Kornimate/medical-research-clean huggingface dataset:
interbody vs instrumented posterolateral fusion following decompression for lumbar spinal stenosis with degenerative spondylolisthesis

Conditions: Degenerative Spondylolisthesis; Spinal Stenosis

Summary: degenerative spondylolisthesis describes the slip of one spinal segment relative to the adjacent segment. it is usually associated with spinal stenosis (which limits one's ability to walk and stand) and is the most common indication for surgery in adults over age 65 years. a variety of surgical techniques are available; the most common are the posterolateral instrumented fusion (plf), and interbody fusion (if) including posterolateral interbody fusion (plif), and transforaminal interbody fusion (tlif). if uses a cage that is placed within the cleaned out disc space between the vertebral bodies being fused. although this approach achieves a good fusion rate and deformity correction it is associated with a higher surgical cost and potential intra-operative complication rate. what is more, no consensus exists as to whether if provides better patient rated functional outcome and quality of life. if the advantages of if do not translate into superior patient rated outcomes, then the risk-benefit ratio would be tipped in favor of plf. the purpose of this study is to determine if if is equivalent to plf for the treatment of degenerative spondylolisthesis. the investigators will conduct a prospective randomized control trial comparing these two procedures. our primary outcome measure will be the oswestry disability index, which evaluates spinal pain and function.


Eligibility criteria:
inclusion criteria: 1. patients aged 50 years or older 2. grade i or ii (less than 50% slip of the cephalad vertebra compared to the caudal vertebra) degenerative spondylolisthesis at one or two contiguous levels between l1 and l5. 3. lumbar spinal stenosis at the same levels of the degenerative spondylolisthesis producing radiculopathy or neurogenic claudication unresponsive to a minimum of 3 months of non surgical treatment 4. patients who are medically suitable for surgical management 5. patients who have consented for surgical treatment 6. patients able to provide informed consent for the study and complete the questionnaires exclusion criteria: 1. lytic spondylolisthesis 2. non degenerative stenosis (example: tumor, trauma, epidural lipomatosis) 3. severe vertical foraminal stenosis necessitating interbody insertion to re-establish foraminal height 4. segmental kyphosis at the level of the spondylolisthesis 5. segmental scoliosis \>10 degrees at the level of the spondylolisthesis 6. rheumatoid arthritis 7. active infection 8. on long term disability or workers compensation claim 9. drug or alcohol misuse 10. lack of permanent home residence 11. previous surgery at the proposed surgical level 12. previous fusion in the lumbar spine 13. contraindication to surgery: medical co morbidities 14. unable to complete questionnaire (e.g. dementia) 15. unable to give voluntary consent

Keywords: posterolateral fusion interbody fusion lumbar spinal stenosis degenerative spondylolisthesis
different local anesthetic volumes for unilateral spinal anesthesia

Conditions: Discharge Time; Ambulatory Surgery; Spinal Anesthesia

Summary: varicose veins are irreversible and abnormal enlargement of the veins. these veins appear and there are curled swellings under the skin in the feet and legs. complaints increase when standing and sitting for long periods. for varicose veins in the initial stages, medical treatment methods such as compression socks (elastic socks) and elevating the feet as much as possible can be tried. for widespread varicose veins in more advanced stages, invasive procedures such as sclerotherapy and endovascular ablation are performed. these procedures can be performed under local, spinal or general anesthesia. spinal anesthesia; it is a type of neuraxial type of regional anesthesia characterized by injecting local anesthetic drugs into the subarachnoid space alone or together with other drugs, resulting in temporary sensory block, motor block, and sympathetic block. the local anesthetic volume administered during spinal anesthesia may affect the anesthesia levels and discharge times of the patients. for varicose vein surgeries, low-dose local anesthetic is sufficient for spinal anesthesia and can also provide early discharge. this study will compare the peri-operative effects of different doses of spinal anesthesia in patients undergoing varicose vein surgery.


Eligibility criteria:
inclusion criteria: * patients aged 18-80 years * american society of anesthesiologists (asa) score i-ii * body mass index (bmi) between 18-30 kg/m2 * patients who underwent spinal anesthesia (bupivacaine 4 mg or 6 mg) for varicose vein surgery in the operating theatre exclusion criteria: * patients under 18 and over 80 years of age * asa score iii and above * patients with a history of bleeding diathesis * patients with infection in the area to be treated * bmi below 18 or above 30 kg/m2

Keywords: local anesthetic volume varicose vein surgery ambulatory surgery spinal anesthesia
postoperative sleep disturbances after fast track hip and knee replacement

Conditions: REM Sleep Measurement

Summary: the purpose of this study is to quantify the degree of sleep disturbances after hip or knee replacement surgery. through polysomnographic monitoring the disturbances in sleep stages will be clarified.


Eligibility criteria:
inclusion criteria: * above 60 * asa classification i-iv exclusion criteria: * general anaesthesia within 90 days * daily use of sedatives * alcohol abuse * insufficient written and verbal danish * severe hearing loss and poor sight * parkinsons disease or other functional neurological deficits * mini mental status \< 24
acute effects of tocotrienols on insulin sensitivity and metabolic risk markers in individuals at risk for metabolic syndrome

Conditions: Metabolic Syndrome

Summary: objectives: to compare the acute effects of gamma delta rich tocotrienol fractions (gd-trf) on insulin sensitivity, metabolic risk markers and postprandial lipemia in individuals at risk for metabolic syndrome. hypothesis: gamma delta-rich trf will improve insulin sensitivity, metabolic risk markers and postprandial lipemia in individuals at risk for metabolic syndrome.

a randomised, double-blind, crossover trial will be undertaken to test the acute effects of supplementation of 200 mg, 400 mg gd-trf vs. placebo. there are 3 occasions for subjects to attend during postprandial period and these occasions will be separated by at least one week. on the day preceding the postprandial high fat meal challenge, subjects will be asked to avoid food high in fat, alcohol, caffeine and taking part in any strenuous exercise. subjects will be provided with a standardised low fat meal (containing \< 10 g fat) on the day preceding the postprandial study days to consume as their evening meal. they will be asked to fast overnight and instructed to avoid eating or drinking anything, except water, after 10 pm. fasting blood samples will be collected on the next day and subjects will then consume the test meal, containing 50 g test fat supplemented with gd-trf. further venous blood samples will be collected at regular intervals for up to 6 hours postprandially.

Eligibility criteria:
inclusion criteria: * age: 20-60 years * bmi ≥ 25 kg/m2 * elevated triacylglycerols ≥ 1.70 mmol/l * low hdl cholesterol \< 1.04 mmol/l (men), \< 1.30 mmol/l (women) * elevated blood pressure ≥ 130/ ≥ 85 mmhg * fasting plasma glucose ≥ 5.60 - 7.00 mmol/l * increased waist circumference ≥ 90 cm (men), ≥ 80 cm (women) exclusion criteria: * bmi ≤ 18.5 kg/m2 * current use of antihypertensive or lipid lowering, insulin/glucose modulating medication * lactose/milk intolerance * alcohol intake exceeding a moderate intake (\> 28 units per week) * smoker * pregnancy or lactation * fever, cold and infection during bleeding day

Keywords: gamma delta trf insulin sensitivity postprandial lipaemia inflammatory markers nf-κb
automated telephone outreach with speech recognition to improve diabetes care: a randomized controlled study

Conditions: Diabetes Mellitus

Summary: the purpose of this study is to evaluate the effectiveness of automated telephone outreach with speech recognition to improve diabetes care.

randomly allocate a total of 1200 health plan members with diabetes to automated telephone outreach with speech recognition (ato-sr; n = 600) or usual care (n = 600). the intervention is a series of three calls, using automated calls, originating from the health plan, using interactive speech recognition technology, spaced approximately 4-6 weeks apart, to encourage participants to fulfill the recommended testing (dilated eye examinations, glycated hemoglobin, ldl-cholesterol, microalbumin) that had not been performed received in the preceding year.

Eligibility criteria:
inclusion criteria: * age 18 years or older * diabetes, defined as either 1) filled a prescription for insulin or an oral hypoglycemic agent; or, 2) had two outpatient or one inpatient or two outpatients encounter claims with an icd9-cm or cpt code indicating diabetes. * gap in a key diabetes management metric as evidenced by no claim for a dilated eye examination in the prior 15 months and no claim for one or more of the following tests: glycated hemoglobin, ldl-cholesterol, or microalbumin. (individuals with evidence of having received ace-inhibitors or angiotensin receptor blockers were considered to have had a microalbumin test.) exclusion criteria: * no primary care clinician in the data base * those who had previously asked the health plan to exclude them from research or quality improvement * women whose claim records contained diagnoses suggesting gestational diabetes

Keywords: diabetes information technology health plans
treatment of postnatal depression for low-income mothers in primary care in santiago, chile

Conditions: Postnatal Depression

Summary: a randomized clinical trial was carried out at primary care level in santiago, chile to investigate a combined treatment for women suffering post-natal depression and preventing the adverse consequences of this illness on infant's growth and development.

background: we compared the effectiveness of a multi-component intervention with usual care to treat postnatal depression among low-income mothers in primary care clinics in santiago, chile. methods: randomised controlled trial. two hundred and thirty mothers with major depression attending postnatal clinics were randomly allocated to either a multi-component intervention or usual care. the multi-component intervention involved a psychoeducational group, treatment adherence support, and pharmacotherapy if needed. data were analysed on an intention-to-treat basis. the main outcome measure was the edinburgh postnatal depression scale (epds) at 3 and 6 months after randomisation.

Eligibility criteria:
inclusion criteria: * mothers meeting criteria for current dsm-iv major depression were eligible. exclusion criteria: * who had received any form of treatment for their depression during their current postnatal period, * those who were pregnant, * with psychotic symptoms, * serious suicidal risk, * history of mania, * alcohol or drug abuse

Keywords: postnatal depression primary care depressed women
role of us,doppler in major salivary gland diseases

Conditions: Salivary Gland Diseases

Summary: to evaluate the role of gray scale and doppler ultrasound in characterizing of parotid and submandibular gland lesions in comparison to biopsy if needed

\* salivary glands are affected by variety of disease processes which include infective, inflammatory, systemic, obstructive and neoplastic conditions . clinical examination alone will not provide the correct diagnosis of salivary gland pathologies. thus, radiological evaluation is essential in correct diagnosis . usg plays a significant and crucial role in the diagnosis and management of salivary gland lesions. results of the usg examination alone may suggest the final diagnosis or provide important differential diagnostic data . usg can differentiate intraglandular from extraglandular lesions in 98% of cases. it can differentiate salivary gland lesions as focal or diffuse. characterisation of focal lesions into benign and malignant can be done by evaluation of edges. with high resolution transducers usg is better than ct or mri in detection of unsharp borders . color doppler findings are helpful in characterising the pathologies. it is helpful in diagnosing pleomorphic adenoma. doppler findings of intralesional vascularity, type and grade of vascularity, psv, ri and pi are useful in differentiating benign from malignant tumours . pathological diagnosis can be established by fine needle aspiration cytology (fnac). fnac is preferably done under usg guidance. this helps in further enhancing ability of usg to differentiate between benign and malignant lesions . other radiological investigations for evaluation of salivary gland pathologies are plain radiography, sialography, ct, mri and pet-ct . sometimes it is not possible to visualize lesions completely on usg because of their location, extension into the deep lobe of the parotid gland or behind the acoustic shadow of the mandible in these situations, further imaging with ct or mri is necessary.

Eligibility criteria:
inclusion criteria: - patients in different age and sex groups with neck swelling, pain or any complaint related to major salivary gland detected by clinical examination. exclusion criteria: * patients who refused to sign a consent
postoperative effects of propofol versus sevoflurane anesthesia

Conditions: General Anesthetic Drug Adverse Reaction

Summary: background: the choice of appropriate anesthetics is essential to protect brain function, decrease perioperative complications, and provide high-quality care, and better quality of life. objectives: to compare the efficacy and safety of propofol versus sevoflurane in patients undergoing elective, non-cardiac operations under general anesthesia. methods: this was a randomized (1:1), parallel, phase four clinical trial; carried out on 44 patients, who were candidates for elective, non-cardiac operations under general anesthesia at our hospital. patients were randomly allocated into two equal groups in which anesthesia was maintained with propofol infusion in group p and sevoflurane inhalation in group s.


Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) physical status ≤ ii * age from 21 years * body mass index (bmi) 25-35 kg/m2 exclusion criteria: * asa physical status \> ii * age \< 21 years * patients with montreal objective cognitive assessment (moca-b) score \< 24 points * patients with significant cardiovascular, cerebrovascular, respiratory, liver, renal, endocrine, blood, or immune diseases * patients with visual or auditory disease, infection, chronic inflammation, disturbance of consciousness, cognitive impairment, or dementia * patients on long-term use of sedatives or steroids, alcohol or drug abuse * allergy to any of the study drugs

Keywords: cognitive function general anesthesia inflammatory response oxidative stress propofol sevoflurane
in-hospital initiation of pcsk9 inhibitor in patients with acute myocardial infarction

Conditions: Coronary Disease

Summary: proprotein convertase subtilisin/kexin type 9 (pcsk9) inhibitors have been shown to improve cardiovascular outcomes when added to conventional statin therapy. this study aims to investigate the efficacy and safety of in-hospital initiation of pcsk9 inhibitor among patients with acute myocardial infarction(ami) based on real-world experience. a total of 7556 ami patients from the biobank database between january 2016 and december 2020 were screened for eligibility. after excluding those without revascularization or statin based therapy, the remaining 5802 statin users, 801 statin plus ezetimibe users and 170 statin plus evolocumab users (including 95 users without and 75 users with ezetimibe), were selected for this study. then, 1st and 3rd-month follow-up data were collected and analysed, including in-hospital mortality, readmission rate and lipid profiles


Eligibility criteria:
inclusion criteria: * confirmed admission diagnosis of ami and were defined based on the universal definition criteria by the american cardiology college exclusion criteria: * (1) severe noncardiac disease with an expected survival of less than 1 year and unwillingness to participate; (2) patients over the age of 80 years or living far away from the hospital's catchment area.
slow gait speed as an indicator of overweight, dynapenic obesity and sarcopenic obesity in elderly people in the community

Conditions: Frailty; Obesity; Sarcopenia; Sarcopenic Obesity; Gait Speed

Summary: the goal of this observational study is to evaluate the relationship of gait speed with dynapenic or sarcopenic obesity in community-dwelling older people. the main questions it aims to answer are: * is slow walking speed related to overweight in older people in the community? * is slow walking speed related to dynapenic obesity in older people in the community? * is gait speed related to sarcopenic obesity in older people in the community? participants will answer a clinical interview to obtain sociodemographic data and will perform the following clinical tests: (1) 10-meter walk test, (2) anthropometric measurement; (3) handgrip dynamometry test, (4) standing dynamometry test and (5) physical functionality questionnaires.


Eligibility criteria:
inclusion criteria: * subjects over 60 years of age * female and male * self-sufficient in the instrumental activities of daily living * subjects with or without drug consumption, capable of carrying out the activity of walking independently or dependent on technical aids. exclusion criteria: * subjects with acute musculoskeletal injuries of the lower extremity.

Keywords: aged aged, 80 and over
prevention of high altitude pulmonary edema

Conditions: High Altitude Pulmonary Edema

Summary: a double-blind placebo controlled study * to compare the effect of tadalafil and dexamethasone versus placebo on ppa and pulmonary edema formation in subjects susceptible to hape. * to investigate the effect of dexamethasone on alveolar fluid clearance, as assessed by measurement of the nasal potential difference, and prevention of hape. * to investigate the effect of the tadalafil and dexamethasone versus placebo on the dynamic cbf autoregulation properties and on the development of ams in hape susceptible subjects.


Eligibility criteria:
inclusion criteria: * at least one previous episode of high altitude pulmonary edema exclusion criteria: * pulmonary arterial hypertension * congenital heart disease * any chronic lung disease
evaluation of full versus fractional doses of covid-19 vaccines given as a booster in adults in australia - mongolia, indonesia, australia coronavirus (miacov).

Conditions: COVID-19

Summary: this is a single-blind, randomised controlled clinical trial to determine the reactogenicity and immunogenicity of severe acute respiratory syndrome-coronavirus-2 (sars-cov-2) vaccines (pfizer-biontech or moderna) as booster dose in adults, who have previously received either pfizer-biontech or astrazeneca as their primary doses. both fractional and standard doses of pfizer-biontech or moderna will be tested. the trial intervention will be given in line with australian technical advisory group on immunisation (atagi) recommendations for booster vaccine doses which allows booster doses from 5 months onwards . there will be a total of 8 groups, with 100 individuals of even spread of participants above and below 50 years in each group. the trial will be single site, based at royal children's hospital, melbourne, australia

as per brief summary

Eligibility criteria:
inclusion criteria: 1. have completed two doses of pfizer-biontech or astrazeneca vaccines with the recommended schedule 6 months prior to the date of enrolment 2. willing and able to give written informed consent 3. aged 18 years or above 4. willing to complete the follow-up requirements of the study exclusion criteria: 1. received 3 doses of covid-19 vaccine 2. received 2 doses of covid-19 less than 6 months prior to the start of the trial 3. received a different covid-19 vaccine not available in australia 4. currently on immunosuppressive medication or anti-cancer chemotherapy 5. hiv infection 6. congenital immune deficiency syndrome 7. has received immunoglobulin or other blood products in the 3 months prior to vaccination 8. study staff and their relatives 9. have a history of a severe allergic reaction to any covid-19 vaccines or have a medical exception to receiving further covid-19 vaccines 10. cannot read or understand english

Keywords: booster dose moderna pfizer fractional and standard doses covid-19 vaccination mrna vaccine
polycystic ovary syndrome and liraglutide

Conditions: PCOS; Obesity

Summary: the purpose of this study was to determine whether liraglutide is more effective than metformin in the treatment of obese women with newly diagnosed polycystic ovary syndrome (pcos). we anticipated greater changes in body weight in patients treated with liraglutide than in those treated with metformin.


Eligibility criteria:
inclusion criteria: * 18 years old to menopause * polycystic ovary syndrome (nichd criteria) * bmi of 30 kg/m² or higher exclusion criteria: * type 1 or type 2 diabetes mellitus * history of carcinoma * cushing's syndrome or congenital (non-classic) adrenal hyperplasia * personal or family history of men 2 * significant cardiovascular, kidney or hepatic disease * the use of medications known or suspected to affect reproductive or metabolic functions * the use of statins, within 90 days prior to study entry

Keywords: pcos obesity glp-1 receptor agonist liraglutide metformin
randomized study on adjuvant chemotherapy and adjuvant chemo-immunotherapy in colon carcinoma dukes c

Conditions: Colon Cancer Stage III

Summary: this clinical investigation examined the effectivity 5-fluorouracil, of adding levamisol or interferon to 5-fluorouracil, and of a 5-fluorouracil/levamisol/interferon triple combination, in terms of recurrence-free and overall survival in curatively operable colon carcinoma stage iii.


Eligibility criteria:
inclusion criteria: * patients with histologically verified, curatively operated colon carcinoma stage iii (r0, t1-4, n1-3, m0) * age: less than 80 years * who performace status \> 2 * adequate bone marrow reserve * informed consent exclusion criteria: * rectal cancer * r1, r2, carcinosis peritonei * start of chemo- or chemo-immunotherapy \> 42 days postop; other adjuvant radiotherapy, chemotherapy or immunotherapy * serious concomitant disease, in particular chronically inflammatory large intestine, cardiopathic disease, malignant second carcinoma

Keywords: fluorouracil levamisol interferon colon cancer