Kornimate/medical-research-clean huggingface dataset:
vestibular rehabilitation for chronic central vestibular deficits: a case study

Conditions: Vestibular Disorder; Fall; Coordination and Balance Disturbances

Summary: the purpose of this study is to assess the effectiveness of vestibular rehabilitation for an individual who has chronic central vestibular deficits due to cerebellar dysfunction. due to the lack of treatment for chronic cerebellar dysfunction with physical therapy, the investigators hope to produce a protocol for chronic cerebellar dysfunction utilizing balance training, vestibular rehabilitation, or any other rehabilitation technique that may alleviate or eliminate symptoms.

the purpose of this study is to assess the effectiveness of vestibular rehabilitation for an individual who has chronic central vestibular deficits due to cerebellar dysfunction. due to the lack of treatment for chronic cerebellar dysfunction with physical therapy, the investigators hope to produce a protocol for chronic cerebellar dysfunction utilizing balance training, vestibular rehabilitation, or any other rehabilitation technique that may alleviate or eliminate symptoms. investigators will test the subject initially at 4 weeks, 8 weeks and 6 months post start date to assess for symptom improvement.

Eligibility criteria:
inclusion criteria: * central vestibular deficits exclusion criteria: * none
the role of the glymphatic system avaluated thourgh mr imaging in the diagnosis and management of nph

Conditions: Hydrocephalus; Normal Pressure Hydrocephalus

Summary: the goal of this observational study is to evaluate the role of dti-alps in the diagnostic and therapeutic management of nph the main questions it aims to answer are: * whether the glymphatic system (gs) is actually impaired in nph * whether dti-alps index can predict the positive response to tap test (tt) and to ventriculo-peritoneal shunt (vps) surgery. a healthy control group of patients (hc group) matched for age with the study group, will undergo mr with dti-alps study

enrolled patients followed a diagnostic-therapeutic pathway, consisting of the following steps: * t0: mr with dti-alps study; * t1 (within 7 days from t0): clinical and neurosurgical assessment with nph-specific rating scales (detailed below) before and after a lumbar tt, including measurements of opening pressure, drainage of 40-50 ml of csf and collection of samples for neurodegenerative biomarkers (β-amyloid 40, 42 total and p-tau) quantification. an mr with dti-alps study within 6 hours from tt; * t2 (within 3 months from t1): patients with a positive tt response (included responders, ir group) underwent vps surgery, with csf samples collected for the same neurodegenerative biomarkers (β-amyloid 40, 42 total and p-tau); * t3 (three months after surgery, ir group only): clinical and neurosurgical evaluation using nph-specific rating scales to classify patients as improved, unchanged, or worsened compared to their preoperative condition; mr with dti-alps study.

Eligibility criteria:
suspected nph patients according to the following: inclusion criteria: * clinical and radiological diagnosis of probable nph according to existing guidelines * age of over 50 years exclusion criteria: * inability to undergo mr * diagnosis of any other neurological pathology, particularly neurodegenerative or neuroinflammatory * previous neurosurgical interventions on the brain of any type. * inability to undergo general anaesthesia

Keywords: hydrocephalus normal pressure hydrocephalus nph glymphatic system dti-alps diffusion tensor imaging alps-index
long-term observation of patients with early rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: the purpose of this research is to observe the effects of ra over a long period in order to learn which of the early characteristics of patients' early ra predict future joint damage and disability. we also investigate whether certain treatments can prevent or slow the development of joint damage and disability. additionally, the costs and effects of ra on the patient are studied in order to improve the methods used to measure these effects. clinical, demographic, radiographic, and laboratory measures are taken by the rheumatologist in the office. in addition, patient questionnaires are mailed \& completed by the patient and returned to the coordinating center at ucla. all information obtained by these means will be studied in their effects on early, severe ra.

see publications

Eligibility criteria:
inclusion criteria: * \>=6 swollen joints \& \>=9 tender joints * symmetrical rheumatoid arthritis (ra) * \<= 2 years worth of symptoms * rheumatoid factor seropositivity exclusion criteria: * \<18 years old * inability to see rheumatologist, complete questionnaires (lack of compliance) * \>2 years worth of symptoms

Keywords: early, severe
prevention of transplant atherosclerosis with everolimus and anti-cytomegalovirus therapy

Conditions: Heart Transplantation; Cardiac Allograft Vasculopathy; Cytomegalovirus Infection

Summary: cardiac allograft vasculopathy (cav) is the major cause of long-term graft failure in heart transplant recipients. although several immune-mediated and metabolic risk factors have been implicated in the pathogenesis of cav, no effective therapy is currently available to treat established cav and prevent its adverse outcomes. therefore, the main clinical strategy is based on prevention and treatment of factors known to trigger its development. although the mechanism is vague, cytomegalovirus (cmv) infection is believed to play a key role in cav progression. two strategies involving administration of specific anti-cmv agents are recommended for prevention of cmv infection/disease: universal prophylaxis and preemptive therapy. the pros and cons of the two strategies are still debated, in the absence of randomized studies addressing graft-related outcomes and viral mechanisms of graft damage, and without any clear evidence of superiority of either approach. the investigators conceived this randomized prospective project to compare the effect of preemptive anti-cmv strategy with universal anti-cmv prophylaxis on cmv infection and on one-year increase in coronary intimal thickening. patients will be additionally randomized to receive either mycophenolate mofetil or everolimus, in light of the possible anti-cmv properties of everolimus.


Eligibility criteria:
inclusion criteria: * age ≥ 18y * heart or heart-kidney combined transplant * positive cmv serology at the time of transplant * glomerular filtration rate ≥ 20 ml/min/1.73m2 with mdrd at randomization. * written informed consent exclusion criteria: * panel reactive antibody ≥50% * less than 1000/mmc neutrophils at the time of randomization * less than 30,000/mmc platelets at the time of randomization * clinical significant infection in the 2 weeks prior to transplant * glomerular filtration rate \< 20 ml/min/1.73m2 estimated with mdrd formula at the time of randomization or hemodialysis treatment * intolerance towards valganciclovir, everolimus, mycophenolate or cyc-losporine * known contraindication to statin use * negative cmv serology at the time of transplant * hiv positive testing * severe comorbidities that, based on investigator's judgment, contraindicate study drugs or procedures * potentially childbearing women who refuse to use contraceptives * participation to an interventional study in the 2 preceding weeks * unwillingness or inability to follow study procedure and to sign written in-formed consent

Keywords: heart transplantation cardiac allograft vasculopathy cytomegalovirus infection everolimus valganciclovir mycophenolate
effectiveness of acupuncture for breast cancer related lymphedema

Conditions: Breast Cancer; Lymphedema; Acupuncture

Summary: this multicenter placebo-controlled trial focuses on the efficacy and safety of acupuncture on breast-cancer related lymphedema. 200 participants will be recruited, and randomized in two groups: the real acupuncture group and the sham acupuncture group.

in the theory of traditional chinese medicine (tcm), breast cancer related lymphedema (bcrl) is classified as "edema", and is considered to be caused by qi (chi) deficiency and blood stagnation. acupuncture, as an ancient therapy in tcm, is thought to have the efficacy to stimulate the transformation of qi and drainage of dampness, and is widely used for various diseases including edema in china. early clinical trials as well as our own clinical observation have demonstrated that acupuncture can ameliorate limb swelling and decrease lymphedema. however, no randomized placebo-controlled trial has been performed to evaluate this efficacy of acupuncture. therefore, this study aimed to evaluate the safety and potential efficacy of acupuncture to treat chronic upper-limb lymphedema.

Eligibility criteria:
inclusion criteria: * women who completed all primary and adjuvant treatments. * age between 20 and 45. * bmi between 18 and 28. * unilateral lymphedema resulting from surgery for breast cancer. * mild to moderate lymphedema, with 10% to 40% increase in volume compared to the unaffected arm based on perometry evaluation. * with no evidence of recurrence. exclusion criteria: * bilateral lymphedema. * history of bilateral axillary lymph node dissection. * serious lymphedema, with over 40% increase in volume compared to the unaffected arm based on perometry evaluation. * pregnant women. * unable to adhere to the protocol or the treatment schedule. * recurrent breast cancer or other malignancies. * current use of chemotherapy or radiation. * current use of diuretic drugs like diosmin, or other investigational drugs.
anterior tibial subluxation in the setting of acl-injury and after acl reconstruction

Conditions: Anterior Cruciate Ligament Injuries

Summary: to identify the related factors for anterior tibial subluxation (ats) on anterior cruciate ligament-injured mri images.

demographic data and mri images of anterior cruciate ligament-injured patients were retrospectively analyzed. anterior tibial subluxation was measured and factors were examined via univariate and multivariate analysis.

Eligibility criteria:
inclusion criteria: * diagnosed anterior cruciate ligament injuries * available preoperative mri images at our hospital exclusion criteria: * patients were excluded in the case of under 18 years of age * bilateral anterior cruciate ligament injuries * concomitant posterior cruciate ligament injuries * concomitant collateral ligament injuries * no access to the preoperative mri scan at our hospital

Keywords: anterior tibial subluxation
a phase 3b multicenter study of pregabalin in fibromyalgia subjects who have comorbid depression

Conditions: Fibromyalgia

Summary: the intent of this study is to identify and treat fibromyalgia subjects with comorbid depression who are receiving an ssri (selective serotonin reuptake inhibitor) or snri (selective norepinephrine reuptake inhibitor) primarily for their depression and to determine whether pregabalin demonstrates improvement relative to placebo in improving pain associated with fibromyalgia.


Eligibility criteria:
inclusion criteria: * men or women of any race or ethnicity who are at least 18 years of age. * adult women and men with a diagnosis of fibromyalgia and stable depression (major depressive disorder, depression not otherwise specified (nos), or dysthymia) who have been taking an antidepressant (ssri or snri) primarily for their depression for at least 3 months. exclusion criteria: * have failed pregabalin treatment due to lack of improvement of symptoms at doses of greater than or equal to 300 mg daily, cannot tolerate pregabalin or any pregabalin ingredient, or participated in a pregabalin clinical trial. if the subject has taken pregabalin and discontinued for reason other than lack of improvement or intolerance, then they will be eligible. pregabalin use within the last 30 days (prior to v1) is not permitted. * patients with severe or unstable depression are not eligible. * patients with other types of pain or conditions that may make it difficult to evaluate fibromyalgia symptoms are not eligible * any subject considered at risk of suicide or self harm based on investigator judgment and/or the details of a risk assessment

Keywords: pregabalin lyrica depression
fluid and salt restriction in decompensated heart failure patients

Conditions: Heart Failure

Summary: the non-pharmacological measures that are widely practiced and recommended for hf patients, such as salt and water restriction, specially at moments of disease decompensation, still lack clearer evidence of their therapeutic effect.

heart failure clinics, healthcare structures formed by a multidisciplinary team specialized in the disease, have demonstrated to provide benefits to patients through multiple non-pharmacological interventions, among them fluid and salt restriction. sodium restriction has a class i recommendation and evidence level c, that is, general agreement that the intervention is beneficial, useful and effective, evidenced by consensus, expert opinion, small studies, retrospective studies or registries. sodium restriction becomes even more controversial when we consider evidence suggesting the benefit of non-salt restriction or treatments with salt administration, in the form of hypertonic solutions. in face of literature evidence not showing conclusive results about the benefit of sodium and fluid restriction, we designed this study in order to assess the effect of fluid and salt restriction on the management of patients hospitalized due to decompensated heart failure

Eligibility criteria:
inclusion criteria: * patients of both sexes, with age equal to or above 18 years, diagnosed with decompensated hr (systolic dysfunction), according to the boston criteria (score \> 8 points), who agree to participate in the study and sign an informed consent form. exclusion criteria: * patients presenting with endogenous creatinine clearance (ecc) values lower than or equal to 50-60 ml/min (obtained by the cockcroft-gault equation) at hospital admission, cardiogenic shock, survival compromised by another evolving disease, those with difficulty complying with treatment (dementia, cognitive deficit).

Keywords: salt restriction fluid restriction congestion heart failure
investigation of the proportion of human epidermal growth factor receptor 2 protein overexpression of gastric adenocarcinoma and prognostic effect of her2, and analysis of practice pattern of herceptin use in stage iv gastric cancer

Conditions: Stomach Neoplasms

Summary: the objective of this study is to investigate the proportion of her2 overexpression in gastric cancer patients group, to evaluate the relation of her2 overexpression with prognosis, and to analyze the proportion of herceptin applied to patients in clinical field. furthermore, the investigators are going to reevaluate the clinical benefit of herceptin for survival prolongation compared to chemotherapy only.


Eligibility criteria:
inclusion criteria: 1. histologically confirmed gastric adenocarcinoma 2. patients were diagnosed during 2006-2013 3. her2 expression status was evaluated in primary gastric cancer or metastatic lesion. exclusion criteria: * patients with second primary cancer within 5 years

Keywords: genes, erbb-2 prognosis
a study of moderate-to-severe plaque psoriasis patients response to secukinumab treatment in real-world setting

Conditions: Moderate-to-severe Plaque Psoriasis

Summary: this study was a one-arm, retrospective cohort study that observed clinical psoriasis patients who received secukinumab treatment in indonesia from the 01 august 2017 until the 31 october 2020. patients' data were obtained from the medical records of a dermatology clinic in jakarta, indonesia. the primary endpoints were set at week 16, and secondary endpoints at weeks 16 and 52. at each endpoint, the study assessed effectiveness by measuring the proportion of psoriasis patients receiving secukinumab who achieved psoriasis area and severity index (pasi) 75 (at week 8) and pasi 90 (at weeks 16 and 52).


Eligibility criteria:
inclusion criteria * male or female, aged at least 18 years old. * diagnosed as moderate-to-severe plaque type psoriasis with pasi score ≥ 5 prior to initiating secukinumab treatment. * treated with secukinumab for a minimum of 8 weeks after the initial secukinumab treatment without any interruption. * patients included in this study received the initial secukinumab treatment within the period of 1 august 2017 to 31 october 2019. with the secondary endpoint of 52 weeks, the latest recorded data included in the analysis was recorded on 31 october 2020. exclusion criteria * patients with other types of psoriasis. * patients with incomplete information on pasi score at weeks 0, 8, and 16 in their medical records.
effect of protein supplementation after bariatric surgery

Conditions: Protein Malnutrition

Summary: obese patients, who underwent bariatric surgery, are at risk to develop protein malnutrition. the aim of this study is to evaluate the influence of postoperative protein supplementation on weight reduction, body composition and protein status.

bariatric surgery has become a major treatment option for severe obesity in adults. it has proven its efficiency regarding weight loss and its benefits concerning the improvement or even remission of obesity related comorbidities. additionally, bariatric surgery procedures can be performed laparoscopically, which decreases the complication rate and reduces postoperative pains. despite the advantages of bariatric surgery, attention needs to be paid to the possible risks following the surgical treatment. postoperative risks often concern the nutritional status. it has been shown that, beside different micronutrient deficiencies, bariatric surgery also leads to an increased risk of developing protein malnutrition. discussed reasons for this are the malabsorption of nutrients and the restricted food intake after surgery, which may lead to reduced protein consumption. postoperative occurrence of vomiting or different food intolerances may support this effect. accordingly, if an inadequate supply persists, a protein deficit will occur and this, in turn, may lead to an undesirable reduction in muscle mass and plasma protein levels. based on this background, numerous studies indicate an increased incidence of protein malnutrition after bariatric surgery by detecting a decrease in levels of albumin and prealbumin, a significant reduction in lean body mass, as well as an inadequate protein intake after surgical treatment. dietary proteins have shown to play an important role in body weight regulation. there is evidence that a protein-rich diet is supposed to facilitate weight loss, to support successful weight maintenance, to attain satiety and to preserve lean body mass. therefore, the use of protein supplements after bariatric surgery may minimize the risk for developing protein malnutrition and hence optimize the postoperative care. the primary aim of this randomized, placebo-controlled, double blind pilot study was to evaluate the influence of postoperative protein supplementation on body weight reduction, body composition and protein status.

Eligibility criteria:
inclusion criteria: * age between 18 and 65 years * bmi of 35 kg/m2 or more * indication for laparoscopic sleeve gastrectomy or roux-en y gastric bypass exclusion criteria: * renal disease * type 2 diabetes

Keywords: bariatric surgery protein malnutrition protein supplementation body composition body fat mass protein intake
evaluation of etc-1002, ezetimibe, and the combination in hypercholesterolemic patients

Conditions: Hypercholesterolemia

Summary: the purpose of this research study is to see how etc-1002 is tolerated in the body, to measure the amount of etc-1002 in the blood, and to determine how etc-1002 affects the level of ldl-cholesterol (bad cholesterol) and other markers of health and disease in blood and urine in patients with elevated ldl-cholesterol with or without statin intolerance.

hypercholesterolemic patients either with or without a history of statin intolerance (1:1 ratio) will be randomized to receive once daily by mouth capsules containing either etc-1002, ezetimibe, or etc-1002 + ezetimibe. this study will explore the safety and efficacy of concomitant administration of etc-1002 and ezetimibe, while also exploring the effect of ezetimibe on etc-1002 systemic exposure.

Eligibility criteria:
key inclusion criteria: * statin intolerant and statin tolerant * fasting ldl-c between 130 mg/dl and 220 mg/dl * fasting triglyceride less than or equal to 400 mg/dl * body mass index (bmi) between 18 and 45 kg/m2 key exclusion criteria: * history or current clinically significant cardiovascular disease * history or current type 1 diabetes or uncontrolled type 2 diabetes * use of metformin or thiazolidinediones (tzd) within 3 months of screening * history of joint symptoms difficult to differentiate from myalgia * uncontrolled hypothyroidism * liver disease or dysfunction * renal dysfunction or nephritic syndrome * gastrointestinal (gi) conditions or prior gi procedures * hiv or aids * history or malignancy * history or drug or alcohol abuse within last 2 years * use of experimental or investigational drugs within 30 days of screening * use of etc-1002 in a previous clinical study

Keywords: statin intolerant statin tolerant ldl cholesterol
post hysterectomy benefits of retained cystoscopy fluid

Conditions: Urinary Retention

Summary: the purpose of this research study is to compare outcomes for women in two study arms that include retaining the cystoscopy distending fluid after minimally invasive hysterectomy verses completely emptying the cystoscopy distending fluid. the outcomes being measured for research purposes include the time spent to first spontaneous urination after surgery, rate of indwelling catheter insertion, length of recovery room stay, the amount of bladder discomfort immediately postoperative and over the first 24 hours postoperative, bladder symptoms over the first 24 hours postoperative, and patient satisfaction.

acute urinary retention can be a common postoperative complication following hysterectomy. one of the many benefits of minimally invasive surgery is shorter hospital stay following a major procedure such as laparoscopic or robotic hysterectomy. an important postoperative milestone before discharge from the postoperative anesthesia care unit (pacu) is spontaneous voiding. if unable to spontaneously void due to urinary retention, insertion of an indwelling catheter may be required. awaiting a spontaneous void in the recovery room can lead to longer hospital and pacu stays, greater cost, and patient dissatisfaction. at the conclusion of traditional laparoscopic or robotic-assisted hysterectomy, intraoperative cystoscopy is performed to evaluate for urologic injury. one possible strategy to more quickly facilitate a postoperative spontaneous void is to retain the cystoscopy distending fluid at conclusion of cystoscopy rather than emptying the bladder of the distending fluid. although there is no published research investigating voiding time following laparoscopic or robotic hysterectomy using strategies such as backfilling the bladder before removal of the indwelling catheter or retaining the cystoscopy distending fluid following diagnostic cystoscopy.

Eligibility criteria:
inclusion criteria: * female patients, greater than or equal to 18 years old * english-speaking * undergoing laparoscopic or robotic hysterectomy for benign indications by one of the three minimally invasive gynecologic surgeons at banner university medical center - phoenix. exclusion criteria: * preoperative indications of pelvic organ prolapse * preoperative indications of urinary incontinence * lower urologic (bladder or ureteric) injury identified at time of hysterectomy or during intraoperative cystoscopy * patients given any measure to aid in visualization of ureteral patency including dextrose, phenazopyridine, indigo carmine, methylene blue, sodium fluorescein, or furosemide.