Kornimate/medical-research-clean huggingface dataset:
effects of genicular nerve block in knee osteoarthritis

Conditions: Knee Osteoarthritis

Summary: genicular nerve block is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (oa). there is increasing support for the neuropathic component to the knee oa pain. investigators proposed that targeting treatment to the underlying pain mechanism can improve pain management in knee oa. there is a debate on injectable solutions used in nerve blocks. investigators aimed to investigate the efficacy of genicular nerve block and to determine which solution should be appropriate for patients with knee osteoarthritis who have neuropathic or nociceptive pain.

the patients who participated in this study were selected from outpatients who attended our hospital for knee pain. these 90 patients were who matched the following criteria. all patients had knee pain for more than 3 months. the ultrasound-guided genicular nerve block was performed at the site of the superior lateral, the superior medial, and the inferior medial genicular nerves. color doppler was used to identify the arterial structures which serve as landmarks for the corresponding nerves. this method was used to inject a total of 6 ml of lidocaine or 6 ml dextrose or 6 ml saline at 3 separate target sites: the superior lateral, superior medial, and inferior medial genicular nerves. pain was evaluated with analog analogue scale (vas), daily living activities with western ontario and mcmaster universities arthritis index (womac), maximum distance walked with lequesne score, and neuropathic pain was evaluated with paindetect inquiry form. outcome measures were assessed at baseline and at 1st, 4th weeks, and 3rd months after the procedure.

Eligibility criteria:
inclusion criteria: * knee pain for more than 3 month. * radiological tibiofemoral oa (kellgren-lawrence grade 2-4 ) exclusion criteria: * acute knee pain, prior knee surgery, other connective tissue diseases that affected the knee, serious neurological or psychiatric disorders, steroid or hyaluronic acid injection therapy during the previous 3 months, sciatic pain, patients with polyneuropathy, anticoagulant medication use, pacemaker use, prior electroacupuncture treatment and physical treatment.

Keywords: neuropathic pain nerve block knee osteoarthritis
safety study of subthalamic nucleus gene therapy for parkinson's disease

Conditions: Parkinson's Disease

Summary: the purpose of this study is to determine the safety of using a modified virus to transfer a gene called gad into a region of the brain called the subthalamic nucleus in patients with advanced parkinson's disease. the overall goal of this approach is to ultimately normalize the flow of information in several brain regions responsible for movement, to ultimately improve function in patients with this disorder. the current study is primarily designed to evaluate the safety of this approach, but patients are also being monitored for possible signs of effectiveness as well.

this study involves treatment of patients with medically refractory parkinson's disease (pd) with gene therapy. the patients are chosen from a population of patients who would normally be candidates for standard deep brain stimulation (dbs) surgery for pd. these patients respond to medical therapy, but develop substantially reduced responses over time, often with severe fluctuations in their condition between a functional and severely non-functional state. some patients also develop dose-limiting side effects from medication, including involuntary movements called dyskinesias and nightmares. when there are no medical contraindications, dbs is often performed in these patients to try to quiet hyperactive brain regions such as the subthalamic nucleus (stn). in pd, the stn is overactive due to a loss of gaba inputs to this region, which normally reduces neuronal firing. in turn, the stn drives other brain regions, including the globus pallidus (gpi) and substantia nigra (snr), which are also hyperactive and which also have reduced gaba inputs. the goal of this gene therapy trial is to introduce the gene for glutamic acid decarboxylase (gad) into the stn using an adeno-associated virus (aav) vector, in order to permit the stn to produce it's own gaba, as well as release gaba into the gpi and snr targets, which also have reduced gaba inputs. this is anticipated to restore a more normal pattern of information flow from this basal ganglia circuit to the thalamus and higher cortical structures in order to reduce the motor symptoms of pd, while eliminating complications arising from inserting dbs electrodes and batteries into the human body.

Eligibility criteria:
inclusion criteria: * duration of disease: greater than 5 years * idiopathic parkinson's disease * parkinson's medication stable for 3 months * absence of dementia * hoehn and yahr rating: 3 or greater and/or updrs: 30 or more in "off" state and/or complications of l-dopa therapy limiting effective use exclusion criteria: * poor candidate for any surgery * significant dementia * secondary parkinsonism * severe autonomic symptoms * atypical parkinson's disease * history of substance abuse

Keywords: parkinson's disease gaba subthalamic nucleus adeno-associated virus aav gene therapy
randomized clinical trial of occlusal sealant

Conditions: Dental Caries

Summary: this study assessed long-term impact of tooth eruption stages (es) on sealant retention on occlusal surfaces previously coated with intermediary bonding layer and it determined caries incidence outcome evolved. the treatment were (sealant/technique): fluroshield; helioseal clear chroma; single bond and fluroshield; excite and helioseal clear chroma.

the greatest risk of sealant failure occurs soon after tooth eruption, when contamination with saliva and gingival fluid is almost inevitable. the use of an intermediate bonding layer between humidity contaminated enamel and sealant can improve bond strength, reduces microleakage, and enhances resin flow into fissures. the benefit of primer and adhesive layer beneath the sealant seems to be based on a combination of moisture-chasing effects of the hydrophilic primer, increased flow dispersion imparted by the less viscous primer and adhesive and increased flexibility of the combined and polymerized primer/adhesive/resin complex once reaction is complete.

Eligibility criteria:
inclusion criteria: * four caries-free erupted first molar permanent teeth; no systemic diseases and no dental material allergies. exclusion criteria: * carious or absence first molar permanent teeth.

Keywords: clinical trial pit and fissure sealants tooth eruption retention adhesive system intermediary layer
direct antiviral agents for hepatitis c virus-associated cryoglobulinaemia vasculitis

Conditions: Vasculitis; Cryoglobulinemia; Hepatitis C

Summary: cryoglobulinemia are responsible for systemic vasculitis, and the most frequently targeted organs are the skin, joints, kidney and peripheral nervous system. cryoglobulinemia vasculitides are associated with significant morbidity and mortality, and require therapeutic intervention. with the discovery of hepatitis c virus (hcv) as the etiologic agent for most cases of mixed cryoglobulinemia new opportunities and problems for crafting therapy of hcv mixed cryoglobulinemia (mc) have emerged. a new and major concern was the potential adverse effects that immunosuppressive therapy with glucocorticoids and cytotoxic drugs could have on an underlying chronic viral infection. alternatively the discovery of hcv provided the opportunity to control hcv-mc with antiviral therapy based on the belief that the underlying infection was driving immune complex formation and resultant vasculitis. inducing a sustained virologic and clinical response and minimizing the use of immunosuppressive drugs are the main goals in the treatment of patients with hcv-mc vasculitis. aggressive antiviral therapy has been shown to induce a complete remission of hcv-mc in up to 70% of patients. new antiviral combination, interferon (ifn)-free regimens have recently proved very high virological response rate and with a very good safety profile and now need to be evaluated in severe and/or refractory hcv-mc patient's population.


Eligibility criteria:
inclusion criteria: * at least 18 years of age or older * present an active hcv vasculitis defined by a clinically active vasculitis with skin, joint, renal, peripheral nerve, central neurological, digestive, pulmonary and/or cardiac involvement (no histological evidence needed if patient had purpura) * chronic active hcv infection (positive hcv rna) * informed consent exclusion criteria: * non-active cryoglobulinaemia vasculitis * hiv * active hepatitis b virus (hbv) infection * current decompensated cirrhosis.
a study of aav2-gdnf in adults with moderate parkinson's disease (regenerate-pd)

Conditions: Parkinson Disease

Summary: the objective of this randomized, surgically controlled, double-blinded, phase 2 study is to evaluate the safety and efficacy of aav2-gdnf delivered to the putamen in subjects with moderate parkinson's disease.


Eligibility criteria:
inclusion criteria: age 1. male and female adults 45-75 years of age inclusive, at the time of signing of informed consent type of subject and disease characteristics 2. diagnosed with parkinson's disease in the past 4-10 years (inclusive) as defined by the following: 1. presence of bradykinesia plus any of the following: * rigidity * rest tremor * postural instability 2. presence of motor fluctuations as measured by the pd motor diary 3. stable anti-parkinsonian medication regiment for \>/= 4 weeks prior to screening 4. must demonstrate responsiveness to levodopa therapy exclusion criteria: * known history or current evidence of medical, genetic, or neurological conditions that may provide an alternative to idiopathic pd diagnosis * presence or history of significant vascular and/or cardiovascular disease * presence of significant cognitive impairment, poorly controlled depression/anxiety * presence or history of psychosis or impulse control disorder * history of malignancy other than treated cutaneous squamous or basal cell carcinomas * presence of clinically relevant conditions that could compromise surgical suitability and/or subject safety * contraindication to magnetic resonance imaging and/or use gadolinium-based contrast agents * prior history of brain surgery including, but no limited: dbs, pallidotomy focused ultrasound thalamotomy, or other experimental neurosurgical procedure * chronic immunosuppressive therapy

Keywords: gene therapy
behavioral management of phosphorus in hemodialysis patients

Conditions: Cardiovascular Disease (CKD); Hyperphosphatemia

Summary: the purpose of this randomized clinical trial is to evaluate alternative technology-supported behavioral approaches to engaging 42 maintenance hemodialysis (hd) patients with persistent hyperphosphatemia in phosphorus binder adherence and dietary phosphorus restriction. participants will be randomized to 1 of 3 intervention groups: (1) education (edu); (2) edu + self-monitoring (sm); or (3) edu + sm + social cognitive theory (sct)-based training program.

investigators will evaluate the intervention in terms of feasibility and acceptability, behavior change at 12 and 24 weeks (reported phosphorus binder adherence, reported nutrient intakes, normalized protein catabolic rate), and clinical outcomes (serum phosphorus concentrations, symptoms). in addition, the impact of the different behavioral approaches on self-efficacy at 12 and 24 weeks, and the mediating effects of self-efficacy in facilitating behavioral changes and clinical outcomes will be examined.

Eligibility criteria:
inclusion criteria: * receiving thrice-weekly hemodialysis treatment for at least 3 months * 3-month average serum phosphorus concentration \>5.5 mg/dl exclusion criteria: * unable to participate meaningfully in the combined edu + sm + sct intervention, including: * unable to read and/or speak english * self-monitoring application is currently available in english only (patients will not be excluded from participation on the basis of race/ethnicity) * cognitively-impaired * physically-impaired * institutionalized or otherwise having limited control over diet * life expectancy of \<1 year per dialysis center staff * women who are pregnant or become pregnant during the study

Keywords: hemodialysis
assessment of blood coagulation disorders in patients with pulmonary hypertension

Conditions: Pulmonary Artery Hypertension; Chronic Thromboembolic Pulmonary Hypertension

Summary: the objective of the present study is to assess blood coagulation disorders in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. the investigators aim to evaluate any possible coagulation abnormalities related to the patients' primary disease and any possible effects the pulmonary hypertension- specific therapy may have on hemostasis.

pulmonary hypertension (ph) is a chronic, progressive, pulmonary vascular disease with a multifactorial etiology and a not fully elucidated pathophysiological background. there is a complex and not adequately understood association between ph and the coagulation process. the aim of the present study is to evaluate hemostasis in patients with ph classified as category 1 of the world health organization pulmonary hypertension group (pulmonary arterial hypertension, pah) and 4 (chronic thromboembolic pulmonary hypertension, cteph). patients with cteph are diagnosed as inoperable. the investigators perform diagnostic tests on blood samples collected directly from the pulmonary artery during the right heart catheterization performed as part of the patients' routine medical care for the diagnosis of the disease or for follow-up 6 months after the initiation of ph-specific treatment. all blood samples are processed by platelet function analyzer-100 (pfa-100), light transmission aggregometry (lta), rotational thromboelastometry (rotem) and endogenous thrombin potential (etp).the primary objective of the study is to assess platelet function, coagulation and anti-coagulation pathways and fibrinolysis in pah and inoperable cteph patients and to investigate the possible effects of ph- specific therapy on hemostasis.

Eligibility criteria:
inclusion criteria: * pulmonary arterial hypertension, * chronic thromboembolic pulmonary hypertension. exclusion criteria: * renal insufficiency, * hepatic insufficiency, * thyroid dysfunction, * malignancy, * active infections, * receiving anticoagulant or antiplatelet therapy, * history of hemostatic disorders irrelevant to their primary disease, * abnormal red blood counts.

Keywords: blood coagulation disorders platelets thrombin treatment
epidemiology of klebsiella pneumoniae in china

Conditions: Klebsiella Pneumoniae Infection

Summary: klebsiella pneumoniae is one of the most common pathogens causing both community-onset and nosocomial infection. more worse, the emergency of carbapenem-resistant klebsiella pneumoniae (crkp) had cause the clinical therapy be very difficult. however, there is not much empirical data as to the prevalence, risk factors, characteristics,outcomes and the rationality of the current therapy for the klebsiella pneumoniae infection in china.thus, the study was aimed to investigate the epidemiology and risk factors, characteristics, outcomes and the rationality of the current therapy for the klebsiella pneumoniae infection in china.

all the patients with culture positive of klebsiella pneumoniae were screened and reported to the the clinical doctors and confirmed by them. and the clinical characteristics of the patiens, such as baseline data, outcomes etc, were recorded. finially, to find the prevalence, risk factors, characteristics, outcome and the rationality of the current therapy for the klebsiella pneumoniae infection in china.

Eligibility criteria:
inclusion criteria: - new confirmed community-onset or noscomial infection of klebsiella pneumoniae infection exclusion criteria: * age\ 85 years old; mixed infection of klebsiella pneumoniae and other microbes
study of photodynamic therapy (pdt) using hpph in barrett's esophagus

Conditions: Barrett's Esophagus; CIS; High Grade Dysplasia

Summary: a study to identify toxicity and optimal photodynamic treatment parameters using the photosensitizer 2-\[1-hydroxyethyl\]-2-devinylpyropheophorbide-a (hpph) in high grade dysplasia, carcinoma-in-situ, or early adenocarcinoma in barrett's esophagus.


Eligibility criteria:
inclusion criteria: * patient must have biopsy proven high-grade (severe) dysplasia, carcinoma-in-situ or early stage adenocarcinoma; * patient may have received prior therapy; e.g. nd-yag laser, radiation therapy or chemotherapy. at least one month must have elapsed between prior treatments and pdt. * tumors can be primary or recurrent, stage 0 or i, n0m (any). * patients must have no contraindications to endoscopy. * male or female patients must be 18 years old or older. female patients must not be pregnant and must be practicing a medically acceptable form of birth control or be sterile or post-menopausal. a pregnancy test is required and must be negative. * patients must sign an informed consent according to fda guidelines and be acceptable to the rpci irb. * patients must have a karnofsky status 50 or above. * operable patients are not excluded. exclusion criteria: * patients with tumors of grade greater than t-1. * porphyria or hypersensitivity to porphyrin or porphyrin-like compounds. * wbc \<2,000; platelet count \<50,000, prothrombin time 1.5 times above the upper normal limit. * patients with impaired renal and/or hepatic function (total serum bilirubin \>3.0 mg/d, serum creatinine \>3 mg%, alkaline phosphatase (hepatic) or sgot \>3 times the upper normal limit. * patients on concurrent chemotherapy or radiation therapy will be excluded as well as those having received prior treatment for the esophageal cancer within 4 weeks of enrollment. * if the patient has cancer other than non-melanoma skin cancer they must be deemed disease free by their treating physician.
assessment of quality of life after adjunct radioiodine therapy in patients with differentiated thyroid cancer

Conditions: Thyroid Neoplasms

Summary: the aim of this study was to assess the impact of adjuvant radioactive iodine therapy on the quality of life(qol) in differentiated thyroid cancer patients and to identify independent factors affecting changes in the qol.


Eligibility criteria:
inclusion criteria: * pathologically confirmed new diagnosis of differentiated thyroid cancer, recently treated by total thyroidectomy * must sign a consent form before treatment * one year or more of follow-up after radioiodine ablation exclusion criteria: * patients with follicular, hürthle cell, poorly differentiated, medullary, or anaplastic thyroid carcinoma * pregnant or lactating women * patients that received adjuvant radioiodine treatment in the past * patients with other cancer
a community-based, behavioral intervention to improve screening for hepatitis c among high-risk young adults in wisconsin

Conditions: Hepatitis C

Summary: the goal of this study is to evaluate the effectiveness of a brief, computerized behavioral intervention for promoting screening for hepatitis c and reducing risky behavior for people who inject drugs (pwid).

people who inject drugs (pwid) are at high risk for hepatitis c virus (hcv) infection if they share contaminated injection equipment with others. many are infected but are unaware of it, making it likely they will transmit the virus to others if they share contaminated injecting equipment. problems related to hepatitis c can be avoided if people know their status by getting tested and referred to treatment. in this study, the investigators will recruit eligible pwid in several cities in wisconsin using a social networks strategy, in which clients who receive services at a syringe exchange program are asked to refer peers who also inject drugs to participate in the study. all participants will undergo a baseline computerized risk assessment that elicits information about hepatitis c status, previous testing, transmission risk behaviors, and overdose risk. participants will then be randomly-assigned to receive either standard risk reduction counseling from a prevention specialist, or computerized tailored risk reduction messages that are specific to their reported risk behaviors, attitudes and beliefs. a follow-up assessment will be completed after 3 months to evaluate changes in behavioral risk and intention to undergo hcv screening. a database will be searched to determine which participants returned for hcv screening within 12 months of enrollment, and of those, which ones tested positive for hcv.

Eligibility criteria:
inclusion criteria: * age 18 or over * english-speaking * reports injection of illicit drugs in the past month exclusion criteria: * unable to provide informed consent due to cognitive impairment * unwilling to provide personal locator information and consent to be contacted for follow-up after 3 months. * currently known to be pregnant

Keywords: injection drug use
strategies for ovulation induction in anovulatory infertile patients with pcos

Conditions: Anovulatory Infertility Related to Polycystic Ovary Syndrome

Summary: anovulatory infertility is a common feature of the polycystic ovary syndrome (pcos). even if several first-step treatments have been proposed for anovulatory infertile pcos patients, very few data are available in literature regarding the best integrated strategy. in fact, a single compound could be effective as first-step approach but not or less useful when integrated in a more complex strategy. the goal of the current protocol will be to compare three different strategies for treating anovulatory infertility in pcos patients having as primary end-point the multiple pregnancy rate.

all patients eligible will undergo baseline assessment consisting of antropometric, hormonal, and ultrasonographic assessments. successively, patients enrolled will be allocated in three different strategies (strategy a, b, and c). a total of 184 infertile pcos patients per arm will be enrolled and treated with three different integrated strategies: clomiphene followed by clomiphene plus metformin followed by gonadotropins (strategy a); metformin followed by metformin plus clomiphene followed by gonadotropins(strategy b); and metformin plus clomiphene followed by gonadotropins(strategy c). in all patients, the same regimen will be used to administered clomiphene, metformin, and gonadotropins.both clomiphene and metformin will be administered at incremental doses in each case.gonadotropins will be administrated to obtain a controlled ovarian stimulation using highly purified urinary fsh in a low-dose step-up protocol. during the study, the clinical and reproductive outcomes, and adverse experiences will be evaluated in each woman.

Eligibility criteria:
inclusion criteria: * polycystic ovary syndrome (using eshre/arsm 2004 criteria) exclusion criteria: * age \ 35 years * severe obesity (bmi \>35) * neoplastic, metabolic, hepatic, and cardiovascular disorders or other concurrent medical illnesses * hypothyroidism, hyperprolactinemia, cushing's syndrome, and non-classical congenital adrenal hyperplasia * current or previous (within the last six months) use of oral contraceptives, glucocorticoids, antiandrogens, antidiabetic and anti-obesity drugs or other hormonal drugs * previous use of ovulation induction agents * intention to start a diet or a specific program of physical activity * no uterine bleeding after progesterone challenge test * organic pelvic diseases * previous pelvic surgery * suspected peritoneal factor infertility * tubal or male factor infertility or sub-fertility

Keywords: anovulation clomiphene citrate infertility metformin pcos rct treatment