Kornimate/medical-research-clean huggingface dataset:
evaluating the use of tranexamic acid (txa) in total joint arthroplasty

Conditions: Blood Loss

Summary: this research study aims to study the use of tranexamic acid (txa) in total joint replacement (arthroplasty) of the hip (thr) and knee (tkr).

tranexamic acid (txa) is given to stop or reduce heavy bleeding. it works by stopping clots from breaking down and by decreasing unwanted bleeding. it is used in many types of surgeries to help reduce surgical complications such as blood loss and blood transfusions. in orthopaedic surgeries, such as in total hip and knee replacements, txa has been shown to effectively reduce blood loss and transfusion requirements without an increased risk of side effects such as deep venous thrombosis (dvt) or pulmonary embolism (pe). the ability to decrease blood loss is crucial, as other studies have shown that reducing blood loss decreases morbidity and mortality in patients. although, many txa dosing regimens have been studied - all of which have been useful at reducing blood loss and decreasing transfusion requirements - the best txa dosing regimen and the most cost-effective method of txa administration for patients have yet to be determined. moreover, a thorough and rigorous study on the use and effects of topical and intravenous txa and the effect of txa on patient outcomes has yet to be conducted. therefore, this research study aims to address those concerns in order to understand how best to use txa to reduce surgical complications in patients undergoing total joint replacements.

Eligibility criteria:
inclusion criteria * all patients 18 years and older who are already scheduled for primary total joint arthroplasty of the hip or knee exclusion criteria for iv txa administration * cardiac stent or ischemic stroke or coronary artery bypass graft (cabg) * if patient is on anticoagulant, patient must have documented approval from a cardiologist that patient can be removed from anticoagulant for total joint arthroplasty procedure * renal impairment defined as serum cr \> 1.5 or cr clearance \< 50 ml/min * severe ischemic heart disease * color blindness or problems with color vision criteria for use of topical txa * topical txa can be used in any patient meeting one of the exclusion criteria for iv txa administration (section 5.3b) as there is minimal systemic absorption with topical txa absolute exclusion criteria * history of deep vein thrombosis (dvt) or pulmonary embolism (pe) * known congenital thrombophilia * history of thromboembolic or vascular disease * disseminated intravascular coagulation (dic) * history of seizures

Keywords: total hip arthroplasty total knee arthroplasty
effectiveness of custom-made foot orthoses vs heel lifts in children with calcaneal apophysitis

Conditions: Calcaneal Apophysitis; Sever's Disease

Summary: the study was a parallel-group, randomized controlled trial with concealed allocation, blinding of investigators and assessors and intention-to-treat analysis. it examined the effect of custom-made foot orthoses and heel lifts in children with calcaneal apophysitis. it was hypothesized that the primary outcome, pain relief, would be significantly improved with the custom-made orthosis compared to the heel lift.


Eligibility criteria:
inclusion criteria: * diagnosed radiologically with calcaneal osteochondritis * diagnosed radiologically with calcaneal osteochondritis * have signed informed consent exclusion criteria: * had suffered some trauma on the heel in the past 2 months * had received anti-inflammatory drugs and/or physical treatment for pain in the past 3 months * had presented physical or neurological impairment * were not interested
cardiovascular variability and heart rate response associated with obstructive sleep apnea

Conditions: Sleep Apnea, Obstructive

Summary: obstructive sleep apnea is often associated with microarousals and a stimulation of the sympathetic nervous system. the knowledge of this autonomic activation may help understanding the increase of cardiac risk observed in elderly. the aim of the study is to evaluate the relationship between obstructive sleep apnea severity, age, gender and heart rate response associated with obstructive sleep apnea. drug-free patients diagnosed with obstructive sleep apneas were included. clinical data and 24-h polysomnography recordings were analyzed.


Eligibility criteria:
inclusion criteria: * restless legs syndrome patients * hospital routine for sleep disorders breathing diagnosis * apnea index \> 0 exclusion criteria: * narcolepsy-cataplexy * sleep irregularities and sleep deprivation symptoms * lack of neurological or psychiatric diseases * periodic leg movements * central sleep apnea, treatment * cerebral lesion * medical illness * medication or drinks affecting sleep and wake state.

Keywords: obstructive sleep apnea heart rate heart rate variability microarousals autonomic nervous system activity
diagnostic challenges in ic (and male cpps)

Conditions: Chronic Prostatitis With Chronic Pelvic Pain Syndrome; Chronic Bacterial Prostatitis; Asymptomatic Inflammatory Prostatitis; Painful Bladder Syndrome; Cystitis, Interstitial

Summary: the etiology and pathogenesis of interstitial cystitis (ic) and its related condition in men, chronic prostatitis/chronic pelvic pain syndrome (cp/cpps) has remained elusive. this has hampered development of mechanistic treatment strategies for these common, chronic and distressing medical conditions. we believe that ic and perhaps cp/cpps are a spectrum of complex but inter-related genetic and acquired diseases resulting from the interaction of several genes regulating immune/inflammatory and neurogenic parameters and environmental factors/circumstances or exposure, culminating in the combination of pain, frequency, urgency and sexual specific symptoms. new research has delineated the dynamic and powerful association of the immune and neurogenic system in pain activation. an immune-modulated neurogenic model of ic illuminating the action of immune derived substances and pain related substances might be important in discovering the determinants of pain, voiding dysfunction and gender specific sexual problems. this inter-related dynamic model of ic disease pathogenesis could be explored for potential avenues leading to novel diagnostic and treatment strategies. we plan to identify and evaluate the sensitivity and specificity of several novel nerve and inflammation related markers in the diagnosis and follow up of ic (and cp/cpps). by correlating the levels of urine immune and pain related substances to disease mechanisms, severity and progression, we may be able to create a human disease specific model for diagnosis and treatment.


Eligibility criteria:
inclusion criteria: * participant has signed and dated the appropriate informed consent document. * participant must have had symptoms of discomfort or pain in the pelvic region for at least a three (3) month period within the last six (6) months. exclusion criteria: * major structural/anatomical urinary tract abnormalities * underlying inborn conditions

Keywords: chronic prostatitis with chronic pelvic pain syndrome chronic bacterial prostatitis asymptomatic inflammatory prostatitis painful bladder syndrome cystitis, interstitial
introduction of aci for cartilage repair

Conditions: Articular Cartilage Defect; Chondral Defect; Osteochondritis

Summary: this study was aimed to evaluate effectiveness and safety of autologous chondrocyte suspension for treatment of knee articular cartilage defects.

* prospective and interventional study * all procedures are carried out after obtaining informed written consent from patients. * study procedures involve a biopsy, cell production, cell implantation and follow-up including a strict post-surgery rehabilitation protocol (12 month timepoint) * all subjects will be assessed at intervals post-implantation (6 weeks, 3 months, 6 months and 12 months). * measures to assess effectiveness and safety will be conducted at follow-ups: magnetic resonance imaging (mocart score), collection of adverse events, orthopaedic scores (koos, ikdc, sf12v2)

Eligibility criteria:
inclusion criteria: 1. age between 15 and 50. 2. lesions classified as icrs grade iii or iv and smaller than 15 cm2 3. lesions that have failed prior therapy (conservative or surgical treatment ≥ six months) 4. subjects who understand and sign the consent form for this study exclusion criteria: 1. body mass index (bmi) of 35 or more 2. osteoarthritis or rheumatoid arthritis 3. diffuse lesion 4. uncorrected mal-alignment, ligamentous instability, or meniscal tear 5. presence of growth cartilage (15-18 years old) 6. active smoking or drug consumption 7. women who are pregnant 8. positive serology for hiv-1 or hiv-2, hepatitis b and c and syphilis 9. proven allergy to porcine collagen, penicillin and gentamicin 10. poor compliance
intranasal ketamine for late-life depression and suicidal ideation

Conditions: Depression; Suicide; Suicidal Ideation

Summary: the investigators of this study plan to investigate the feasibility and efficacy of repeated doses of intranasal ketamine in severely depressed patients who are at least 65 years of age and experiencing suicidal ideation. the results of the study could lead to development of new strategies for treating depression.


Eligibility criteria:
inclusion criteria: 1) be ≥65 years old, 2) provide written informed consent, 3) meet criteria for a primary psychiatric diagnosis of major depressive disorder according to the structured clinical interview for dsm-iv (scid) and have a hdrs28 total score ≥20; depression may have started at any time point in their life, and certain co-morbid diagnoses (e.g., anxiety disorders) will be allowed insofar as they are not the primary psychiatric diagnosis, 4) have a history of ≥2 failed medication trials during the current episode (per the massachusetts general hospital antidepressant treatment history questionnaire; mgh atrq), 5) endorse suicidal ideation for more than 2 months, per the columbia suicide severity rating scale (c-ssrs) and have a hdrs28 suicide item score ≥1 (thoughts that life isn't worth living), 6) be on a stable antidepressant regimen for ≥14 days prior to study phase ii, 7) maintain a treating psychiatrist who is in agreement with study participation, and 8) have a reliable chaperone accompany them home following the completion of the intranasal administration. exclusion criteria: * patients will be excluded if any of the following criteria are met: 1) delirium or dementia diagnosis, 2) unstable medical illness, 3) history of clinically significant cardiovascular disease or electrocardiogram (ekg) findings, or medical conditions that put the patient at risk for possible cardiac side effects, 4) history of multiple adverse drug reactions, 5) current/past history of psychotic disorders or homicidality, 6) active substance use disorders (except nicotine and caffeine) within the past six months, positive urine toxicology screen, or past history of ketamine abuse, 7) requirement of excluded medications (narcotics, barbiturates, theophylline, or st. john's wort), or 8) concurrent or recent participation in other research studies.

Keywords: depression suicide suicidal ideation ketamine late-life
pain and anxiety reduction using a vibrating eye massage device with relaxing nature sounds

Conditions: Behavior, Child; Dental Anxiety; Anesthesia, Local

Summary: this study aims to evaluate the effectiveness and acceptance of an eye massage device that produces nature sounds and vibratory stimulations in the management of anxious pediatric patients during inferior alveolar nerve block group a (control group): inferior alveolar nerve block will be administrated with basic behavior guidance techniques and without distraction aids. group b: inferior alveolar nerve block will be administrated with the usage of the eye massage device producing both vibrations and nature sounds group c: inferior alveolar nerve block will be administrated with the eye massage device producing vibratory stimulations only. all of the children who experienced an inferior alveolar block with/without distraction will be assessed by using a combination of measures: wong-baker faces and the children's fear scale (self-report), heart pulse rate and blood pressure (physiological), and behavior (using anxiety levels using face - legs - activity - cry - consolability "flacc" scale "external evaluator") acceptance will be measured using a two-point likert scale.

this study will evaluate the effectiveness and acceptance of a distraction aid that produces both vibratory and natural sound stimulations. pain and anxiety will be assessed during inferior alveolar nerve block using four behavioral scales, wong-baker pain scale and children's fear scale (self-report), pulse rate and blood pressure (physiological), and behavior (using flacc behavior rating scale "external evaluator". heart pulse rate measurement will be recorded firstly when the patient is seated comfortably on the dental chair, during anesthesia, and finally, after the procedure is done and the child patients will be asked to choose a face that describes their status from one of both wong baker faces scale and children's fear scale. blood pressure will be recorded before, during, and after anesthesia. body responses of all child patients will be recorded during the whole procedure and then will be evaluated by an external evaluator to determine the children's behavioral score according to the flacc scale.

Eligibility criteria:
inclusion criteria: 1. age between 7 and 9 years. 2. no previous dental experience. 3. definitely positive or positive ratings of frank scale. 4. need of ian block for any dental treatment. exclusion criteria: 1. previous dental experience 2. systematic or mental disorders. 3. definitely negative or negative ratings of frankel scale 4. any contraindication for regional anesthesia

Keywords: eye massage device vibratory stimulation nature sounds distraction
suicide prevention program for veterans discharged from community care settings

Conditions: Suicide Prevention

Summary: the goal of this pilot randomized controlled trial is to test an adapted suicide prevention program (the building va engagement, self-efficacy, and social support to prevent suicide or besst) in rural veterans discharged from community care mental health treatment settings. the main question it aims to answer is: * does besst combined with standard care improve suicide-related outcomes among this population compared to standard care alone? participants will be assigned by change to a treatment group. some will receive the besst intervention combined with standard care, and some will receive standard care alone. all participants will be in this research study for up to three months. those receiving the besst intervention will have: * 1 one-hour brief educational session; * seven follow-up check-ins (\~30 minutes each) all participants will have three assessment interviews where they will be asked about their mental health and treatment received outside of the va. the investigators will compare participants assigned to the besst intervention combined with standard care vs participants assigned to standard care alone to see if the besst intervention improves suicide-related outcomes.


Eligibility criteria:
inclusion criteria: * the patient was recently discharged from a va community care mental health treatment setting * the patient is at risk for self-harm * be a patient connected to the white river junction va medical center (vamc), the togus va medical center (vamc), or the manchester va medical center (vamc); * be a veteran; * be 18 years or older; * be able to speak english; exclusion criteria: * unable to provide informed consent; * the investigators do not plan to enroll any potentially vulnerable populations including prisoners, institutionalized patients, or involuntarily committed patients; * study physician deems the patient not clinically appropriate

Keywords: mental health education clinical trial suicidal ideation suicide, attempted
effects of different percentages body weight supported treadmill training on gait, balance, quality of life and fatigue in parkinson's disease

Conditions: Parkinson Disease

Summary: body weight supported treadmill training (bwstt) is an important rehabilitative choice for neurologically impaired subjects such as parkinson's disease (pd). the aim of the study is to evaluate the effectiveness of different percentages bwstt on gait, balance, quality of life and fatigue in moderate to advanced pd.

body weight supported treadmill training (bwstt) is an important rehabilitative choice for neurologically impaired subjects such as parkinson's disease (pd). the aim of the study is to evaluate the effectiveness of different percentages bwstt on gait, balance, quality of life and fatigue in moderate to advanced pd. thirty five patients were randomly assigned to one of the three groups according to the percentage unweighed: 0% bwstt, 10% bwstt and 20% bwstt. all patients participated 30 minutes bwstt sessions 5 days a week, for 6 weeks. primary outcomes were 6 minute walk test (6mwt), berg balance scale (bbs), unified parkinson's disease rating scale (updrs); and secondary outcomes were nottingham health profile (nhp), fatigue impact scale (fis) and fatigue severity scale (fss) which were performed at the beginning and end of the rehabilitation.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of parkinson's disease according to the uk brain bank criteria. * subjects had clinically moderate to advanced severity of disease (hoehn and yahr stage 2 - 4). * subjects whose medical treatment had been on stable dosage of dopaminomimetics for at least 4 weeks before the study. * subjects ability to walk with or without assistive device. exclusion criteria: * subjects had cardiovascular, inflammatory or musculoskeletal problems that could prevent them to participate in an exercise program. * subjects whose mini mental status examination score was less than 26.

Keywords: parkinson's disease gait balance treadmill training fatigue
pressure ulcer incidence cat. ii+ on a static air mattress: a multicenter cohort study in nursing home residents at risk

Conditions: Pressure Ulcer; Pressure Injury; Pressure Sore; Bed Sore

Summary: pressure ulcers are a serious and common problem for residents admitted to long-term care facilities and community care patients. they represent a major burden to patients, carers and the healthcare system, affecting approximately 1 in 20 community patients. international guidelines recommend the use of pressure redistribution support surfaces, systematic patient repositioning and preventive skin care to prevent pressure ulcers. it has been acknowledged that a significant proportion of pressure ulcers are avoidable. the prevalence of pressure ulcers is 1 of the 4 common harms recorded in the uk nhs safety thermometer, a local improvement tool for measuring, monitoring and analyzing patient harms across a range of settings, including nursing homes, community nursing and hospitals on a monthly basis. static or reactive overlay mattresses are an example of a low-tech constant low-pressure support. static air mattresses maintain a continuous low air pressure that exerts a pressure redistributing effect. serraes and beeckman found a pressure ulcer incidence of 5.1% in patients placed on static air support (mattress overlay, heel wedge and seat cushion) in a high risk population in a nursing home setting in belgium. the curocell sam pro (care of sweden ab) is a static air mattress overlay system used as prevent and treat pressure ulcers (up to category 3) and for pain therapy. the aim of current study is to measure pressure ulcer incidence on the curocell sam pro static air mattress in nursing home residents at risk for pressure ulcer development over a 30-day period in belgium.


Eligibility criteria:
inclusion criteria: * at risk of pressure ulcer development based on a braden score ≤ 17 * bedbound or chair bound * aged ≥ 65 exclusion criteria: * short-stay residents (expected length of stay ≤14 days) * end of life care * medical contraindication for patient repositioning/turning * pressure ulcer cat. ii+ present on initial evaluation

Keywords: static air support surface support device elderly prevention
endocrine and menstrual disturbances in women with polycystic ovary syndrome (pcos)

Conditions: Polycystic Ovary Syndrome; Insulin Resistance; Vitamin D Deficiency; Obesity

Summary: polycystic ovary syndrome (pcos) is a common endocrine disorder in reproductive age women, which causes disordered follicle growth and ovulation resulting in infertility. in addition women with pcos have hyperandrogenemia and a dysregulated hormonal profile, resulting in altered feedback on the hypothalamic-pituitary-gonadal (hpg) axis. obesity, insulin resistance, vitamin d (vd) deficiency and ageing worsen the symptoms. the gonadotrophins - follicle stimulating hormone (fsh) \& luteinising hormone (lh), along with the pregnancy hormone human chorionic gonadotrophin (hcg) have structural similarities. the altered levels of fsh and lh in women with pcos cause production of hcg from the brain leading to false positive pregnancy tests. part one of this project will involve the investigation of this over-production of hcg in urine and serum of women with pcos to develop suitable ovulation and pregnancy test kits, in collaboration with swiss precision diagnostics (spd). in part two of the project, we would like to see if intervention with vd supplementation and/or using myo-inositol supplement compared with metformin (insulin sensitiser), improves prediabetes, distribution of fat/water content, weight loss and menstrual cyclicity in women with pcos. we aim to correlate these interventions with particular serum \& urine markers to develop better diagnostic tools.

women are referred by the general practioner (gp)/primary care with a suspected diagnosis of pcos to the endocrine clinic at st george's hospital. they have an initial routine clinical assessment involving history, bp, weight \& assessment of pcos using the rotterdam criteria. the routine clinical investigations involve the following: • one fasting blood sample to measure various hormones; fasting glucose:insulin ratio; pelvic ultrasound scan to determine ovarian morphology, follicular count and endometrial thickness part 1 of the research protocol will include obtaining the following: * one urine \& serum sample to be taken at the same time as their routine clinical blood samples. * these samples will be anonymised before despatch to spd. part 2 of the study will involve treating patients with vitamin d (if they are deficient) and/or myo-inositol supplement or metformin depending on their clinical need. the outcomes measured will be as above (blood sample to measure hormones) and an assessment of body fat distribution.

Eligibility criteria:
inclusion criteria: * premenopausal women with pcos (rotterdam criteria) attending the endocrine clinic, aged between 18-45 years exclusion criteria: * there is a clear exclusion criteria under the rotterdam criteria; age \ 45 years; oral contraceptive use within 3 months prior to recruitment, diabetes mellitus \& pregnancy

Keywords: pcos hyperandrogenemia rotterdam criteria insulin sensitivity bmi antral follicle count