Kornimate/medical-research-clean huggingface dataset:
cope: cannabinoids to obviate pain experiment after knee replacement

Conditions: Arthroplasty, Replacement, Knee

Summary: total knee replacement is a major and painful orthopaedic (joint and bone) surgery where the knee joint is replaced with an artificial joint. it is an effective and successful procedure to treat severe knee arthritis and reduce pain, but many patients report intense pain after the surgery. postoperative pain control is predominated by opioids (morphine-based drugs). while opioids are effective to manage the pain, they can have acute and chronic complications, including confusion, nausea, vomiting, constipation and high risk of addiction. medical cannabis is an effective and safe alternative for pain treatment. recent studies showed that patients have reported a reduction in opioid usage when taking cannabis as a substitute for pain relief. this study aims to investigate whether adding medical cannabis (cannabidiol - cbd) treatment will decrease the amount of opiates needed in the first 2 weeks after knee replacement compared to a group given placebo.

cope (cannabinoids to obviate pain experiment after knee replacement) will be a single-centre, prospective, randomized, placebo-controlled, superiority trial, with two parallel groups designed to investigate the effect of cannabis as postoperative pain treatment compared to placebo on total opioid consumption after total knee replacement. eligible patients are: men and non-pregnant women aged ≥18 years scheduled to undergo primary total knee replacement. and with no opioid usage within the last 3 months or history of narcotic abuse. patients will be recruited at the department of orthopaedic surgery at st michael's hospital (toronto - canada), and informed consent will be obtained from those eligible. central computer-generated randomization will be used to randomly assign participants to cannabis or placebo groups (1:1 ratio). only the study pharmacist will know allocated treatments.

Eligibility criteria:
inclusion criteria: * 18 years of age and older * men and women * patients with radiographic confirmation and clinical correlation for severe osteoarthritis diagnosis with an indication for total knee replacement * patients undergoing primary unilateral total knee replacement * patient is able to provide informed consent to participation in the study exclusion criteria: * pregnancy * breastfeeding * current opioid use * cognitive impairment or mental illness (e.g., dementia, alzheimer disease and psychoses), which will prevent patients from reliably providing primary outcome data * unable to swallow an oral tablet (medication) * history of opiate, narcotic and alcohol abuse * revision total knee replacement surgery * high risk of falls as determined by the treating physician * patients refusing participation * pre-existing/ regular cannabis use

Keywords: pain management; analgesics, opioid; cannabis
rsv antibiotic drivers and resource-use

Conditions: Respiratory Syncytial Virus Infections; Antibiotic Stewardship in Community Hospitals

Summary: this study retrospectively evaluated the clinical, laboratory, and radiologic factors that influence the decision to prescribe antibiotics in children under 2 years of age hospitalized with rsv-positive acute lower respiratory tract infections. the study also examined the economic impact of antibiotic use in these patients. the goal is to improve clinical decision-making and reduce unnecessary antibiotic exposure in children with viral infections.

this retrospective, single-center study aimed to assess the clinical decision-making process regarding antibiotic prescription in children aged 1 to 24 months hospitalized with rsv-positive acute lower respiratory tract infections (alrti). the study was conducted at dr. behçet uz children's hospital and covered four consecutive rsv seasons (april 2017 - april 2021). rsv infection was confirmed via multiplex pcr. clinical and laboratory variables potentially influencing antibiotic use included fever, respiratory distress, crp levels, leukocyte count, and radiologic findings such as infiltrates on chest x-ray. the study also examined whether antibiotic selection (agent, timing, and duration) was associated with specific clinical profiles or severity indicators. hospitalization cost data were analyzed to estimate the economic burden of antibiotic use in rsv-positive patients. the study contributes to improved antimicrobial stewardship by identifying patterns of potentially unnecessary antibiotic prescriptions in viral respiratory infections. ethical approval was obtained from the local ethics committee (approval no: 2021-634), and the study adhered to the principles of the declaration of helsinki.

Eligibility criteria:
inclusion criteria: * age between 1 and 24 months at the time of hospitalization * laboratory-confirmed rsv positivity via multiplex pcr * hospitalized for acute lower respiratory tract infection * complete hospitalization and clinical data available exclusion criteria: * detection of additional respiratory pathogens on multiplex pcr * discharge against medical advice before treatment was completed * missing or incomplete key clinical, laboratory, or radiologic data * icu admission without full follow-up data

Keywords: respiratory syncytial virus infections anti-bacterial agents health care costs polymerase chain reaction c-reactive protein
resting-state functional connectivity changes during migraine treatment

Conditions: Migraine Disorders

Summary: the purpose of this study is to determine whether reduced frequency of migraine attacks are associated with signal alternation and connectivity of cerebral cortex.

patients with migraine show reduced cortical thickness in regions subserving pain processing, and it is related to increasing headache frequency. in the past, only one study has shown a reversibility consequence of chronic nociceptive transmission, which normalizes when the pain is adequately treated. however, little is known whether these changes predispose to migraine or represent the effect of repeated migraine attacks. our region of interest is reduced frequency of migraine attacks are associated with reversibility of signal alternation and functional connectivity of cerebral cortex. in 30 migraineurs with 8-14days with headache per months who already performed brain magnetic resonance imaging will be recruited. treatment medications such as frovatriptan and topiramate will be used for 6 months. after 6 months, follow-up brain magnetic resonance imaging will be performed. the primary outcome is the longitudinal changes in functional connectivity in pain-processing/modulating brain regions. the secondary outcome is following: 1)longitudinal changes in structural and morphological alterations in brain regions of pain processing; 2)structural, morphological, and functional correlates of treatment response; 3)changes in monthly migraine days, migraine frequecies, headache days, and headache frequencies after treatment; 4)responses to acute migraine treatment.

Eligibility criteria:
inclusion criteria: * premenopausal women * aged 18-50 * drug-naïve high frequency episodic migraineurs (8-14 attacks/m) * performed a baseline interictal brain mri exclusion criteria: * medication overuse * chronic pain other than migraine * on treatment of major depression, bipolar, schizophrenia, or bdi\>25
report of the survival outcomes of patients with esophageal cancer after definitive radiotherapy in china

Conditions: Esophageal Neoplasms

Summary: in this study, data of esophageal cancer patients undergoing definitive radiotherapy in 14 institutions from various provinces in china were evaluated to help strengthen confidence in anti-cancer, including rehabilitation, economic burden, and quality of life.


Eligibility criteria:
inclusion criteria: 1. patients with esophageal cancer who received definitive radiotherapy (radiotherapy dose ≥50gy) from 2015 to 2016 2. age ≥ 18 3. the radiation field included primary esophageal tumor with or without lymph node metastasis exclusion criteria: 1. radiotherapy dose \< 50gy 2. palliative radiotherapy 3. the radiation field are metastatic areas, such as bone, brain, adrenal gland, isolated metastatic lymph nodes, etc
effect of raltegravir in patients with acute tropical spastic paraparesis - human t-lymphotropic virus 1 infection

Conditions: HTLV-I Infections; Tropical Spastic Paraparesis

Summary: this is a pilot study of intervention in a group of patients with tropical spastic paraparesis/ myelopathy to evaluate virologic and clinical response of raltegravir plus zidovudine in this group of patients.

the study will the investigators develop in the tropical medicine institute alexander von humboldt that is a referral center in peru for diseases associated to human t-lymphotropic virus 1 infection (htlv-1). the institute has a cohort of around 600 patients currently being followed up and around 20 to 25 new patients are admitted every year with this disease. this is a pilot study of intervention in a group of patients with tropical spastic paraparesis/ myelopathy to evaluate virologic and clinical response of raltegravir plus zidovudine in this group of patients on the follow-up of 48 weeks.

Eligibility criteria:
inclusion criteria: * human t lymphotrophic virus 1 confirmed * tropical spastic paraparesis of recent onset (less than 4 years) exclusion criteria: * pregnant or breastfeeding or unwilling to use contraception. * treatment with immunosuppressive, immunomodulatory or experimental treatments within the last 6 months of enrolment in the study. * patients presenting with medical disorder such as poorly controlled diabetes or arterial hypertension, severe cardiac insufficiency, unstable ischemic heart disease, abnormal liver function tests (\>2.5 times upper limit normal (uln)) and abnormal complete blood count (in particular leukopenia, as defined by a lymphocyte count \<500, neutrophil \<1.5 or platelet count \< 100, or thrombocytopenia \< 1.5 low limit normal (lln), or any medical condition which, in the opinion of the chief investigator, would pose additional risk to the patient. * presence of human immunodeficiency virus antibodies. * patients with active hepatitis b or/and c with liver function tests \>2.5 times uln * exposure to any other investigational drug within 30 days of enrolment in the study.
an observational study of avastin (bevacizumab) in combination with interferon alpha-2a as first-line treatment in patients with advanced and/or metastatic renal cell carcinoma

Conditions: Renal Cell Cancer

Summary: this observational study will evaluate the safety and efficacy of avastin (bevacizumab) in combination with interferon alpha-2a as first-line treatment in patients with advanced and/or metastatic renal cell carcinoma. data will be collected from each patient as per routine clinical practice of the investigator (maximum of 52 weeks, until disease progression /unacceptable toxicity or withdrawal of consent) and/or based on the local label.


Eligibility criteria:
inclusion criteria: * adult patients, \>/= 18 years of age * advanced and/or metastatic renal cell carcinoma * receiving first-line treatment with avastin and interferon alpha-2a according to standard of care and current local label * at least one measurable and non-measurable lesion according to recist criteria * eastern cooperative oncology group (ecog) performance status 0-2 * adequate bone marrow, renal and liver function exclusion criteria: * contraindications to avastin and/or interferon alpha-2a as per local label
nutritional supplement and bone health in post-menopausal women

Conditions: Bone and Bones; Osteoporosis Risk; Osteoporosis, Postmenopausal

Summary: the process of bone remodeling exhibits pronounced diurnal pattern that is important for bone health. a balanced rate of bone resorption is required to maintain bone health, a balance that can be disturbed during the lifecycle to effect net rate of formation (as occurs during growth and development to adulthood) or net resorption (as occurs, for example, during the menopause).the research to be undertaken investigates the pluripotent effect of dairy-based products on the regulation of the diurnal process of bone metabolism in post-menopausal women at risk of osteoporosis.

study design: a block randomised, cross-over design of 24h rates of bone turnover in healthy, post-menopausal women with osteopenia receiving either a milk-based protein supplement (mbps) or isoenergetic placebo control (placebo). participants: 16 post-menopausal women with osteopenia as determined by site-specific bone mineral density bmd (dxa) diagnosed and screened by a clinician and for dietary intake of calcium and vit d by a clinical dietitian. subject screening (clinical examination) and dietary intake of calcium and vit d (by food frequency questionnaire) will precede the experimental protocol. experimental protocol and data collection: subjects will attend for a 2 day and 2 night (overnight) residence equipped to conduct residential human trials. the subjects' programmed protocol is as follows; 1. arrive @ 17:00h with overnight bag; 2. empty bladder and then provide and retain urine samples for the duration of the stay (assisted collection by researchers); 3. consume a standardised evening meal (pre-prepared by the research dietitian) and then relax reading/watching films etc; 4. at 20:00h a research nurse will insert a cannula into a superficial arm vein and a blood draw (5ml) will be taken and processed for later analysis; 5. further blood draws (5ml) will be taken at 22:00h, 2300h, 2400h,0100h and 0200h and the cannula withdrawn; 6. at 22:00h consume either placebo control (placebo) (day 1) or supplement (mbpm)(day 2) - or vice versa - in randomised order. 7. retire to bedroom; 8. consume a standardised breakfast and lunch (pre-prepared by the research dietitian) whilst living in and around the university grounds (i.e. in close proximity to ensure 24h urine collection is complete); 9. repeat from 2 above to end of 2nd day.

Eligibility criteria:
inclusion criteria: post-menopausal women aged 50-70y. assessed by site-specific bmd to be osteopenic. assessed by clinical screen to be otherwise healthy and free from other illness or current medication likely to influence the study outcome. exclusion criteria: intolerance to dairy-based food products

Keywords: post-menopausal osteoporosis bone turnover markers dairy products
family mid-upper arm circumference (muac) follow-up after recovery from acute malnutrition (modam-fmuac)

Conditions: Severe Acute Malnutrition; Moderate Acute Malnutrition

Summary: protocols for the community-based management of acute malnutrition (cmam) have not changed significantly for more than 20 years, with relatively complex treatment protocols and persistent supply chain challenges that have limited overall program coverage, leaving millions of malnourished children without care annually. the overarching goal of this research project is to simultaneously test two novel simplified approaches in cmam with potential to improve program coverage. the simplified approach includes two parallel clinical trials for sam and mam treatment. for the family muac follow-up study, children who recover from these two parallel clinical trials will be enrolled in trial to test the effectiveness of muac screening at home by the child's caregivers as a self-referral strategy, compared to a scheduled health facility-led strategy and the standard of care of community-based follow-up visits.


Eligibility criteria:
inclusion criteria: * children 6-59 months of old who recovered from sam or mam following treatment in either the modam-sam or modam-mam trials exclusion criteria: * caregiver not planning on remaining in the local area for the subsequent 6 months
investigation of vitamin d3 enriched, reduced-fat yellow cheese efficacy to prevent vitamin d deficiency

Conditions: Hypovitaminosis D; Deficiency of Micronutrients

Summary: the primary aim of the current study was to investigate whether the consumption of vitamin d3 enriched, reduced-fat yellow cheese can counterbalance the expected decrease in serum 25-hydroxyvitamin d concentration during winter in postmenopausal women in greece, and in what degree it can contribute as a potential food-based strategy for the prevention of vitamin d deficiency. a secondary aim was also to investigate any potential effect of the intervention in several quality of life (qol) indices in the population of postmenopausal women under study.

vitamin d status in postmenopausal women is of interest because of the association of low vitamin d status with increased risk of osteoporosis and related fractures. in addition, since there is increasing evidence that the dietary supply is often insufficient to offset the seasonal deficit in sunlight during winter months, fortified food and supplements are becoming important sources of dietary vitamin d intake to achieve optimal vitamin d status, especially in this high risk population. although most studies have examined the effectiveness of vitamin d enriched milk and yogurt, there have been limited studies also exploring the effectiveness of vitamin d enriched cheese in enhancing vitamin d status and preventing vitamin d deficiency. however, fortification of cheese with vitamin d has certain technological considerations, particularly for reduced-fat varieties considering that vitamin d is a fat soluble nutrient. the primary aim of the current study was to investigate whether the consumption of vitamin d3 enriched, reduced-fat yellow cheese can counterbalance the expected decrease in serum 25-hydroxyvitamin d concentration during winter in postmenopausal women in greece, and in what degree it can contribute as a potential food-based strategy for the prevention of vitamin d deficiency. a secondary aim was also to investigate any potential effect of the intervention in several quality of life (qol) indices in the population of postmenopausal women under study. .

Eligibility criteria:
inclusion criteria: * subjects are eligible if they are 55-75 years of age * being at menopause for more than 5 years * they used to consume cheese daily * those with a body mass index (bmi) range 20-33kg/m2 exclusion criteria: * having any disease/ pathology that interacts with vitamin d metabolism * taking medications that interact with vitamin d metabolism or vitamin d supplements for medical reasons (e.g. osteoporosis) * planned vacation to a sunny holiday destination during the intervention period * having a cow's milk allergy * having a drugs and/or alcohol abuse

Keywords: vitamin d status 25-hydroxyvitamin d cheese randomized controlled trial postmenopausal women enriched vitamin d3
foley catheter versus vaginal misoprostol for cervical ripening and induction of labor

Conditions: Pregnancy, Prolonged; Pre Eclampsia; Oligohydramnios

Summary: purpose: the purpose of this study is to determine the effectiveness of balloon dilatation (foley) with vaginal misoprostol for cervical ripening and induction of labor. method: a randomized clinical assay has been performed with 160 women with indication of induction of labor, randomly divided in two groups, 80 for foley catheter and 80 for misoprostol.

the cesarean delivery rate has risen dramatically in almost all world. brazil shows the highest rate in the world so we need urgently efforts to reduce this fact. several studies have shown that maternal morbidity and mortality rates are higher in cesarean deliveries. on the other hand an abdominal delivery cost much more than a vaginal delivery. a clinical trial to assess the performance of two simple and sheep methods can provide evidence based on local experience. our results alow us to recommend both methods for clinical practice with a good possibility to reduce cesarean rates and without adverse events.

Eligibility criteria:
inclusion criteria: * gestational age from 37 weeks, * feto unic, alive and cephalic, * bishop index equal or lesser than four. exclusion criteria: * uterine scar, * premature rupture of the membranes, * fetal weight bigger than 4000 g, * previous placenta, * conditions that imposed the immediate ending of the gestation.

Keywords: balloon dilatation, misoprostol, cervical ripening, obstetric labor, labor induced.
evaluation of cerebral small vessel disease in patient with primary aldosteronism

Conditions: Evaluation of Cerebral Small Vessel Disease in Patient With Primary Aldosteronism

Summary: hypertension is known to be the major risk factor for stroke. the most common cause of secondary hypertension, primary aldosteronism (pa), is characterized by the excessive secretion of aldosterone and is related to hypertension and hypokalemia. pa accounts for 3-10 % of hypertensive patients, and a higher incidence of vascular complications compared to patients with essential hypertension was observed in several studies. the vascular injury from excessive aldosterone can occur via oxidative stress and collagen remodeling, causing endothelial dysfunction and fibrosis in the vasculature. the association between cerebral small vessel disease (csvd) and hypertension has been well studies in the past decades. however, not much study has focused on the csvd burden in patient with pa. the goal of this study is to understand the features of csvd in patients with pa and for the purpose of understanding the underlying pathophysiology of cerebrovascular injury in this particular patient group.


Eligibility criteria:
inclusion criteria: * age between 20-90 years-old * patient with primary aldosteronism or healthy control * consciousness clear * willing to receive brain mri exclusion criteria: * renal failure or creatinine \> 2mg/dl * coagulopathy or hepatic insufficiency * unstable vital sign under inotropic agents * pregnancy * metal implant or cardiac pacemaker * major brain surgery

Keywords: hypertension,primary aldosteronism
the effects of unstable shoes on chronic low back pain

Conditions: Low Back Pain

Summary: some physicians, physiotherapists and nurses use or even suggest unstable shoes in cases of low back pain. no studies on the real effects of these shoes on low back pain in health care professions have been carried out and therefore as yet there is no real evidence of their effectiveness. thus the investigators assume that wearing unstable shoes over a period of six weeks could reduce low back pain and functional disability due to the changes of the gait and posture and may increase the quality of life. the purposes of this study are: 1. to evaluate the modifications of pain level, functional capacity and quality of life among individuals with moderate level of non-specific chronic low back pain after wearing unstable shoes. 2. to quantify biomechanical modifications of gait and posture.


Eligibility criteria:
inclusion criteria: * employees of geneva university hospital * working in a standing position for at least 50% of their working day * aged between 30 and 65 * having chronic low back pain that has been defined at least 3 out of 10 on a visual analogue scale during the last 3 months or the need to take regular pain medication for this reason exclusion criteria: * having severe pain in other body parts * undergone back surgery, neurological or balance problems * inability to walk a distance of 100 meters * already worn unstable shoes and being off of work because of low back pain

Keywords: low back pain unstable shoes gait balance