state university, northridge (csun) exclusion criteria: * taking blood pressure or sleep medication; or already currently practicing a daily meditation.

Keywords: student stress meditation sleep quality blood pressure
endobronchial ultrasound strain elastography in sarcoidosis

Conditions: Sarcoidosis, Pulmonary

Summary: strain elastography (se) is an imaging method used for the measurement of relative tissue elasticity through qualitative (color pattern) or semi-quantitative methods (strain ratio or strain histogram). very recently, the first pilot study has provided preliminary evidence that ebus-se elastography may help identify fibrotic lymph nodes in sarcoidosis and that sampling lymph nodes characterized by low strain elastography, that is "stiff" nodes, is associated with an increased risk of retrieving an inadequate sample (i.e. a sample which is not representative of the lymph node tissue). the investigators hypothesize that an ebus-se pattern indicative of lymph node stiffness will be associated with less granulomas and more fibrosis.

in the last decade, the possibility to sample under ultrasound guidance (endosonography) the intrathoracic lymph nodes through the airways (endobronchial ultrasound guided, ebus-tbna) or through the oesophagus (endoscopic ultrasound-guided fine needle aspiration, eus-fna/eus-b-fna) has revolutionized the diagnostic approach to sarcoidosis. individual studies and meta-analyses performed in selected and unselected patient populations have shown that ebus and eus both have overall diagnostic accuracy exceeding 80%. in addition, endosonography provides useful information about lymph node density; indeed, the presence of inhomogeneity in the lymph node texture on b-mode during endosonography represents the most important factor favouring infection over sarcoidosis in patients with lymphadenopathy. although the diagnostic success rate of ebus-tbna in detecting granulomas in lymph nodes of patients with suspected sarcoidosis is very high, the procedure is not foolproof and tends to have a lower yield in stages ii/iii as compared to stage i disease. clinical experience suggests that at least some of the false-negative ebus-tbna results in sarcoidosis patients may be caused by the presence of lymph nodes with extensive fibrosis. we aim to evaluate whether ebus-se may help identify fibrotic lymph nodes in sarcoidosis and if the outcome of ebus-tbna is different in lymph nodes for which ebus-se suggest high fibrotic content.

Eligibility criteria:
inclusion criteria: * age 18 years or older. * asa physical status i-iii. * clinical/radiological (computed tomography) suspicion of sarcoidosis (stages i to iii) exclusion criteria: * inability or unwillingness to consent. * severe bleeding disorders * contraindication for temporary interruption of the use of anticoagulant or antiplatelet therapy different from aspirin. * recent and/or uncontrolled cardiac disease, uncontrolled pulmonary hypertension. * compromised upper airway (eg, concomitant head and neck cancer or central airway stenosis for any reason). * pregnancy

Keywords: sarcoidosis endobronchial ultrasound elastography endosonography granuloma
can we improve mortality prediction in patients with sepsis in the emergency department

Conditions: Sepsis Syndrome; Emergency Department; Biomarker

Summary: this study aims to identify the prognostic role of procalcitonin (pct), soluble triggering receptor expressed on myeloid cells-1 (strem-1), the soluble form of the urokinase plasminogen activator receptor (supar), highly sensitive c-reactive protein (hs-crp), interleukin-6 (il-6), and azurocidin 1 (azu1) in 28-day mortality for patients with sepsis in emergency department.

the levels of the specified biomarkers were measured upon patient arrival at the emergency department (ed) and analyzed their correlation with 28-day mortality. the values of these biomarkers were monitored over the initial three days following admission to the ed, aiming to explore their potential in guiding the de-escalation of antibiotic treatment. considering their prognostic significance, the main goal is to develop a novel scoring system tailored for use in the emergency department setting.

Eligibility criteria:
inclusion criteria: * sepsis 3 criteria exclusion criteria: * individuals aged under 18 or above 90 * pregnant women * individuals in custody or deprived of their liberty * patients with associated pathologies such as severe trauma * other types of shocks * acute stroke * burns * pancreatitis myocardial infarction, pulmonary edema, status asthmatics, convulsions, drug overdose, those requiring emergency surgery * terminal stage of neoplastic disease

Keywords: procalcitonin azurocidin 1 high sensitivity c reactive protein urokinase-type plasminogen activator system soluble triggering receptor expressed on myeloid cells - 1 interleukin-6 severity scores emergency department sepsis septic shock
two different minimal invasive techniques in caries removal of primary teeth

Conditions: Dental Caries in Children

Summary: pain control during dental treatments is the most challenging situations that face the pediatric dentist especially in young and fearful or anxious child. minimal invasive approach for caries removal includes many techniques to remove caries either by dental excavators, rotatory burs, atraumatic restorative treatment (art), chemo-mechanical caries removal and smart bur.


Eligibility criteria:
inclusion criteria: * each child has three teeth with carious cavity enough for insertion of hand instruments * positive or definitely positive child behaviour according to the frankl behaviour scale (fbs) * caries lesion in dentin of primary teeth exclusion criteria: * negative" or "definitely negative" child behaviour according to the fbs. * presence of sign and symptoms of pulp lesion

Keywords: minimal invasive dentistry
improving treatment adherence in hiv-infected individuals

Conditions: HIV Antiretroviral Therapy (ART) Adherence; Health Behavior

Summary: this study will develop and evaluate the efficacy of an individualized, interactive, computer software program delivered in conjunction with clinical care in increasing and supporting antiretroviral therapy adherence in hiv-infected individuals.

when antiretroviral therapy (art) is taken correctly, it can dramatically improve the health and well-being of hiv-infected individuals. however, when the treatment regimen is not followed carefully, the therapy can be ineffective in managing one's hiv, and also can allow for the development of strains of hiv that may be resistant to treatment. effective art adherence interventions can help patients to avoid potentially serious individual and public health consequences of suboptimal adherence, but such interventions are often expensive and too intensive for clinics to support offering over time to their patients. this study will develop and evaluate the effectiveness of an individualized, interactive, computer-software intervention program delivered in clinical care in increasing art adherence in hiv-infected individuals. because the intervention is a software program, clinic resources required for implementation and sustaining availability over time are minimized. participants in this \~18-month study were recruited from one of 5 participating clinics that provide hiv care and randomly assigned to control (an assessment only version of the software) or intervention (assessment and tailored intervention software) arm. participants completed their assigned task in concert with their regularly scheduled hiv medical care visits (but no more frequently than once a month). primary outcomes were measured at each medical visit. the effect of the adherence intervention was evaluated through comparison of treatment and control arm adherence reports over time and vl.

Eligibility criteria:
inclusion criteria: * hiv-infected * english-speaking * currently receiving treatment at one of the participating sites * currently receiving antiretroviral therapy exclusion criteria: * marked cognitive impairment

Keywords: hiv aids antiretroviral medication adherence
combined effects of motor imagery and core stability exercises in stroke patients

Conditions: Stroke

Summary: this research explores the combined effects of motor imagery and core stability exercises on trunk control, balance, and sleep quality in stroke recovery, addressing pakistan's unique healthcare challenges. by enhancing neuroplasticity, core strength, and physical function, these interventions aim to improve mobility, independence, and overall quality of life for stroke survivors, while addressing common sleep disturbances.

stroke patients can benefit from motor imagery and mirror therapy, which are easy to perform anytime and anywhere at their convenience. integrating motor imagery training with task-specific training leads to greater improvements in sit-to-stand performance compared to task-specific training alone. core exercises, whether performed alone or combined with other therapies, have been shown to influence trunk performance in stroke patients compared to traditional training. patients who have had strokes can benefit from rehabilitation training that focuses on strengthening their core muscles. this is likely because it thickens the transverse abdominis muscle. post-stroke patients were able to regain their motor function and sense of independence with the use of motor imagery as an additional resource. it has been shown to be an effective therapeutic strategy for this particular patient population. more than with routine physiotherapy, core stability exercises on both stable and unstable support surfaces improve ambulatory stroke patients' trunk control, core muscular strength, standing weight-bearing symmetry, and balance confidence. combined action observation and motor imagery therapy may be helpful for neurorehabilitation in chronic stroke survivors when physical practice is not appropriate. compared to standard physical treatment alone, core stability exercise and conventional physical therapy has demonstrated better outcomes in trunk control and balance. the combination of motor imagery and core stability exercises remains underexplored in stroke rehabilitation, leaving a significant knowledge gap about their synergistic potential. investigating their combined effects could offer innovative strategies to improve trunk control, balance, and sleep quality, paving the way for more comprehensive and effective post-stroke treatment programs.

Eligibility criteria:
inclusion criteria: adults aged 40-65 years. * diagnosed with stroke (ischemic or hemorrhagic) within the last 6 months to 2 years. * hemiplegic patient * having mmse score ≥ 24 * experiencing balance impairments on bbs 21-40 * having sleep disturbances on psqi 15-21. * willing to provide informed consent. exclusion criteria: severe cognitive impairments (e.g., severe dementia). * other neurological or musculoskeletal conditions affecting balance. * severe cardiovascular or respiratory conditions contraindicating exercise. * participation in another clinical trial within the past 3 months.

Keywords: stroke core stability exercises motor imagery balance
the swiss neurodevelopmental outcome registry for children with chd

Conditions: Neurodevelopmental Abnormality; Congenital Heart Disease; Cardiac Disease; Intensive Care Neurological Disorder

Summary: introduction: congenital heart disease (chd) is the most frequent birth defect. as survival has significantly improved, attention has turned to neurodevelopmental outcomes of children undergoing heart surgery in early infancy. since multiple risk factors contribute to neurodevelopmental alterations, a nationwide registry collecting data on medical characteristics, interventions, clinical course and neurodevelopment until school-age is needed to improve the quality of management, identify risk- and protective factors affecting neurodevelopment, and facilitate multicenter trials. methods and analysis: the swiss outcome registry for children with severe congenital heart disease (orchid) is a nationwide, prospective, population-based patient registry developed (1) to collect baseline characteristics and clinical data of chd patients operated with bypass-surgery or hybrid procedures in the first 6 weeks of life in switzerland, (2) to monitor long-term neurodevelopment, and (3) to relate clinical characteristics and neurodevelopment to identify risk and protective factors in these children. this registry started data collection relating to pregnancy, birth, preoperative course, catheter-based and surgical treatment, postoperative course and reinterventions in 2019. the primary outcome includes standardised neurodevelopmental assessments at 9 to 12 months, 18 to 24 months and 5.5 to 6 years. investigators expect to include 80 to 100 children per year. correlation and regression analyses will be used to investigate risk- and protective factors influencing neurodevelopment. ethics and dissemination of results: swiss orchid received support by the accentus charitable foundation, the anna mueller grocholoski foundation, the swiss society of pediatric cardiology, and the corelina - foundation and was approved by the cantonal ethics committees. findings will be presented at national and international scientific meetings, and published in peer-reviewed journals. results will also be shared with patient organizations, primary health care providers, and public health stakeholders to ensure a widespread dissemination of the results.


Eligibility criteria:
inclusion criteria: * neonates (including preterm born children) with severe chd * requiring an invasive cardiac intervention (including heart-lung-machine) within the first 6 weeks of life. exclusion criteria: * neonates (including preterm born children) with simple chd * requiring simple cardiac surgery or catheter intervention such as closure of patent arterial duct or simple repair of aortic coarctation without heart-lung-machine and low impact on neurodevelopmental outcome.
dipeptidyl peptidase-4 inhibition on glucagon-like peptide-1 (glp-1)

Conditions: Glucose Homeostasis

Summary: this research is being done to evaluate the effect of glucagon-like peptide-1 (glp-1, a naturally occurring hormone) on insulin release and to examine whether there is extra insulin release when glp-1 is not allowed to be rapidly inactivated.

the purpose of the present proposal is to 1) examine the role of dipeptidyl peptidase (dpp-4) inhibition on insulin release during a hyperglycemic clamp while glp-1 is being infused and, 2) further elucidate the role of the metabolite of glp-1, that is glp-1 9-36 amide (glp-1m). during stable and very reproducible elevated plasma glucose levels the effect of increased active incretin levels with dpp-4 inhibitors should result in increased plasma insulin levels. therefore the aim of this protocol is to document whether plasma insulin levels are increased following glp-1 infusion in the presence or absence of dpp-4 inhibitors. additionally, the investigators have shown that some improvement in glucose homeostasis during glp-1 administration is due in part to the metabolite of glp-1, i.e. glp-1 (9-36) amide (glp-1m). therefore, the investigators will also test the role of the latter by infusing glp-1m when the volunteers are being treated with dpp-4 inhibitors.

Eligibility criteria:
inclusion criteria: * hct level of at least 34% for women and 36% for men * women of non-bearing potential and women of childbearing potential using adequate contraception * serum creatine level of less than 1.7 mg/dl * four groups: * age 21-45 (bmi between 18.50-24.99) \& (bmi between 30-35) * age greater than 65 years (bmi between 18.50-24.99) \& (bmi between 30-35) exclusion criteria: * pregnant and/or lactating females * women of childbearing potential not willing to use adequate contraception * hct below inclusion criteria * serum creatine level greater than 1.8 mg/dl * age less than 21 and age between 46-64 * diabetes mellitus * bmi less than 18 and bmi greater than 35

Keywords: healthy volunteers glp-1 januvia sitagliptin
tablet-based aphasia therapy in the chronic phase

Conditions: Aphasia; Stroke

Summary: aphasia is one of the most common and disabling disorders following stroke, in many cases resolving in long-term deficits. there is evidence that intensive aphasia therapy is effective for language recovery, even in the chronic phase post-stroke. however, as many patients are left with residual language disorders and intensive aphasia rehabilitation is difficult to achieve, the investigators are exploring tablet-based therapies to further facilitate language recovery in a cost-effective manner.

this study will investigate the clinical effects of intensive tablet-based aphasia therapy as an add-on to conventional aphasia therapy (= high intensive) compared to conventional aphasia therapy (either alone, or in combination with recreational tablet use (= low intensive) in patients with aphasia following stroke, as measured by specific linguistic tests, within task improvements, functional communication and quality of life. furthermore, the investigators want to learn more about the recovery of specific underlying language processes via event-related potentials (erps). at last, the investigators aim to explore whether patients with aphasia are satisfied with a tablet-based aphasia therapy, whether the app is user-friendly and which barriers the participants might have encountered.

Eligibility criteria:
inclusion criteria: * diagnosed with mild-severe aphasia (token test score between 7 and 49) after a left hemispheric ischemic or hemorrhagic stroke * inclusion starting from 6 months post-stroke * age 18 - 85 years * being right-handed (according to the questionnaire for handedness, van strien) * mother tongue: dutch * imaging (ct or mri) prior to inclusion * signed informed consent exclusion criteria: * history of a previous stroke with persistent (\> 24 hours) language symptoms * history of other diseases of the central nervous system, psychological disorders and (developmental) speech and/or language disorders * serious non-linguistic, cognitive disorders (as documented in the patients' medical history) * inability to perform tablet-based tasks (based on a short training session) * excessive use of alcohol or drugs