Kornimate/medical-research-clean huggingface dataset:
evaluation of the manos carpal tunnel release system in patients with carpal tunnel syndrome

Conditions: Carpal Tunnel Syndrome

Summary: the manos device is a carpal tunnel blade used to perform carpal tunnel release (ctr). ctr is indicated for the treatment of carpal tunnel syndrome when conservative therapy fails. this study is being conducted to evaluate the safety and effectiveness of ctr with the manos device.


Eligibility criteria:
inclusion criteria: * patient is scheduled to undergo carpal tunnel release surgery. * patient has chronic carpal tunnel syndrome with persistent symptoms despite non-operative treatment, or refusal of non-operative treatment, with one or more of the following: splinting, nsaids or corticosteroid injections. * carpal tunnel syndrome must be confirmed by positive results of electromyography (emg) and nerve conduction velocity (ncv) tests. * patient is a male or non-pregnant, non-lactating female. * patient is 18-75 years of age, inclusive. * female patients of child-bearing potential, including those who have had a tubal ligation, but excluding those who have not experienced a menstrual period for at least two years, must have a negative urine pregnancy test at screening. * patient must voluntarily provide written, informed consent. exclusion criteria: * patient has a prior or current musculoskeletal or neurologic condition that limits strength, motion, or sensation in the affected hand. * patient has a medical condition that precludes the use of anesthetic required for surgery. * patient has an ipsilateral injury or other conditions affecting hand function. * patient has acute cts resulting from an injury (e.g., fracture). * patient has had previous ctr surgery on the affected hand. * patient has psychiatric history, head injury or any other condition which, in the investigator's opinion, would prevent patient from complying with post-operative hand therapy or follow-up visits.
tenofovir in asian chronic hepatitis b patients

Conditions: Chronic Hepatitis B

Summary: tenofovir (tdf) has been demonstrated to have potency antiviral against the hepatitis b virus (hbv) in various multiple-centre trials, with no cases of resistance encountered. however, its efficacy and resistance profile in the asian population, which constitute the majority of chronic hepatitis b (chb) patients, is unknown. compared to other nucleoside analogues, tdf has been associated with relatively high rates of hepatitis b surface antigen (hbsag) seroclearance. it would be interested to see if this could be reproduced. the investigators plan to report the serologic and virologic results of our 140 nucleoside analogue-experienced patients who were commenced on tdf.

recent multi-center trials have shown tenofovir disoprovil fumarate (tdf) demonstrating potent antiviral efficacy in both nucleoside-naive and -experienced chronic hepatitis b (chb) patients. at present, there has been no identifiable amino acid substitutions associated with resistance to tdf. since tdf and adefovir (adv), another licensed drug for chb, belong to same molecular group, acyclic phosphonate, there had been various studies investigating the efficacy of tdf in adv-resistant patients. the efficacy of tenofovir in this group of patients is conflicting. while several studies have shown tdf achieving similar viral suppression when compared to chb patients without adv-resistance , another study found that patients with the signature adv mutations of rta181v/t and /or rtn236t responded suboptimally to tdf. for all published studies, the number of patients with documented genotypic resistance to adefovir is actually small (n = 17-40), and therefore, further studies in this area are required. another interesting point to note was the relatively high rate of hepatitis b surface antigen (hbsag) seroclearance found in patients taking tdf. the cumulative rate of hbsag seroclearance up in hepatitis b e antigen (hbeag)-positive was 10% after 4 years . however, the same study did not find any hbeag-negative patients achieving hbsag seroclearance. in addition, studies on tdf were mainly performed in caucasian patients, the majority being genotypes a and d. a preliminary study performed in asian patients, predominantly genotypes b and c, did not discover any cases of hbsag seroclearance . given the majority of the chb population is found in asia, further studies are needed to clarify if hbsag seroclearance by nucleoside / nucleotide analogues is potentially achievable using tdf.

Eligibility criteria:
inclusion criteria: 1. hbsag-positivity for at least 6 months at presentation 2. commenced on tenofovir for chronic hepatitis b 3. exposure to other nucleoside analogues before starting tdf exclusion criteria: 1. concomitant liver diseases including chronic hepatitis c and/ or d infection, wilson's disease, autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis. 2. significant alcohol intake (\> 20 grams per day)

Keywords: hbv tenofovir hbv dna hbsag resistance
a natural history study of patients with dry eye

Conditions: Dry Eye

Summary: this is a multi-center, prospective, controlled, observational study of the natural history of patients with dry eye disease.


Eligibility criteria:
inclusion criteria: * males at least 55 years old or females, at least 40 years old with perimenopausal symptoms * baseline osdi score of ≥ 13 * patients with mild to moderate dry eye (dry eye disease patients only; not applicable for control group) exclusion criteria: * use of any topical cyclosporine ophthalmic emulsion within 3 months of baseline * history of herpes keratitis or varicella zoster keratitis * any history of allergic conjunctivitis * temporary or permanent occlusion or cauterization of the lacrimal puncta for either eye * any anterior segment surgery involving a limbal or corneal incision (cataract surgery), keratorefractive procedure (lasik, lasek, prk) within 12 months of baseline, or expectation of such surgery within 2 years * patients with known systemic disease * any history of corneal transplant
modified sternal precautions versus conventional sternal precautions in physical function after sternotomy

Conditions: Cardiovascular Diseases

Summary: this research study effectiveness of modified sternal precautions versus conventional sternal precautions in improving physical function after sternotomy .after recruitment of the subjects, the intervention group will receive modified sternal precaution while the control group will receive conventional sternal precautions and they will be assess for their physical activity, kinesiophobia, quality of life and post sternotomy pain.

this study will address the scarcity of research and the variations in recommendations regarding sternal precautions and restrictions of upper limb movement in cardiac patients and will help to evaluate the effect of modified sternal precautions on patients' pain and functional activity. as physical therapists are the ones who have maximum exposure to practice and teaching of sternal precautions, therefore this study will help to formulate the guidelines regarding the use of upper limb during cardiac rehabilitation exercises and making standards for sternal precautions and its management following cardiac surgery.

Eligibility criteria:
inclusion criteria: * open heart surgery patients (cabg and valve surgeries) exclusion criteria: * unstable vitals * patient needing maximum assistance * decline consent

Keywords: sternal precautions sternal restrictions cabg
can administration of etamsylate reduce postpancreatectomy hemorrhage

Conditions: Postpancreatectomy Hemorrhage

Summary: in several studies comparing the tow types of pancreato-digestive anastomosis: pancreatogastrostomy (pg) and pancreatojejunostomy (pj), authors concluded that pg exposed to more postpancreatectomy hemorrhage (pph) especially early, digestive and moderate hemorrhage classified as type a according to the classification of the isgps. in this way we try to test the ability of the enteral administration through the nasogastric tube of etamsylate for 48 hours after whipple to reduce the rate of digestive pph and mortality.

whipple procedure is usually performed for periampullary malignancies. if the mortality of this intervention has been markedly decreased, it persists a morbid one. morbidity is mainly due to postoperative leak of the pancreato-digestive anastomosis or postoperative pancreatic fistula (popf), but also to postpancreatectomy hemorrhage (pph). in several studies comparing the tow types of pancreato-digestive anastomosis: pancreatogastrostomy (pg) and pancreatojejunostomy (pj), authors concluded that pg exposed to more postpancreatectomy hemorrhage (pph) especially early, digestive and moderate hemorrhage classified as type a according to the classification of the isgps. in this case of hemorrhage, blood generally comes from pancreatic stump which is anastomosed or telescoped in the stomac. incomplete hemostasis , soft pancreatic tissue and vascular fragility can help pph to occur. etamsylate is an antihemorrhagic agent which works by increasing the resistance in the endothelium of capillaries and stimulating platelet adhesion. it also inhibits synthesis and action of prostaglandins causing platelet disaggregation, vasodilation and increased capillary permeability. in this way, the investigators try to test the ability of the enteral administration through the nasogastric tube of etamsylate for 48 hours after whipple to reduce the rate of digestive pph and mortality.

Eligibility criteria:
inclusion criteria: * all patients undergoing whipple procedure regardless the type of pathology and in which a pg is performed. exclusion criteria: * patients undergoing whipple procedure regardless the type of pathology and in which a pj is performed.
a study of oral kavalactones effect on nurses

Conditions: Stress

Summary: this research study is being done to assess the impact of taking kava extract (piper methysticum), a dietary supplement on cortisol in a healthy nursing population.


Eligibility criteria:
inclusion criteria: * surgical services nurses at mayo clinic in rochester, mn. * able to participate fully in all aspects of the study. * willing to use birth control for the duration of the study (if of childbearing potential). * understood and signed study informed consent. exclusion criteria: * pregnant, nursing, or trying to conceive. * persons with a menstrual cycle who are not willing and able to use an approved contraceptive during the study (female sterilization (tubal ligation, hysterectomy), iud or another implant, oral or injectable contraceptive, contraceptive patch/ring, diaphragm/cervical cap, male sterilization (vasectomy), male condom, female condom, sponge/spermicide) (persons who do not have sex with men can participate without the use of an approved contraceptive). * use of kava or kava-containing products within the past 8 weeks. * any prior adverse reaction or known sensitivity or allergy to kava or related botanicals (peppers). * use of acetaminophen that cannot be discontinued or replaced with an nsaid during the study. * use of oral corticosteroids (e.g., hydrocortisone) or other steroids (e.g., prednisone). * alcohol use greater than 1 drink per day. * use of kratom within the past 8 weeks. * recent history of clinical depression or anxiety diagnosis. * known significant liver disease or dysfunction. * known significant kidney disease or dysfunction. * known addison's or cushing's disease. * known catecholamine imbalance or medication use which influences catecholamine levels. * history or current diagnosis of cancer (except for successfully treated basal cell carcinoma diagnosed less than 5 years prior to screening or cancer in full remission more than 5 years after diagnosis). * recent history or acute disease or unstable medical condition. * surgery planned during the course of the trial. * a known history of any condition or factor judged by the investigator to preclude participation in the study or which might hinder adherence.

Keywords: nursing professionals
effect of enalapril and losartan association therapy on proteinuria and inflammatory biomarkers in diabetic nephropathy: a clinical trial on type 2 diabetes mellitus

Conditions: Macroalbuminuric Diabetic Nephropathy

Summary: chronic kidney disease (ckd)has become a significant health problem worldwide. strategies to decrease the rate of progression of this disease and reduce the number of patients needing dialysis or renal transplantation are urgently needed. in this study we wish to compare the effect of dual blockade of renin-angiotensin system (ace inhibitors plus angiotensin ii receptor blocker) compared to the effect of ace inhibitor monotherapy in patients with diabetic chronic nephropathy.

diabetic kidney disease is the current leading cause of chronic kidney disease (ckd) in the world. despite all efforts to control this disease, rates of ckd progression are still high and a significant number of patients will ultimately need renal replacement therapy. pharmacological blockade of renin-angiotensin system is one of the key elements of ckd secondary prevention, and ace inhibitors or angiotensin ii receptor 1 blocker (arb)can be used for this purpose. however, it is still not clear if dual blockade (acei and arbs simultaneously)is superior to monotherapy with ace inhibitors or arbs. a recent trial has suggested that dual blockade is superior to monotherapy in non-diabetic chronic kidney disease. the purpose of this trial is to evaluate the effect of combination therapy compared to ace inhibitors alone in type 2 diabetic patients with macroalbuminuric diabetic nephropathy.

Eligibility criteria:
inclusion criteria: * diabetic nephropathy characterised by a daily proteinuria superior to 500 mg * type ii diabetes exclusion criteria: * type 1 diabetes * serum creatinine \> 2.5 mg/dl or creatinine clearance lower than 30 ml/min * serum potassium \> 5.5 meq/l * intolerance or allergy to ace inhibitors or bra * pregnancy * hepatitis c or b * hiv * current chemotherapy treatment

Keywords: diabetic nephropathy proteinuria ckd progression dialysis
white matter in pediatric bipolar disorder: a dti study

Conditions: Bipolar Disorder

Summary: fourteen subjects with bipolar disorder and 14 matching healthy controls, aged 6-13, will receive a magnetic resonance imaging (mri) scan on a 3 tesla scanner. they will also have a clinical interview, including the ksads-pl. all subjects must be right-handed.

we propose to investigate the connectivity of white matter tracts using diffusion tensor imaging (dti) in children with very early onset bipolar disorder (bpd). we hypothesize that the connectivity between the prefrontal cortex and the temporal lobe and parietal lobe and limbic structures will be abnormal, indicating white matter and gray matter deficits in early onset bpd. we also hypothesize that the superior lateral fasciculus cingulum bundle and the inferior lateral fasciculus will have decreased fractional anisotropy in very early onset bpd relative to healthy controls.

Eligibility criteria:
inclusion criteria: * age 6 to 13 * male or female * right-handed exclusion criteria: * iq less than 70 * learning disabilities * history of autism, schizophrenia, anorexia or bulimia nervosa * substance abuse * claustrophobia * metal in body * pregnancy or lactation

Keywords: bipolar disorder magnetic resonance imaging white matter diffusion tensor imaging children adolescents
flare photometry in uveitis patients

Conditions: Uveitis

Summary: this is a cross sectional study of a novel non-invasive optical flare photometer (ofam). patients meeting the inclusion/exclusion criteria will receive a standard eye examination including a slit lamp examination to collect ocular flare data. in addition to the standard eye examination, subjects will receive flare measurements using the ofam device.


Eligibility criteria:
inclusion criteria: * age greater than 18 years * ability to understand and willingness to sign a written informed consent document. * to be eligible for the uveitis arm of the study subjects must have active anterior chamber uveitis in one or both eyes as determined by a physician * to be eligible for the non-inflammatory arm of the study the study subjects must have no ocular inflammation in either eye as determined by a physician. exclusion criteria: * inability to give informed consent * exclusion criteria for the uveitis arm: no active disease * exclusion criteria for the non-inflammatory arm: signs of uveitis

Keywords: uveitis
nursing management of irritable bowel syndrome:improving outcomes

Conditions: Irritable Bowel Syndrome

Summary: the purpose of this study is 1) to determine whether a comprehensive self-management intervention is effective in a sample that includes men and women with irritable bowel syndrome, and 2) to determine whether the comprehensive self-management intervention is as effective when delivered over the telephone as compared to a face-to-face approach.

randomization and intervention phase. upon completing the baseline assessment phase, participants will be randomized to one of 3 treatment groups. a customized computer program will be used to do the randomization in an adaptive manner that ensures the 3 groups remain fairly balanced with respect to possible important predictors of outcomes: age, sex, predominant stool pattern (alternating, constipation-predominant or diarrhea-predominant), and severity of ibs symptoms and psychological symptoms at baseline. when each new participant is randomized, the program will adjust the probabilities of assignment to the three groups so that there is a higher probability of assignment to the group that results in the best balance. intervention groups. face-to-face individualized comprehensive self-management (csm-ff) group. participants in the individualized csm-ff group will be scheduled for 9 weekly sessions with the nurse therapist followed by post-intervention follow-up assessment. telephone individualized comprehensive self-management (csm-tel) group. participants in the individualized csm-tel group will initially have 2 face-to-face meetings with the nurse therapist, 6 sessions over the phone and the final session face-to-face at 9 weeks. usual care control group (uc). following randomization the participants in the control group will no receive any contacts during the comparable 9-week intervention in the treatment groups. follow-up phase. participants in all 3 groups will be reassessed at 3-mo, 6-mo, and 12-mo post randomization. at this time the participants will complete questionnaires, a 4 week diary and collect 4 urines.

Eligibility criteria:
inclusion criteria: * irritable bowel syndrome exclusion criteria: * gi pathology (organic disease) * co-morbid pain disorders

Keywords: irritable bowel syndrome cognitive-behavioral intervention psychological distress quality of life
lower abdominal pain during office hysteroscopy can assess tubal patency in infertile women

Conditions: Infertility

Summary: office hysteroscopy through vaginoscopic approach was done in gynecology out-patient clinic with saline distension medium. the presence or absence of lower abdominal pain and the side of pain were recorded. then, transvaginal sonography within 20 minutes was done to detect the presence of free fluid in the pouch of douglas. then, laparoscopy with tubal chromopertubation was done.

office hysteroscopy through vaginoscopic approach was done in gynecology out-patient clinic using a 4 mm endoscopic sheath \& 30 ᵒ endoscopic camera with saline distension medium using 90-100 mmhg pressure. meanwhile, the presence or absence of lower abdominal pain and the side of pain were recorded. then, transvaginal sonography within 20 minutes was done to detect the presence of free fluid in the pouch of douglas.then, laparoscopy with tubal chromopertubation was done.

Eligibility criteria:
inclusion criteria: * infertile women normal semen analysis exclusion criteria: * ladies with evidence of upper or lower genital tract infections, * presence of free fluid in the pouch of douglas before hysteroscopy or pelvic pathology or those with cervical stenosis that required cervical dilatation prior to hysteroscopy

Keywords: office hysteroscopy tubal patency infertility lower abdominal pain
metabolic remodeling in fontan patients

Conditions: Congenital Heart Disease; Metabolism Disorder

Summary: assessment of metabolic alterations in adult fontan patients with a dominant left ventricle with the help of serum examinations (metabolomics). the aim is to find a tool for the completion of the (semi-)invasive monitoring of fontan hemodynamics.

patients who are born with just one single heart chamber need to undergo surgical therapy allowing the single heart chamber to pump the blood into the systemic circulation and allowing the blood to flow passively to the lungs (fontan circulation). regular ultrasound, cardiopulmonary exercise testing, and invasive diagnostic tools (catheterization, general anaesthesia needed) are necessary to early find out cardiac, vascular, or circulatory impairment. it is still very difficult to diagnose and therapy failure of this fontan system early enough. it is reported that in patients with a failing two-chambered heart, the energy source for the heart and the body in general switches from the use of lipids to the use of sugar and ketone bodies. first studies show decreased concentrations of membrane lipids in fontan patients with a left dominant ventricle, and the energy metabolism has not been focused yet in those patients. the investigators hypothesize that there are differences in the pattern of the structural metabolism in adult fontan patients with a left-dominant vs. a right-dominant ventricle. furthermore the investigators hypothesize that there are alterations in the energy metabolism in adult fontan patients in comparison to healthy two-chambered controls, and that those alterations correlate with the grade of impairment of cardiopulmonary function. with the help of a special biochemical examination (mass spectrometry-based metabolomics study) blood of fontan patients will be analyzed, and the results will be correlated with the results of ultrasound and cardiopulmonary exercise testing. the aim of this study is to establish sensitive blood markers indicating cardiac, vascular, circulatory or further organ dysfunction in fontan patients. this should allow optimal fontan system monitoring with an optimal timing of an additional invasive diagnostic catheterization and of nutritional, medical or interventional therapy.

Eligibility criteria:
inclusion criteria: * fontan circulation (right systemic ventricle), biventricular heart with heart failure resp. * ≥ 18 years * written informed consent of patients * 8 hours fasting period before blood sample exclusion criteria: intake of medication directly affecting metabolic (e.g. metabolism of lipids (statine)) or hemodynamic state (e.g. beta-blockers, sildenafil) (other than angiotensin converting enzyme (ace)-inhibitors and anticoagulation therapy) * cachectic disease * non-congestive hepatic or renal dysfunction * (inherited) metabolic disorders