Kornimate/medical-research-clean huggingface dataset:
effects of exercise versus topical agents on knee osteoarthritis

Conditions: Osteo Arthritis Knee

Summary: osteoarthritis, a chronic and degenerative joint disease, is the most common type of arthritis and affects more than 300 million adults worldwide. osteoarthritis, which is characterized by joint pain and stiffness, has negative consequences for function, participation and quality of life, which are important components of health. the knee joint is the most common joint in terms of osteoarthritis and is more common in individuals over 50 years of age. there is no proven definitive treatment in today's literature for common osteoarthritis, which is one of the important causes of the global disease burden. however, since it is a progressive disease with varying degrees of severity, it is a chronic problem that requires long-term treatment. according to current clinical guidelines prepared by the working groups of the international osteoarthritis research society (oarsi) and the european society for clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases esceo , treatment typically includes physiotherapy interventions with the use of non-steroidal anti-inflammatory drugs (nsaids) and analgesics, including intra-articular injections of corticosteroids; in more severe cases, joint replacement surgery is recommended. the aim of this research project is to examine the effectiveness of a supervised exercise program applied in combination with nsaid-specific topical agents, in comparison with groups receiving only topical agents or only exercise treatments.

voluntary participants who have been diagnosed with knee osteoarthritis will be included in the study. signed voluntary consent will be obtained from participants. participants will be divided into tree groups. study groups will be as follows: a) exercise, b) exercise \& topical agent, c) topical agent.

Eligibility criteria:
inclusion criteria: * diagnosed with knee oa according to the criteria of the american society of rheumatology * stage 2 or 3 according to kellgren lawrence radiological staging criteria * those between the ages of 40 and 65 * body mass index below 30 kg/m2 * pain intensity defined by the patient in the last 3 months is at least 3 out of 10 according to nprs * patients who do not have any obstacles to be included in the exercise program exclusion criteria: * using viscosupplementation or steroid injection or systemic steroids in the related knee in the last 3 months * to have received a physiotherapy program for the relevant knee in the last 3 months * having a valgus or varus deformity greater than 15° * presence of active infection or tumor * presence of neurological diseases and/or deformity leading to lower extremity muscle weakness * having serious systemic and cardiovascular diseases that interfere with exercise

Keywords: diclofenac non-steroidal anti-inflammatory drugs physiotherapy gonarthrosis
lower urinary tract infection (uti) evaluation in women with uterine leiomyomata

Conditions: Urinary Tract Infection; Leiomyoma

Summary: to the investigators knowledge there is no research data published to date regarding the lower urinary tract symptoms in women with leiomyomas. the primary aims of this study are: 1. to determine prevalence of lower urinary tract symptoms in patients who present for care for symptomatic leiomyomata. 2. to compare change in lower urinary tract symptoms within treatment groups measured by the udi-6 total before and at six months after three common treatments for symptomatic uterine fibroids including: hysterectomy, myomectomy, or uterine artery embolization. the study proposed here will hopefully answer the question if one particular therapy is appropriate to treat fibroids and relieve lower urinary tract symptoms.

1. uterine fibroids uterine leiomyomas or fibroids are one of the most common conditions affecting women of reproductive age. they account for approximately a third of all hysterectomies performed. symptoms often attributed to uterine leiomyomas include excessive menstrual bleeding, dysmenorrhea, pelvic pain, and so called "bulk symptoms," or symptoms related to pressure on adjacent organs such as ureteral obstruction, urinary frequency and urgency, rectal pressure, pelvic pressure and increasing abdominal girth. current treatment for symptomatic uterine fibroids includes hysterectomy, myomectomy and uterine fibroid embolization. 2. lower urinary tract symptoms although, urinary symptoms like frequency, urgency, incontinence, and voiding dysfunction are often attributed to fibroids, the relationship between fibroids and lower urinary tract symptoms (luts) has been poorly studied. the public health burden of fibroids has been studied before and after radical hysterectomy, supracervical hysterectomy, and total abdominal hysterectomy.(1-3) what is missing in the literature is a comparison of traditional and non-traditional surgical fibroid techniques in a prospective fashion. moreover, there are no studies evaluating the relationship between anatomic factors like uterine size or fibroid number or location and the presence of luts.

Eligibility criteria:
inclusion criteria: * patients who are at least 18 years of age, * vaginal bleeding secondary to anatomic uterine leiomyomas confirmed at the cleveland clinic fibroid and menstrual disorders center, * patients complaining of mass effect symptoms due to fibroids, and * patients undergoing either hysterectomy, myomectomy, or uterine artery embolization exclusion criteria: * patients who are pregnant, or * diagnosis of solitary or multiple intracavitary fibroids without subserosal or intramural leiomyomas present, or * prior or interval anti-incontinence procedure, or * patients with a urinary tract infection, or * patients taking anti-cholinergic medications, or * presence of an adnexal mass, or * unable or unwilling to complete a follow up survey at six months following treatment

Keywords: frequency women fibroids uterine artery embolization myomectomy hysterectomy
this is the comparison of clinical effectiveness of hydrochloric acid-pumice compound and sodium hypochlorite-pumice compound used in microabrasion technique for the treatment of dental fluorosis. change in tooth shade was checked before and after the procedure.

Conditions: Dental Fluoroses

Summary: to compare the clinical effectiveness of hydrochloric acid-pumice compound and sodium hypochlorite-pumice compound in treating dental fluorosis using microabrasion technique.

a randomized clinical trial was taken fatima jinnah dental college hospital, karachi, from 1st november 2019 to 30th april 2020. total 30 teeth in each group were included. preoperatively shade was checked. the mixture was applied 10 times or more during the same session. total treatment time was around 30 minutes. every patient received entire microabrasion treatment. at the end of the treatment, neutral sodium fluoride gel was applied. then changes in shade were checked. descriptive statistics were calculated.

Eligibility criteria:
inclusion criteria: * patients aged 18-40 years . * permanent dentition assessed on clinical examination. * have at least four maxillary incisors with scores of 4 to 5, according to the dean's fluorosis index. * have no caries or restoration on the teeth to be treated assessed clinically. exclusion criteria: * poor oral dental and general health assessed on clinical examination. * history of smoking and any form of tobacco. * patients with periodontal disease assessed on clinical examination. * caries on anterior teeth assessed on clinical examination. * hypersensitive teeth assessed on clinical examination.

Keywords: hydrochloric acid sodium hypochlorite dental fluorosis microabrasion technique
beta-glucan and immune response to influenza vaccine

Conditions: Healthy Aging

Summary: this trial in healthy adults will determine the effects of beta-glucan, a dietary fiber supplement isolated from baker's yeast, on immune response to the influenza vaccine.

beta-glucans have been shown to enhance the innate and adaptive immune responses in cell cultures, animal models, and humans, thus adults over the age of 50 years receiving the influenza vaccination may benefit in terms of their immune response from supplementation with beta-glucans. this is a 6-week randomized, double-blind, placebo-controlled, 2-arm parallel study designed to evaluate the adjuvant effect of beta-glucan dietary supplementation during influenza vaccination. participants will consume either the beta-glucan or placebo capsules for 42 days. participants will complete an online qualtrics daily questionnaire of compliance, fatigue, and cold and flu symptoms throughout the 42-day study. influenza vaccine will be administered on or about day 14. the gastrointestinal symptom rating scale (gsrs) and the mood and feelings questionnaire (mfq) will be completed at baseline, 2 weeks and 6 weeks. blood draws for antibody and cytokine response will be completed at baseline, and on or about days 14 and 15, and on day 42.

Eligibility criteria:
inclusion criteria: 1. adult volunteers ≥ 50 years of age. 2. planning to be vaccinated for influenza 3. have been immunized for covid-19 4. willing and able to provide written informed consent in english. 5. willing and able to comply with all the study-related procedures, including attending to study visits for blood draw, taking the influenza vaccine, intake of the study supplement, and completing study questionnaires. exclusion criteria: 1. demonstrate an inability to comply with the study-related procedures. 2. have a history of a severe reaction or hypersensitivity following vaccination with influenza vaccine, vaccination with any other vaccine containing the same substances, or intake of the study product. 3. have an immune system alteration because of an underlying illness (e.g., autoimmune disease) or immune-suppressing treatment (e.g., steroids (last 30 days); cytotoxic drugs, medical surgery, or radiation therapy during the 6 months, previous to enrollment). 4. be concurrently participating in a clinical trial that, in the judgement of the investigator, would interfere with the evaluation of the study outcomes.

Keywords: beta-glucan; influenza; immunity; antibodies
issue3: international study on syncope of uncertain etiology 3

Conditions: Syncope

Summary: issue 3 is a multi-center, prospective, randomised controlled double-blind study aimed to assess the effectiveness of pacemaker therapy for prevention of asystolic neurally-mediated syncope.

in asystolic neurally-mediated syncope (nms) documented by implantable loop recorder (ilr), issue-2, an observational trial, showed that pacemaker was effective in reducing the 1-year first syncope recurrence rate from 33% rate before implant (ilr phase 1) to 5% rate after implant (phase 2). moreover, the control non-asystolic group still continued to have a 41% recurrence rate after the first recurrence of syncope, thus supporting the conclusion that the reduction with pacemaker was due to the beneficial effect of pacemaker itself and not to other factors. however a formal controlled trial is needed to confirm these findings.

Eligibility criteria:
inclusion criteria: * suspected or certain neurally-mediated syncope, based on the guidelines recently published by the task force on syncope of the european society of cardiology 2,3 (appendix 1); * more than 3 syncope episodes in the last 2 years; * clinical presentation of syncope of sufficient severity requiring treatment initiation in the physician's and patient's judgement. * age \> 40 years. * negative carotid sinus massage. * patients accept to have an ilr implantation. exclusion criteria: * carotid sinus hypersensitivity * suspected or certain heart disease and high likelihood of cardiac syncope: * symptomatic orthostatic hypotension diagnosed by standing blood pressure measurement; * loss of consciousness different from syncope (e.g. epilepsy, psychiatric, metabolic, drop-attack, tia, intoxication, cataplexy); * subclavian steal syndrome; * psychologically or physically (due to any other illness) or cognitively unfit for participation in the study according to the opinion of the investigator; * patient compliance doubtful; * patient geographically or otherwise inaccessible for follow-up; * patient unwilling or unable to give informed consent; * life expectancy \<1 year.

Keywords: syncope implantable loop recorder
a prospective, single-center, open-label, pilot study to compare the effectiveness and safety of diuretics add-on strategy in chronic heart failure patients (dios 1)

Conditions: Congestive Heart Failure

Summary: to compare the effectiveness and safety of diuretics add-on strategy in chronic heart failure patients


Eligibility criteria:
inclusion criteria: 1. dyspnea at rest or minimal activity 2. tachypnea (respiratory rate \> 20/min) or rales or pulmonary edema on chest x-ray 3. who need diuretics add over 40mg of daily furosemide dose exclusion criteria: 1. hospitalization for acute heart failure decompensation 2. cardiogenic shock (systolic blood pressure \< 80mmhg) 3. need or plan for renal replacement therapy (dialysis, kidney transplant) 4. serum creatine level \> 2.5mg/dl 5. serum potassium (k+) \> 5.5mg/dl 6. daily spironolactone dose \> 50mg 7. previous thiazide or metolazone user 8. age \> 75 years old or poor compliance patients 9. allergy, adverse drug reaction, hypersensitivity to any kinds of diuretics 10. life expectancy \< 6 months (e.g. metastatic malignancy, liver cirrhosis) 11. pregnancy or women at age of childbearing potential

Keywords: heart failure diuretics kidney glomerular filtration rate
compliant analysis of patient samples and data

Conditions: Pregnancy Related; Cancer; Infectious Disease

Summary: patients of scientific interest who have provided a commercial sample to labcorp or one of its' affiliates will have their de-identified remnant samples and/or data used for research and development. other commercial patients will be followed up on after informed consent is obtained.

arm 1 - remnant commercial samples and data that has been de-identified of personal health information in compliance with hipaa may be used for r\&d studies or population-based analysis by labcorp or affiliates. arm 2 - collection of samples and/or data from commercial test patients requiring follow-up or from subjects of scientific interest after informed consent is obtained.

Eligibility criteria:
inclusion criteria: * arm 1 * all samples and data are de-identified and hipaa compliant * arm 2 * subject is of scientific interest to the sponsor or treating physician * subject provides written informed consent and has a clinical sample and/or supporting clinical data collected. exclusion criteria: * arm 1 * subject is from a us state or a country where local law restricts the use of de-identified data and/or remnants of specimens for research and/or development * arm 2 * any medical or mental condition that would interfere with the subjects' ability to willingly give written informed consent
weight loss intervention before total knee replacement

Conditions: Osteoarthritis, Knee; Obesity

Summary: the purpose of this study is to compare the efficacy in a group of patients who must follow the current procedure for treatment of artificial knee, compared with a group of patients who must undergo an 8-week weight loss program before surgery. 1 year after surgery the investigators will examine whether there are differences between the two groups' quality of life and functional capacity.

background in denmark the numbers of primary total knee arthroplasty (tka) operations annually increase. in the year 2000 was performed approximately 2,500 operations and in 2008 was performed more than 7,500 total knee arthroplasty operations, and there appears in all countries to be similar tendency. meanwhile, the prevalence of overweight and obesity has increased markedly over the last 50 years. approximately 13% of the danish population is obese. for several years the association between obesity and knee osteoarthritis (oa) has been recognized, and osteoarthritis is the most frequent indication for total knee arthroplasty(80%). the purpose of this study is to investigate whether weight loss interventions before primary total knee arthroplasty will improve quality of life and functional level, reduce pain and risk of early and late postoperative complications. sample size significance level is set to 5% by using a 2-sided analysis and the power is set at 80%. based on an expectation of a difference in patient-reported outcome scores in between the groups at 8%, as measured by sf-36 12 months postoperatively, standard deviation (sd) 13 must be include 41 participants in each group. to allow a drop-out rate of 20% the group size increases to 51 participants in each group. in total 102 participants. statistical analysis, the two groups scores at 12 months postoperatively, and the two groups' change in the primary outcome measurer, from 1 week before surgery to 12 months postoperatively, compared with t-test or mann-whitney test rang sum depending on data distribution.

Eligibility criteria:
inclusion criteria: * all patients recommended for primary total knee replacement. * body mass index \> 30. * must be motivated for weight loss. * must be able to read and understand danish. exclusion criteria: * rheumatoid arthritis. * patients who are operated on both knees during the project period can only participate once. * planned obesity surgery.

Keywords: osteoarthritis, knee obesity weight loss arthroplasty
mindfulness meditation for insomnia

Conditions: Sleep Initiation and Maintenance Disorders; Insomnia; Insomnia Chronic; Mindfulness; Telemedicine

Summary: the investigators will conduct a 3-arm, pilot rct where participants (n=30) will be randomized in a 1:1:1 design to 4 weeks of instructed bedtime mm practice at night (n=10) vs. uninstructed mm (n=10) vs. sleep hygiene education only (n=10). aim 1 is to understand the feasibility and acceptability of the intervention and study procedures. aim 2 is to explore patterns of within-group changes in sleep outcomes (i.e., insomnia severity and sleep quality). patient-reported outcomes will be collected using a hipaa-compliant electronic data management system (redcap). following informed consent, participants will receive links to redcap surveys via email at weeks 0, 4, 8, and 16. the investigators will also conduct a post-intervention interview at the end of week 4 and an exit interview at week 16. all participants will also receive a research kit with wearable devices and meet with our staff after they receive the kit for instructions. data collected in the pilot rct will help us to preliminarily identify tools for subjective measures and physiological signals to inform a future trial.


Eligibility criteria:
inclusion criteria: * age 18 years and older; * chronic insomnia (≥ 3 nights/week, for ≥ 3 months), defined by dsm-v or icsd-3; * have a primary complaint of difficulty falling asleep (sleep-onset insomnia) with self-reported sleep onset latency \>20 min; * insomnia severity index score ≥ 15; * speak and understand english; * have a smart device (phone or tablet) for mobile app installation exclusion criteria: * current diagnosis of sleep disorders other than insomnia (e.g., narcolepsy, restless leg syndrome, rem sleep behavior disorder, etc.); * shift worker or routine night shifts; * women with pregnancy or breastfeeding; * regular (defined as twice a week or more) practice of mind-body interventions; * patients with pace-maker or routinely using cardiovascular medications that have effects on heart rates (i.e., beta-blockers); * neurological disorders (e.g. epilepsy, dementia, stroke, parkinson's disease, neuroinfections, brain tumors, etc.) or current diagnosis of comorbid psychotic, substance use, and trauma-related disorders; * currently under medications with sleep changing effects (e.g., anxiolytics/benzodiazepines, selective serotonin reuptake inhibitors, hypnotics, etc.); * hearing impairment or loss. participants will be asked to report any medication for at least 2 weeks prior to study onset and during the study period.
comparison of four and eight hours dialysis sessions in thrice weekly hemodialysis

Conditions: End-Stage Renal Disease; Hemodialysis

Summary: the investigators hypothesize that an increase in the duration of dialysis session in thrice weekly center hemodialysis may provide better outcome, less morbidity, higher quality of life, lesser requirement of medications, and lower total cost.

the proposed prospective and controlled clinical trial aims to compare 4-hour and 8-hour dialysis sessions in thrice weekly center hd regarding mortality, hospitalization rate, several clinical and laboratory parameters, and total cost. four hundred and ten hd patients will be taken into the study. the study will last for 12 months. the patients will be placed in two groups: 1. four-hour dialysis session, blood flow rate 300-400 ml/min 2. eight-hours dialysis session, blood flow rate 200-250 ml/min sample size is estimated with following hypotheses: twelve months duration of follow-up; twelve months survival of the control group 85%; a bilateral alpha risk equal to 5%; an expectation that 12-months survival to be 95% by 8-hours dialysis; a 85% power to detect the decrease in annual mortality by 8-hours dialysis comparing to 4-hours dialysis; a 10% of dropout rate. the required sample is total 410 patients.

Eligibility criteria:
inclusion criteria: * older than 18-years * on maintenance bicarbonate hd scheduled thrice weekly 12 hours/week; achieved mean single pool kt/v above 1.2 * willingness to participate in the study with a written informed consent exclusion criteria: * to be scheduled for living donor renal transplantation * to have serious life-limiting co-morbid situations, namely active malignancy, active infection, end-stage cardiac, pulmonary, or hepatic disease * pregnancy or lactating * current requirement for hd more than three times per week due to medical comorbidity * gfr greater than 10 ml/min/1.73 m2 as measured by the average of urea and creatinine clearances obtained from a urine collection of at least 24 hours * use of temporary catheter * current use of investigational drugs or participation in an interventional clinical trial that contradicts or interferes with the therapies or measured outcomes in this trial * mental incompetence

Keywords: hemodialysis nocturnal dialysis cardiovascular disease quality of life left ventricular hypertrophy