Kornimate/medical-research-clean huggingface dataset:
plaque reversal with early, aggressive lipid lowering therapy

Conditions: Coronary Artery Disease Progression

Summary: this study evaluates whether plaques in young patients with familial hypercholesterolemia (aged below 50 years) are susceptible to significant plaque regression with early, intensive lipid lowering therapy.


Eligibility criteria:
inclusion criteria: * diagnosed with heterozygous familial hypercholesterolemia * adult between 18 and 50 years old * ldl cholesterol levels above 100 mg/dl (\>2.6 mmol/l) at inclusion exclusion criteria: * renal insufficiency, defined as egfr \< 30 ml/min * history of atherosclerotic cardiovascular events * atrial fibrillation * any other treatment or clinically relevant condition that could interfere with the conduct or interpretation of the study in the opinion of the investigator * inability or unwillingness to comply with the protocol requirements, or deemed by investigator to be unfit for the study.
bupivacaine in tonsillectomy

Conditions: Pain, Postoperative

Summary: a placebo-controlled and double-blind study is planned according to current legislation and ich gcp guidelines with 80 patients at nordland hospital, bodø. fifty percent are randomized to receive bupivacaine 5 mg / ml on the gauze swabs used to stop the bleeding after tonsillectomy, and 50% receive 0.9% sodium chloride. pain at rest and pain when swallowing according to numerical rating scale (0-10), as well as the presence of the following symptoms (yes / no): nausea, vomiting, food intake, bleeding, fever, need for extra painkillers in the form of morphine or similar will be registered 1, 2, 3, 4, 5, 6 hours and 1, 2 4 and 6 days after the operation. differences are analyzed with "mixed models" statistics and the results will be published in a peer-based journal.


Eligibility criteria:
inclusion criteria: all patients undergoing isolated tonsillectomy from the age of 5 years to 40 years exclusion criteria: 1. known allergy to local anesthetics. 2. patients using painkillers in the form of opioids fixed before inclusion in the study. people who have a lot of pain often have more pain after known painful stimuli, such as surgery. this is known as the phenomenon of "central sensitization" and "opioid-induced hyperalgesia" and will probably contribute to great heterogeneity within the groups. because very few people use opioids regularly from those who have an isolated tonsillectomy performed, it can make it difficult to detect any differences between the groups, and the number is far too low to be able to perform stratified analyzes on only these people. 3. persons weighing less than 10 kg. 4. persons over the age of 18 who are not competent to give consent. 5. patients using class ib antiarrhythmics (lidocaine, mexiletine) due to increased risk of additive toxicity due to structural similarities. (see spc) 6. known partial or total heart block that has not had a pacemaker inserted (see spc) 7. severe hepatic failure (spontaneous prothrombin time -international normalized ratio (pt-inr)\> 2.0). these patients are not offered this type of procedure as day surgery due to the high risk of complications for the surgery itself. 8. severe renal failure (estimated glomerular filtration rate \<15 ml / min / 1.73m2).
teriparatide for improved knee prosthesis fixation

Conditions: Osteoarthritis of the Knee

Summary: the investigators will study how well knee joint prostheses become fixed to the bone when patients get teriparatide, compared to placebo. measurements will use high resolution 3d radiography (radiostereometry, rsa).


Eligibility criteria:
inclusion criteria: * osteoarthritis of the knee planned for prosthesis surgery exclusion criteria: * poor health, drugs affecting bone metabolism.
mobilization with movement technique on the stiffness of cervical muscles in individuals with mechanical neck pain

Conditions: Neck Pain

Summary: mobilisation with movement (mulligan sustained natural apophyseal glides (snag)). method has been shown to have significant effects on pain, joint range of motion, and functionality in patients with neck pain. however, there is a lack of studies examining the effects of this technique on muscle stiffness associated with neck pain. considering the immediate effects of a single session of lumbar snag application on lumbar muscle stiffness in patients with low back pain, it raises curiosity about the effects it would have on cervical spinal segments and surrounding muscles. the aim of this study is to investigate the immediate effects of mulligan snag application on muscle stiffness, pain, and joint range of motion in patients with mechanical neck pain.

this study is designed as a parallel double-blind randomized controlled trial. patients will be divided into two groups: the mobilization with movement group (mmg) and the sham group (sg). the mmg will receive cervical mobilization (snag) treatment. the sg, on the other hand, will receive active joint movements without the 'sliding' motion applied to the spinal segment. prior to and immediately after the intervention, participants will undergo myometric evaluation of neck muscles, joint range of motion measurements, and pressure pain threshold measurements bilaterally, followed by assessment of the individual's pain and level of disability using questionnaires related to pain and pain-associated disability. a 2-minute break will be provided after the intervention before reassessment is conducted. patients will not be followed up.

Eligibility criteria:
inclusion criteria: * having widespread neck pain lasting more than 3 months * pain symptoms that increase with neck movements or palpation * volunteering to participate in the study exclusion criteria: * history of neck trauma * previous cervical surgery * cervical radiculopathy or myelopathy * fibromyalgia syndrome diagnosis * any physiotherapy intervention in the previous 12 months * sign of vertebrobasilar insufficiency * upper cervical spine ligament instability * those using steroids or muscle relaxants

Keywords: neck pain manual therapy sham treatment
mechanisms of refractory hypertension (carvedilol)

Conditions: Hypertensive

Summary: the purpose of this protocol is test whether patients with hypertension refractory to antihypertensive treatment have evidence of excessive sympathetic (i.e., nervous system) activity.

refractory hypertension refers to high blood pressure that is failing conventional antihypertensive therapies. in a retrospective assessment of such patients in our clinic we observed that resting clinic heart rates were higher in patients with refractory hypertension compared to patients with controlled hypertension. this observation has led to the hypothesis that refractory hypertension is caused by excessive sympathetic output. this protocol is designed to test this hypothesis by comparing the bp response to carvedilol verses chlorthalidone in patients with refractory hypertension. if their extreme treatment resistance is neurogenic is etiology, a significantly larger bp response to carvedilol should occur compared to chlorthalidone.

Eligibility criteria:
inclusion criteria: * uncontrolled clinic bp (\>140/90 mmhg) * receiving 5 or more antihypertensive agents including an ace inhibitor or arb, calcium channel blocker, and chlorthalidone 25 mg exclusion criteria: * current use of an alpha or beta or combined alpha-beta antagonist * known allergy to alpha-beta antagonists * ckd (egfr \<40 ml/min/m2) * mi, stroke or episode of chf exacerbation within 3 months * bradycardia \<50 bpm; history of 2nd or 3rd degree heart block unless treated by a pacemaker * pregnant or breast-feeding women * known hypersensitivity to chlorthalidone or other sulfonamide-derived drugs
letrozole versus clomifene citrate for ovulation induction

Conditions: Infertility; Polycystic Ovarian Syndrome

Summary: the primary aim of the study is to assess the efficacy of letrozole as an ovulation induction agent and to test the hypothesis that letrozole will generate better pregnancy rates with fewer multiple pregnancies and higher live birth rate than the current standard agent, clomifene citrate in anovular infertile women with polycystic ovarian syndrome.


Eligibility criteria:
inclusion criteria: 1. age: 18 - 39 2. bmi \< 36 3. infertility due to anovulation 4. pcos: at least two of the following diagnostic criteria of: 1. oligo/amenorrhoea 2. hyperandrogenaemia: biochemical (testosterone ≥2.5 nmol/l or free androgen index (fai) ≥ 5) or clinical (acne/hirsutism) evidence 3. uss evidence of pco (either ≥12 follicles measuring 2-9 mm in diameter, or an ovarian volume of \> 10 ml) 5. no recent (within 6 months) treatment for induction of ovulation 6. normal semen analysis (who 1999) 7. proven patency of at least one fallopian tube exclusion criteria: 1. inability to give informed consent 2. contraindication to letrozole or clomifene citrate 3. absence of any inclusion criteria

Keywords: anovulation ovulation induction, polycystic ovarian syndrome clomifene citrate letrozole
electrolytes disturbances in critically ill egyptian patients

Conditions: Electrolyte Imbalance

Summary: all selected individuals will be subjected to the following: 1. full medical history taking 2. full clinical examination, apache ii score on admission 3. electrolytes panel daily on icu admission 4. estimate the duration of stay at icu also all selected individuals will be sectioned into groups regarding sites of collection (surgical icu, ccu and medical icu). all collected individuals will be sectioned regarding electrolytes imbalance into mild, moderate and severe groups

study procedures: all selected individuals will be suffering from electrolyte imbalance (ei) with the following data will be obtained: o measurements: 1. demographic data: age - gender - bmi - electrolytes data on icu admission 2. vital data: heart rate - respiratory rate - blood pressure measurement - oxygen saturation - urinary output - temp +/- cvp measurement. 3. lab.: "cbc - kidney function tests - liver function tests - abg - levels of serum sodium, potassium, magnesium, phosphorus, ionized calcium and chloride", with maximum 5 mm blood sampling per day. serum-sodium levels will be corrected for serum-glucose by lowering the sodium concentration by 2.4 mmol/l for every 100 mg/dl increase in glucose. corrected sodium = measured sodium + 0.016 (serum glucose - 100) a correction formula was also used to calculate albumin-corrected calcium levels (mmol/l) corrected calcium = (0.8 (normal albumin - pt's albumin)) + serum ca 4. apache ii score 5. comorbidities 6. complications: aki- acute myocardial infarction 7. duration of icu stay 8. duration of hospital stay 9. outcome (regarding eventual complications: aki- acute myocardial infarction)

Eligibility criteria:
inclusion criteria: - all patients admitted to medical icu, surgical icu and ccu suffering from electrolyte imbalance (ei) over 18 years with the comorbid conditions : 1. hypertension 2. heart failure 3. chronic chest diseases 4. cancers 5. chronic kidney disease 6. diabetes mellitus 7. cardiac dysrhythmias 8. pneumonia 9. sepsis 10. dehydration 11. critical bones fractures exclusion criteria: * patients with 1. age less than 18 year old 2. patient or his 1st degree relatives refuse to participate 3. patients without electrolytes data 4. current smoking

Keywords: electrolytes egyptian
pacifiers and breastfeeding among mothers at risk for postpartum depression

Conditions: Breastfeeding; Postpartum Depression

Summary: we will enroll 40 mother-infant dyads in a randomized trial exploring the effect of distribution of pacifiers during the birth hospitalization to mothers at high risk for postpartum depression on pacifier use, infant feeding, and maternal stress.

this study is a pilot a randomized controlled trial to determine if pacifier distribution affects breastfeeding among mothers at high risk for postpartum depression. we will recruit 40 mothers of healthy singleton births in a u.s. hospital who are at high risk of postpartum depression and randomly assign them to receive a pacifier or not. we will ascertain pacifier use, maternal stress, and infant feeding behaviors with web-based surveys at 2, 4, 6, 12, 18, and 24 weeks. mothers will also wear a wristband to detect maternal heart rate variability throughout the first 6 weeks as a marker of maternal stress.

Eligibility criteria:
inclusion criteria: * breastfeeding mother/infant dyad, receiving postpartum care at uc davis medical center, maternal personal or family history of depression or postpartum depression, mother 18-45 years of age, infant 12-72 hours of age exclusion criteria: * infant without congenital anomalies that could affect feeding (cleft lip/palate, chromosomal anomaly, micro or retrognathia), infant preterm (born prior to 37 weeks' gestation), mother unable to participate in english, infant admitted to the neonatal intensive care unit, no smart phone

Keywords: pacifier
effect of nonsurgical periodontal therapy on salivary biomarkers related to bone turnover in smoker and nonsmoker periodontitis patients

Conditions: Non Surgical Periodontal Therapy

Summary: 1. to assess the alteration in the level of salivary osteopontin (opn), osteonectin(on) and histatin-1 following nspt in smoker and nonsmoker unstable periodontitis patients at different time intervals(one month and three months) . 2. to evaluate the response of clinical periodontal parameters ( plaque index ,bleeding on probing ,probing pocket depth ,clinical attachment loss)following nspt in smoker and nonsmoker unstable periodontitis patients at different time intervals (one month and three months)

the study include nonsurgical periodontal therapy for smoker and non smoker patients with unstable periodontitis and evaluate the clinical periodontal parameters ( plaque index, bleeding on probing , probing pocket depth ,clinical attachment loss) and assess the alteration in the level of salivary osteopontin (opn), osteonectin(on) and histatin-1 following nspt in smoker and nonsmoker unstable periodontitis patients at different time intervals(one month and three months)

Eligibility criteria:
inclusion criteria: * participants will be systemically healthy without history of any systemic diseases. * hadn't underwent periodontal treatment during the previous 6 months and not taken medication during the previous 3 months. * present with at least 20 teeth, those who only diagnosed with 4-6 mm probing pocket depth, generalized ,unstable periodontitis who had bone loss \> 30% , probing probing pocket depth at ≥4mm . periodontitis cases were defined if clinical attachment loss was detected at ≥2 non- adjacent teeth or when buccal (facial) showed clinical attachment loss ≥3mm associated with probing pocket depth \>3mm at ≥ 2 teeth . * the patients in the smokers group will be current smokers ( cigarette smokers) with smoking habit for over 3 years exclusion criteria: * subjects have any intraoral plaque retentive factors such as those wearing partial denture, crown and bridges, and orthodontic appliances ,furcation involved teeth, overhang filling, tooth anomaly. * receiving antibiotic therapy during the previous 3 months. * those with systemic diseases such as diabetes mellitus, cardiovascular or renal diseases, etc...., pregnant or lactating women, not willing to participate or continue to conduct the study.

Keywords: osteonectin osteopontin histatin1
understanding the mechanisms of clonal and non-clonal cytopenia following car-t therapy for multiple myeloma or cd19+ lymphoproliferative disorder (lpd)

Conditions: Lymphoproliferative Disorder; Multiple Myeloma

Summary: this clinical trial evaluates the impact of preexisting and therapy-emergent germline and somatic variants on cytopenia in patients with multiple myeloma or cd19 positive lymphoproliferative disorder (lpd) following chimeric antigen receptor t-cell (car-t) therapy. the most common adverse event after car-t therapy is lower than normal blood cells (cytopenia) and up to one third of patients experience cytopenia that last longer than 30 days post-infusion. germline and somatic variants are changes in genes found using cancer genomic tests. cancer genetic/genomic testing is a series of tests that find specific changes in cancer cells or in blood deoxyribonucleic acid. identifying gene mutations may help identify the risk of cytopenia in patients with multiple myeloma or cd19 positive lpd following car-t therapy.

primary objective: i. determine the preexisting and therapy-emergent germline and somatic variants associated with an increased risk of clonal and non-clonal cytopenia following car-t cell therapy. secondary objective: i. characterize the baseline transcriptomic signature associated with non-clonal and clonal cytopenia following car-t therapy. outline: patients undergo bone marrow aspiration and hair, buccal, and saliva sample collection up to 14 days prior to lymphodepleting (ld) therapy. patients undergo clinical follow-up (cfu) on day 90 post-car-t therapy. patients with unexplained cytopenia also undergo bone marrow aspiration for sequencing analysis on day 90 and at development of myeloid neoplasm post-cytotoxic therapies (mn-pct) during cfu. patients also undergo bone marrow aspiration at determination of clonal evolution or myeloid neoplasm if not done during on day 90. additionally, patients a receive genetic counselor consultation on study. patients with unexplained cytopenia at day 90 are followed up every 90 days for up to 2 years until resolution. patients without unexplained cytopenia are followed clinically for up to 2 years.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * histologically or cytologically confirmed diagnosis of multiple myeloma (mm) as defined in international myeloma working group (imwg) criteria or a cd19+ lymphoproliferative disorder (lpd) as defined by 2016 world health organization (who) classification * provide written informed consent * willingness to provide mandatory bone marrow aspirate specimens for correlative research. all bone marrow aspirate samples are collected during a clinical procedure * willingness to provide mandatory hair follicle specimens for correlative research * willing to return to enrolling institution for follow-up (during the active monitoring phase of the study) * willingness to provide saliva and buccal samples for research exclusion criteria: * ineligible for car-t therapy * patients diagnosed with myeloid neoplasm before car-t therapy
study of the intravitreal implantation of nt-503-3 encapsulated cell technology (ect) for the treatment of recurrent choroidal neovascularization (cnv) secondary to age-related macular degeneration (amd)

Conditions: Macular Degeneration

Summary: prospective, multi-center 2-stage study. stage 1 (phase i) is open-label with all patients treated with the nt-503-3 ect implant. stage 1 (phase i) patients will undergo explantation at year 2. those who, in the opinion of the investigator, are still candidates for continued anti-vegf therapy will be re-implanted with a new nt-503-3 investigational product and followed for an additional 12 weeks before study exit. stage 2 (phase ii) is a separate, randomized, masked phase during which eligible patients will be randomized to the nt-503-3 group or the control group. clinical hypotheses: * nt-503-3 ect is comparable to eylea® injected intravitreally every 8 weeks in the prevention of vision loss due to recurrent cnv secondary to amd * nt-503-3 ect has an acceptable safety profile


Eligibility criteria:
key inclusion criteria: * diagnosis of active (recurrent or persistent) subfoveal cnv lesions secondary to amd in the study eye * prior intravitreal anti-vegf injections key exclusion criteria: * significant subretinal hemorrhage * significant scar and/or, fibrosis * suspected polypoidal choroidopathy, or pigment epithelial tears or rips * inadequate response to anti-vegf therapy

Keywords: wet amd wet age related macular degeneration recurrent cnv secondary to amd active subfoveal cnv
safety and immunogenicity study of quadrivalent influenza virus vaccine in healthy people aged years 3-60

Conditions: Quadrivalent Influenza Virus Vaccine

Summary: this study evaluates the safety and immunogenicity of the quadrivalent influenza virus vaccine in healthy people aged years 3-60.subjects will be randomly divided into 3 groups,receiving the test vaccine, commercially available trivalent influenza vaccine and trivalent influenza vaccine containing new influenza b component respectively. each group has 800 subjects,2400 in total.


Eligibility criteria:
inclusion criteria: * healthy subjects more than 3 years old, and the subjects can be informed consent, and sign the informed consent. * the subjects and his guardians can obey the demands of the scheme . * axillary temperature less than 37℃ exclusion criteria: * the people who has flu or influenza-like symptoms(fever \ , cough or sore throat) within 3 months * the people who has vaccinated influenza vaccine in 3years. * the people who has a vaccine allergies, or who allergic to any kind of composition in experimental vaccine, such as eggs, ovalbumin etc. * the people who has serious side effects to vaccine, such as allergy, urticaria, skin eczema, dyspnea, angioneurotic edema or abdominal pain. * the subject who has symptoms of acute infection within a week. * autoimmune diseases or immune function defect, people has immunosuppressive therapy, cytotoxic treatment or inhaled corticosteroids in the past 6 months. * people has congenital malformations, developmental disorder or serious chronic diseases( such as down's syndrome, diabetes, sickle cell anemia or nerve system disease) * people has asthma unstable that need emergency treatment, hospitalization, intubation, oral or intravenous corticosteroid in the past 2 years. * diagnosed abnormal coagulation(lack of clotting factors,clotting disorders,platelet abnormality) or significant bruising or coagulopathy * people has history or family history of convulsions, seizures, encephalopathy and psychiatric. * alienia, functional asplenia, and alienia or splenectomy in any situation. * serious neurological disorders such as green barry syndrome. * people who has received blood products or immunoglobulin products in the past one months. * people who has received other study drug in the past one month. * people who received live attenuated vaccine, subunit vaccine or inactivated vaccine. * people who has received allergy treatment in in the past 14 days. * people who is on anti-tb treatment. * people whose axillary temperature is more than 37℃ before the vaccination. * people who is pregnant. * any factors unsuitable for clinical trail according to the researchers.

Keywords: vaccine safety immunogenicity