Kornimate/medical-research-clean huggingface dataset:
a prospective clinical trial comparing serum mast cell tryptase (smct) levels to arthrofibrosis rates among primary total knee arthroplasty (tka) patients

Conditions: Knee Osteoarthritis; Arthropathy of Knee; Arthrofibrosis

Summary: this research is being done to see if the amount of an enzyme in blood (called serum mast cell tryptase) changes before and after surgery. the investigators would like to see if these amounts are related to knee stiffness and pain in subjects that undergo a total knee replacement.

arthrofibrosis (af), characterized by pain and limited mobility, affects a notable percentage of patients post-total knee arthroplasty (tka). despite various treatment advancements, the condition remains challenging to manage. prior research has indicated a relationship between elevated serum mast cell tryptase (smct) levels and increased fibrosis in animal models, suggesting that smct could serve as a biomarker for arthrofibrosis in humans. this study aims to 1) assess pre- and postoperative smct levels in tka patients, 2) evaluate smct's association with arthrofibrosis and clinical outcomes, and 3) determine the impact of allergic or inflammatory co-morbidities on smct levels.

Eligibility criteria:
inclusion criteria: * investigators will include all patients with osteoarthritis who are surgical candidates for primary tka. investigators will include all eligible male or female patients between the ages of 20 years to 100 years old. all included study participants must be able to give an informed consent. exclusion criteria: * significant femoral or tibial deformity due to congenital or traumatic etiologies, inflammatory arthritis, post-septic arthritis, osteomyelitis, prior infection of knee joint, osteoporosis, dislocated or fragmented patella * patients taking mast cell inhibitors and/or degranulation inhibitors for any reason. * the presence of infections, highly communicable diseases (e.g. aids), active tuberculosis, venereal disease, hepatitis. * significant neurological or musculoskeletal disorders or disease that may adversely affect normal gait or weight bearing. * presence of previous prosthetic knee replacement devices (of any type) * metastatic disease * psychiatric illness * drug or alcohol abuse * inability to participate in standard postoperative rehabilitation protocol
the importance of needle gauge for pain during injection of local anaesthetic

Conditions: Needlestick Injuries

Summary: this study will investigate the influence of needle gauge on pain during injection of local anaesthetic. healthy volunteers will be recruited, who will each receive three injections with either 21g, 23g or 27g subcutaneously on the abdomen. after each injection, the participants will be asked to evaluate the pain on a visual analog scale (0-100 mm). it is anticipated that the pain will decrease with decreasing thickness of the needle. the aim of this study is to find a simple method for pain reduction that can be used in clinical practice.


Eligibility criteria:
inclusion criteria: * age 18-65 years exclusion criteria: * kidney, heart or liver disease * eczema or psoriasis on injection site * neuropathy * regular use of painkillers * hypersensitivity of lidocaine * pregnancy * diabetes

Keywords: injections pain healthy volunteers lidocaine
pulsed field ablation versus radiofrequency ablation for persistent atrial fibrillation

Conditions: Persistent Atrial Fibrillation; Radiofrequency Catheter Ablation; Pulsed Field Ablation

Summary: this clinical trial aims to compare the efficacy and safety of pulsed field ablation and radiofrequency ablation to treat persistent atrial fibrillation in adults. participants will: undergo pulsed field ablation or radiofrequency ablation. keep follow-up for at least 12 months.

traditional treatment options for persistent atrial fibrillation (peaf) include pharmacological management, electrical cardioversion, and catheter ablation. pulmonary vein isolation (pvi) has become the cornerstone of ablation therapy and has been shown to be effective in clinical practice. however, its efficacy is relatively limited in patients with persistent af compared with those with paroxysmal af, and many patients still experience recurrence after treatment. in recent years, linear ablation strategies based on alcohol ablation have been shown to improve the one-year maintenance of sinus rhythm in patients with peaf. traditional radiofrequency ablation (rf) has demonstrated good outcomes but still has certain limitations when dealing with peaf. in several clinical studies, pulsed field ablation (pfa), an emerging and innovative technique, has shown non-inferiority in treating paroxysmal af. furthermore, pfa has also demonstrated significant efficacy in linear ablation sites such as the mitral isthmus line, posterior left atrial wall, and tricuspid isthmus line, highlighting its potential in treating peaf. this study aims to compare the safety and efficacy of pfa and radiofrequency ablation (rf) in the treatment of peaf through a multi-center, prospective, randomized, open-label, non-inferiority clinical trial, to provide a safer and more effective treatment option for clinical practice.

Eligibility criteria:
inclusion criteria: * 18-80 years * patients with non-valvular persistent atrial fibrillation undergoing their first catheter ablation (af duration: 3 months to 3 years) * left atrial diameter on parasternal long-axis view of echocardiogram \< 50 mm * agree to be randomly assigned to the ablation strategy and able to follow up exclusion criteria: * atrial fibrillation due to reversible causes * lvef \< 30% * severe congenital heart disease * severe liver or kidney dysfunction (egfr \< 15, child-pugh grade 3), or history of dialysis * history of cardiac surgery, such as coronary artery bypass grafting, mechanical valve or prosthetic valve replacement * history of pacemaker implantation, left atrial appendage closure, or patent foramen ovale closure * contraindications to oral anticoagulation * contraindications to right or left heart catheterization * pregnancy * life expectancy \< 1 year (e.g., advanced malignancy, end-stage renal disease) * currently enrolled in another trial evaluating medical devices or drugs * other situations where the investigator determines the subject is unsuitable for the study

Keywords: persistent atrial fibrillation radiofrequency catheter ablation pulsed field ablation
portuguese registry on acute coronary syndromes

Conditions: Acute Coronary Syndrome

Summary: the purpose of this registry is creating a database management that allows continuous monitoring characteristics, evolution, prognostic indicators and management of patients with acs admitted in portuguese hospitals, and identify the appropriateness of clinical practice recommendations for diagnosis and treatment of acs and monitor its evolution.

cardiovascular diseases remain the principal causes of death in portugal and approximately one quarter of these are directly to ischemic heart disease, especially acute coronary syndromes (acs). in order to reduce mortality for acs, a significant number of new drugs and new techniques have been introduced into clinical practice, resulting in important heterogeneity of approach and treatment of patients with acs. the portuguese society of cardiology have sought to review and incorporate in its recommendations the evidence to date, with the aim to standardize diagnosis and treatment of patients with acs, which is not always able to in daily practice. since it is essential to characterize the national reality of the acs, the portuguese society of cardiology has promoted the portuguese registry on acute coronary syndromes, aimed at bridging the knowledge gaps in this area of cardiovascular disease. this will include all adult patients (≥ 18 years) diagnosed with acute coronary syndrome (acs) with \ 30 minutes) of the st segment. the rest should be considered as acs st-segment elevation. in the absence of angina, the sca will be considered consistent elevation (curve ascending / descending) biomarker (above reference value for cardiac troponin or higher 2 times the value of reference to the ck-mb) associated with other clinical manifestations such as ill-defined chest discomfort or dyspnea. are included patients participating in clinical trials are excluded patients with mi after revascularization procedures (eam type 4 and 5) and mi type 2 (classification according to the redefinition of myocardial infarction, 2007 the joint esc / accf / aha / whf task force)

Eligibility criteria:
inclusion criteria: * presence of angina at rest last 48 hours, with: 1) ischemic electrocardiographic changes - st-segment deviations or negative t waves, and / or 2) elevation of biomarker(cardiac troponin and ck-mb) above the reference value. exclusion criteria: * patients with mi after revascularization procedures (eam type 4 and 5) and mi type 2 (classification according to the redefinition of myocardial infarction, 2007 the joint esc / accf / aha / whf task force).

Keywords: myocardial infarction angina, unstable
effect of remote ischaemic preconditioning on liver injury in patients undergoing liver resection surgery

Conditions: Hepatocellular Cancer

Summary: liver resection has improved health outcomes in patients with hepatocellular carcinoma (hcc) in singapore and worldwide. however, due to acute ischaemia/reperfusion injury (iri) to the liver at the time of surgery, patients still experience significant morbidity and mortality. therefore, novel therapies are required to protect the liver against acute iri during partial hepatectomy. remote ischaemic conditioning (ric) using transient limb ischaemia/reperfusion has been shown to protect the liver in experimental animal studies. in the eric-liver trial the investigators investigate whether ric can reduce liver injury and preserve liver function in patients with hcc undergoing partial hepatectomy.

liver resection has improved health outcomes in patients with hepatocellular carcinoma (hcc) in singapore and worldwide. however, due to acute ischaemia/reperfusion injury (iri) to the liver at the time of surgery, patients still experience significant morbidity and mortality. therefore, novel therapies are required to protect the liver against acute iri during partial hepatectomy. remote ischaemic conditioning (ric) using transient limb ischaemia/reperfusion has been shown to protect the liver in experimental animal studies. in the eric-liver trial the investigators investigate whether ric can reduce liver injury and preserve liver function in patients with hcc undergoing partial hepatectomy. 50 patients with hcc undergoing partial hepatectomy will be randomised to receive either ric (four-5 minute arm cuff inflations/deflations) or sham control (four-5 minute arm cuff simulated inflations/deflations) after induction of anesthesia and prior to surgical incision. the primary endpoint of the study will be acute liver injury assessed by serum transaminases measured at 24 hours post-resection. secondary endpoints will include liver function in subset of patients (n=24, assessed by indocyanine green \[icg\] clearance measured at 24 hours post-resection), incid ence of liver failure, episodes of confirmed sepsis, acute kidney injury, intensive care unit and hospital stay, and quality of life.

Eligibility criteria:
inclusion criteria: * patients aged 21 years and above * patients undergoing partial hepatectomy for primary hc exclusion criteria: * patients with significant pulmonary disease (fev1\<40% predicted). * patients with known severe renal failure with a gfr\<30 ml/min/1.73 m2. * patients on sulphonylurea or nicorandil, as these medications may interfere with the protective effect of ric. * patients recruited into another study which may impact on this study. significant peripheral arterial disease affecting the upper limbs. * patients undergoing repeat liver resection surgery.
exercises in the post-operative rehabilitation of tha

Conditions: Hip Osteoarthritis

Summary: subjects submitted to unilateral tha will be randomized into two rehabilitation groups. one group will receive a booklet with guidelines for postoperative care, while the other group will participate in face-to-face sessions with exercises with emphasis on muscle strengthening.

individuals with osteoarthritis (oa) of the hip submitted to total hip arthroplasty (tha) may present alterations in their functional capacity, and associated, among other aspects, the reduction in muscle strength. our overall objective is to compare the effects of an exercise program based on training of muscular strength to orientations and functional home exercises in patients submitted to tha, as well as to compare the outcomes of both groups with those of healthy individuals. individuals with tha will be randomly assigned to two groups. one group will receive face-to-face treatment (g1) and the other will receive postoperative guidance (g2). a blinded appraiser regarding the allocation will apply the evaluation tools at the moments: preintervention, after completing 7 days and after 10 weeks of the end of the treatment. the research will present as clinical outcomes: the muscular strength, through the values of torque peaks obtained in dynamometry; the functional capacity through the results of the timed up and go test and the harris hip score questionnaire; the range of joint motion measured with and flexometer; the pain through the results of the numerical scale of pain; and kinesiophobia, through the scores obtained in the tampa scale.

Eligibility criteria:
inclusion criteria: * referred by orthopedic doctors of the city of porto alegre, rio grande do sul, brazil; * between 30-60 days of unilateral total hip arthroplasty (cemented and hybrid prostheses) postoperative phase; * read and consent to the free and informed consent form and understood the guidelines necessary to carry out the evaluations proposed in this research. exclusion criteria: * performing a surgical procedure, in the last six months, in other articular joints in the lower limbs; * previous surgical procedures in the coxofemoral joint; * surgical procedures and osteoarticular diseases in the lumbar spine; * osteoarticular diseases in lower limb joints; * muscle injuries in lower limbs; * presence of signs or symptoms of osteoarthritis in the contralateral hip; * postoperative complications such as prosthesis dislocation, deep venous thrombosis, periarticular fractures and neural lesions; * intra-articular injection of corticosteroids in the lower limbs during the last six months; * cardiovascular diseases with presence of disability, such as severe dyspnea and uncontrolled arterial hypertension; * presence of neurological diseases.
electronic diabetes tune-up group (edtu) for african americans

Conditions: Diabetes Mellitus, Type 2; Diabetes Complications

Summary: the primary aims of this study are: 1. to test the acceptability and feasibility of the electronic dtu intervention (edtu) that has been adapted for cultural relevance and online delivery compared to waitlist control and the in-person dtu (idtu). the hypothesis is that the adapted intervention will be culturally acceptable (by participant satisfaction scores) and well-subscribed (intervention attendance rates). 2. to test differences in diabetes distress and a1c change scores between intervention (changes in t2 to t4) and waitlist control (change in t1 to t2) by intervention group (edtu vs. waitlist control; idtu vs. waitlist control). the hypothesis is that both the edtu and idtu groups will show significant improvements in diabetes distress and a1c compared to waitlist control. in order to conserve sample size and budget, participants in each intervention group will serve as their own waitlist control. secondary objective. the secondary aim of the study is to evaluate changes in depressive symptoms, diabetes self-efficacy, and general and diabetes-specific quality of life in intervention (t2-t3 \& t4) compared to waitlist control (t1-t2). an exploratory aim will be to compare changes in edtu to the idtu pre/post intervention (t2-t3 \& t4). the hypothesis is that both groups will show comparable improvements in diabetes distress and a1c.


Eligibility criteria:
inclusion criteria: * age ≥ 21 years * self-identified black or african american female * type 2 diabetes diagnosis ≥ 1 year * a1c ≥ 7.0% in the past year per medical record or patient report * dds-17 score ≥ 2.0 at screening * active email address exclusion criteria: * limited english language proficiency * presence of serious mental health disorder (e.g., psychotic disorders or severe mood disorders with suicidal ideation) * diagnosis of a major acute medical condition (e.g., myocardial infarction, stroke, cardiac rehabilitation, stage 3 or stage 4 cancer diagnoses) within the last three months * initiation of new medical treatment regimens (e.g., chemotherapy) for acute medical diagnoses that would require the patient's primary attention

Keywords: diabetes distress
adina vs. high flow nasal cannula comparison study

Conditions: Respiratory Distress Neonatal

Summary: this study is to evaluate the feasibility of using a pressure limited nasal cannula system instead of a high flow nasal cannula system in the management of premature babies with respiratory distress.

ncpap has been used increasingly to manage respiratory distress in newborns as well as apnea of prematurity. humidified high flow nasal cannula devices (flows 1-8 lpm) have also been used in neonatal intensive care units. this study is to evaluate the feasibility of using a pressure limited nasal cannula system instead of a high flow nasal cannula system in the management of premature babies with respiratory distress.

Eligibility criteria:
inclusion criteria: * neonates admitted to nicu * weights of 400-500 grams * requiring oxygen greater than 30% * no evidence of focal lobar consolidation in lung fields exclusion criteria: * intolerance to procedure * gelatinous skin * known allergy to adhesive material * interference with therapy * profound sepsis * pneumonia * unmanaged apnea/bradycardia * known or suspect complex congenital heart disease * severe cleft lip or palate * suspect or proven lethal congenital anomaly * intolerance to the interface used in the devices * inability to secure an appropriate fit of the patient nasal interface * considered non-viable or of uncertain viability * parental refusal.

Keywords: respiratory distress nasal cpap high flow nasal canula
persistent pulmonary hypertension after percutaneous mitral commissurotomy

Conditions: Pulmonary Hypertension

Summary: to identify clinical, echocardiographic, and hemodynamic parameters which can predict persistent ph after pmc, and also to determine the impact of persistent ph on the clinical outcomes.

pure mitral stenosis develops in approximately 40% of all patients with rheumatic heart disease, and is frequently complicated by pulmonary hypertension (ph). pulmonary hypertension influences symptomatology and long-term prognosis. percutaneous mitral commissurotomy (pmc), was first described in 1984, has good results and is performed by antegrade access to the mitral valve through trans-septal puncture by one of various techniques (e.g. inuoe, and multitrack system). pulmonary artery pressures (pap) decrease following pmc. the improvement in pulmonary hypertension after pmc is explained by the improvement in the mitral valve area and subsequent decompression of left atrium (la) and pulmonary venous beds. even though there have been studies showing excellent results following pmc in all grades of ph, nonregression of ph following pmc is not uncommon. the component of pap contributed by the passive transmission of the elevated la pressure regresses immediately after a successful pmc proportional to the reduction in transmitral gradient. the ph contributed by pulmonary arteriolar constriction slowly comes down over weeks or a few months, but a "fixed" component due to pulmonary vascular disease usually persists.

Eligibility criteria:
inclusion criteria: * severe mitral stenosis (mitral valve area ≤1.5cm). * significant dyspnea. * favorable anatomical characteristics for pmc as assessed by transthoracic echocardiography exclusion criteria: * significant mitral regurgitation (≥ grade ii/iv). bilateral commissural calcification. * presence of other lesions which need open heart surgery. * wilkins' score \> 12. * persistent la thrombus despite adequate anticoagulation. * end stage renal or liver disease. * patients with severe copd and other chest problems that might be complicated by pulmonary hypertension per se.
a study on the associations between microribonucleic acid gene polymorphisms and crohn's disease

Conditions: Crohn Disease

Summary: from january 2020 to january 2025, crohn's disease (cd) patients and gender- and age-matched normal controls were collected from the department of gastroenterology, the second affiliated hospital of wenzhou medical university. the aim of this research is to explore the associations of microribonucleic acids (mirnas) gene polymorphisms with the risk and clinicopathological characteristics of cd, and to analyze the effects of mirnas gene variantions on the clinical response of ustekinumab (ust) treatment in cd patients at week 8.

from january 2020 to january 2025, a total of 312 cd patients and 527 gender- and age-matched normal controls were collected from the department of gastroenterology, the second affiliated hospital of wenzhou medical university.the genotypes of mirnas were determined by multiplex polymerase chain reaction-ligase detection reaction technique. unconditional logistic regression was employed to analyze the distribution of mirnas gene polymorphisms between cd group and normal control group, as well as their influences on the clinicopathological characteristics of cd patients. unconditional logistic regression model was used to explore the effect of mirnas gene variation on the clinical response of cd patients in the treatment of ust at week 8.

Eligibility criteria:
inclusion criteria: * diagnosed cd based on comprehensive clinical, colonoscopy, histopathological, laboratory, and radiographic examination results exclusion criteria: * rheumatoid arthritis, systemic lupus erythematosus, intestinal tuberculosis, ischemic enteritis, radiation enteritis, tumors, etc.
effect of same treatment on recurrence after radical treatment of primary hepatic carcinoma

Conditions: Primary Liver Cancer

Summary: the aim of this study is to explore the effect of same on recurrence after radical treatment of primary liver cancer.

primary liver cancer is now a major health problem. in the worldwide, plc is the fifth most common cancer in male, the seventh in female, and has the second highest rate to cause death for men . although the recent advances in treatment of primary liver cancer have significantly improved the prognosis of patients with primary liver cancer, the overall survival rate is still unsatisfactory. one of the reasons for the poor prognosis of primary liver cancer is its high rate of recurrence. anti-relapse treatment remains a pressing work to do. in recent years, some study reported that same had an impact on promoting apoptosis and inhibiting the growth on breast cancer, colon cancer, gastric cancer and liver cancer in vitro and vivo. in this study, we aim to examine whether same have an effect on improving patients' recurrence after radical treatment of primary liver cancer.

Eligibility criteria:
inclusion criteria: * patient must sign the informed consent prior to the beginning of any study-related procedures; * patients diagnosed of primary liver cancer; * bclc stage：stage 0、stage a; * accept radical treatment; exclusion criteria: * with any other anti-cancer treatment before or after the surgery; * patients with extrahepatic metastasis; * patients with apparent cardiac, pulmonary, cerebral and renal dysfunction; * subjects accepting other trial drugs or participating in other clinical trials; * female with pregnancy or during the lactation period.