Kornimate/medical-research-clean huggingface dataset:
the effects of immersion in 42℃ thermal-mineral water on chronic low-back pain

Conditions: Chronic Low-back Pain

Summary: in this controlled, follow-up study the effects of immersion in 42℃ radon, natrium, calcium, bicarbonate content thermal-mineral water on clinical parameters and quality of life of patients with chronic low-back pain is evaluated. the participants in the intervention group are treated with balneotherapy plus usual care, while in the control group only with usual care. the planned participants number is 120. follow up period is 3 months.

in this controlled, follow-up study the effects of immersion in 42℃ radon, natrium, calcium, bicarbonate content thermal-mineral water on clinical parameters and quality of life of patients with chronic low-back pain is evaluated. the participants in the intervention group are treated with balneotherapy plus usual care, while in the control group only with usual care. the balneotherapy takes place in rudas spa in budapest, 15 times in 3 weeks. the intensity of pain in rest and during activity evaluated on visual analogue scale (vas), the oswestry disability index and the euroqol-5d is taken at week 0., at week 3. and at week 12. the planned participants number is 120. follow up period is 3 months.

Eligibility criteria:
inclusion criteria: * outpatients suffering from non-specific chronic low back pain standing for at least 12 weeks; only slightly reduced mobility (able to admit the treatments or visits on his own or without the help of another person); * pain intensity of low back pain during activity at least 35 on visual analog scale (0-100 mm vas); likely degenerative symptoms exclusion criteria: * severe neurological deficit associated with the lower back; * suspected vertebral compression of osteoporotic or other aetiology; * malignancy; * pain due to inflammatory spinal disease; * severe spondylolisthesis (grade 2 or above); * balneotherapy within 3 months prior the enrollement * steroid therapy within 1 month prior the enrollement * and general contraindications to balneotherapy: decompensated cardiopulmonary status (unstable hypertension, earlier tromboembolia, serious arteriosclerosis obliterans, serious varicositas, etc), unbalanced endocrinological and metabolic disease, fever condition, infectious disease, extensive inflammation/injury/absence of the skin, other severe interstitial, urogenital, and other diseases, malignancy, urine and stool incontinent, decompensated psychosis and neurosis, unconsciousness, pregnancy, postoperative status, alcoholic influence, and lack of compliance.

Keywords: low back pain balneotherapy spa therapy
useability and acceptability of the cue1 device in older people with parkinson's disease

Conditions: Parkinson Disease

Summary: the cue1 device is a non-invasive wearable device for people with parkinson's disease (pd) approved for sale in the uk. the cue1 device utilises two established methods to improve motor symptoms in pd, namely pulsed cueing and vibrotactile stimulation. many people with pd wish to explore non-pharmacological interventions as an adjunct to manage their motor symptom. study design and eligibility: this feasibility study is to establish whether the cue1 device is a useable and acceptable device for older people with pd. 20-25 participants aged \>60 years with pd will be recruited from a movement disorder service to the study. methodology: participants will undertake baseline assessments of motor symptoms and quality of life with a pd nurse assessor in their own home. following this the cue1 device will be fitted and repeat assessments of motor symptoms will take place after 20 minutes. the participants will complete a daily diary of useability and acceptability for 4 weeks. a second visit will occur at 4 weeks with the same pd nurse assessor where the final set of motor symptom and quality of life assessments will be completed.


Eligibility criteria:
inclusion criteria: 1. individuals under the care of a cambridge university hospitals foundation trust movement disorder service with an established clinical diagnosis of parkinson's disease based on the uk brain bank criteria exclusion criteria: 1. co-existing significant neurological disorder (disabling stroke, multiple sclerosis, dementia, motor neurone disease), 2. atypical parkinsonian disorder diagnosis (e.g. multiple systems atrophy, progressive supranuclear palsy or cortical basal degeneration syndrome) 3. co-existing physical impairment or disability causing significant mobility impairment (severe lower limb osteoarthritis) 4. trauma or pain to the sternum 5. use of other medical device e.g. pacemaker, deep brain stimulator, tens machine etc 6. lacking capacity to consent to the study 7. sensitivity to medical adhesives 8. existing participant in intervention research trial
a study to examine serologic response in hospitalized patients receiving polyvalent pneumococcal vaccine

Conditions: Pneumonia

Summary: investigators in the division of infectious diseases and the division of hospital medicine of the george washington university medical center are carrying out a study to determine if hospitalized patients receiving the polyvalent pneumococcal vaccine during an acute illness develop an adequate antibody response. the study group will consist of individuals diagnosed with pneumonia and admitted to the medicine ward under the pneumonia core measure protocol, which assigns appropriate patients for vaccination based on the current guidelines from the advisory committee on immunization practices (acip).


Eligibility criteria:
inclusion criteria: * males or female patients ages 18 or older * diagnosis of pneumonia requiring hospitalization * admission to the medicine ward under the pneumonia core measure protocol * eligible to receive standard of care pneumococcal vaccine by the treating physician * able to receive an injection * able to provide informed consent exclusion criteria: * preexisting history of immunosuppression, to include any of the following: hiv/aids, chronic corticosteroid use, malignancy requiring myeloablative chemotherapy, hematologic malignancy, history of solid organ or stem cell transplant * pregnancy * receipt of pneumococcal vaccine within the last 5 years * prior history of hypersensitivity reaction to the vaccine * unable to return for follow-up testing
sonographic parameters and risk of antepartum hemorrhage in asymptomatic women with placenta previa: a cohort study

Conditions: Placenta Previa

Summary: the aim of this study is to evaluate the effectiveness of ultrasonographic parameters (cervical length, placental thickness and distance placental edge from internal os of the cervix) in predicting the risk of antepartum hemorrhage and emergency cesarean delivery in asymptomatic women with placenta previa.

the incidence of placenta previa is 3-5 per 1000 pregnancies worldwide and is still rising because of increased maternal age, parity, cesarean section rates, assisted reproductive technology, maternal smoking with the widespread use of transvaginal ultrasound. antepartum hemorrhage is an important cause of maternal and neonatal morbidity and mortality in pregnant women with placenta previa. however, the epidemiological characteristics are not completely understood. this study aims at evaluating the sonographic findings in asymptomatic women with placenta previa as cervical length, placenta thickness and distance from cervix to placental edge to recommend management for in-patients versus out-patient antenatal care and early planned hospital admission and delivery for women at high risk of antepartum hemorrhage and preterm cesarean section and hysterectomy for life threatening antepartum hemorrhage.

Eligibility criteria:
inclusion criteria: * asymptomatic women diagnosed with placenta previa according to rcog (gtg no. 27a, 2018): placenta lies directly over the internal os for pregnancies more than 16 weeks' gestation on transabdominal or transvaginal scanning. * gestational age between 28 till 37 weeks' gestation (as delivery should be considered between 36 and 37 weeks of gestation for women presenting with uncomplicated placenta previa) exclusion criteria: * multiple pregnancies. * threatened preterm labor or preterm rupture of membranes. * history of bleeding in the current pregnancy. * polyhydraminos (afi \> 25 cm). * history of cervical surgery (cone biopsy). * presence of cervical cerclage. * maternal use of vaginla progesterone. * history of maternal disease (hypertensive, dm, cardiac). * fetal malformation or growth restriction
understanding motivation in parkinson's patients through neurophysiology

Conditions: Parkinson Disease; Deep Brain Stimulation; Motivation

Summary: the study aims to better understand motivation and value-based decision-making in parkinson's patients through neurophysiology using medtronic's percept dbs device. by combining behavioral tasks with neural recordings, the study seeks to uncover how dbs affects motivation, particularly in relation to effort, reward, and timing.

participants will perform reward-based decision-making tasks designed to assess both self-benefitting and prosocial motivation. the tasks will evaluate how effort and reward influence decision-making, as well as how proximity to a deadline impacts choices. these tasks will be conducted in both clinic and home settings. throughout the study, participants will remain on their regular dopaminergic medications. each participant will complete sessions under two stimulation conditions: their usual dbs settings and with dbs turned off. neural activity will be recorded using the percept device, which enables real-time and chronic at-home data streaming. additionally, participants will wear a device that captures movement, sleep, heart rate variability, and self-reported measures. the primary outcomes are behavioral: changes in reaction time, acceptance rate, and success rate across different dbs conditions. the secondary outcomes focus on identifying neural oscillatory biomarkers time-locked to specific decision-making events. by linking brain activity to motivational behavior, this study aims to advance our understanding of non-motor symptoms in pd and inform the development of adaptive dbs algorithms targeting these symptoms.

Eligibility criteria:
inclusion criteria: * has parkinson's disease or dystonia * has medtronic percept or rc+s dbs device implanted in either gpi or stn * has dbs device implanted either bilaterally or unilaterally * male or female * more than 1 month post-dbs surgery exclusion criteria: * severe cognitive impairments * has moca score below 20 * pregnancy * age less than 18 years old

Keywords: parkinson's medtronic percept dbs deep brain stimulation parkinson's disease parkinson disease pd reward-based decision making task
point-of-care pharmacogenomic testing to optimize isoniazid dosing for tuberculosis prevention

Conditions: Tuberculosis Infection; Isoniazid Adverse Reaction

Summary: this trial is designed to determine whether modifying the dose of isoniazid for individuals according to their n-acetyltransferase 2 (nat2) genotype could increase the probability of achieving equivalence of area-under-the-curve.


Eligibility criteria:
inclusion criteria: * eligible for latent tuberculosis treatment by brazil's national guidelines\* * provides written informed consent to participate in the study exclusion criteria: * evidence of active tuberculosis or currently under evaluation for active tuberculosis * receiving drugs that interact with rifapentine (e.g. methadone, warfarin) * known intolerance or hypersensitivity to isoniazid or rifapentine * prior treatment for active or latent tuberculosis \> 14 days * close contact to isoniazid- or rifampicin-resistant tuberculosis (tb) case * neutropenia (absolute neutrophil count \<1000 cells/mm3) * clinical diagnosis of active liver disease or alcohol dependence * alanine aminotransferase (alt) or aspartate aminotransferase (ast) \>3 times the upper limit of normal
studies on the h pipelle, a new device for endometrial sampling at hysteroscopy

Conditions: Abnormal Uterine Bleeding

Summary: the investigators have developed a novel instrument for taking endometrial biopsies at no touch (vaginoscopic) hysterectomy which avoids the need to instrument the vagina with speculums and tenaculums, and also avoids the possible need for cervical dilatation. the investigators wish to study the ease of use and efficacy of the new device compared with traditional techniques of endometrial sampling at hysteroscopy.

we have developed a novel instrument for taking endometrial biopsies at no touch (vaginoscopic) hysterectomy which avoids the need to instrument the vagina with speculums and tenaculums, and also avoids the possible need for cervical dilatation. we wish to study the ease of use and efficacy of the new device compared with traditional techniques of endometrial sampling at hysteroscopy in terms of biopsy adequacy, the time taken to obtain a biopsy and patient experience.

Eligibility criteria:
inclusion criteria: * indication to carry out diagnostic hysteroscopy * agrees and is suitable for outpatient/office hysteroscopy exclusion criteria: * failed outpatient/office hysteroscopy

Keywords: menorrhagia uterine fibroids endometrial polyps endometrial cancer
global safety and efficacy registration study of crinecerfont in pediatric participants with classic congenital adrenal hyperplasia (cahtalyst pediatric study)

Conditions: Congenital Adrenal Hyperplasia

Summary: this is a phase 3 study to evaluate the efficacy, safety, and tolerability of crinecerfont versus placebo administered for 28 weeks in approximately 81 pediatric participants with classic congenital adrenal hyperplasia (cah) due to 21-hydroxylase deficiency. the study consists of a 28-week double blind, placebo-controlled period, followed by 24 weeks of open-label treatment with crinecerfont. subsequently, participants may elect to participate in the open-label extension (ole) period. the duration of participation in the study is approximately 14 months for the core study and will be a variable amount of time per participant for the ole (estimated to be approximately 3 years).


Eligibility criteria:
inclusion criteria: * be willing and able to adhere to the study procedures, including all requirements at the study center, and return for the follow-up visit. * have a medically confirmed diagnosis of classic cah due to 21-hydroxylase deficiency. * be on a stable steroid regimen. * have elevated androgen levels. * participants of childbearing potential must be abstinent or agree to use appropriate birth control during the study. exclusion criteria: * have a diagnosis of any of the other forms of classic cah. * have a history of bilateral adrenalectomy, hypopituitarism, or other condition requiring chronic glucocorticoid therapy. * have a clinically significant unstable medical condition or chronic disease other than cah. * have a history of cancer unless considered to be cured. * have a known history of clinically significant arrhythmia or abnormalities on electrocardiogram (ecg). * have a known hypersensitivity to any corticotropin-releasing hormone antagonist. * have received an investigational drug within 30 days before initial screening or plan to use an investigational drug (other than the study drug) during the study. * have current substance dependence or substance (drug) or alcohol abuse. * have had a significant blood loss or donated blood or blood products within 8 weeks prior to the study.

Keywords: classic congenital adrenal hyperplasia (cah) 21-hydroxylase deficiency
relative effectiveness and adverse effects of cervical manipulation, mobilisation and the activator instrument in patients with sub-acute non-specific neck pain: a pragmatic randomised trial

Conditions: Neck Pain

Summary: the primary purpose of this study was to compare the relative effectiveness of cervical manipulation, mobilisation and the activator instrument in the treatment of subacute non-specific neck pain. the secondary purpose was to describe any adverse effects of these treatments.

neck pain is a common disorder. about 70% of adults will experience neck pain during their lifetime. after low back pain, neck pain is the most common reason patients give for seeking chiropractic care, and the second most common reason for the use of spinal manipulation. usually, the underlying cause of neck pain is non-specific and cannot be related to a particular pathology as a cause of the presenting symptoms. due to the uncertainty of the results obtained in the limited number of studies of manipulation and mobilisation for neck pain, further studies are needed to compare the different therapies available for neck pain. participants in the study were treated as they would normally be with the exception of the type of spinal manipulation. there were three groups: a manipulation group, a mobilisation group, and an activator instrument group.

Eligibility criteria:
inclusion criteria: * age 18-64 years; a new or recurrent episode of neck pain present for more than 4 weeks, but no longer than 12 weeks; * neck pain that could extend to the shoulder region or upper extremities, and be accompanied by headache, but neck pain was more painful; * the patient agreed not to take medication or receive other treatment for neck pain during the course of the study (paracetamol 500 mg 4 times a day was allowed as rescue medication); * and a baseline pain level of at least 4 on the 11-point numerical rating scale. exclusion criteria: * exclusion criteria were treatment with any of the interventions during 6 months prior to recruitment to the study; specific neck pain due to fracture, neoplasm, infection, inflammatory arthropathy, radiculopathy or myelopathy; * factors contraindicating manipulation, such as blood coagulation disorders, long-term use of corticosteroids, anticoagulant medications, history of neck surgery, stroke or transient ischaemic attacks; plans to relocate; * inability to read or understand english; * and third-party liability or workers' compensation claims.

Keywords: chiropractic; osteopathic physicians; manipulation; neck pain; adverse effects; randomized clinical trial subacute non-specific neck pain
eus-guided transenteric drainage with a novel lumen-apposing metal stent

Conditions: Pancreatic Pseudocyst; Pancreatic Necrosis; Biliary Obstruction; Acute Cholecystitis

Summary: to evaluate clinical efficacy and safety of a novel lumen-apposing fcsems for eus-guided transenteric drainage of pfc or of biliary tree including gb

patients with the following conditions would be recruited for drainage under eus guidance with the new lumen apposing fcsems * symptomatic or infected pancreatic pseudocyst or walled-off necrosis (won) (spaxus 16 or 10 mm) * acute cholecystitis by inoperable malignant diseases (spaxus 10 mm) * acute cholecystitis by benign conditions with high-risk for operation (spaxus 10 mm) * long-term cholecystostomy at high-risk for operation (spaxus 10 mm) * symptomatic malignant obstruction of the distal cbd with unsuccessful transpapillary approach (the diameter of the cbd \> 10 mm) (spaxus 8 or 10 mm) outcome paramaters include technical and clinical success, adverse events.

Eligibility criteria:
inclusion criteria: patient must meet all of the following inclusion criteria to be eligible for enrollment into the study. * pancreatobiliary diseases that are eligible for eus-guided transenteric drainage * the patient who aged from 20 to 80 years. legally acceptable representative must be capable of giving written informed consent prior to participation in this study * target lesion that is accessible through the transenteric approach * the woman of child-bearing age must be negative from the pregnancy test in order to participate in this study * the patient who is willing and able to comply with the scheduled visits, treatment plan, laboratory tests, and other study procedures * the patients should not have any unacceptable conditions (e.g., physiological, familyism, social, geographical) for medical follow-up and adaptation of the study. exclusion criteria: patient presenting with any of the following will not be included in the study. * inaccessible to eus-guided approach * bleeding tendency: international normalized ratio (inr) of prothrombin time \< 1.5 or platelet conunt \< 60,000/mm3 * patients with disseminated intravascular coagulation syndrome(dic) * patients who have been taking medicines that can cause hemorrhage (e.g., aspirin, wafarin etc.) * patients with other serious disease or medical condition * patients with past medical history of significant neurologic or psychiatric disorders such as dementia or seizure * unstable heart disease despite of treatment, recent myocardial infarction within 6 month (even though mi was diagnosed within 6 months, if it becomes stable presently, the patient can be possible to participate).
seizure rescue medication: caregiver education in a simulation setting

Conditions: Status Epilepticus

Summary: 1. design an educational quality improvement program to assess the most effective educational approach on caregiver seizure rm application. the investigators hypothesize that this educational program will improve caregiver comfort, knowledge of emergent seizure care, and time to medication application. specifically, the aims include: 1. create an educational video reviewing rm administration 2. develop and validate a simulation training model/mannequin for rectal diazepam administration 3. expand training to other seizure rms (e.g. intranasal midazolam, buccal lorazepam) and transition the most effective educational model back to the clinics/bedside to standardize caregiver teaching throughout the department/hospital

the investigators will implement an intervention jointly with a simulation program to determine the most effective training model: verbal instructions, instructional video, or use of a mannequin. caregivers will undergo a training curriculum, and 60 caregivers (20 assigned to each educational model) will be matched into three groups and assigned to participate in one of three educational models in the sim center. pre-and post-training questionnaires will be distributed to assess provider knowledge and comfort level. scoring of caregiver technique administering rectal diazepam to a mannequin and time to rm administration will be obtained to compare between the three educational arms of the study. thirty additional patients (10 per group) will not receive an assessment of caregiver technique administering rm to the mannequin prior to the educational intervention to control for exposure to the mannequin. ultimately, the most effective educational method in this simulation pilot study will be expanded to other rm types (e.g. intranasal midazolam, buccal lorazepam), standardized, and brought back to the clinics/bedside throughout the hospital.

Eligibility criteria:
inclusion criteria: 1. adult caregivers of patients with epilepsy followed at bch with the following: 1. at least one seizure \>5 minutes 2. prescription for rectal diazepam rescue medication 3. admission for seizure/neurologic problem or neurology/epilepsy clinic visit during the enrollment period 2. adult caregivers of patients without epilepsy exclusion criteria: 1. adult caregivers of epilepsy patients without a rectal diazepam prescription 2. non-english-speaking caregivers