Kornimate/medical-research-clean huggingface dataset:
rebound pain and related factors in postoperative patients with total knee arthroplasty

Conditions: Postoperative Pain; Postoperative Complications; Postoperative Nausea and Vomiting

Summary: the aim of this prospective observational study is to detect rebound pain and related factors in postoperative patients with total knee arthroplasty.

total knee arthroplasty is an effective treatment method for knee osteoarthritis and because it is an invasive method, more than 50% of patients experience postoperative pain. peripheral nerve blocks are widely used for optimal pain control. the femoral block is a frequently preferred peripheral nerve block method for postoperative analgesia in total knee arthroplasty surgery. however, after peripheral nerve block, a condition called rebound pain (rebound pain), which is described as very severe pain, lasting about 2 hours, usually of the burning type, occurs. the aim of this prospective observational study is to detect rebound pain and related factors in postoperative patients with total knee arthroplasty.

Eligibility criteria:
inclusion criteria: * 18-80 years older age who underwent total knee arthroplasty exclusion criteria: * asa score 4 or \>4 * active infection * end stage organ failure * pregnancy * established diagnosis neuropsychiatric disease ( epilepsy, neuropathy, neuromuscular disease, cerebrovascular disease...) * uses of oral corticosteroids
effectiveness of diode laser and sclerotherapy in treatment of oral pyogenic granuloma

Conditions: Pyogenic Granuloma of Gingiva

Summary: to clinically assess the effectiveness of diode laser versus sclerotherapy in the treatment of oral pyogenic granuloma. a randomized-controlled clinical trial conducted on 20 patients with oral pyogenic granuloma. patients were assigned into two groups. group i treated by diode laser1; group ii treated by injection of ethanolamine oleate2 as sclerosing agent. all patients were clinically assessed for pain, bleeding during surgery and healing quality; 1st week, 2nd week and 4th week. the patients were followed up after 3 months from the end of treatment.

background: pyogenic granuloma (pg) is one of the most common reactive hyperplasia that causes soft tissue enlargement. it affects skin and oral mucosa. the traditional treatment for oral pg is conservative surgical excision with cold blade together with the removal of causative irritant or source of trauma. bleeding susceptibility, healing quality and pain represent common complications following surgical excision of pyogenic granuloma. sclerosing agents are widely used in the treatment of pyogenic granuloma as it is a conservative non painful procedure. the use of lasers in dentistry have grown in the last 4 decades. it has proved its efficacy in the treatment of pyogenic granuloma. study objective: study will be conducted to evaluate healing quality of using diode laser versus sclerotherapy (ethanolamine oleate) in the treatment of oral pyogenic granuloma. materials and method: this randomized controlled clinical trial will include 20 patients with pyogenic granuloma, divided equally into two groups. group-i (test group) will be managed by application of diode laser. group- ii (control group) will be managed by injection of ethanolamine oleate as sclerosing agent on weekly injection visits. patients of both groups will be evaluated intraoperatively for bleeding severity and postoperatively in terms of pain at the 2nd and 7th day and healing quality. results: results will be tabulated and statistically analysed.

Eligibility criteria:
inclusion criteria: 1. patients of both genders diagnosed clinically and confirmed histologically with oral pyogenic granuloma. 2. size of the lesion not less than 5mm. 3. patients included in the study will be having gingival pyogenic granuloma as it is the most common site for its occurrence. 4. patient age ranges from 19 to 50 years old. exclusion criteria: 1. patients with uncontrolled diabetes. 2. immuno-compromised patients. 3. patients with renal disease. 4. patients having coagulation disorders. 5. patients having allergic reaction to any of the sclerosing drug constituents. 6. pregnant and lactating women.

Keywords: pyogenic granuloma diode laser sclerotherapy ethanolamine oleate
efficacy of neoadjuvant endocrine therapy compared to chemotherapy in breast cancer patients

Conditions: Female Breast Cancer

Summary: eligible patients will be divided into two groups; one will receive neoadjuvant endocrine therapy and the other one will receive neoadjuvant chemotherapy.

patients will be randomized into two groups: the first group (arm a) will receive nct; (any approved chemotherapy protocol by guidelines. the second group(arm b) will receive net; gnrh analog goserelin acetate 3.6 mg every 4 weeks with tamoxifen 20 mg daily for premenopausal patients or an aromatase inhibitor for postmenopausal patients. * before and during treatments (every 3 weeks for the nct group, and every 4 weeks for the net group), the clinical assessment will be performed for all patients. * all patients will undergo breast magnetic resonance imaging (mri) before the start of treatment, after 12 weeks (3 months) of treatment, and after the end of treatment before surgery. * we will determine the objective tumor response with every measurement method and assess the response according to the response evaluation criteria in solid tumor (recist) version 1.1. * treatment will be continued for 19-21 weeks before surgery for the chemotherapy group and 24 weeks for the endocrine therapy group. * ki-67 will be assessed using a sample of the core biopsy before treatment and a surgery specimen after treatment. * adverse events will be recorded at every patient visit and will be assessed according to the common terminology criteria for adverse events version 5.0. * surgery will be performed between the 24th and 26th week. * arm b patients who will develop pd or sd after 6 months of treatment will be shifted to arm a. the primary endpoint will be; * the clinical response rate at the end of neoadjuvant treatment, as will be determined using caliper and mri measurements. * a clinical response included either a complete response (cr), a partial response (pr), progressive disease (pd), or stable disease (sd) according to the (recist) version 1.1. secondary endpoints will be; * the rate of pathological complete response (pcr). * the rate of breast conservation surgery. * ki-67 changes. * the length of time to maximum response within a treatment period. * the adverse events associated with each treatment arm.

Eligibility criteria:
inclusion criteria: * any histological type of invasive breast cancer. all grades of breast cancer (i, ii, iii). er-positive and/or pr-positive, her2-negative breast cancer. er and/or pr level of positivity ≥34 % (score 4 according to modified allred score). clinical stages: any t n1-3, or t2-4 any n, m0. exclusion criteria: * hormone receptor positivity \< 34%. inflammatory breast cancer metastatic breast cancer. recurrent breast cancer. other malignancy. unfit patients for chemotherapy.

Keywords: neoadjuvant endocrine therapy ,neoadjuvant chemotherapy
evaluating the effect of mucinex 1200mg on mucociliary and cough clearance during an acute respiratory infection

Conditions: Acute Respiratory Infection

Summary: the purpose of this research study is to explore the mechanism of action of mucinex, an oral, over-the-counter, fda approved expectorant in patients with acute respiratory tract infections.


Eligibility criteria:
inclusion criteria: * symptoms of cough, thickened mucus and chest congestion * able to produce sputum * non smoker exclusion criteria: * pregnant * smokers * fever above 101°f * any chronic illness

Keywords: acute respiratory infection mucociliary cough clearance guaifenesin
epigenetic features of foxp3 in children with cow's milk allergy

Conditions: Cow's Milk Allergy

Summary: epigenetic mechanisms have been implicated in the pathogenesis of food allergy. the investigators previously demonstrated that tolerance acquisition in children with immunoglobulin e- (ige) mediated cow's milk allergy (cma) is driven by epigenetic modulation of the th1 and th2 cytokine genes. a regulatory t cell (treg) suppressive phenotype, characterized by stable expression of the transcription factor "forkhead box protein 3" (foxp3), plays a pivotal role in food tolerance. foxp3 mrna expression is lower in children with atopic asthma or ige-mediated food allergy than in healthy children. foxp3 stable expression requires full cpg demethylation of its transcriptional regulatory regions, and, moreover, hypermethylation of the foxp3 gene has been associated with reduced treg function and allergy. dna methylation is a biologically and chemically stable epigenetic modification that locks in long-term gene expression patterns. the demethylation status of foxp3 at a highly conserved region within the treg-specific-demethylated-region (tsdr), a cpg-rich, located on the 2nd conserved non-coding sequence of foxp3 (cns2), is restricted to tregs. transcriptional activity of the tsdr is essentially determined by its methylation status : it is completely inactive in its methylated state, but when the tsdr is demethylated, transcription factors such as ets-1 and creb can bind to the tsdr. tsdr demethylated and open chromatin conformation in the foxp3 locus leads to stable phenotype differentiated foxp3+ treg. foxp3 tsdr demethylation in peripheral blood mononuclear cells (pbmcs) has been associated with reduced atopic sensitization and asthma in children. epigenetic regulation of antigen-induced t-cell subsets may predict a state of immune tolerance in food allergy. indeed, dna methylation of the foxp3 gene in tregs decreased during oral tolerance acquisition in patients with peanut allergy undergoing oral immunotherapy. the aim of this study was to evaluate further the epigenetic regulation of foxp3 gene in children with ige-mediated cma.


Eligibility criteria:
inclusion criteria: * ige-mediated cma children (aged 3 to 18 months) exclusion criteria: * allergic disorders or food allergies other than cow's milk allergy * eosinophilic disorders of the gastrointestinal tract * food protein-induced enterocolitis syndrome * concomitant chronic systemic diseases * congenital cardiac defects * active tuberculosis * autoimmune diseases * immunodeficiency * chronic inflammatory bowel diseases * celiac disease * cystic fibrosis * metabolic diseases * lactose intolerance * malignancy * chronic pulmonary diseases * malformations of the gastrointestinal tract
cognitive behavioral therapy (cbt) for adherence and depression in type 1 diabetes

Conditions: Depression; Type 1 Diabetes

Summary: this study is a pilot behavioral intervention trial, designed to initially examine cognitive behavioral therapy for medical adherence and depression (cbt-ad) in patients with depression and poorly controlled type 1 diabetes.


Eligibility criteria:
inclusion criteria: * diagnosis of type 1 diabetes that is poorly controlled (hba1c greater than or equal to 8.0%) despite treatment with insulin. * diagnosis of major depression and/or dysthymia, or current subclinical symptoms of depression in spite of being treated with antidepressants. * age 18-80. * if on an antidepressant, stable for two months. oral hypoglycemic medications stable for 2 months, and insulin prescription stable for 2 months (if prescribed). exclusion criteria: * active or untreated major mental illness that would interfere with participation (e.g., untreated psychosis), untreated/unstable bipolar disorder, eating disorder, mental retardation, dementia, or active suicidality. * unable or unwilling to provide informed consent. * history of or current cbt for depression. * currently on dialysis.

Keywords: depression diabetes adherence medication glucose insulin
endovascular thrombectomy of acute mesentery vessels occlusion hybrid with emergent laparoscopic surgery

Conditions: Mesenteric Artery Ischemia; Thromboembolism

Summary: acute mesenteric artery thromboembolism(amt) is one of the important causes of acute abdomen and intestinal necrosis. if the intestinal blood supply is not restore in time, the prognosis of the disease is often poor and even endangers the life of the patient. through laparoscopic surgery combined with modern minimally invasive endovascular technology, the blood supply of patients' intestine is restored. observe the perioperative vascular patency rate, all-cause mortality, and the probability of short bowel syndrome. through the hybrid operating room, we want to seek a multidisciplinary collaborative treatment mode to improve the long-term survival rate of such patients with enough intestines and completely free from tpn, and improve the prognosis of these patients.

this study is a clinical cohort study; consecutively registered 30 patients with acute intestinal ischemia caused by superior mesenteric artery thromboembolism. if all the radiography, physical signs, and laboratory markers hint at intestinal necrosis, exploratory laparotomy followed by enterectomy and thrombectomy is the first choice. if none of them hint at intestinal necrosis, endovascular therapy is superior. laparoscopic exploration followed by endovascular therapy was performed for other patients, after that the intestinal blood supply was evaluated again by laparoscopy. the main endpoints are the survival rate of bowel function preserved at 30 days, and the secondary endpoints are 30-day mortality, in-hospital mortality, symptoms-free survival rate, and rate of transition to laparotomy.

Eligibility criteria:
inclusion criteria: * patients with intestinal ischemia and acute abdomen pain caused by superior mesenteric artery thromboembolism exclusion criteria: * those who have acute large-area myocardial infarction, large-area cerebral infarction, or have serious heart failure or sequelae of cerebral infarction within 1 month; * combined with portal hypertension, gastrointestinal hemorrhage, portal and mesenteric venous reflux obstruction diseases; * contrast agent allergy, severe renal insufficiency, and inability to perform intravascular surgery; * past medical history contains superior mesenteric artery thromboembolism. * patients diagnosed with intestinal necrosis and peritonitis before surgery based on physical signs and imaging studies who directly undergo laparotomy and incision for thrombectomy. * patients without intestinal necrosis or peritonitis based on physical signs and imaging studies, who are treated by endovascular intervention therapy directly.

Keywords: acute mesenteric artery thrombosis hybrid operation mechanical thrombectomy
dance for the improvement of balance and gait after stroke

Conditions: Chronic Stroke

Summary: stroke can drastically impact the ability to walk and keep your balance. in addition people with chronic stroke feel social isolated, become less satisfied with their walking and lose confidence in their ability to move without falling. ned new treatments are needed for walking and balance. dancing is a fun, social activity that has similar benefits to traditional exercise. another benefit of dancing is the use of music, which improves mood, increases motivation and can even improve motor performance. finally, moving in synchrony with other people during dancing can make people feel connected. we believe that dance classes can benefit people with stroke, but few studies have been done. the objective of our project is to conduct a randomized controlled trial to test whether dance can improve balance and walking for people with chronic stroke. the investigators are also interested in whether dancing improves people's confidence in their ability to do activities without losing their balance (i.e. balance confidence), decreases their feelings of isolation and increases their quality of life.

this study is a randomized controlled trial to investigate the effects of an adapted dance program for people with chronic stroke. participants with stroke living in the community will be randomly assigned to either the dance group or the control group. participants will attend classes 2 times a week for 12 weeks. the primary outcomes are change in balance balance (measured with the mini bestest) and change in gait speed. participants will be assessed before and after the 12 week program.

Eligibility criteria:
inclusion criteria: 1. \> 6 months post stroke 2. ability to transfer sit to stand and stand to sit with minimal use of arm rests 3. ability to stand without physical support from an aid or another person for 30 seconds 4. ability to walk 10m without physical assistance from a walking device, but with standby assistance from another person if needed 5. ability to follow 2-3 step instructions with minimal prompting from another person 6. have received clearance from their physician to participate in exercise. exclusion criteria: 1. severe hearing loss 2. pre-existing conditions that significantly impact gait and balance (e.g. osteoarthritis) 3. other neurological conditions that impact gait and balance (e.g. pd). 4. have participated in a dance class within the past 12 months

Keywords: dance stroke randomized controlled trial rehabilitation gait balance
the factors that affected the outcome of treatment of congenital nasolacrimal duct obstruction

Conditions: Congenital Nasolacrimal Duct Obstruction

Summary: the purpose of this study was to investigate various potential factors that affected the outcome of treatment of congenital nasolacrimal duct obstruction.

congenital nasolacrimal duct obstruction is a common condition during the first few years of childhood. most cases may resolve spontaneously, but the remaining children whose blockage does not resolve may require primary probing. controversy remains regarding the optimal timing of the probing procedure. another controversy is related to the setting of surgery. therefore, we try to investigate the factors that affected the outcome of treatment of congenital nasolacrimal duct obstruction under the same surgical doctor during the past 13 years in our hospital.

Eligibility criteria:
inclusion criteria: * a history of tearing and/or mucopurulent discharge beginning during the first few weeks of life * anatomical nasolacrimal duct obstruction exclusion criteria: * previous probing * glaucoma * trauma * lid malpositions * craniofacial anomalies * congenital mucocele of the nasolacrimal sac
transrectal vacuum assisted drainage: a new method of treating anastomotic leakage after rectal resection

Conditions: Colorectal Surgery

Summary: anastomotic leakage is a major and potentially mortal complication with an incidence of 10-13% after resection of the rectum. for patients showing no clinical signs of peritonitis, the traditional method has been a conservative treatment with transrectal rinsing. this treatment is often associated with a very protracted postoperative course with healing times of up to a year or more for the anastomotic leakage. treatment with vacuum drainage (vd) is a new method primarily developed for wound therapy. the objective of this study is to investigate the effects of transrectal vacuum treatment on the healing of anastomotic leakage after rectum resection in a prospective, randomized, controlled multicentre trial in 60 patients found to develop clinically significant anastomotic leakages after elective rectal resection.


Eligibility criteria:
inclusion criteria: * patients with clinically significant\* anastomotic leakage after intended curative rectal resection (lar) for rectal cancer with primary anastomosis. * patients whose operation did not include ileostomy must have surgery to create a stoma within two days after beginning of the vacuum therapy and before randomization. anastomotic leakage must have been diagnosed within 21 days of the primary operation. * patients with and without preoperative radiation therapy may participate. * groups will be formed accordingly, because patients who had preoperative radiation therapy heal more slowly. * patients with anastomotic leakage (diagnosed by endoscopic or radiology techniques) and clinical signs and symptoms indicating a health impairment (fever, pain, elevated creatinine levels). * anastomotic leakage after rectal cancer surgery exclusion criteria: * informed consent * age \< 18 years * acute surgery * leakage diagnosed more than 21 days after the primary operation * patient does not consent to temporary ileostomy * anastomosis technically inaccessible for vacuum-assisted drainage * small intestine visible in abscess cavity * residual cancer tissue in the pelvic cavity * suspicion of fistulation between the abscess cavity and internal genitalia, urinary tract system, or small intestines.

Keywords: anastomotic leakage
replication of the isar-react 5 antiplatelet trial in healthcare claims data

Conditions: Acute Coronary Syndrome

Summary: investigators are building an empirical evidence base for real world data through large-scale replication of randomized controlled trials. the investigators' goal is to understand for what types of clinical questions real world data analyses can be conducted with confidence and how to implement such studies.

this is a non-randomized, non-interventional study that is part of the rct duplicate initiative (www.rctduplicate.org) of the brigham and women's hospital, harvard medical school. it is intended to replicate, as closely as possible in healthcare insurance claims data, the trial listed below/above. although many features of the trial cannot be directly replicated in healthcare claims, key design features, including outcomes, exposures, and inclusion/exclusion criteria, were selected to proxy those features from the trial. randomization is also not replicable in healthcare claims data but was proxied through a statistical balancing of measured covariates through standard practice. investigators assume that the rct provides the reference standard treatment effect estimate and that failure to replicate rct findings is indicative of the inadequacy of the healthcare claims data for replication for a range of possible reasons and does not provide information on the validity of the original rct finding.

Eligibility criteria:
criteria: please see https://drive.google.com/drive/folders/1wd618wrywyjeaxzfltcuk-vccnb6b-gv for full code and algorithm definitions. inclusion criteria: * hospitalization for unstable angina or acute mi and age \>= 18 years days \[acs admission\] * stemi or nstemi/unstable angina (during admission) + 1 of the following * \>= 60 years old days \[acs\] * \>= 3 risk factors for coronary artery disease * diabetes mellitus * chronic renal disease * carotid stenosis \>= 50% or cerebral revascularization * peripheral artery disease days \[-365, acs\] * aspirin use * angina days \[-7, acs\] * prior mi or cabg any time prior exclusion criteria: * acute complication pci days \[-30, acs admission\] * history of any stroke or tia days \[all available data, 0\] * intracranial neoplasm, intracranial avm, intracranial neoplasm days \[-180, 0\] * active bleeding days \[-180, 0\] * platelet count \< 100.000/ul days \[-180, 0\] * anemia (hemoglobin \< 10 g/dl) days \[-180, 0\] * chronic renal insufficiency requiring dialysis days \[-180, 0\] * moderate to severe hepatic dysfunction days \[-180, 0\] * increased risk of bradycardia events days \[-180, 0\] * life expectancy, 1 year days \[-180, 0\] * pregnancy days \[-180, 0\] * concomitant therapy cyp3a inhibitors, cyp3a substrates, or strong cyp3a inducers days \[-14, 0\]