Kornimate/medical-research-clean huggingface dataset:
periprosthetic bone mineral density changes after implantation of a short hip stem compared to a straight stem

Conditions: Osteoarthritis, Hip

Summary: the aim of this study is to evaluate periprosthetic bone mineral density (bmd) changes in the proximal femur after implantation of the fitmore compared to the cls stem.

after power analysis, 140 consecutive patients were prospectively included in the randomisation protocol receiving either a fitmore short or a cls straight stem. the short stem was assigned in 57 (37% females) cases and the straight stem in 83 (38% females) hips. periprosthetic bone mineral density was measured before surgery, 7 days, 3, 12 and 60 months postoperatively, using dual energy x-ray absorptiometry (dexa). the results of the first postoperative measurement served as the baseline value. because of the different length of the two prostheses we used adapted gruen zones to divide the periprosthetic bone in seven regions of interest (roi) with equal length in the proximal zones 1,2,6 and 7, only the regions 3 and 5 featured different sizes. clinical results were recorded using the womac and the harris hip score (hhs).

Eligibility criteria:
inclusion criteria: * primary or secondary osteoarthritis of the hip * written informed consent * indication for cementless total hip arthroplasty exclusion criteria: * previous surgery in the same hip * femoral fracture * metabolic bone disease * drugs affecting bone quality * contralateral tha within the study period * infectious disease or bony tumor

Keywords: total hip arthroplasty short stem dexa
study of s-1 in combination with radiotherapy in esophageal cancer

Conditions: Esophageal Squamous Cell Carcinoma

Summary: this trial aims to study the safety, the local control, and the overall survival of s-1 combined with radiotherapy for patients with esophageal squamous cell carcinoma. 105 patients will be recruited into this trial.


Eligibility criteria:
inclusion criteria: * joined the study voluntarily and signed informed consent form; * age \>75 or age 18-75 who are intolerant of or reject intravenous chemotherapy * both genders * esophageal squamous cell carcinoma confirmed by pathology * local advanced esophageal squamous cell carcinoma (t2-4n0-1m0-1a,txn1m0-1a,txnxm1a, ajcc 6th) * no radiotherapy, chemotherapy or other treatments prior to enrollment * ps ecog 0-2 * life expectancy of more than 3 months * hemoglobin（hb）≥9 g/dl * wbc≥3x109/l, neutrophils (anc )≥1.5x109/l * platelet count (pt) ≥100x 109/l * hepatic function: alat and asat \< 2.5 x uln, tbil\<1.5 x uln * renal function: creatinine \< 1.5 x uln * no immuno-deficiency * use of an effective contraceptive for adults to prevent pregnancy. exclusion criteria: * complete esophageal obstruction * deep esophageal ulcer * esophageal perforation * haematemesis * after surgery, exploratory thoracotomy, radiotherapy, chemotherapy, or targeting therapy * other malignant tumors, except for skin basal cell carcinoma, or cervical carcinoma in situ, who survived with no evidence disease for over 3 years * participation in other interventional clinical trials within 30 days * pregnant or breast-feeding women or people during the birth-period who refused to take contraceptives * drug addiction * alcoholism or aids * uncontrolled seizures or psychiatric diseases, loss of control over their own behavior * patient who has metastasis such as lung, liver metastasis
effect of glp-1 and gip on insulin secretion in type-1 diabetes mellitus

Conditions: Type-1 Diabetes Mellitus

Summary: study hypothesis: treatment with glp-1 and/or gip is able to potentiate the maximal stimulated insulin secretion even in c-peptide negative type-1 diabetic patients classified as having no residual beta cell function left.


Eligibility criteria:
inclusion criteria: * age 18-60 years * type-1 diabetes diagnosed between 5-40 years of age * normal weight(bmi 18-27), * insulin treatment from time of diagnosis. exclusion criteria: * severe complications to diabetes * abnormal liver or kidney function * haemoglobin below the lower limit * macroalbuminuria * systemic disease * pregnancy.
does intensive task specific training improve balance after acute stroke?

Conditions: Cerebrovascular Accident

Summary: the aim of this study is to investigate whether additional task specific physiotherapy treatment and a self administrated home training program results in better balance compared to traditional follow up care.

increased risk of falling is a major problem after stroke and impaired balance is one of the main reasons for falling. early and intensive physiotherapy seems to be beneficial for functional outcome after stroke although it is still unknown whether one specific physiotherapy technique is better than another. comparison: traditional follow up care by the community health care system with additional task specific physiotherapy three times a week and a daily self administrated home training program compared to traditional follow up care by the community health care system.

Eligibility criteria:
inclusion criteria: * admitted to the stroke unit with a diagnosis of stroke * living in the city of trondheim * included 4 - 14 days after first sign of symptoms * modified rankin scale \> 3 before admission to hospital * scandinavian stroke scale (sss) less than 58 points and more than 14 points * sss leg item less than 6 points or sss movement item less than 12 points * discharged to home or a rehabilitation clinic * mini mental state examination score more than 20 points * able and willing to provide informed consent exclusion criteria: * seriously heart- and lung-diseases * other diseases which makes it difficult to evaluate the function * already included in the trial

Keywords: cerebrovascular accident physical therapy techniques musculoskeletal equilibrium rehabilitation
gastric ischemic preconditioning before esophagectomy

Conditions: Operable Esophageal Cancer; Embolization of the Left Gastric Artery Prior to Surgery

Summary: the aim of the study is to investigate the impact of left gastric artery embolization before esophagectomy on postoperative complications, particularly anastomotic leaks and necrosis of the gastric conduit.


Eligibility criteria:
inclusion criteria: patient with operable esophageal cancer who underwent embolization of the left gastric artery prior to surgery. exclusion criteria: patient with no operable esophageal cancer
digital therapeutic vs psychoeducation for management of mild to moderate depression in adolescents

Conditions: Depression, Teen

Summary: the purpose of the present randomized controlled study is to investigate if there is a difference in depression symptoms at 4-weeks among adolescents ages 16-17 years assigned to w-genzd, a digital therapeutic, as compared to a psychoeducational control group.


Eligibility criteria:
inclusion criteria: * adolescents aged 16-17 years old * experiencing mild-moderate depression as indicated by a phq-8 score between 5-19, inclusive, assessed at screening/baseline * has regular access to a smartphone (android or ios smartphone with a recent supported operating system) with reliable wifi access or sufficient data to engage with assigned study arm for the duration of the study * available and committed to engage with the program and complete assessments for an 8-week duration * able to read and write in english * u.s. resident * regular, stable dose of antidepressant medications for (e.g. escitalopram/lexapro, fluoxetine/ prozac) for at least 60 days at screening with no plans to change medication/dose throughout the study * if currently receiving psychotherapy, then must be in therapy for at least 4 weeks at screening with no changes planned for the duration of the study * participants must be able to understand and willing to provide informed assent and to comply with all study procedures and restrictions exclusion criteria: * lifetime diagnosis of a psychotic disorder, including schizophrenia and schizoaffective disorder * lifetime diagnosis of bipolar disorder * lifetime diagnosis of autistic spectrum disorder or pervasive developmental disorder (e.g. autism, asperger syndrome, rett's syndrome, or pervasive developmental disorder not otherwise specified) * suicidal attempt or ideation with a plan and intent to harm oneself during the last 12 months * history of (a) drug and/or alcohol abuse within the past 12 months (determined by self-report) * current use of benzodiazepines (e.g. lorazepam, clonazepam, alprazolam, diazepam, triazolam) or certain sleep aids (zolpidem, eszopiclone, zaleplon) * previous woebot application use
risk assessment of endometrial hyperplasia and endometrial cancer

Conditions: Endometrial Cancer

Summary: abnormal uterine bleeding (aub) represents common diagnostic challenge in everyday gynecological practice. however, abnormal bleeding is a common symptom of many benign diseases and only indicates the presence of ec in 9% of postmenopausal women and 1% to 2% of premenopausal women, suggesting that many women at low risk undergo unnecessary invasive procedures to rule out cancer. the aim of the study is to create a risk-scoring model of endometrial hyperplasia and endometrial cancer.

approximately 90% of endometrial cancer (ec) cases are preceded by aub in premenopausal or perimenopausal women or post-menopausal bleeding (pmb).transvaginal ultrasonography(tvs) has become the first step diagnostic tool of aub. the main advantage of ultrasound imaging is that it has high accuracy for the preoperative classiﬁcation of intra and extra uterine lesions, both benign and malignant. if increased endometrial thickness (et) is found in women with pmb, the risk of ec increases. however, in women with type ii ec, et below 3-4 mm might also be found. because of these limitations, et should not be the only factor for cancer risk estimation in women with aub. three-dimensional sonography and blood ﬂow vascular indices improve the diagnostic precision of the sonographic estimation of endometrial lesions. several scoring systems using different ultrasound image characteristics were proposed to estimate the risk of ec in women with aub including the recently proposed system" risk of endometrial cancer scoring model "(rec). existing guidelines recommend considering clinical risk factors such as bmi, age, obesity, type ii diabetes, polycystic ovary syndrome(pcos) and use of unopposed estrogen when evaluating aub. however, only few clinical risk prediction models have been developed. despite the important role of ultrasound imaging in assessment of endometrial lesions, one wonders if clinical variables can improve the diagnostic performance of risk prediction models. the aim of the study is to create a risk-scoring model of endometrial hyperplasia and endometrial cancer using patient clinical characteristics and ultrasound image characteristics among women with abnormal uterine bleeding, and to validate the diagnostic performance of our model and to compare it's predictive value with the recently proposed rec score for ec risk stratiﬁcation.

Eligibility criteria:
inclusion criteria: women ≥40 years with pre- or perimenopausal aub or pmb presenting to women's health hospital, department of obstetrics and gynecology, faculty of medicine, assiut university, assiut, egypt. exclusion criteria: * women with a vaginal bleeding arising from a cervical, vaginal or vulvar disease. * patients with cervical cancer or uterine metastases. * history of prior hysterectomy, prior pelvic radiation, endometrial sampling within the past 3 months. * presence of existing pregnancy. * women with inadequate endometrial sampling or with no histopathological diagnosis.

Keywords: endometrial hyperplasia
docetaxel with rapid hormonal cycling as a treatment for patients with prostate cancer

Conditions: Prostate Cancer

Summary: we postulate that multiple apoptototic events are indusce through testosterone depletion and repletion with taxotere given in conjunction with androgen withdrawal.


Eligibility criteria:
inclusion criteria: * diagnosis of prostate adenocarcinoma histologically confirmed at mskcc or skccc. * patient must have a serum testosterone \> 180 ng/dl. * karnofsky performance status (kps)\>_70%. * patients must have adequate organ function as defined by the following * laboratory criteria: * wbc \>_ 3500/mm3 * anc \>_1500/mm3 * platelet count \>100,000/mm3 * hemoglobin \>8.0g/dl * creatinine \<1.6mg/dl * total bilirubin wnl (unless due to gilbert's disease and other lfts are wnl) * sgot and sgpt if alkaline phosphatase is _\< 2.5 x uln, any elevations in * ast/alt; or if ast/alt is _\<1.5 x uln, any elevation in alkaline phos * prior hormonal therapy is allowed as: 1. neoadjuvant treatment prior to radiation therapy or radical pmstatectomy, provided that the total duration of therapy does not exceed 6 months (proscar is not considered a hormone therapy). 2. one cycle of intermittent therapy up to a maximum exposure of 6 months (proscar is not considered a hormone therapy). * patients must be at least 18 years of age. * patients must have signed an informed consent document stating that they understand the investigational nature of the proposed treatment exclusion criteria: * clinically significant cardiac disease (new york heart association class iii/iv), or severe debilitating pulmonary disease. * uncontrolled serious active infection. * anticipated survival of less than 3 months. * active cns or epiduraltumor * inability or unwillingness to comply with the treatment protocol, follow-up, or research tests * peripheral neuropathy \>_ grade 3. * patients with a history of severe hypersensitivity reaction to drugs formulated with polysorbate 80. * men of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 6 months after completion of the treatment. * prior chemotherapy * concomitant use of phenytoin, carbamazepine, barbiturates, rifampicin, phenobarbital, st. johns's wort (hypericum perforatum) and ketoconazole is prohibited.

Keywords: prostate cancer docetaxel 03-076
circadian function and cardio-metabolic risk in adrenal insufficiency

Conditions: Adrenal Insufficiency

Summary: the purpose of this study is to compare cardio-metabolic risk, glucose tolerance, and night time blood pressure between healthy control subjects and patients with adrenal insufficiency. no intervention will be administered and the study is observational only.

we propose to use a case control design to test the main hypothesis that as compared to healthy control subjects matched for sex, age, adiposity and race/ethnicity, patients with adrenal insufficiency, whether primary or secondary, have disturbances of the circadian system that are associated with high day to day variability of sleep time as well as elevated markers of cardio-metabolic risk, including abnormal oral glucose tolerance and reduced nocturnal blood pressure dipping. a secondary hypothesis of the study is that adrenal insufficiency patients on a replacement regimen (as part of their standard of care ongoing treatment) that results in daytime cortisol profiles approximating the normal diurnal variation will have better cardio-metabolic function than adrenal insufficiency patients who have grossly abnormal cortisol profiles.

Eligibility criteria:
inclusion criteria: * primary or secondary adrenal insufficiency, healthy matched controls, acute or unstable health conditions age 18 or older exclusion criteria: * diabetes, tertiary adrenal insufficiency
pain-related long covid in covid-19 survivors

Conditions: COVID-19; Pain, Chronic

Summary: the exploratory project aims to investigate the presence of pain as a long covid-19 symptom in previously hospitalised patients and in non-hospitalised persons previously tested positive in a pcr test.

the main objectives investigated will be to determine the general prevalence of pain symptoms in covid-19 survivors, correlating and analysing the role of previously comorbidities in the development of pain symptom in covid-19 survivors, and to understand the prevalence of pain related long covid-19 symptoms for future characterisations. hence, the projects main outcome will be to try to understand why som covid-19 survivors develop persistant pain and others don't. furthermore, the project plan to analyse gender and age differences, and data between covid-19 waves as well as any possible association between pain prevalence and time after positive pcr-test.

Eligibility criteria:
inclusion criteria: * previously infected with sars-cov-2 virus exclusion criteria: * participants under the age of 18 * hidden/secret address/name * no access to digital mail (the channel of data collection)

Keywords: covid-19 coronavirus chronic pain persistant pain long covid sars-cov-2
treatment of wounds using oasis® ecm

Conditions: Non-healing Wound

Summary: the purpose of this clinical study is to gather post-market clinical evidence on the use of oasis ecm as a treatment for different types of chronic wounds in the community setting in the united kingdom.


Eligibility criteria:
inclusion criteria: 1. non-healing ulcer (any etiology) present for at least 1 month and treated in the ambulatory clinic or home healthcare setting exclusion criteria: 1. age \< 18 years 2. unable or unwilling to provide informed consent 3. unable or unwilling to comply with the study follow-up schedule, and procedures 4. simultaneously participating in another investigational drug or device study 5. target wound area is \ 140 cm2 after baseline debridement 6. target wound has reduced in area by \> 40% with 4 weeks of documented standard of care therapy 7. known allergy to pig or porcine products 8. systemic infection 9. infection of the target wound as determined by the collection of pus 10. osteomyelitis 11. abi/tbi \< 0.6 obtained within 3 months prior to the screening visit 12. other exclusions may apply

Keywords: partial and full-thickness wounds pressure ulcer venous ulcer chronic vascular ulcer diabetic ulcer
sphenopalatine ganglion block for postdural puncture headache in the emergency department

Conditions: Postdural Puncture Headache

Summary: this study evaluates sphenopalatine ganglion block (spgb) for the treatment of postdural puncture headache (pdph) in the emergency department (ed). half of the patients will receive a true nerve block with lidocaine and bupivacaine. the other half will receive a placebo nerve block.

postdural puncture headaches (pdph) are a common consequence of diagnostic lumbar puncture. the gold standard treatment for a pdph is currently an autologous epidural blood patch (aebp), which involves placing a needle into the epidural space of the spine and then injecting 20 ml of the patients own blood through the needle and into the epidural space to form a clot over the tear in the tissue layer that causes the headache. this is an invasive procedure that carries risks of pain, bleeding, infection, and in rare cases, neurological complications. we want to test the efficacy of using a less invasive procedure, called a sphenopalatine ganglion block (spgb), for treatment of pdph. spgb has been used for many years in the treatment of migraines and cluster headaches, and there are several case reports of its use to successfully treat pdph as well. spgb simply involves applying a local anesthetic to the mucosa in the back of each nostril to numb the nerves that cause the headache. we hope that the spgb will reduce the number of pdph patients that require an aebp.

Eligibility criteria:
inclusion criteria: * active postdural puncture headache within 7 days after diagnostic lumbar puncture * age ≥ 18 years. * american society of anesthesiologists (asa) physical status ≤ 3 exclusion criteria: * known coagulopathy * known nasal septal deviation or abnormalities * medical conditions contraindicated to lidocaine or bupivacaine
comprehensive home-based dementia care coordination for medicare-medicaid dual eligibles in maryland

Conditions: Dementia; Caregiver Burden

Summary: this center for medicare and medicaid funded health care innovation award will implement the mind at home dementia care coordination program (called mind at home-plus) through two community-based service agencies (jewish community services, johns hopkins home care group) to rapidly improve the ability of 600 dually eligible older adults with dementia in the baltimore region to remain at home while improving care quality, enhancing quality of life, and reducing total health care costs. mind at home participants receive an in-home needs assessment followed by up to 18 months of care coordination aimed at filling unmet needs.

the demonstration project has 3 major tasks which will be implemented in concurrent, iterative phases: (1) implement mind-plus in 2 community-based health service agencies to rapidly improve the ability of 600 community-living dually eligible older adults with ad in the baltimore region to remain at home while improving care quality, enhancing quality of life, and reducing total health care costs associated with institutional care or hospitalization; (2) develop a replicable model for nationwide diffusion of the mind program through a web-based certification package designed to prepare for implementation, build work-force capacity through training certification modules, and provide automated self-monitoring and quality improvement tools; and (3) develop and test a detailed payment model that takes a blended approach and includes provider care management fees with provider performance incentives from division of shared savings. the investigators hypothesize that the mind-plus dementia care coordination program will (1) rapidly improve health \& care quality and reduce total health care costs among medicare-medicaid dually eligible community-living older adults with ad, (2) drive health care system transformation by creating a new cms financed benefit that would shift the hub of dementia care coordination to well-trained, dementia competent, interdisciplinary teams based in community health agencies, (3) achieve a sustainable payment model that produces significant net savings and incentives provider performance. this "shovel ready" community-based model is expected to improve outcomes within 6 months and save an estimated net-saving of $12.5 million by over 3 years.

Eligibility criteria:
inclusion criteria: * diagnosis of dementia * community living * has identified study partner willing to participate * english speaking exclusion criteria: * situation at time of referral is a medical or mental health crisis * they plan to move out to another area or into a residential care facility in the next 6 months * they are currently on hospice.

Keywords: dual eligible care coordination community-based care quality care needs health services care management low income neuropsychiatric behaviors