Kornimate/medical-research-clean huggingface dataset:
paravertebral blocks: pilot study to compare nerve stimulation vs. anatomic landmarks in inguinal hernia repair

Conditions: Inguinal Hernia

Summary: primary aim: 1. to compare the nerve stimulation vs. anatomic techniques of paravertebral block of t11-l1 in providing surgical anesthesia for patients undergoing inguinal hernia repair. secondary aims: 1. compare vas pain scores in the two groups of patients over the first 24 hours. 2. compare opioid intake over the first 24 hours in the two groups of patients.


Eligibility criteria:
inclusion criteria: * unilateral open inguinal herniorrhaphy * patient must be \>18 years of age * asa physical status of i, ii, or iii * patient competent to provide informed consent exclusion criteria: * patient \< 18 years of age * pregnant or lactating women * patient unwilling or unable to provide informed consent * contraindications to regional anesthesia * allergy to amide local anesthetics
transthyretin cardiac amyloidosis in patients with idiopathic carpal tunnel syndrome referred for release surgery

Conditions: Transthyretin Amyloidosis; Carpal Tunnel Syndrome

Summary: this study will determine the prevalence of transthyretin amyloidosis in pathology of the transverse carpal ligament and cardiac involvement using natriuretic peptides, electrocardiography and echocardiography in patients referred for carpal tunnel release surgery of idiopathic carpal tunnel syndrome. this study will describe the relationship between amyloid deposition observed on the transverse carpal ligament and the presence of cardiac involvement.

unrecognized wild-type transthyretin amyloidosis (attrwt) in patients with idiopathic carpal tunnel syndrome (cts) is a prevalent aging-related disorder. amyloid deposition in the tenosynovial tissue has been reported in \~35% of patients with idiopathic carpal tunnel syndrome. otherwise, cts has been shown to be the most common initial symptom of systemic wild-type transthyretin amyloidosis. the clinical significance of subclinical attrwt deposits in the heart in elderly patients has yet to be determined, but these deposits could contribute to the development of heart failure with preserved ejection fraction. attrwt has been reported in \~15% of patients with heart failure with preserved ejection fraction. early detection of amyloid deposition in the transverse carpal ligament of patients with cts could anticipate cardiac damage and progression to heart failure.the aim of this study is to determine the prevalence of transthyretin amyloidosis in pathology of the transverse carpal ligament and cardiac involvement using natriuretic peptides, electrocardiography and echocardiography in patients referred for carpal tunnel release surgery of idiopathic carpal tunnel syndrome.

Eligibility criteria:
inclusion criteria: * patients over 18 year-old * indication carpal tunnel release surgery of idiopathic carpal tunnel syndrome. * to agree to participate (signature of the informed consent) * affiliate or beneficiary of a social security scheme exclusion criteria: * patients with non-idiopathic carpal tunnel syndrome with medical contraindication : pregnancy, obesity (body mass index \> 30), diabetes, rheumatoid arthritis, sarcoidosis, purulent tenosynovitis, tuberculosis, systemic lupus erythematosus, hypothyroidism or hyperthyroidism and gout. * patients with history of cardiac disease or coronary artery disease. * patients with systemic amyloidosis already known. * patients unde guardianship or curatorship

Keywords: cardiac amyloidosis transthyretin amyloidosis carpal tunnel syndrome
a study of a topical form of nitroglycerin and placebo in the treatment and prevention of raynaud's phenomenon

Conditions: Raynaud's Disease; Raynaud's Disease Secondary to Scleroderma; Raynaud's Disease Secondary to Other Autoimmune Disease

Summary: the purpose of this research study is to test the safety, tolerability, and effectiveness of topical amphimatrix with nitroglycerin (mqx0503) to relieve raynaud's symptoms and increase blood flow to the fingers.

the purpose of this clinical study is to determine, in a controlled fashion, the ability of a topical formulation of nitroglycerin, mqx-503, to improve the patient's health assessment as indicated by patient and physician assessments, decrease the frequency of raynaud's events, decrease the duration of raynaud's events, and decrease the symptoms (pain, tingling, numbness) in the fingers of raynaud's patients. the study will include patients with moderate to severe primary raynaud's phenomenon (rp) and with moderate to severe raynaud's phenomenon secondary to autoimmune diseases, such as scleroderma.

Eligibility criteria:
inclusion criteria: * outpatients ages 15 - 70. * patients with a diagnosis of raynaud's phenomenon. * patients who agree to apply study medication to their fingers. * patients who are willing to stop current topical vasodilator therapies. * patients who agree not to start or change dosage of current oral vasodilator therapies. * patients who agree not to use any nitrate therapy while participating in this study. * negative pregnancy test in fertile women and agreement to use effective contraception throughout the study. exclusion criteria: * patients who currently use nitrate medication or medications known to interact with nitroglycerin. * patients who have an allergy to nitroglycerin or common topical gel ingredients. * patients with a history of severe headaches. * patients with an unstable medical problem. * patients with cognitive or language difficulties that would impair their ability to complete assessment of pain instruments. * patients who have had a recent heart attack or other uncontrolled heart condition. * patients who have participated in an investigational drug study within four weeks of visit one. * patients who have clinically significant abnormal lab values. * patients who have had recent major abdominal, thoracic or vascular surgery. * patients with interfering skin conditions. * pregnant or nursing women or women unwilling to comply with contraceptive requirements.

Keywords: raynaud's nitroglycerin scleroderma
the effect of cbt- based weight loss program on obesity

Conditions: Obesity; Hypercholesterolemia; Diabetes Mellitus, Type 2; Anhedonia

Summary: the investigators purpose is to study how cbt (cognitive behavioral therapy)-based weight loss program affects on eating behavior, weight loss and risk factors for chd (coronary heart diseases)and type 2 diabetes. moreover, the investigators aim is to recognize subjects suffering from anhedonia (one of the core symptoms of depression, lack of pleasure) and follow how they benefit from the program in order to achieve maintained weight loss. also, the associations between weight loss, physical activity and musculoskeletal disorders are studied.

obesity is an increasing problem and effective weight loss methods are needed. the study is randomized follow-up study with 9 months intervention and three (3) years follow-up period. the study is organized in oulu university hospital, department of internal medicine. eighty (80)obese, 20-65 years, study subjects will be randomized into intervention or control group. the hypothesis of the cognobe study is: cbt (cognitive behavioral therapy)-based weight loss program is successful in sustained and favourable change in eating behavior and weight as well as decreased risk for coronary heart diseases or type 2 diabetes.

Eligibility criteria:
inclusion criteria: * bmi \> 30 exclusion criteria: * other concurrent weight loss programs * disease which prevents weight loss * medication which affects on weight loss
concurrent training and prediabetes control

Conditions: Metabolic Disturbance

Summary: despite exercise training decrease blood fasting glicaemy in 'average' terms, there is a wide inter-individual variability after exercise training explored mainly in adults but not in adults with prediabetes comorbidities. thus, is yet unknown the effects and influence of the concurrent training (ct) eliciting responders (r) and non-responders (nr) cases (i.e., percentage of subjects who experienced a non-change/worsened response after training in some metabolic outcomes).


Eligibility criteria:
inclusion criteria: * written informed consent. * interested in improving health and fitness. exclusion criteria: * cardiovascular contraindications to exercise, * history of stroke, asthma or chronic obstructive pulmonary disease, * muscle-skeletal disorders, and * smoking. * a compliance rate to the exercise program ≥ 70% was required for the participants in the intervention group to be included in the statistical analyses.

Keywords: metabolic syndrome obesity
application of time restriction feeding in patients with type 2 diabetes mellitus

Conditions: Type 2 Diabetes

Summary: in this 3-week interventional study, the investigators hypothesize that therapeutic time-restricted feeding in patients with poorly controlled type 2 diabetes mellitus (t2dm) can improve their mean glucose or estimated glycated hemoglobin levels with the same dose, or even reduced dose, of antidiabetics.

time-restricted feeding (trf) has recently gained popularity as a means of reducing body weight and improving glycemia. a recent clinical trial in men who had prediabetes showed that trf for five weeks significantly reduced fasting insulin concentration and improved the derived oral glucose tolerance test ( ogtt) indexes of beta-cell responsiveness and insulin resistance. however, the effects of trf have not been studied in patients with poorly controlled type 2 diabetes mellitus (t2dm). in this 3-week interventional self-controlled clinical trial, the investigators hypothesize that trf in patients with poorly-controlled t2dm can improve their mean glucose with the same dose/reduced dose of antidiabetics. potential study subjects will be identified from endocrinology clinic patients with a diagnosis of poorly controlled type 2 dm (a1c \>= 8.0 in the 3 months before enrollment) based on inclusion and exclusion criteria. all study subjects will be in the ad libitum feeding phase for one week, and then will be placed on time-restricted fasting (feeding between 4 am - 4 pm, fasting in the rest of the day) for the second week. for the third and final week, patients will be returned to the ad libitum feeding phase. the first and third weeks will serve as the control phases, and the second week will be the experimental phase. the mean glucose, serum triglyceride levels, insulin resistance, and body weights will be compared between the two phases. results of this clinical study may demonstrate a low-cost and practical way of diabetic control.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years and \< 65 years * with the diagnosis of type 2 diabetes * a1c \>= 8.0 on the most recent test in the 3 months before enrollment * have been on stable antidiabetics in the 3 months before enrollment * ohiohealth patient exclusion criteria: * pregnant or breastfeeding patients * severe hypoglycemic episodes (defined as having low blood glucose levels that requires assistance from another person to treat) in the past 12 months * unable to give informed consent * currently enrolled in another therapeutic study * thyroid dysfunction, as defined by abnormal thyroid function test results within the past 6 months * advanced stage of renal (stage 4 or above) or hepatic (cirrhosis) or respiratory (needs oxygen) or heart failure (nyha class 3 or above) * active infection or malignancy * dementia, or other significant mental impairment that would, in the opinion of the investigator, impede patient self-reporting * clinician-reported history of patient non-adherence

Keywords: intermittent fasting type 2 diabetes
glp-1 analogue in preventing progression of small vessel disease (gapp-svd)

Conditions: Cerebral Small Vessel Disease

Summary: cerebral small vessel disease (csvd), a result of neurovascular cell dysfunction, is a major cause of stroke, dementia and mobility problems worldwide. vascular risk factor control alone may not be sufficient to prevent the development of vascular cognitive impairment (vci) in patients with csvd according to previous clinical trials. the presence of glucagon-like peptide-1 receptor (glp-1r) in cerebral microglia may reveal a potential therapeutic target for prevention of csvd progression and its disabling clinical outcomes. at the cellular and animal experimentation levels, glp-1r agonist demonstrated reversal of some pathogenic processes in csvd. however, its application to csvd patients remains to be elucidated. investigator aims to investigate the safety and efficacy of glp-1r agonist in patients with moderate-to-severe csvd.

in this single-center, open-label (assessor blinded), randomized controlled study, 110 patients with csvd of age-related white matter changes scale of 2 or 3 will be randomized into "treatment arm" with glp-1r agonist and standard medical therapy, and "control" arm with standard medical therapy alone in a 1:1 ratio. in this 78 weeks pilot study, investigators shall evaluate the tolerability and safety profile of exenatide, a glp-1r agonist in svd patients, together with changes in clinical, imaging and sonographic parameters. clinical and biochemical measures will be assessed at baseline, 12 weeks, 26 weeks and 52 weeks. transcranial doppler ultrasound (tcd) will be performed at baseline, 12 weeks, 26 weeks, 52 weeks and 78 weeks. mri will be performed at baseline and 78 weeks

Eligibility criteria:
inclusion criteria: 1. chinese ethnicity; 2. age 55 to 80 years old; 3. age-related white matter change (arwmc) scale of 2 or early 3 in flair mri; 4. modified functional ambulation classification 5 or above; 5. montreal cognitive assessment (moca) score \< 25; 6. both diabetic and non-diabetic patient are eligible; 7. patient who understands the purpose and requirements of the study, and able to provide an informed consent; exclusion criteria: 1. dementia or moca score lower than 2nd percentile of the age and education adjusted cutoff ; 2. cerebral white matter changes unrelated to neurodegenerative, e.g. cadasil, x-linked adrenoleukodystrophy, metabolic diseases, multiple sclerosis, etc.; 3. contraindication to glp-1r agonist, including thyroid carcinoma, pancreatic pathology, proliferative retinopathy, hypersensitivity to glp-1r agonist and history of family history of multiple endocrine neoplasia; 4. bmi \<18.5kg/m2; 5. contraindication to proposed imaging, e.g. chronic kidney disease (kdnigo) stage 4 or above, acute kidney injury, hypersensitivity to gadolinium-based contrast, non-mri conditional implants or prosthesis; 6. medical condition that would not allow the patient to adhere to the protocol or complete the study.; 7. patient with established neurodegenerative disorders (e.g. parkinson's disease, alzheimer's disease, etc.); 8. pregnancy.

Keywords: csvd
phase iii randomized study of high vs standard dose of interferon alfa for chronic hepatitis c

Conditions: Hepatitis C

Summary: objectives: i. determine whether the initial response to interferon alfa (ifn-a) can be increased by starting at a dose of 5 mu three times a week in patients with chronic hepatitis c. ii. determine whether patients who had normalized alanine aminotransferase (alt) levels can maintain normal alt during stepwise dose reduction from 5 mu to 3 mu to 1.5 mu.

protocol outline: patients are randomly assigned to 1 of 2 treatment groups in a 2:1 ratio. the first group is treated with high-dose interferon alfa (ifn-a) administered subcutaneously twice a week for 12 weeks. if the alanine aminotransferase (alt) level has normalized, the ifn-a dose is decreased in a stepwise fashion. if the alt level decreases by more than 50%, ifn-a is continued at the same dose until week 24 or the alt normalizes. if the alt level decreases by less than 50%, treatment is discontinued. the second group is treated with standard-dose ifn-a administered subcutaneously twice a week for 24 weeks.

Eligibility criteria:
protocol entry criteria: --disease characteristics-- * biopsy-proven chronic hepatitis anti-hepatitis c virus positive hepatitis b surface antigen negative * no decompensated cirrhosis --prior/concurrent therapy-- * no concurrent immunosuppressives at least 1 year since interferon --patient characteristics-- * hepatic: no other cause of liver disease * other: not hiv positive

Keywords: hepatitis c immunologic disorders and infectious disorders rare disease viral infection
classical guitar for parkinson's disease

Conditions: Parkinson Disease

Summary: the purpose of this study is to understand if training parkinson's disease patients in classical guitar will improve motor function, mood, and quality of life. while medication has been found to be effective for many parkinson's disease patients, many patients still have symptoms. previous studies have found that music and rhythm-based activities can help parkinson's disease symptoms. a previous study looked at the effect of playing classical guitar on parkinson's disease symptoms. they found positive changes in parkinson's disease symptoms that lasted for 6 weeks after the study ended. further, there were positive changes in depression, anxiety, and quality of life.

subjects will be asked to take part in classical guitar lessons once a week for six weeks and physical therapy once a week for six weeks. there will be 40 people enrolled in the study. twenty people will have classical guitar lessons first and physical therapy second. the other twenty people will have physical therapy first and classical guitar lessons second. the study will last a total of 12 weeks. each session will last 1-2 hours. sessions will be held at the northwest chapter headquarters of the american parkinson's disease association. examples of the types of activities subjects will do during the physical therapy sessions include finger exercises, tasks with both hands, tasks while standing, and tasks while walking. examples of the types of activities you will do during the classical guitar lessons include playing chords and songs on the guitar. subjects will have physical exams and complete questionnaires at the beginning of the study, at six weeks, and at the end of the study. if subjects have apple watches, they will be asked to download an application called strivepd on their watch and iphone. strivepd is an application that allows subjects to keep track of their parkinson's disease symptoms or set medication reminders, for example. when used with an apple watch, it can automatically record symptoms like tremors. during this study, the strivepd application will only be used to collect data about what percentage of the day they have tremors and how much they sleep.

Eligibility criteria:
inclusion criteria: * 50-90 years old * diagnosis with parkinson's disease by a movement disorder specialist exclusion criteria: * professional musician or formal music training * inability to play a classical guitar physically * inability to follow instruction * receiving physical therapy at the time of the study * unable to attend all sessions of study

Keywords: parkinson's disease music-based therapy
vexus in patients with acute heart failure

Conditions: Acute Heart Failure

Summary: the importance of assessing venous congestion in heart failure patients is widely acknowledged, but its study is hampered by the lack of a practical evaluation tool. venous excess ultrasound score (vexus) is a promising noninvasive ultrasound-guided modality that can detect and objectify clinically significant organ congestion. vexus congestion grading score was still not formally validated in patients with ahf, as there is limited data on its clinical application in this group of patients.

it is currently unknown whether changes in systemic venous congestion, assessed by venous excess ultrasound score (vexus), are associated with worsening renal function, reduced diuretic and natriuretic response, and poor prognosis in patients with acute decompensation of heart failure (ahf). this prospective, observational, single-center study included patients admitted to the intensive care unit with ahf. at admission all patients undergo bedside doppler ultrasound of inferior vena cava, hepatic, portal and renal veins to determine blood flow patterns. congestion was graded with the vexus score (grade 0, grade 1, grade 2, grade 3). sodium concentration in a spot urine sample was assessed in 1 hour after first standard intravenous loop diuretic administration. the primary endpoint was the development of acute kidney injury (aki), defined as oligoanuria (diuresis rate \ 26 µmol/l within a 48-hour period or 50% from baseline creatinine within a week. the secondary endpoints were in-hospital mortality, change in spot urine sodium content \<50 mmol/l and development of diuretics resistance (defined as the need to double starting dose of intravenous furosemide in 6 hours without adding a different class of diuretic agents).

Eligibility criteria:
inclusion criteria: * acute decompensation of heart failure (diagnosis was based on the european society of cardiology (esc) heart failure guidelines, with patients presenting with dyspnoea at rest or with minimal exertion and signs and symptoms of congestion (rales on chest auscultation, peripheral oedema, swelling of the cervical veins, hepatomegaly, ascites, hepatojugular reflux) and n-terminal pro-b-type natriuretic peptide (nt-probnp) \> 1000 pg/ml exclusion criteria: * chronic renal replacement therapy or glomerular filtration rate \< 15 ml/min/1.73m 2 (chronic kidney disease epidemiology collaboration (ckd)-epi) * cirrhosis with portal hypertension * acute myocardial infarction according to the fourth universal definition of myocardial infarction * pulmonary embolism * sepsis (according to the third international consensus definitions for sepsis and septic shock (sepsis-3)) * endotracheal intubation at the time of admission * pregnancy or breastfeeding * aortic dissection * active cancer * neurological or mental disease during exacerbation * refusal to sign an informed consent form, inadequate acoustic window

Keywords: cardiorenal syndrome acute kidney injury fluid overload vexus natriuresis diuretics resistance congestion intrarenal blood flow
performance of universal adhesive in primary molars: a randomized clinical trial

Conditions: Dental Caries

Summary: the aim of this study is to evaluate the 18-month clinical performance of a multimode adhesive (scotchbond universal adhesive, 3m espe, st paul, mn, usa) in primary molars after partial carious removal. this randomized clinical trial will include subjects (5-10 year-old children) selected at two university centers (ufsm and fousp). the sample will consist of 132 primary molars presenting active cavitated carious lesions (with radiographic involvement of the outer half of the dentin), located on the occlusal and occlusal-proximal surface. the sample will be randomly divided into two groups according to bonding approach: etch-and-rinse or self-etch strategy. the restorations will be clinically followed every 6 months for up to 18 months using the usphs modified criteria for clinical evaluation. survival estimates for restoration longevity will be evaluated using the kaplan-meier method.

randomized clinical trials of performance of universal adhesive in primary molars

Eligibility criteria:
inclusion criteria: * active carious lesion in middle dentin limited to the occlusal or occluso-proximal surfaces of primary molars; * children (male or female) in good general health. exclusion criteria: * children who refuse or fail to cooperate with the completion of clinical procedure; - teeth without antagonist; * carious lesions in inner half of dentin; * presence of painful symptoms or signs of pulpal changes.