Kornimate/medical-research-clean huggingface dataset:
evaluation of reactive oxygen metabolites in the value of copd

Conditions: COPD(Chronic Obstructive Pulmonary Disease)

Summary: this study through the long-term observation followed up for 2 years to find the change of the copd patients blood roms, systematically evaluate the relationship between roms and the severity of copd. evaluate the differences of prognosis between the different oxidative stress level (according to the level of roms are divided into higher and normal phenotype). explore the new oxidative stress evaluation index roms application value in copd.

reactive oxygen metabolites (reactive oxygen metabolites, roms) test is a method by measuring the total reactive oxygen metabolites (roms) content in blood so as to evaluate the overall level of oxidative stress in the human body .our previous studies have established the method of detecting roms which is suitable for fully automatic biochemical analyser.our study through the long-term observation followed up for 2 years to find the change of the copd patients blood roms, systematically evaluate the relationship between roms and the severity of copd. evaluate the differences of prognosis between the different oxidative stress level (according to the level of roms are divided into higher and normal phenotype). explore the new oxidative stress evaluation index roms application value in copd.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of copd according to gold 2013 exclusion criteria: * a history of asthma or other chronic lung diseases take antioxidant therapy there are new or recurrent symptomatic myocardial ischemia, severe arrhythmia, cardiac insufficiency cerebrovascular disease senile dementia or cognitive impairment cancer severe liver and kidney and other viscera function insufficiency language communication barriers limb activity disorder the last 3 months participated in sports training

Keywords: copd reactive oxygen metabolites
efficiency of speech therapy in resistant hypertensive patients with mild obstructive sleep apnea syndrome

Conditions: Sleep Apnea, Obstructive; Hypertension Secondary

Summary: the purpose of this study is to analyze the effect of speech therapy on quality of life, sleep quality, daytime sleepiness level and apnea-hypopnea index in patients with hypertensive patients with mild obstructive apnea syndrome.

the database will include demographic characteristics, cardiovascular risk factors and and target-organ damages. anthropometric measurements (height, weight, and abdominal and neck circumference) will be registered. daytime sleepiness, quality of sleep and quality of life wiill be evaluated through the respective questionnaires: epworth sleepiness scale, pittsburgh sleep quality index (psqi) and sf-36. in order to evaluate the airway, the mallampati grade will be used in addition to the adapted assessment protocol from guimarães (2009). the differences between the final score and the baseline score will be calculated and adjusted by the baseline value found in each of the questionnaires applied. finally, the analysis excluding the patients with suboptimal adherence to speech therapy treatment (less than 85%) compared to the control group will be redone. if there are benefits of treatment with speech therapy, it will also be offered to the control group after the end of the clinical trial. statistical analysis will be done in the statistical package spss version 19.0 package (spss inc. chicago, illinois, usa). data obtained may be of benefit to future patients and will be used only for statistical purposes. the confidentiality of the information collected will be guaranteed, thus ensuring the privacy and confidentiality of the information. in addition, the data obtained will not be used for other purposes not foreseen in the protocol.

Eligibility criteria:
inclusion criteria: * patients in follow-up in the hypertension program (prohart) at hospital universitário clementino fraga filho - ufrj at least six months; * patient with resistant hypertension and mild obstructive sleep apnea detected by polysomnography; * all participants that give written informed consent. exclusion criteria: * age\> 85 years; * cognitive deficit that prevents speech therapy; * severe clinical events in the last 6 months; * refusal of the patient to participate in the study; * pregnancy; * prior and regular use of cpap; * clinical data suggestive of neurological disease with cognitive and / or motor sequelae, craniofacial malformation, severe upper airway obstruction, neuromuscular disease, users of hypnotic drugs

Keywords: speech therapy sleep apnea resistant hypertension quality of life quality of sleep
thermal ablation vs thyroidectomy for large benign thyroid nodules

Conditions: Benign Thyroid Nodules

Summary: to compare the safety, efficacy and quality of life between staged thermal ablation and thyroidectomy in the treatment of large benign thyroid nodules.

large benign thyroid nodules （btns）usually cause compressive symptoms or cosmetic concerns and therefore require treatment. thyroidectomy remains the mainstay treatment for large, symptomatic btns. however, if surgery is not feasible or refused, ablative approach could be considered in selected patients. however, it has been proved that single application of thermal ablation is less effective in causing shrinkage in large thyroid nodules. the possible reason is that it is difficult for single application of thermal ablation to cover all of the nodule tissue in a three-dimension if the nodule is large. in addition, nodule locations adjacent to vital structures might hinder complete treatment in one session because of safety concerns. few studies reveal that staged thermal ablation (pre-designed multiple sessions of thermal ablation) can also achieve complete ablation and adequate volume reduction of large benign thyroid nodules. however, there is a lack of comparison between these two methods. thus, this study is aimed to compare the safety, efficacy, quality of life between staged thermal ablation and thyroidectomy for treating large benign thyroid nodules.

Eligibility criteria:
inclusion criteria: * benign thyroid nodules confirmed by surgical pathology in surgery group, and by two separate us-guided fine-needle aspiration (fna) or core needle biopsy (cnb) in thermal ablation group; * the largest diameter of the nodule ≥4 cm; * the presence of nodule-related symptoms, cosmetic concerns, or psychological stress; * patients treated with surgery, or staged thermal ablation (who explicitly refused surgery); * more than 12-month follow-up duration exclusion criteria: * suspicion of malignant nodule on ultrasound findings (e.g., marked hypoechoic, microcalcifications, or ill-defined margins); * comorbidities of other severe diseases; * without complete treatment and/or follow-up information

Keywords: thermal ablation thyroidectomy
evaluation of a web-based fall prevention program on people with multiple sclerosis

Conditions: Multiple Sclerosis

Summary: this study evaluates the effectiveness of a web-based fall prevention program called free from falls online (fffo) on people with multiple sclerosis.

the overarching goal of this study is to evaluate the effectiveness and impact of an online self-management program for preventing falls among people with multiple sclerosis (pwms). to accomplish this objective, the investigators have designed a web-based fall prevention program called free from falls online (fffo), based on the traditionally in-person program developed by the national multiple sclerosis society. the specific aims of this study are three-fold: (1) to evaluate the effectiveness of an online fall prevention self-education program by comparing fall frequency between participants and controls; (2) evaluate the impact of fffo by comparing patient reported measures of physical function, fatigue, self-efficacy, psychosocial illness impact, social participation and satisfaction, and perception of global health between participants and controls; (3) and to determine usability of and satisfaction with fffo.

Eligibility criteria:
inclusion criteria: * ms of any type with no relapse in the previous month * self-reported history of 2 or more falls in the previous 2 months * ability to walk at least 100 meters with intermittent or unilateral constant assistance (expanded disability severity scale (edss) step \<6.0) * daily access a computer and willingness to respond to a daily survey exclusion criteria: * medical conditions that would preclude reliable participation or increases risk for injury during the program

Keywords: fall prevention multiple sclerosis web-based education self-efficacy
ultrasound applications for emergency medical technicians in taiwan

Conditions: Prehospital Emergency Medical Services; Point-of-care Ultrasound

Summary: the goal of this prospective observational study is to develop and assess the core ultrasound applications for emergency medical technicians (emts) in taiwan. the study focuses on advanced emergency medical technicians (emt-ps) and their ability to perform point-of-care ultrasound (pocus) in prehospital settings. the main questions it aims to answer are: can a standardized pocus training program improve emt-ps' competency in ultrasound applications? what is the reliability and validity of the newly established pocus assessment modules for emt-ps? researchers will compare trained emt-ps' ultrasound proficiency and clinical decision-making before and after training to see if structured pocus education enhances diagnostic accuracy and patient care in prehospital settings. participants will: attend a structured pocus training program, including lectures and hands-on practice with standardized patients and simulation models. undergo competency assessments, including written exams, objective structured clinical examinations (osces), and image interpretation tests. perform ultrasound scans on actual patients in prehospital settings, focusing on trauma, respiratory distress, stroke, and cardiac arrest cases. receive feedback and participate in follow-up assessments to evaluate knowledge retention and clinical application.


Eligibility criteria:
inclusion criteria: * patients presenting with one of the following conditions in the prehospital setting: trauma dyspnea (shortness of breath) suspected stroke out-of-hospital cardiac arrest (ohca) exclusion criteria: * patients with hemodynamic instability or critical conditions requiring immediate resuscitation, making them unsuitable for focused prehospital ultrasound performed by emt-ps. * patients under the age of 18.

Keywords: prehospital ultrasound emergency medical technicians education
mold allergy in austria: clinical relevance of alternaria alternata and related species

Conditions: Fungal Allergy; Allergy

Summary: mold allergies are becoming increasingly important among the population. increasing amounts of fungal spores are analyzed in air-samples because of urbanization, industrialization of food products and climate change. mold also grows indoor and hence lead to additional health complaints. alternaria alternata, and its only major allergen alt a 1, is the most important fungus for allergy sufferers. alternaria alternata can not only cause allergic symptoms but can also cause intensified asthmatic symptoms. besides alternaria alternata, there are over 700 other species of the genus alternaria. the influence of these other species on allergic symptoms is poorly understood. furthermore, prevalence and incidence of an allergy to alternaria alternata among the austrian population is not known. estimates range between 1-5% among the austrian population. this study aims to further investigate the incidence and characteristics of an allergy to alternaria in austria. this will be investigated with the help of participants (50 alternaria allergy sufferers and 20 non allergic participants), spore counts in austria and crowd-sourced symptom data.


Eligibility criteria:
inclusion criteria: * participants will be healthy people over 18 years of age. allergic participants should have an allergic reaction against alternaria, visible in the skin-prick-test. furthermore symptom data in the pollen diary of the austrian pollen information service should be existing exclusion criteria: * subjects participating in a pharmacological study, pregnant subjects and subjects with an existing infectious- and/or autoimmune disease

Keywords: allergy fungal allergy alternaria alternata
tumor electric fields treatment system for glioblastoma

Conditions: Glioblastoma

Summary: this early phase i trial will investigate the safety and feasibility of applying the tumor electric fields treatment system to subjects with recurrent glioblastoma.

subjects who have previously completed radiotherapy and at least two cycles of chemotherapy with imaging or pathological evidence of tumor recurrence will receive tumor electric fields treatment system. the main objective is to evaluate the safety of applying the tumor electric fields treatment system to subjects with recurrent gbm.

Eligibility criteria:
inclusion criteria: * patients with pathological diagnosis of glioblastoma at first surgery (who grade iv, supratentorial location); * age between 18 and 65 years, male or female; * previously completed radiotherapy and at least two cycles of chemotherapy; * with imaging or pathological evidence of tumor recurrence; * karnofsky performance score (kps) score ≥ 70 before intervention; * with a life expectancy more than 3 months; * adopted effective contraceptive measures at child-bearing age; * provided written informed consent. exclusion criteria: * patients unwilling to use the equipment ≥ 18h per day; * with poor compliance or live too far from the research center, who cannot keep regular follow-up or adjust the electrode position of the treatment equipment, and who refuse to receive follow-up to terminal survival; * with poor healing of scalp wound, poor scalp condition, large skull defect or other cases where electrodes are not suitable for wearing; * within 3 months from radiotherapy; * within 4 weeks from the last cycle of chemotherapy; * within 4 weeks from surgery for recurrence; * participated in other clinical trials. * pregnant; * epilepsy symptoms not effectively controlled; * blood and biochemical indicators in the following range: a. liver function impairment: ast or alt \> 3 times the upper limit of normal; b. total bilirubin\> upper limit of normal value; c. renal impairment: serum creatinine\>1.7mg /dl (\>150 mol/l); d. coagulopathy: pt or aptt \>1.5 times normal; e. platelets counts \< 100x10\^9/l; f. absolute neutrophils count \< 1x10\^9/l; g. hemoglobin \< 100g/l; * with severe infectious diseases, such as acute severe infection and hiv positive; * other conditions, such as an implanted cardiac pacemaker or deep brain stimulator, severe intracranial edema, increased intracranial pressure resulting in midline shift\>5mm, clinically significant papilledema, or reduced level of consciousness, allergy to conductive coupling agent, gel, and other serious life-threatening diseases. * other circumstances considered inappropriate to participate in the research by the investigator.

Keywords: glioblastoma tumor electric fields treatment
transcranial direct current stimulation effects in patients with chronic consciousness disorders

Conditions: Minimally Conscious State; TBI

Summary: chronic consciousness disorders have high level of impact on public health and its costs.

consciousness disorders have high impact on society and national health system. one of these disorders is vegetative condition in which, as in coma, there isn't any self or environmental consciousness but there is alertness, whereas in minimal state of consciousness at least part of awareness is conserved. in emilia romagna region about 80 people per million of inhabitants are hospitalized after cerebral damage, and after discharge about 1/5 of patients are stabilized in a consciousness disorder. the diagnosis of these disorders is based on neurobehavioural tests, for example jfk coma recovery scale revised (crs-r). in these patients recovery of state of consciousness is one of the main challenges. there are very little evidences about treatment, it has been proposed the use of therapies that could modulate central nervous system activity, like specific drugs, neuroimaging and neuromodulation techniques such as transcranial magnetic stimulation and repetitive transcranial current stimulation. a non invasive neuromodulation technique is transcranial direct current stimulation (tdcs) which can modulate cortical excitability: cathodic current reduces excitability whereas anodic current increases it. in conclusion, tdcs is an easy technique to use, it's not invasive and it's an efficient tool for the modulation of cortical excitability that demonstrated reliable results in healthy subjects. as the tdcs can modulate cortical excitability it is likely that the combination of this stimulation tool with transcranial magnetic stimulation for the registration of cortical excitability could give important information about cerebral damage in patients with consciousness disorders and to test new treatments. it is also likely that the modification of cortical excitability could induce neurobehavioural changes.

Eligibility criteria:
inclusion criteria: * males and females aged \>18 years old and \<70 years old * diagnosis of disorders of consciousness classified as mcs according to criteria of american academy of neurology1. * traumatic etiology (\>12 months after the acute injury) exclusion criteria: * contraindications to single pulse tms (tms will be used to measure cortical excitability) such as metal head implants, history of seizures, metal in the head, implanted brain medical devices. * contraindications to tdcs such as metal in the head, implanted brain medical devices.

Keywords: minimally conscious state tdcs
the mixed phenotype of asthma and copd: the overlap syndrome

Conditions: Asthma; COPD

Summary: rationale: in asthmatic subjects, smoking can lead to several changes in disease characterictics. in smokers of more than 20 pack-years, chronic obstructive pulmonary disease (copd) can be associated with asthma, also called asthma-copd overlap syndrome (acos). increasing data support the concept that acos is a clinical entity. however, this should be further studied in order to better target therapy. aim: the objective of this study is to evaluate the comparative features of acos methods: this will be a descriptive study comparing the features of the acos with the features of asthmatic subjects with an incomplete reversibility of airway obstruction (irao).the study will be done over 1 or 2 visits (within a week interval), according to subjects' availability. the visit will include completion of different questionnaires (asthma control asthma quality of life, medical history, exacerbations, etc.), a thoracic examination, allergy skin-prick tests, spirometry and bronchodilator response, lung volumes and compliance measurements, exhaled nitric oxide measurement, blood sampling and a sputum induction.


Eligibility criteria:
inclusion criteria: all subjects 1. subjects aged 45 years and older. 2. free of any other respiratory condition, except for asthma and/or copd, which may interfere with the tests. 3. asthma that requires a baseline treatment with inhaled corticosteroids and/or additional asthma medication. 4. free of respiratory infection in the 4 weeks preceding the study. 5. no changes in the asthma and copd-related medications in the 4 weeks preceding the study. 6. if female, not pregnant (or lactating). 7. able to adhere to study procedures. 8. able and willing to provide written informed consent to participate in the study, in accordance with international conference on harmonization (ich) good clinical practice (gcp) requirements. acos subjects 1. smokers or ex-smokers of at least 20 pack-years. 2. with an irao (see definitions section). irao subjects 1. long-life non-smokers or ex-smokers defined as someone who smoked less than 5 pack-years and who completely stopped smoking for at least 12 months before inclusion in the study. 2. with an irao. exclusion criteria: * all subjects 1. with copd without a past diagnosis of asthma. 2. unstable respiratory or non-respiratory condition. 3. any active chronic inflammatory disease. 4. any evidence of malignancy (active and/or treated) within the previous 5 years. 5. any significant concomitant illness or injury that would interfere with the subject's participation in the study. 6. any history of bronchial thermoplasty. irao subjects 1. use of any nicotine containing product within 1 year prior to study entry or a smoking history of \> 5 pack-years.

Keywords: phenotype inflammation pulmonary function comorbidities
psychometric validation of cognitive endpoints

Conditions: Multiple Sclerosis

Summary: the study will entail cognitive assessment of a single cohort of patients with multiple sclerosis. each subject will be assessed twice, approximately 45 days apart. there will be no intervention or control group. each participant will have a caregiver capable of responding to a brief report of observations regarding neuropsychological skills and abilities in the patient.


Eligibility criteria:
inclusion criteria: * 18 to 65 years old (inclusive). * history of relapsing-remitting or secondary progressive multiple sclerosis * physically able to see the testing materials and complete the tests * have a family member or caregiver who is capable of consent and willing to complete the msnq-informant questionnaire. exclusion criteria: * a history of treated or untreated severe mental illness or diagnosis of major depression prior to ms onset. * untreated major depression or untreated anxiety disorder. * history of attention deficit/hyperactivity disorder, developmental learning - disorder including mental retardation. * history of traumatic brain injury with intracranial bleed, stroke, alzheimer's disease, parkinson's disease, motor coordination disorder or other neurologic illness. i understand that if the investigator believes this would interfere with successful completion of the protocol, i will be excluded. * a clinically significant relapse within the past 2 months. i have had a serious infection (e.g., pneumonia, septicemia) within the 2 month. * history of drug or alcohol abuse (as defined by the investigator) within 1 year prior to study day 1. * active bacterial or viral infection. * use of marijuana within 2 months prior to study day 1or at any time during the study * alcohol consumption within 24 hours of either test session. * unable to comply with study requirements. * expected survival time of less than 3 months.

Keywords: ms neuropsychological tests
surgical revascularization outcomes after oral anticoagulation or antiplatelets

Conditions: Coronary Artery Disease; Saphenous Vein Graft Patency

Summary: the primary purpose of this study is to evaluate whether treatment with oral anticoagulation or oral anticoagulation and aspirin is better than aspirin alone in cardiovascular outcomes and saphenous graft patency in patients submitted to coronary artery bypass graft.


Eligibility criteria:
inclusion criteria: * patients referred to coronary artery bypass graft and at least one saphenous vein graft exclusion criteria: * need for dual antiplatelet therapy, other non-aspirin antiplatelet therapy or oral anticoagulant therapy * stroke within 1 month or any history of hemorrhagic or lacunar stroke * estimated glomerular filtration rate (egfr)\<15 ml/min