Kornimate/medical-research-clean huggingface dataset:
extracorporeal shock wave therapy on diabetes related frozen shoulder

Conditions: Frozen Shoulder; Diabetes Mellitus

Summary: the aim of this study is to observe the changes in the combined eswt application and physiotherapy program in the frozen shoulder pathology associated with diabetes. different treatment approaches will try to identify the most effective treatment method. changes in muscle tone, pain, range of motion and functionallity will be observed with eswt treatment. for the first time placebo-controlled research is being conducted with different doses of eswt in our country and in the world literature. in this way the lower floor of the further work to be done will be established.

the study will be performed with participants who has diabetic frozen shoulder diagnosis after clinical examination and imaging procedures performed, held at okan university hospital, physical therapy and rehabilitation clinic. data will be recorded with the shoulder evaluation form in the study and cases will be divided into three groups with simple randomization method. the initial range of motion of the participants will be evaluated bilaterally using an electro-goniometer. the muscle tone evaluation will be made with myotonpro. muscle strength assessment will be performed with the microfet2 dynamometer at the appropriate measurement positions. participants' pain assessment will be done in the rest, activity and night pain using the visual analog scale. the shoulder pain disability scale will be used to assess participants' shoulder function. the short-form-36 questionnaire will be used evaluating the quality of life. physiotherapy application will be applied to all three groups in the form of standard treatment protocol, duration and number. for the first group eswt application will be done at energy density of 0.12 mj/mm2, in the second group, at an energy density of 0.3 mj/mm2, for the third group application will be done as sham eswt. the eswt will be administered once a week and in two separate sessions of 2000 strokes. after initial measurements, re-evaluations will be done in the fourth and sixth weeks. the statistics will be analyzed by appropriate methods.

Eligibility criteria:
sex: no limit on eligibility based on the sex of participants. gender: eligibility is not based on gender. age limits: minimum age: 30 years maximum age: 65 inclusion criteria: pain in the shoulder joint longer than for six weeks the shoulder joint movements of cases at least two of the abduction, flexion, external rotation, and internal rotation movements with a limitation of motion \> 50% differentiated from other pathologies according to shoulder mri results exclusion criteria: limitation of pain due to cervical radiculopathy rotator cuff massive tears recurrent subluxation trauma or patients with active infection using cardiac pills, patients blood coagulation disorders neurologic causes-restriction of movement in shoulder joint due to cerebrovascular pathologies, limitation of movement due to rheumatic causes sampling method: simple random sampling

Keywords: physical therapy eswt
serum autotaxin levels in cholestasis of pregnancy

Conditions: Intrahepatic Cholestasis of Pregnancy

Summary: intrahepatic cholestasis of pregnancy is the most common liver disease in pregnancy. it is is a pregnancy-specific liver disorder with onset mainly in the third trimester of pregnancy. icp is characterized by pruritus, elevated serum fasting bile salts and transaminases and an increased risk of adverse fetal outcomes. serum autotaxin levels were found highly sensitive and specific biomarker to to differentiate icp from other pregnancy-related liver disorders or pruritic dermatoses. the purpose of the study is to determine the diagnostic accuracy of serum autotaxin activity in cholestasis of pregnancy.

collected data will enable us to compare serum autotaxin levels in cholestasis of pregnancy and healthy control group.

Eligibility criteria:
inclusion criteria: * clinical diagnosed cholestasis of pregnancy patients exclusion criteria: * acute or chronic liver disease * acute or chronic gallbladder disease

Keywords: intrahepatic cholestasis of pregnancy
intensive versus conventional hyperglycemic control in hospitalized non-critically ill patients

Conditions: Diabetes Mellitus; Non-critically Ill Patients

Summary: hyperglycemia is a common condition among hospitalized patients. the occurrence of severe hyperglycemia is associated with increased morbidity and mortality in several populations. several trials assessed the benefits of aggressive versus conventional glucose control. these studies evaluated different patient populations, glucose targets and treatment protocols and as a result reported conflicting results. to date there are no clear guidelines regarding to the preferred glucose target range in hospitalized non-critically ill patients. the common practice is to maintain glucose level lower than 180 mg/dl however there are no evidence based regarding to the outcomes of hospitalized patients treated with intensive compared to conventional glycemic control. this prospective randomized controlled study will compare intensive vs. standard glycemic control in hospitalized non-critically ill patients. within 24 hours of hospitalization in the internal medical or geriatric departments, patients who are expected to require hospitalization for at least three consecutive days will be randomly assigned into one of the two study groups - intensive with a target blood glucose range of 130 mg per deciliter or less, or conventional glucose control, with a target of 130-180 mg per deciliter. the investigators defined the primary end point as a composite outcome of mortality in 30 days, severe hypoglycemia, severe infections within 30 days, cva and cardiac ischemic events within 30 days.


Eligibility criteria:
inclusion criteria: * age older than 18 years old. * history of type 2 diabetes mellitus for at least three months or a blood glucose level of 200 mg per deciliter or higher in two different consecutive measurements. * a minimum of three days of hospitalization. exclusion criteria: * diabetic ketoacidosis or hyperosmolar non-ketotic state at any stage of hospitalization. * patients expected to require intensive care unit admission or immediate surgical intervention. * history of current drug or alcohol abuse. * history of current mental illness. * child-bearing potential or a positive urine pregnancy test.

Keywords: diabetes mellitus hyperglycemic control hospitalization internal medicine
pentoxifylline for the prevention of pep

Conditions: Pancreatitis

Summary: between december 2016 and june 2017, 110 consecutive patients older than 18 years who are scheduled to undergo diagnostic or therapeutic ercp at the anhui provincial hospital will be recruited for the study. patients were randomized using opaque, sealed envelopes containing random numbers assigning them to treat with pentoxifylline (pentoxifylline group) or placebo (placebo group) for preventing ercp pancreatitis.


Eligibility criteria:
inclusion criteria: 1. males and females, age \> 18 years. 2. normal amylase level before undergoing ercp. 3. signed inform consent form and agreed to follow-up on time. exclusion criteria: 1. medical or psychological condition that would not permit the patient to complete the study or sign the informed consent. 2. patients involved in other study within 60 days. 3. billroth ii or roux-en-y anatomy 4. acute pancreatitis. 5. a history of previous ercp 6. pregnancy or history of allergy to pentoxifylline 7. patient treated for arterial hypertension 8. patient with severe coagulopathy 9. patient with hyper sensibility of pentoxifylline 10. nursing mothers
the impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cyst

Conditions: Ovarian Cysts

Summary: the purpose of this study is to investigate the impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cyst and the possible mechanisms.

laparoscopic cystectomy is currently considered the treatment of choice in women with benign ovarian cysts and has gained increasing acceptance among gynecological surgeons(1). however, the safety of this technique in terms of ovarian damage to the operated gonad has recently been questioned. in the present study, with the combined use of serum hormonal evaluation and ultrasound examination, we planned to prospectively investigate the ovarian reserve after the excision of benign ovarian cysts. the damage to ovarian reserve will be evaluated through a 12-months follow-up after the application of bipolar, ultrasonic scalpel electrocoagulation or suture during ovarian cystectomy

Eligibility criteria:
inclusion criteria: * age 18-40 years * uni/bilateral ovarian cyst(s) without clinical and sonographic suspicion of ovarian cancer * regular menstrual cycles defined as cycle length between 25 and 35 days in the 6 months before surgery * agreement to be enrolled in the study exclusion criteria: * prior ovarian surgery * surgical necessity to perform adnexectomy * known endocrine disease * post operative pathologic diagnosis was not benign ovarian cyst * oral contraceptive use before surgery

Keywords: ovarian cysts electrocoagulation ovarian function tests laparoscopy
chronic kidney disease in pakistani population

Conditions: Chronic Kidney Disease

Summary: the indo-asian developing countries are facing an epidemic of chronic diseases including hypertension, diabetes and chronic kidney disease (ckd). diagnosis of early ckd is essential for institution of effective and timely prevention of its complications; costly late stage treatment for end stage renal disease is currently an unfeasible option in these populations. gfr estimates of kidney function provide a common reference standard for all people and are therefore readily applicable by physicians and understood by patients. however, the existing gfr equations yield widely discrepant results in the indo asian population, and none of the currently available estimating equations have been validated in this population. the main objective is to develop a tool which can be used for screening subjects at high risk for developing ckd (with hypertension and diabetes) as well as the general population.

the proposed study is being conducted at the aga khan university in collaboration with tufts-new england medical center and imperial college, uk. it is a population based cross-sectional study using a 2-stage cluster design. the study would be performed on 650 adult subjects from the general population in karachi. a new gfr equation specific to a pakistani population would be developed and validated using the gold standard of measured insulin gfr. the performance of the new equation will be compared to the existing ones developed in other populations with respect to bias, precision, and accuracy. the project is likely to contribute significantly to moving the field to kidney disease forward, and its results are likely to have far reaching implications for understanding of ckd and, ultimately, its prevention in indo-pakistani populations worldwide.

Eligibility criteria:
inclusion criteria: * all individuals aged 40 years and above exclusion criteria: * shortness of breath on minimal to moderate exertion * acute fibril illness * doctor diagnosed liver disease * doctor diagnosed rheumatological disease * heart attack within past three months * pregnancy * mentally incompetent to give informed consent * too frail to travel to clinic * bed ridden subjects

Keywords: chronic kidney disease renal insufficiency
beta-blockade with landiolol in out-of-hospital cardiac arrest

Conditions: Cardiac Arrest

Summary: this study investigates the efficacy of landiolol versus placebo in patients with out-of-hospital cardiac arrest (ohca) and refractory ventricular fibrillation (electrical storm).

the use of beta-blockers in ohca patients with refractory vf could potentially reverse the unwanted beta-1-mediated effects of endogenous and exogenous epinephrine (proarrhythmic effect), which could in turn lead to a shorter time until return of spontaneous circulation (rosc). this is a prospective, double-blind, randomized placebo-controlled pilot trial. the investigators consider this a pilot trial, as this is the first prospective trial evaluating the use of beta-blockade in cardiac arrest.

Eligibility criteria:
inclusion criteria: * ohca , \>/=18 years of age * 3 or more shockable rhythms (vf or pvt) and last rhythm shockable exclusion criteria: * age \> 85a * severe head trauma or acute active bleeding * known allergy or insensitivity to landiolol or another beta-blocker

Keywords: cardiac arrest refractory ventricular fibrillation electrical storm landiolol
multiple-dose,double-blind,placebo-controlled study of sodium oxybate in patients with essential tremor

Conditions: Essential Tremor

Summary: to determine the relationship between drug plasma levels and safety, tolerability and efficacy in patients with essential tremors after dosing with sodium oxybate


Eligibility criteria:
inclusion criteria: * diagnosis of moderate or severe classic essential tremor (bilateral, largely symmetric postural or kinetic tremor involving hands and forearms. * willingness to abstain from ethanol and caffeine intake for at least 48 hours prior to days 1 and 4 and on inpatient days exclusion criteria: * subjects with a clinically significant unstable medical abnormality, chronic disease or history or presence of significant hepatic, renal, endocrine, cardiovascular, gastrointestinal, pulmonary, psychiatric, or metabolic disease or any other abnormality * subjects who are on sodium-restricted diets * subjects with a known history of sleep apnea
the impact of different csii and cgm systems on different clinical outcome variables in children and adolescents with type 1 diabetes. an observational study form the norwegian childhood diabetes registry (ncdr)

Conditions: Diabetes Mellitus, Type 1

Summary: to examine the effect of continuous subcutaneous insulin infusion (csii) and continuous glucose monitoring (cgm) on metabolic control, in a large population-based nationwide observational study under real life conditions. all children and adolescents with type 1 diabetes are investigated,using annual data in 2017 from the population-based norwegian childhood diabetes registry (ncdr). hba1c, incidence of diabetes ketoacidosis (dka) and severe hypoglycemia (sh) are evaluated depending on the use of csii and cgm in a linear mixed-effects and linear regression model adjusted for age, biologic gender and diabetes duration. health-related quality of life (hrqol) is assessed by using the disabkids diabetes specific module (ddm-10), and associations with the use of csii, cgm, age, gender and diabetes duration are evaluated.

in norway, all children with diabetes 0-18 years should, due to a recommendation from the national health care authority, receive their diabetes follow-up in a pediatric department. all pediatric departments participate in the ncdr reporting standardized clinical data on their patients to the ncdr, at diabetes onset and annually, until the patients reach 18 years of age. the data completeness of ncdr is high, on individual level 99 % at diabetes onset, and 98 % on the annual examinations in 2016 - 2017. in addition, hrqol data were collected in 2017, using the disabkids diabetes specific module (ddm-10). children 10-17 years with type 1 diabetes were invited to independently fill out the questionnaire regarding their own disease-related quality of life. all parents to children with type 1 diabetes (independent of the child's age) were invited to fill out the same questionnaire, giving a proxy evaluation of their child's quality of life.

Eligibility criteria:
inclusion criteria: all registered subjects with type 1 diabetes in the 2017 annual cohort of the ncdr exclusion criteria: none

Keywords: t1d csii cgm diabetic ketoacidosis hypoglycemia hrqol
gvax pancreas vaccine (with cy) and crs-207 with or without nivolumab

Conditions: Previously Treated Metastatic Adenocarcinoma of the Pancreas

Summary: the primary objective of this study is to compare the overall survival (os) of subjects with previously treated metastatic pancreatic cancer treated with cyclophosphamide (cy)/nivolumab/gvax pancreas vaccine followed by nivolumab/crs-207 (arm a) to subjects treated with cy/gvax pancreas vaccine followed by crs-207 (arm b).


Eligibility criteria:
inclusion criteria: * age ≥18 years. * have histologically- or cytologically-proven adenocarcinoma of the pancreas. patients with mixed histology will be excluded. * have metastatic disease. * have failed only 1 prior chemotherapy regimen for metastatic pancreatic cancer. * patients with the presence of at least one measurable lesion. * patients acceptance to have a tumor biopsy of an accessible lesion at baseline and on treatment if the lesion can be biopsied with acceptable clinical risk (as judged by the investigator). * ecog performance status 0 or 1. * life expectancy of greater than 3 months. * patients must have adequate organ and marrow function defined by study-specified laboratory tests. * must use acceptable form of birth control while on study. * ability to understand and willingness to sign a written informed consent document. exclusion criteria: * known history or evidence of brain metastases. * had surgery within the last 28 days * have received any non-oncology vaccine therapy used for prevention of infectious diseases including seasonal vaccinations within 28 days of study treatment. * prior treatment with anti-pd-1, anti-pd-l1, anti-pd-l2, anti-ctla4, gvax or crs-207 * systemic steroids within the last 14 days * use more than 3 g/day of acetaminophen. * patients on immunosuppressive agents. * patients receiving growth factors within the last 14 days * known allergy to both penicillin and sulfa. * severe hypersensitivity reaction to any monoclonal antibody. * have artificial joints or implants that cannot be easily removed * have any evidence of hepatic cirrhosis or clinical or radiographic ascites. * have significant and/or malignant pleural effusion * infection with hiv or hepatitis b or c at screening * significant heart disease * conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access, that would affect the patient's ability to comply with study visits and procedures * unable to avoid intimate contact with another individual known to be at high risk of listeriosis (e.g., newborn infant, pregnant woman, hiv-positive individual) during the course of crs-207 treatment until completion of antibiotic regimen. * are pregnant or breastfeeding. * have rapidly progressing disease
launching an asthma initiative designed to improve asthma management and outcomes

Conditions: Asthma

Summary: following on from a 10 year study conducted in finland this study is designed to test the validity and sustainability of an enhanced asthma management model for the uk.

the british lung foundation (blf) aims to work with the governments in the four uk nations to launch an asthma initiative designed to improve asthma management and outcomes. the project incorporates key learning from a 10 year programme in finland designed to improve asthma care and cap healthcare costs for paediatric and adult populations. the finland programme focused on accurate diagnosis, training and education of healthcare professionals and patients and early use of anti-inflammatory therapy. the programme successfully improved medication compliance, reduced asthma hospital admissions, reduced asthma-related benefit claims and reduced the overall cost of asthma to the finnish government. to test the validity and sustainability of an enhanced asthma management model for the uk, the blf proposes to undertake a pilot initiative in england. the pilot will focus on: improving diagnostic accuracy through analysis of gp asthma registers; increasing asthma education among healthcare professionals; assessment of risk and control of patient's asthma; supportive self-management and education of people with asthma. it is anticipated that the pilot will lead to measureable and significant improvements in asthma management, including: * reduced number of severe exacerbations (asthma hospitalisation, a\&e attendance and oral steroid rescue) * improved diagnostic accuracy (and reduction of diagnostic doubt) * improved implementation of recognised asthma guidelines, including appropriate step wise management of patients the pilot will also aim to increase the proportion of patients on the asthma register with an asthma management plan and a recorded asthma control test therefore supporting higher levels of control, and will promote peer-to-peer health care professional asthma education and knowledge sharing to establish an asthma-training legacy. the pilot model will be sustainable and reproducible across england and the devolved nations (scotland, wales and northern ireland). whilst the core aspects of an agreed national model will be rolled out across the pilot site, it will be tailored and refined through local collaboration (primary care, secondary care and commissioners) to help attain local targets in line with regional differences, needs and priorities. results from the pilot will be reported 15 months after project initiation on site (july/august 2014)

Eligibility criteria:
inclusion criteria: * motivated and driven local champions in the area * high rates of hospital admissions (aged 3-65) * high asthma prevalence * high percentage of patients who have had an asthma review in the previous 15 months. exclusion criteria: -

Keywords: asthma management anti-inflammatory therapy compliance hospital admission educations self-management guidelines exacerbations diagnostic accuracy symptom control
a study of roactemra/actemra (tocilizumab) in combination with methotrexate in patients with active rheumatoid arthritis who have an inadequate response to disease-modifying antirheumatic drugs (dmards) (alabaster)

Conditions: Rheumatoid Arthritis

Summary: this open-label, single arm study will assess the safety and efficacy of roactem ra/actemra (tocilizumab) in combination with methotrexate in patients with activ e moderate to severe rheumatoid arthritis who have an inadequate response to dis ease-modifying antirheumatic drugs (dmards). patients will receive roactemra/act emra at a dose of 8 mg/kg (maximum 800 mg) intravenously every 4 weeks for a tot al of 6 infusions. methotrexate will be continued at a stable dose. anticipated time on study treatment is 24 weeks.


Eligibility criteria:
inclusion criteria: * adult patients, \>/= 18 years of age * active moderate to severe rheumatoid arthritis (ra) * on methotrexate treatment (oral or parenteral) for at least 12 weeks, at stable dose of at least 15 mg/week for at least 6 weeks * oral corticosteroids must have been at stable dose of \</= 10 mg/day prednisone (or equivalent) for at least 25 out of 28 days prior to first dose of study drug * body weight \</= 150 kg exclusion criteria: * major surgery (including joint surgery) within 8 weeks prior to screening or planned major surgery within 6 months of study entry * rheumatic autoimmune disease other than ra * functional class iv according to american college of rheumatology (acr) classification * prior history of or current inflammatory joint disease other then ra * treatment with traditional dmards other than methotrexate within 1 month (for leflunomide 3 months) prior to baseline * treatment with any biologic drug that is used in the treatment or ra * intraarticular or parenteral corticosteroids within 6 weeks prior to baseline * known active current or history of recurrent infection * history of or currently active primary or secondary immunodeficiency * positive for hiv