Kornimate/medical-research-clean huggingface dataset:
resistance training to prevent lymphedema after breast cancer surgery randomized controlled study

Conditions: Breast Cancer Female

Summary: breast cancer-related lymphedema is one of the most common chronic complications of breast cancer survivors. in existing studies, the reported incidence of lymphedema ranges from 2.5% to 42.9% . at present, there is no cure for lymphedema. resistance training has been proved by many studies to alleviate the symptoms of lymphedema, improve the muscle strength of the upper limbs of patients, and improve the quality of life of patients, while not worsening lymphedema. based on the best evidence, this study intends to construct resistance appropriate for this clinical scenario training program: conduct 3-month intervention for patients after breast cancer surgery to explore the effect of resistance training on the grip strength of the affected limb, the range of motion of the shoulder joint of the affected limb, the occurrence of lymphedema of the affected limb, quality of life, etc.


Eligibility criteria:
inclusion criteria: it was first diagnosed as grade i to iii unilateral breast cancer by pathological examination； breast cancer surgery was completed and axillary lymph node dissection was performed; to receive postoperative adjuvant treatment and follow-up in the outer fourth ward; be able to communicate and exchange normally; volunteer to participate in this research exclusion criteria: extreme fatigue, severe anemia, ataxia, etc.; the presence of upper limb or shoulder problems from breast cancer treatment; edema is in a non-stable stage (stable stage of edema means no treatment for edema in the past 3 months; no inflammation of the upper extremities requiring anti-infective treatment; no change in daily activities; limb circumference change \< 10%) ； limited limb movement due to trauma, shoulder periarthritis, etc.; limb braking is required for health reasons. patients are lost to follow-up

Keywords: breast cancer resistance training lymphedema randomized control
fecal microbiota transplantation in pediatric crohn's disease

Conditions: Crohn Disease

Summary: this study will test the safety and effectiveness of fecal microbiota transplantation (fmt) plus partial enteral nutrition (pen) in refractory pediatric crohn's disease (cd) who have failed conventional treatment

recent studies have suggested that gut imbalance and deregulation of immunological responses plays a pivotal role in the disease development of crohn's disease (cd), and that fmt could be a useful treatment. our study is aims to repeated and multiple fmts plus pen in the treatment of refractory pediatric cd. in the induction stage of cd, standard therapy remained unchanged, fmt and pen were added, and fmt was given 1-2 courses, 3-6 times per course. in the maintaining stage, fmt was performed every 3 months, with the same 3-6 times of fmt treatment for each course, and the withdrawal of conventional drug therapy was gradually reduced. refractory cd was defined as refractory to standard therapy (e.g., steroids, immunomodulators, cyclosporine, tacrolimus, or anti-tnf agents).

Eligibility criteria:
inclusion criteria: aged 2-16 years and without genetic diseases; all refractory pediatric with mild-to-moderate cd; mild-to-moderate cd, defined by the pediatric crohn's disease activity index (pcdai) \>10 and ≤40 and simple endoscopic score for cd (ses-cd) \> 3 were enrolled in the study; refractory cd, defined by children who failed conventional treatment (hormone, immunosuppressant, biologics) exclusion criteria children who were treated by pen (80%) less than 8 weeks; follow up less than 3 months; known contraindication to all fmt infusion method such as nasoduodenal tube insertion, oesophago-gastro-duodenoscopy (ogd), enteroscopy, colonoscopy, enema and fecal capsule; unwilling to give informed consent/assent

Keywords: fecal microbiota transplantation , crohn disease
calcium administration in life-saving management during massive hemorrhage

Conditions: Massive Hemorrhage; Trauma; Hypocalcemia

Summary: this study evaluates the feasibility of conducting a larger study on the impact of treating massive hemorrhage with calcium in trauma patients. patients undergoing the massive hemorrhage protocol (mhp) will be randomly assigned to receive either calcium gluconate or placebo drug after every 4 packs of units of rbcs received during the mhp.

the treatment of hemorrhage with blood products has been well studied, however very little literature exists on the administration of specific electrolytes such as calcium. citrate is added to blood products to prevent coagulation by chelating free calcium. this process reduces serum calcium and can lead to hypocalcemia, especially in trauma patients who have altered metabolism, hypovolemia, and receive large quantities of blood products. the majority of trauma patients have hypocalcemia upon arrival at the hospital. serum hypocalcemia in trauma patients matters because calcium is crucial for bleeding control due to its contributions to platelet function, coagulation, and vasoconstriction. calcium is also essential for other physiological functions during trauma, such as heart and smooth muscle contractility. it is likely due to these key roles that the literature demonstrates hypocalcemia's association with increased mortality, bleeding, blood transfusion requirements, and coagulopathy. the primary objective of our proposed trial is to assess the feasibility of conducting an interventional calcium trial on patients undergoing the massive hemorrhage protocol (mhp). feasibility will be evaluated through the recruitment of patients, adherence to protocol, as well as assessment of any protocol violations that occur during the trial. secondary objectives of our trial include analyzing the effect calcium supplementation has on patient ionized calcium (ica) level, total blood product transfused, hemodynamic instability, icu mortality, and hospital mortality. the investigators will complete a single-centre, double-blinded randomized control feasibility trial. both trial arms will receive study drug in accordance with ontario's massive hemorrhage protocol (mhp). after every 4 units of rbcs, the treatment group will receive 3g of calcium gluconate and the control arm will receive saline placebo. results will be assessed for feasibility to inform the development of a larger trial.

Eligibility criteria:
inclusion criteria: * adult trauma patients undergoing the mhp at victoria hospital, london, ontario exclusion criteria: * under the age of 18 * pregnant

Keywords: calcium massive hemorrhage protocol
infarction register

Conditions: Acute Coronary Syndrome

Summary: the aachener digitale myokardinfarkt register (admire) is a prospektive registry study which was designed in order to obtain data of patients with acute coronary syndrome and herewith control and optimize guideline conform therapy of these patients.

aims of this registry stdy are documentation of the characteristics of all patients representing to the rwth aachen university hospital (uka) with stemi or nstemi documentation of the invasive and adjuvant medicinal therapy of stemi and nstemi at uka documentation of the in-hospital mortality documentation of the procedure-associated complications documentation of therapeutic principals for patients with stemi or nstemi at uka and investigation conformity of treatment with already established guidelines

Eligibility criteria:
inclusion criteria: * acute coronary syndrome exclusion criteria: * under age or not able to give informed consent

Keywords: acute coronary syndrome stemi nstemi registry
stellate gnaglion block in refractory bell's palsy

Conditions: Facial Palsy; Neuropathy

Summary: idiopathic facial nerve palsy (bell's palsy) is caused by damage to the facial nerve at any site of the peripheral branches after the facial nucleus.stellate ganglion block is inteneded to increase blood flow and promotes nerve regeneration.

the conventional systemic corticosteroid treatment for acute peripheral facial nerve palsy in patients can induce hyperglycemia, and an alternative local therapy may be necessary and some time may ve ineffective. our purpose in this study is to evaluate therapeutic effects of stellate ganglion block (sgb) on idiopathic persistant facial nerve palsy.

Eligibility criteria:
inclusion criteria: * diagnosed by clinical and neurological assessment as one-sided idiopathic facial palsy * age 18 to 60 * asa ⅰ\~ⅲ exclusion criteria: * diabetic * coagulation dysfunction * mental or cognitive dysfunclion * allergy to injected medication

Keywords: neuropathy
tamoxifen or letrozole in treating women with ductal carcinoma in situ

Conditions: Breast Cancer

Summary: rationale: estrogen can cause the growth of breast cancer cells. hormone therapy using tamoxifen or letrozole may fight breast cancer by blocking the use of estrogen by the tumor cells or by lowering the amount of estrogen the body makes. purpose: this clinical trial is studying how well tamoxifen or letrozole work in treating women with ductal carcinoma in situ.

objectives: * determine the clinical response in women with estrogen receptor-positive ductal carcinoma in situ (dcis) treated with neoadjuvant hormonal therapy comprising tamoxifen or letrozole, by evaluating the maximal change in tumor diameter on mammography and mri following treatment. * identify those cellular antigens which are altered by hormonal therapy. * determine which cellular antigens are predictive of clinical response to hormonal therapy. * evaluate whether genomic changes or gene expression in dcis are altered by hormonal therapy and find candidate genes which are correlated with response to treatment. outline: this is a pilot study. patients who are premenopausal receive oral tamoxifen once daily for 3 months in the absence of unacceptable toxicity. patients who are post menopausal receive oral letrozole once daily for 3 months in the absence of unacceptable toxicity. after 3 months of hormonal therapy, patients undergo lumpectomy or mastectomy. after completion of study treatment, patients are followed every 6 months for 5 years and then annually thereafter. projected accrual: a total of 40 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * diagnosis of ductal carcinoma in situ (dcis) on core biopsy * no evidence of contralateral breast disease or palpable masses on breast examination * no presence or suspicion of invasive cancer, including contralateral invasive cancer, on core biopsy and mri * no documented ipsilateral axillary adenopathy * planning to undergo lumpectomy or mastectomy * estrogen receptor (er)-positive tumor by immunohistochemistry patient characteristics: * female patient * premenopausal or postmenopausal * postmenopausal is defined by any of the following: * no spontaneous menses for \>= 1 year * bilateral oophorectomy * radiation castration and amenorrheic for \>= 3 months * follicle-stimulating hormone (fsh) \> 20 iu/l and off all hormonal therapy (e.g., hormone replacement therapy or birth control pills) for \>= 1 month * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception * no co-morbidities contraindicating the use of tamoxifen, including any of the following: * prior history of thrombotic events * history of hypercoagulable state * history of endometrial hyperplasia * abnormal vaginal bleeding * no history of contrast dye-related allergies/reactions * no history of metal-containing prostheses or implants prior concurrent therapy: * see disease characteristics

Keywords: breast cancer in situ ductal breast carcinoma in situ
vitamin d supplementation to prevent vitamin d deficiency for children with epilepsy

Conditions: Epilepsy; Vitamin D Deficiency

Summary: to determine the maintenance dose of vitamin d supplementation required for children with epilepsy to maintain normal vitamin d level.

children aged 2-16 years diagnosed with idiopathic epilepsy will be randomized to receive either cholecalciferol doses (400iu vs 1000iu) with follow up at 3 and 6 months post supplementation.

Eligibility criteria:
inclusion criteria: 1. children aged between 2-16 years who were diagnosed with epilepsy and being treated with aeds 2. followed up in the outpatient pediatric neurology clinic at king khalid university hospital during the period of two years. exclusion criteria: 1. children with pre-existing vitamin d metabolism problems; because they are known to need different vitamin d doses and monitoring for clinical improvement: * vitamin d dependent rickets * malabsorption syndromes like celiac disease, inflammatory bowel disease * renal disease * hepatic disease 2. children who are not safe to start vitamin d supplementation; because vitamin d supplementation will causes toxicity and induces nephrocalcinosis: * hypercalcemia at baseline total corrected calcium \>2.5mg/dl * vitamin d level \> 250 nmol/l * urine calcium: creatinine ration \> 1.2 mol/mol, or \> 0.41g/g.
exploratory study providing telepsychiatry in the home with a clinician present

Conditions: Mental Disorder

Summary: telemedicine can expand access to behavioral health services for people who have difficulty traveling to clinics. travel can be especially challenging for older adults with mobility issues or access to reliable transportation. assessment in the home can uncover factors impacting patient's physical and behavioral health. the goals of this project to document benefits and barriers to expanding reimbursement for telemedicine to older patient's home as the originating site.

the goal of this project is to document the benefits and barriers to expanding reimbursement for telemedicine to older patient's home as the originating site. the objectives are: * develop training module for midlevel clinicians to be ready for dissemination * improved patient outcomes measures on satisfaction with care; functioning and symptoms (anxiety, depression, traumatic stress, sleep apnea, alcohol use and problems) * reductions in emergency healthcare utilization and medications prescribed as obtained from electronic health record (ehr) at the federally qualified health center (fqhc) and self-reports * summarize activities and barriers, including communication with primary care provider, identification and improvement of home environmental risks, and assistance to support system this is an observational study of team-based telepsychiatry in the home for one group and team-based psychiatry in the clinic for the comparison group. the initial assessment will include information and informed consent for treatment, biopsychosocial assessment, summary for the psychiatrist, psychiatric evaluation and recommendations (all standard of care). to that the investigators are adding informed consent for program evaluation with 6 month follow-up with information for re-contacting (3 sources, addresses, email-telephone numbers), and brief administration of selected instruments before informed consent for treatment. if an eligible patient does not want to participate in the research study, the patient would still receive services. additional telemedicine sessions and/or therapy sessions will be conducted as medically needed in accordance with quality care. at six months (with one month window on either side) the evaluation packet will be re-administered by the clinician if convenient or by the research assistant either in person or by phone. the sample size was selected to provide robust indicators of barriers to home based assessments. the comparison group was included to provide a context for the findings. it is anticipated that the home group will have greater problems at baseline than the clinic based comparison group but both will show improvements.

Eligibility criteria:
inclusion criteria: * patient at fqhc * referred for psychiatric services * 50 or older exclusion criteria: * does not speak english

Keywords: telepsychiatry telemedicine home-based care
understanding pine bark extract as an alternative treatment (upbeat) study

Conditions: Hypertension

Summary: the purpose of this study is to investigate the efficacy of flavangenol® (toyo shinyaku, japan), a pine bark extract, in lowering blood pressure and improving glycemic control and plasma lipoprotein profile.

cardiovascular disease is the number one cause of death in the unites states. our study tests the efficacy of pine bark extract in improving a number of cardiovascular disease risk factors. we are conducting a randomized, placebo-controlled, double-blind, parallel trial that will investigate the efficacy and safety of flavangenol® (toyo shinyaku, japan), a pine bark extract, among 130 study participants. these participants will be individuals at mildly or moderately elevated risk of cardiovascular disease (cvd) because of having prehypertension, excess body weight, and insulin insensitivity. we aim to determine (in order of priority): 1. the efficacy of flavangenol in lowering blood pressure. 2. the efficacy of flavangenol in improving glycemic control and plasma lipoprotein profile. 3. changes in body weight, antioxidative capacity, anti-inflammatory markers, blood coagulation factors, and liver function tests in response to flavangenol. 4. the safety of flavangenol, as confirmation of past studies.

Eligibility criteria:
inclusion criteria: * systolic blood pressure between 125 and 159 mmhg and diastolic blood pressure (dbp) \< 100 mmhg * body mass index (bmi) 25.0-34.9 * triglycerides (tg) \< 450 mg/dl * low density lipoprotein (ldl) \< 200 mg/dl * fasting blood glucose (fbg) \< 126 mg/dl exclusion criteria: * dbp \> 95 mmhg * ldl \> 170 mg/dl * tg \> 300 mg/dl * fbg \> 110 mg/dl
applications of mri in kidney disease

Conditions: Chronic Kidney Disease; End-stage Kidney Disease

Summary: this study has two major purposes: 1. to test developed multiple anatomic and functional mri methods; 2. to evaluate the potentials of these mri methods in the diagnosis, prognosis, and monitoring of the progression of renal dysfunction. these purposes will be achieved by performing pilot studies with cohorts of patients.

this study is observational with no intervention applied for the patients. in this study, multiple anatomic and functional mri methods will be performed with three cohorts of patients. in addition to anatomic mri methods, non-contrast enhanced functional mri methods will also be applied to evaluate tissue perfusion and vascular reactivity in these patients.

Eligibility criteria:
inclusion criteria: 1. english-speaking as primary language 2. able to complete an approximately 75 to 90 minute cognitive and/or physical tests 3. capable to consent to studies exclusion criteria: 1. acute psychiatric illness that would impede cognitive testing 2. active chemical dependence, such as alcohol, narcotics or other drugs 3. legally blind or unable to complete cognitive tests due to visual loss or deafness 4. renal transplant recipient at time of screening or baseline 5. severe ci unable to complete the modified mini-mental state examination \[3mse\] 6. chronic and acute pulmonary disease
functional magnetic resonance imaging (fmri) study of memory in children

Conditions: Childhood Absence Epilepsy [Pyknolepsy]

Summary: memory is a cognitive function whose development is still poorly documented in children, but which is often disturbed in temporal epilepsy. there are no studies about the disorders of episodic memory. the investigations using functional mri (fmri) are scarce, they do not involve this field and none are dedicated to children. the objectives of this project are to study the neuronal networks involved in episodic memory in normal children, as well as the disorders of episodic memory in children with epilepsy and the mechanisms of cognitive and cerebral reorganization in epilepsy.

twenty children aged from 6 to 18 years with temporal and/or frontal epilepsy and 20 normal children in the same age range will undergo the following examinations in a unique day in the unit hospital f. joliot(cea in orsay, france): 1. complete neuropsychological evaluation including episodic memory, 2. structural mri to quantify, using vbm, the potential abnormalities of the anatomical structures, to perform cognitive-morphological correlations, and to localize the neuronal networks activated on fmri, 3. functional mri using an original task of episodic memory, specifically dedicated to children and being under behavioural validation laboratory. the analysis of fmri data will be performed using spm and taking into account the existence of epilepsy or not, of cerebral lesion or not, age, handedness, the side and location of epileptogenic focus, the age of seizure onset, and the type of antiepileptic treatment. this study has been approved by the ethic committee in september 2004 (ccpprb bicetre, promotion of assistance publique - hopitaux de paris).

Eligibility criteria:
inclusion criteria: * parents or legal tutors of the children having given written consent to participate to the study, after having being fully informed. * patients presenting with a temporal and/or frontal epilepsy and being able to perform the tasks of the protocol. * controls being recruited among brothers, sisters, and friends of the patients and being right-handlers, without any neurological history or learning disorders. exclusion criteria: * any contra-indication to mri or being claustrophobia or blind.

Keywords: memory epilepsy children magnetic resonance imaging functional magnetic resonance imaging
fluticasone-vilanterol once daily dose for the treatment of mild asthma in adults

Conditions: Asthma

Summary: investigators will test the superiority of superiority trial of fluticasone-vilanterol as needed in mild asthma compared to standard of care

single centre randomised control trial with the aim of comparing the superiority of effectiveness and safety of fluticasone-vilanterol versus usual care. in this study there is random allocation of participants to usual care (any ics or saba combination) or fluticasone-vilanterol daily single dose for the relief of symptoms.

Eligibility criteria:
inclusion criteria: * adults between the ages of 18 and 75 years old with a diagnosis of mild asthma attending the participating primary health care centres in bahrain, being managed with usual care (saba or ics and saba combination) and no other medications exclusion criteria: * health centre medical record or self-reported use of laba, leukotriene receptor agonist, theophylline, anticholinergic agent, oral corticosteroids for regular maintenance therapy in 3 months before entry to the trial. \[nb. nasal corticosteroid is permitted

Keywords: asthma fluticasone laba fluticasone-vilanterol long acting beta agonist