Kornimate/medical-research-clean huggingface dataset:
treatment of the osgood schlatter

Conditions: Osgood Schlatter Disease

Summary: the disease osgood-schlatter is most commonly found in sports teenager growing up apophysose accounting for 28.4% of osteochondrosis by breck. it relates to 62% of osteochondrosis knee and affects adolescent girls between 10 and 12 and boys between 12 and 15 it is usually considered a benign pathology that cures in the majority of cases. however, in 5-10% of cases there is persistent residual pain in adulthood. the classic complication is the avulsion fracture of the tibial tuberosity in adolescents who continued his sports without restriction. the possible consequences are numerous including the presence of a free bone fragment at the insertion of the tendon originally described by osgood the establishment of a genu recurvatum, a high kneecap or patella alta and an enlarged tibial tuberosity (att) annoying sport. the main two treatments are complete rest from sport activity or cast immobilization. the main objective is to compare these two technics according to the proportion of full sporting recovering at 12 months


Eligibility criteria:
inclusion criteria: * boys and girls * from 9 to 15 years old * coming to consult in the sports' medicine ward * patients diagnosed with osgood-schlatter disease defined by a swelling of the anterior tibial tuberosity (att) , pain on palpation of the att , pain with passive knee flexion , pain thwarted knee extension and soft rays in profile knee radiography according to the classification of woolfrey and chandler (types a -c * unilateral or bilateral * previously treated or not * agreed to participate * agreement of the parents to participate * affiliation to national security exclusion criteria: * contraindication to the set-up of vascular access in femoral position (femoral scarpa wound, aortic dissection) * local infection * hypothermia \<32°c * need for implementation of arterial catheter only * need for implementation of venous catheter only

Keywords: cast immobilization complete rest osgood schlatter
lymphedema treatment registry

Conditions: Breast Cancer Lymphedema

Summary: patients with breast cancer related lymphedema (clinical stage 0-2) will include in this study. patients will take their demographic and clinical history and will evaluate with measurements of extremity volumes, body mass index, quality of life status and image studies (lymphoscintigraphy, ultrasonography (usg), indocyanine green (icg) lymphograph or magnetic resonance imaging (mri)) before and after the complete decongestive therapy. outcome measurements such as limb volume, quality of life questionnaire and usg will repeat every 6,12,18, 24 months.

patients with breast cancer related lymphedema (clinical stage 0-2) will include in this study. patients will take their demographic and clinical history and will evaluate with measurements of extremity volumes, body mass index, quality of life status and image studies (lymphoscintigraphy, usg, icg or mri) before and after the complete decongestive therapy (cdt). outcome measurements such as limb volume, quality of life questionnaire and usg will repeat every 6,12,18, 24 months. group 1: cdt group 2: cdt + po ketoprofen +local ketoprofen gel group 3: cdt + local ketoprofen gel

Eligibility criteria:
inclusion criteria: * breast cancer * lymphedema more than 6 months * lymphedema stage 0-2 * completed treatment (ct-rt) exclusion criteria: * stage 3 lymphedema * cardiovasculary disease * hepatic disease * kidney disease * cerebrovascular event * metastasis * gastritis * infection * smoking * active cancer * bleeding history

Keywords: lymphedema breast cancer treatment
study of oxaliplatin, capecitabine, and bevacizumab to treat older patients with colorectal cancer

Conditions: Colorectal Cancer; Neoplasm Metastasis

Summary: currently there is no one standard of care for older patients with metastatic colorectal cancer. the study will examine the tumor response to capecitabine, oxaliplatin, plus bevacizumab. the study will also gather information on the usefulness and side effects of this treatment combination.

colorectal cancer is primarily a disease of the elderly, with the median age in the united states of 70 years. age greater than 65 years at presentation is not a contraindication to standard therapies; acceptable morbidity and mortality, as well as long term survival, are achieved in this patient population. however, studies evaluating combination therapy have generally involved younger patients with high performance status scores. given the non-over-lapping safety profiles of the proposed study agents and the potential synergy, it would be of benefit to explore the combination of oxaliplatin, capecitabine, and bevacizumab in the treatment of older patients with colorectal cancer. time to progression, overall response, duration of response, and toxicity profile will be evaluated. the feasibility of using a self-report geriatric assessment tool will also be assessed.

Eligibility criteria:
inclusion criteria: * age 65 years and above; * histologically or cytologically documented adenocarcinoma of the colon or rectum; * metastatic disease; * measurable disease or assessable but nonmeasurable disease allowed; * ecog 0-1 * no prior oxaliplatin or bevacizumab. * no prior chemotherapy for metastatic disease. prior adjuvant chemotherapy allowed; * no prior fluoropyrimidine therapy (unless give in an adjuvant setting and completed at least 4 months earlier); * no bleeding diathesis or coagulopathy * adequate renal and hepatic functions as per protocol; * signed informed consent exclusion criteria: * clinically significant cardiovascular or peripheral vascular disease; * concurrent chronic aspirin, nonsteroidal anti-inflammatory drugs, warfarin, or therapeutic heparin; * serious non-healing wound, ulcer, or bone fracture;

Keywords: colorectal metastatic elderly metastatic colorectal cancer
ffr driven complete revascularization versus usual care in nstemi patients and multivessel disease

Conditions: Coronary Artery Disease; NSTEMI - Non-ST Segment Elevation MI; Fractional Flow Reserve, Myocardial; Myocardial Revascularization; Percutaneous Coronary Intervention

Summary: to compare ffr guided complete revascularization during the index procedure with usual care in non-stemi patients with multivessel disease.

background: patients with non-st elevation myocardial infarction (non-stemi), as compared with stemi patients, have a higher risk profile, more often mvd and less favourable outcome. recent studies showed that complete revascularization in stemi patients is feasible and effective. however, there is no clear evidence regarding the role of complete coronary revascularization by pci in patients with non-stemi with mvd. objective: to compare ffr guided complete revascularization during the index procedure with usual care in non-stemi patients with multivessel disease. design: prospective, multicentre, 1:1 randomized, investigator initiated study. hypothesis: ffr guided complete percutaneous revascularisation of all significant stenosis in the non-culprit lesion performed within the index pci procedure will improve clinical outcomes compared to the usual care, guided by discretion of the physician.

Eligibility criteria:
inclusion criteria: * patients aged between 18-85 years presenting with non-stemi according to current guidelines, who will be treated with pci of the culprit and have at least one stenosis of \>50% in a non-ira on qca or visual estimation of baseline angiography and judged feasible for treatment with pci by the operator. * non-ira stenosis amenable for pci treatment (operator's decision) * signed informed consent exclusion criteria: * left main disease (stenosis \> 50%) * chronic total occlusion of a non-ira * indication for or previous coronary artery bypass grafting * uncertain culprit lesion * complicated ira treatment, e.g. extravasation, permanent no re-flow after ira treatment (timi flow 0-1) and inability to implant a stent * known severe cardiac valve dysfunction that will require surgery or tavi in the follow-up period. * killip class iii or iv during the completion of culprit lesion treatment. * life expectancy of \< 1 year. * intolerance to aspirin, clopidogrel, prasugrel, ticagrelor or heparin. * gastrointestinal or genitourinary bleeding within the prior 3 months. * planned elective surgical procedure necessitating interruption of thienopyridines during the first 6 months post enrolment. * patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period. * pregnancy
study to evaluate the performance and safety of expedial and compare it to expanded polytetrafluoroethylene (eptfe) vascular access grafts

Conditions: End Stage Renal Disease

Summary: the purpose of this study is to establish the substantial equivalence of expedial and eptfe grafts for effectiveness in maintaining primary or assisted primary patency.


Eligibility criteria:
inclusion criteria: * patient has chronic renal failure and requires vascular access for hemodialysis * patient has given informed consent to participate in the trial and is willing to comply with the study protocol * patient is male or female, 18 years of age or older * the vascular access graft can be placed in the upper extremity (forearm, including across the elbow, or upper arm) * patient is undergoing or will undergo hemodialysis at a hospital or hemodialysis center * patient has a vein 4 mm or larger to which the graft can be anastomosed exclusion criteria: * patient is unable to comply with the study follow-up * patient has a known sensitivity to polyurethane or porcine heparin * patient has a previous vascular access graft implanted and it is not possible to place the study graft proximal to the existing device and no other sites are available * patient has an immunodeficiency syndrome * patient has a prior history of bacterial infection within 8 weeks of implantation of graft * patient has a severe coagulation disorder * patient has an elevated platelet count of greater than 1 million * patient has a history of heparin-induced thrombocytopenia syndrome (hit) * patient is pregnant * patient has a fever greater than 100 degrees fahrenheit

Keywords: vascular access graft hemodialysis dialysis end stage renal disease
evaluation of the use of granulocyte colony stimulating factor (gcsf) in post kasai type 3 biliary atresia

Conditions: Granulocyte Colony-stimulating Factor; Biliary Atresia

Summary: the aim of the study is to evaluate the use of granulocyte colony stimulating factor (gcsf) on the clinical and biochemical outcome of type 3 biliary atresia post kasai.

biliary atresia (ba) is a devastating disease manifest early in infancy characterized by bile duct injury and extrahepatic biliary obstruction, leading to cirrhosis in the majority of infants. although ba is a rare disease, occurring in \~1 in 5600 to 1 in 18,000 infants worldwide, it is considered the most common indication for liver transplantation in children. however, despite a 50-60% rate of initial jaundice clearance, liver transplantation by 2 years of age is necessary for long term survival in many of the post-kasai patients. gcsf cytokine that stimulates neutrophil and hematopoietic stem cell (hsc) production and mobilization from the bone marrow, and has served as a complementary agent to bone marrow stem cell therapy for patients with congenital or acquired diseases of bone marrow suppression. granulocyte colony-stimulating factor (g-csf) mobilizes cd34+(cluster of differentiation34) cells, these cd34+ cells increase hepatocyte growth factor inducing the proliferation of hepatic progenitor cells within 7 days. in experimental liver diseases of toxin-induced or bile duct ligation-induced liver injury, gcsf-based stem cell therapy has the same effects as direct hsc transplantation on improving liver regeneration and suppressing the inflammatory and fibrotic responses to hepatic injury. the cellular and molecular mechanisms are unknown but are postulated to be derived from the many paracrine actions of gcsf.

Eligibility criteria:
inclusion criteria: * infants with initial diagnosis of biliary atresia with biliary atresia score \> 23.927 will be allocated for kasai porto-enterostomy with intra-operative cholangiogram reaching type 3 biliary atresia anatomy as a final diagnosis. exclusion criteria: * major cardiac, renal, pulmonary, neurological malformations or illnesses. * hemoglobinopathies, such as sickle cell anemia * active systemic infection. * white blood cell count \> 20,000 cells/mm3. * platelet count \< 40,000 cells/mm3 or ≥ 800,000 cells/mm3. * purpura fulminans or unexplained vascular thrombotic conditions.
postoperative pain and recovery time after pulpotomy

Conditions: Postoperative Pain

Summary: the aim of this retrospective study was to compare immediate postoperative pain scores and the need for rescue analgesia in children who underwent pulpotomies and general restorative treatment and those who underwent general restorative treatment only, all under general anaesthesia.

ninety patients aged between 3 and 7 years who underwent full mouth dental rehabilitation under general anaesthesia were enrolled in the study and reviewed. the experimental group included patients who were treated with at least one pulpotomy, and the control group was treated with dental fillings only. the wong-baker faces scale was used to evaluate self-reported pain and the need for rescue analgesia. the data were analysed using the kruskal-wallis test, two sample t- tests, chi-square tests and pearson's correlation analysis.

Eligibility criteria:
inclusion criteria: * patients who underwent full mouth dental rehabilitation under ga because of their lack of chairside cooperation * patients with at least 1 pulpotomy were included in the experimental group (n=45), and patients treated with dental fillings only were included in the control group (n=45); a total of 90 patients were eligible for the study. exclusion criteria: * children with special needs and those with any systematic problem (cardiac disease, diabetes, or intellectual disability) were excluded from the study.

Keywords: postoperative pain child pulpotomy general anesthesia
effect of physical exercise program during pregnancy on excessive weight gain and its consequences

Conditions: Pregnancy

Summary: the purpose of this study was to assess the effectiveness of a moderated physical exercise program called blooming exercise program (bep) developed during pregnancy in order to control excessive maternal weight gain and its consequences. additionally, other objectives of the study were to analyse the influence of bep on urinary incontinence, on the other pregnancy outcomes and on the perception of the pregnant's health

backround: pregnancy and delivery can condition significantly women's health. in particular, an excessive gain of weight during pregnancy constitutes a risk factor which may lead to (i) different alterations during pregnancy such as gestational diabetes or hypertension, (ii) foetus health problems (macrosomia), (iii) delivery complications (dystocia, prolonged labour and increased number of caesareans) and (iv) future health disorders for the woman (overweight, obesity and cardiovascular alterations). furthermore, during pregnancy pelvic floor health problems, such as urinary incontinence (iu) may arise or worsen. objectives: the main aim of this study was to assess the effectiveness of a moderate physical exercise program called blooming exercise program (bep) developed during pregnancy in order to control excessive maternal weight gain and its consequences. additionally, other objectives of the study were to analyse the influence of bep on urinary incontinence, on the other pregnancy outcomes (maternal and foetal) and on the perception of the pregnant's health. design: a randomized, controlled trial called has been conducted. 300 healthy pregnant women were recruited and divided into an intervention group (ig, n=100) and a control group (cg, n=200). the ig participated in bep as from week 10-12 of gestation (at least 56 sessions through 22 weeks. 3 sessions per week). the cg did not participate in any supervised program addressed to pregnant women but received regular health care. pregnancy outcomes regarding the mother and the new born, urinary incontinence and women's habits data were obtained and registered through initial interviews, medical records and two specific questionnaires on health and urinary incontinency (iciq-sf and king's).

Eligibility criteria:
inclusion criteria: * healthy pregnant women * delivering in "hospital universitario de fuenlabrada" * at week 10-14 of gestation * able to attend 3 sessions per week until the end of the pregnancy exclusion criteria: * contraindications appointed by acog * less than 56 sessions

Keywords: pregnancy exercise excessive weight gain outcomes urinary incontinence
clinical trials of two non-drug treatments for chronic depression

Conditions: Mood Disorders; Depressive Disorders; Depression; Chronic Depression

Summary: this study investigates the potential efficacy of two nonpharmacologic treatments for nonseasonal depression, bright light exposure or high-density negative air ion exposure. treatments are self-administered at home by the patient under close clinical supervision.

bright light exposure and high-density negative ion exposure have been designed to mimic outdoor environmental conditions and are effective in relieving symptoms of seasonal (winter) depression, but their effectiveness in treating chronic depression has not been explored. participants in this 10-week study will have an interview, a complete physical exam, and six one-hour appointments for progress evaluations. they will be randomly assigned to either light or high- or low-dose negative ions. each treatment must be taken consistently for five weeks at the same time every day, after which treatment is temporarily suspended to determine whether symptoms return. participants will then have the opportunity to try the alternate active treatment to determine which works best for them. on two occasions, participants will provide saliva samples, used to determine the level of melatonin, a hormone that becomes active at night and indicates whether a person's internal circadian clock is "in sync" with the day-night cycle or is early or late. this diagnostic test for melatonin, which is not yet readily available in medical practice, provides our research participants with unique information that can be used to optimize the timing of future treatment.

Eligibility criteria:
inclusion criteria: * diagnosis of major depression * must be able to maintain a regular sleep schedule exclusion criteria: * depression restricted to certain seasons of the year * presence of other psychiatric disorders * current use of psychotropic medication, except for selective serotonin reuptake inhibitors (ssris) * current use of recreational drugs or supplements that may affect mood * current medical illness or medication that may affect response to antidepressant treatment * long-distance travel while participating in the program * pregnancy

Keywords: antidepressive agents chronobiology chronotherapy circadian rhythms depressive disorder ions light lighting mood disorders phototherapy.
exercise testing to screen for unknown coronary artery disease in diabetic patients: does it contribute to a risk reduction in very high risk patients?

Conditions: Coronary Artery Disease; Diabetes Mellitus

Summary: in the present study a cohort of diabetic patients without any symptoms and without known coronary artery disease (cad) will be screened at the investigators' diabetes outpatients services. those with intermediate or high risk will be asked to participate and enrolled. they will be seen and followed by the cardiologists in order to provide the best adherence to medical therapy. by mean of a randomization process, a group of patients will undergo an exercise electrocardiography (ecg) testing while the other group will continue to be regularly seen at the investigators' cardiology service. those patients with a positive exercise ecg test will be study by coronary angiography and treated according to the severity of coronary lesions by percutaneous stenting or surgery. both groups of patients will be seen every six-eight months for the next three years.


Eligibility criteria:
inclusion criteria: * type two diabetes mellitus * cardiovascular risk equal or higher than 10% according to italian risk score (www.cuore.iss.it) exclusion criteria: * known coronary artery disease * symptomatic heart failure * objective inability to perform treadmill exercise * known or active malignancy, advanced renal failure (clearance \< 25 ml/mi/1.73m2), liver cirrhosis (child pugh iii); stroke within the past 30 days * presence of left bundle branch block or st depression at rest greater than 0.9 mm
muscle response to high intensity interval resistance training (hiirt)

Conditions: Exercise; Resistance Training

Summary: resistance training (rt) is one of the most important stimuli for muscle hypertrophy and it plays an important role on weight loss and fatty acid oxidation increase. rt affects anabolic pathways but the differences among various training techniques has been till now were poorly investigated. the aim of this study was to compare the effect of two different intensity of training, high-intensity interval resistance training (hiirt) and traditional resistance training (trt), on muscle signalling pathway.

nine young healthy subjects performed hiirt and trt protocol in two different moments and with different legs. hiirt technique consisted of three sets of: 6 repetitions at 6rm (6 repetitions maximum) and then 20 seconds of rest and 2/3 repetitions (until exhaustion) repeated for 3 times with 2'30" rest between sets; while trt consisted of 3 sets of 15 reps with 75 sec of rest between sets. biopsies from the vastus lateralis were taken at baseline (pre), immediately (0h) at the end of training, 6 hours (6h) and 24 hours (24h) after training. western blot and rt-pcr mrna (reverse transcriptase-polymerase chain reaction) analysis were performed to assess muscle signalling pathway activation

Eligibility criteria:
inclusion criteria: * moderate active * experience with resistance training exclusion criteria: * history of recent myocardial infarction, * severe cardiac arrhythmia, * unstable angina, * poorly controlled hypertension, * poorly controlled diabetes mellitus, * frequent or complex ventricular ectopy which might interfere with one's ability to adhere to exercise protocols

Keywords: resistance training recovery muscle hypertrophy muscle signalling