Kornimate/medical-research-clean huggingface dataset:
immersive virtual reality for chronic neuropathic pain after spinal cord injury: a feasibility trial

Conditions: Neuralgia; Spinal Cord Injuries; Chronic Pain

Summary: the aim of this study is to provide critical information about the efficacy of immersive virtual reality (ivr) to decrease the experience of neuropathic pain in the upper and lower extremities of people with a spinal cord injury.

when a spinal cord injury occurs, the spinal somatosensory circuit is thought to generate aberrant nociceptive impulses that the brain interprets as pain. neuropathic pain (np) affects 40 to 70% of people with sci and is a very disabling clinical condition. many treatment options have been offered, but provide limited effects, leaving people with sci with a reduced quality of life. the study team believes that immersive virtual reality (ivr) neurorehabilitation has the potential to be an effective treatment for chronic neuropathic pain. for this reason, the objective of this study is to evaluate the feasibility of using a virtual reality device to decrease chronic neuropathic pain in individuals with spinal cord injury.

Eligibility criteria:
inclusion criteria: * spinal cord injury survivors (chronic only) * presence of neuropathic pain at or below sci level for at least 6 months following trauma or disease of the spinal cord * a pain intensity of at least 2 out of 10 in the numerical pain rating scale (nprs) test at baseline * stable pharmacological treatment for at least 4 weeks prior to the study and throughout the trial exclusion criteria: * psychiatric or other neurological disorders (participants will not be excluded for having a sci, if they score 0-30 points on the bdi, or if they report having anxiety) * head injuries causing cognitive or visual impairment * severe vertigo

Keywords: virtual reality neuronal plasticity neurological rehabilitation immersive virtual reality
medical mindfulness: virtual reality mindfulness therapy for eating disorders

Conditions: Eating Disorder; Anxiety; Abdominal Pain

Summary: adolescents and young adults with eating disorders undergoing refeeding on an inpatient unit often experience abdominal pain and anxiety either as a result of their medical condition or as an expected side effect of nutritional rehabilitation. the purpose of this study is to assess if vr (virtual reality) mindfulness therapy is more or as effective as the standard of care (supportive care such as aromatherapy, heat packs, distraction, and nausea bands) for treating and/or preventing anxiety and pain in patients with eating disorders during the re-nourishment process. the anticipated primary outcome will be reduction of abdominal pain and anxiety with utilization of this intervention.

in this study, investigators hope to 1) assess acceptance of vr mindfulness among inpatient adolescents and young adults with eating disorders 2) assess effects of vr mindfulness on perceived abdominal pain and 3) determine the impact of vr mindfulness on anxiety scores. this study is designed to test the feasibility, acceptability and effectiveness of vr mindfulness in patients as they undergo various medical and nutritional therapies to treat their conditions.

Eligibility criteria:
inclusion criteria: * patients admitted to the inpatient medical unit for refeeding for malnutrition exclusion criteria: * non-english speakers
endoscopic goniotomy for infantile glaucoma

Conditions: Glaucoma

Summary: glaucoma surgery is performed on children less than 3 years old for infantile glaucoma which untreated can cause blindness. glaucoma is an uncontrolled high eye pressure in these children often due to incomplete development of the part of the eye which normally allows fluid to drain out of the eye. two procedures are possible and equal in their success of lowering the eye pressure. however, one (the goniotomy procedure) is preferred since it takes 10 minutes rather than 1 hour (for the trabeculotomy procedure) to perform under general anesthesia. this is important in young children to reduce anesthesia exposure especially if both eyes need surgery. if the glaucoma has caused the cornea or front of the eye to become too cloudy, then the view is too poor to place a lens on the cornea and use a needle to perform the shorter procedure. however, a small endoscope which has been fda approved for use in the eye will allow direct viewing of the area which needs treatment. a needle attached to this endoscope allows the shorter goniotomy to be performed rather than proceeding to the longer trabeculotomy procedure. the outcome measure of this study is anesthesia time and reduction in intraocular pressure .

b. the standard examination under anesthesia initially will be performed including measuring the child's intraocular pressure, measuring dimensions of the eye, examining the front of the eye under the operating microscope, examining the portion of the eye where the fluid drains, evaluating the back of the eye with an ultrasound, and possible documentation with photographs. when the diagnosis is confirmed by this examination, the eye or eyes will be carefully evaluated for their clarity. if a standard goniotomy procedure can not be done, then the endoscopic goniotomy will be performed. the procedure is identical with: cleaning the eyelid skin, using a speculum to open the eyelids, making a small cut into the cornea, and placing a viscoelastic substance into the eye to maintain its shape. the procedure then differs since the inserted needle is attached to the viewing endoscope. i will then view the inside of the eye on a tv monitor in addition to looking through the operating microscope. this will allow me to directly see the structures which i will need to cut. normally, i depend upon looking through a lens placed on the cornea which must be fairly clear so that i can see to cut the structures in the standard procedure. the procedure should not take much longer than the standard goniotomy and the same amount of tissue will be cut as in a standard goniotomy. the needle is then removed. the remainder of the procedure is identical which includes placing a stitch in the corneal incision, adjusting the amount of fluid in the eye so the pressure is not too low or high, giving a dilating drop, giving a steroid and antibiotic injection around the eye, giving steroid ointment and an eye patch.

Eligibility criteria:
inclusion criteria: * childhood glaucoma with corneal edema unable to perform goniotomy exclusion criteria: * older than 3 years

Keywords: childhood glaucoma
a study of vericiguat (mk-1242) in participants with chronic heart failure with reduced ejection fraction (hfref) (mk-1242-035)

Conditions: Chronic Heart Failure With Reduced Ejection Fraction

Summary: the purpose of this study is to evaluate the efficacy and safety of vericiguat in participants with chronic heart failure with reduced ejection fraction (hfref), specifically those with symptomatic chronic hfref who have not had a recent hospitalization for heart failure or need for outpatient intravenous (iv) diuretics. the primary hypothesis is that vericiguat is superior to placebo in reducing the risk of cardiovascular death or heart failure hospitalization.


Eligibility criteria:
inclusion criteria: * history of chronic hf \[new york heart association (nyha) class ii to iv\] on guideline-directed medical therapy for heart failure (gdmt) with no hf hospitalization within 6 months or outpatient iv diuretic use within 3 months before randomization. * left ventricular ejection fraction (lvef) of ≤40%, assessed within 12 months before randomization by any imaging method. * elevated n-terminal pro-brain natriuretic peptide (nt-probnp) levels. * a female participant is eligible to participate if she is not pregnant or breastfeeding, is not a woman of childbearing potential (wocbp), or is a wocbp and agrees to follow contraceptive guidance during the study intervention period and for at least 1 month after the last dose of study intervention. exclusion criteria: * has sbp \<100 mm hg or symptomatic hypotension. * awaiting heart transplantation, is receiving continuous iv infusion of an inotrope, or has or anticipates receiving an implanted ventricular assist device. * amyloidosis or sarcoidosis. * primary valvular heart disease requiring surgical procedure or intervention or has undergone a valvular surgical procedure or intervention within 3 months before randomization. * hypertrophic cardiomyopathy. * acute myocarditis or takotsubo cardiomyopathy. * history of heart transplant. * tachycardia-induced cardiomyopathy and/or uncontrolled tachyarrhythmia. * acute coronary syndrome, or undergone coronary artery bypass grafting (cabg) or percutaneous coronary intervention (pci) within 3 months before randomization. * history of symptomatic carotid stenosis, transient ischemic attack (tia), or stroke within 3 months before randomization. * malignancy or other noncardiac condition limiting life expectancy to \<3 years. * requires continuous home oxygen for severe pulmonary disease. * interstitial lung disease. * discontinuation or dose modification of gdmt or vericiguat within 4 weeks before randomization. * recent history (within the last year) of drug or alcohol abuse or dependence.
validation of clinical decision support tool for acute stroke diagnosis (instadx)

Conditions: Stroke, Acute

Summary: this is a observational validation study. the stroke clinical decision support tool ( instadx) , an information technology application will be adapted and developed in accordance to evidence based clinical practice guidelines ( level ia). neurology residents will be using the instadx cdst to improve their diagnostic accuracy and the findings will be validated against the review of a stroke subject expert. the study hypothesis is that clinical decision support tool used by neurology residents will have an agreement of \>0.77 when compared to stroke expert (gold standard) in diagnosing type of ischemic stroke.

overall objective: to adapt, develop and validate the clinical decision support tool, an information technology application to assist acute stroke diagnosis for use among neurology graduate trainees compared to stroke expert (gold standard). specific aims: 1. to validate the adapted clinical decision support tool, an information technology application to assist acute ischemic stroke diagnosis for use among neurology residents compared to stroke expert (gold standard) in the adult population presenting at a tertiary care hospital in pakistan. the study will be conducted in emergency department and the neurology ward at aga khan university hospital. the data collector will enroll the patients meeting the eligibility criteria and providing informed consent. neurology residents will use the clinical decision support tool application to assist in acute stroke diagnosis. in the second part, the stroke expert will independently assess all diagnosis. the purpose of this would be to validate the clinical decision support tool application to assist in acute stroke diagnosis.

Eligibility criteria:
inclusion criteria: 1. adult men and women, \>18 years of age. 2. patients admitted with neurological deficit consistent with stroke. 3. confirmation of stroke by objective modality of ct scan and mri. 4. consenting to participate in the study. exclusion criteria: 1. patients presenting with any type of haemorrhagic stroke such as sub-arachnoid haemorrhage, intracerebral haemorrhage and others. 2. stroke due to any iatrogenic causes such as post-surgeries, trauma, or any rare or non atherosclerotic causes eg carotid dissection. 3. patients signing lama (left against medical advice) and leaving undiagnosed

Keywords: stroke validation clinical decision support tool
"effectiveness of dual-wavelength laser therapy in third molar extraction pain, swelling, and trismus"

Conditions: Molar, Third; Low-level Laser Therapy

Summary: objective: to investigate the effects of single session dual wavelength low dose laser therapy to be applied after third molar tooth extraction on postoperative pain, edema and physical activities. materials and methods: thirty-six patients who applied for the extraction of a class iii and position b lower impacted wisdom tooth were included in the study. the patients were divided into 2 groups as laser and control group. envelope selection method was used for randomization of patients. after the surgery, a single session of double wavelength low-dose laser therapy was applied to the patients. on the 2nd and 7th postoperative days, pain was measured with the vas scale, edema was measured by face measurements of 3 different points, and quality of life was measured with the modified posse scale.

objective and background: pain, edema, and trismus are common problems after tooth extraction. photobiomodulation therapy (pbmt) is frequently used as an adjunctive method to reduce these problems. however, there is no consensus in the literature regarding the type, power, session duration, and application frequency of the laser for this treatment method. the aim of this study is to examine the effectiveness of a single-session application of dual-wavelength pbmt (using a 904 nm gaalas infrared laser and a 650 nm red laser) on pain, edema, trismus, and the quality of life of patients following impacted mandibular third molar extraction. methods: the study included patients whose impacted mandibular third molars were to be extracted for prophylactic purposes. the patients were divided into two groups as the pbmt group and the placebo control group. pain, swelling, maximum mouth opening, and quality of life parameters of the patients were evaluated.

Eligibility criteria:
inclusion criteria: asa i 18-40 years aged exclusion criteria: pregnancy lactating, anticoagulant or antiaggregant medication radiotherapy to the head and face area, allergy to local anesthetics and prescribed drugs

Keywords: photobiomodulation, impacted third molar pain edema
feasibility of implementation of card for school-based immunizations

Conditions: Immunisation Anxiety Related Reaction

Summary: a multi-faceted knowledge translation intervention - the card (c-comfort, a-ask, r-relax, d-distract) system - was developed to improve the vaccination experience of students at school. card is a framework for delivering vaccinations that is student-centred that promotes coping. this study will examine the feasibility of card implementation procedures and measures in the school vaccination program in calgary, alberta for use in a larger cluster trial.

vaccination is estimated to have saved more lives in canada over the last 50 years than any other single intervention and is considered one of the most important advances in the prevention of disease. one major drawback of vaccination, however, is that the usual route of administration involves a painful needle injection. in students undergoing school-based mass vaccinations, vaccine injections frequently cause sever distress and fainting, with some serious injuries resulting from fainting. concerns about pain and/or needle fear are also directly responsible for vaccine refusal in this population. an evidence based clinical practice guideline for mitigating vaccine injection pain, fear and fainting has been developed, however, it is not yet implemented across different school-based vaccination settings and students are not benefiting from the research evidence. in a prior small-scale project, investigators developed and implemented a multi-faceted knowledge translation intervention - the card (c-comfort, a-ask, r-relax, d-distract) system - in some schools in a small public health region in niagara, ontario. card is a framework for delivering vaccinations that is student-centred and promotes coping. it integrates recommendations from the guideline in two separate components of the vaccination delivery program: 1) pre-vaccination day preparation, and 2) vaccination day activities. investigators found preliminary evidence of acceptability, appropriateness, satisfaction and clinical effectiveness of card when used in grade 7 students in niagara. in this study, investigators plan to determine the feasibility of implementing card in a diverse and more complex public health region in calgary, alberta. specifically, investigators will determine recruitment rates, adherence to card protocol, response rates for questionnaires, acceptability, appropriateness (fit), and satisfaction. the results will inform a future cluster trial.

Eligibility criteria:
inclusion criteria: * grade 9 student eligible for vaccination at school * public health staff in community health centre involved in the study * school staff in a participating school involved in school vaccination program * parent of a student eligible for vaccination at school exclusion criteria: * unable to understand and read english

Keywords: school vaccinations pain management knowledge translation
connecting smartphones with electronic health record to facilitate behavioral goal monitoring in diabetes care

Conditions: Diabetes Mellitus, Type 2; Obesity

Summary: in order to facilitate the evidence-based goal setting and self-monitoring intervention into the diabetes education practice, the investigator proposes to use chronicle diabetes, an electronic system provided available to the american diabetes association diabetes education programs, to set patient diet and physical activity goals, and connect patient self-monitoring information collected from smart phones and fitness trackers to chronicle diabetes system to facilitate educators' monitoring of patient adherence to their goals.

specific aim 1: to develop and test an interface with chronicle diabetes to transfer smartphone collected self-monitoring diet and physical activity information from patients to diabetes educators. specific aim 2: to 2a) conduct usability testing and 2b) examine efficacy of this connected interface technology in a 3-month randomized clinical trial in 60 overweight or obese patients with type 2 diabetes in houston, texas and pittsburgh, pennsylvania.

Eligibility criteria:
inclusion criteria: 1. diagnosed with type 2 diabetes 2. overweight or obese with an bmi \> 25 3. able to read and write english 4. own a smart phone that is jawbone compatible exclusion criteria: 1. currently undergoing current treatment for a severe psychiatric disorder.

Keywords: diabetes diabetes mellitus, type 2 obesity self-monitoring goal setting mobile health connected health
collecting blood and tissue samples from family members of patients with pancreatic diseases, pancreatic cancer, and melanoma

Conditions: Familial Pancreatic Cancer

Summary: rationale: collecting and storing samples of blood and tissue from family members of patients with cancer to test in the laboratory may help the study of cancer in the future. purpose: this clinical trial is collecting blood and tissue samples from family members of patients with pancreatic disease, pancreatic cancer, and melanoma.

objectives: * to collect clinical history, family history, and blood and/or tissue samples from family members of patients diagnosed with pancreatic diseases, pancreatic cancer, or melanoma. * to learn whether inherited factors increase the risk of pancreatic diseases, pancreatic cancer, or other cancers. outline: study participants undergo collection of blood and/or tissue samples as well as survey data for inclusion in a familial data and tissue registry. participants complete two baseline surveys regarding their personal, family, health, and environmental exposure histories and regarding their opinions on cancer and cancer screening. patients also complete a follow-up survey at 1 year and undergo review of their medical records.

Eligibility criteria:
disease characteristics: * meets 1 of the following criteria: * has at least 2 blood relatives with pancreatic cancer (both must be related) * has at least 1 blood relative with pancreatic cancer and 1 with melanoma (both must be related) patient characteristics: * mentally competent and able to provide informed consent * able to understand and read english prior concurrent therapy: * not specified

Keywords: family history pancreas cancer melanoma genetic
study of bcx7353 as a treatment for attacks of hereditary angioedema

Conditions: Hereditary Angioedema (HAE)

Summary: this 3-part study will evaluate the efficacy and safety of an oral kallikrein inhibitor, bcx7353, in the treatment angioedema attacks in subjects with type i or ii hereditary angioedema (hae). in each study part, subjects will treat 3 attacks with bcx7353 (2 attacks) or placebo (1 attack), in a randomly allocated order. in part 1, the dose of 750mg will be assessed relative to placebo in up to 36 patients. if this is shown to be effective, then a further 12 patients will be enrolled at a 500mg dose (part 1), followed by a further 12 (if efficacy still shown) at a dose of 250mg (part 3) to determine the minimum effective dose of bcx7353 compared to placebo for treating hae attacks. efficacy will be determined by subject diary entries completed at pre-defined times post-dose.


Eligibility criteria:
inclusion criteria: 1. able to provide written, informed consent. 2. a clinical diagnosis of hereditary angioedema type 1 or type 2 as documented at any time in the medical records or at the screening visit. 3. access to and ability to use standard of care acute attack treatment for attacks of hae. 4. sexually active women of child-bearing potential and sexually active men must utilize effective contraception. exclusion criteria: 1. women who are pregnant or breast-feeding. 2. any clinical condition or medical history that would interfere with the subject's safety or ability to participate in the study. 3. use of c1inh, androgens or tranexamic acid for prophylaxis of hae attacks. 4. history of or current alcohol or drug abuse. 5. infection with hepatitis b, hepatitis c or hiv. 6. participation in any other investigational drug study currently or within the last 30 days. 7. positive drugs of abuse screen (unless as used as medical treatment, e.g., with a prescription). 8. an immediate family relationship to either sponsor employees, the investigator or employees of the study site.

Keywords: hae hereditary angioedema kallikrein inhibitor plasma kallikrein
water exchange versus carbon dioxide for colonoscopy

Conditions: Colorectal Cancer; Colorectal Adenomas; Colorectal Polyps; Pain

Summary: colonoscopy is commonly used in screening for colorectal cancer. a refined technique of colonoscopy involving the use of water as the sole modality to aid colonoscope insertion, water exchange, has been described in recent research papers to decrease patient discomfort and pain, and to reduce the need for sedation during colonoscopy when compared with standard air insufflation. carbon dioxide insufflation has been described to decrease patient discomfort after colonoscopy. no randomized trial has so far compared the use of water exchange to carbon dioxide insufflation. our hypothesis is that water exchange inflicts less discomfort to patients undergoing colonoscopy than carbon dioxide insufflation. patients undergoing screening colonoscopy in two centers in norway, one center in poland and one center in the netherlands will be enrolled and randomized to examination of either of the two methods.

single blinded randomized controlled trial.

Eligibility criteria:
inclusion criteria: * patients scheduled for screening or polyp surveillance colonoscopy * patients accepting sedation on demand exclusion criteria: * demand for sedation/analgesia before the start of the procedure * previous partial or total colonic resection * pregnancy * unwilling/unable to provide informed consent

Keywords: colonoscopy colorectal cancer colorectal adenomas pain