Kornimate/medical-research-clean huggingface dataset:
physiological benefits of high-intensity interval training for individuals with parkinson's disease

Conditions: Parkinson Disease; Exercise Training

Summary: aerobic exercise is recommended for individuals with parkinson's disease (pd) and can improve quality of life, both physically and mentally. the most efficacious program to achieve these exercise benefits is unknown. recently, high-intensity interval training (hiit) has been shown to be safe and more effective in many high-risk populations with limited exercise tolerance. shorter bouts of exercise are likely better tolerated in pd due to difficulty sustaining muscle contractions. the goal of this project is to determine whether hiit produces superior cardiorespiratory, neuromuscular, biomechanical, and clinical adaptations than conventional continuous moderate intensity training (cmit) in pd.

the specific research aims are to compare, in pd, the effects of hiit or cmit on: 1) maximal exercise capacity; 2) neural and non-neural factors contributing to muscle strength, power and fatigability; 3) biomechanical measures of postural stability and gait; and 4) clinical markers (mini-bestest and unified parkinson's disease rating scale (updrs)). the investigators hypothesize that, hiit will produce greater improvements in: 1) exercise capacity; 2) muscle strength, power and reduced fatigability; 3) stability and gait velocity; and 4) clinical markers. methods: this pilot project will involve a randomized trial of 30 individuals with pd comparing the effects of hiit and cmit. training will be completed thrice weekly for 10 weeks. participants will include men and women between 50-85 years of age, who are able to stand unsupported for 1 min, walk 18m without use of an aid, and mount a stationary bike. participants will be randomized to either hiit (10, 1-minute cycling intervals at 90% of peak power output, each separated by 1-min at 10% peak power output) or cmit (30-50min cycling at 60% of peak power output). participants will undergo the following pre- and post-training assessments: cardiovascular testing will examine hemodynamic and efferent muscle sympathetic responses to static handgrip exercise and post-exercise circulatory occlusion; neuromuscular testing will examine muscle activity (electromyography) during voluntary and electrically stimulated contractions of the knee extensors; biomechanical testing will examine whole-body stability, gait, and balance patterns; and clinical risk assessments (mini-bestest and updrs).

Eligibility criteria:
inclusion criteria: * men and women between 45-85 years of age * clinical diagnosis of parkinson disease * able to stand unsupported for 1 minute * able to walk 18 metres without aid * able to mount a stationary bike exclusion criteria: * history of dementia * history of stroke * type 1 diabetes * autonomic neuropathy * currently involved in formal exercise training (\>3 day per week).

Keywords: high intensity interval training
yoga, mindfulness and cognitive psychotherapy as treatment for stress and burnout

Conditions: Stress, Psychological; Burnout, Professional; Anxiety; Depression

Summary: the purpose of this study is to investigate if treatment with yoga or mindfulness has a more profound and longstanding effect on stress and burnout than treatment with cognitive psychotherapy alone.


Eligibility criteria:
inclusion criteria: * on sick leave at least 50% at the beginning of the study. * sick leave for a maximum of 1 year if on full-time sick leave at the beginning of the study or for a maximum of 3 years if on part-time sick leave at the beginning of the study. * speak swedish well enough to participate in the study interventions. * body mass index (bmi) of between 18 and 30. * meet the diagnostic criteria for burnout syndrome from the swedish national board of health and welfare. exclusion criteria: * medication, including all medication or topical skin preparations with cortisone in any form. exceptions: antidepressants, contraceptives, hormone replacement therapy for hypothyroidism if hormone levels were within the normal range, and hormone replacement therapy to treat menopausal symptoms. to receive an exception for medication, a participant had to take the same medication at the same dose at both blood tests.

Keywords: stress burnout anxiety depression
nasal allergen challenge - reproducibility of biomarkers and effect of topical steroid treatment

Conditions: Allergic Asthma

Summary: subjects with allergic asthma developing the required nasal symptoms in response to nasal allergen titration during a screening period will be randomized 1:1 to one of 2 cohorts. all subjects will have repeated nasal challenges with allergen. one cohort will have nasal saline challenge as control. one cohort will have intranasal corticosteroid intervention.

eligible subjects will be randomized 1:1 to cohort a or cohort b. each cohort will undergo 3 nasal challenges, each separated by 3 weeks. cohort a will undergo 2 nasal allergen challenges, and 1 nasal diluent challenge. tnss, pnif, spirometry, and samples of blood, urine and nasal secretions will be collected until 24h post-challenge to assess reproducibility. cohort b will undergo 3 nasal allergen challenges; one of the challenge will be conducted after 14 days treatment with placebo, and one challenge will be conducted after 14 days treatment with triamcinolone acetonide aqueous nasal spray at a dose of 220 mcg administered twice daily for a total daily dose of 440 mcg. tnss, pnif, spirometry, and samples of blood, urine, nasal secretions will be collected until 24h post-challenge to determine reproducibility, and nasal tissue will be collected 24h post-challenge to determine effect of steroid treatment.

Eligibility criteria:
inclusion criteria: * allergic rhinitis + mild asthma exclusion criteria: * other respiratory disease * any medication for treatment of asthma/allergic rhinitis with the exception of infrequent beta-2 agonist.
perg and mfperg in band atrophy

Conditions: Band Atrophy

Summary: the study is designed to evaluate the ability of pattern electroretinogram (perg) and multifocal pattern electroretinogram (mfperg) to measure and identify the pattern of band atrophy of the optic nerve in patients with long standing chiasmal lesions. the hypothesis is that these electrophysiological tests were able to identify this such pattern. the idea is to investigate the ability of the these electrophysiological technics in detecting the neural loss from chiasmal compression and to evaluate the ability of perg and mfperg parameters to differentiate between eyes with band atrophy of the optic nerve and healthy eyes.


Eligibility criteria:
inclusion criteria: 1. visual acuity better than 20/30 2. refractive error less 5 spherical diopter and 3 cylinder diopter 3. temporal field defect exclusion criteria: 1. presence of glaucoma and optic nerve anomalies 2. anormal nasal field

Keywords: band atrophy pattern electroretinogram chiasmal compression neural loss electrophysiological tests
effects of sulforaphane on cognitive function in patients with frontal brain damage

Conditions: Frontal Lobe Dysfunction

Summary: high rates of patients with frontal brain damage show serious cognitive functional deficits, which negatively impact their quality of life and are linked with poor clinical outcomes. sulforaphane has shown significant antioxidant and cellular protective effects in animal models associated with oxidative stress, such as focal cerebral ischemia, brain inflammation, and intracranial hemorrhage. preclinical research has shown that sulforaphane can significantly improve spatial localization and working memory impairment after brain damage. the primary aim of this clinical trial is to assess the efficacy of sulforaphane for improving cognitive function in patients with frontal brain damage.

90 patients aged 18-65 years, of both genders, who have incurred cognitive deficits after frontal brain damage will be recruited in the neurosurgery department in xiangya hospital. all focal lesions were confined to the frontal brain, which is verified by ct or mri. cognitive deficits will be diagnosed using the chinese version of the montreal cognitive assessment (moca-c). all eligible recruited patients will be randomly divided into two groups in a 2:1 ratio. participants will receive a battery of cognitive tests at baseline and again after 4 and 12 weeks to determine the effect of sulforaphane on cognition. t1-weighted brain magnetic resonance images and resting-state functional mri will be carried out using 3 tesla (3t) brain mri at these timepoints. brain magnetic resonance spectrum will be applied to detect mri markers of brain metabolites and gut microbiota will also be assessed over this period.

Eligibility criteria:
inclusion criteria: * 18-65 years old * focal lesions were confined to the frontal brain, which is verified by ct or mri * clinical diagnosis of cognitive deficits using the chinese version of the montreal cognitive assessment (moca-c) with scores \< 26 will be assessed as having cognitive deficits (\<25 for patients educated \<12 years) * be adherent to the continued sulforaphane treatment medication exclusion criteria: * previous history of cognitive impairment * brain mri indicating damage was not restricted to the frontal lobe. * inability to cooperate with cognitive testing for disturbance of consciousness or mental disorder * pregnancy or maternal lactation * life expectancy \< 3 months * co poisoning, autoimmune encephalitis, intracranial infection, or other types of diffuse intracranial disease. * plan to receive radiotherapy during the trial period * laboratory examination showing liver and kidney insufficiency or other severe complications; the presence of diseases which may interfere with the results of the evaluation * involvement in other trials 1 month prior to the start of the trial or during the trial period

Keywords: sulforaphane frontal brain damage cognitive deficits cognitive function brain metabolites gut microbiota
effectiveness of epidural anesthesia for thoracic and abdominal surgery

Conditions: Analgesia Disorder; Anesthetic Complication Epidural; Adverse Reaction to Epidural Anesthesia

Summary: this study aims to evaluate the effectiveness of the epidural analgesia in patients having elective thoracic and abdominal surgery under general anesthesia combined with epidural analgesia in siriraj hospital.

epidural analgesia is the recommended perioperative analgesia in patients having major surgery in order to significantly reduced pain scores, minimize patient distress and can accelerate postoperative recovery especially with the major operation this technique has been reported to provide better pain control and less postoperative fatigue compared with patients receiving general anesthesia alone.additionally, it is recommended in patients having major surgery to allow patients to mobilize quickly and have effective mobilization.this technique has been shown to be highly efficient at preventing postoperative ileus and various complications. moreover, epidural analgesic technique is demonstrated to be safer and have fewer side effects than using intravenous opioids alone. however, the epidural technique is not universally successful and the number of patients experiencing inadequate analgesia with this technique is approximately 12-32%. the failure of epidural analgesia is still a frequent clinical problem and needs active management including a new block or other analgesic medication in order to rescue postoperative pain. previous study showed that the incidence of patients having epidural analgesia with postoperative moderate pain was 20.9% and that with severe pain was 7.8%. in siriraj hospital, recent study showed that 19.6% of patients having elective upper abdominal surgery under general anesthesia combined with epidural analgesia reported severe first pain scores in post anesthetic care unit.27 as a result of severe pain, patients needed a number of intervention and management from acute pain service, and finally spent longer time in post anesthetic care unit. inadequate pain control in patients receiving epidural analgesia frequently occurred in clinical practice but the number of the success rate or the failure rate have not been reported in our hospital. this study aims to evaluate the effectiveness of the epidural analgesia in patients having elective thoracic and abdominal surgery under general anesthesia combined with epidural analgesia in siriraj hospital.

Eligibility criteria:
inclusion criteria: * patients aged more than 18 years old scheduled to have thoracic or abdominal surgery under general anesthesia combined with epidural analgesia in siriraj hospital exclusion criteria: * inability to communicate or inform pain score * cesarean section or labor analgesia * additional analgesic techniques (spinal analgesia, paravertebral nerve block, intercostal block, transversus abdominis plane block, rectus sheath block, ilioinguinal block, iliohypogastric block * emergency surgery * fail epidural block after test dose of local anesthetics

Keywords: epidural analgesia pain score
effectiveness of manual and instrumental myofascial release in chronic low back pain and the posture of practitioners crossfit®

Conditions: Low Back Pain

Summary: background: chronic low back pain (lbp) can lead to major functional disabilities and force people to take time off work, sports or leisure activities. regular physical exercise is an important ally in reducing the risk factors for most diseases, and crossfit® is one of the modalities that has been gaining momentum when choosing an exercise. however, the intensity recommended in training can collaborate with the development of musculoskeletal problems such as pain and postural changes, interfering with the development of the practice, with low back pain being one of the most common disorders in these practitioners, especially caused by mechanical stress. considering that crossfit® practitioners have already incorporated physical exercise into their routine, passive techniques such as myofascial release (ml) have been discussed as a form of treatment for lbp. for this reason, this study was designed to verify the efficacy of ml in the lbp of crossfit® practitioners, comprising two techniques, one manual and one instrumental, and to see if the outcome of the lbp alters the posture of the spine. this is a randomised controlled clinical that will be conducted in a crossfit® box in the city of goiânia-go, brazil. at least 51 people will take part who have been doing crossfit® for at least 3 months, who have lbp, are aged between 18-59 and are not undergoing any other treatment for low back pain. there will be two experimental groups, one that will receive manual mr and the other, cupping therapy, as well as a control group that will not receive any technique. the sessions will take place twice a week for 8 weeks. the primary outcome will be low back pain intensity, assessed at baseline, weekly and after 8 weeks, and the secondary outcomes, which will be postural deviations, spinal mobility and history of musculoskeletal pain, assessed at baseline and at the end of 8 weeks. there will be no blinding between therapist and participants. discussion: this study will investigate whether mr is effective in relation to lbp, given that some results have already shown positive responses in acute conditions, while also verifying the repercussions on the postural aspect. the results could provide additional knowledge about the best technique to use and, having applicability to our outcomes, will favour and simplify treatment, helping professionals to make clinical decisions.


Eligibility criteria:
inclusion criteria: * men and women aged between 18 and 59 years; * presence of low back pain for at least 12 weeks; * have started regular crossfit® activity at least 3 months ago. exclusion criteria: * perform other physical activity than crossfit®; * continuous use of painkillers; * previous pathologies or spinal surgery; * amputations; * haematological disorders; * fibromyalgia; * hypersensitivity or skin lesions.

Keywords: low back pain myofascial release crossfit posture
evaluation of the nicotine lozenge in relief of provoked acute craving

Conditions: Smoking; Smoking Cessation

Summary: this study is designed to evaluate the ability of a nicotine lozenge to relieve craving for a cigarette compared to a matched placebo (a placebo is like sugar pill and contains no active).


Eligibility criteria:
inclusion criteria: * generally healthy smokers who smoke more than 5 cigarettes per day * body mass index (bmi) within the range 19-35 kilogram (kg)/meter (m)\^2 * females of childbearing potential who are, in the opinion of the investigator, practicing a reliable method of contraception. exclusion criteria: * women who are pregnant or who have a positive urine pregnancy test. * participants with known or suspected intolerance or hypersensitivity to the study materials (or closely related compounds) or any of their stated ingredients. * clinical study/experimental medication: participation in another clinical study or receipt of an investigational drug within 30 days of the screening visit. * prior concomitant medication: treatment with enzyme altering agents (e.g. carbamazepine, phenytoin, cimetidine, sodium valporate) within 30 days of the craving provocation visit; use of any prescription psychoactive medication (such as but not limited to antidepressants, antipsychotics, anxiolytics) within 14 days of the craving provocation visit; participant has used an over-the-counter (otc) medication such as antihistamines, sedating agents, or any compound that would have a sedating effect within 24 hours of the craving provocation visit; current use of any nicotine replacement therapy. * substance abuse: recent history or current history (within the last 1 year) of alcohol or other substance abuse.

Keywords: nicotine nicotine craving
neurocognitive outcome after coronary artery bypass surgery using minimal versus conventional extracorporeal circulation

Conditions: Coronary Artery Bypass

Summary: the aim of this study is to assess the effect of minimal (mecc) versus conventional (cecc) extracorporeal circulation on neurocognitive function after elective coronary bypass grafting (cabg) as well as whether this can be attributed to improved cerebral perfusion intraoperatively.

despite improvements in the biocompatibility of cardiopulmonary bypass (cpb) circuits, the activation of inflammatory systemic response can result in clinically relevant organ dysfunction. regarding the central nervous system, prolonged hypoperfusion and microembolization during conventional cpb have been related to postoperative neurologic impairment with an incidence varying from 30% to 60%. this clinical scenario covers a spectrum from a transient subtle cognitive dysfunction to a permanent stroke. postoperative cognitive decline (pocd) is characterized as impairment in attention, cognition, recognition, orientation, memory, and learning. it may result in prolonged hospitalization, increased morbidity and mortality, while it has an adverse impact on quality of life after surgery. near-infrared spectroscopy (nirs) provides a continuous and noninvasive monitoring of regional cerebral oxygen saturation (rso2). recent studies have shown a significant relationship between intraoperative cerebral oxygen desaturation, indicative of cerebral ischemia, and early pocd in patients undergoing elective coronary bypass grafting (cabg) with conventional extracorporeal circulation (cecc). in an attempt to reduce cpb-inherent side effects, a minimal extracorporeal circulation (mecc) system was developed and it is evaluated in clinical practice. the aim of this pilot study was to define whether there is a difference in early postoperative neurocognitive functioning between patients being operated for cabg on mecc versus cecc systems as well as whether this can be attributed to improved cerebral perfusion intraoperatively.

Eligibility criteria:
inclusion criteria: * all patients scheduled for elective coronary artery bypass grafting exclusion criteria: * history of psychiatric disorder * inability to undergo neuropsychological assessment * history of transient ischemic attack or stroke * carotid artery stenosis \> 60% assessed by duplex ultrasonography

Keywords: coronary artery disease; coronary artery bypass grafting; cardiopulmonary bypass; minimal extracorporeal circulation
miltefosine and gm-csf in cutaneous leishmaniasis

Conditions: Cutaneous Leishmaniasis

Summary: cutaneous leishmaniasis (cl) standard treatment is done with parenteral pentavalent antimony (sbv) at the dose of 15-20mg / kg per day for 20 days. however, therapeutic failure has been described in up to 50% of patients, and the long period of 60 to 90 days required for healing of the ulcerated lesion indicate the need for alternative drugs. currently the alternatives include other parenteral drugs such as pentamidine and amphotericin b, whose use is limited either by toxicity or because, as with sbv, the parenteral route hinders adherence and regularity of treatment in the rural area. recent studies by our group indicate that oral miltefosine is the most effective drug for the treatment of patients with cl caused by l. (v.) guyanensis and l. (v.) braziliensis in brazil, with a cure rate of 71.4% and 75% respectively. cl pathogenesis is associated with intense inflammatory infiltrate and tissue damage. previous trials associating gm-csf to sbv improved the cure rate of cl caused by l. (v.) braziliensis. the objective of this trial is to evaluate the therapeutic response to the use of miltefosine associated to gm-csf in the treatment of cl caused by l. (v.) braziliensis in an endemic region in bahia and ceará, and by l. (v.) guyanensis in the amazon region.


Eligibility criteria:
inclusion criteria: 1. untreated ulcerative cutaneous leishmaniasis, with laboratory diagnosis obtained through at least one of the following tests: direct examination of the lesion, positive culture or pcr for leishmania. 2. age: 18 to 65 years; 3. sex: male and female patients; 4. presence of at least 1 ulcerated lesion at any location; 5. presence of a maximum of 3 ulcerated lesions; 6. diameter of lesions varying between 1 and 5 cm; 7. clinical evolution of the disease of not less than 1 month and not more than 3 months. exclusion criteria: 1. evidence of severe underlying disease (cardiac, renal, hepatic, pulmonary) or malignant disease; 2. patients with immunodeficiency or hiv carriers; 3. serious protein and / or caloric malnutrition; 4. active and uncontrolled infectious-contagious disease such as tuberculosis, leprosy, systemic fungal disease (histoplasmosis, paracoccidioidomycosis) or any other similar condition; 5. women who are pregnant or breastfeeding; 6. allergy to sbv or miltefosine; 7. previous treatment for leishmaniasis; 8. lack of capacity or willingness to provide informed consent (patient and / or parent / legal representative); absence of availability for the visits or to comply with the study procedures.

Keywords: cutaneous leishmaniasis miltefosine cytokines treatment