Kornimate/medical-research-clean huggingface dataset:
periurethral vs intravaginal estrogen for prevention of recurrent urinary tract infections

Conditions: Recurrent Urinary Tract Infection

Summary: due to rising antibiotic resistance, there has been a focus on non-antibiotic prophylactic measures for postmenopausal patients with recurrent urinary tract infections (ruti), one of which is the safe and efficacious option of vaginal estrogen therapy. standard application of vaginal estrogen cream entails intravaginal application of the cream twice a week, but some providers counsel patients with ruti to apply a small, pea-sized amount to the periurethral area. this ideally reduces the amount of vaginal estrogen used while attaining a similar effect. however, to date, there is no data to prove that the periurethral technique of application is similar or non-inferior to intravaginal application in preventing uti.


Eligibility criteria:
inclusion criteria: * postmenopausal (definition: no menses for 1 or more years or surgical menopause (bilateral oophorectomy). if there is a past history of hysterectomy, patient must be age 56 or older (95th percentile for age at menopause) or have laboratory evidence of menopause (ie. fsh \>30) * meets criteria for recurrent urinary tract infections (utis) with 2 or more uti in 6 months or 3 or more uti in 1 year * may include patients who used vaginal estrogen previously if they have stopped use for 3 or more months prior to inclusion into study. * patients must be recommended vaginal estrogen as part of normal clinical care for prevention of recurrent uti exclusion criteria: * current use of vaginal or oral estrogen products * inability or refusal to use vaginal estrogen * daily antibiotic use * significant vaginal stenosis (eg. due to lichen sclerosis, radiation or obliterative prolapse surgery) that would prohibit use of a vaginal applicator (ie. genital hiatus \<1cm) * inability to use vaginal applicator and without caregiver who can administer (eg. provider-managed pessary use, significant arthritis) * frequent (1x weekly or more frequent) use of bladder instillations containing an antibiotic * known hydronephrosis as a result of incomplete bladder emptying * use of intermittent or indwelling urinary catheterization * known bladder stones, mesh erosion into bladder, or foreign object in bladder * unable to consent for self * active treatment for an estrogen-dependent malignancy
a study to review treatment outcomes from treatment with dysport® injections in adults for upper and/or lower limb focal spasticity

Conditions: Upper and/or Lower Limb Focal Spasticity

Summary: the aim of this retrospective study is to describe the real-world outcomes with the treatment of adult patients with dysport® injections for focal upper limb spasticity (uls) and/or focal lower limb spasticity (lls) in nhs hospital settings in the united kingdom (uk).


Eligibility criteria:
inclusion criteria: * adult patients diagnosed with focal uls and/or lls for whom abobont-a (dysport®) was prescribed in line with the smpc (according to clinician judgement). * patients initiated on abobont-a for focal uls after the 31st january 2016 and/or for focal lls after the 06th december 2016. * patients receiving ≥1 injection(s) (i.e. ≥1 treatment cycle) of abobont-a during the observation period, in line with dysport® summary of product characteristics (smpc). * patients aged ≥18 years old at the time of the first abobont-a injection for focal uls and/or lls. * patient is naïve to treatment with any type of bont-a during the 6 months prior to initiation of abobont-a. * patients treated at the participating centre for the duration of the observation period, with data recorded in the medical records available for review. exclusion criteria: * patients with an interval of \<12 weeks between abobont-a treatments * patients are participating (or who have participated) in an interventional clinical trial of an investigational medicinal product indicated for spasticity which may influence and confound the real-world data collected for this study. * patients treated with abobont-a off-license, this may include off-license indications, muscles indicated for injection or dosing

Keywords: spasticity
safety, tolerability and preliminary efficacy of multiple intra-articular injections of lrx712 in patients with knee oa

Conditions: Osteoarthritis (OA)

Summary: this study will explore the preliminary efficacy of multiple intra-articular injections of lrx712 by evaluating the ability of the drug to restore structural integrity of articular cartilage. efficacy will be evaluated in the context of the systemic safety and local tolerability of the investigational drug.

the purpose of this study is to evaluate the safety, tolerability and preliminary efficacy of multiple intra-articular injections of lrx712 in the knee when treating patients with knee osteoarthritis of mild/moderate severity, in order to support the further clinical development. this study will also allow refinement of the systemic and local pharmacokinetics of lrx712 and the exploration of drug effects on biomarkers of cartilage breakdown and regeneration in oa patients.

Eligibility criteria:
inclusion criteria: written informed consent must be obtained before any assessment is performed. to be eligible for inclusion in this study patients must meet all of the following criteria: * patient must have a bmi between 18 -35 kg/m2 * patient must have symptomatic knee osteoarthritis predominantly in one knee (index knee) * patient must have knee osteoarthritis (kellgren-lawrence grade 2 or 3) in the index knee, as confirmed by radiography * patient must have radiographic confirmation of a medial joint space width of 1.5 to 3.5 mm for females, or 2 to 4 mm for males within the medial tibio-femoral compartment of the index knee exclusion criteria: subjects meeting any of the following criteria are not eligible for inclusion in this study: * patient has a known autoimmune disease, inflammatory or chronic arthropathy * patient had partial or complete joint replacement in one or both knees * patient has symptomatic, isolated patello-femoral pain in the index knee as per the investigator's examination * pregnant or nursing (lactating) women * women of child-bearing potential, defined as all women physiologically capable of becoming pregnant. * previous use of lrx712 or use of other investigational drugs at the time of enrollment, or within 5 half-lives of enrollment, or within 30 days, whichever is longer; or longer if required by local regulations * patient has malalignment (valgus- or varus-deformity) ≥ 7.5° in the index knee as per anatomic pa axis measured by weight-bearing short knee radiography * history of significant cardiac conduction/electrophysiological disorder, e.g. familial long qt syndrome or known family history of torsades de pointes or prolonged qt syndrome or qtcf ≥ 450 msec (fridericia correction) for males and ≥ 460 msec for females at screening or baseline (by local 12-lead digitized ecg reading) * signs or symptoms, in the judgment of the investigator, of a clinically significant systemic viral, bacterial or fungal infection within 30 days prior to screening. other protocol-defined inclusion/exclusion criteria may apply.

Keywords: knee osteoarthritis chondroanabolic drug magnetic resonance imaging patient reported outcomes
evaluating efficacy of smart device in assisting with inhaler technique and adherence

Conditions: Asthma; Adherence, Medication; Childhood Asthma

Summary: asthma affects over 10 million children in the u.s., and poses a significant health and cost burden. metered dose inhaler (mdi) is the most common method of treatment. studies show that up to 80% of patients demonstrate incorrect use of mdis, which results in suboptimal medication delivery to the lungs. asthma control can be followed by symptoms, rescue medication usage and measures of airflow obstruction. current options to monitor control include an asthma diary (relies on consistent use by the patient), pharmacy records of medication dispensing (dispensing does not equal usage), and peak expiratory flow (pef) meters (significant variability in technique leading to inconsistent results). capmedic is a smart inhaler and home spirometer device which aims to assist with correct mdi usage and to monitor asthma control. capmedic fits on top of the mdi inhaler and provides live audio-visual-haptic cues to guide the patient for correctly using their inhaler. capmedic includes a built-in forced expiratory flow in 1 second (fev1, a measure of airflow) and pef meter. it will utilize the same audio-visual-haptic hardware to implement live cues that encourage patient's effort in performing accurate at-home fev1/pef test. cap will also be able to log medication usage and medic application will allow patients to keep an asthma symptom diary.

capmedic is a smart inhaler and home spirometer device which aims to assist with correct mdi usage and to monitor asthma control. capmedic fits on top of the mdi inhaler and provides live audio-visual-haptic cues to guide the patient for correctly using their inhaler. capmedic includes a built-in forced expiratory flow in 1 second (fev1, a measure of airflow) and pef meter. it will utilize the same audio-visual-haptic hardware to implement live cues that encourage patient's effort in performing accurate at-home fev1/pef test. cap will also be able to log medication usage and medic application will allow patients to keep an asthma symptom diary.

Eligibility criteria:
inclusion criteria: * diagnosis of asthma * regular user of mdi * asthma control test (act) scores between 15 and 25 * fev1 between 60-80% of predicted (persistent mild-moderate) * disease severity in the range mild-moderate * access to a smartphone and internet during the entire duration of the study. * cognitively able to utilize the device and express interest in participating. exclusion criteria: * patients without asthma * with developmental disabilities * do not speak english * do not own a smartphone
the efficacy of intravenous pulse in attaining remission in refractory juvenile idiopathic arthritis

Conditions: Refractory Juvenile Idiopathic Arthritis (Despite 2 DMARDs Still Active)

Summary: interventional phase 3 study aiming to unravel the value of pulse steroids in achieving remission or low disease activity in refractory active jia

first group will receive 2 consecutive days intravenous pulse of 125 mg methylprednisolone. second group will not receive additional drugs. assessment was done at baseline and every month for 3 months for both groups using juvenile arthritis disease activity score (jadas) and the american college of rheumatology pediatric 30, 50, and 70 response criteria (acr pedi. 30, 50, 70).

Eligibility criteria:
inclusion criteria: * patients still active despite administration o 2 dmards exclusion criteria: * other connective tissue diseases * endocrine disorders such as thyroid disorders.
endovascular repair of juxtarenal aortic aneurysm

Conditions: Juxtarenal Aortic Aneurysm

Summary: the investigators compare different endovascular techniques as an alternative to surgical reconstruction to repair jaas regarding ; success rates, 30-day mortality,endoleak events secondary intervention rates

aortic disease is the direct cause of close to 10000 deaths annually in the united states. 1 aneurysmal disease can affect any segment of the aorta, from the aortic root to the aortic bifurcation. juxtarenal aortic aneurysms (jaa) (where a specialty designed custom -made device (endograft)which has holes, or fenestrations ,on the graft body to maintain the patency of the visceral arteries) account for approximately 15% of abdominal aortic aneurysms.2 successful aortic aneurysm treatment depends on either open replacement or endovascular exclusion of the aneurysmal segment with healthy artery proximal and distal to the repair. the decision to treat an aaa is based on the associated risk of treatment, the risk of aneurysm rupture, the patient's life expectancy, and patient preference. the primary determinant of rupture risk is maximum aneurysm diameter, with negligible rupture risk in aneurysms \ 8 cm . 3, 4. the society for vascular surgery recommends repair for all patients of acceptable perioperative risk with an aaa ≥5.5 cm in diameter as well as all patients with saccular and symptomatic aneurysms.5 ,6 these guidelines also suggest repair for women at a diameter of 5.0 cm. fenestrated endovascular aneurysm repair (fevar) and chimney endovascular aneurysm repair (chevar)are both effective methods to treat jaas

Eligibility criteria:
inclusion criteria: * • subject is ≥18 years old * subject is scheduled for treatment of the juxtarenal aortic aneurysm with a short infrarenal neck aortic neck length \ 60%, conical neck) (i.e. denovo cases). * subject is able and willing to comply with the protocol and to adhere to the follow-up requirements. * subject has provided written informed consent. exclusion criteria: * subject is participating in a concurrent study which may confound study results * subject has a life expectancy ≤1 year * subject has an aneurysm that is: * mycotic * inflammatory * pseudoaneurysm * subject requires emergent aneurysm treatment, for example, trauma or rupture * subject has previously undergone surgical treatment for abdominal aortic aneurysm * subject is a female of childbearing potential in whom pregnancy cannot be excluded * subject has a known hypersensitivity or contraindication to anticoagulants, anti-platelets, or contrast media, which is not amenable to pre-treatment.
the aging endocrine pancreas: characterization of the entero-insular axis physiology in the elderly

Conditions: Diabetes Mellitus, Type 2; Insulin Resistance

Summary: like most endocrine axes, the entero-insular axis is expected to go through an age-related physiological deterioration, what might contribute to special features of the elderly onset type 2 diabetes in comparison to middle-age. twenty four ngt volunteers will be evaluated by a meal tolerance test (mtt) for incretin hormone measurements, and by the hyperglycemic clamp followed by an arginine test for assessing the beta-cell function and the acute insulin response. others parameters as body composition and basic biochemistry will be also evaluated at laboratory of investigation on metabolism and diabetes - limed / state university of campinas, brazil. the characterization of the glucagon-like peptide-1 (glp-1) production, dipeptidyl peptidase iv (dpp-iv) activity and/or endocrine pancreas incretin-response at aging, might be an interesting evidence to reinforce an incretin-based therapeutic approach for elderly onset type 2 diabetes.


Eligibility criteria:
inclusion criteria: * stable weight (\< 5% variation) within the last three months * age: 35 to 50 years old for middle-age group, and 65 to 80 years old for elderly group. * bmi: 20 to 29.9 kg/m2 * normal glucose tolerance (ngt) for groups elderly and middle-age exclusion criteria: * use of estrogen, progestogen or systemic corticosteroids. * hepatic cirrhosis, renal failure or any clinical condition with impaired insulin sensitivity * smoking * obesity * uncontrolled systemic or debilitating diseases

Keywords: diabetes mellitus, type 2 insulin resistance aging incretins dpp-iv protein, human glucagon-like peptide 1 gastric inhibitory polypeptide insulin glucagon ghrelin
l. brevis cd2 strain persistence in oral cavity

Conditions: Oral Health

Summary: the aim of this study is to select the optimal conditions for quantification in the oral cavity of lactobacillus brevis cd2, a probiotic strain contained in a commercially available dietary supplement and to assess its persistency after oral administration. different sets of primers for l. brevis detection will be tested in real-time pcr reactions to find optimal amplification efficiency and target specificity. primers ability in the identification of l. brevis dna will be assessed in a pilot study conducted on 12 healthy volunteers clinically free of oral pathologies. the subjects will take 3 tablets/day for 3 days and one tablet on the 4th day. clinical samples (dorsal surface of tongue, first molar, vestibular fornix and saliva) will be collected at baseline (before beginning the trial), at t0 (in the morning before the assumption of the last tablet) and 3, 6, and 9 hours after taking the last tablet. the quantities of l. brevis dna will be compared to the total number of bacteria present in the samples. the activity of the enzyme arginine deiminase, responsible for oral ph homeostasis (particularly abundant in the cd2 strain) will be also assessed in the saliva samples before and after treatment, by hplc measurements.


Eligibility criteria:
inclusion criteria: * age \> 18 years * healthy subjects with no oral cavity pathologies * written informed consent exclusion criteria: * patients with oral diseases * patients with systemic diseases * celiac patients or subjects affected by allergic reactions to soy proteins * use of antibiotics or other probiotics

Keywords: lactobacillus brevis oral health bacterial adhesion
combined effects of exercise breaks and rest breaks on fatigue and musculoskeletal discomfort in static workstation office workers

Conditions: Musculoskeletal Pain

Summary: musculoskeletal discomfort and work fatigue has enormous impact on quality of personal and professional life and increases health related economic burden on country due to increased cost of healthcare and reduced productivity in work. upper limb and neck pain complains are the most frequent when evaluated in computer workers. the incidence of musculoskeletal discomfort in office workers is as high as 50%. while fatigue is also common due to its high prevalence and its relationship with dysfunctional disorders in office workers. the objective of this study is to compare and determine the effects of exercise breaks, rest breaks and exercise along with rest breaks on fatigue and musculoskeletal discomfort in static workstation office workers


Eligibility criteria:
inclusion criteria: * both male and female * age: 25-45 years * those static workstation office workers using computer for at least 6 hours per day. * static workstation office workers screened by rosa. exclusion criteria: * discomfort from non-musculoskeletal origin * recent history of trauma and receiving any kind of treatment for the current condition. * severe orthopedic disease * any mental and physiological illness that could interfere in the exercise.
home parenteral nutrition in cancer patients

Conditions: Cancer

Summary: this study is being done to examine the effect of parenteral (intravenous) nutrition support in the home setting on quality of life in cancer patients. in addition, this study is being done to examine the effect of home parenteral nutrition on the use of pain and anti-nausea medication.

this is a prospective descriptive non-randomized clinical study to examine quality of life outcomes and use of pain and anti-emetic therapy for patients receiving hpn support. the eortc qlq-c30 will be used to evaluate quality of life. all subjects will be monitored monthly throughout the course of treatment for a minimum of 3 months and a maximum of 1 year.

Eligibility criteria:
inclusion criteria: * patients with a cancer diagnosis who have been receiving parenteral nutrition in the hospital or have started on hpn while at cancer treatment centers of america and meet the criteria for home parenteral nutrition. * patient expected to have a life expectancy of greater than 90 days post discharge. exclusion criteria: * patients less than 18 years of age * hpn patients who do not receive nutrition assessment and follow-up by the coram healthcare nutrition support team * refuse to participate

Keywords: parenteral nutrition quality of life
surgical treatment of stage t3 squamous cell carcinomas of the scalp

Conditions: Squamous Cell Carcinoma; Surgery; Cancer Head Neck

Summary: this study examines tumor- en surgical characteristics of stage t3 cutaneous squamous cell carcinomas on the scalp, diagnosed between 2010 and 2018. histological data and patient- and tumor characteristics were collected.

cutaneous squamous cell carcinoma is the second most common type of non-melanoma skin cancer, following basal cell carcinoma. following the american joint committee on cancer tumour, node and metastasis (tnm) classification of malignant tumors staging system (tnm8), t3 cutaneous squamous cell carcinomas comprise an interesting group, especially on the scalp, because of the thin subcutaneous fat layer. according to the tnm8 criteria, t3 include all cutaneous squamous cel carcinomas with greatest tumor dimension ≥4cm, tumors with minimal bone erosion or perineural growth (defined as involvement of the nerve sheath of a nerve lying deeper than the dermis or measuring 0.1mm or larger in caliber or showing clinical or radiographic involvement of nerves without invasion of the skull base) or with deep invasion. deep invasion is defined as invasion deeper than the subcutaneous fat or a tumor thickness \>6mm. the scalp has a natural anatomical and oncological barrier for extension in depth known as the epicranial aponeurosis, also called the galea aponeurotica. this retrospective study, examines the tumor- en surgical characteristics of these stage t3 cutaneous squamous cell carcinomas on the scalp.

Eligibility criteria:
inclusion criteria: * stage t3 cutaneous squamous cell carcinoma of the scalp (histologically proven) * surgical treatment or radiotherapy treatment exclusion criteria: * metastasis by diagnosis * stage t1/t2/t4
the efficacy of denosumab in decreasing periprosthetic bone loss in patients with total knee arthroplasty

Conditions: Bone Resorption

Summary: this study evaluates the effect of denosumab in decreasing the periprosthetic bone resorption after total knee arthroplasty compared to placebo in 60 patients (30 placebo and 30 denosumab) within a year after surgery.

periprosthetic bone resorption after total knee arthroplasty occurs as a consequence of prosthetic implant on the bone. some of this patients (up to 13%) develop an aseptic failure of the prosthesis needing revision surgery. 2 groups of patients are treated with placebo and denosumab in a double blind prospective trial. densitometry, knee society score (kss), western ontario mcmaster university osteoarthritis index (womac) and the medical outcomes study short form 36 (sf-36) were done in both groups at 0,3,6 and 12 months after surgery.

Eligibility criteria:
inclusion criteria: * patients with knee osteoarthritis treated with total knee arthroplasty exclusion criteria: * patients allergies to denosumab * patients with previous osteoporosis treatment * patients with renal failure * patients with previous bisphosphonate treatment for more than 5 years

Keywords: knee arthroplasty