Kornimate/medical-research-clean huggingface dataset:
twice weekly steroids and exercise as therapy for dmd

Conditions: Duchenne Muscular Dystrophy (DMD)

Summary: the study team will determine the potential of low dose twice weekly prednisone and whether exercise training can synergize to delay disease progression and improve muscle strength/physical function in boys with duchenne muscular dystrophy (dmd). current standard of care (daily prednisone) is associated with adverse side effects. evidence from dmd mouse models suggest that weekly dosing provides same efficacy without side effects. appropriate exercise may also benefit but this area has not been adequately explored.


Eligibility criteria:
inclusion criteria: * diagnosis of dmd confirmed by 1) clinical history with features before the age of five, 2) physical examination, 3) elevated serum creatine kinase level and 4) absence of dystrophin expression, as determined by immunostain or western blot (\<2%) and/or dna confirmation of dystrophin mutation. * age 5.0 to 9 years: a lower age limit of 5.0 years is selected as children younger than that are likely unable to cooperate and comply with all of the exercise measures as needed. an upper age limit of 9 years has been set as boys with dmd tend to reach a rapid progression into a late ambulatory phase soon after this age. * ambulatory at the time of the first visit, defined as the ability to walk for at least 100 m without an external assistive device and able to climb four stairs. * aim 1 only: gc-naïve at baseline (and prior 6 months) * aim 2 only: on stable daily gc regimen for 6 months prior to baseline exclusion criteria: * contraindication to an mr examination (e.g. aneurysm clip, severe claustrophobia, magnetic implants) * presence of unstable medical problems, significant concomitant illness including cardiomyopathy or cardiac conduction abnormalities * presence of a secondary condition that impacts muscle function or muscle metabolism (e.g. myasthenia gravis, endocrine disorder, mitochondrial disease) * presence of a secondary condition leading to developmental delay or impaired motor control (e.g. cerebral palsy) * presence of an unstable medical condition (e.g. uncontrolled seizure disorder) * behavioral problems causing an inability to cooperate during testing or understand exercise instruction * participation in other forms of drug or gene therapy during the period of the study

Keywords: steroid side effects, low dose steroid regimen, exercise training therapy
the efficacy and safety of atacicept in combination with mycophenolate mofetil used to treat lupus nephritis

Conditions: Lupus Nephritis

Summary: the purpose of this study is to learn whether atacicept treatment leads to improvement in kidney function in subjects with active lupus nephritis in combination with mycophenolate mofetil (mmf) and corticosteroids. the study was sponsored by merck serono international; operational oversight was provided by zymogenetics.


Eligibility criteria:
inclusion criteria: * diagnosis of systemic lupus erythematosus (sle) satisfying at least 4 out of the 11 american college of rheumatology (acr) criteria (appendix b) * renal biopsy performed consistent with active international society of nephrology/renal pathology society (isn/prs) class iii or iv lupus nephritis exclusion criteria: * estimated glomerular filtration rate (gfr) less than or equal to (\<=) 30 milliliter per minute (ml/min) per 1.73 square meter (m\^2) * active central nervous system sle deemed to be severe or progressive and/or associated with significant cognitive impairment * any treatment with mmf, azathioprine, or cyclophosphamide within the last 6 months, or known hypersensitivity to mmf or atacicept. * any prior treatment with abatacept, rituximab, belimumab, or other b cell modulating agents.

Keywords: nephritis atacicept
acetyl-l-carnitine supplementation during hcv therapy with peg ifn-α2b plus ribavirin: effect on work performance.

Conditions: Quality of Life; Daily Activity; Fatigue

Summary: to assess the effects of acetyl-l-carnitine, probiotics and antioxidant nutritional substances administration on work productivity, daily activity, and fatigue in subjects with chronic hepatitis c treated with pegylated-interferon-α2b and ribavirin.


Eligibility criteria:
inclusion criteria: * eligible patients are workers who are 18 years of age or older, infected by hcv with a quantifiable serum hcv rna level (as determined by polimerase chain reaction, cobas ampliprep/cobas taqman - roche). hcv infected populations must have elevated serum alanine transaminase levels and findings on liver biopsy consistent with chronic infection. cirrhotic patients have to have a child-pugh score less than 7 to be eligible. exclusion criteria: * ineligible patients are those who had other liver diseases, as well as those who are affected by cancer, severe jaundice, pulmonary and renal chronic diseases, prostatic diseases, autoimmune diseases and diabetes mellitus. excessive use of alcohol (\>20 g/die) or hepato-toxic drugs. other causes of exclusion include decompensated cirrhosis, pregnancy, and contraindications for peg-ifn-a or rbv therapy such as cardiopathy, hemoglobinopathies, hemocromatosis, major depression or other severe psychiatric pathological conditions.

Keywords: acetyl-l-carnitine interferons ribavirin hepatitis c fatigue
role of nitric oxide in diabetic patients with erectile dysfunction

Conditions: Erectile Dysfunction; Diabetes Mellitus

Summary: erectile dysfunction (ed) is defined as penile erection that is insufficient and unsustainable for a satisfactory sexual performance. the etiology of ed is multifactorial including chronic diseases such as hypertension, diabetes mellitus and coronary artery disease however, the main underlying cause is degenerative changes that result in endothelial dysfunction

diabetes leads to endothelial dysfunction and a pro-inflammatory state, which reduces the usability and activity of nitric oxide (no). no is a powerful force for sustaining penile blood flow. diabetes is an estab¬lished risk factor for sexual dysfunction in men; a three-fold increased risk of erectile dysfunction (ed) was documented in diabetics compared with non-diabetic men. in smooth muscles, no activates guanyl cyclase and increases cyclic guanosine monophosphate (cgmp) concentration. cgmp activates certain intracellular protein kinases that phosphorylate receptor proteins. activated protein kinases open the potassium channels and increase the influx of potassium and block the influx of calcium by inhibiting calcium channels. this leads to hyperpolarization and relaxation of smooth muscle. reduced arteriolar resistance leads to sinusoidal spaces filled with blood. these enlarged sinusoids further increase the intracavernosal pressure by blocking the venous return and producing a rigid erection. cgmp is converted to gmp by phosphodiesterase, which is inhibited by phosphodiesterase 5 (pde-5) inhibitors. (no) has vasodilatory properties and balances rhoa/rho-kinase-mediated vasoconstriction, which is a predominant mediator of the physiologic induction and maintenance of erections. evidences show that functional polymorphisms within endothelial no synthase (enos) gene interfere with normal erectile function. in humans, the enos gene is located on chromosome 7q35-36 and consists of 26 exons spanning 21 kilobases (kb). several polymorphisms of enos have been investigated. more frequently, investigated regions of this gene include a variable number of 27 bp tandem repeats in intron 4 (vntr), g894t (rs1799983) polymorphism in exon 7 and a t-786c (rs2070744) polymorphism in the promoter region

Eligibility criteria:
inclusion criteria: 1. diabetic patients with ed. 2. using tadalafil 5mg exclusion criteria: 1. patients with history of pelvic trauma or major pelvic surgical intervention. 2. patients with hypogonadism and hyperprolactinemia. 3. patients with chronic liver disease or cardio vascular system diseases. 4. history of chronic intake of central nervous system, anti-androgen drugs or other drugs as tramadol. 5. smokers. 6. patients with non-vasculogenic erectile dysfunction
sem evaluation of the quantity of microrepair® on resin composite surfaces: an in vivo randomized clinical trial.

Conditions: Dental Caries; Dental Fillings

Summary: the aim of this study is to evaluate the quantity of biorepair total protection toothpaste on composite surfaces inside oral cavity. three orthodontic lingual buttons are bonded on the vestibular surfaces of upper right premolars (1.4 and 1.5) and upper right first molars (1.6) of volunteers. a composite resine is applied upon them. then, after 7 days, 1.4 button will be debonded; after 15 days, 1.5 button are debonded; in the end, after 30 days the last button (1.6) is debonded. the buttons will be stored in sterile environment and then sent to laboratory for sem evaluation.

orthodontic buttons are bonded on the vestibular surfaces of the upper right premolars (1.4 and 1.5) and the upper right first molar (1.6). a composite resin is polymerized on the top of the buttons. then, participants are divided into two groups. * trial group: participants from this group will receive a manual toothbrush and biorepair total protection toothpaste for home oral hygiene after lunches. * control groups: participants from this group will receive a manual toothbrush and sensodyne repair \& protect for home oral hygiene after lunches. after 7 days from the procedure of bonding, the buttons on upper right first premolars (1.4) are debonded. after 15 days from the procedure of bonding, the buttons on upper right second premolars (1.5) are debonded. in the end, after 30 days from the procedure of bonding, the buttons on upper right first molars (1.6) are debonded. debonded buttons are then stored in sterile environment at 2-3°c temperature; successively, they are sent to laboratory for sem evaluation.

Eligibility criteria:
inclusion criteria: * adult patients * no current orthodontic treatment during the study * no use of occlusal splint or retention device exclusion criteria: * presence of white spot lesions on the vestibular surfaces of teeth * corrupted vestibular surfaces of teeth

Keywords: composite resins toothpastes orthodontic buttons
randomized control trial: elbow extension versus flexion cast in proximal half both bone forearm fractures

Conditions: Fracture of Radius and Ulna

Summary: the purpose of this study is to compare outcomes between two immobilization methods for pediatric proximal half both bone forearm fractures.

after being informed of the study including potential risks and benefits, all patients giving assent and guardian/parents consent who meet eligibility will undergo randomization of the casting technique used (elbow extension or elbow flexion casting). randomization will occur using a random umber generator. even numbers generated will result in an extension cast and odd numbers generated will result in a flexion cast. the patients will be followed in clinic with an examination and x-rays at 2, 3, 5, and 8 weeks after casting to evaluate alignment of the fracture maintained by each cast. the two cohorts will be compared at the end of the study to determine which casting technique is the superior immobilization for pediatric proximal half both bone forearm fractures.

Eligibility criteria:
inclusion criteria: * ages 3-18 * skeletally immature * unilateral radius and ulna fracture located within the proximal ½ of each bone * fracture requires reduction and casting exclusion criteria: * ages \< 3 * distal ½ radius and ulna forearm fracture * isolated radius or ulna fracture * humerus fracture of the ipsilateral arm (including floating elbow) * metabolic bone disease * open fractures * monteggia and galeazzi fractures * deformity or abnormality not allowing for standard casting (limb deficiency, contracture) * parent speaks language other than english

Keywords: both bone forearm fracture cast pediatric
steroids for early treatment of radiation retinopathy

Conditions: Radiation Retinopathy

Summary: radiation retinopathy is a known complication of ocular radiation therapy. to date there is no known effective treatment. in addition to their anti-vascular endothelial growth factor (vegf) properties, corticosteroids decrease the retinal capillary permeability by increasing the activity/density of tight junctions and acute inflammatory effects of radiation in various tissues.

the purpose of the project is threefold: 1. to study the natural history of radiation retinopathy using advanced imaging techniques. a combination of macular oct to evaluate for edema, oct angiography to evaluate for macular and peri-papillary ischemia and wide-field angiography for peripheral ischemia and leakage. potential role of oct angiography in radiation retinopathy will be evaluated by comparison to other eye (control) and fa. 2. currently there is no consensus on effective management strategy for radiation retinopathy. patients in the interventional will be prospectively followed to study efficacy of steroids for early treatment of radiation retinopathy while comparing the multimodal therapeutic approach in a randomized trial. 3. patients in the observational arm will be prospectively followed while comparing the multimodal therapeutic approach in a randomized trial.

Eligibility criteria:
inclusion criteria: * primary uveal melanoma * primary treatment with plaque brachytherapy * baseline visual acuity 20/200 or better * posterior tumor margin \>1.50 mm from the center of the macula * posterior tumor margin \> 1.50 mm from the closest disc margin * calculated total dose to center of the macula \>40 gy exclusion criteria: * iris melanoma * opaque media * less than 21 years of age * inability to give consent * positive pregnancy test
bicarbonated ringer's solution versus lactated ringer's solution in patients with septic shock

Conditions: Septic Shock; Fluid Resuscitation; Crystalloid Solution; Intensive Care Unit

Summary: in this prospective randomized controlled trial, investigators aim to study the effects and safety of bicarbonated ringer's solution in patients with septic shock compared with lactated ringer's solution, and provide evidence for current fluid resuscitation strategies for septic shock.

although the latest guidelines recommend crystalloids as the first choice for the patients' fluid resuscitation, it still remains controversial that which crystalloid solution is the best choice. it is reported that balanced crystalloid can result in better outcomes than saline for critically ill patients. however, there are few studies conducted between different crystalloid solutions. lactated ringer's solution is the longest-used crystalloid solution. compared with lactated ringer's solution whose anion is lactate, the anion of bicarbonate ringer's solution is bicarbonate. and lactate needs to be metabolized into bicarbonate through the mitochondria of the liver before it can play an alkalization role. therefore, in theory, bicarbonate ringer's solution does not need to rely on liver metabolism, the onset time to maintain acid-base balance is shorter, and it may be more suitable for patients with severe acidosis. in patients with septic shock, the incidence of moderate to severe metabolic is increased. bicarbonate ringer's solution can directly supplement the concentration of bicarbonate, while lactated ringer's solution needs to take time and be metabolized in the liver. thus, we hypothesize that bicarbonate ringer's solution is more effective for patients with shock and metabolic acidosis than lactated ringer's solution.

Eligibility criteria:
inclusion criteria: * 1. at the age of 18 to 75; * 2. being treated in the icu; * 3. diagnosed as septic shock according tho the definition of sepsis 3.0 with fluid resuscitation requirement. exclusion criteria: * 1. severe hepatic failure; * 2. possible brain injury; * 3. with absolute contraindications for central vena catheterization; * 4. ever participated in another clinical trial within 30 days prior enrollment; * 5. have corrected metabolic acidosis through alkaline drug application within 24 hours prior to enrollment; * 6. hypermagnesemia or hypothyroidism; * 7. pregnant of breast-feeding women; * 8. considered inevitable death; * 9. other situations where investigators think enrollment is not appropriate.

Keywords: septic shock fluid resuscitation crystalloid solution intensive care unit
identifying factors underlying the discontinuation of triptans

Conditions: Migraine; Medication Adherence

Summary: the objective of this study is to identify reasons migraine patients stop using triptan medications for abortive headache treatment. it is hypothesized that inadequate education of the patient at the time of prescribing the triptan is positively associated with triptan discontinuation.


Eligibility criteria:
triptan user inclusion criteria: * episodic migraine or chronic migraine * have used a triptan medication in the prior 3 months * have used triptan medications for at least 1 year triptan discontinuation inclusion criteria: * episodic migraine or chronic migraine * used any triptan medication in the last 2 years * have not used a triptan medication in the last 6 months
uvb phototherapy treatment of oral chronic gvhd

Conditions: Oral Chronic Graft-Versus-Host Disease

Summary: the purpose of this trial is to find out how effective narrow band-ultraviolet light b (nb-uvb) phototherapy is in treating oral cgvhd. nb-uvb phototherapy involves exposing the inside of the mouth to light of a particular spectrum (a specific wavelength of light, 311nm) of the ultraviolet band, called nb-uvb. it is known that narrow band ultraviolet light therapy can improve symptoms in patients with skin chronic gvhd.

* at the first visit the following information will be collected about the participant: original diagnosis, the date and type of transplant, transplant conditioning regimen, cgvhd prophylaxis regimen, the time when oral cgvhd was first noticed, specific treatments for oral cgvhd, and any current medications. * at each visit, and before the participant begins phototherapy treatment, they will answer a series of questions asking about how their mouth feels and what they are able to eat. a clinical examination of the mouth will be performed and recorded and photographs will be taken of the inside of the mouth. * participants will then receive phototherapy treatment. this will take approximately three minutes and will involve opening the mouth and closing the eyes. following phototherapy, the participant will be asked several questions on how they tolerated the treatment. phototherapy treatments will be done two or three times per week for a total of 24 treatments. after each treatment, if the participant has not experienced any discomfort, the phototherapy dose will be increased following a specific protocol. * after 24 treatments the participant will have the option to continue phototherapy treatments.

Eligibility criteria:
inclusion criteria: * patients with oral chronic graft-versus-host disease * 4 years of age or older * stable cgvhd medication regimen for the four weeks prior to study enrollment exclusion criteria: * new immunomodulatory medications or increasing dosage of current immunomodulatory medications during the four weeks prior to study enrollment * concurrent extracorporeal photopheresis.

Keywords: nb-uvb cgvhd
influence of body position on the defecation model during anorectal manometry.

Conditions: Constipation; Children; Anorectal Disorder

Summary: anorectal 3d manometry (3d hram) is the most advanced version of manometric equipment that measures pressures along the anal canal in a very detailed manner. it provides complete data about pressure profile of anorectum and may indicate impaired defecation dynamics. resent studies suggest that the position in which 3d hram is performed should be changed. so far, no scientific research has been performed in children that directly compares both positions. the reference values of registered pressures during 3d hram in people without complaints were not specified, which would allow for a more precise diagnosis of patients with an incorrect defecation model and precise selection of patients who could benefit from biofeedback therapy.

patients with the diagnosis of constipation will be enrolled in the study. each patient will be investigated by anorectal manometry in both- sitted and lying position. during anorectal manometry conventional manometric parameters will be recorded, such as resting pressure, squeeze pressure, bear down manoeuver, thresholds of sensation and threshold of recto anal inhibitory reflex. 3d picture of anal canal will be recorded.

Eligibility criteria:
inclusion criteria - the study group: * age from 5 to 18 years old * functional constipation diagnosed on the basis of rome iv criteria * parental or guardian written consent to the participation of the child in the study; in the case of a child ≥16 years old also the child's written consent inclusion criteria - the control group: * age from 5 to 18 years old * no lower gastrointestinal symptoms * parental or guardian written consent to the participation of the child in the study; in the case of a child ≥16 years old also the child's written consent exclusion criteria - the study group and the control group: * undergone surgeries due to congenital anomalies in the lower gastrointestinal tract * inflammatory bowel diseases or inflammation of the large intestine with a different aetiology * anal fissure, inflammation of the anal area or other conditions which, in the opinion of the researcher, could affect the functioning of the distal gastrointestinal tract

Keywords: anorectal manometry hram constipasion position
chemotherapy combined with immunotherapy and targeted therapy in cholangiocarcinoma

Conditions: Cholangiocarcinoma

Summary: this study aims to validate the efficacy and safety of gp/gemox combined with pd-1/l1 inhibitors and tki agents in patients with advanced cholangiocarcinoma through a multicenter, retrospective study to guide clinical practice.

this study plans to enroll patients diagnosed with advanced cholangiocarcinoma. after confirming patients treated with gp/gemox or gp/gemox combined with pd-1/l1 and tki agents as initial therapy, the investigators will collect relevant clinical data, including basic clinical information, laboratory data, imaging data, pathological data, and surgical data through an electronic medical record system.

Eligibility criteria:
inclusion criteria: * histologically or radiologically confirmed intrahepatic cholangiocarcinoma * initially treated with gp/gemox or gp/gemox combined with pd-1/l1 and tki inhibitors exclusion criteria: * direct surgery after hospitalization * initial treatment combined with local therapies (radiotherapy, radiofrequency, particle implantation, tace, etc.) * initial treatment involving other comprehensive therapeutic regimens

Keywords: advanced cholangiocarcinoma chemotherapy combined with immunotherapy and targeted therapy clinical efficacy and safety