Kornimate/medical-research-clean huggingface dataset:
phase iv comparing rods of yield strengths to correct adolescent idiopathic scoliosis.

Conditions: Scoliosis

Summary: there has been a growing trend amongst surgeons to use a construct for correction of scoliosis which involves segmental instrumentation with pedicle screws. pedicle screw proponents cite greater curve control in all planes, which results in improved spinal curve correction. some surgeons have noted due to the increased strength of the all screw construction that the rod is now the weak part of the spinal fixation. although no evidence has been raised in regards to hardware failure there is a perception that a loss of balance in the sagittal plane is the result of flex in the titanium rod. a novel solution to the issue of rod flexibility is raised with the expedium super steel instrumentation which allows for greater stiffness than a 5.5 mm titanium rod with the same lower profile. this study aims to compare the new super steel technology with other established instrumentations used to correct spinal stenosis.

screw purchase was to be recorded but study has been withdrawn.

Eligibility criteria:
inclusion criteria: * aged 10-20; * presenting with a progressive lenke type 1a, n; or * type idiopathic adolescent scoliosis measuring greater than 45 degree cobb angle exclusion criteria: * rigid scoliosis requiring a three column release or osteotomy; * patients that can not have pedicle screw instrumentation due to technical concerns

Keywords: scoliosis correction rod strength adolescent
efficacy of dexmedetomidine for cough suppression in patients undergoing thyroid surgery

Conditions: Anesthesia Complication

Summary: maintenance of a remifentanil infusion during anesthetic emergence has been reported to decrease the incidence of coughing and thereby help to ensure a smooth emergence. it may, however, cause respiratory depression and possibly delay emergence. the purpose of this study was to investigate the effect of different dose of dexmedetomidine infusion on cough suppression during emergence from general anesthesia in patients undergoing thyroid surgery. american society of anesthesiologists physical status i-ii adults undergoing elective thyroidectomy under general anesthesia are recruited and randomly allocated to receive dexmedetomidine iv infusion of 0.2μg·kg-1·h-1 (group d1, n = 100), 0.5μg·kg-1·h-1 (group d2, n = 100), 0.7μg·kg-1·h-1 (group d3, n = 100) or saline (group c, n = 100). primary outcome is the incidence of coughing during emergence. second outcomes include severity of coughing, which is assessed using a four-point scale; ramsay score, bruggrmann comfort scale score, vas pain score are recorded. the respiratory rate (rr), heart rate (hr), and mean arterial pressure are also recorded.


Eligibility criteria:
inclusion criteria: 1. 30kg/m2 ≥ bmi \> 18kg/m2; 2. undergoing general anesthesia; 3. asa physical status i and ii 4. undergoing elective thyroid surgery. exclusion criteria: 1. hyperthyroidism; 2. preoperative bradycardia; 3. liver function impairment; 4. renal function impairment; 5. heart function failure; 6. history of asthma or copd; 7. history of diabetes; 8. cognition function impairment; 9. pregnant or lactating women

Keywords: dexmedetomidine coughing during anesthetic emergence thyroid surgery
enhanced supportive care for advanced cancer patients: evaluation of standardized care pathway

Conditions: Advanced Cancer

Summary: the purpose of this study is to evaluate the efficacy of the standardized care pathway which provides enhanced supportive care for patients with advanced cancer. a pilot study (single arm pre-post test) will be conducted to evaluate feasibility of applying standardized care pathway to provide enhanced supportive care. a randomized controlled trial will be conducted by randomly allocating participants in a 1:1 ratio to intervention arm (receiving enhanced supportive care according to the standardized care pathway) or control arm (receiving usual care: symptom monitoring only). participants in the intervention arm will receive enhanced supportive care consisted of symptom management and coping enhancement counseling for 5 times. data from advanced cancer patients will be collected at baseline (before start of chemotherapy), during chemotherapy (intervention arm), at the visit for cycle 5 of chemotherapy, at 6 month, and at 12 month data from caregivers will be collected at baseline, 3 month, and 6 month. primary outcomes will be measured as advanced cancer patients' symptom, coping and quality of life.


Eligibility criteria:
inclusion criteria: * adult (age \>=19 years old), * cancer patients and their family * ecog =\<2 exclusion criteria: * patients with cognitive or psychiatric issue
to evaluate if the medication gabapentin lessens vulvar pain

Conditions: Vulvar Pain Symptoms; Vulvodynia (Chronic Vulvar Pain)

Summary: the purpose of this research study is to evaluate if the medication gabapentin lessens the vulvar pain some women experience.

there is not a "best" treatment plan for vulvar pain including vulvodynia (chronic vulvar pain) and vulvar vestibulitis syndrome (vvs, chronic vulvar pain localized to the vaginal opening). we propose that vulvodynia is a neuropathic pain (pain that effects the nervous system) as characterized by pain from stimuli that is not usually painful, stimuli that would not usually be painful causing significant pain, and burning pain. gabapentin has been shown to be effective in treating chronic pain.

Eligibility criteria:
inclusion criteria: * all women, ages 18 years and older with the diagnosis of vulvodynia or vvs (by friedrich's criteria), who present to the university of iowa vulvar vaginal disease clinic. exclusion criteria: * vulvar vaginal disease clinic patients who are pregnant, less than 3 months postpartum, breast-feeding, non-english speaking, or have contraindication to use of gabapentin due to allergy or renal disease (serum creatinine level greater than 1.4).

Keywords: vulvar pain
establishment of a database of hiv subjects initiating or simplifying dual therapy with dolutegravir/lamivudine

Conditions: HIV -1 Infection

Summary: the introduction of combination antiretroviral therapy (cart) has completely revolutionized the management of hiv-positive patients, drastically reducing hiv-associated mortality and morbidity. in fact, the course of hiv infection has transformed into a chronic disease. the availability of different classes of antiretroviral drugs, such as nucleoside and non-nucleoside reverse transcriptase inhibitors (nrtis, nnrtis), protease inhibitors (pis), integrase inhibitors (instis) and viral entry inhibitors (ies) that act in different phases of the hiv life cycle, together with careful patient management, has allowed us to obtain long-lasting therapeutic efficacy in the vast majority of italian patients, making this infection a chronic disease.


Eligibility criteria:
inclusion criteria: * signed informed consent * patients treated with triple therapy who simplify to 3tc+dtg * patients treatment-naive who start a dual therapy with 3tc+dtg from clinical practice exclusion criteria: * lack of willingness to provide informed consent
mindfulness program for older-diabetes

Conditions: Mental Health Wellness 1

Summary: this study aimed to evaluate the effectiveness of the newly developed mindfulness-based stress reduction-taiwan program (mbsr-t) for old people with type 2 diabetes living in long-term care facilities.

this study reported the first randomized controlled trial of mindfulness-based reduction stress for residents with type 2 diabetes newly moved into long-term care facilities on depression, relocation stress and hba1c levels. the results highlighted the benefits of using strategies in the mbsr-t to promote good quality of diabetes care for residents in long-term care. the contents of the 9-week mbsr-t program were adapted from an initial mbsr program by the taiwan mindfulness association for older people with diabetes (chinese version). the program consisted of a 1.5-hour session each week for 9-weeks for a group of 8 to 10 participants. each session included 30 minutes of mindful deep breathing relaxation and 60 minutes of practicing mindfulness activities. a total sample of 140 was determined. all eligible individuals in each long-term care facility were randomized by computerized random numbers, sequence generated by an independent statistician with one-to-one ratio for allocating to either control or intervention group. all participants were blinded to group allocation. participants in the control group received usual care, while participants in the intervention group received the mbsr-t in addition to the usual care. all sessions in the mbsr-t were delivered by a trained mindfulness registered nurse who had received additional trainer qualification of mindfulness. a research assistant was blinded to the study protocol, who was employed to undertake data collection at baseline, at 3, 6, and 9 weeks (t0, t1, t2, t3).

Eligibility criteria:
inclusion criteria: * age 65-85 years old * diagnosed with type 2 diabetes * moving into the facility within a year * no obvious delirium, confusion or current psychiatric illness * being able to communicate in chinese. exclusion criteria: * terminally ill * unable to communicate in chinese.

Keywords: mindfulness-based program relocation stress depression glycemic control
cardio-ankle vascular index (cavi) in hypertension patients after one year of treatment

Conditions: Hypertension

Summary: this study aimed to evaluate the role of the cardio-ankle vascular index (cavi) in evaluating arterial stiffness changes, the degree of atherosclerosis in patients with hypertension after 1 year of treatment and analysis the correlation between cavi and cardiovascular risk factors.


Eligibility criteria:
inclusion criteria: * patients have never been diagnosed with hypertension. * patients have been diagnosed with primary hypertension, but not take any treatment exclusion criteria: * cases with non-primary hypertension or suffering from cardiovascular complications such as myocardial infarction, cerebral stroke, vascular disease, severe heart failure (ef\<1) in the time of measurement.

Keywords: cardio-ankle vascular index (cavi)
a study of pirtobrutinib in participants with immune thrombocytopenia

Conditions: Immune Thrombocytopenia (ITP)

Summary: the purpose of the phase 1 part of this study is to evaluate how well pirtobrutinib is tolerated and what side effects may occur. the phase 2 part of the study will further investigate efficacy and safety of multiple pirtobrutinib dosages versus placebo. the study drug will be administered orally in participants with primary immune thrombocytopenia (itp). blood tests will be performed to check how much pirtobrutinib gets into the bloodstream and how long it takes the body to eliminate it. the study will last up to approximately 16 weeks for phase 1 dose-escalation and 28 weeks for phase 2 dose-optimization, excluding screening.


Eligibility criteria:
inclusion criteria: * have a diagnosis of primary itp, defined as isolated thrombocytopenia not associated with another known disease process * have documented history of response, defined as 2 or more platelet counts greater than or equal to 50,000/microliter (μl), to at least 1 prior line of therapy. splenectomy is considered a line of therapy * have relapsed or treatment-resistant primary itp, with no available therapies known to provide clinical benefit * have a platelet count less than 30,000/μl on 2 occasions more than 5 days apart in the 15 days before randomization * have adequate liver, renal, and hematologic functions as defined by a table * are willing to follow contraception requirements exclusion criteria: * have a history of any thrombotic or embolic event within 12 months before screening * had a transfusion with blood or blood products or plasmapheresis within 14 days (phase 1) or within 28 days (phase 2) of randomization * have significant cardiovascular disease * have a diagnosis or history of hematologic malignancy * have hepatitis b virus (hbv) defined as positive for antigen of hepatitis b (hbsag) or polymerase chain reaction (pcr) positive for hbv deoxyribonucleic acid (dna) * have hepatitis c virus (hcv) defined as positive for anti-hcv antibodies and pcr positive for hcv ribonucleic acid (rna)
molecular predictors of cancer in patients at high risk of lung cancer

Conditions: Lung Cancer

Summary: rationale: using samples of blood, urine, sputum, and lung tissue from patients at high risk of cancer for laboratory studies may help doctors learn more about changes that may occur in dna and identify biomarkers related to cancer. purpose: this research study is looking at molecular predictors of cancer in patients at high risk of lung cancer.

objectives: * to use fixed lung tissue for histological evaluation and fresh tissue samples for molecular studies to study dna, rna, and protein abnormalities in lung preneoplastic and neoplastic lesions. * to use proteomic techniques, including matrix-assisted laser desorption ionization-mass spectrometry (maldi-ms), to develop a method of diagnosing and staging both pre-invasive and invasive lesions, using less invasive methods. outline: blood, urine, nasal cell, and sputum samples are collected. lung tissue samples are also collected using fluorescence bronchoscopy and epithelial cell collection. samples are studied by genetic and proteomic analyses, including comparative genomic hybridization, expression microarray, and protein profiling.

Eligibility criteria:
inclusion criteria: -all adults referred to vanderbilt medical center, veterans administration medical center, st. thomas hospital and meharry medical center for evaluation of signs or symptoms of lung cancer. exclusion criteria: * inability to provide informed consent * minors * pregnant women

Keywords: lung cancer
flying intervention team for endovascular treatment of acute ischemic stroke in rural areas

Conditions: Brain Infarction

Summary: the aim of this study is to compare time delay and safety parameters of stroke patients initially admitted to a rural primary stroke center (psc) who receive endovascular treatment (evt) by a flying intervention team with patients who receive evt after secondary transfer to a comprehensive stroke center (csc).

a novel health care concept was implemented in the telemedical stroke network tempis (telemedical project for integrative stroke care) to reduce time delays to evt in stroke patients with large vessel occlusion: after telemedicine-assisted identification of evt candidates in a psc, a flying intervention team (neuroradiologist and angiography assistant) is flown from a csc via helicopter to the psc to perform evt in the local angiography suite. flying intervention team service runs from 8 a.m. to 10 p.m. patients remain at local stroke unit for further treatment. analysis will include time delay to evt, recanalization, symptomatic intracerebral hemorrhage, periprocedural complications, in-hospital complications, and mortality.

Eligibility criteria:
inclusion criteria: * admission to participating primary stroke center (psc) with acute symptoms of stroke * telemedicine-supported decision for endovascular treatment (evt) inclusion criteria for primary study population: * occlusion of m1, proximal m2, intracranial internal carotid artery (ica) or basilar artery * decision for evt between 8 a.m. an 10 p.m. * time from symptom onset to evt decision within treatment window (0-6 h for m1, m2 and ica occlusions, 0-24 h for basilar artery occlusions, 0-24 for m1, m2 and ica occlusions with suitable mismatch in perfusion imaging performed in psc) * endovascular treatment in psc by flying intervention team or in comprehensive stroke center after secondary transfer exclusion criteria for primary study population: * age \> 85 years * alberta stroke program early ct score (aspects) \< 6 * premorbid severe or moderately severe disability (modified rankin scale \> 3) * premorbid serious or advanced illness with high mortality

Keywords: endovascular treatment stroke large vessel occlusion telemedicine helicopter thrombectomy mobile interventionalist flying intervention team
lowering interleukin-1 receptor antagonist concentrations after tb treatment onset

Conditions: Tuberculosis

Summary: despite marked improvements in the diagnosis of tuberculosis there are difficulties in diagnosing and monitoring treatment outcome among tb patients. the use of immunological biomarkers alone or in combination with other clinical parameters could predict early the response to tb treatment. the aim of this study is to demonstrate that the il-1 receptor antagonist (il-1ra) concentrations significantly decrease within two weeks following tb treatment initiation in adults with active documented tb.

the hiv/aids epidemic and tuberculosis (tb) remain important challenges for global public health and are strongly linked. despite marked improvements in the diagnosis of tuberculosis, there are difficulties in diagnosing and monitoring treatment outcome among tb patients. the use of immunological biomarkers alone or in combination with other clinical parameters could better predict the response to tb treatment. the aim of this study is to demonstrate that the il-1 receptor antagonist (il-1ra) concentrations significantly decrease within two weeks following tb treatment initiation in adults with active documented tb. this is a proof-of-concept study, among 100 patients (50 hiv positive and 50 hiv negative) with documented active tb, in cambodge and côte d'ivoire. patients recruited for this study will receive the standard tb treatment per their respective national treatment guidelines. plasma samples will be collected at baseline (initiation of tb treatment), weeks 1, 2, 4 and 8 to measure il-1ra, scd163 and ip-10.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * evidence of tb, with: positive xpert mtb/rif * for hiv infected patients: * art-naïve * regardless of cd4 cell counts * written informed consent * willingness to be followed up in the study clinics for 6 months after inclusion exclusion criteria: * mycobacterium tuberculosis strain resistant to rifampin with xpert mtb/rif * ongoing tb treatment * overt evidence of other ongoing opportunistic infections * pregnant or breastfeeding women * karnofsky score ≤ 30 * person unable to understand the study * person currently participating in clinical trial * females on oestroprogestative and progestative hormonal contraception
gaze and gait training with rtms

Conditions: Mild Cognitive Impairment

Summary: the purpose of this study is to evaluate the feasibility of combining repetitive transcranial magnetic stimulation (rtms), gaze and gait training to improve walking and balance in people with or without mild cognitive impairment.

the study plan is to recruit a total of 15 cognitively impaired and 15 healthy adults. the study will involve two visits. each study visit will involve: * real rtms or sham rtms that last about 60 minutes * gaze stabilization exercise via a virtual reality headset for about 1-hour * target stepping on a treadmill for about 1-hour researchers will compare changes in gaze and gait following training sessions with real rtms and sham rtms.

Eligibility criteria:
inclusion criteria: * age 18 - 80 years * capable of providing informed consent and complying to the experimental procedures exclusion criteria: * significant gait difficulty requiring ambulatory aids * presence of implanted device such as a neurostimulator, cochlear implant or pacemaker * history of epilepsy * history of hearing issues
effect of anesthesia on insulin secretion in patients with preoperative decreased insulin sensitivity

Conditions: Colorectal Surgery

Summary: epidural anesthesia has been found to manipulate the hyperglycemic response to surgery. it is unclear, however, whether the preoperative metabolic status of the surgical patient plays a role in the degree of this hyperglycemic response. for instance, the presence of low insulin sensitivity before surgery could predispose the individual to an altered metabolic response after surgery. in this case, it would be appropriate to identify adequate interventions that attenuate the response to surgical stress and facilitate the recovery process. the aims of this research projects are the following: 1. to determine the extent in which epidural local anesthetics, initiated before surgery and continued after surgery, improves insulin secretion in patients with preoperative low insulin sensitivity. 2. to understand which measures of postoperative recovery are sensitive to the restoration of insulin secretion in this particular group of patients


Eligibility criteria:
inclusion criteria: * patients receiving elective resection of malignant, non metastatic, colorectal lesions exclusion criteria: * american society of anesthesiologists (asa) health status class 4-5 * dementia,neuromuscular disease, psychosis * cardiac abnormalities * severe end-organ disease such as cardiac failure (new york heart association classes i-iv) * chronic obstructive pulmonary disease * renal failure (creatinine \> 1.5 mg/dl) * hepatic failure (liver transaminases \>50% over the normal range) * diabetics with glycosylated hemoglobin \> 6% * steroid consumption longer than 30 days sepsis * morbid obesity (body mass index \>40) * anemia (hematocrit \< 30 %, haemoglobin \<10g/dl, albumin \< 25mg/dl). * patients will be excluded if they have poor english or french comprehension.
the link between diets and health indicators

Conditions: Healthy Diet; Microbiota

Summary: the cohort study investigates the effect of different dietary intake among omnivorous, vegan, vegetarian and low-carb diets on health parameters and on long-term overall health. the participants blood parameters, dietary intake, gut microbiota composition, body mass and composition, resting energy expenditure, lifestyle factors and psychological factors will be determined and measured.

vegetarian and vegan diets have been shown to have health benefits on preventing cardiovascular diseases, type 2 diabetes and cancer. they are both gaining popularity in public. ketogenic diet has also been very popular, especially due to its effect on weight loss and blood glucose parameters. to our knowledge there, are no studies that compare long-term effects of all three diets and omnivorous diets with regards to health parameters and gut microbiota composition. the aim of the proposed study is to investigate the link between different diets and health parameters, such as parameters related to longevity, inflammation, stress and gut microbiota composition. the study is designed to compare different diets and their relationship with the body as a whole.

Eligibility criteria:
inclusion criteria: * 18,5 \< bmi \< 30 kg/m2 * asymptomatic for any disease * medication free * same pattern of eating in the last 3 months * stable body mass in the last 3 months exclusion criteria: * bmi \ 30 kg/m2 * presence of any chronic disease * taking any medications * changed eating pattern in the last 3 months * unstable body mass in the last 3 months * taking antibiotics in the last 3 months

Keywords: diet gut microbiota longevity inflammation health