Kornimate/medical-research-clean huggingface dataset:
safety and efficacy of 25 and 50 mg doses of proellex® in treating the recurrence of uterine fibroid symptoms

Conditions: Uterine Fibroids

Summary: subjects with symptomatic uterine fibroids will be enrolled and will receive daily oral study medication for 4 months. this will be followed by a 6 month off-drug interval until there is a return of significant symptomatology. if they experience symptoms of a certain severity, the subject will enter a second 4 month treatment cycle and then a follow-up period.

subjects with documented symptomatic uterine fibroids will be enrolled in the study. following screening, subjects will receive daily oral study medication and will be assessed monthly for a 4 month treatment cycle. this first cycle will be followed by an off-drug interval until there is a return of significant symptomatology. subjects will be followed for up to six (6) months post-treatment. if their lack of symptoms does not qualify them for a second cycle of treatment, they will be discharged from the study. if they experience symptoms of a certain severity, the subject will enter a second 4 month treatment cycle and then a follow-up period.

Eligibility criteria:
inclusion criteria: * at least one uterine fibroid must be identifiable and measurable by transvaginal ultrasound (tvu) * subject must have uterine fibroid-associated symptoms during the-screening visit * subject has menstrual cycle lasting from 20 to 40 days * other inclusion criteria may apply exclusion criteria: * post-menopausal women or women likely to become post-menopausal during the study * subject with a significant organ abnormality or disease (based on the investigator's judgment) that would in the opinion of the investigator exclude the subject from participating * subject with any medical condition that, in the opinion of the investigator, is not compatible with study procedures or which would prevent the subject from starting or completing the study, or interfere with the subject participating in this study. * subject who has had an acute illness within five days of study medication administration * subject with endometrial thickness of ≥ 18 mm on screening ultrasound or historically * subject with an abnormal screening endometrial biopsy including the presence of endometrial intraepithelial neoplasia (ein) * subject with an abnormal dexa scan with a diagnosis or indication of osteoporosis at screening

Keywords: uterine fibroids
explore the effectors of the transtheoretical model on nutritional education in patients on hemodialysis

Conditions: End-Stage Kidney Disease; Hyperphosphatemia

Summary: the purpose of this study is to assess the improvement degree of nutritional care program on the nutritional status and eating habits of hemodialysis patients

after being informed about the study and potential risks, all patients giving written informed consent will undergo a 1-week screening period to determine eligibility for study entry. at week 0, eligible patients will be assigned to the intervention group and the control group by single-blind manner(participant) with convenience sampling. in the intervention group, the patients were trained in the transtheoretical model on nutritional education for 8 weeks. in the control group, the patients were trained in roution nutrition education.

Eligibility criteria:
inclusion criteria: 1. the biochemical value ≥ 5.5 mg/dl or albumin value\<3.8g/dl 2. bmi\<23kg/m2 3. unexpected weight loss. 4. must be able to swallow tablets exclusion criteria: 1. clinical diagnosis of alzheimer's disease 2. malignant tumors, gastrointestinal cachexia, and catheterization

Keywords: hemodialysis,nutrition education,the transtheoretical model
sirolimus therapy for poor prognosis immunoglobulin a nephropathy

Conditions: Glomerulonephritis, IGA; Nephropathy, IGA; IGA Nephropathy

Summary: the purpose of this study is to test in a pilot trial the efficacy and tolerance of sirolimus oral (at low doses) in patient to treat poor-prognosis iga nephropathy.


Eligibility criteria:
inclusion criteria: * age 18 to 70 and with capacity to grant informed consent * biopsy-proven iga nephropathy by means of standard immunohistochemical and morphological criteria * renal biopsy in the in the 3 months prior to randomization date * absence of known hepatic, cardiac, pulmonary or intestinal disease * glomerular filtrate estimated by cockcroft-gault, more than 30 ml/min * any of the following clinical states: a) high blood pressure defined as systolic blood pressure higher than 140 mmhg or diastolic blood pressure higher than 90 mmhg associated with proteinuria between 0.3-1 g/day and/or microhematuria. b) proteinuria higher than 1g/day * women of child-bearing age will follow a suitable contraceptive method, and a negative pregnancy test will be needed before inclusion in the study exclusion criteria: * serology positive for hiv or hepatitis b infection (defined as positive for the hbsag antigen) or hepatitis c infection (defined as viral rna detection) * treatment with steroids or immunosuppressors in the two previous years * evidence of active infection at the time of inclusion in the study * pregnancy or breastfeeding at the time of inclusion in the study * estimated glomerular filtration \ 2 mg/dl, or alt or ast two times higher than the normal upper limit * diabetes mellitus, defined as patients treated with insulin or oral antidiabetics or glycemias higher than 140 mg/dl in two or more episodes * poor control of high blood pressure (defined as systolic blood pressure greater than 160 mm hg or diastolic blood pressure greater than 100 mm hg, taking 3 or more antihypertensives) or evidence or suspicion of renovascular disease * thrombocytopenia less than 100,000 /mm3 or total neutrophil value lower than 2000 /mm3 or triglycerides value \> 400 mg/dl (4.6 mmol/l) or cholesterol \> 300 mg/dl (7.8 mmol/l) or ldl \> 200 mg/dl * iga nephropathy systemic forms, i.e., schönlein-henoch purpura, iga nephropathy secondary forms, post-renal transplant iga nephropathy recurrences, cases presented in the form of rapidly progressive renal failure and cases with the presence of cellular crescents in more than 50% of the glomeruli will be excluded * history of cancer in the previous 5 years,exception of skin basocellular carcinoma and uterine in situ carcinoma (completely removed both of them) * know intolerance to sirolimus or macrolides

Keywords: nephropathy, iga pilot trial sirolimus rapamune
a case control study of resveratrol effects in coronary artery disease patients with metabolic syndrome

Conditions: Metabolic Syndrome; Coronary Artery Disease

Summary: the aim of this study is to explore the role of canonical β-catenin/wnt and forkhead box o (foxo) pathways by means of investigating their target genes in coronary artery disease (cad) pathogenesis and to examine the effects of resveratrol (res) on these pathways in cad patients.

metabolic syndrome is a constellation of cardiovascular and metabolic risk factors including obesity, insulin resistance, hypertension and dyslipidemia. coronary artery disease (cad) is considerably linked with these risk factors. oxidative stress has a major role in development of atherosclerosis that is believed as the most common pathologic process underlying cad. the up-regulated gene-expression of free radical scavenging enzymes such as manganese superoxide dismutase (mnsod) by members of the forkhead box o (foxo) transcription factors is considered to be one of the paramount cell defensive mechanisms against oxidative damage. it is now well recognized that β-catenin binds to foxos during oxidative stress and acts as the pivotal mediator in canonical wnt signaling, so that it translocates to the nucleus and interacts with the family of transcription factors t-cell factor/lymphoid enhancer factor (tcf/lef), to regulate the expression of wnt target genes. recent evidence suggested that the canonical wnt signaling plays a profound role in regulation of lipid metabolism and glucose homeostasis. peroxisome proliferator-activated receptor delta (ppar-δ) is one of the wnt target genes which is believed to be operative in cardiometabolic protection. interestingly, it has been demonstrated that impaired wnt signaling pathway is contributed to inflammation, foam cell formation, and endothelial dysfunction which are recognized as atherosclerosis pathogenic factors. resveratrol (res) (3, 4´, 5 trihydroxystilbene), a natural polyphenol with antioxidant effects can be found in red grapes and its processed drinks (e.g. red wine), peanuts, pomegranates and mulberries.increasing body of evidence suggest a protective role for res against cad, however the underlying mechanisms still remain to be elucidated. we perform this study on 10 metabolic syndrome patients with three-vessel cad and 10 sex-aged matched (men with 40-55 years old) healthy subjects as controls. the effects of res on β-catenin, manganese superoxide dismutase (mnsod), and peroxisome proliferator-activated receptor delta (ppar-δ) expression are evaluated in peripheral blood mononuclear cells (pbmcs) of participants.

Eligibility criteria:
inclusion criteria: -three vessel coronary artery disease with metabolic syndrome based on who criteria exclusion criteria: * malignancy, * myocardial infarction, * unstable angina, * previous coronary intervention, * inflammatory diseases, * diabetes, * hypertension, * endocrine disorders, * other known chronic diseases, * antioxidant therapy or vitamin supplements in the previous 12 months, * smokers .

Keywords: coronary artery disease metabolic syndrome resveratrol β-catenin wnt signaling foxo mnsod
management of retained placenta with the "windmill" technique of umbilical cord traction

Conditions: Placenta; Retention

Summary: the incidence of leftover placenta after vaginal delivery is between 0.1% and 3.3%, with a maternal mortality of up to 10% reported. the traditional management is ultimately the manual removal of the retained placenta (mrop) in the operating room. however, mrop itself increases the risk of further bleeding, postpartum infection, uterine perforation and inversion of the uterus. in a preliminary study with a small cohort, the "windmill technique" has already been successfully tested.

the windmill technique of placenta development for the management of the retained placenta involves the application of a continuous 360-degree umbilical traction force with centripetal rotation in such a way that it runs at the level of the introitus perpendicular to the direction of the birth canal. the aim of this prospective randomized study is to compare the windmill placental development technique with traditional placental development strategies. it also analyzes the need to carry out mrop in both groups. the primary objective of the study is to compare the success rate of removing the placenta in retained placenta pregnancies between the windmill technique and the control group. based on this objective, we expected the difference of success rate between groups of 30% (from the previous study, the success rate of the windmill technique was 86%\]. the sample size of 35 participants per group will be required to provide 90% power at a 0.05 two-sided significance level.

Eligibility criteria:
inclusion criteria: * presence of the written consent of the patient * the patients must be over 18 years old * patients are not limited in their ability to consent exclusion criteria: * age under 18 * limited ability to work * known coagulation disorder * blood loss\> 500ml * known placenta accreta * no extension of the umbilical cord on traction.
strength-based tailored-exercise program at home for geriatric patients

Conditions: Frailty; Geriatrics

Summary: this study focuses on the "strength-based tailored-exercise program at home (step@home)" aimed at improving health outcomes for geriatric patients at risk of hospitalization-associated functional decline. it is a sequential mixed-method study that combines quantitative and qualitative approaches.

this is a sequential mixed-method study, including a multi-site randomized controlled trial to evaluate the effects of the 20-week step@home program and a subsequent descriptive qualitative study to explore the subjects' experience of program engagement. an overview of the timeline is given in figure 1. block randomization with block sizes of 4, 8, and 12, using a restricted shuffled approach with a computer-generated random sequence, will randomly allocate the subjects to receive either step@home or usual care at a 1:1 ratio.to develop the step@home intervention, integrating a strength-based, tailored exercise regimen for elderly patients post-hospital discharge. it addresses hospitalization-associated functional decline (hafd) by engaging patients in sustainable self-practice of physical exercises at home. the study employs empowerment strategies, lifestyle-integrated functional exercises, and optimized tele-platform use to maximize therapeutic benefits. by focusing on empowering patients through sustainable self-practice of physical exercises at home, it aims to enhance physical functions and improve health-related quality of life. the study also has significant real-world implications, potentially offering a scalable, effective solution for the broader geriatric population to manage hafd, thereby reducing healthcare costs and improving overall well-being. the research intends to assess the program's impact on physical functions and health-related quality of life, utilizing a sequential mixed-method approach for a comprehensive evaluation.

Eligibility criteria:
inclusion criteria: * i) aged 60 or above * ii) has an acute hospitalization and the length of hospital stay is of ≥ 2 days2, * iii) has risk of functional decline in 3 months following hospitalization as measured by the screening for high-risk patients (sherpa) score of \>4.5. sherpa is a brief measure to identify the high risk by screening for the risk factors, including old age, poor health perception, iadl dysfunction, mild cognitive impairment and fall in the previous year. * iv) discharged home without any referral for exercise-based rehabilitation * v) has a smartphone to access video calls * vi) consented to participate. exclusion criteria: * i) admitted with a disabling condition leading to significant functional loss such as stroke,) * ii) bed-bound or chair bound * iii) with conditions contradictory to exercise training (e.g., acute muscular-skeletal problem, acute and unstable cardio-respiratory disease, etc), * iv) engaging in moderate or vigorous exercise (\>60min/week) in the past 6 months.

Keywords: strength-based tailored-exercise program geriatric care hospitalization-associated functional decline health aging functional outcome post-discharge period
papillae tunneling techniques in the treatment of isolated intrabony defects

Conditions: Periodontitis Complex; Xenograft Model

Summary: papillae tunneling techniques (ptt) are a new approach toward regeneration of isolated intrabony defects. compared to regular papillae preservation techniques, ptt rely on complete preservation of involved interdental papillae, providing optimal healing environment for periodontal wound. surgical access is therefore gained either by vertical incision in vestibulum, or by short releasing incision on adjacent tooth. interdental tissue is then carefully raised in a full thickness manner by tunneling instruments, root surface thoroughly cleaned by the ultrasound scaler or gracey curettes and defect filled with the biomaterial of choice. while the success and aesthetic results of non-incised papillae techniques are well documented, no paper so far compared clinical results of papillae preservation techniques with different biomaterials. therefore, the aim of our study is to compare gain of clinical attachment level (defined by sum of pocket probing depth and recession) to regular papillae preservation techniques, and to prove non-inferiority of gel 40® (collagen matrix, loaded with micronized heterologous bone) to gen-os® (granulated cortico-cancellous heterologous bone mix). secondary objectives include analysis of aesthetic parameters - differences in recession and tip of the papillae location before and after the treatment.


Eligibility criteria:
inclusion criteria: * periodontitis stage iii/iv * at least one periodontal lesion with pocket probing depth \> 5 mm, limited by 2 or more bone walls and intrabony component \> 3 mm. * good oral hygiene with plaque index and sulcular bleeding index \< 30%. * systemically healthy * smokers and non-smokers exclusion criteria: * systemic diseases that contraindicate the treatment, * on medications that affects periodontal healing * pregnant or lactating women * one wall intrabony defects * defects that involve buccal and lingual side of the tooth * tooth with incorrect endodontic treatment or restoration
apemesh- preventing perineal complications after abdominoperineal resection

Conditions: Rectal Cancer; Abdominoperineal Resection; Wound Heal

Summary: abdominoperineal resection leaves an empty space to be filled by mesh or musculocutaneus flap. several studies have reported over 30% morbidity with perineal wound healing after abdominoperineal resection. preoperative radiotherapy is a strong predictor for perineal complications. musculocutaneus flaps and use of biological mesh seem to minimize perineal morbidity. the role of omentoplasty at apr is controversial. previous studies on synthetic mesh repair on perineum are almost lacking.

the objective of this pilot study is to assess the feasibility and the potential benefits of synthetic mesh reconstruction in perineum in case-control setting. 30 subjects will be prospectively enrolled to this study as intervention group. controls matched with age, gender and preoperative radiotherapy are selected from retrospective data collected from oulu university database and operated for rectal adenocarcinoma 2009-2017 with otherwise identical methods.

Eligibility criteria:
inclusion criteria: * abdominoperineal resection and permanent colostoma exclusion criteria: * patient with a comorbid illness of condition that would preclude the use of surgery (asa5) * potentially curable resection not possible * patient undergoing emergency procedure * metastatic disease * pregnant or suspected pregnancy
olanzapine for the treatment of chronic nausea and/or vomiting in advanced cancer patients

Conditions: Advanced Cancer

Summary: the purpose of this study is to evaluate the use of olanzapine for the treatment of cancer patients with chronic nausea and/or vomiting unrelated to chemotherapy or radiation in a randomized placebo-controlled pilot trial.

patients with advanced cancer experience a variety of physical and psychosocial symptoms that significantly affect the patients' quality of life. chronic nausea is a particularly distressing symptom present in \>60% of patients with advanced cancer. a number of palliative care studies have evaluated treatments of nausea with limited success. olanzapine with its unique formulation and decreased drug interactions compared to many other drugs appears to be a reasonable candidate for further evaluation. olanzapine has significant potential for use in the prevention and treatment of nausea in a palliative care setting with a once-daily dosing.

Eligibility criteria:
inclusion criteria: * be at least 18 years of age * have histologically or cytologically-confirmed malignant disease in an advanced incurable stage * have not received chemotherapy or radiation for \>14 days (advanced cancer patients receiving hormonal therapy or targeted therapy that does not come with a recommendation for prophylactic anti-emetic therapy are eligible) * have chronic nausea that has been present for at least one week (worst daily score \>3, 0-10 visual analogue scale) or vomiting at least five times over past one week * have serum creatinine \< 2.0 mg/dl and serum glutamic oxaloacetic transaminase (sgot) or serum glutamic pyruvic transaminase (sgpt) \< 3 times upper limits of normal ≤120 days prior to registration * absolute neutrophil count (anc) \>1500 mm3 \<120 days prior to registration * women of childbearing potential must consent to use adequate contraception throughout protocol therapy; females of childbearing potential must have a negative urine pregnancy test \<7 days prior to registration. exclusion criteria: * not be receiving treatment with another antipsychotic agent such as risperidone, quetiapine, clozapine, phenothiazine or butyrophenone for less than or equal to 30 days prior to registration or planned during protocol therapy (patients may have received prochlorperazine and other phenothiazines as prior anti-emetic therapy) * not have concurrent use of ethyol * not have severe cognitive compromise * history of central nervous system (cns) disease (e.g. brain metastases, seizure disorder) * concurrent use of amifostine, concurrent abdominal radiotherapy; concurrent use of quinolone antibiotic therapy * chronic alcoholism (as determined by the investigator) * known hypersensitivity to olanzapine * known cardiac arrhythmia, uncontrolled congestive heart failure or acute myocardial infarction within the previous six months * history of uncontrolled diabetes mellitus (stable insulin dose and/or stable oral hypoglycemic agent permitted) * planned chemotherapy or radiation during the 7 days following study initiation.

Keywords: nausea vomiting olanzapine
femoral extramedullary versus intramedullary alignment systems in total knee arthroplasty

Conditions: Knee Osteoarthritis

Summary: a prospective study will be performed to compare the clinical outcome after total knee arthroplasty (tka) using two different alignment systems: an extramedullary system versus an intramedullary system. the extramedullary femoral alignment system is newly designed. these two systems are used to make the distal femoral resection in 100 patients in a random order.


Eligibility criteria:
inclusion criteria: * varus knee; degrees of extra articular deformity \ 90°; no hip abnormalities exclusion criteria: * valgus knee; degrees of extra articular deformity \> 15°; knee infection; rheumatic arthritis; ankylosing spondylitis; prior femoral surgery

Keywords: extramedullary intramedullary total knee arthroplasty (tka)
gut microbiota in acute stroke patients

Conditions: Stroke; Stroke, Acute; Stroke, Ischemic; Microbiome; Atherosclerosis Cerebral

Summary: this study is to find out the significance of gut-microbiota in acute stroke patients, including their neurological, radiological outcomes as well as their stroke mechanisms.

patients who suffered from acute stroke and in hospitalization in prince of wales hospital will be recruited in the study. after the informed consent, their first bowel opening will be collected for storage. they will also receive assessment by the stroke team at 3 and 6 months to determine their outcomes (nihss and mrs). clinically and radiologically parameters including their degree of disability, imaging findings will also be collected to determine whether there are any correlations with the stool microbiota composition against matched individuals.

Eligibility criteria:
inclusion criteria: 1. diagnosed as acute ischaemic stroke 2. aged 18 or above chinese 3. radiological evidence of acute ischaemic stroke by computed tomography (ct) or magnetic resonance imaging (mri) brain. exclusion criteria: 1. patient with symptoms and signs suggestive of alternative diagnoses, 2. evidence of intracerebral haemorrhage, 3. absence of dwi evidence of acute ischaemic infarct, 4. pregnancy, 5. evidence of gastrointestinal infection/ inflammation/ obstruction 6. history of partial or total resection of small or large bowel, as well as gut re-anastomosis, 7. use of antibiotics within 2 weeks prior to symptoms onset, 8. gastrointestinal malignancy 9. any hospitalization within 3 months before recruitment 10. institutionalized patients

Keywords: stroke ischemic stroke microbiome atherosclerotic