Kornimate/medical-research-clean huggingface dataset:
prevention of post-traumatic stress disorder by telephone based cognitive behavioral therapy

Conditions: Stress Disorder - Post-traumatic (Acute)

Summary: this is a randomized controlled study comparing telephone-based cognitive behavioral therapy (cbt) for recent survivors of traumatic events with acute stress disorder (asd) or acute ptsd with a waitlist control group. survivors with ptsd from both groups will receive face-to-face cbt one month from the traumatic event. the study's main hypothesis is that early telephone-based cbt will reduce the prevalence of ptsd three and eight months after the traumatic event.

post-traumatic stress disorder (ptsd) is a prevalent and pervasive mental disorder. studies have shown that there is a significant reluctance to use mental health services by trauma-exposed individuals at high risk for developing ptsd. providing clinical services in combat or disaster zone might be difficult. trauma-focused cognitive behavioral therapy (cbt) effectively reduces the prevalence of ptsd among recent survivors. telephone based cbt was found to be effective in mood and anxiety disorders, but has not been tried in ptsd. establishing the effectiveness of telephone based cbt has significant service delivery and public health implications. preventing ptsd significantly reduces individuals' suffering and disability we will screen, by telephone, up to 1200 survivors of traumatic events, from a general hospital emergency department trauma registry list, randomize the first 240 with asd or acute ptsd to either early, telephone based cognitive behavioral therapy (et_cbt) (n=120) or a no-treatment control condition (n=120). we will provide five sessions of et-cbt to the former and compare the two groups three and eight months later. survivors from both groups who will continue to have ptsd at three months (after either treatment or waiting list), will receive 12 sessions of face-to-face, trauma focused cbt. a first phase of the study will consist of establishing the acceptance of et-cbt and its main components (e.g., exposure to traumatic reminders) by survivors, and optimizing the protocol. it will involve 20 survivors and no randomization. subsequent to that phase we will start recruiting for the main study. the study's main hypothesis is that early cbt will reduce the prevalence of ptsd three and eight months after the traumatic event.

Eligibility criteria:
inclusion criteria: * adults * exposure to psychologically traumatic events * diagnosis of acute stress disorder or post-traumatic stress disorder * up to four weeks after trauma exposure exclusion criteria: * chronic ptsd * past and present psychosis, bipolar disorder, opiate or stimulants use * medical or surgical condition that interfere with subjects ability to participate in the study or sign an informed consent * lack of fluency in the study's main language (hebrew)

Keywords: post-traumatic stress disorder acute stress disorder cognitive behavioral therapy secondary prevention anxiety disorders service delivery
topical vs oral metronidazole after benign anorectal surgery

Conditions: Hemorrhoids; Anal Fissure; Anal Fistula

Summary: while some investigators found oral metronidazole to be effective in reducing pain after hemorrhoidectomy, other researchers did not find a significant analgesic effect of systemic metronidazole. on the other hand, topical application of metronidazole had more consistent favorable results as ala et al documented a remarkable analgesic effect of topical metronidazole 10% after excisional hemorrhoidectomy which was in line with nicholson and armestrong who also concluded similar results. no previous study compared the analgesic effect of topical and oral metronidazole after anorectal surgery. therefore, the present trial was conducted to compare the impact of oral versus systemic metronidazole on pain and recovery after surgery for benign anorectal conditions.


Eligibility criteria:
inclusion criteria: * adult patients of either sex aged below 70 years * underwent surgery for hemorrhoids, anal fissure, or simple anal fistula. exclusion criteria: * grade i-ii hemorrhoids. * acute anal fissure. * complex anal fistula * perianal abscess * perianal crohn's disease * malignancy.
factors influencing selective mutism

Conditions: Selective Mutism

Summary: the study's goal is to check and verify basic assumptions of a new selective mutism developmental model from melfsen and walitza through standardized and routinely used patient questionnaires. the primary emphasis is the question of a connection between selective mutism and high sensitivity, dissociation, emotional regulation, family structure, social anxiety and self-esteem.


Eligibility criteria:
inclusion criteria: * children and young people from 8-18 years of age who fulfill the international classification of diseases tenth edition (icd-10) for selective mutism * adults who suffered selective mutism when they were children or adolescents * all study participants or their legal representative have given written permission for their experiences to be documented in the study. exclusion criteria: * temporary mutism, e.g. from emotional disturbances or separation anxiety (f93.0), or depression * profound developmental disturbances (f84.2) like early childhood autism (f84.0), atypical autism (f84.1), rett syndrome (f84.2), alternative disintegrative childhood disturbances (f84.3), hyperactivity disturbance with decrease of intelligence and movement stereotypes (f84.5), or asperger's syndrome. * schizophrenia (f20) * profound mental retardation * delineated development disturbances of speech and language (f80) * organic brain disease with loss of language or disturbance of speech development
the efficacy and safety of sodium-glucose cotransporter 2 inhibitors in patients with acute kidney disease

Conditions: Acute Kidney Injury

Summary: acute kidney disease (akd) happens between 7 and 90 days after an initial kidney injury (aki). this period is crucial because it can determine whether the condition worsens into chronic kidney disease (ckd). despite knowing this, there is no proven treatment to improve outcomes for people with akd. recent studies have shown that drugs called sodium-glucose cotransporter 2 (sglt2) inhibitors can slow down the worsening of chronic kidney disease, help with heart failure, and reduce the risk of death. now, researchers are looking into whether these drugs can also help prevent acute kidney injury (aki) and improve outcomes for akd patients. our project will explore the use of sglt2 inhibitors in patients with akd, with the belief that these drugs can safely reduce the amount of protein (albumin) in the urine and improve kidney health. to address this, investigators plan to conduct a large, multicenter study in taiwan. this study will be randomized and placebo-controlled, meaning some patients will receive the sglt2 inhibitors while others will receive a placebo (a harmless, inactive substance). investigators will include akd patients with and without diabetes, focusing on reducing the protein in their urine and monitoring for any serious side effects. the goal of this trial is to provide strong evidence on whether sglt2 inhibitors can be an effective treatment for akd. if successful, this could offer a new strategy to prevent the progression from aki to ckd and improve the health and outcomes of patients with kidney disease.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years and \< 80 years * diagnosed with acute kidney disease * estimated glomerular filtration rate (egfr) ≥ 20 ml/min/1.73m² * albuminuria \> 100 mg/g or proteinuria \> 300 mg/g (adjusted by urine creatinine) * diagnosed with diabetes or chronic kidney disease exclusion criteria: * received sodium-glucose cotransporter 2 (sglt2) inhibitors within 28 days prior to enrollment * patients with type 1 diabetes * receiving aggressive immunosuppressive therapy for glomerulonephritis * obstructive nephropathy * polycystic kidney disease * malignancy within 3 months or expected to undergo aggressive treatment such as chemotherapy, radiation therapy, immunotherapy, or targeted therapy in the future * pregnant or breastfeeding women * clinically assessed as not having recovered from acute kidney injury * clinically assessed as at high risk for complications related to sglt2 inhibitors

Keywords: sodium-glucose cotransporter 2 inhibitor acute kidney disease albuminuria
mr guided tdcs in alzheimer's disease

Conditions: Alzheimer's Disease

Summary: the purpose of the study is to investigate the effect of high density- tdcs (hd- tdcs) on cognitive function in alzheimer's disease. one anode and four return electrodes are placed over dlpfc, where low intensity current (2ma) is induced to the surface of the scalp. electrode placement is individualized for each participant. participants will undergo 15 stimulations, with a duration of 20 minutes each. all patients will undergo neuropsychological assessment and mri evaluation.

the project will be run as a randomized controlled trial (rct), where patients will be randomized to receive either active anodal tdcs or sham tdcs. the performance on neuropsychological tests will be the primary outcome variables in the present project. in addition, whole brain mri volume measures will be used to measure specific effects of tdcs treatment. electrode placement is individualized for each participant with brain modeling techniques.

Eligibility criteria:
inclusion criteria: * alzheimer's disease, mild and moderate stage exclusion criteria: * other neurological diseases or injuries * stroke * cancer * psychiatric disorders (moderate/ severe depression, psychosis)

Keywords: transcranial direct current stimulation neuromodulation individualizing brain stimulation neuropsychology
outcomes of hemiarthroplasty versus cephalo-medullary fixation to treat unstable intertrochanteric femoral fractures

Conditions: Fracture of Femur

Summary: comparing functional outcomes of hemiarthroplasty (prosthetic joint) versus cephalo-medullary fixation ( proximal femoral intramedullary nail) in the treatment of unstable intertrochanteric femoral fractures (proximal femur fractures) in elderly people above 60 years old.

the intertrochanteric femoral fractures incidence rate has increased through the last years because of increasing life expectancy, leading to more morbidity and mortality rates . unstable fracture pattern occurs due to age increase and bone quality decrease. unstable intertrochanteric femoral fractures (itff) are considered about 40-45% of hip fractures in elderly people . of note, 55% of these fractures had unstable patterns . the main objective of treatment is to restore the patients to their preoperative daily activities and medical conditions . therefore, the surgical treatment aims to return the patient to his pre-fracture level of activity to ensure that the patient moves as soon as possible to prevent complications due to immobility which can lead to death. in an unstable fracture pattern which is characterized by decreased bone quality, it is of great importance to providing efficient and proper treatment . a lot of treatment modalities had been used in the treatment of this fracture pattern such as pfn, unipolar hemiarthroplasty, bha, and dynamic hip screw (dhs) . on the other hand, it is difficult to perform stable fixation owing to osteoporotic bone quality. the treatment aims to restore the patient's ambulation and decrease medical complications and technical failure. by using either bha or pfn methods, patients can return to pre-injury levels decreasing complications induced by prolonged immobilization or implant failure . the primary objective of the current study is to compare functional outcomes of unstable itff managed by pfn or bha among cases with ages more than 60 years old. the second main objective is to compare intraoperative and postoperative in both groups.

Eligibility criteria:
inclusion criteria: * patient over 60 years old. * unstable intertrochanteric femoral fractures exclusion criteria: * patient with age less than 60 years old * hip osteoarthritis * pathological fractures * bilateral fractures * metabolic bone disease * multiple trauma

Keywords: bha , pfn , hhs
efficacy and safety of red ginseng on decrement of body fat

Conditions: Obesity

Summary: the investigators performed a 12-week, randomized, double-blind, placebo-controlled human trial to evaluate the efficacy and safety of red ginseng on decrement of body fat. the investigators measured decrement of body fat parameters , including body fat mass, percent body fat, weight and bmi(body mass index), and monitored their blood pressure.


Eligibility criteria:
inclusion criteria: * males and females 19-65 years old * bmi(body mass index) ≥ 25 kg/m\^2 or wc(waist circumference) ≥ 90(men), wc ≥ 85(women) * able to give informed consent exclusion criteria: * significant variation in weight(more 10%) in the past 3 months * allergic or hypersensitive to any of the ingredients in the test products * history of reaction to any of the test products or of gastrointestinal diseases such as crohn's disease or gastrointestinal surgery * history of alcohol or substance abuse * participation in any other clinical trials within past 2 months * laboratory test, medical or psychological conditions deemed by the investigators to interfere with successful participation in the study * pregnant or lactating women etc.
rapid reversal of cns-depressant drug effect prior to brain death determination

Conditions: Brain Death; Anoxic Brain Injury; Cardiac Arrest; Sedative Intoxication; Narcotic Intoxication

Summary: current standard of care prior to determination of brain death in subjects with suspected anoxic brain injury is to exclude complicating medical conditions that may confound clinical assessment (such as severe electrolyte, acid base, endocrine or circulatory disturbance), achieve normothermia and normal systolic blood pressure over 100 mmhg (with or without vasopressor use), exclude the presence of neuromuscular blocking agents (with the presence of a train of 4 twitches with maximal ulnar nerve stimulation) as well as to exclude the presence of cns depressant drug effects. at the present time the latter is done by history, drug screen and allowing enough time for paralytic and sedative drugs to be metabolized and cleared from the body. clearance is calculated by using 5 times the drug's half-life assuming normal hepatic and renal functions. half-life can also be prolonged in subjects who have been treated with induced hypothermia. literature search revealed articles with general guidelines and approaches to brain death, but none addressed pharmacological reversal of sedative drugs

question of proposed study is whether a subject's comatose state is secondary to delayed clearance of a previously administered cns depressant. by using pharmacologic reversal agents of commonly used benzodiazepines and opioids, the investigators aim to identify participants that may likely improve after complete clearance of the drugs from their system. prospective trial with enrollment of 30 subjects in 2 intensive care units at palmetto health richland from january 1st 2019 to june 30th 2020. research procedures will be performed in the intensive care setting. if participants had undergone targeted temperature management (33-36 degrees celsius for 24 hours via intravascular or surface control methods, with or without sedation or neuromuscular blockade, followed by rewarming actively or passively at 0.25-0.5 degrees per hour over 8-12 hours to 37 degrees) investigators will wait 24 hours after rewarming prior to testing. end point is to evaluate if pharmacological reversal agents would result in improved gcs scores or return of cerebral or brainstem functions in some comatose subjects, which will be considered a positive test result.

Eligibility criteria:
inclusion criteria: * adults with cardiac arrest who may have completed targeted temperature management (hypothermia protocol) and have had no neurological recovery after 24 hours of rewarming will be enrolled. subjects will have a suspected diagnosis of anoxic brain injury secondary to cardiac arrest, and seizures ruled out with an eeg. all subjects are expected to be unable to consent and consent will be obtained from their legal authorized representative. exclusion criteria: * spontaneous recovery of neurological functions, presence of seizures on eeg, individuals who are not yet adults, pregnant women and prisoners.

Keywords: brain death sedative narcotic
effect of acute bout of exercise on levels of pahsa

Conditions: Insulin Sensitivity

Summary: exercise represents an important tool in the prevention and treatment of metabolic disorders associated with obesity and aging, such as type 2 diabetes and cardiovascular disease. besides skeletal muscle and its myokinins, the metabolic effects of exercise also rely on the induction of favorable changes in adipose tissue function. for example, adipose tissue is a source of lipokinins from the family of palmitic acid esters of hydroxy fatty acids (pahsa), which have anti-inflammatory and insulin-sensitizing properties. we have recently shown that 4 months of exercise training increases pahsa levels in adipose tissue and circulation. however, the mechanisms involved in the induction of pahsa levels in response to exercise are unknown. the aim of the effect of acute bout of exercise on levels of pahsa (etapa) project is therefore to investigate the regulation of pahsa metabolism in response to both acute and chronic exercise. to achieve this goal, we will employ state-of-the-art analytical methods to measure pahsa levels in both adipose tissue and circulation of subjects of various ages and adiposity status. the main output of the etapa project will be the proof of principle regarding the important role of pahsa lipokinins in exercise-induced enhancement of insulin sensitivity and the identification of potential drug targets that could be used to further improve pahsa metabolism for the treatment of metabolic disorders associated with aging or obesity.


Eligibility criteria:
inclusion criteria: * healthy young lean, young obese and elderly omnivorous men and women as defined by bmi, self-reported activity, self-reported medical history and self-reported diet assessment * must be able to withstand repeated blood draws * must be able to undergo abdominal fat biopsy exclusion criteria: * use of betablockers * use of glucocorticoids * use of non-steroidal anti-inflammatory drugs * use of metformin in prediabetes * use of psychiatric drugs such as selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, anticonvulsants and others * oncologic malignancy * chronic inflammatory or autoimmune diseases * diabetes mellitus * chronic ischemic heart disease * cardiovascular and pulmonary disease * renal and hepatological disease as assessed per biochemistry * musculo-skeletal deviations limiting physical performance * substance abuse * other than omnivorous diet

Keywords: acute exercise adipose tissue insulin sensitivity pahsa lipokinins
dna methylation combined with artificial intelligence imaging to identify lung nodules

Conditions: Lung Cancer Diagnosis

Summary: lung cancer is the leading cause of cancer deaths,and the key to reducing mortality in lung cancer patients is early diagnosis and treatment.currently,peripheral blood dna methylation is a novel in vitro molecular marker for tumors.meanwhile artificial intelligence diagnostic system can further improve the diagnostic ability.the purpose of this study is to apply the overall dna methylation level (i.e.,methylation profile) and the altered methylation degree of specific genes as tumor diagnostic indexes,and combined with the artificial intelligence imaging technology for the early and accurate diagnosis of lung cancer,to achieve the early detection,diagnosis,and treatment of lung cancer,and to effectively reduce the mortality rate of lung cancer.


Eligibility criteria:
inclusion criteria: * (1) patients with pulmonary nodules diagnosed by imaging; * (2) no contraindications to blood collection; * (3) voluntary completed dna methylation testing; * (4) signed informed consent and performed all the study mandated procedures. exclusion criteria: * (1) pregnant or lactating(6 months) women; * (2) history of malignancy or known malignancy or precancerous lesions or known tuberculosis within 3 years; * (3) autoimmune system disorders; * (4) undergoing any diagnostic puncture therapy, such as percutaneous lung biopsy, transbronchial, pre-enrollment biopsy, or surgical procedures (within 6 months); (5) recipients of organ transplants or prior non-autologous (allogeneic) bone marrow transplants or stem cell transplants; (6) received antibiotic therapy within 14 days or applied a drug that elevates white blood cells within 45 days prior to the blood draw.
hormone klotho level in heart failure patients that participate in rehabilitation programme

Conditions: Heart Failure

Summary: 30 patients suffering from heart failure with ejection fraction less than 40% start cardiac rehabilitation programme, serum klotho hormone level and other labs and echo measurements will be taken on the first visit. after completion of 3-month rehabilitation programme the second set of labs and echo measurements will be taken. than participants will be divided for 2 groups: the patients who wish to continue rehabilitation programme for additional 3-month period and the second group that prefer to stop rehabilitation programme after completion of the first 3 month period. for both groups additional set of labs will be taken this time and at the end of the study. the aim of the study: to investigate association between serum klotho level, physical activity and possible correlation with laboratory and echocardiographic parameters in cohort of heart failure patients.

30 patients, age range older than 18 years old suffering from heart failure, functional capacity ii-iii and echocardiographic evidence of left ventricular ejection fraction less than 40% beginning cardiac rehabilitation programme. following recruitment of patients to the study each one will undergo serum klotho hormone level assessment along with kidney functions, n terminal -pro b-type natriuretic peptide hormone activity and echo measurements . after completion of 3-months exercise based rehabilitation programme set at 70-80% of maximal individual exercise capacity,a second identical set of lab tests and echo measurements will be performed. after than participants will be divided into 2 groups: group i will comprise patients who wish to continue rehabilitation programme for additional 3-months period and the group ii those who will stop exercise rehabilitation programme following completion of the first 3 months. both groups will undergo additional set of lab tests at this six-months-point. except for the primary and secondary end-points all possible correlations between serum klotho level and age, sex, ejection fraction, functional capacity, n terminal -pro b-type natriuretic peptide hormone activity hormone level and kidney function indices will be evaluated.

Eligibility criteria:
inclusion criteria: 1. both genders 2. patients ≥ than 18 years 3. ejection fraction ≤ than 40 % exclusion criteria: 1. myocardial infarction ≤ than 1.5 month before inclusion 2. renal failure with creatinine ≥ 1.5 mg/dl 3. known inflammatory condition. 4. patient taking calcium supplement,vitamin d or pyrophosphate.