Kornimate/medical-research-clean huggingface dataset:
does pth 1-34 (teriparatide) enhance spinal fusion in humans?

Conditions: Spinal Stenosis

Summary: parathyroid (pth) hormone has been shown to enhance fracture healing in animal studies. there are so far only three published papers concerning humans. postero-lateral fusions have shown a healing rate of less than 50% after bone. the purpose of this study is to determine if pth 1-34 (teriparatide) improves the healing rate and the clinical course after spinal stenosis surgery.

100 patients undergoing surgery due to spinal stenosis and intraoperatively treated with autologous bone graft, will be randomised to either 4 weeks of daily injections with teriparatide or control. primary outcome: the rate of healing at 6 months on ct scans. secondary outcomes; pain (vas), function (oswestry disability index), quality of life (eq-5d) at 3 and 6 months.

Eligibility criteria:
inclusion criteria: * lumbar spinal stenosis operated on with decompression and bone grafting. all ages are accepted, but women must be postmenopausal. exclusion criteria: * •dementia or psychiatric disorder * known malignancy \< 5 years prior to fracture * calcium above reference value * signs of liver disease * creatinine over ref. value * inflammatory joint disease * alcohol or drug abuse * oral corticosteroid medication * long-term nsaid-treatment (=\> 3 months prior to fracture)

Keywords: pth spinal stenosis teriparatide
comparison of comprehensive rehab program and pelvic floor training in women with stress urinary incontinence

Conditions: Stress Urinary Incontinence

Summary: the goal of this clinical trial is to compare a comprehensive rehabilitation program and a conventional pelvic floor training program in women with stress urinary incontinence,to compare the effects of comprehensive rehabilitation program and conventional pelvic floor training on the severity of sui, on the strength of pelvic floor muscle and on quality of life in women with sui. following the randomization into either the conventional pelvic floor training or comprehensive rehabilitation program group, participants will receive their assigned interventions of three weekly sessions for eight weeks.

the proposed study comparing the effects of conventional pelvic floor training versus a comprehensive rehabilitation program on stress urinary incontinence (sui) among perimenopausal women holds significant rationale and importance. given the prevalence and impact of sui on the quality of life of perimenopausal women, investigating the comparative efficacy of these interventions is crucial for informing evidence-based clinical practice. the study aims to provide insights into the most effective management strategies for sui in this population, potentially leading to improved treatment outcomes, enhanced quality of life, and reduced healthcare burden associated with this common condition. by addressing this research gap, the study has the potential to significantly benefit both individual patients and the broader healthcare system. this will be a randomized controlled trial. non probability sampling technique will be used.the data collection procedure begins with the recruitment phase, potential participants meeting the study's criteria will be identified and provided with detailed information about the research aims and procedures. once recruited, participants will undergo a screening process to confirm their eligibility, including assessments such as medical history reviews and diagnostic tests. after obtaining informed consent, baseline assessments will be conducted to establish the participants' initial status regarding urinary symptoms and quality of life. following randomization into either the conventional pelvic floor training or comprehensive rehabilitation program group, participants will receive their assigned interventions of three weekly sessions for eight weeks.

Eligibility criteria:
inclusion criteria: * perimenopausal and post-menopausal women * age 40-60 years * medically diagnosed patients of stress urinary incontinence exclusion criteria: * history of pelvic surgery within the past six months. * current urinary tract infections or other active urinary tract disorders. * neurological conditions affecting bladder control. * inability to participate in the prescribed intervention due to physical or cognitive limitations. * participation in other pelvic floor rehabilitation programs concurrently or previously within the last 6 months.
the role of inflammation and aging in hiv-associated cardiovascular risk

Conditions: HIV Infection; Cardiovascular Disease; Inflammation

Summary: it is the central hypothesis of the investigators study that hiv disease is a pro-inflammatory condition, and that years of inflammation result in premature "aging' of the immune system ("immunosenescence"). just as these changes are thought be causally associated with heart disease in the very old,the investigators postulate that these changes will be associated with early heart disease in the untreated and perhaps treated hiv disease. to address this hypothesis, the investigators will measure immunosenescence in a large cohort of patients who span the entire disease process.


Eligibility criteria:
inclusion criteria: * hiv controllers: positive for hiv by standard antibody serological determinations with undetectable hiv rna level (\< 75 copies rna/ml) in absence of therapy * hiv non-controllers: detectable hiv rna levels in absence of therapy * highly active anti-retroviral therapy responders (haart responders): on combination antiretroviral therapy with undetectable hiv rna levels. * hiv-seronegative participants will also be studied. exclusion criteria: * treated individuals that changed antiretroviral regimen within 12 weeks prior to study enrollment. * individuals who have started or stopped antihypertensive medication or lipid lowering medication or changed doses of these drugs within 12 weeks of the study will be excluded. * as nitroglycerin is administered to assess endothelium-independent vasodilation, we also plan to exclude patients who have taken sildenafil, vardenafil, or tadalafil within 72 hours of the endothelial function study, or who are hypotensive (systolic bp \<100).

Keywords: hiv infection endothelial function cardiovascular disease inflammation antiretroviral medication treatment naive treatment experienced
5fluorouracil for advanced photoaging

Conditions: Photoaging; Actinic Keratosis

Summary: it is well known the efficacy of 5% 5-fluoruracil for multiple and superficial actinic keratosis (aks)treatment. recently its additional benefit for advanced and severe photoaging while treating aks was reported. the aim of this study is to compare the efficacy and safety of the two modalities of 5% 5-fu use for forearms photoaging.

the use of 5% 5-fluorouracil (5-fu) cream, twice a day, during 3 weeks represents a classic treatment for multiple and superficial aks. the main adverse event is the severe skin irritation leading to interruption of the treatment in some cases. in the last decade a superficial pulse-peeling using it as agent in sequential applications was described. this modality of treatment has been demonstrated efficacy and better tolerability. the improvement of the overall aspect of photodamaged skin is observed while treating multiple aks. there are no comparative study between the two types of 5% 5-fu use. so that is the purpose of our clinical trial.

Eligibility criteria:
inclusion criteria: 1. healthy men and women, aged from 50 to 75 anos; 2. phototype i a iii (fitzpatrick classification); 3. advanced photoaging on forearms, with multiple superficial actinic keratosis; 4. agreement with no sun exposure during the study and 5. agreement with study conditions,capacity to understand and follow the orientations and form consent signature. exclusion criteria: 1. topical treatment with: * tretinoin in the last 6 months ; * other retinoids, alpha-hydroxyacids, poli-hydroxyacids, beta-hydroxyacids and ascorbic acid in the last 3 months; 2. treatment by chemical peeling, microdermabrasion and non-ablative laser in the last 3 months; 3. treatment with systemic retinoid in the last 6 months ; 4. chemotherapy in the last 3 months; 5. hypersensibility to parabens; 6. infectious or inflammatory dermatosis on forearms; 7. clinical evidence of immunosuppression and 8. presence of photodermatosis

Keywords: photoaging actinic keratosis 5-fluoruracil carcinogenesis
effectiveness of proprioceptive exercise in neck pain

Conditions: Neck Pain

Summary: introduction: neck pain is among the most common and costly for industrialized societies. it is difficult to know the exact structure causing the pain so most are considered as non-specific neck pain. there is a correlation between the alteration of craneocervical proprioception and neck pain. the evidence for treatment with proprioceptive exercises is very limited. objective: to know the efficacy of a proprioceptive exercise program for neck pain and to compare its effects with a cervical mobility program. materials and methods: subjects between 18-65 years old with non-traumatic neck pain are included. they will be randomized into two groups of exercises: proprioception or mobility, which will be developed over a period of two weeks, every day, with a total of 10 sessions per patient.


Eligibility criteria:
inclusion criteria: * neck pain (nad i-ii) of recent onset (0-3 months) exclusion criteria: * cognitive difficulties * lack of commitment to attend sessions * subjects with pacemakers or defibrillators * being receiving another physiotherapeutic treatment * other pathologies

Keywords: proprioception
comparison of strength and constant score pre- and post-subacromial injection for full thickness rotator cuff tears

Conditions: Rotator Cuff; Subacromial Impingement Syndrome

Summary: clinical manifestations of rotator cuff tear include shoulder pain, weakness, and stiffness. the level of pain is often a limiting factor when assessing shoulder range of motion and strength pre-operatively. pain itself has even been a cause of weakness due to muscle atrophy. the purpose of this study is to further understand the effect pain has by measuring constant shoulder scores in patients before and after ultrasound guided subacromial (the outer end of the shoulder blade) injection of lidocaine (a local anesthetic or numbing agent) compared to saline (salt solution), in patients indicated for arthroscopic rotator cuff repair. the saline and lidocaine has been approved for use by the u.s. food and drug administration (fda). the constant shoulder score includes your level of pain, activity level, range of motion and strength measures.


Eligibility criteria:
inclusion criteria: * patient is determined to have a full thickness rotator cuff tear (1-3 cm), on the pre-operative mri scan or found arthroscopically, and is scheduled to undergo arthroscopic surgical repair * written informed consent is obtained exclusion criteria: * revision surgery * irreparable tear or partial tear * subscapularis involvement * any patient lacking decisional capability
plan intervention to enhance engagement of latino cancer patients in advanced care planning

Conditions: Locally Advanced Malignant Solid Neoplasm; Metastatic Malignant Solid Neoplasm

Summary: this trial tests whether planning for your advance care needs (plan) intervention works to enhance latino patients' understanding of and engagement in advanced care planning. the plan intervention may be an effective method to help people with cancer plan for and talk about advance care planning (the care they would want if they were unable to communicate) with their loved ones and doctors.

outline: patients are randomized to 1 of 2 arms. arm i: patients participate in plan intervention, consisting of 3 coaching sessions over 45-60 minutes each with a health coach. arm ii: patients receive usual care. after completion of study treatment, patients are followed up at 1 week and then at 3 months.

Eligibility criteria:
inclusion criteria: * identifying ethnically as latino. * locally advanced or metastatic cancer and/or have experienced disease progression on at least first-line chemotherapy. * ability to provide informed consent. exclusion criteria: * not fluent in english or spanish. * severely cognitively impaired (as measured by short portable mental status questionnaire scores of \>= 6 to be delivered by trained study research staff during screening). * too ill or weak to complete the interviews (as judged by interviewer). * currently receiving palliative care/hospice at the time of enrollment (to allow prediction of \[advanced care planning\] acp). * children and young adults under age 18. * patients deemed inappropriate for the study by their treating oncologist.

Keywords: advance care planning latinos communication
assessment of bone quality and quantity for three dimensional bone augmentation for maxilla using patient specific titanium meshes loaded with bone marrow aspirate mixed with xenograft versus xenograft mixed with autografts only: a randomized clinical trial

Conditions: Atrophic Maxilla

Summary: assessment of bone quality and quantity for three dimensional bone augmentation for maxilla using titanium meshes loaded with bone marrow aspirate mixed with xenograft versus xenograft mixed with autografts only


Eligibility criteria:
inclusion criteria: * patients are free from any systemic conditions and bone metabolic diseases that might interfere with the surgical intervention, soft tissue or hard tissue healing. * edentulous anterior or posterior maxilla with deficient alveolar ridge that is less than 5 mm measured from the crest of the alveolar ridge to the nasal or maxillary sinus and less than 4mm in buccolingual width. * the minimum number of missing teeth in the alveolar ridge is two adjacent teeth. exclusion criteria: * intra-bony lesions (e.g. cysts) or infections (e.g. abscess) that may retard the osteotomy healing. * previous grafting procedures in the edentulous area.
a phase 3 trial of mm120 for major depressive disorder (emerge)

Conditions: Major Depressive Disorder

Summary: a phase 3 double-blind, placebo-controlled study (part a) with an open-label extension (part b) evaluating mm120 compared to placebo in major depressive disorder - emerge

the study will enroll approximately 140 adult men and women aged 18 to 74 years, inclusive with a diagnostic and statistical manual of mental disorders, fifth edition (dsm-5) confirmed primary diagnosis of mdd,a minimum madrs total score of at least 26 and a cgi-s score of at least 4 at screening and baseline without clinically relevant medical or psychiatric history. the study consists of a 12-week randomized, double-blind, single-dose administration period evaluating mm120 versus placebo, followed by a 40-week extension phase with the opportunity for open-label treatment. during this phase, participants will be monitored and evaluated for potential treatment with mm120 based on pre-specified safety and symptom severity criteria.

Eligibility criteria:
inclusion criteria: 1. diagnosis of mdd per dsm-5 2. male or female aged 18 to 74 3. currently experiencing a major depressive episode (mde) of ≥8 weeks and ≤24 months duration 4. madrs total score ≥26 5. cgi-s score ≥4 exclusion criteria: 1. certain psychiatric disorders (other than major depressive disorder) 2. first degree relative with or lifetime history of a psychotic disorder or bipolar disorder 3. current diagnosis of alcohol or substance use disorder (excluding nicotine and caffeine 4. any clinically significant unstable illness
ranibizumab for neovascularization in sickle cell retinopathy

Conditions: Sickle Cell Anemia; Retinopathy

Summary: the purpose of this study is to determine the ocular and non-ocular safety of a single dose of ranibizumab in treating neovascularization secondary to sickle cell retinopathy.

in the u.s., about 10% of african americans have an abnormal hemoglobin gene. about 8% of african americans are heterozygous for hemoglobin s. in the united states, sickle cell anemia primarily occurs in the black population, with approximately 0.2% of african american children afflicted by this disease. it may be associated with other hemoglobinopathies as well. the prevalence in adults is lower because of the decrease in life expectancy. systemically, the sickle cell anemia variation (ss) produces the most symptoms. with respect to the eye, the sickle cell disease mutation (sc) produces the most effects. overall, the sickle cell trait expression (as) produces the fewest complications. * among patients with sc or sthal, the incidence of proliferation sickle cell retinopathy is 33% and 14% respectively. * proliferative sickle cell retinopathy is the major cause of vision loss in sickle cell disease. for sickle cell retinopathy, the commonly used therapeutic modalities include laser retinal photocoagulation, retinal cryotherapy, and vitrectomy/membranectomy depending on the severity of the disease. the most effective therapeutic modality with minimal postoperative complications appears to be scatter laser retinal photocoagulation. a single case study of bevacizumab was found to effective in short term regression of neovascularization and improving vision after a single injection. further study with ranibizumab is warranted. recent clinical trials (marina and anchor) have demonstrated that ranibizumab is effective in treating patients with cnv with age-related macular degeneration. retinopathy in sickle cell disease has also been linked to vegf. therefore, patients with sickle cell retinopathy should respond to ranibizumab therapy. this is an open-label single dose, phase i study of intravitreally administered ranibizumab in patients with sickle cell retinopathy. consented, enrolled subjects will receive a single open-label intravitreal injection of 0.5 mg ranibizumab. three subjects from one site in the united states will be enrolled. patients will receive one dose of 0.5 mg ranibizumab administered intravitreally.

Eligibility criteria:
inclusion criteria: * patients with sickle cell anemia and retinopathy * over age 18 years * non-pregnant exclusion criteria: * pregnant * glaucoma * patients using anticoagulants (e.g., warfarin) * retinal detachment
stability and balance in locomotion through exercise

Conditions: Parkinson's Disease

Summary: persons with morbus parkinson commonly develop gait and balance disorders leading to dependence, loss of mobility and a high risk of falling. this study investigates the effectiveness of a sensorimotor treadmill intervention to improve walking and balance abilities in persons with early stages of parkinson's disease. the sensorimotor treadmill training is conducted on a special treadmill device which is challenging the participants by small oscillations. this intervention, which is supposed to simulate walking on natural, uneven surfaces, is compared to a conventional treadmill training. hypothesis: sensorimotor treadmill training leads to larger improvements in walking and balance abilities as compared to conventional treadmill exercise.


Eligibility criteria:
inclusion criteria: * parkinson's disease stage 1-3 hoehn and yahr * united parkinson disease rating scale (updrs) 'gait' or 'postural stability' subscore of 1 or more * ability to stand unaided and walk without an assistive device * stable medication during the study period exclusion criteria: * on-off and wearing-off phenomena * unstable medical or psychiatric illness * clinically relevant cardiovascular or orthopaedic disease * severe polyneuropathy * cognitive impairment

Keywords: parkinson's disease treadmill training gait balance mobility
the effect of esketamine on postoperative pain relief in patients undergoing laparoscopic surgery

Conditions: Postoperative Pain

Summary: the purpose of this study is to investigate whether continuous intraoperative infusion of esketamine combined with the addition of esketamine to postoperative pcia can improve postoperative pain and sleep quality in patients undergoing laparoscopic uterine surgery under general anesthesia.

esketamine is the right isomer of ketamine, which is better than the original ketamine and has fewer side effects. in addition, for some gynecological hysterectomy patients who have poor sleep quality and anxiety after surgery, esketamine also has the effect of treating depression. due to the side effects of postoperative nausea, vomiting and hyperalgesia caused by excessive dosage of some opioids, this study will continue to inject small doses of esketamine during the operation to reduce the intraoperative dosage of opioids, and add esketamine to the postoperative pcia for analgesia. to explore whether this method can reduce the incidence of moderate and severe postoperative pain in patients with laparoscopic uterine surgery under general anesthesia.

Eligibility criteria:
inclusion criteria: 1. patient undergoing laparoscopic uterine surgery under general anesthesia (total hysterectomy, myomectomy); 2. patients gave the informed consent and signed the informed consent form. 3. the asa is ⅰ-ⅱ exclusion criteria: 1. patients allergic to anesthetics, ropivacaine, and esketamine or with contraindications to use; 2. patients with cognitive dysfunction or an inability to communicate; 3. transfer to the icu after surgery; 4. patients with hyperthyroidism, tachyarrhythmia, or severe hypertension; 5. unwilling to use pcia or refuse to participate in this trial; 6. patients with liver and kidney dysfunction

Keywords: esketamine laparoscopic uterine surgery postoperative pain and sleep quality
trained immunity in fungal infection and its mechanism

Conditions: BCG Vaccination

Summary: investigator vaccinated 76 healthy bcg-naive participant with bcg, while 3 participants received. half of bcg-vaccinated participants (n = 38) received an incremental dose of metformin for 6 days (up to 1,000 mg twice daily on day 6). on the day 0 (total 20; n = 10 for bcg vaccination, n = 10 for bcg vaccination plus taking metformin), day 14 (total 30; n=15 for bcg vaccination, n = 15 for bcg vaccination plus taking metformin), day 90 (total 26; n = 13 for bcg vaccination, n=13 for bcg vaccination plus taking metformin) of bcg vaccination, pbmcs were isolated, restimulated with c. albicans or mycobacterium tuberculosis.


Eligibility criteria:
inclusion criteria: * healthy bcg-naive participants. * the ages range from 20 to 45. * participants without any infections or immune deficiencies. exclusion criteria: * participants when infections or other illnesses occurred during the clinical trial. * participants who have a fever of unknown causes during the clinical trial. * participants who have gotten other vaccines during the clinical trial.

Keywords: immunity metformin bcg
p gingivalis oral infection, intimamedia thickening in infants, atherosclerosis

Conditions: Tooth Eruption, Atherosclerosis

Summary: to determine if there is an association between porphyromonas gingivalis infection of dental gingiva during primary tooth eruption and thickening of the radial artery intimamedial layers. thickening of these layers in infants could be a promoting factor for later development of atherosclerosis.

specific aim 1. to determine the presence of pg in the mouth of edentulous pre-eruption and then teething infants. over a 9-month period 15 normal babies will be recruited for a prospective pilot study from creighton university students. cotton swabs of the tongue mucosa and dental plaque will be made to detect the presence of pg by dna analysis. specific aim 2. to determine the daily temperature of infants. daily child temperatures will be recorded by the parent. specific aim 3. to measure the thickness of the radial artery using a 50 mhz ultrasound probe. a 50 mhz ultrasound scan will be made by a trained dental hygienist of the left radial artery at an initial visit and at 3-monthly intervals to measure imt.

Eligibility criteria:
inclusion criteria: * pre-primary tooth eruption infants in the range of 4-8 months - exclusion criteria: * no erupted teeth. no diabetes, obesity, chronic inflammatory disorders, hyperlipidemia, -