Kornimate/medical-research-clean huggingface dataset:
endoscopic decompression versus microscopic decompression in lumbar canal stenosis

Conditions: Lumbar Spinal Stenosis

Summary: to compare between the clinical and surgical efficacies of bi-portal endoscopic and microscopic decompressive laminectomy in patients with degenerative lumbar spinal stenosis.

lumbar canal stenosis is a disease caused by the compression of the dural sac and nerve root due to various factors such as hypertrophy of the ligamentum flavum (lf), facet joint hypertrophy, disc herniation, and spondylolisthesis, resulting in low back pain, leg pain with or without numbness, intermittent claudication, and bladder and bowel dysfunction in which intermittent neurogenic claudication is the main feature (1, 2). traditional surgical approaches include open laminotomy decompression, foraminotomy, discectomy, and fusion. conventional open lumbar decompression has a long history and has the advantages of adequate decompression and clear visualization of neural structures, while surgical invasiveness and extensive stripping of paraspinal muscles and soft tissues may lead to a series of problems such as postoperative low back pain, spinal instability, and prolonged hospital stay and time to return to normal life after the operation (3). minimally invasive spine surgery has become increasingly popular in recent years. unilateral bi-portal endoscopy (ube) was proposed by heo in 2017 to treat degenerative lumbar spinal diseases with less damage to the paraspinal muscles (4). minimally invasive decompression was introduced as a tissue-sparing alternative and applied to lumbar central stenosis. minimally invasive decompression revealed good clinical outcomes comparable to those of conventional surgery (5, 6). it also showed a reasonable operative time, shorter hospital stay, and reduced blood loss, time to mobilization, postoperative pain, and narcotic use when compared to that seen with conventional surgery (7). however, it presents some disadvantages, including poor visualization, difficulty of instrument manipulation, potential to induce inadequate decompression, and longer operative time than other minimally invasive surgeries (8).

Eligibility criteria:
inclusion criteria: * patients with acquired degenerative lumbar canal stenosis. age \>40 years. single or double level stenosis exclusion criteria: * post-traumatic lumbar canal stenosis. previous spine surgery. multi-level stenosis more than 2 levels. associated instability e.g. spondylolisthesis. spinal diseases (e.g., ankylosing spondylitis, infection, spine tumor, fracture, or neurologic disorders).

Keywords: endoscopic bi-portal decompression microscopic decompression lumbar canal stenosis
confirmatory study: assessing the efficacy and safety of the acusmu microneedle patch in treating periorbital wrinkles

Conditions: Wrinkle

Summary: the core objective of this study is to validate the safe and efficacious application of the acusmu microneedle patch (fmd wk) to enhance the appearance of periorbital wrinkle

this clinical study is a randomized, double-blind, split-face clinical trial investigating the efficacy of acusmu (fmd wk) for the treatment of periorbital wrinkles. participants will attend a study center for a two-week period and undergo a two-week post-treatment follow-up after their final treatment session. each day, they will apply one of two test products: (a) micro-needle patches containing active anti-wrinkle ingredients and (b) placebo patches beneath their eyes. the patches will be gently pressed onto the skin for 5-10 seconds and left in place for 2-8 hours, continuing this regimen for 14 days. dermatologists will conduct evaluations at four time points during the study: on day 0, day 7, day 14, and day 28 (±2 days) from the commencement of the experiment. the evaluation process will include the calculation of a fine wrinkle improvement index specifically designed for assessing under-eye wrinkles to measure improvements. non-invasive skin testing equipment will be employed to measure skin conditions and capture skin images for objective data analysis (wrinkle index). additionally, self-assessment questionnaires will be administered to gather insights into participants' perceptions of the efficacy of micro-needle patches with active anti-wrinkle ingredients and placebo patches in improving periorbital wrinkles over the two-week duration.

Eligibility criteria:
inclusion criteria: * participants aged 18 to 99 (regardless of race or gender). * diagnosed with mild or moderate periorbital wrinkles by a dermatologist. exclusion criteria: * participants with open wounds or active infections on their skin. * individuals involved in other studies that could interfere with this trial. * pregnant, breastfeeding, or planning to become pregnant during the trial. * those with significant medical conditions such as cancer, liver disease, diabetes, kidney disease, or cardiovascular disorders. * individuals who have undergone alternative treatments for periorbital wrinkles in the past six months (e.g., laser therapy, radiofrequency). * participants concurrently receiving alternative treatments for periorbital wrinkles.

Keywords: microneedle patch anti-wrinkle
the potential association of long non-coding rna (neat1 and malat1) in the process of epithelial-mesenchymal transition in periodontitis

Conditions: Periodontal Disease, AVDC Stage 3and 4; Epithelial Mesenchymal Transition; Long Noncoding RNA

Summary: periodontitis is a polymicrobial, inflammatory condition affecting tooth-supporting tissues. it is characterized by a progressive loss of epithelial attachment and resorption of alveolar bone, which can lead to tooth loss. epithelial-mesenchymal transition (emt) has been proposed as a reversible process that shifts the cell phenotype from epithelial to mesenchymal-like and may be involved in the process of periodontal inflammation either completely or partially. long non-coding rnas (lncrnas) are a large class of regulatory transcripts longer than 200 nucleotides lacking evident protein-coding potential. studies have shown that lncrna dysregulation plays key roles in human diseases, including cancer, by modulating the epithelial-mesenchymal transition (emt). the involvement of lncrnas markers in the pathogenesis of periodontal disease induced emt has not been studied thoroughly and have created a gap in the knowledge.


Eligibility criteria:
inclusion criteria: * patients with no history of systemic disease e.g., diabetes. * both males and females will be included in the study. * control group: patients fit the case definition of gingival health2, and confirmed by histopathological inflammatory cell infiltration analysis. * periodontitis group: patients fit the case definition of periodontal disease referred for periodontal flap surgery (modified widman's flap). * patients radiographically confirmed with infrabony pocket eligible for periodontal flap surgery. exclusion criteria: * patients not willing to participate or consent. * patient taking medications that affect or modify immunity (e.g., corticosteroid), for the last 3 months. * patient taking nsaids for the last 3 months. * active smoker.
studying solriamfetol modulation of taar-1, dopamine, and norepinephrine in shift work disorder (sustain)

Conditions: Excessive Sleepiness; Shift-work Disorder

Summary: sustain (studying solriamfetol modulation of taar-1, dopamine, and norepinephrine in shift work disorder) is a phase 3, multi-center, randomized, double-blind, placebo-controlled, parallel- group trial to assess the efficacy and safety of solriamfetol in adults with excessive sleepiness associated with shift work disorder (swd).

eligible subjects must meet the international classification of sleep disorders, third edition (icsd-3) criteria for shift work disorder (swd). subjects will be randomized in a 1:1:1 ratio to receive solriamfetol titrated to either 150 mg, 300 mg, or placebo once per night shift for 12 weeks.

Eligibility criteria:
inclusion criteria: * meets international classification of sleep disorders, third edition (icsd-3) criteria for shift work disorder (swd) * provides written informed consent to participate in the study before the conduct of any study procedures. * male or female, aged 18 to 65 inclusive. exclusion criteria: * prior exposure to solriamfetol/sunosi, through either a clinical study or prescription. * unable to comply with study procedures. * medically inappropriate for study participation in the opinion of the investigator.

Keywords: excessive sleepiness solriamfetol sunosi swd dopamine norepinephrine reuptake inhibitor non-stimulant therapy insomnia circadian rhythm sleep disorder trace amine-associated receptor 1 (taar1) agonist
a trial of intravenous n-acetylcysteine in the management of antituberculous drug-induced hepatitis

Conditions: Drug-Induced Liver Injury

Summary: we will conduct a randomized placebo controlled trial to determine whether administration of intravenous (iv) nac to participants with tb dih, in dosages similar to that used in paracetamol poisoning, can improve recovery from hepatotoxicity.

south africa has a huge tuberculosis (tb) disease burden, with 948 per 100 000 people diagnosed with tb in 2008. tb drug induced hepatitis (dih) is a common adverse effect of tb therapy that causes significant patient morbidity and prolonged hospital stays. n-acetylcysteine (nac) has been extensively studied and used for many years in the treatment of paracetamol-induced hepatotoxicity, with good evidence of efficacy and safety. nac has also been used in other forms of liver injury and drug toxicity. it has not previously been used in the management of tb dih. we will screen all patients with clinical hepatitis on tb treatment admitted to new somerset and groote schuur hospitals and aim to recruit 100 participants over 3 years. we will randomise 50 participants to receive an iv loading dose of 150mg/kg of nac over 60 minutes followed by 50mg/kg iv over 4 hours by continuous infusion and finally 100mg/kg iv over 16 hours. fifty participants will be randomised to receive placebo. the primary outcome will be time to normalisation of liver function (alt\<100). we will also determine the effect of nac on duration of hospitalization, rate of recovery from liver failure, all cause mortality, and describe adverse effects of iv nac in this patient population.

Eligibility criteria:
inclusion criteria: * adults \> 18 years old * diagnosed with pulmonary or extrapulmonary tuberculosis based on symptoms, radiological features and/or laboratory evidence. * on first line antituberculous therapy * diagnosed with tb dih exclusion criteria: * patients with a diagnosis of acute viral hepatitis based on a positive anti-hav, igm, anti- hbcigm, or confirmed hepatitis c infection * patients known to be asthmatic

Keywords: drug induced hepatitis (dih) toxic liver drug induced liver injury (dili)
role of intermittent fasting before icsi

Conditions: Infertility

Summary: intermittent fasting could have a role in infertility

intermittent fasting could have a role in infertility and could adjust the body weight before icsi

Eligibility criteria:
inclusion criteria: * women with infertility exclusion criteria: * ovarian factor or uterine factor of infertility
prevention of neurosurgical wound infections

Conditions: Surgical Wound Infections

Summary: the goal of this study is to determine whether injecting the antibiotic vancomycin directly into surgical wounds can decrease the rate of infection following implantation of neurosurgical devices.


Eligibility criteria:
inclusion criteria: * deep brain stimulators (dbs) * spinal cord stimulators (scs) * motor cortex stimulators (mcs) * vagus nerve stimulators (vns) * peripheral nerve stimulators (pns) exclusion criteria: * allergies to vancomycin * immunocompromise or taking immunosuppressant drugs * currently taking aminoglycoside antibiotics, such as amikacin, gentamicin, neomycin, streptomycin or tobramycin * diagnosed renal failure * currently undergoing chemotherapy * pregnancy * non-english speakers * unable to return for follow-up, or unable to be contacted by telephone

Keywords: infection vancomycin neurosurgery stimulator pump deep brain stimulation intrathecal pump
analysis of prognostic and predictive genomic signatures using archival paraffin-embedded breast tumor - a pilot study

Conditions: Breast Tumor

Summary: a number of prognostic and/or predictive genomic signatures for breast cancer have been developed by genome institute of singapore (gis). in the past 1 year, gis has developed protocols and methods to conduct expression assays from formalin-fixed, paraffin-embedded (ffpe) tumor specimens. a study on 800 tumor samples is planned to analyze these gene signatures and compare them with conventional clinical prognosticators and predictors. as the investigators plan to use archival tumor samples that dates back to the 1990s, the aim of this pilot study is to first analyze 10 anonymized samples to determine the feasibility of running these assays on old archival blocks. the information generated will help us determine whether very old samples (diagnosed before 2000) may be selected for the actual study.

up to 10 archival breast tumor blocks will be obtained from the department of pathology, nuh - half of these blocks will be from patients who were diagnosed before year 2000, and the other half of the blocks will be from patients diagnosed between year 2000-2005 (control specimens). basic tumor and patient information will be collected without patient identifiers - grade, stage, er/pr/her2 status, treatment received, outcome data. 8-10 ten-micron sections will be cut from each tumor block. rna will be extracted from the tumor sections using the roche high pure ffpe rna micro kit. rna will be profiled using the illumina veracode assay and the affymetrix quantigene assay. rna extraction and gene expression profiling will be performed by collabroators at the genome institute of singapore.

Eligibility criteria:
inclusion criteria: * half of these blocks will be from breast cancer patients who were diagnosed before year 2000. * half of the blocks will be from breast cancer patients diagnosed between year 2000-2005 (control specimens). exclusion criteria: * breast cancer patients diagnosed after year 2005.
educational and supportive interventions to prevent cardiopulmonary rehospitalization

Conditions: Cardiovascular Diseases; Heart Diseases

Summary: this study will use a comprehensive hospital discharge toolkit to implement up-to-date guidelines for cardiopulmonary diseases. the study will also include a computer-based patient-education program and a telephone-based post-discharge program, both designed for individuals with limited health literacy. the purpose of this study is to reduce early hospital readmission.

background: limited health literacy is prevalent in america and has been identified as a cross-cutting priority area for transforming health care quality. this study will explore the effect of innovative patient-education and self-management systems on early rehospitalization for patients admitted to a general medical service. design narrative: this is a two-armed randomized study of patients with chronic cardiopulmonary diseases in three levels of health literacy. patients will be tested with the 66 word version of the rapid estimate of adult literacy in medicine (realm) test to allow us to analyze the data according to literacy categories ( 6th grade, 7th-8th grade, and 9th grade). patients will be randomized to one of the following groups: 1) standard discharge (control group); 2) a experimental group receiving both the case management intervention plus educational and self-management support by embodied conversational agents (ecas) and post-discharge reinforcement of the discharge plan using a computerized telephone system

Eligibility criteria:
inclusion criteria: * admitted to the general medical service at boston medical center (bmc) * desires to be hospitalized in the future if there is a clinical need * able to communicate in english with health providers exclusion criteria: * transferred from an outside hospital or a specialty services at bmc (e.g., orthopedic surgery, obstetrics and gynecology, otolaryngology, general surgery, or psychiatry) * requires hospice, nursing home, or other institutional settings * vision that is inadequate to discern the computer-based education and self-management support system * hearing that is inadequate to use a telephone * unable to independently consent * scheduled admission (e.g. for surgery) * has sickle cell disease
pediatric influence of cooling duration on efficacy in cardiac arrest patients (p-icecap)

Conditions: Cardiac Arrest, Out-Of-Hospital; Hypothermia, Induced; Hypoxia-Ischemia, Brain

Summary: this is a multicenter trial to establish the efficacy of cooling and the optimal duration of induced hypothermia for neuroprotection in pediatric comatose survivors of cardiac arrest. the study team hypothesizes that longer durations of cooling may improve either the proportion of children that attain a good neurobehavioral recovery or may result in better recovery among the proportion already categorized as having a good outcome.


Eligibility criteria:
inclusion criteria: * age 2 days to \< 18 years with corrected gestational age of at least 38 weeks * chest compressions for at least 2 minutes * coma or encephalopathy after resuscitation from out-of-hospital cardiac arrest (ohca) * requires continuous mechanical ventilation through endotracheal tube or tracheostomy * definitive temperature control device initiated * randomization within 6 hours of return of spontaneous circulation (rosc) * informed consent from legally authorized representative (lar) including intent to maintain life support for 120 hours exclusion criteria: * glasgow coma motor score (gcms) = 6 * lar does not speak english or spanish * duration of cardiopulmonary resuscitation (cpr) \> 60 minutes * severe hemodynamic instability with continuous infusion of epinephrine or norepinephrine of 2 micrograms per kilogram per minute (μg/kg/minute) or initiation of extracorporeal membrane oxygenation (ecmo) * pre-existing severe neurodevelopmental deficits with pediatric cerebral performance category (pcpc) =5 or progressive degenerative encephalopathy * pre-existing terminal illness, unlikely to survive to one year * cardiac arrest associated with brain, thoracic, or abdominal trauma * active and refractory severe bleeding prior to randomization * extensive burns or skin lesions incompatible with surface cooling * planned early withdrawal of life support before 120 hours * sickle cell anemia * pre-existing cryoglobulinemia * non-fatal drowning in ice covered water * central nervous system tumor with ongoing chemotherapy * previous enrollment in p-icecap trial * prisoner * chronic hypothermia * new post-cardiac arrest diabetes insipidus * pregnancy

Keywords: bayesian adaptive clinical trial hypothermia, therapeutic coma pediatric
clinical evaluation and study of the efficacy of a centella asiatica-infused facial mask on discosmetic dermatosis

Conditions: Rosacea; Acne; Centella; Melasma

Summary: the purpose of this study was to investigate the efficacy and safety of repairing facial mask containing asiaticum asiatica in treating disjunctive skin diseases. a multi-center randomized double-blind self-half face control method was used. a computer-generated randomization method was used. each cheek was randomly assigned to receive the snow glycoside mask and the control group.


Eligibility criteria:
inclusion criteria: 1. meet mild to moderate rosacea, acne diagnostic criteria; meet the diagnostic criteria for melasma; 2. over 18 years of age; 3. be able to follow the treatment rules of the study and be followed for 8 weeks; 4. informed consent; 5there were no significant cardiac, liver, kidney, gastrointestinal, neurological, psychiatric, or metabolic disorders 6.no medication was used within 1 month exclusion criteria: 1. currently pregnant, planning to become pregnant or breastfeeding; 2. documented hypersensitivity to any active ingredient or excipient included in the study drug, or a history of adverse reactions to cosmetic products; 3. participate in other clinical studies within 3 months before the start of the study; 4. frequent use of chinese medicine, sleeping pills, sedatives, anti-anxiety drugs or potentially addictive substances; 5. present with concomitant skin conditions that may confuse the clinical assessment of rosacea, melasma, seborrheic dermatitis or pose a risk to participants, or have a history of severe skin conditions; 6. normal use of relevant treatment (including intense pulsed light, pulsed fuel laser, oral and topical tranexamic acid, oral tetracycline antibiotics, oral compound glycyrrhizin and other anti-inflammatory drugs) 7. patients with incomplete observation data, incomplete course of treatment and inability to take drugs as prescribed by doctors were removed
effect of dexmedetomidine on the duration of pain control in esp block for breast surgery

Conditions: Breast Cancer; Mastectomy; Axillary Lymph Node Dissection; Pain, Postoperative

Summary: patients undergoing partial or total mastectomy with axillary ln dissection will receive prior to induction of general anaesthesia esp block at t4 level at the same side of the surgery. one group will receive ropivacaine 0.375% and the other will get ropivacaine 0.375% with dexmedetomidine 0.5mcg/kg as an adjuvant. time to first narcotic requirement will be documented and therefore an assessment of the duration of action of the block will be made

background and objective: whether partial or complete, mastectomy with axillary lymph node dissection is a painful surgery. acute postoperative pain management is challenging and crucial due to high chances of it transforming into chronic pain. erector spinae plane (esp) block has been shown to be effective in managing post mastectomy pain.dai et al showed the effectiveness of dexmedetomidine in prolonging the duration of sensory block, motor block and analgesia when dexmedetomidine as an adjunct is added to ropivacaine in brachial plexus block (1). the aim of our study is to show the effectiveness of dexmedetomidine in prolonging the analgesic effect of ropivacaine when added to it in esp block compared to using ropivacaine alone in patients undergoing mastectomy with axillary lymph node dissection, and to study its impact on postoperative opioid consumption. methods: 44 american society of anesthesiologist (asa) physical status classification class i, ii and iii will be randomly allocated to one of two groups, both receiving a single injection erector spinae plane block at t4 vertebral level using 20ml ropivacaine 0.375% 20 minutes before the induction of anesthesia. the first group will receive 0.5mcg/kg of dexmedetomdine added to the ropivacaine solution. the control group will receive no dexmedetomidine. postoperatively, patients in both groups will be receive acetaminophen 1g orally every 6 hours and oxycodone 5 mg orally as needed every 6 hours if vas is more than 4. postoperative pain will be measured using verbal analogue scale (vas) at 0, 1, 2, 4, 6, 12, 18, and 24 hours. conclusion: this study will be the first of its kind to investigate the impact of adding dexmedetomidine as an adjunct to ropivacaine in prolonging the esp block duration in patients undergoing mastectomy with axillary lymph node dissection.

Eligibility criteria:
inclusion criteria: 1. asa class i, ii and iii patients 2. age range: 18-80 years old 3. elective partial or unilateral radical mastectomy with sentinel lymph node dissection exclusion criteria: 1. pregnant woman 2. bilateral mastectomy. 3. skin infection at the site of needle puncture 4. coagulopathy problems 5. allergy or contraindication to any of the study drugs 6. recent use of opioid drugs

Keywords: esp block erector spinae plane block mastectomy ropivacaine dexmedetomidine pain breast