Kornimate/medical-research-clean huggingface dataset:
investigation on the efficacy of oral carnitine challenge test based on a gut microbiota functional test

Conditions: Dysbiosis; Healthy

Summary: this study seeks to enlist healthy volunteers to form a validation cohort. the purpose is to confirm the observed correlations between the gut microbiome and the capacity to produce trimethylamine n-oxide (tmao), which will be assessed using the oral carnitine challenge test (occt).

carnitine, a nutrient widely found in meat, can promote the use of fatty acids by mitochondria to produce energy in the human body. it was previously thought to be beneficial in helping the body consume fat for energy and might be helpful for muscle training or weight loss. however, some human populations have harmful bacteria in their intestines that compete with the body for the use of carnitine. these bacteria metabolize carnitine to produce potentially harmful trimethylamine n-oxide (tmao). this might be one of the reasons why long-term consumption of red meat, which is rich in carnitine, is associated with a higher risk of cardiovascular disease. therefore, understanding the functional state of one's gut microbiota and whether it is suitable to consume foods rich in carnitine can greatly aid in long-term dietary and health planning. in recent years, we have established an oral carnitine challenge test that (occt) can distinguish whether the intestinal bacteria in a subject produce a large amount of tmao in the body. this was published in the gut journal in 2019 and is expected to provide dietary or nutritional supplement recommendations for personalized nutrition for the test subjects. however, the value of the carnitine challenge test in distinguishing between high tmao producers and low tmao producers, and whether it can serve as an effective reference for whether a subject is suitable to consume large amounts of meat or take carnitine supplements, still needs further experimental verification. this study seeks to enlist healthy volunteers to form a validation cohort. the purpose is to confirm the observed correlations between the gut microbiome and the capacity to produce tmao, which will be assessed using the occt.

Eligibility criteria:
inclusion criteria: * adults aged 20 and above who are willing to participate in the trial. exclusion criteria: 1. under the age of 20 2. history of gastrointestinal surgery 3. history of malignant tumors 4. those who have used antibiotics, probiotics, or carnitine supplements within the past month will be excluded 5. liver cirrhosis 6. end-stage kidney disease
observing the effect of fascial manipulation in athletes with shin splits.tibial stress syndrome.

Conditions: Shin Splint; Fascial Manipulation; Running Kinematics

Summary: aims \& objectives: 1. the aim of the study is to find out the influence of fascial manipulation on running kinematics among athletes with medial tibial stress syndrome (mtss). 2. the objectives of our study are i. to use fascial manipulation as a mode of treatment in mtss. ii. to compare running kinematics before and after treatment intervention. iii. to compare pain perception before and after treatment intervention.

the justification for study: 1. mtss is associated with altered lower extremity kinematics. 2. there is an association between tibial fascia tightness and forces acting along the tibial crest due to alterations in the transfer of energy from foot proximally in the closed kinematic chain. 3. fascial manipulation is found to be effective in improving the pliability of connective tissues in the management of musculoskeletal conditions. 4. therefore there is a need to determine the influence of fascial manipulation on mtss.

Eligibility criteria:
inclusion criteria: * aged between 18-40 years, both sexes athletes with shin pain or diagnosed with mtss symptoms lasting for 2-3 weeks in the last 1 month exclusion criteria: * trauma to lower extremity in the past 3 months neurological, cognitive, psychological factors affecting the test acute injuries- laceration, sprains, strains, recent fractures lumbopelvic-hip complex and knee pathologies(intra-articular lesions, osteoarthritis, rheumatic arthritis, osteomyelitis)
the efficacy of combination therapy in atrophic scars

Conditions: Atrophic Scar

Summary: there are more than 100 million patients who develop scar formation caused by various factors, such as post-inflammatory acne and trauma (1). they often have physical, aesthetic, psychological, and social barriers. scar tissue is naturally a stage of wound healing. abnormal wound healing produces a spectrum of scar tissue types such as atrophic, hypertrophic, and keloid scars (2). atrophic scars are dermal depressions, which are commonly caused by the destruction of collagen following inflammatory process. this permanent disfiguring sequelae correlates with the duration of pathology, severity of lesion, and delay in therapy (3). treatment of atrophic acne scars remains a therapeutic challenge, yet there is no standard option as the most effective treatment (4). a range of possible options has been investigated including surgical techniques (subcision, non-ablative laser treatment, resurfacing techniques (ablative laser treatment, dermabrasion), and injection or dermal fillers or fat, and a combination of two or more modalities (5). ultrasound is a unique non-invasive and non-radiating medical imaging tool in the investigation of dermatological diseases by providing detailed anatomic and physiologic data of skin lesions and deeper soft tissue changes. lesion size in three dimensions-lengths, width, and depth, morphology, the detailed anatomic information provided by sonography is useful to assessment of effect of different types of treatment modality to improve atrophic scar and avoid invasive assessment tools as punch biopsy for histopathological examination (6)

atrophic scar mangment

Eligibility criteria:
inclusion criteria: - patients aged from 12 to 60 years with * post inflammatory atrophic scar. * post traumatic atrophic scar. * post operative atrophic scar exclusion criteria: * post acne scar. * active skin infection.
use of the abss in infants with aris treated with outpatient respiratory physiotherapy

Conditions: Acute Disease Respiratory

Summary: background. acute respiratory infections in childhood have high incidence and morbimortality rates, generating significant sanitary and social costs. due to its diversity of manifestations and clinical forms, the degree of severity varies widely. published acute respiratory infections assessment severity scales are mainly focused on acute bronchiolitis, but there is no validated scale to evaluate the effects of respiratory physiotherapy in acute respiratory infections in children. objective. to study the usefulness of the acute bronchiolitis severity scale to assess children under 24 months suffering from acute respiratory infections susceptible to receive outpatient respiratory physiotherapy treatment. methods. pre-post assessment descriptive study using the acute bronchiolitis severity scale. children under 24 months suffering from acute respiratory infection will be evaluated during the first outpatient respiratory physiotherapy treatment.


Eligibility criteria:
inclusion criteria: * under 24 months * aris diagnosed * medical indication of respiratory physiotherapy * evaluated during the first outpatient respiratory physiotherapy treatment exclusion criteria: * chronic desease * abss ≥ 7 * temperature≥ 38ºc * stridor * expiratory groan * sternal sinking * any sign or symptom indicative of need for urgent medical evaluation

Keywords: clinical scale infant respiratory therapy
phase 1b study of plx5622 in rheumatoid arthritis patients who are receiving methotrexate

Conditions: Rheumatoid Arthritis

Summary: plx115-02 is a phase 1b study to assess how the study drug, plx5622: 1. affects the body, 2. how the body affects plx5622 3. the interaction of plx5622 with methotrexate and 4. the safety of plx5622 in rheumatoid arthritis patients taking methotrexate


Eligibility criteria:
inclusion criteria: * male or female patients ≥ 18 years old with a diagnosis of rheumatoid arthritis by acr criteria for ≥ 3 months. * prior to day 1, patients must be on oral or subcutaneous methotrexate (≥10 mg/week and ≤ 25 mg/week) for at least 12 weeks (with a stable dose for at least 4 weeks) and folate (≥ 5 mg/week) for at least 6 weeks, and willing to continue on this regimen for the duration of the study. * adequate hematologic, hepatic, and renal function (absolute neutrophil count ≥ 1.5 x 109/l, hgb \> 9 g/dl, platelet count ≥ 100 x 109/l, ast/alt wnl, albumin ≥ 3 g/dl, calculated crcl\>60 ml/min using cockcroft-gault formula). * women of child-bearing potential must have a negative pregnancy test within 7 days prior to initiation of dosing with study drug and must agree to use a double barrier method of birth control from the time of the negative pregnancy test up to 30 days after the last dose of study drug. women of nonchildbearing potential may be included if they are either surgically sterile or have been postmenopausal for ≥ 1 year. * fertile men must agree to use an acceptable method of birth control while on study drug. acceptable methods of contraception must include either abstinence from the first dose of study drug through 4 weeks after the last dose of study drug, or use of a condom with instructions to the female partner of child-bearing potential to also be protected as above. * willing and able to provide written informed consent prior to any study-related procedures and to comply with all study requirements. exclusion criteria: * use of biologic response modifiers within the following periods prior to day 1: 4 weeks for kineret (anakinra) and enbrel (etanercept); 12 weeks for remicade (infliximab), humira (adalimumab), simponi (golimumab), orencia (abatacept), actemra (tocilizumab), or cimzia (certolizumab); 12 months for rituxan (rituximab). * use of arava (leflunomide) within 12 weeks prior to day 1 or any immunosuppressive agents, including hydroxychloroquine or sulfasalazine, within 4 weeks of day 1. * investigational drug use within 4 weeks of day 1. * positive urine drug screen for drugs of abuse (except for opiates if being used for ra). * concomitant use of dmards (other than methotrexate), biological response modifiers, or known strong inducers or inhibitors of cyp3a4 (see appendix 2). * uncontrolled intercurrent illness. * refractory nausea and vomiting, malabsorption, external biliary shunt, or significant bowel resection that would preclude adequate absorption. * qtc ≥ 450 msec at screening. * the presence of a medical or psychiatric condition that, in the opinion of the principal investigator, makes the patient inappropriate for inclusion in this study.

Keywords: ra methotrexate
fast track laparoscopic surgery: a better option for treating colorectal cancer than conventional laparoscopic surgery

Conditions: Colorectal Cancer

Summary: to compare the outcomes of fast track laparoscopic surgery and conventional laparoscopic surgery.

method: this study is a blinded randomized trial. 70 patients with colorectal cancer will undergo laparoscopic colorectal resection, and will be divided into two groups. protocols for fast-track group includes skipping preoperative mechanical bowel preparation, early restoration of diet and early postoperative ambulation. outcome measures, length of hospital stay, postoperative surgical stress response (c reactive protein) and postoperative complications will be compared between the two groups.

Eligibility criteria:
inclusion criteria: * age ≤75 years * good nutrition * no systemic infection * elective laparoscopic surgery exclusion criteria: * age \>75 years * malnutrition or an organ system infection * associated with obstruction, bleeding, emergency surgery or surgical intervention * tumor with extensive metastasis * before operation patient was fasting, underwent gastrointestinal decompression and received nutritional support * previous history of abdominal surgery * patient had previously undergone gastrostomy

Keywords: fast track surgery, laparoscopic surgery, colorectal cancer
chest wall repair of rib fractures after trauma

Conditions: Rib Fractures

Summary: this is a prospective, observational trial of 50 patients who have multiple, severe rib fractures following trauma. the investigators will follow their hospital stay for outcomes (infections, length of stay and medical care) as well as their early post-hospital course.

hypothesis: rib fracture repair utilizing open reduction and internal fixation with commercially available rib plating systems improves outcomes (i.e., infectious complications), decreases hospital stay and mortality. study design: this is a prospective, observational study of 50 patients who, due to their injury pattern, are operative candidates for open reduction and internal fixation with commercial available rib plating systems for one of the following indications: 1. flail chest with/without failure to wean from the ventilator 2. significantly displaced rib fractures with/without lung impalement 3. symptomatic multiple rib fractures - failure of pain control outcome measures to be evaluated include: 1. hospital mortality 2. ventilator free days 3. need for tracheotomy 4. infectious complications (pneumonia, bacteremia, uti, empyema) 5. hospital \& icu days 6. disposition following discharge

Eligibility criteria:
inclusion criteria: * subjects must be at least \>18 years of age * subjects must have one of the following clinical indications: * \>3 rib flail segments with paradoxical chest wall movement * non-repair of defect may result in pulmonary hernia * minimal associated injuries * severely displaced fractures are significantly impeding lung expansion. * failure of narcotics or epidural pain catheter to control pain exclusion criteria: * significant pulmonary contusion * significant brain injury (ais 4 and/or icp monitoring) * severe associated injuries which, in the opinion of the surgeon will preclude operative chest wall stabilization * subjects not expected to survive the 90-day follow-up period * known pregnancy * prisoners
comparison of patient-controlled analgesia with different background infusion

Conditions: Patient-Controlled Analgesia

Summary: in this study, the investigators investigated the efficacy, usefulness and analgesic consumption of three different patient-controlled analgesia(pca) programmes:bolus dose alone without background infusion, bolus dose with low background infusion and bolus dose with high background infusion to evaluate postoperative analgesia for patients after laparoscopic colorectal surgery.

there have been many studies using patient-controlled analgesia (pca) and opioids for postoperative analgesia.patient-controlled analgesia with opioids is now widely used after surgery for the treatment of acute postoperative pain. this technique provides effective pain treatment, adjusts the dose according to personal need and keeps plasma analgesic levels at a constant level,but the incidence of opioid-induced side-effects still be reported frequently.a proper pca programme may increase efficiency of analgesic and decrease incidence of analgesic-induced side-effects. in this study, 90 patients who is undergoing elective laparoscopic colorectal surgery will be randomly allocated into three groups (no background infusion group(group b0),low background infusion group(group b1) and high background infusion group(group b2)). patients in all groups will be given a patient-controlled analgesia (pca) pump in post anesthetic recovery unit (pacu) after surgery.the pca programme of group b0 is dezocine 0.6mg/kg, flubiprofen 3mg/kg, diluted into 120ml and administer at a background infusion of 0ml/h, and a bolus of 4ml, with a lock-out of 15min. the pca protocol of group b1 is dezocine 0.6mg/kg,flubiprofen 3mg/k diluted into 120ml and administer at a background infusion of 1ml/h, and a bolus of 2ml, with a lock-out of 15min.the pca protocol of group b2 is dezocine 0.6mg/kg,flubiprofen 3mg/k diluted into 120ml and administer at a background infusion of 2ml/h, and a bolus of 2ml, with a lock-out of 15min.

Eligibility criteria:
inclusion criteria: 1. american society of anesthesiologists(asa) ⅰ-ⅱ patient undergoing laparoscopic colorectal surgery 2. written informed consent from the patient or the relatives of the participating patient. 3. bmi:18～30kg/m2 exclusion criteria: 1. mental illness or cannot communicate.; 2. a second operation during the study; 3. lung infection or sleep apnea syndrome; 4. renal failure; 5. alcohol or drug abuse; 6. already taking gabapentin, pregabalin, benzodiazepin or antidepression drug; 7. long-term use of analgesics,sedatives or non steroidal anti-inflammatory drugs history .

Keywords: analgesia colorectal surgery background infusion
rotator cuff repair using standard double row technique with platelet rich fibrin membrane vs. standard double row technique

Conditions: Rotator Cuff Tear

Summary: this study is a single-blind, randomized study evaluating the 6 month and 2 year outcomes of patients treated with arthroscopic rotator cuff repair using one of two techniques. one technique used is the standard double row repairs utilizing medial and laterally based anchor fixation and the other technique is the standard double row repairs utilizing medial and laterally based anchor fixation with the use of plateley rich fibrin membrane (prfm). it is hypothesized that patients undergoing the surgery with the prfm will report a higher quality of life than the patients that do not receive this treatment.


Eligibility criteria:
inclusion criteria: * evidence of a rotator cuff tear as determined by clinical examination and diagnostic imaging (mri) * patient undergoes arthroscopic rotator cuff repair * age 18 or older exclusion criteria: pre-operative exclusion criteria * patient has had a previous arthroscopic rotator cut repair * a previous diagnosis of rheumatoid arthritis * evidence of major joint trauma, infection, avascular necrosis, chronic dislocation, inflammatory or degenerative glenohumeral arthropathy, frozen shoulder, or previous surgery of the affected shoulder, * evidence of significant rotator cuff arthropathy with superior humeral translation and acromial erosion diagnosed by x-ray or other investigations, * medical device that would exclude the patient from having a mri, including a pacemaker, cardiac defibrillator, aneurysm clips, carotid artery clamp, neurostimulator, insulin or infusion pump, implanted drug infusion device, bone growth/fusion stimulator, or ear implant. * major medical illness (life expectancy less then 2 years or unacceptably high operative risk), * inability to speak or read english * psychiatric illness that precludes informed consent. * pregnant patients. * age 17 or younger * unwillingness to be followed for 2 years. * bilateral rotator cuff tear confirmed by clinical exam and mri * patients enrolled in the study who demonstrate retear on clinical exam and mri, then elect for a repeat surgery. intra-operative exclusion criteria (note: this information will be collected during the chart audit and patients will be excluded from the study at that time.) * irreparable cuff tears or tears extending into the subscapularis or teres minor * isolated teres minor or subscapularis tears. * inelastic and immobile tendon which cannot be advanced to articular margin

Keywords: rotator cuff tear rotator cuff injury shoulder pain shoulder injury
endoscopic gastroenterostomy versus surgical gastrojejunostomy

Conditions: Malignant Gastric Outlet Obstruction

Summary: recent comparative data suggest that eus gastroenterostomy offers more durable patency than enteral stents for treatment of malignant goo, leading some endoscopists to suggest that eus gastroenterostomy should be the preferred endoscopic treatment approach. eus gastroenterostomy and surgical gastrojejunostomy have been compared in retrospective cohort analysis, suggesting a high technical success rate a shorter hospital length of stay for the endoscopic approach \[4\]. comparison of these techniques has not been reported in controlled prospective fashion. a prospective trial is necessary in order to define the optimal interventional management option for treatment of malignant goo in the context of the contemporary and rapidly evolved range of available endoscopic and surgical treatment options.


Eligibility criteria:
inclusion criteria: * age 18 years or older * able to provide informed consent * biopsy-proven cancer * cancer without surgical resection as a curative treatment option * clinical and radiographic presentation consistent with primary or metastatic tumor causing foregut obstruction at the level of the pylorus and/or duodenum exclusion criteria: * age \<18 years * pregnancy * unable to provide informed consent * white blood count \< 3,000 * absolute neutrophil count \< 1,500 * international normalized ratio \> 1.6 * platelet count \< 100,000 * cancer with surgical resection as a curative treatment option * surgically altered foregut anatomy * multifocal intestinal obstruction * abdominal ascites prohibitive of surgical candidacy * abdominal wall mesh prohibitive of surgical candidacy * child's class b or c cirrhosis * gastroesophageal varices or known portal hypertension * body mass index \>40
a trial to see if the combination of fianlimab with cemiplimab works better than pembrolizumab for preventing or delaying melanoma from coming back after it has been removed with surgery

Conditions: Melanoma

Summary: this study is researching an experimental drug called regn3767, also known as fianlimab (r3767), when combined with another medication called cemiplimab (each individually called a "study drug" or called "study drugs" when combined) compared with an approved medication called pembrolizumab. the objective of this study is to see if the combination of fianlimab and cemiplimab is an effective treatment compared to pembrolizumab in patients that have had melanoma removal surgery but are still at high risk for the recurrence of the disease. pembrolizumab is an approved treatment in some countries in this clinical setting. the study is looking at several other research questions, including: * what side effects may happen from receiving the study drugs. * how much study drug is in the blood at different times. * whether the body makes antibodies against the study drug (which could make the drug less effective or could lead to side effects). antibodies are proteins that are naturally found in the blood stream that fight infections. * how administering the study drugs might improve quality of life.


Eligibility criteria:
key inclusion criteria: 1. all patients must be either stage iib, iic, iii, or stage iv per american joint committee on cancer (ajcc) 8th edition and have histologically confirmed melanoma that is completely surgically resected in order to be eligible as defined by the protocol 2. complete surgical resection must be performed within 12 weeks prior to randomization, and enrollment may occur only after satisfactory wound healing from the surgery 3. all patients must have disease-free status documented by a complete physical examination and imaging studies within 4 weeks prior to randomization, as described in the protocol key exclusion criteria: 1. uveal melanoma 2. any evidence of residual disease after surgery by imaging, pathology, or cytology. 3. ongoing or recent (within 2 years) evidence of clinically significant autoimmune disease that required treatment 4. uncontrolled infection with human immunodeficiency virus (hiv), hepatitis b virus (hbv), or hepatitis c (hcv) infection; or diagnosis of immunodeficiency that is related to, or results in chronic infection, as described in the protocol 5. another malignancy that is currently progressing or that required active treatment in the past 5 years, as described in the protocol 6. participants with a history of myocarditis 7. adolescent patients (≥12 to \<18 years old) with body weight \<40 kg note: other protocol defined inclusion/ exclusion criteria apply

Keywords: resected high risk melanoma skin cancer stage iib stage iic stage iii stage iv lag-3 lymphocyte activation gene 3 adjuvant setting anti-pd-1 monoclonal antibody