Kornimate/medical-research-clean huggingface dataset:
surgical fixation and non-operative management outcomes in proximal humerus fractures

Conditions: Proximal Humeral Fracture

Summary: the management of proximal humerus fractures (phfs) remains a significant challenge in orthopaedics. the acute treatment options for phfs are numerous and are typically guided by the fracture pattern and functional demands of the patients. the most commonly used methods include non-operative management with a sling or surgical fixation. although non-surgical treatment is a reasonable treatment option for the majority of humerus fractures, there is an increasing interest in surgical intervention. there are no evidence-based treatment recommendations, thus permitting large local variation in treatment preferences. there are a number of studies in the literature about how outcome measures of the patients after phfs management change, but these results generally compare functional results before and after treatment. misra et al. stated that conservatively managed patients with phfs have more pain and a poorer range of motion than those managed by either fixation or arthroplasty, while cochrane review stated that surgery is not superior to nonsurgical treatment in most proximal humerus fractures. jayakumar et al. determined that kinesiophobia is one of the strongest predictors of functional limitation and recovery from a phf is enhanced by overcoming fears of movement or reinjury within a week after injury. there is no clear knowledge regarding how the surgical or conservative management used in the management of phf affects the early results of assessment parameters. the aim of this study was to compare early results of surgical fixation versus non-operative management outcomes in patients with proximal humerus fractures.

voluntary patients who have been diagnosed with proximal humerus fracture and managed by surgical or conservative will be included in the study. patients with stabilization after proximal humerus fracture with surgical fixation will be considered as the surgery group, and patients treated with non-surgical treatment with sling immobilization will be considered as the conservative group. signed voluntary consent will be obtained from participants. patients having surgical fixation or nonoperative management will be assessed for kinesiophobia, pain, range of motion, functional status, and quality of life.

Eligibility criteria:
inclusion criteria: * stabilization after proximal humerus fracture with surgical fixation (post-op 3-6 weeks) or non-surgical treatment with sling immobilization (callus formation on radiography). * volunteer exclusion criteria: * malunion tubercle majus, * advanced osteoporosis, * avascular necrosis of the humeral head, * presence of neurological and rheumatologic disease, * recurrent infection and open wound-incision in the region, * communication problems
evaluating post-test hiv counseling videos for teens

Conditions: HIV; HIV Infections

Summary: the design of this randomized controlled trial (rct) is to test the effectiveness of a post-test behavioral video in educating adolescents about hiv transmission and affecting their intentions to engage in risk-reduction behavior.

adolescents are at risk for hiv because of their engagement in high risk sexual activity. this study seeks to determine effective ways to educate teens about hiv and how to protect themselves by use of multimedia. all eligible participants who agree to enroll in this trial will be randomized into two arms: the behavioral intervention video (intervention group) or meeting with an in-person counselor (control group) as they wait for their rapid hiv results. the goals of the rct involve establishing the feasibility of using touch-screen technology for teenagers in the ed; establishing the receptivity of teens to hiv rapid testing in the ed; providing data on rates, and obtaining preliminary data on the effectiveness of the video in changing condom efficacy, condom outcome expectancies and condom use intention. consenting to rapid hiv testing is a secondary outcome.

Eligibility criteria:
inclusion criteria: 1. youth who have had vaginal, anal or oral sex 2. 15-21 years of age 3. english speaking exclusion criteria: 1. clinically unstable secondary to pain or unstable vitals signs 2. unable to understand the consent process for the study 3. known hiv status or recent hiv test 4. language other than english

Keywords: hiv teenagers adolescent hiv testing hiv seronegativity
red light treatment in peripheral artery disease

Conditions: Peripheral Artery Disease; Claudication, Intermittent; Vasodilation

Summary: subjects with a known diagnosis of peripheral artery disease as measured by an abnormal ankle brachial index (\ 1.1) will undergo a single 5 min exposure of 670 nm light, 1 cm above the gastrocnemius muscle. blood flow will be measured by infusion of ultrasound contrast and subsequent acquisition of ultrasound images. 2 blood samples will be collected for measurement of nitric oxide metabolites.

the intent of this protocol is to measure blood flow in the gastrocnemius muscle in patients with documented peripheral artery disease before and after exposure to 670 nm light energy. the study consists of one visit. blood flow measurement will be performed using contrast enhanced ultrasound, a method by which ultrasound contrast is continuously infused into the blood stream. ultrasound records images in the area of interest and flow is related to the intensity of the contrast in each image. blood will be drawn to measure nitric oxide metabolites. the study is designed to consist of one visit. however, if the protocol changes or the data quality initially collected is uninterpretable, subjects may be asked to return to allow for a standard methodology across all participants. in this case, the subjects who are asked to return will be subject to the same informed consent process a second time. the two visits will be at least one week apart to further reduce the already minimal risks of the study. this will also limit the number of study participants required to gather the necessary data to complete the study, thereby limiting the risks of the study to a smaller number of participants.

Eligibility criteria:
inclusion criteria: * participants will be subjects between the ages of 18 and 85 who have been diagnosed with peripheral artery disease. men and women will be recruited for participation. all ethnicities will be included in this study. diagnosis of peripheral artery disease is defined as an ankle brachial index of \<0.9 or greater than 1.1 either at rest or during treadmill exercise. exclusion criteria: * exclusionary criteria include age under 18 years and over 85 years, those who are unable to understand the consent process , those who cannot read or speak english, active pregnancy, hypersensitivity to perflutren contrast agents, pulmonary hypertension, active illicit drug use, untreated blood pressure over 160/95, sickle cell disease, or a history of intracardiac shunt. additional exclusion criteria neurological diseases such as spinal stenosis, unspecified pain disorders, and any uncontrolled medical conditions.

Keywords: red light vasodilation nitric oxide
post-poliosyndrome treated with intravenous immunoglobulin (ivig)

Conditions: Post-Polio Syndrome

Summary: inflammatory cytokines in the cerebrospinal fluid may contribute to the new muscle weakness, fatigue and pain experienced by patients with post-polio syndrome. intravenousimmunoglobulin (ivig) reduces this inflammation. the purpose of this study is to investigate the clinical effect of ivig in post-polio syndrome.

post-polio syndrome (pps) is characterised by new muscle weakness, pain, and fatigue several years after the attack of acute polio. this leads to increased disability, and up to now only supportive therapy is available. patients with pps lose more motor neurons than expected and surviving neurons fail to maintain neurogenic supply to enlarged motor units. new data report an increased level of inflammatory cytokines in the cerebrospinal fluid (csf). immune modulating therapy like ivig could be an option and this pilot study is the first to investigate the clinical effect of ivig in pps. in addition, levels of cytokines in csf and serum before and after treatment will be investigated.

Eligibility criteria:
inclusion criteria: post-polio syndrome diagnosed at dept of neurology, haukeland university hospital walking ability - exclusion criteria: other autoimmune disorders other ongoing autoimmune therapy severe cardiopulmonary disease iga deficiency previous treatment of ivig wheelchair dependence

Keywords: post-polio syndrome ivig
efficacy of contrast enhanced voiding urosonography for urodynamic studies

Conditions: Myelomeningocele; Neurogenic Bladder; Tethered Cord Syndrome; Bladder, Neurogenic; Urologic Diseases; Neurologic Dysfunction

Summary: the investigators will assess the feasibility of replacing fluoroscopy/iodinated contrast with ultrasound/sulfur hexafluoride lipid-type a microspheres during routine urodynamic studies.

urodynamic studies routinely involve instillation of iohexol (omnipaquetm), a low osmolality contrast agent, into the bladder followed by fluoroscopic imaging to assess for reflux or variant anatomy of the genitourinary system. recently, sulfur hexafluoride lipid-type a microspheres (lumasontm), an ultrasound contrast agent, has been approved in the united states for intravesicular administration in the pediatric population. contrast enhanced voiding urosonography (cevus) is being increasingly utilized in the place of voiding cystourethrograms, with the major advantages being decreased (zero) radiation for the patient, as well as decreased cost. given the similarity in procedure between urodynamic studies (uds) and voiding cystourethrograms, we hypothesize that a urodynamic study may be performed with contrast enhanced ultrasound instead of fluoroscopy. we plan to continue enrollment from our feasibility study and perform an efficacy study by recruiting a group of 105 patients under the age of 18, who are willing to undergo their normally schedule uds using cevus to image the study in place of fluoroscopy. the uds typically consists of two cycles of bladder filling and voiding; we intend replace the use of fluoroscopy and iohexel with ultrasound and sulfur hexafluoride lipid-type a microspheres. this will decrease the time commitment and eliminate radiation exposure for the patient. data to be analyzed will include images from the study and patient/caregiver preference. results from the cevus images will be compared to images obtained during previous tests imaged with fluoroscopy from the same patients currently enrolled in this study. bladder shape and morphology, bladder neck configuration and performance, structure of the urethra, presence and degree of vesicoureteral reflux, and active voiding images will all be compared to fluoroscopy images from previous studies. the purpose of the study is to demonstrate that cevus is effective as an imaging technique for urodynamic studies, with an ultimate goal of using cevus instead of fluoroscopy in all urodynamic and voiding studies in order to decrease pediatric radiation exposure. the hypothesis is that cevus will be as effective for imaging urodynamics studies as fluoroscopy.

Eligibility criteria:
inclusion criteria: * age 0-17 * must have had prior urodynamic study at uva exclusion criteria: * pregnant women (self-reported) * fetuses * neonates * prisoners * subjects with preexisting cardiac conditions (such as chf and ventricular arrhythmias) * subjects with a known hypersensitivity to lumason

Keywords: contrast enhanced voiding urosonography urodynamics neurogenic bladder detrusor sphincter dyssynergia
metformin for treatment of psoriasis combined with disorders of glucose and lipid metabolism

Conditions: Psoriasis Vulgaris With Metabolic Disorders

Summary: psoriasis and metabolic disorders are well-known mutual comorbidities. the investigators hypothesized metformin can ameliorate both psoriasis and metabolic disorders mainly via gut microbiota modulation. the investigators design a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of treatment of metformin for psoriasis combined with disorders of glucose and lipid metabolism and to explore the role of gut microbiota during the process.


Eligibility criteria:
inclusion criteria: criteria 1 and 2 are both needed for inclusion: 1. included if all of the following criteria are met * ≥18 years and ≤75 years * diagnosed according to classification criteria for psoriasis vulgaris * understanding the whole process of the study, voluntary participation and signed the informed consent 2. included if at least one of the following criteria is met * body mass index (bmi) over 24 * impaired glucose or insulin resistance exclusion criteria: * pregnant women, or women who ready for pregnancy or lactating; * have special primary endocrine system lesions that can influence glucose or lipid metabolism * more than 20% change of their predrug body weight within a half year * severe diabetes which needs combined therapy * known major systemic diseases like cancer, liver or kidney malfunction, etc. * alcohol abuse * known severe or chronic infections like tuberculosis or hiv * use of other systemic medication that could influence the metabolic level * patients participated in any clinical trials within 3 months * other cases which researchers believe that can not enroll

Keywords: psoriasis metformin gut microbiota
description of insulin resistance in patients with chronic heart failure

Conditions: Chronic Heart Failure

Summary: the purpose of this study is to describe insulin resistance in a general chronic heart failure population, in combination with muscle strength, body composition and cardiac function. it is assumed that insulin resistance is increased in chf patient, and that this is related to decreased muscle strength and decreased lean tissue mass.


Eligibility criteria:
inclusion criteria: * diagnosis of chronic heart failure for at least 6 months, * clinically stable (not hospitalized) for more than 3 months prior to the onset of the study, exclusion criteria: * glucose lowering medical therapy
neoadjuvant hypofractionated stereotactic body radiation therapy prior to surgery for hepatocellular carcinoma: a feasibility study.

Conditions: Hepatocellular Carcinoma

Summary: hepatocellular carcinoma (hcc) is the fifth more common cancer in the world, with high mortality rates, due to the low number of patients who are eligible for therapy with curative intent, like surgical resection. moreover, surgical resection is associated with a high risk of tumor recurrence, because of the tumor seeding through microscopic intrahepatic vessels that surround the tumor, the so-called "microvascular invasion". to adequately deal with this phenomenon, the surgeon has to perform either an 'anatomical' liver resection, which remove not only the tumor but also the whole corresponding vascular network, or a 'tumorectomy' with resection margins of at least 2 cm. unfortunately, these principles cannot always be achieved due to underlying liver cirrhosis that is present in more than 80% of patients. stereotactic body radiation therapy (sbrt) has been proven to efficiently necrotize or stabilize hcc nodules when surgery is not possible. our hypothesis is that pre-treatment with sbrt prior to surgical resection of hcc might improve the results through the destruction of possible seeding in the peritumoral environment. given the novelty of this therapeutic strategy, it is necessary to verify its feasibility and safety, prior to test its efficacy in patients with hcc. the karcher-1 study aims at making sure that preoperative sbrt would not result in important delays or serious adverse events such as to cancel the planned surgical resection, in patients who otherwise could have benefited from it. this issue is commonly called 'drop-out'. thirty patients are expected to be included in the karcher-1 study, which would be in favor of continuing to evaluate this therapeutic strategy if less than 3 drop-outs occur, and would be immediately discontinued if 3 drop-outs occur. other outcomes will also been studied, like intraoperative issues, postoperative morbi-mortality, pathological features on the surgical specimen and its correlation with preoperative imaging, and finally, tumor recurrence and survival.


Eligibility criteria:
inclusion criteria: * biopsy-proven hepatocellular carcinoma or easl/aasld criteria * single nodule, 3 to 8 cm of largest diameter * hepatocellular carcinoma eligible for conventional liver resection with curative intent (r0), without preoperative portal vein embolization exclusion criteria: * performance status \> 2 * severe comorbidity with contraindication for either surgery or radiation therapy * decompensated liver cirrhosis (child-pugh b or c) * neoplastic portal vein thrombosis or extra-hepatic metastases * previous anticancer therapy within the last 5 years

Keywords: hepatocellular carcinoma stereotactic body radiation therapy hepatectomy neoadjuvant therapy drop-out
napping, sleep, cognitive decline and risk of alzheimer's disease

Conditions: Sleep; Alzheimer Disease; Cognitive Impairment; Aging; CBT

Summary: this study aimed to pilot test a non-pharmacological (behavioral) treatment program targeting improved cognition through improving 24-h sleep-wake cycle in people with mild cognitive impairment (mci) or mild alzheimer's disease. a treatment program incorporating bright light therapy and a modified cognitive behavioral therapy for insomnia will be developed to address 24-hour patterns of sleep. we will then pilot test its feasibility and explore its preliminary effects on improving sleep/napping and cognition in patients with mci or mild alzheimer's disease.


Eligibility criteria:
inclusion criteria: * ≥65 years old * memory complaints verified by an informant * clinical diagnosis of mild cognitive impairment (mci) or mild alzheimer's disease * general cognitive performance sufficiently persevered such that a diagnosis of alzheimer's disease cannot be made by the site physician * no evidence (ct or mri scans within 12 months prior to screening) of infection, infarction, or other focal lesions and no clinical symptoms suggestive of intervening neurological disease * adequate visual and auditory acuity to allow neuropsychological testing * meets icsd-2 criteria for insomnia or circadian rhythm disorders, or shows actigraphy evidence of sleep disturbances and excessive napping exclusion criteria: * any major neurologic disease other than suspected incipient alzheimer's disease, such as parkinson's disease, multi-infarct dementia, multiple sclerosis, seizure disorder, huntington's disease, brain tumor or history of significant head trauma * any comorbid psychiatric conditions or severe personality disorder within the past 2 years (by dsm-iv), such as major depression, bipolar disorder, schizophrenia and other psychotic features * any uncontrolled medical conditions or systemic illness that might lead to difficulty complying with the study protocol * history of alcohol or substance abuse within the past 2 years * any inadequately treated primary or secondary sleep disorder (due to medical conditions) that might confound the association
theory-driven manualized approach to improving new learning and memory in healthy aging and mci

Conditions: Aging

Summary: the purpose of this research study is to investigate the effectiveness of a memory enhancement technique in an aging population.

memory enhancing techniques have been incorporated into an 8-session treatment protocol, strategy based training to enhance memory (stem), designed to teach participants about each of the techniques, train them on how to apply the techniques in daily life and practice their application to daily life memory demanding situations. the protocol includes teaching participants over age 60 how to restructure a memory demanding situation in order to make optimal use of the techniques.

Eligibility criteria:
inclusion criteria: * inclusion criteria: * read and speak english fluently exclusion criteria: * prior stroke or neurological injury/disease (i.e. traumatic brain injury, multiple sclerosis, or stroke). * history of significant psychiatric illness (for example, bipolar disorder, schizophrenia, or psychosis). * significant alcohol or drug abuse history (inpatient treatment). * benzodiazepines and steroid use * diagnosis of dementia

Keywords: memory
the role of hydration on exercise performance - odin

Conditions: Dehydration

Summary: during exercise in the heat, there is a need to replenish fluids in order to avoid dehydration and decrease the risk for heat illness. what drives this urge to drink is the thirst mechanism. following ingestion of fluids, there is an inhibition of thirst before there is a replenishing of fluids. however, there is little scientific evidence of where thirst is inhibited, if this thirst inhibition is augmented by exercise and how thirst itself influence exercise performance. further, during rehydration studies, it is very difficult to successfully blind a subject to their drinking/hydration protocol. previous studies that have blinded a subject to their drinking have used various methods such as intravenous fluid administration and/or nasogastric tubes. therefore, the purpose of this research is to examine the mechanistic roles thirst inhibition plays while exercising in the heat while undergoing intravenous fluid administration. specific attention will be directed to the cardiovascular and thermoregulatory function of the individuals. all blood, cardiovascular, thermoregulatory, and perceptual measures are shown in the diagram below.


Eligibility criteria:
inclusion criteria: * cycling racing history category 3 or higher usa cycling certification * maximal oxygen uptake \>55 ml/kg/min exclusion criteria: * history of heat stroke * renal, cardiovascular, metabolic diseases * regular medication