Kornimate/medical-research-clean huggingface dataset:
efficacy of diathermy on healing power of cesarean section scar

Conditions: Healing Surgical Wounds

Summary: to compare the effects of electro-surgery on healing power as a primary outcome (from skin to the peritoneum. and volume of blood loss, incision time and postoperative surgical wound pain as secondary outcomes.

this is a prospective study is carried out at ain shams university maternity hospital, obstetrics and gynecology department, faculty of medicine in women undergoing cs through pfannentiel incisions. all women will receive intravenous antibiotic prophylaxis according to the ain shams guideline, 1 g of cefazolin given at the time of incision. diathermy incisions will be carried out using monopolar blade pen electrode, set on cutting mode and delivering a 35 continuous current. electrosurgical cutting will be performed without pressure or mechanical displacement. 'bleeders' will be controlled by using diathermy, on coagulating mode, and will be applied to a hemostat on the vessels. incisions made by the scalpel will be done by the traditional method, with proper hemostasis by application of pressure to skin blood vessels and by ligating the subcutaneous bleeders. after the operation and during the postoperative period, paracetamol (10mg/ml) 50-ml vial will be administered by i.v. infusion for analgesia on demand according to the patient's need with a 500-mg dose. and the wound will be sutured subcuticle by a prolene 3.0 sutures.

Eligibility criteria:
inclusion criteria: * primi-section * bmi (18-29) kg/m\^2. * age from (18-40). * women undergoing cs with pfannenstiel incision. exclusion criteria: * women with one of the following conditions: patients requiring midline incision or on anti-coagulant therapy * cardiac patients on pacemakers and patients with chronic diseases expected to affect wound healing, such as diabetes, liver diseases, chronic anemia and renal impairment * obese patients bmi (\>30) kg/m\^2.
6 week open-label trial with lumiracoxib 200mg o.d. in primary knee osteoarthritis or rheumatoid arthritis

Conditions: Osteoarthritis; Rheumatoid Arthritis

Summary: this study tested the safety, tolerability and efficacy of lumiracoxib - a cox-2 inhibitor- in patients with primary knee osteoarthritis or rheumatoid arthritis.


Eligibility criteria:
inclusion criteria: * requirement of regular nsaid therapy * with primary osteoarthritis of the target knee (by acr criteria) or with a diagnosis of rheumatoid arthritis (by acr criteria) exclusion criteria: * evidence of active ulceration of the ugi tract within 6 months prior to the screening visit or history of active bleeding of the ugi tract within the previous 5 years. as well as with pyloric or duodenal obstruction or with history of gastrointestinal parasites. * history of cardiac and cerebral thrombotic/ischemic diseases and/or events * patients taking additional nsaids (including cox-2 inhibitors) during the course of the study. other protocol-defined inclusion/exclusion criteria may apply

Keywords: osteoarthritis rheumatoid arthritis cox-2 lumiracoxib
reinflation after early tourniquet release in total knee arthroplasty

Conditions: Osteoarthritis, Knee

Summary: this study is aimed to determine the efficacy and the safety of the tourniquet reinflation after early tourniquet release in total knee arthroplasty, compared to the method of early deflation without reinflation. the investigators hypothesized that the reinflation after early release of the tourniquet would be effective in terms of improved visualization of the surgical field and decreased operation time and blood loss, whereas it would increase tourniquet-related complication due to longer tourniquet-use time.

total knee arthroplasty(tka) is mostly performed with tourniquet applied, because it allows decreased intraoperative blood loss, better visualization of surgical field and better cement fixation of the implants, compared to the tka without using tourniquet. however, there remains a controversy about the timing of tourniquet release, so the tourniquet may be unreleased throughout the whole operation time or released early just after cement fixation of the implants, atc. early tourniquet release is generally aimed to control hidden arterial bleeding which would not be revealed if the tourniquet was unreleased. this method was reported to reduce arterial bleeding and its related complications, but it was also known that increase intraoperative bleeding, incidence of transfusion, and operation time. on the other hand, late tourniquet release, which the tourniquet is unreleased until the wound is closed, is reported to increase tourniquet-use time and related complications owing to longer tourniquet time, although it gives shorter operation time. the investigators have been used a way of reinflation of tourniquet after early release, once the arterial bleeding was controlled sufficiently, to balance the advantages and disadvantages of the early tourniquet release. the investigators were able to control arterial bleeding during the time the tourniquet was released, and the remained procedures were performed conveniently with good visualization of the surgical field after the tourniquet was reinflated again. however, there was no previous studies about the efficacy and the safety of the way of reinflation after early release of the tourniquet in the literature. therefore, the investigators ask in this study whether the reinflation after early tourniquet release has advantages over the method of early tourniquet release without reinflation, in terms of efficacy and safety.

Eligibility criteria:
inclusion criteria: * diagnosis of primary osteoarthritis of the knee * scheduled for elective total knee arthroplasty * written signed consent exclusion criteria: * revision tka * diagnosis other than primary osteoarthritis * intra-articular indwelling drainage * refusing participate

Keywords: osteoarthritis knee total knee arthroplasty tourniquet early release reinflation
retention in physically demanding jobs with low back pain: a randomised controlled trial (goback)

Conditions: Low Back Pain

Summary: low back pain (lbp) is a recognized public health problem with high life time prevalence. medical treatment may reduce the physical and mental discomfort, while it has not been able to improve the possibilities for retaining or return patients with lbp to work. this is an occupational intervention study for patients with lbp and physically demanding work, who are at risk of drop out of labour; a randomized controlled trial designed to test the effectiveness of an early intervention for retaining subjects with lbp attached to the labour marked. a work place modification intervention combined with moderate physical activity is given in the intervention group additional to lbp treatments according to best practice recommendations for general practice. the study population consists of patients in self-reported physically demanding, who are sick listed or at risk of sick leave due to lbp. outcome will continually be collected during the intervention as well as 6 and additionally at 12 months follow up. the primary aim is to evaluate if an occupational intervention with focus on early workplace orientated counselling and work place intervention can retain subjects with physically demanding work and lbp in gainful employment to prevent/reduce the sick leave due to lbp. the secondary aims are to identify prognostic factors of an occupational intervention using the baseline and follow-up participant-rated outcomes: pain, physically function, generic health status, fear avoidance behaviours, job satisfaction, work-ability, satisfaction with intervention, clinical examination and mri findings. among these variables, we also aim to identify subjects, who will benefit from such an occupational intervention, and the subjects, who already have a good prognosis and therefore have no need for a larger scale intervention.

eligible participants are: 1) 18-65 years of age; 2) current episode of 2-4 weeks of lbp; 3) self-reported physically demanding work; 4) express concerns about the ability to maintain their current job. the exclusion criteria are: 1) pregnancy; 2) server somatic or psychiatric diseases; 3) cancer or metastatic disease

Eligibility criteria:
inclusion criteria: * working age adults 18-65 * low back pain (current episode of 2-4 weeks) * self-reported physically demanding work * sick-listed or at risk * speak, read and understand danish * accept workplace visit by the occupational physicians * be in gainful employment for at last 30 hours/week exclusion criteria: * severe somatic or psychiatric comorbidity * pregnancy * cancer or metastatic disease * lbp treatment or referral to outside providers (e.g. back-surgery) * contraindications for having a mri.

Keywords: low back pain return to work sickness absence rehabilitation occupational intervention
endobiliary radiofrequency ablation for malignant biliary obstruction due to perihilar cholangiocarcinoma

Conditions: Perihilar Cholangiocarcinoma

Summary: a multicentre, parallel group, open label, randomized controlled trial comparing endobiliary rfa prior to metal stent placement with stent placement only in patients with inoperable perihilar cholangiocarcinoma.


Eligibility criteria:
inclusion criteria: * 18 years or older. * capable of providing written and oral informed consent. * histological or cytological proof of perihilar cca (adenocarcinoma). * perihilar biliary obstruction with an indication for drainage with usems.\* * advanced (no candidate for surgical resection) due to metastases, vascular or lymph node (n2) involvement on imaging or during staging laparoscopy according to multidisciplinary team (mdt). * only patients with pcca are eligible however in case of reasonable doubt between intrahepatic cca with a perihilar biliary obstruction or massforming pcca, patients can be included. exclusion criteria: * patients who potentially qualify for curative resection of pcca. * pcca eligible for liver transplantation. * life-expectancy less than 3 months. * ercp and ptc technically not feasible. * uncontrolled coagulopathy (ptt \>1,5x prolonged or thrombocytes below 40\*10e9/l). * ongoing cholangitis or liver abscess. patients are required to be off antibiotic treatment for cholangitis and/or liver abscess at least 7 days. * any condition that is unstable or that could jeopardize the safety of the subject and their compliance in the study. * patients who are pregnant or breastfeeding.

Keywords: endobiliary radiofrequency ablation stent patency
meridian activation remedy system for parkinson's disease

Conditions: Parkinson Disease

Summary: in this study, the investigators aim to evaluate the clinical efficacy and cost-effectiveness of mars-pd. conventional, usual care will be used as the comparator because this trial aims to assess the add-on effect of mars-pd. the investigators hypothesize that the complex therapy will relieve motor and nonmotor symptoms, improve gait performance, and enhance neuroplasticity in pd patients, and will be safe and cost-effective.

this study is a randomized controlled trial conducted at a single center with raters blinded to the intervention. we will look at the clinical effect of mars-pd, consisting of 16 interventions over an 8-week period, in 88 individuals with parkinson's disease. patients will be assigned to either the experimental (n=44) or control (n=44) groups at random. he experimental group will receive the mars intervention, while the control group will receive usual care only. the treatment duration is 8 weeks, followed by a 12-week follow-up. the primary outcome is the change in mds-updrs part iii (movement disorder society unified parkinson's disease rating scale part iii) score from baseline to 8 weeks. secondary outcomes include assessments such as mds-updrs, international physical activity questionnaire short form, parkinson self questionnaire, parkinson's disease sleep scale, timed up and go test, gaitrite metrics, functional near-infrared spectroscopy measurements, smart band results, gut microbiome composition and diversity, and iris connective tissue texture.

Eligibility criteria:
inclusion criteria: 1. 45 to 75 years of age 2. patients with pd, diagnosed according to the united kingdom parkinson's diseases society brain bank criteria 3. hoehn and yahr scale stage i to iii 4. patients who have voluntarily decided to participate in the clinical study and signed the informed consent form exclusion criteria: 1. clinically unstable patients (e.g., elevated aspartate transaminase (ast) or alanine aminotransferase (alt) more than three-fold the upper limit of normal in the research institute's laboratory, heart failure, respiratory failure, etc.) 2. patients who are planning to undergo deep brain stimulation within the study period 3. pregnant or lactating women 4. patients with mmse-k (mini-mental state exam) score of 18 or less 5. if there has been a change in the dosage of antiparkinsonian drugs (e.g., l-dopa, comt (catechol-o-methyltransferase) inhibitor, dopamine agonist, mao-b (monoamine oxidase b) inhibitor, etc.) according to a doctor's prescription within the last 4 weeks prior to enrollment 6. patients who are receiving manual therapy, exercise therapy, or rehabilitation therapy for parkinson's disease according to a doctor's prescription within the last 4 weeks prior to enrollment, or are planning to receive such therapy within the study period 7. patients who are not suitable for participation in this clinical study according to the judgment of the researcher
treatment of periodontal intrabony defects with a-prf or ofd

Conditions: Periodontal Diseases

Summary: the aim of this randomized clinical trial was to clinically evaluate and compare the healing of intrabony defects after treatment with advanced platelet-rich fibrin (a-prf+) toped flap debridement (ofd) in periodontitis patients.

thirty (30) intrabony defects are randomly divided in two treatment groups: test (n = 15) and control (n = 15). the intrabony defects are filled with a-prf+ (n=15) in the test group, respectively treated with open flap debridement in the control group, and fixed with sutures to ensure wound closure and stability.

Eligibility criteria:
inclusion criteria: * no systemic diseases * a good level of oral hygiene * presence of a 2-, 3-, or combined 2-3-wall intrabony defect with a defect angle of 20-40 (+/- 5) degrees * with a minimum ppd of 6 mm and intrabony component of a minimum 4 mm as detected on radiographs * no smoking exclusion criteria: * systemic diseases that could influence the outcome of the therapy * poor oral hygiene * smoking * horizontal bone loss

Keywords: intrabony defects periodontal regeneration a-prf advanced platelet-rich fibrin open flap debridement
medical and economical impact of igras diagnosis of latent tuberculosis in hiv-infected patients

Conditions: HIV; Tuberculosis; Latent Tuberculosis Infection

Summary: tuberculosis is a current infection during hiv infection. after infectious contact, some patients will develop tuberculosis some will only be infected without symptoms, they have latent tuberculosis infection (ltbi) which can reactivate later.in order to prevent this tuberculosis reactivation, ltbi diagnosis screening is preconised in hiv-infected patients. this diagnosis is made till now by the tuberculin skin test (tst) but this test is not specific of tb. new blood tests (qftb-g and t-spot.tb) specific po mtb infection are now sold but have not been evaluated in immunocompromised hiv-infected patients. the primary endpoint of this study is the evaluation of the theoretic therapeutic impact of the use of igras for diagnosis of ltbi in hiv-infected patients

principal outcome: -theoretic therapeutic impact evaluation of the use of igras for diagnosis of ltbi in hiv-infected patients . secondary outcomes: * medico-economic impact of replacement of tst by igras in ltbi screening in hiv infected patients. * concordance of igras results with tst * concordance between igras. * concordance between igras in accordance to cd4 number(\ à 300/mm3). * ltbi prevalence in the study group. * effective consequences of tests results on therapeutic outcome of the patients ltbi criteria and therapeutic recommendations * one or 2 positive igras test: ltbi recommended to be ltbi * 1 negative igras test and one undetermined : no ltbi * 2 undetermined: * no clinical risk and negative tst: no diagnosis, eventually new test at 3 months or after haart onset. * clinical risk or tst\> 10mm: ltbi recommended to be treated. therapeutic outcome evaluation effective consequences of igra's result on patients outcome at 6 months. analyzed criteria: therapeutic impact: * patients percentage with different therapeutic outcome based on usual recommendations * medico-economic impact * medico-economic impact of both tests as early and late cost - efficacy * statistics primary criteria: * percentage of patients for whom therapeutic would have been changed by igras results compared to usual diagnosis strategy. secondary criteria: * concordance of igras with tst * concordance between both igras. * taille: 1000 patients timing: -inclusions: 2 years

Eligibility criteria:
inclusion criteria: 18 yrs old confirmed hiv infection no haart consent signed 6 months follow-up possible exclusion criteria: confirmed tb disease no social right pregnancy

Keywords: hiv tuberculosis igra diagnosis treatment naive
trimetazidine in pulmonary artery hypertension

Conditions: Pulmonary Artery Hypertension

Summary: pulmonary artery hypertension (pah) is a chronic and progressive disease that affects 15 persons per million. although current therapy has improve disease prognosis, pah still has a poor survival, with a median survival of 2.8 years after diagnosis. in the last few years new key elements in pah pathogenesis have been discovered, such as the role of metabolism in disease onset and progression. in fact, pah pulmonary smooth muscle cells switch into a glycolytic phenotype which resembles the metabolism of cancer cells. the investigators hypothesis is that "fatty acid oxidation inhibition reverts the pah adverse phenotype by restoring mitochondrial function and morphology, decreasing proliferation and restoring apoptosis susceptibility in pulmonary smooth muscle cells "


Eligibility criteria:
inclusion criteria: * pah patients belonging to the following subgroups of the updated dana point classification group 1 1. idiopathic pah 2. heritable pah 3. drug or toxin-induced pah 4. pah associated with connective tissue disease 5. pah associated to congenital heart disease with simple systemic-to-pulmonary shunt at least 1 year after surgical repair 6. pah associated to hiv infection * documented hemodynamic diagnosis of pah by right ventricular catheterization performed any time prior to screening * signed informed consent exclusion criteria: * patients belonging to the subgroups of the updated dana point classification group i not listed in the inclusion criteria * patients belonging to the groups 2-5 of the updated dana point classification group * moderate to severe chronic pulmonary obstructive disease * documented left ventricular dysfunction * severe renal impairment (serum creatinine \> 2.5 mg/dl) * patients who are receiving or have been receiving any investigational drugs within 1 month before the baseline visit * acute or chronic impairment (other than dyspnea) limiting the ability to comply with study requirements * psychotic, addictive or other disorder limiting the ability to provide informed consent or to comply with study requirements * life expectancy less than 12 months * females who are lactating or pregnant or those who plan to become pregnant during the study * known hypersensitivity to any of the excipients of the drug formulation
assessing the utility of ultrasound compared to cross-sectional imaging in the follow-up of patients with renal cell carcinoma

Conditions: Renal Cell Carcinoma

Summary: the aim of this study is to determine the utility of renal ultrasonography (us) in the detection of abdominal recurrences after definitive therapy for renal cell carcinoma (rcc) and compare the detection rate to that of cross-sectional imaging.


Eligibility criteria:
inclusion criteria: * patients must be 18 year of age or older. * patients having undergone radical or partial nephrectomy for the indication of renal cell carcinoma. * most recent imaging study must have been either computed tomography (ct) or magnetic resonance imaging (mri). exclusion criteria: * patients with pt4 disease (tumor invades beyond the gerota fascia: including contiguous extension into the ipsilateral adrenal gland). * patients with metastatic disease prior to time of surgery requiring systemic treatment. * patients with another active cancer diagnosis requiring systemic treatment. * patients with contrast allergies. * patients with baseline chronic kidney disease (gfr \< 45 ml/min/1.73 m2).
lung ultrasoung guided treatment in chronic heart failure patients: a randomized controlled trial

Conditions: Heart Failure

Summary: introduction: despite the great advances in treatment, heart failure (hf) continues to be an important health problem because of its high prevalence, morbidity, mortality and associated costs. research shows at least 40% of hf in-patients are going to be readmitted in the following year. thus, new strategies to reduce hf decompensations are needed. in recent studies, pulmonary congestion which is expressed in the form of b-lines detected by lung ultrasound (lus) has proven to be a potent prognostic predictor of hospitalization and mortality in hf. moreover, the use of lus is becoming more common due to its availability (with pocket devices with sizes approaching those of smart phones); its simplicity (rapid learning curve and rapid examination, less than 5 minutes) and its safety (radiation free). we hypothesize that a management guided by lus in hf patients may improve outcomes. objective: the aim of our study is to evaluate if ambulatory lus guided treatment of patients after a hospitalization for hf, decreases the combined end-point of mortality or re-hospitalization after a 6 months follow-up. study design: the design of our study is a randomized, simple blinded, clinical trial. eligible patients are patients older than 18 years of age who have been hospitalized for hf. the exclusion criteria are life expectancy of less than 6 months or uninterpretable lung ultrasound. eligible patients are going to be randomized into either the "lus group" or the "control group". the follow-up consists of visits to the hf clinic at periods of 15 days, 1, 3 and 6 months after the initial hospitalization. lus is going to be performed on all patients despite their respective group. only in relation to the "lus group", the treating physician will have the result of the examination and the subsequent treatment adjustment could be made in response to those findings. this study complies with the declaration of helsinki and the study protocol is being evaluated by the ethic committee of our institution.


Eligibility criteria:
inclusion criteria: * age over 18 years old * current hospitalization for heart failure decompensation exclusion criteria: * not able to do the follow up * life expectancy of less than 6 months * uninterpretable lung ultrasound