Kornimate/medical-research-clean huggingface dataset:
function, pain, and alignment following knee replacement for the treatment of osteoarthritis

Conditions: Knee Replacement, Total; Pain, Postoperative; Functional Independence

Summary: there are many factors that can influence patient satisfaction and patient related outcomes following total knee replacement including the surgical alignment of the joint components. historically, total knee replacements have been performed with an aim aiming to achieve neutral alignment or a mechanical weight axis in the lower extremity . however, only 0.1 % of the population have a pre-surgical anatomical neutral alignment, and therefore the constitutional anatomy of the patient is neglected. there is a growing trend to return patients back their anatomical constitutional alignment after a knee replacement, referred to as kinematic alignment using robotics. the aim of this randomized controlled trial is to examine how mechanical alignment and kinematic alignment impacts function, pain, mood and fatigue following tkr for the treatment of osteoarthritis. outcomes will be measured at 6 week, 6 months, 1 year and 2 years after surgery.


Eligibility criteria:
inclusion criteria: * undergoing unilateral tkr for the treatment of osteoarthritis * between the age of 18 and 85 years of age * able to read, speak and understand english, have a telephone * are able to provide consent exclusion criteria: * enrolled in another study, are * undergoing revision surgery or bilateral surgery, and are * over the age of 85 years. patients will also be excluded if they * have a cognitive impairment (as indicated in the medical record) affecting their ability to comprehend the questions being asked
molecular and genomic profiling of head and neck tumors

Conditions: Head and Neck Neoplasms

Summary: the purpose of this study is to study the genetic profile of head and neck tumors and their relationship to treatment response and outcome

previous research by our group using genetic microarray analysis of hnscc and normal keratinocytes has identified two distinct groups of genetic expression based on clustering patterns of a subgroup of genes. clinical data was summarized for each group and overall, patient segregation by gene expression profiling was a better predictor of outcome than clinicopathological variables. further analysis identified 375 genes that discriminate between the genotypic subtypes of hnscc. overall, our preliminary data has shown that the pattern of global gene expression in a hnscc specimen can be used as a predictor of prognosis. we isolated subsets of genes showing the greatest patterns of divergence in gene expression. we have also identified 366 over-expressed and 246 underexpressed genes when comparing primary tumor to normal surgical margins and have identified a similar number of genes whose expression has changed when comparing primary tumor to lymph node metastasis. combining these data sets we have identified genes which consistently increase or decrease expression during progression from normal tissue to primary tumor, and subsequently to metastatic node. we have selected several candidate genes for subsequent analysis using hnscc tissue arrays. through dna microarray analysis and other techniques for looking at genetic and molecular characteristics, a more detailed knowledge of the malignant transformation process, and alterations with therapy, in these patients may be obtained. this study will seek to perform comprehensive molecular and genetic profiling to improve biomarker development in hnscc and correlate this data with patient clinical data. ultimately it is hoped that tumor specific genetic abnormalities may be identified which could provide targets for treatment strategies such as gene therapy, immunotherapy, or other interventions. study objectives: to evaluate gene expression patterns in human head and neck squamous cell carcinoma and correlate this with treatment response, both surgical and non-surgical. to identify a series of diagnostic markers in blood, urine and/or sputum for head and neck squamous cell carcinoma and study the mechanism of action of these proteins.

Eligibility criteria:
inclusion criteria: * actual or suspected malignant or non-malignant tumors of the head and neck * planned biopsy and/or resection, or availability of paraffin embedded or stored frozen tumor tissue for non-genetic analysis exclusion criteria: * insufficient tissue available for both standard diagnostic evaluation and study specimen

Keywords: genetic microarray head and neck cancer
efficacy of low-level laser acupuncture and microcurrent electrical stimulation on gag reflex on children

Conditions: Gagging

Summary: the aim of the current study is to evaluate the effectiveness of the laser acupuncture in comparison to the electroacupuncure for controlling gag reflex in children

the study will select children who are suffering from gag reflex that can affect their dental appointments negatively. they will be diagnosed then randomly distributed to one of the 3 groups of the study gag reflex and anxiety will be measured before and after the intervention then the results will be compared.

Eligibility criteria:
inclusion criteria: * children free of any systemic disease or special health care needs * children with score 2 or 3 according to the frankle behavioral rating scale * a full arch maxillary alginate impression is needed * moderate to severe gagging according to the gagging severity index * written informed consent of the legal guardian exclusion criteria: * children taking anti-emetic drugs * children sensitive to alginate

Keywords: gag reflex dental anxiety low-level laser
vitamin k supplementation in patients on hemodialysis

Conditions: End Stage Renal Failure on Dialysis; Atrial Fibrillation

Summary: the purpose of this study is to determine whether vitamin k supplementation will improve anticoagulation control in patients on hemodialysis taking warfarin for atrial fibrillation. patients who participate will receive vitamin k1 three times a week on dialysis days for a period of four months. inr levels collected during this period will be compared to the four month period prior to receiving the vitamin k1 to determine if vitamin k improves the standard deviation of inrs and time in therapeutic range.

patients on hemodialysis with atrial fibrillation are at increased risk of stroke. these patients often take warfarin to reduce this risk. warfarin is a drug that is used to prevent clots in the bloodstream. the dose of warfarin varies from person to person, and its effect is measured using a blood test called the international normalized ratio (inr). in most patients with atrial fibrillation the goal is to keep the inr between 2 and 3. patients on hemodialysis often have unstable inr levels. vitamin k supplementation has been shown to improve inr control in patients on warfarin but has not yet been studied in hemodialysis patients. in this study, patients on hemodialysis receiving warfarin for atrial fibrillation will receive vitamin k 400 mcg orally three times a week on dialysis days for 4 months. inr levels in the four months before and the four months while receiving vitamin k will be reviewed. the primary end point will look at inr stability and be measured by calculating the standard deviation of inr values before and after receiving vitamin k. the goal of this study is to determine whether vitamin k supplementation improves inr control in patients on hemodialysis taking warfarin for atrial fibrillation.

Eligibility criteria:
inclusion criteria: * greater than 18 years of age * receiving in-house hemodialysis for at least 6 months * previously diagnosed with atrial fibrillation * on warfarin for at least 6 months with a target inr of 2-3 exclusion criteria: * are unable to provide informed consent * have a mechanical heart valve * are receiving supplements containing vitamin k * have a known hypersensitivity to vitamin k

Keywords: warfarin international normalized ratio vitamin k
efficacy and safety of one-stage hybrid coronary revascularization

Conditions: Multivessel Coronary Artery Disease

Summary: coronary revascularization could be accomplished either by percutaneous coronary intervention (pci) or coronary artery bypass graft (cabg). pci with drug-eluting stent (des) implantation is featured by minimal invasive, low complication and rapid rehabilitation. cabg is characterized by improved long-term, event-free survival attributable to the use of left internal mammary artery (lima) graft. hybrid coronary revascularization (hcr) consists of lima bypass to left anterior coronary descending artery (lad) by minimal invasive direct coronary artery bypass (midcab) and pci of other stenosed coronary arteries with des implantation. one-step hcr entails lima-lad anastomosis performed through midcab, immediately followed by pci for non-lad lesions, sometimes for diagonal branch, in the hybrid operating room. limited data are available in comparing one-step hcr to pci alone for the treatment of multivessel coronary artery disease(mvd). the current east-hcr study will investigate the efficacy and safety of one-step hcr for patients with mvd, as comparing to pci alone.


Eligibility criteria:
inclusion criteria: 1. 18 years and older 2. signed the informed consent 3. indicated for revascularization, with possible bypass segment in lad and amendable lesions by pci in other vessels 4. anatomy requiring as following: (1) multivessel cad involving the lad (proximal or mid) and/or lm (ostial, mid-shaft or distal) with at least 1 other epicardial coronary artery requiring treatment in lcx or rca, including: (2) lad disease, and a major diagonal lesion, either bifurcation or independent in location, with both requiring revascularization (determined by qfr or ffr) (3) lm distal bifurcation lesion (medina 1,1,1), intended for 2-stent approach if randomized to pci 5. heart team discussion after angiogram, with conclusion of suitable candidate for either pci or hcr 6. able to tolerate and no plans to interrupt dual anti-platelet therapy for 3\~12 months 7. willing to comply with 2-year clinical follow-up exclusion criteria: 1. previous cardiac or thoracic surgery 2. previous pci of the lm and/or lad within 12 months 3. totally occluded left main vessel 4. cardiogenic shock or lvef \<30% 5. previous stemi within 30-day prior to randomization 6. concomitant vascular or other cardiac disease with plan of surgical treatment 7. indication for chronic oral anticoagulation therapy 8. previous stroke history within 6-month prior to randomization 9. survival expectation less than 3 years due to non-cardiac illness 10. allergy or hypersensitivity to any of the study drugs or devices used in the trial 11. enrolled in additional clinical study 12. informed consent not available or noncompliance with follow-up 13. pregnant

Keywords: hybrid coronary revascularization (hcr) percutaneous coronary intervention (pci) coronary artery bypass graft (cabg) multivessel coronary artery disease
clinical performance of low technique sensitive self cured universal adhesive vrs light cured universal adhesive in patients with (nccls): 18 m rct

Conditions: Non Carious Cervical Lesion

Summary: this study will be conducted to evaluate the clinical performance of self-cured adhesive versus light cured universal adhesive in non-carious cervical lesions (nccl) resin composite restorations after 18 month


Eligibility criteria:
inclusion criteria: * particepant with age rang 18-55 * particepant with non carious cervical lesion exclusion criteria: * particepant outside age rang * particepant with periodontal problem that might affect the teeth to be treated

Keywords: universal bond nccls 3m single bond universal palfique, tokuyama, japan self cure non carious cervical lesions
thermal ablation versus parathyroidectomy for secondary hyperparathyroidism

Conditions: Achievement Rate; Efficacy and Safety; PTH; Calcium; Clinical Symptoms

Summary: secondary hyperparathyroidism (shpt), which is frequently associated with chronic kidney disease, leads to problems such as bone pain, fractures, and cardiovascular issues, thereby affecting patients' quality of life. this clinical trial is designed to compare the efficacy of thermal ablation and surgical treatment for shpt. parameters including parathyroid hormone levels, serum calcium and phosphorus levels, shpt-related symptoms (for example, bone pain, muscle weakness), and complication occurrence will be monitored. the advantages involve enabling better treatment decisions for patients, enhancing patients' quality of life, and alleviating the burden on families, in addition to augmenting the clinical knowledge of healthcare providers. however, both treatments carry risks. thermal ablation may have problems like incomplete ablation, local tissue damage, and blood parameter changes. surgical risks comprise bleeding, infection, adjacent tissue damage (such as the recurrent laryngeal nerve), and hypoparathyroidism. the investigators will strive to minimize these risks. this trial is of great significance for shpt treatment, and the investigators welcome participants to contribute to the advancement of medical science in this area.


Eligibility criteria:
inclusion criteria: * persistent serum ipth (intact parathyroid hormone) levels \> 800 pg/ml； * resistance to calcimimetics, vitamin d, and its analogs, with ineffective conventional internal medicine comprehensive treatment； * severe bone pain, osteoporosis, muscle pain, ectopic soft tissue calcification, or other factors affecting quality of life； * imaging examinations indicating the presence of at least one enlarged parathyroid gland exclusion criteria: * severe bleeding tendency or coagulation disorders, severe cardiopulmonary abnormalities, and abnormal vital signs such as severe hypertension, arrhythmias, and anemia
nutritional stimulation of growth in children with short stature

Conditions: Nutritional Stunting; Growth Failure

Summary: short stature is a frequent reason for referral to a pediatric endocrinology clinic. short stature is especially prevalent among those with failure to thrive (whose weight is significantly below the average weight of his/her peers). the growth hormone has limited efficacy for medical treatment of short stature when the cause of short stature is not growth hormone deficiency. this study will investigate the effect of 6 months of nutritional supplement (essential amino acids) compared to placebo in the linear growth of short children who have not yet reached puberty.


Eligibility criteria:
inclusion criteria: * ages 3 to 11 years (inclusive). * pre-pubertal status (i.e. tanner stage 1 for breast development for girls and testicular enlargement for boys and pubic hair for both sexes). exclusion criteria: * ages younger than 3 years or older than 11 years. * medical history of a neurologic, endocrinologic, genetic, or metabolic problem known to have a direct effect on height growth. this includes, but is not limited to, children with a growth hormone deficiency, down syndrome, turner syndrome, russel-silver syndrome, prader-willi syndrome, pseudohypoparathyroidism, chronic kidney disease, malabsorptive syndromes, cancer survivors, etc. * currently being treated or previously treated with growth hormone, or history of oral steroid treatment within the last 3 months. * being in puberty.

Keywords: essential amino acids short stature
prognosis of acute kidney injury:china collaborative study on aki（ccs-aki）study

Conditions: Acute Kidney Injury

Summary: acute kidney injury (aki) is a common clinical syndrome, especially in the hospital patients. aki is recognized as an important risk factor for incident chronic kidney disease, accelerated progression to end-stage renal disease,and increased risk of short-term and long-term mortality.this study is to observe the prognosis of hospitalized patients with aki in china.


Eligibility criteria:
inclusion criteria: * clinically diagnosed with acute kidney injury, according to kdigo criteria exclusion criteria: * nephrectomy * kidney transplantation * peak serum creatinine of less than 53µ mol/l * serum creatinine decrease after amputation * patients died during hospitalization * end-stage kidney disease(chronic kidney disease stage 5) * malnutrition
weaning and variability evaluation

Conditions: Mechanically Ventilated Patients; Extubation

Summary: knowing when to liberate patients from mechanical ventilation (i.e. removal of breathing or endotracheal tube or extubation) is critically important, as both prolonged ventilation and failed extubation are both associated with harm and risk of death. our objective is to improve the safety of extubation by harnessing hidden information contained in the patterns of variation of heart and respiratory rate measured over intervals-in-time. currently, to assess a patient's ability to be extubated, a spontaneous breathing trial (sbt) is routinely performed, where the level of ventilator support is reduced, and their response is observed in order to help predict if they will tolerate extubation (i.e. complete removal of ventilator support). given that health is associated with a high degree of variation of physiologic parameters (e.g. heart and respiratory rate), and illness \& stress are associated with a loss of variability, the investigators aim to uncover the loss of variation as a measure of stress during sbt's. the investigators hypothesize that maintaining stable heart rate and respiratory rate variability (hrv and rrv) throughout the sbt will predict subsequent successful extubation, and conversely, a reduction in either hrv or rrv manifest during a sbt predicts extubation failure. a pilot study has demonstrated feasibility, and compelling preliminary results. a website, centralized data storage and analysis, and a trans-disciplinary team of scientists are in place to definitively test this novel technology. determination of when to extubate critically ill patients remains a high-stakes clinical challenge; and improved prediction of extubation failure has potential to save lives and reduce costs in critically ill patients.


Eligibility criteria:
inclusion criteria: * invasive mechanical ventilation for \>48 hours, * patient is ready for sbts for assessment for extubation, * has a normal sinus rhythm at time of sbt (no pacemaker), * is tolerating pressure support ventilation ≤14 cm h2o (spo2 ≥ 90% with fio2 ≤ 40% and peep ≤ 10 cm h2o), * hemodynamically stable (low or no vasopressors), stable neurological status (no deterioration in gcs during prior 24 hours \& icp \< 20), * intact airway reflexes (cough \& gag). exclusion criteria: * order not to re-intubate, * anticipated withdrawal of life support, * known or suspected severe weakness (myopathy, neuropathy or quadriplegia), * tracheostomy, * and prior extubation during icu stay.

Keywords: spontaneous breathing trial heart rate variability respiratory rate variability
assessing the safety and effectiveness of a neurological thrombectomy medical device for acute ischemic stroke

Conditions: Ischemic Stroke

Summary: the jacobs institute is participating in a sponsor investigator study designed to collect prospective clinical evidence to evaluate the use of a neurological thrombectomy device for clot retrieval in acute ischemic patients

the neurological thrombectomy device is an investigational device

Eligibility criteria:
inclusion criteria: at least 18 years of age at time of consent has baseline national institutes of health stroke scale (nihss) ≥ 8; able to be treated within 8 hours of stroke symptom onset or last known normal (lkn); exclusion criteria: cannot provide consent or legally authorized representative not available to provide consent
patient-reported outcome and safety between preoperative and postmastectomy radiotherapy in diep flap reconstruction

Conditions: Breast Cancer

Summary: this study is the first prospective randomized study assessing the patient-reported outcomes and safety outcomes between preoperative and postmastectomy radiotherapy in locally advanced breast cancer patients with immediate reconstruction of deep inferior epigastric perforator(diep) flap. radiotherapy before mastectomy and autologous free-flap breast reconstruction can avoid adverse radiation effects on healthy donor tissues and delays to adjuvant radiotherapy. we aimed to explore the feasibility of preoperative radiotherapy followed by diep flap reconstruction in patients with breast cancer requiring mastectomy.


Eligibility criteria:
inclusion criteria: * patients with histological proven invasive breast cancer; * clinical t0-3, t4b and n0-3a disease who require neoadjuvant chemotherapy; * no distant metastasis; * adjuvant radiotherapy and who are suitable for diep flap reconstruction at the time of mastectomy. exclusion criteria: * patients enrolled in other clinical trial which may as influence the outcome; * patients received neoadjuvant therapy without radiotherapy indications； * disease progression during neoadjuvant chemotherapy； * patients of pregnancy or lactation； * previous history of diabetes； * previous history of heavy smoking.

Keywords: diep flap radiotherapy breast cancer
impact of systematic shaving on margins

Conditions: Margin, Tumor-Free; Breast Cancer; Surgery

Summary: the objective of this clinical trial is to demonstrate the reduction of positive margins in the definitive pathology of patients undergoing breast-conserving surgery with the systematic shaving technique compared to conventional surgery, and the reduction of second interventions for margin enlargement.

patients with breast cancer who undergo breast-conserving surgery are randomized in the operating room after lumpectomy into 2 groups of 117 patients each: shaving/no-shaving (standard surgery).

Eligibility criteria:
inclusion criteria: 1. breast-conserving surgery. 2. imaging diagnosis as the only breast tumor focus according to mammography, breast ultrasound and/or nuclear magnetic resonance; 3. pathological diagnosis of carcinoma in situ or infiltrating 4. oncoplastic without associated flaps; exclusion criteria: 1. male patients; 2. patients with a history of ipsilateral breast cancer. 3. oncoplastic that includes flaps 4. multifocality or multicentricity; 5. pregnant or lactating patient; 6. stage iv patients; 7. patients eligible for mastectomy;
streamer : stent restenosis and medicaments release

Conditions: Critical Ischemia

Summary: it is a pilot study to evaluate the feasibility and the efficiency of local delivery of paclitaxel after stenting of long femoropopliteal arterial lesions tasc c and d before the realization of a large randomized multicentric study. patients concerned are in critical ischemia.


Eligibility criteria:
inclusion criteria: * patients with critical ischemia of a lower limb with ankle pressure \< 50 mmhg * lesions tasc c and d of the superficial femoral or popliteal artery exclusion criteria: * patient allergic to paclitaxel * patient with a cancer, a neutropenia, with immunosuppressor medicament or chemotherapy * patient with contraindication to take 2 anti-aggregants platelets

Keywords: paclitaxel critical ischemia restenosis femoropopliteal artery lesions tasc c and d