Kornimate/medical-research-clean huggingface dataset:
macro and micro haemodynamic responses to shock in the renal and systemic - microshock - renal

Conditions: Acute Kidney Injury; Septic Shock

Summary: an observational study of the state of the renal and systemic circulations in patients with early septic shock. both macro and microvascular parameters will be assessed using echocardiography, sublingual incident dark field video-microscopy and renal contrast enhanced ultrasound. patients will be categorised by kdigo degree of kidney injury at day 7 and stratified. haemodynamic and perfusion based variables over time for these groups will be compared to assess the impact of changes in same on the development of aki. lab based work to quantify renal injury biomarkers will also be undertaken.


Eligibility criteria:
inclusion criteria: age \> 18 years within 48 hours of icu admission evidence of suspected or confirmed infection serial organ failure assessment (sofa) score increase of 2 or more (assuming baseline 0 if no previous measures) requiring vasopressor therapy to maintain a map \> 65mmhg lactate \> 2 mmol/l despite initial fluid resuscitation exclusion criteria: known intolerance to sonovue or any other ultrasound contrast agent acute respiratory distress syndrome pregnancy breast feeding mothers patients not expected to survive 24 h in whom the intent of treatment is palliative

Keywords: septic shock acute kidney injury haemodynamic monitoring microcirculation
treatment of occult inguinal hernias

Conditions: Inguinal Hernia

Summary: inguinal hernias are a common surgical problem. best management of occult inguinal hernias, defined as hernias unable to be felt on physical exam, is unknown. from prior studies we know that most inguinal hernias will eventually become symptomatic and require surgery (70%). however, doing a repair on a very small, occult hernia may open the patient up to surgical complications, like chronic pain, earlier than necessary. this will be a multi-center randomized controlled trial of surgical repair versus expectant management of occult inguinal hernias. patients undergoing laparoscopic unilateral inguinal hernia repair will be included. at the time of surgery, the surgeon will determine if there is an occult hernia contralateral side. if present, patients will be randomized to repair of the occult side or expectant management of the occult side. after 1 year post-operative data has been assessed, a decision tool will be created and administered to patients to aid in their decision making about treatments for their hernia.


Eligibility criteria:
inclusion criteria: * age 18 or older * patients undergoing unilateral laparoscopic inguinal hernia repair, found to have a contralateral occult inguinal hernia exclusion criteria: * patient has life expectancy of less than 2 years * patients unlikely to follow-up (e.g. live out of state, unable to be reached by phone/e-mail * non-english and non-spanish speakers * pregnant or breast-feeding patients
duration of spinal manipulation effects as influenced by orthotics

Conditions: Low Back Pain

Summary: purpose of study: to assess the effects of wearing custom orthotics as opposed to placebo foot inserts on the duration of chiropractic correction of spinal fixations and muscle imbalances using applied kinesiology techniques.

participants with chronic lower back pain of greater than one month duration will be randomized to receive custom foot orthotics or placebo flat inserts. both groups will receive chiropractic treatment 5 times over the course of 4 weeks following receipt of orthotics. subjects and treating doctor will be blind to the insert type. patients will report present, average, best and worst pain at each visit, and complete a roland-morris questionnaire. secondary outcome measures will be number of fixated vertebral levels identified by motion palpation and challenge and number of muscles testing grade 4 and below from a list of 5 muscles to be tested bilaterally before and after each treatment.

Eligibility criteria:
inclusion criteria: * current low back pain episode present for one month or more * no change in the past month in prescription medications affecting musculoskeletal pain * able to speak and understand english adequately to complete study forms * score on roland-morris questionnaire of 7.5 or higher or * average score on chiropractic pain index (now, average, and worst scales from the quadruple vas pain scale) of 4 or higher. exclusion criteria: * use of foot orthotics within the past 12 months * previous lumbar spine surgery * ongoing treatment for lower back pain by other health care providers other than stable prescription medications affecting musculoskeletal pain. * clinically significant chronic inflammatory spinal arthritis * severe osteoporosis for which spinal manipulation is contraindicated * spinal pathology or fracture * progressive neurologic deficits due to nerve root or spinal cord compression, including symptoms/signs of cauda equina syndrome * history of bleeding disorder * known arterial aneurysm * pending/current litigation pertaining to back pain, including workers compensation claims * current pregnancy * lack of means of contacting which might preclude successful completion of study requirements * does not speak , read or understand english to an extent which would affect the subject's capacity to participate in informed consent

Keywords: low back pain chronic orthotic device applied kinesiology manual muscle testing chiropractic
alemtuzumab for anca associated refractory vasculitis

Conditions: Vasculitis; Microscopic Polyangiitis; Granulomatosis With Polyangiitis; Wegener's

Summary: overview: this open label, randomized, multi-centre study will enroll and treat 24 patients with refractory aav. aims: to determine the clinical response and severe adverse event rates associated with alemtuzumab therapy among patients with relapsing or refractory anca associated vasculitis (aav). hypothesis: treatment with alemtuzumab induces sustained remission in aav and will reduce immunosuppressive and steroid exposure.


Eligibility criteria:
inclusion criteria: 1. a diagnosis of aav, according to a standardized definition 2. active vasculitis with at least one severe or three non severe items of bvas/wg activity (equivalent to bvas/wg\>3) 3. previous therapy with either cyclophosphamide or methotrexate, in combination with prednisolone for at least 3 months. exclusion criteria: 1. age less than 18 or greater than 60 years 2. creatinine \> 150μmol/l (1.7mg/dl) 3. total white count \< 4x109/l or lymphocyte count \< 0.5x109/l, or igg \< 5g/l, or neutrophil count \< 1.5x109/l. 4. severe lung haemorrhage with hypoxia (\<85% on room air) 5. severe gastrointestinal, central nervous system or cardiac vasculitis 6. previous therapy with: 1. alemtuzumab at any time 2. ivig, infliximab, etanercept, adalimumab, abatacept, anti-thymocyte globulin or plasma exchange in past three months 3. rituximab within the past 6 months 7. intensive care unit requirement 8. active infection with hiv, hepatitis b or hepatitis c or other infection requiring parenteral or long-term oral antibiotics 9. history of itp or platelet count at screening below 50,000 x 106/l 10. pregnancy or inadequate contraception in pre-menopausal women 11. breast feeding 12. any condition judged by the investigator that would cause the study to be detrimental to the patient. 13. any other multisystem autoimmune disease including churg strauss angiitis, systemic lupus erythematosus, anti-gbm disease and cryoglobulinaemia 14. any previous or current history of malignancy (other than resected basal cell carcinoma)

Keywords: vasculitis anca refractory
functional mri of hypoxia-mediated rectal cancer aggressiveness

Conditions: Rectal Diseases; Rectal Neoplasms; Gastrointestinal Diseases; Gastrointestinal Neoplasms

Summary: the purpose of this study is to establish a reliable method for detection of rectal cancer patients with aggressive tumor at risk of metastatic disease and death by functional mri.


Eligibility criteria:
inclusion criteria: * the patient is willing and able to give full written consent according to the protocol approved by the regional ethics committee. * the patient has confirmed rectal cancer diagnosis and is scheduled to radical surgery alone or preoperative crt followed by surgery. * the patient is ≥ 18 years. * the patient has no prior rectal cancer treatment. * the patient has adequate renal function: creatinine clearance ≥ 60 ml/minute. * the patient has signed the written informed consent according to the protocol approved by the regional ethics committee. exclusion criteria: * the patient has contraindication to mri or mri contrast agent according to clinical practice. * the patient wants to withdraw for any reason during the study.

Keywords: magnetic resonance imaging magnetic resonance imaging, functional
strain counterstrain technique and graston technqiue on quadratus lumborum trigger points

Conditions: Trigger Point Pain, Myofascial

Summary: poor body mechanics and posture affects body positioning and stresses quadratus lumborum muscle which ultimately leads to myofascial trigger points in muscle. this study aims to compare the effects of strain counterstrain technique and graston technique on trigger points of quadratus lumborum in nonspecific low back patients. this study will be a randomized controlled trial and will be conducted in riphah rehabilitation clinic lahore and sparc physiotherapy clinic lahore. non-probability convenient sampling will be used to collect the data. sample size of 34 subjects with age group between 20-45 years will be taken. baseline and after 4 weeks. data analysis will be done by spss version 25.

researches have been conducted about effect of instrument assisted soft tissue mobilization versus kinesiotape for chronic mechanical low back pain: a randomized controlled trial. introduction. the objective was to compare the effect of conventional program, instrument assisted soft tissue mobilization (iastm) and kinesiotape (kt) in patients with chronic mechanical low back pain (cmlbp). 51 participants were randomly enrolled into three equal groups. group a (n = 17) received conventional program, group b (n = 17) received conventional program plus iastm, and group c (n = 17) received conventional program plus kt. the participants were evaluated before and after eight sessions using the visual analogue scale (vas), pressure algometer, dual inclinometer, and oswestry disability index (odi). it was concluded that conventional program, iastm and kt are effective methods for improving pain, rom and function on cmlbp..low back pain especially which is not related to any specific disease has become very common nowadays. almost every other person complains about back pain. while there have been numerous studies on low back pain and its treatments but limited work has done on both techniques, the strain counterstrain technique and graston technique. this study aims to determine the comparison of strain counterstrain technique and graston technique on trigger points of quadratus lumborum among patients with non-specific low back pain

Eligibility criteria:
inclusion criteria: * participant's age range 20-45 years * both genders. * individuals having low back pain for atleast 12 weeks with limited segmental mobility especially after maintaining certain prolonged posture . * individuals with localized pain and tenderness at attachments of quadratus lumborum due to the presence of trigger points (unilateral or bilateral). * positive segmental mobility assessment at the level of l4 and l5 on one side or on both sides * patients having moderate pain on nprs exclusion criteria: * individuals with anticoagulation or bleeding disorders, acute muscle trauma, infections, lumbar disc herniation, spinal deformities, or a history of spinal surgery or anticoagulation medication * orthopedic surgery or any other low back surgery . * fracture of vertebrae and any lower limb injury

Keywords: low back pain quadratus lumborum
effect of acupressure on fatigue in hemodialysis patients

Conditions: End-stage Renal Disease

Summary: objective: to investigate the effect of acupressure on fatigue in patients with end-stage renal disease (esrd) undergoing hemodialysis (hd) as well as assess sleep quality and psychological status hypothesis to be tested: upon intervention completion, the experimental group will exhibit lower severity of fatigue and depression/anxiety and improved sleep quality compared to the control group. design and subjects: a randomized controlled trial with experimental and control groups. a total of 116 patients with esrd who screen positive for fatigue severity ≥ 4 (using a single-item indicator of fatigue, which ranges from 0 to 10 points) will be recruited. study instruments: brief fatigue inventory (bfi), pittsburgh sleep quality index (psqi), and hospital anxiety and depression scale (hads) intervention: a 4-week acupressure intervention was performed by the principal investigator (pi) for every subject by applying the rate of two rotations per second, three times a week. main outcome measures: primary: fatigue. secondary: sleep quality, depression, and anxiety. data analysis: multiple regression was used to analyze between-group differences in bfi and psqi, while ordinal logistic regression was used to analyze the subscales of the hads. expected results: the proposed acupressure intervention is useful for alleviating fatigue and related symptoms (sleep quality, depression, and anxiety) experienced by patients with esrd.

the prevalence and impact of fatigue and related symptoms in patients with esrd have been clearly demonstrated in the literature, which also emphasizes the need for evidence-based interventions targeting symptom management in such patients. the main challenge is identifying an intervention that is not only effective in managing hemodialysis-related symptoms, but also feasible, acceptable, and safe for this patient group. the proposed study primarily aims to test the effects of acupressure intervention on fatigue in esrd patients receiving hd using the robust study design of a randomized controlled trial.

Eligibility criteria:
inclusion criteria: * 1. age ≧ 18 years * 2. hd therapy for at least 3 months * 3. experience of fatigue (fatigue severity ≥ 4, using a single-item indicator of fatigue, ranging from 0 to 10 points) * 4. absence of lower limb wounds * 5. did not receive any complementary treatment exclusion criteria: * 1. diagnosis of major depression or psychiatric disorders * 2. wound or amputation of the lower extremities, rheumatoid arthritis, or limb fracture

Keywords: end-stage renal disease hemodialysis acupressure fatigue sleep anxiety/depression
knee function in patients with two or more episodes of patella dislocations

Conditions: Joint Instability

Summary: patients aged 12 - 30 years, with recurrent patella dislocations, are consecutively included into a randomized prospective study. this study comparess the outcome of two forms of treatment for recurrent patella dislocation. one group is offered reconstruction of the medial patellofemoral ligament (mpfl), the second group is offered a standardized training program.

introduction: patella dislocation is a serious knee injury whose peak incidence occurs in patients aged 10-17 years and is associated with a high rate of re-dislocation. knee injuries frequently cause long-term disability and reduced physical activity among adolescents and young persons. surgery in this patient group requires a low tolerance for complications, meaning that physical therapy might offer more successful outcomes in many knee injury cases. the proposed project studies a particular patient cohort subjected to recurrent dislocation of the patella. aim: the principal objective of this clinical, randomized controlled trial is to evaluate and compare knee function and symptoms in patients with recurrent patella dislocation randomized into treatment with surgical reconstruction of the medial patellofemoral ligament (mpfl) with those of patients in a standardized physiotherapy program designed to stabilize the patella and improve patient function. materials and methods: patients aged 12-30 years who have experienced two or more patella dislocations are randomized into groups receiving either mpfl reconstruction or physical therapy only. follow-ups at 3, 6, 12, and 36 months involve functional tests, validated knee scores, arthroscopic examination, and cartilage-specific mri protocols for the knee.

Eligibility criteria:
inclusion criteria: * more than one luxation * norwegian citizens * unilateral problems * age range 12-30 years exclusion criteria: -generalized degenerative changes

Keywords: patella luxation
study of hepatic responses in patients receiving direct-acting anti-hcv drugs

Conditions: Hepatitis C

Summary: this study is designed to obtain and store samples of serum and liver tissue in hcv (hepc virus)-infected patients being treated with direct-acting antiviral (daa) therapy, and to determine the effect of new daa therapies on hcv-related responses in the liver and peripheral blood. the introduction of new daas regimens that do not include ifn provides unique and novel opportunities to examine whether successful treatment-induced eradication of viral antigen results in reconstitution of t cell immunity. serum and liver tissue samples will be collected and stored in hopes of improving treatment and outcomes for future patients.

this study is designed to obtain and store samples of serum and liver tissue in hcv-infected patients being treated with daa therapy. a liver biopsy will be performed pre-treatment for research reasons. a small liver sample that is not required for pathologic analysis will also be stored. patients will undergo another liver biopsy at either 4 or 12 weeks after initiation of daa therapy. any patients with hcv-related liver disease (age \> 18) will be considered for this study. patients will have a 120 ml blood draw for research purposes at baseline and 12 weeks after stopping daa treatment along with a 60 ml blood draw at 2, 4, 8, and 12 weeks of treatment. the liver biopsy at baseline and then either at 4 or 12 weeks will be examined using molecular techniques to measure transcription of key genes involved in the antiviral response.

Eligibility criteria:
inclusion criteria * signed informed consent * ages 18-70 * hcv-infected patients being treated with direct-acting antiviral (daa) therapy. exclusion criteria * pregnant women or females of childbearing potential that are not on contraception * institutionalized or mentally disabled persons * prisoners * unwilling or unable to provide informed consent * subjects who are hiv positive * anticipated inability to follow up * chronic anemia * platelet count \< 100 for liver biopsy patients who have documented fatty liver disease by ultrasound prior to enrollment * any patient with bleeding disorders or prolonged inr * abstinent or consuming less than two drinks of alcohol per day. * clinical hepatic decompensation (i.e., ascites, encephalopathy or variceal hemorrhage).

Keywords: hcv
wavefront analyzes and visual performance of three multifocal intra-ocular lenses

Conditions: Cataract; Astigmatism

Summary: the purpose of this study is to determine if differences in the design of multifocal intra-ocular lenses would mean different values of higher-order aberrations and different performance in objective parameters such as modulation transfer function.


Eligibility criteria:
inclusion criteria: * patients with bilateral visually significant cataract with corneal astigmatism lower than 1.0d exclusion criteria: * any ocular diseases, such as: * corneal opacities or irregularity * dry eye * amblyopia * anisometropia * glaucoma * retinal abnormality * surgical complications * iol tilt * iol decentration greater than 0.4 mm (estimated by retroillumination) * incomplete follow-up

Keywords: wavefront multifocal iol modulation transfer function intraocular lenses wavefront data visual performance
carboxytherapy in the treatment of atrophic scars

Conditions: Atrophic Scar

Summary: to evaluate the efficacy of co2 versus fractional co2 laser versus platelet rich plasma in treatment of atrophic scars using clinical assessment and ultrasonography


Eligibility criteria:
inclusion criteria: * traumatic and surgical scar exclusion criteria: * active infections
lot-consistency clinical trial of sabin strain inactivated polio vaccine

Conditions: Poliomyelitis

Summary: the purpose of this study is to evaluate the lot consistency, immunogenicity and safety of three lots of sabin strain inactivated polio vaccine (vero cell) (sipv) manufactured at commercial scale by sinovac biotech co., ltd., and evaluate the non-inferiority of investigational vaccine against a post-market inactivated polio vaccine.

this study is a randomized, double-blinded, and positive-controlled clinical trial. a total of 1300 infants aged 2 months will be enrolled and assigned to 4 groups in a ratio of 1:1:1:1 to receive vaccination of 3 lots of investigational sipv and control ipv manufactured by sanofi pasteur s.a respectively. each subjects should finish the three-doses primary vaccination at the schedule of 2,3,4 months of age. thirty-days safety observation after each dose of vaccination will be carried out. venous blood should be collected from all the subjects before and 30 days after the three-doses primary vaccination, for the neutralizing antibody assay, and further to evaluate the immunogenicity.

Eligibility criteria:
inclusion criteria: * healthy infants aged 60-89 days; * legal identity; * informed consent form has been signed by guardians. exclusion criteria: * vaccination history of polio vaccine; * allergy history, history of asthma, including allergy history to vaccine or vaccine components, serious adverse reactions to the vaccine, such as urticaria, dyspnea, angioneurotic edema or stomachache, etc.; * congenital malformation or developmental disorder, genetic defect, serious malnutrition, etc.; * autoimmune disease or immunodeficiency/immunosuppression; * serious nervous system disorders (epilepsy, convulsion or tic) or mental disorders; * abnormal coagulation functions (such as coagulation factor deficiency, blood coagulation disease and blood platelet disorders) or obvious bruise or blood coagulation disorders diagnosed by the doctors; * receipt of immunosuppressant therapy, cytotoxic drug therapy and inhaled corticosteroid therapy (excluding the corticosteroid aerosol therapy for allergic rhinitis and surface corticosteroid therapy for acute non-complicated dermatitis); * receipt of blood products prior to this study; * receipt of other study drugs within 30 days prior to this study; * receipt of live attenuated vaccines within 14 days prior to this study; * receipt of subunit or inactivated vaccines within 7 days prior to this study; * acute diseases or acute exacerbation of chronic diseases within recent 7 days; * axillary temperature \>37.0℃; * any other factors which are unsuitable for participation in the clinical trial as judged by the investigator.