Kornimate/medical-research-clean huggingface dataset:
illizarov fixation in open type iii (a&b) pediatric and adolescent tibial shaft fractures

Conditions: Open Type III (A&B)Pediatric and Adolescent Tibial Shaft Fractures; Ilizarov Fixation

Summary: the ilizarov method is our usual treatment of choice for open, complex, physeal or unstable fractures and for patients in whom non-operative or other treatments have failed .

tibial fractures are the third most common injury involving a long bone in children. most occur in the distal third, and approximately 10% are open.high-energy injuries with soft tissue compromise or segmental bone loss, present specific challenges. there is a significant risk of nonunion (7.5%),malunion (17%),infection (10%),and loss of reduction (32%).many forms of treatment are available including a cast, elastic nailing, and external fixation using either a monolateral fixator, or a circular frame . in complex adult tibial fractures, evidence for the effectiveness of definitive external fixation using a circular frame continues to emerge.fixators may be used for the correction of tibial deformities in children.currently, only relatively small case series have been published describing their use for trauma in children and adolescents, albeit with good results.

Eligibility criteria:
inclusion criteria: * patients aged 8-16 years old. * diagnosed to have open grade iiia and iiib tibial fracture according to gustilo-anderson fracture classification system. * fractures of the shaft of the tibia or distal tibial fractures involving the ankle joint and were complicated by bone and/or soft-tissue loss of more than 3 cm. * an external fixator could be placed in the proximal lower extremity, distal lower extremity, or foot, and normal bone segments available for osteotomy. * admitted in the duration between 1st of january 2022 until end of december 2023. exclusion criteria: * patients requiring free flap or local flap transfer to close the wound. * open grade iiic tibial fractures (with vascular injury). * loss to follow-up.
filtered trial for telmisartan 40mg non-responder

Conditions: Hypertension

Summary: the primary purpose of this study is to: demonstrate that a fixed-dose combination of telmisartan 40 mg plus amlodipine 5 mg is superior to telmisartan 40 mg alone in patients with essential hypertension and inadequately controlled with telmisartan 40 mg monotherapy.


Eligibility criteria:
inclusion criteria: 1. essential hypertensive patients who satisfying non-responder criteria 2. male or female 3. age 20 years or older 4. outpatient exclusion criteria: 1. taking four or more anti-hypertensive medications 2. secondary hypertension 3. mean seated diastolic blood pressure (dbp) \> 114 mmhg and/or mean seated systolic blood pressure (sbp) \> 200 mmhg at visit 1, 2, 3, or 4, or mean seated dbp \< 90 mmhg at visit 3. 4. sustained ventricular tachycardia or other clinically relevant cardiac arrhythmias 5. congestive heart failure patients with the new york heart association (nyha) functional class iii-iv 6. history of myocardial infarction or cardiac surgery within last 6 months 7. history of coronary artery bypass graft or percutaneous coronary intervention (pci) within last 3 months 8. history of unstable angina within last 3 months 9. hypertrophic obstructive cardiomyopathy, aortic stenosis, hemodynamically relevant stenosis of aortic or mitral valve 10. history of stroke or transient ischemic attack within last 6 months 11. history of sudden exacerbation of renal function with angiotensin ii receptor blockers (arbs) or angiotensin converting enzyme (ace) inhibitors, or patients with post-renal transplant or post-nephrectomy 12. experienced characteristic symptoms of angioedema during treatment with arbs or ace inhibitors 13. known hypersensitivity to any component of the investigational drug , or a known hypersensitivity to dihydropyridine -derived drugs 14. hepatic and/or renal dysfunction 15. diagnosed biliary atresia or cholestasis 16. hyperkalemia 17. dehydration 18. sodium deficiency 19. chronic administration of high doses of acidic nonsteroidal anti-inflammatory drugs (nsaids) 20. patients who cannot change to the restricted administration and dosage during study period 21. pre-menopausal women who meet any one of the following 1 - 3: * pregnant or possibly pregnant (1) * nursing (2) * desire to become pregnant during study period (3) 22. drug or alcohol dependency 23. complication of malignant tumour or a disease requiring immunosuppressants 24. compliance of \ 120% during the run-in period 25. receiving any investigational therapy within 3 months 26. judged to be inappropriate by the investigator or the sub-investigator
de tethering exercises for scolisis

Conditions: Scoliosis Idiopathic; Exercise; Muscle Tone

Summary: this study aimed to investigate the effect of detethering exercises on muscle tone in patients with adolescent idiopathic scoliosis. h1: detethering exercises affect muscle tone in patients with adolescent idiopathic scoliosis.

this study is planned to include 15 patients diagnosed with adolescent idiopathic scoliosis. muscle tone and trunk rotation degree will be measured before and after the application of detethering exercises.

Eligibility criteria:
inclusion criteria: * be between the ages of 10-30, * being diagnosed with is * cobb angle between 20º and 50º, * to be able to continue the program to be implemented, * no chronic disease requiring the use of any neurological or psychiatric medication, * parents and/or child volunteering to participate in the study. exclusion criteria: * the patient has any contra-indication for exercise, * previous spine surgery, * having a curve with an apex thoracic 6 and above, * the presence of any mental problem, * scoliosis is not idiopathic but has different causes (neurological, congenital, etc...), neurological, psychiatric, muscular, rheumatic or orthopedic diseases are present.

Keywords: scoliosis exercise muscle tone
air barrier system for the prevention of prosthesis-related infections

Conditions: Prosthesis-Related Infections

Summary: this is a prospective, randomized, blinded clinical trial to determine if the air barrier system device reduces the incidence of surgical site infection after total hip replacement, acetabular repair, posterior spinal fusion, and prosthetic vascular graft procedures.

this project is an evaluation of a novel device, the air barrier system (abs), to reduce the risk of prosthesis-related surgical site infection in a multi-center clinical trial. the abs shields surgical incisions intra-operatively by creating a field of high-purity air surrounding an incision that prevents airborne microorganisms from entering the incision. this research will evaluate abs performance in a prospective, randomized, blinded multi-center trial. the surgical procedures studied will include total hip arthroplasty, trauma-related acetabula reconstruction, posterior instrumented spine fusion, and prosthetic vascular graft procedures. patients will be enrolled during the first two years of the study, and cdc guidelines require a one year follow-up period to monitor patients for potential prosthesis-related infections.

Eligibility criteria:
inclusion criteria: * total hip arthroplasty; * acetabular repair with instrumentation; * posterior lumbar, cervical, or thoracic (up to and including 6 vertebral levels) spine fusion with instrumentation and vascular prosthetic graft implantation. exclusion criteria: * history of prior prosthesis infection; * active infection; * open traumatic wounds as is the case after some acetabular fractures.
a structuralised sick-leave program compared to usual care sick leave management in patients after an acute myocardial infarction

Conditions: Myocardial Infarction

Summary: in this study the investigators aim at comparing the effect on quality of life and the cost-effectiveness of a structuralised sick-leave program compared to usual care sick leave management in patients after an acute non st myocardial infarction(nstemi).the investigators hypothesize that a structuralised sick-leave program after an acute nstemi is cost-effective without a negative effect on quality of life compared to usual care management in this patient group.


Eligibility criteria:
inclusion criteria: * patients with acute nstemi who are revascularized. * 65 years old or less * self caring * adequately literate in norwegian * have a regular work in at least 50% position. exclusion criteria: * patients not willing to participate * professional drivers * patients with alcohol or drug abuse * severe complications after the myocardial infarction such as malignant arrythmias, heart failure and major bleedings. * patients with recent cabg ( coronary artery bypass graft operation) within the last 6 months.

Keywords: cardiovascular diseases heart diseases myocardial infarction rehabilitation health economy randomized controlled trials non st elevation myocardial infarction (nstemi) cost analysis sick-leave quality of life
comprehensive pain programme to determine mechanism of transition of acute to chronic postsurgical pain

Conditions: Chronic Pain; Anaesthesia; Genetics Predisposition

Summary: to determine whether central sensitization is a mechanism of cpsp (chronic postsurgical pain) in women who will develop cpsp compared to women with no cpsp after hysterectomy. this mechanism is illustrated by a higher pain score in experimental pain models such as tonic heat stimulation, increased evoked mechanical temporal summation and increased wound hyperalgesia.

chronic pain affects 9% of singapore population resulting in major socioeconomic burden. chronic postsurgical pain (cpsp) that persists for over 3 months could be related to nerve injury making this a strategic model to study the transition of acute to chronic pain. cpsp occurs in up to 50% after surgery and up to 32% after hysterectomy. over 600000 hysterectomies were performed in the us in 2003 making cpsp a significant problem. investigators will perform this prospective cohort study to determine whether increased central sensitization and negative psychological experience are involved in the transition of acute to chronic pain after hysterectomy. investigators will recruit 444 women undergoing hysterectomy and employ validated physical pain testing including tonic heat stimulation, mechanical temporal summation and wound hyperalgesia which had been shown to be related to central sensitization. pain catastrophizing (negative thoughts of pain) and state trait anxiety scoring will be assessed for the impact of negative cognitive-affective experience on cpsp. a phone survey will be performed at 4 months to determine the primary outcome of cpsp. arterial spin labeling will be used to delineate cerebral blood flow using arterial spin labeling, functional connectivity and structural connectivity to evaluate insula-anterior cingulate cortex differences in 30 women with cpsp compared to 30 women without cpsp. in addition to evaluating whether central sensitization, negative psychological experience and activation of brain regions are different in women with cpsp after hysterectomy, the results of this study will elucidate potential mechanisms of cpsp development that will guide in future studies on potential novel therapeutic targets.

Eligibility criteria:
inclusion criteria: * anthropometric profile within the following range: age 21-70 yr, american society of anesthesiology status i and ii women * benign condition such as fibroids or adenomyosis * abdominal or laparoscopic hysterectomy exclusion criteria: * vaginal hysterectomy * being pelvic pain * failure to adequately determine tonic heat stimulation and mechanical temporal summation * history of drug dependence or recreational drug use * allergy to any study drugs
sonographic 3d measurement of fetal thymus may be used to predict the small baby in pregnancy.

Conditions: Intrauterine Growth Restriction

Summary: the exact etiology of intrauterine growth restriction (iugr) remains unclear but is known to involve immunologic/infectious factors. the thymus is one of the main organs involved in the development of the fetal immune system. the aim of this study was to explore the association between 3d fetal thymus volume (vocal) on ultrasound and intrauterine growth restiction by adding the 3-dimensional measurement of thymus volume to the routine fetal ultrasound scan at 15-24 week of gestation. investigators performed a prospective clinical study in 100 pregnant women in their second trimester of pregnancy who attended the fetal medicine unit of the medicine faculty of karadeniz technical university during the study period. maternal age, gravida, para, bmi, blood pressure, gestational age, bpd, fl ,ac, efw and fetal timus volume measured with vocal programme are recorded. for all patients routine clinical and ultrasound examinations were performed during pregnancy. gestational age at birth, way of birth and newborn birthweight were recorded. the results were statistically compared in the spss 13.0 program. student-t test and chi-square test were used for statistical analysis. roc curve analysis was used for limit values. the data of patients with iugr and without iugr were compared. the ability of the thymus volume to predict the iugr was tested using binary logistic regression analysis. p value \<0.05 was considered statistically significant.

a signed informed consent form for voluntary participation in the study was provided by all the women. a record was made for each patient of age, gravida, parity, body mass index (bmi), and sonographic measurements of biparietal diameter (bpd), abdominal circumference (ac), femur length (fl), and estimated fetal weight (efw). 3d fetal thymus volume (tv) was measured by using a voluson e-10 ultrasonography device, by a single researcher experienced in the use of obstetric ultrasound with a transabdominal volumetric probe. the fetal thymus, transverse section of the fetal chest, and the 3 vessel sections were visualised, then the 3d us modality was activated and the thymus volume was obtained immediately with the same probe. all cases were followed up in terms of pregnancy complications (iugr development) until delivery.

Eligibility criteria:
inclusion criteria: * aged 18-35 years, * who presented at the polyclinic for routine antenatal follow-up at 15-24 weeks * had no complaints. * had normal renal, hepatic, and thyroid functions test results. exclusion criteria: * any known endocrinopathy, * systemic disease, * collagen disorder, * hypercholesterolemia, * hemoglobinopathy * history of neoplasm, * current or previous cardiovascular disease, * the use of any drugs within the 3 months before the pregnancy, * multiple pregnancy, * current smoking, * abnormal renal, hepatic, or thyroid function test results, * the presence of any findings of fetal chromasomal or structural anomaly, * refusal to participate in the study.
effect of ino on invasively derived pulmonary pressures in patients with pah

Conditions: Pulmonary Arterial Hypertension

Summary: pulmonary hypertension is characterized by an increase in the pressures in the blood supply to the lungs greater than a mean pressure of 25mmhg and a concomitant increase in overall pulmonary vascular resistance (pvr). in patients who have remodeling of their pulmonary vasculature, pvr will increase with exercise instead of decreasing as it would in normal patients. based on published evidence, the investigators intend to investigate the effects of inhaled nitric oxide (ino) on patients undergoing standard exercise techniques who have separately and previously had an implanted pulmonary artery monitoring device (cardiomems by st jude medical, inc.) placed.


Eligibility criteria:
inclusion criteria: * males or females age 18 to 80 years with a diagnosis of pulmonary arterial hypertension (who group i pulmonary hypertension). * must be able to read and understand english and consent for themselves * previously implanted cardiomems continuous pa pressure * ambulatory and able to complete 6mwd test. exclusion criteria: * pregnant or lactating females; negative pregnancy test as confirmed by evaluation of data from pre-enrolled risk evaluation and mitigation strategies (rems) program.

Keywords: inhaled nitric oxide exercise 6 minute walk test cardiomems
extended ambulatory monitoring improves risk stratification in hypertrophic cardiomyopathy

Conditions: Hypertrophic Cardiomyopathy

Summary: eligible subjects will wear 4 consecutive external monitoring devices for a total of 28 days of monitoring.

eligible subjects will be monitored with a seeq device. the seeq device is a patch-like device that is worn externally on the chest and continuously monitors heart rhythm. each device is worn for seven days and replaced with additional devices for a total of 28 days of monitoring. subjects will return the seeq equipment at the end of the monitoring period. subjects will be contacted by telephone or seen at the clinic approximately 60 days from the first day of monitoring. information will be gathered about medications and any cardiac interventions the subject may have had. subjects will again be contacted by telephone or seen in the clinic approximately 1 year from study start. information will be gathered about general health, changes in medications, and cardiac interventions or events. cardiac testing results will be reviewed.

Eligibility criteria:
inclusion criteria: clinical diagnosis of hcm scheduled for routine ambulatory monitoring for risk stratification followed at the chanin t. mast hcm center at morristown medical center exclusion criteria: prior implantation of an icd history of persistent/permanent atrial fibrillation (af)
exploring the suitability of movement and sound in couple therapy: a proof-of-concept trial

Conditions: Depression

Summary: the present phase-iia waiting-list controlled proof-of-concept trial aims to explore the adequacy of immediate sound feedback for physical distance and touch between individuals as a potential means to complement existing methods in couple therapy. the results obtained will determine the design of a subsequent phase-iib randomized controlled trial.

according to early 20th century psychoanalysis, the "unsaid" becomes apparent in the relationship between patient and therapist, as well as in metaphors and symbols revealed through unintended utterances, imaginative techniques, and dreams. to convey emotions and thoughts, this method relies on the use of spoken language. likewise, spoken language remains central to the practice of psychotherapy in subsequent decades, as clinicians and researchers sought to translate and transform major claims of psychoanalysis into newer paradigms, the most prominent of them being cognitive-behavioral, client-centered and family-systems psychotherapy. inspired by somatic psychology and neuroscience evidence, more recent approaches focus on body and movement to target the "unsaid" beyond spoken language. funded by the german federal ministry of education and research, the "sentire" project attempts to provide immediate sound feedback for physical distance and touch between individuals (www.sentire.me). the present phase-iia waiting-list controlled proof-of-concept trial aims to explore the adequacy of "sentire" as a potential means to complement existing methods in couple therapy. the results obtained will determine the design of a subsequent phase-iib randomized controlled trial.

Eligibility criteria:
inclusion criteria: * in couple relationship for at least six months; * living in shared household or close daily contact. exclusion criteria: * currently acute episode of any mental disorder.
a trial of centanafadine efficacy, safety, and tolerability in adult subjects with binge eating disorder

Conditions: Binge-Eating Disorder

Summary: the primary objective of this study is to assess the efficacy of 2 doses of centanafadine sustained-release (sr) (200 milligrams \[mg\] and 400 mg total daily dose \[tdd\]) compared with placebo in adults with moderate to severe binge eating disorder (bed).


Eligibility criteria:
inclusion criteria: * adult participants 18 to 65 years of age (inclusive) at the time of informed consent. * a primary diagnosis of bed, or is diagnosed at screening, according to diagnostic and statistical manual of mental disorders - 5th edition (dsm-5) criteria and confirmed by the structured clinical interview for dsm-5 (scid). * bed with a history of at least moderate severity. * a rating of 4 or higher on the clinical global impression - severity (cgi-s) at screening and baseline. * body mass index (bmi) of 18 to 45 kg/m\^2, inclusive. exclusion criteria: * lifetime history of bulimia nervosa or anorexia nervosa. * participation in a formal weight loss program within 3 months of screening or planning to start a weight loss program during the trial. * history of bariatric surgery. * montgomery-asberg depression rating scale (madrs) score ≥ 18.

Keywords: centanafadine binge eating disorder
lessons in affect regulation to keep stress and pain under control (larkspur r34)

Conditions: Chronic Pain; Musculoskeletal Pain

Summary: chronic pain affects millions of americans but integrative as well as conventional treatments fall short in terms of alleviating this pain. the investigators are testing a tailored online positive affect skills intervention through a high-quality, randomized controlled trial for people with chronic musculoskeletal pain. the proposed work holds promise as an effective, low cost, easily disseminated intervention to help people cope with chronic pain, decrease depression and distress that pose barriers to optimal adherence, and potentially boost the efficacy of integrative as well as conventional pain treatments.


Eligibility criteria:
inclusion criteria: * age 18 and over * current patient at northwestern memorial hospital * seeking treatment for chronic musculoskeletal pain at the northwestern osher center for integrative medicine. pain will be defined as persisting for at least the past three months with an average level over the past month of at least 4 of 10 on a numerical rating scale, including back pain, neck pain/cervicalgia, knee pain, other joint pain (hips, ankles), fibromyalgia, osteoarthritis and rheumatoid arthritis. * fluent in the english language * have a working email address * have reliable internet access in order to access the website online

Keywords: online intervention chronic pain positive emotion affective science
tab08 in patients with psoriasis vulgaris, not adequately controlled with current treatment

Conditions: Psoriasis Vulgaris

Summary: study to assess pharmacodynamics, safety, pharmacokinetics and clinical effects of tab08 during 12 weeks of treatment in patients with psoriasis vulgaris, not adequately controlled with current therapy.

1. to assess dynamics of the t-lymphocytes subpopulations in patients peripheral blood during 12 weeks of tab08 treatment. 2. to assess dynamics of selected cytokines levels in patients peripheral blood during 12 weeks of tab08 treatment. 3. to assess tab08 concentrations in patients blood during 12 weeks of tab08 treatment. 4. to assess frequency, seriousness and severity of adverse events during 12 weeks of tab08 treatment. 5. to assess changes in pasi, iga and dlqi during 12 weeks of tab08 treatment and subsequent 4 weeks follow-up.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of vulgar psoriasis * area of psoriasis skin damage ≥ 10% * pasi score ≥ 12 * score on iga scale ≥ 3 exclusion criteria: * other forms of psoriasis in addition to vulgar * prohibited treatment * pregnant or nursing women * concomitant systemic therapy dosage modification (if any) within 4 weeks before randomization