Kornimate/medical-research-clean huggingface dataset:
pulsed shortwave therapy adjunct pain and recovery in total knee replacement

Conditions: Total Knee Arthroplasty

Summary: this clinical study is designed to assesses the benefit of adding pulsed shortwave therapy to the postoperative pain and recovery protocol following total knee replacement. pulsed shortwave therapy is a safe adjunct pain therapy for acute and chronic pain.

despite the recent advances in the understanding of pain mechanisms and the introduction of new drugs and new techniques in the postoperative management, pain after total knee arthroplasty (tka) is still an unresolved issue. it affects the quality of life and rehabilitation of an important percentage of patients undergoing tka. a recent study looked at the percentage of patients with chronic knee pain after knee replacement at a minimum of one year following surgery in 272 patients, 107 patients (nearly 40%) reported that they still had persistent pain at one-plus year following surgery. central sensitization is now well established as an integral factor in many chronic pain states, including the commonly occurring knee and back pain. many patients undergoing tka are likely to have a significant degree of central sensitization, therefore the likely hood of high pain levels postoperative and persistent long standing pain after tka is increased in this patient population. pulsed shortwave therapy negates central sensitization by imputing new

Eligibility criteria:
inclusion criteria: * meet the diagnostic criteria for knee osteoarthritis; * planned spinal anesthesia; american society of anesthesiologists (asa) physical status i-ii; * scheduled for unilateral tka; * patients aged 50 to 80 years old. * willingness to give written informed consent and willingness to participate in and comply with the study. exclusion criteria: * unwillingness of the patient; * presence of neuropathic pain or sensory disorders in the leg to be operated on; * intolerance to the study drugs; * failure of spinal anesthesia; * previous major knee surgery, re-operation or trauma to the knee within the study period.
advancing adolescent screening and brief intervention protocols in primary care settings

Conditions: Substance Abuse

Summary: this proposed study tests the effectiveness and examines the implementation of screening and brief intervention techniques to delay initiation and reduce substance use among adolescents accessing medical care in federally qualified health care settings with a computer-facilitated intervention. the primary hypothesis is that participants in the intervention groups will be more likely to cease or reduce substance use at follow-up compared to clients in the treatment as usual condition.

the aims of the proposed 5-year study are threefold: (1) to examine the effectiveness of a computer-facilitated screening and brief advice (csba) to reduce initiation and substance abuse among adolescents in a novel setting; (2) to examine the comparative effectiveness of adding a brief intervention and referral to treatment component to the csba intervention among adolescents in these centers; (3) to examine factors facilitating and inhibiting the implementation of sbirt-type procedures with adolescents in fqhcs.

Eligibility criteria:
inclusion criteria: * 12-18 year old patients seeking care at the primary care participating sites exclusion criteria: * unable to read and understand english * medically unstable * unavailable for follow-up

Keywords: adolescents screening advice referral
a comparative study of mefloquine and s-p as prophylaxis against malaria in pregnant hiv + patients

Conditions: Malaria in Pregnant HIV + Patients

Summary: randomized controlled single blind prospective comparative study.

this study is intended to be a randomized controlled single blind prospective comparative study conducted to compare the efficacy of three, monthly doses of sulphadoxine-pyrimethamine as intermittent preventive therapy with mefloquine as-intermittent preventive therapy in hiv-infected pregnant women.

Eligibility criteria:
inclusion criteria: * pregnant hiv positive patients * gestational age 16 weeks and above * no history of use of mefloquine or sulphadoxine * pyrimethamine four weeks prior to recruitment. exclusion criteria: * anaemia packed cell volume less than 30% * pre -existing medical conditions- diabetes mellitus, -hypertension * allergy to sulphadoxine- pyrimethamine or mefloquine * non-consenting patients * multiple gestation * known psychiatric illness * known seizure disorder * history of severe renal or hepatic disease

Keywords: intermittent preventive therapy malaria pregnant hiv positive prevention
a randomized comparison of laparoscopic myotomy and pneumatic dilatation for achalasia

Conditions: Esophageal Achalasia

Summary: the purpose of this study is to compare pneumatic dilatation and laparoscopic heller myotomy in patients with achalasia in order to learn which of these two treatments should be recommended to patients in the future.

achalasia is a rare disease of the esophagus. it can cause difficulty swallowing, regurgitation of swallowed food, and chest pain. in achalasia, there are two problems in the esophagus. first, the esophagus does not properly push swallowed food down towards the stomach. second, the valve at the lower end of the esophagus, called the lower esophageal sphincter, does not relax to allow food to pass from the esophagus into the stomach. achalasia cannot be "cured". however, the symptoms of achalasia can be improved by treatment. treatment is usually directed towards reducing the degree of blockage caused by the lower esophageal sphincter. the muscle of the lower esophageal sphincter can be stretched using a technique called pneumatic dilatation, or it can be divided (cut in half) during a surgical operation. the operation is called laparoscopic heller myotomy, and is done by laparoscopic ("keyhole") surgery, where small incisions are used and patients usually stay in hospital 1-2 nights. other treatments for achalasia, such as medications or injection of botulinum toxin type a are not often used because they do not provide effective long-term improvement.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of achalasia by a physician * manometric diagnosis of achalasia including both: incomplete relaxation of the lower esophageal sphincter during swallowing (\<80% of elevation over intragastric pressure and absence of esophageal peristalsis (peristalsis in \<20% of initiated contractions) * facility with english, ability to complete english language questionnaires exclusion criteria: * pseudoachalasia: esophageal carcinoma; esophageal stricture; previous esophageal or gastric surgery; previous instrumentation of the lower esophageal sphincter i.e. suture, polymer injection, silicone band * previous gastric or esophageal surgery: fundoplication; heller myotomy; gastric resection; vagotomy with or without gastric drainage * age 17 year or less * pregnancy * presence of severe comorbid illness: unstable angina; recent myocardial infarction (\<6 months), cancer (except integumentary), unless free of disease for more than 5 years; end stage renal disease; previous stroke with cognitive, motor speech, or swallowing deficit persisting longer than one month; severe respiratory disease; cognitive impairment

Keywords: laparoscopic myotomy pneumatic dilatation motility disorder dysphasia health-related quality of life
acute effects of exercise at different temperatures in allergic rhinitis patient

Conditions: Allergic Rhinitis

Summary: the purpose of this study was to determine the effects of exercise at different temperatures on nasal blood flow and symptoms in allergic rhinitis patients.

fifteen patients with allergic rhinitis aged between 18 and 35 years who had a positive skin prick test to house dust mite (d. pteronyssinus). the experiment was a crossover design in which each participant was given aerobic exercise by ergometer in two difference temperatures room : 25 degree celsius and 34 degree celsius. rhinitis symptoms, nasal blood flow, heart rate, and oxygen saturation were measured before, during exercise at 15, 30, and 45 minutes, and after exercise at 0, 15 and 30 minutes in each temperature. moreover, blood pressure, peak nasal inspiratory flow, pulmonary functions, respiratory muscle strength, and fractional exhaled nitric oxide were measured before and after exercise at 0, 15 and 30 minutes in each temperature.

Eligibility criteria:
inclusion criteria: * subjects had a clinical history of persistent rhinitis, and had positive skin prick test to house dust mite (d. pteronyssinus) * persistent allergic rhinitis * subjects with known asthma, chronic rhinosinusitis, lung cancer and emphysema diseases were excluded. * bmi 18.5 - 24.9 kg/m2 * subjects will ask to abstain from taking antihistamine for at least 5 days, leukotriene receptor antagonist for at least 1 week, and nasal steroids for at least 2 weeks prior to the start of the experiment. * subjects will ask to abstain from taking any form of dietary supplement during the experiment. * subjects had no exercise training program (not exercise regularly or not exercise for 30 minutes or more at least 3 times per week during the past 6 months) exclusion criteria: * accident that are unable to continue the research, such as accidental injury or illness, etc. * participants did not voluntarily participate.

Keywords: aerobic exercise allergic rhinitis nasal blood flow peak nasal inspiratory flow acute exercise
very long versus overlapping stents in long coronary lesions

Conditions: Coronary Artery Disease; Chronic Coronary Syndrome; Drug Eluting Stents

Summary: this study is performed to compare the angiographic and clinical outcomes of the use of single long stent versus overlapping stents in the treatment of long coronary lesions in patients with chronic coronary syndrome.

percutaneous coronary intervention (pci) in diffuse coronary artery disease is still considered a big obstacle for interventional cardiologists. very long coronary lesions are usually found, and implantation of a single stent was a great problem forcing the operator to do overlapping of several stents. recently, new stent designs with increasing length are developed and emerging as a great tool for the percutaneous treatment of long lesions. nowadays, stents up to 60 mm are available to be used in these cases reducing stent overlap. intravascular ultrasound (ivus)-guided percutaneous coronary intervention has been shown in clinical trials, registries, and meta-analyses to be associated with a reduction in clinical events after percutaneous coronary intervention; however, ivus utilization during percutaneous coronary intervention remains low in the united states and worldwide. the impact of ivus in these complex lesions may be associated with a lower rate of clinical adverse events in comparison with angiography alone. the study will be conducted on forty patients with chronic stable angina on maximal medical treatment who are going to have elective coronary angiography and elective pci and having one long coronary lesion that is more than 40 mm in length, they will be randomized into either treatment of the lesion with a single very long stent (more than 40 mm in length) or with more than one overlapping stents in 1:1 randomization. control angiography and ivus will be done to the 2 groups after 6 months and the major cardiovascular outcomes will be addressed at 1,3 and 6 months follow-up periods.

Eligibility criteria:
inclusion criteria: * patients \> 18 years of age * single vessel disease and undergoing pci for significant long lesion. * chronic stable angina on maximal medical treatment. exclusion criteria: * patients presenting with acute coronary syndromes. * patients having two or more vessel disease on coronary angiography. * previous myocardial infarction. * previous vascularization either by pci or bypass grafting. * very low ejection fraction less than 35%. * renally impaired patients with creatinine clearance less than 50 ml/min. * contraindication to dual antiplatelet drug therapy. * contraindication to coronary angiography.

Keywords: ivus drug eluting stents chronic coronary syndrome
the use of thermal suits as preventing hypothermia during surgery

Conditions: Prostate Cancer

Summary: unintentional hypothermia of a patient is a common adverse effect during surgical procedures. the aim of this prospective, randomised, controlled study is to determine whether the use of thermal suit could prevent surgical patient from experiencing thermal loss than conventional measures. hypothesis: the investigators assume that a difference of 0.5°c in body temperature between the groups is clinically relevant.

the aim of this study was to compare a thermal suit (t-balance) and conventional warming methods to maintain a constant body temperature in patients undergoing robotic laparoscopic radical prostatectomy under general anesthesia. a sample size calculation was made using a power analysis. patients were randomly allocated into two groups. patients in the intervention group were put on the t-balance 1 hour before anesthesia induction. patients in the control group got conventional cotton clothes. intra-operatively same warming methods were used in both groups. the measuring points of the temperature were esophagus (core temperature), left axilla, dorsal surface of the left middle finger and back of the left foot. anesthesia was induced via target-controlled infusion. all temperature data of the patients were collected and recorded electrically and continuously.

Eligibility criteria:
inclusion criteria: * radical prostatectomy, american society of anaesthesiologists class i-iii, age 18-90 exclusion criteria: * mental status with inability to give informed consent, neuromuscular disorders, raynaud's disease, unstable angina pectoris
invasive fungal infections surveillance initiative

Conditions: Fungal Infection

Summary: the purpose of this study is to optimize the management of patients treated for invasive fungal infections by establishing a real-time, continuous clinical data base that will capture and monitor trends in the epidemiology, diagnosis, treatment and outcomes of invasive fungal infections; reflect routine clinical management of patients with invasive fungal infections in order to evaluate treatment and provide a rationale for future treatment paradigms; and allow physicians to assess adherence to institutional clinical practice guidelines, validate current standardized definitions for patients with invasive fungal infections and promote change where appropriate.

gender, height, weight, ethnicity, antifungal treatment, fungal colonization, laboratory results, past medical history, invasive fungal infection diagnosis, medications, outcomes

Eligibility criteria:
inclusion criteria: * all patients with a diagnosis of proven or probable invasive fungal infection . this includes patients with proven or probable invasive mold infections as well as patients with proven candidemia. exclusion criteria: * all patients with a diagnosis of possible invasive fungal infection . this includes patients with possible mold infections as well as patients with possible candidemia.

Keywords: invasive fungal infection
double blind study of hypertonic saline vs mannitol in the management of increased intracranial pressure (icp).

Conditions: Elevated Intracranial Pressure

Summary: the study goal is to compare the management of increased intra-cranial pressure (icp) using 3% hypertonic saline vs. mannitol (given in same osmolar loads). primary hypothesis: 1. hypertonic saline will be non-inferior to mannitol in decreasing elevated icp. secondary hypotheses: 1. hypertonic saline therapy will result with fewer complications than mannitol 2. icp reduction duration will be longer using hypertonic saline when compared with mannitol

there is growing evidence in the literature indicating that icp and cerebral perfusion pressure measurements may not be sufficient in the management of elevated icp. based on this evidence, monitoring of partial brain tissue oxygenation has gain acceptance among neurosurgeons and neurointensivists, and has become a standard of care monitor in some centers across the country. there is, however, insufficient information in the literature describing the effects of hyperosmolar medications on regional brain tissue oxygenation. we intend to undertake this non-inferiority, prospective, randomized double-blind study to answer very important clinical questions not yet answered in the literature: will hypertonic saline therapy, given at equiosmolar load, be non-inferior to mannitol in reducing elevated icp?

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * elevated icp requiring icp monitoring * icp ≥ 25 mmhg 5 min after icp bolt or evd placement exclusion criteria: * requiring decompressive craniotomy or post decompressive craniotomy * hyponatremia (sodium level \< 125 meq/l) * hypernatremia (sodium \> 155 mmol/l) * serum osmolality ≤ 250 mosm/kg * serum osmolality ≥ 320 mosm/kg * physical exam compatible with brain death * patients on hemodialysis with end-stage renal disease

Keywords: clinical trial mannitol intracranial pressure (icp) hypertonic saline cerebral edema traumatic brain injury (tbi)
transcutaneous tibial nerve stimulation for treating neurogenic lower urinary tract dysfunction

Conditions: Neurogenic Bladder Dysfunction

Summary: many patients with neurological diseases suffer from neurogenic lower urinary tract dysfunction (nlutd), which often severely impairs quality of life, due to urinary urgency with or without incontinence and voiding dysfunction. in addition, the upper urinary tract may be jeopardized because of high intravesical pressure caused by detrusor overactivity with concurrent detrusor-sphincter-dyssynergia and/or low bladder compliance. the treatment of nlutd is a challenge since conventional conservative therapies often fail and more invasive treatments such as intradetrusor onabotulinumtoxina injections, bladder augmentation and urinary diversion have to be considered. neuromodulation therapies including tibial nerve stimulation (tns) may be alternative non-invasive treatment options. indeed, tns is an effective and safe treatment for idiopathic overactive bladder proven in randomized controlled trials (rcts), but its value in neurological patients is unclear. in a recent systematic review, the investigators found evidence that tns might become a promising treatment option for nlutd, however, more reliable data from well-designed rcts are urgently needed to reach definitive conclusions. however, the investigators study will be the first adequately sampled and powered, randomized, placebo-controlled, double-blind trial assessing transcutaneous tns (ttns) for nlutd. this trial will provide significant insights into the efficacy of ttns in patients suffering from nlutd and in the case that this treatment is really effective in the neurological population, the investigators findings would completely revolutionize the management of nlutd in daily clinical practice. moreover, this interdisciplinary trial will relevantly influence the neurological and urological approach in the management of nlutd promoting future collaborative projects improving patients' medical care and underlying the pioneering role of switzerland in the rapidly developing and ambitious research field of neuro-urology.


Eligibility criteria:
inclusion criteria: * refractory lutd due to a neurological disorder: * urgency frequency syndrome and/or urgency incontinence refractory to antimuscarinics (pharmacotherapy for at least 4 weeks with at least 2 antimuscarinics) * chronic urinary retention refractory to alpha-blocker (pharmacotherapy with an alpha-blocker for at least 4 weeks) * combination of urgency frequency syndrome and/or urgency incontinence and chronic urinary retention refractory to antimuscarinics (pharmacotherapy for at least 4 weeks with at least 2 antimuscarinics) and alpha-blocker (pharmacotherapy with an alpha-blocker for at least 4 weeks) * age \>18 years * informed consent exclusion criteria: * botulinum a toxin injections in the detrusor and/or urethral sphincter in the last 6 months * age \<18 years * pregnancy * individuals especially in need of protection (according to research with human subjects published by the swiss academy of medical sciences www.samw.ch/en/news/news.html) * no informed consent
diet and rheumatoid arthritis risk in the united kingdom women's cohort

Conditions: Rheumatoid Arthritis (RA)

Summary: rheumatoid arthritis (ra) is the most common inflammatory arthritis, affecting around 1% of the uk population. it affects around 400,000 adults and is characterised by synovial inflammation, cartilage and bone damage that requires lifelong treatment and represents a significant burden for both the individual and society. diet can affect inflammatory status and ra risk, with varying risks for women on specific diets. low to moderate levels of alcohol consumption may be associated with lower risk of ra, and those who do not consume enough fruit and vegetables could be at a greater risk than those with adequate intakes. our research aim is to better understand the role of diet in reducing ra risk in united kingdom women. the research will use existing dietary and lifestyle data from the united kingdom women's cohort study and hospital records of ra incidence.

background: rheumatoid arthritis (ra) is a typical inflammatory arthritic disease that increases morbidity and mortality of cardiovascular diseases worldwide. previous observational studies have shown potential for risk reduction through dietary factors modification, but associations between most of dietary factors and ra incidence are still uncertain, and evidence in united kingdom populations is limited. therefore, this study aims to assess associations between diet and ra incidence in the united kingdom women's cohort. research plan and methods: the dietary and lifestyle data from the united kingdom women's cohort, which recruited 35,372 middle-aged women between 1995-1998, will be used. these data were linked to hospital episode statistics to provide data on the incidence of ra in participants. cox regression models will be applied to explore potential associations between dietary factors and ra incidence. dietary factors will be modelled both as categorical and continuous variables so that models can be fit comparing the risk of ra between categories of intakes and per increment increase in exposure intake (linear dose-response). restricted cubic splines will be used to model non-linear associations for dietary intake of alcohol, fruits, vegetables, tea, and coffee, since previous research has suggested possible non-linear associations for these variables.

Eligibility criteria:
inclusion criteria: * female * ages 35 - 69 years at time of recruitment * able to provide informed consent exclusion criteria: * male * not a resident of england * unable to link dietary and lifestyle data with hospital episode data * missing covariate data * rheumatoid arthritis records before or on the date of recruitment

Keywords: nutrition rheumatoid arthritis alcohol consumption body mass index cohort study epidemiology arthritis, rheumatoid, seropositive