Kornimate/medical-research-clean huggingface dataset:
oral huzhang granules for acute gouty arthritis

Conditions: Gouty Arthritis

Summary: we designed this study as a double-blind, randomized, controlled clinical trial. the aim of the study is to evaluate the clinical efficacy, safety and control of recurrence rate of acute gouty arthritis

gout is a recurrent chronic inflammatory disease caused by monosodium urate (msu) crystal . acute gouty arthritis (ga) is the most common first symptom of gout. with the progress of the disease, the frequency of acute attack increases, and joint destruction may occur. the prevalence of hyperuricemia in china was about 13.3%, and the pooled prevalence of gout was 1.1%. repeated attacks of ga seriously affect the quality of life, resulting in huge economic costs and mental stress. due to inadequate prevention and treatment, the target of healing gout is often not achieved. in ga, tcm has shown satisfactory therapeutic effect with less adverse effects and minimal toxicity. huzhang granule (hzg), a chinese herbal prescription, is a compound preparation with twelve ingredients which has been used in the clinical treatment of gout for over 30 years at the yueyang hospital of integrated traditional chinese and western medicine affiliated to shanghai university of tcm.therefore，this double-blind, randomized, controlled clinical trial. will provide high-quality clinical evidences for evaluating the clinical efficacy, safety and control of recurrence rate of huzhang granule ，a representative prescription for the treatment of acute gouty arthritis , in the treatment of ga.

Eligibility criteria:
inclusion criteria: * diagnosis of acute gout arthritis as defined by the american college of rheumatology 1977 preliminary criteria; * male or non-pregnant, non-nursing female; * 18-70 years of age; * gout attack less ≤48 hours; * in the week before this observation, non-steroidal anti-inflammatory drugs and analgesic drugs and drugs affecting uric acid metabolism were not taken; * subjects capable of giving informed consent; exclusion criteria: * failing to meet the diagnostic criteria; * evidence of uncontrolled concomitant cardiovascular, nervous system,hepatic or gastrointestinal disease. potential participants who have active concomitant disease can only be eligible after discussion and agreement with the treating medical team; * the patient is in critical condition and it is difficult to evaluate the effectiveness and safety of the clinical observation; * severe deformity, stiffness and labor loss of patients with advanced arthritis; * known allergic to the drug used in this study.

Keywords: gouty arthritis randomized controlled trial huzhang granule traditional chinese medicine
parenteral artesunate compared to quinine as a cause of late anaemia in african children with malaria

Conditions: Anaemia

Summary: delayed anaemia has been reported in european travellers with malaria cured by artesunate. although no deaths related to this delayed anaemia have been reported so far, blood transfusion has been necessary in some affected patients. recent observations suggest that this episodes of anaemia also occurs in endemic countries. the aim of this trial is to assess the incidence of late onset anaemia after treatment with intravenous artesunate compared to intravenous quinine, to identify patients at risk and to clarify the causes of this delayed anaemia.


Eligibility criteria:
inclusion criteria: * age \> 6 months and ≤ 14 years * acute uncomplicated p. falciparum malaria, confirmed by positive blood smear with asexual forms of p. falciparum or mixed with non-falciparum species * asexual p. falciparum parasitaemia ≥ 100,000/ul and ≤500,000/ul * haemoglobin ≥5.0 g/dl * parents/guardians agree to hospitalize the child for the length of treatment (3 days) and bring the patient for planned follow-up visits at day 7, 14, 21, 28, 35, 42 * signed consent from the guardian/parents exclusion criteria: * body weight ≤ 5 kg * severe malaria or signs of severe malaria as defined by who guidelines 2013 * history of hypersensitivity or contraindication to quinine or artesunate * a clear history of adequate antimalarial treatment in the preceding 24 hours with drugs expected to be effective * presence of intercurrent illness or any condition which in the judgement of the investigator would place the subject at undue risk or interfere with the patient treatment or results of the study * participation in another clinical trial

Keywords: malaria anaemia artesunate
defining the optimal cryoballoon duration therapy for treatment of atrial fibrillation: defining the optimal cryoballoon duration therapy for treatment of atrial fibrillation: the 1-2-3 study

Conditions: Atrial Fibrillation

Summary: cryoballoon based therapy is an established therapy for the treatment of (paroxysmal) atrial fibrillation. however, with the rapid evolution in cryoablation technique and its increased effectiveness, the risk of complications increases. therefore it is of utmost importance to define the optimal duration of cryoballoon ablation time.the objective of the study is to assess the optimal ablation duration using the second generation cryoballoon for isolation of pulmonary veins in the treatment of atrial fibrillation.

rationale cryoballoon based therapy is an established therapy for the treatment of (paroxysmal) atrial fibrillation. however, with the rapid evolution in cryoablation technique and its increased effectiveness, the risk of complications increases. therefore it is of utmost importance to define the optimal duration of cryoballoon ablation time. objective to assess the optimal ablation duration using the second generation cryoballoon for isolation of pulmonary veins in the treatment of atrial fibrillation. study design the study is designed as a prospective multicentre randomized efficacy study. study population patients 18-70 years of age with paroxysmal atrial fibrillation eligible for pulmonary vein isolation according to current international guidelines. intervention patients will be randomized to 2 cycles of 1, 2 or 3 minutes of cryoballoon ablation after reaching the temperature "plateau phase". main study parameters/endpoints acute success of pulmonary vein isolation. nature and extent of the burden and risks associated with participation, benefit and group relatedness: no additional risk is present as the procedure is common clinical practice, current cryoballoon application time is 3 minutes shorter application times are not expected to add to the risk.

Eligibility criteria:
inclusion criteria: * paroxysmal atrial fibrillation eligible for pulmonary vein isolation according to current international guidelines. * age \< 70 years. * willing and able to sign informed consent. * willing to and capable of following the requested study procedures. exclusion criteria: * age \< 18 years. * pregnancy * life or follow-up expectancy \< 12 months. * previous pvi. * contrast allergy. * creatin clearance level \< 60. * left ventricular ejection fraction \< 40% * abnormal left atrium anatomy defined as number of pv's ≠ 4 or left atrium diameter \>50mm (measured in the parasternal long axis, as assessed with transthoracic echocardiography) or \>40 cc/m2 . this will lead to exclusion after inclusion but before randomisation.

Keywords: pulmonary vein isolation atrial fibrillation cryoballoon therapy duration
effect of auricular vagus stimulating in non specific chronic neck pain

Conditions: Neck Pain; Vagus; Autonomic Nervous System

Summary: the aim of our study is to compare the efects of conventional treatment and vagus nerve stimulation on pain, normal joint movement, disability and sleep in non-specific chronic neck pain. 36 patients aged between 18 and 65 years with non-specific neck pain participated in our randomly planned study. all these patients were divided into 2 groups. demographic and physical characteristics of the patients were recorded. the first group was treated with auricular vagus nerve stimulation. conservatire treatment that consists of hotpack, transcutaneous electrical nerve stimulation (tens) and therapeutic ultrasound was applied to the second group. in addition to their treatment, some home exercises were given and tought. pain was assessed with a visual analog scale (vas). muscle strength was evalvated with a digital hand dynamometer. neck normal joınt motion was evaluated with goniometer clinometer which is a mobile phone application. while disability was mensured with the neck disability index, sleep quality was evalvated with the pittsburg sleep questionnaire. all the measurements were recorded before the trearment and after the 15 session treatment.


Eligibility criteria:
inclusion criteria: * 18-65 years old * people with non-specific neck pain exclusion criteria: * who has neurological problems, * who has vision and hearing loss, * who has a tumor and infection in the cervical region, * who has undergone surgery related to the cervical region, * who has had a cervical streroid injection in the last 3 months
nitrate patch use as treatment of knee avn

Conditions: Necrosis, Avascular, of Bone

Summary: the pathogenesis of avn includes a defective blood supply to the knee joint. local nitrates induce peripheral vasodilation and may improve blood supply to the affected tissue. this study aims to test whether the use of a nicotine patch may accelerate the healing process from avn of the knee.

the main purpose of this study is to examine whether treatment with a local nitrate patch will improve mri findings and clinical outcomes in patients with avn of the knee. this is a double-blind prospective study that will include 50 adult volunteers, randomly assigned to a "nitrate" group that will be given a nitrate patch, and a "placebo" group that will be given a placebo patch. the following outcomes will be measured: * mri findings before and after the patch treatment * use of analgesics * subjective pain relief.

Eligibility criteria:
inclusion criteria: * adult patients (18-80 y.o) * diagnosis of avn according to mri exclusion criteria: * terminal illness * cognitive impairment / any condition disturbing informed concent. * nitrate intolerance * patients using cyclic gmp inhibitiors

Keywords: knee avn, nitrates
endoscopic treatment of the buried bumper syndrome: comparison of the flamingo device versus standard therapy

Conditions: Buried Bumper Syndrome

Summary: percutaneous endoscopic gastrostomy (peg) is a method for nutrition delivery for patients with insufficient oral intake. a rare but severe complication of peg is the buried bumper syndrome (bbs). in bbs the internal fixation device of the peg migrates along the stoma chanel. the internal fixation disc becomes covered by gastric mucosa, which causes loss of patency, fixation of the peg and possible leakage around the peg. bbs can be treated endoscopically by dissecting the overgrowing tissue with endoscopic submucosal dissection (esd) knifes. a new and alternative approach is the use of the flamingo device, which is inserted over the peg and then is used to radially dissect the overgrowing tissue with a cutting wire. in this study both methods, the standard method using an esd knife and the flamingo device, are compared in a randomized controlled open-label trial. primary endpoint is the time needed for peg removal.


Eligibility criteria:
inclusion criteria: * endoscopy proven buried bumper syndrome * peg or jet-peg exclusion criteria: * major coagulation disorder * percutaneous endoscopic jejunostomy or use of a ballon fixed device
effects of mixed nut consumption on satiety and weight management

Conditions: Satiety

Summary: the first goal of the proposed study is to determine acute and long-term effects of mixed nuts (almonds, hazelnuts, pecans, pistachios, walnuts, and peanuts) on metabolic parameters and weight management. while numerous studies have shown the beneficial effects of nuts on promoting negative energy balance and weight loss, mechanistic studies exploring how the inclusion of nuts in the diet promotes a negative energy balance and weight loss have not been conducted. the second goal is to determine the mechanisms by which mixed nut consumption regulates of food intake and body weight.


Eligibility criteria:
inclusion criteria: * 18-55 years old * bmi 27-40 exclusion criteria: * smoker * pregnant woman * required dietary supplement use * required medication of metabolic disorders * allergy to nuts or gluten
mri in clinical staging and estimation of treatment response in bladder cancer

Conditions: Bladder Cancer

Summary: bladder cancer (bc) as the most common malignancy arising from the urinary tract continues to be a major health problem. this prospective non-randomized study will enroll 150 patients undergoing magnetic resonance imaging (mri) at different stages of their diagnostic and therapeutical process. the enrolled patients with suspected bc (bc) based on cystoscopy will have their initial mri examination before transurethral resection of bladder tumor (tur-bt) and biomarker collection. after pathology review of the histological specimens, patients will be treated according to standard clinical practice. the second mri examination will be performed before therapeutic intervention, if tur-bt alone is not sufficient enough. neoadjuvant chemotherapy will be applied in high risk patients having muscle invasison, while intermediate risk patient - t1 high grade or carcinoma in situ patients - will be treated using bacillus calmette-guerin (bcg) instilliations. after the completion of the neoadjuvant chemotherapy or bcg treatment, the patients will undergo the third mri examination. low risk patients will be followed by annual with mri examination.


Eligibility criteria:
inclusion criteria: * age: 18 to 85 years old * suspected bc based on cystoscopical evaluation. * mental status: patients must be able to understand the meaning of the study * informed consent: the patient must sign the appropriate ethical committee (ec) approved informed consent documents in the presence of the designated staff exclusion criteria: * history of serious cardiovascular, liver or kidney disease * uncontrolled serious infection * contraindications for mri (cardiac pacemaker, intracranial clips etc) * patient refusing radical cystectomy or chemotherapy or bcg * intravesical bacillus calmette-guerin instillations within 6 months before the first mri examination

Keywords: bladder cancer mri tur-bt cystectomy chemotherapy
agreement and accuracy of different devices corneal measurements

Conditions: Keratoconus

Summary: to compare repeatability, reproducibility and agreement of both, as- oct and scheimpflug imaging, for the measurement of corneal curvature and corneal thickness in patients with keratoconus.


Eligibility criteria:
inclusion criteria: * men and women aged between 18 and 99 years * presence of keratoconus * signed informed consent exclusion criteria: * contact lens history within 5 days * pathologic changes of the lid or conjunctiva on slit-lamp examination * history of corneal ocular surgery/previous corneal cross-linking
postspinal hypotension and cardiac performance in the elderly

Conditions: ARTHROPLASTY, REPLACEMENT; ANESTHESIA

Summary: patients, scheduled for elective arthroplasty were monitored with lithium dilution cardiac output monitor (lidcoplus™) before and 45 minutes after spinal anesthesia. hypotension was defined as systolic blood pressure ≤ 100 mmhg or ≥ 30% decrease from baseline. associations between hypotension and the hemodynamic changes after preanaesthetic fluid loading and spinal anesthesia were analysed by logistic regression analyses.


Eligibility criteria:
inclusion criteria: * hip or knee arthroplasty * spinal anaesthesia * age 65 years or more exclusion criteria: * weight \<40kg * concomitant lithium medication * written informed consent not obtained * research team unavailable
reducing stigma toward mental illness and substance use issues in primary health care in chile

Conditions: Mental Health; Substance Abuse; Stigmatization

Summary: this research project aims to determine the effectiveness of a comprehensive anti-stigma intervention in reducing stigmatizing attitudes and behaviours among primary health care (phc) providers toward individuals with mental illness and/or substance use issues (misui) in the chilean context, using centros de de salud familiar (cesfams) as the point of intervention.

the intervention model will be culturally adapted with cesfam phc provider and user input to be relevant and valid to chile. the 18-month intervention includes five (5) components that are simultaneously implemented in cesfams: (1) develop a team of local champions in each intervention cesfam, comprising phc providers and users; (2) analysis of internal cesfam policies, procedures, and protocols to determine areas of improvement in service delivery for individuals with misui; (3) raising awareness of stigma toward misui using various forms of media within the cesfam; (4) innovative contact-based education workshops on anti-stigma and recovery principles, co-lead by academic/clinical trainers and a person with lived experience of misui; and (5) recovery-based arts, a multi-week arts workshop for phc providers and users to produce artwork related to misui and recovery, culminating in an exhibition to showcase artwork for the cesfam providers, users, and community. due to coronavirus disease of 2019 (covid-19) sanitary context some of the interventions may be developed remotly dependind on each primary healthcare center needs and capability. this interventions will be implemented in years two and three of the study and the final year of the study is dedicated to integrated data analysis, a 6-month follow-up data collection, and dissemination of results. if the intervention proves to be effective, control cesfams will be provided with an anti-stigma initial training and protocols for intervention implementation.

Eligibility criteria:
inclusion criteria: * cesfam must serve a registered population of at least 15,000 people * cesfam have at least 50 staff employed exclusion criteria: * cesfam being part of another antistigma program.

Keywords: primary health care implementation science social stigma
educational intervention in preventing early childhood caries

Conditions: Dental Caries

Summary: objective: the aim of this study is to assess the effectiveness of an oral health educative intervention in preventing early childhood caries (ecc). methods: the trial targets 0- to 12-month-old children and their mothers in pelotas, brazil. twenty-four public health centres (clusters) were randomly selected and assigned to intervention or control group (12 clusters per intervention group). in each center, up to 30 children/mothers were selected and invited to participate in the trial. each mother was interviewed in order to collect socio-economic and demographic variables. the intervention group received by means of a pamphlet the oral health instructions, which were emphasized with verbal instructions. dental examination will be carried out after 1 year for all teeth surfaces to determine caries status.


Eligibility criteria:
inclusion criteria: * children with 0 to 12 months exclusion criteria: * children with teeth in mouth at the time of enrollment * children not living in pelotas * no sufficient information provided by the mother at the time of enrollment * systemic diseases

Keywords: educational intervention dentals caries population new populational caries prevention strategies.
treatment of newly diagnosed standard risk acute lymphoblastic leukemia in children

Conditions: Lymphoblastic Leukemia in Children

Summary: aim of this study is to investigate the outcome of ngs mrd based risk stratified treatment for high risk acute lymphoblastic leukemia in children and adolescents.


Eligibility criteria:
\ * newly diagnosed pediatric/adolescent acute lymphomblastic leukemia patient with ncl standard risk that stratifies all 1-4 of following 1. 1 year old ≤ age \< 10 years old 2. white blood cell at initial diagnosis \< 5x10\^10/l (50,000ul) 3. no testis involvement 4. satisfaction of following organ functions a. kidney function (satisfies i or ii) i. creatinine clearance (or radioisotope-measured gfr) ≥ 70ml/min/1.73m2 ii. creatinine value according to age/sec satisfies the following: 1 to \< 2 years: male: 0.6 / female: 0.6, 2 to \< 6 years: male: 0.8 / female: 0.8, 6 to \< 10 years: male: 1 / female: 1, 10 to \< 13 years: male: 1.2 / female: 1.2, 13 to \< 16 years: male: 1.5 / female: 1.4, ≥ 16 years: male: 1.7 / female: 1.4 however, subjects who meet the selection criteria within 1 week before registration after receiving appropriate conservative treatment, including fluid therapy, can be registered. b. liver function i. direct bilirubin \< 3.0mg/dl \ 1. steroid administration within 2 weeks before the registration 2. t(9;22) or t(4;11)(q11;q23) or chromosome \< 44 or iamp21 or t(17;19)/tcf3-hlf 3. newly diagnosed t cell all 4. one of the following syndromes: down syndrome, bloom syndrome, ataxia-telangiectasia, fanconi anemia, kostmann syndrome, shwachman-diamond syndrome, or other bone marrow failure syndrome 5. burkitt leukemia/lymphoma 6. in the presence of electrocardiographic findings suggesting uncontrolled cardiac dysfunction (e.g., unstable ischemia, symptomatic arrhythmia, congestive heart failure) or congenital long qt syndrome 7. when the clinical trial subject(or legal representative) does not consent or is unable to give written consent

Keywords: standard risk all ngs mrd
botulinum toxin type a and modified constraint-induced movement therapy for poststroke upper extremity spasticity

Conditions: Stroke

Summary: botulinum toxin type a (btxa) injection and modified constraint-induced movement therapy (mcimt) are both promising approaches to enhance recovery after stroke. however, the combined application of the two modalities has rarely been studied. the aim was to investigate whether combined btxa and mcimt would produce greater improvements in spasticity and upper extremity function than btxa plus conventional rehabilitation in chronic stroke patients with upper extremity spasticity.

botulinum toxin type a (btxa) injection and modified constraint-induced movement therapy (mcimt)are both promising approaches to enhance recovery after stroke. however, the combined application of the two modalities has rarely been studied. to date, only a single case report addressed this issue. theoretically, application of a mcimt program with intensive functional tasks practice after spasticity reduction by btxa may improve affected upper extremity function in patients with poststroke spasticity. the aim was to investigate whether combined btxa and mcimt would produce greater improvements in spasticity and upper extremity function than btxa plus conventional rehabilitation in chronic stroke patients with upper extremity spasticity.

Eligibility criteria:
inclusion criteria: * age 18 to 80 years * at least 1 year after a unilateral stroke * modified ashworth scale (mas) score \> 3 in the elbow, wrist or finger flexors * ability to actively extend \> 10 degrees at metacarpophalangeal and interphalangeal joints and 20 degrees at wrist of the affected upper limb (minimal motor criteria). exclusion criteria: * presence of fixed joint contractures * serious balance problems * preexisting neurological deficits, neuromuscular diseases or uncontrolled medical conditions * significant cognitive deficits (mini-mental status examination score \< 24) * excessive pain in the affected upper limb * previous treatment with botulinum toxin a, neurolytic agents or surgery for spasticity all patients were not currently participating in any experimental studies and did not receive concomitant oral anti-spastic medication during the study period

Keywords: botulinum toxin, spasticity, stroke, rehabilitation.