Kornimate/medical-research-clean huggingface dataset:
role of placental growth factor (plgf) in the management of non-severe preeclampsia

Conditions: Pregnancy; Pre-eclampsia, Mild

Summary: preeclampsia is an important disease that develops during pregnancy and it is one of the main contributors to maternal and fetal complications. the only known definitive treatment is delivery. although delivery is always appropriate for the mother, it might not be the best for a very premature neonate. in cases of non-severe preeclampsia there no benefit delaying delivery beyond 37 weeks. it is also well established that before 34 weeks an expectant management confers perinatal benefit with minimum amount of additional maternal risk. there is then an area of uncertainty between 37 and 37 weeks. this is why in this period it is a clinical need to select high risk patients of complications that will benefit from labor induction, and differentiate them from low risk patients that can be manage expectantly until 37 weeks. placental growth factor (plgf) is an angiogenic factor that is lower in pregnant women with preeclampsia and current evidence shows that it as a predictor of adverse pregnancy outcome and requirement of delivery. circulating levels of pigf at 34 weeks could help to identify those women that may benefit from labor induction and those where delivery can be delayed until 37 weeks with low risk for maternal complications.

background the current definition of pre-eclampsia is a new onset hypertension (\>140/90mmhg) and proteinuria (\>0'3g per 24 hours) after 20 weeks of gestation. pre-eclampsia affects 3% to 8% of all pregnancies and it is a leading cause of maternal and neonatal morbidity and mortality. it has been subclassified by clinical severity in severe and non-severe and by gestational age at the diagnosis in early and late onset pre-eclampsia (\>34 weeks of gestation). pre-eclampsia is associated with abnormal placentation and uterine angiogenesis. pregnant women with preeclampsia show lower circulating levels of placental growth factor (plgf), a proangiogenic factor related to placental angiogenesis, compared with healthy pregnant women. moreover evidence has been found regarding the role of plgf as a predictor of adverse pregnancy outcome and requirement of delivery. the only definitive treatment of the disease is delivery. in patients with non-severe preeclampsia between 34 and 37 weeks there is no consensus regarding the ideal time of delivery. aim: the aim of this study is to assess whether circulating levels of pigf at 34 weeks could help to identify those women that may benefit from labor induction and those where delivery can be delayed until 37 weeks with low risk for maternal complications.

Eligibility criteria:
inclusion criteria: * \> or = 18 years * pregnant women with non-severe preeclampsia * gestational age between 34 and 36.5 weeks exclusion criteria: * no exclusion criteria are defined (intention-to-treat analysis)
a phase iii study of civamide nasal solution (zucapsaicin) for the treatment of episodic cluster headache

Conditions: Episodic Cluster Headache

Summary: this is a 49-day study to evaluate the effectiveness of intranasal civamide (zucapsaicin) in the treatment of an episodic cluster headache period compared to placebo (medically inactive substance which does not contain any active ingredients).


Eligibility criteria:
* at least 2 year history of episodic cluster headache (meeting ihs criteria) * at least 2 previous episodes * expected duration of cluster period is at least 6 weeks but not longer than 16 weeks * at least 1 but not more than 8 headaches on each of the 3 days immediately prior to treatment

Keywords: headache cluster ec episodic cluster
does use of a wound after-care summary improve patient satisfaction and time to wound healing?

Conditions: Wounds

Summary: the purpose of this research study is to evaluate a patient education program for chronic wound care. the wound care nurse practitioner (np) at the ann arbor vamc will use a wound self-management "after-care summary" with approximately half of her patients. this study will examine whether using this patient education tool for self-management of wound care results in improved patient outcomes.


Eligibility criteria:
inclusion criteria: all patients presenting for outpatient wound care at the ann arbor va medical center np wound care clinic, who meet the following inclusion criteria for chronic wounds: stage ii, iii, iv pressure ulcers; venous stasis ulcers, and diabetic ulcers. exclusion criteria: cognitively impaired patients who cannot give informed consent.

Keywords: wound healing self-management patient education
is there increased polyethylene wear and increased periprosthetic bone loss in femur in reverse hybrid technique compared with conventional cemented technique in total hip replacement?

Conditions: Osteoarthritis

Summary: total hip replacement is a very cost effective procedure to enhance life quality in a group of patients. in the period 2000-2004 7-8000 procedures were preformed, 13% were revisions (1). historically, many different principles have been used from the first resurfacings to cemented and uncemented total hip replacements as we know them today. in 2000, 28 different femoral stems and 26 different acetabular components were in regular use in norway. there are several well-documented cemented acetabular components, but no such uncemented cup. on the femoral side there are several well-documented stems both cemented and uncemented. (2). from the late 1990's a reverse hybrid (uncemented stem and cemented cup) is being more frequently used. in 2004 a total of 276 reverse hybrid hips were done and the trend is increasing. (1). this technique is solely based on experience and the fact that one combines the better of two principles (cemented and uncemented). there is no scientific evidence that this technique is as good or better than a cemented thr. one of the potential problems with hydroxyapatite coated components is that it is suspected that it may increase wear due to the particle theory. (3,4). there are no prospective randomised controlled rsa and dxa studies that conclude on this matter. this is such a study and our hypothesis is that there is no difference in wear or osteolysis between the methods.


Eligibility criteria:
inclusion criteria: * osteoarthritis * indication for thr exclusion criteria: * significant anatomical abnormalities * rheumatoid artheritis, dysplasia, fracture sequela

Keywords: thr reversed hybrid wear
clinical study assessing a new scale to measure onset of action in generalized anxiety disorder

Conditions: Anxiety Disorders

Summary: the study is to assess the performance characteristics of a new measure to assess onset of efficacy in a gad patient population.


Eligibility criteria:
inclusion criteria: * primary diagnosis of gad (dsm iv, 300.02) as established by the clinician using all sources of data including the mini structured interview * ham a score ³20 at the screening (study day -7) and baseline (study day 1) visits by observer rating * good health as determined by medical history, physical examination, vital signs, electrocardiography (ecg), and clinical laboratory measurements * covi anxiety scale total score ³9 and raskin depression scale total score £7 at the screening visit (to ensure predominance of anxiety symptoms over depression symptoms) * age 18 to 65 (inclusive) exclusion criteria: * patients with most other current dsm-iv axis i disorders. * patients with current or past schizophrenia, psychotic disorder * delirium, dementia, amnestic, and other clinically significant cognitive disorders * bipolar or schizoaffective disorder * benzodiazepine abuse or dependence; and/or factitious disorder.

Keywords: generalized anxiety disorder onset of efficacy daily assessment of symptoms-anxiety (das-a) methods
ototoxicity of artemether / lumefantrine (coartem) and other antimalarials

Conditions: Malaria

Summary: the purpose of the study is to evaluate the potential side-effects of artemether / lumefantrine and other antimalarials on the auditory function.

artemisinin based combination therapies (act) currently are the most promising treatment options for uncomplicated falciparum malaria. there have been controversial reports about possible ototoxicity of artemether / lumefantrine (coartem®) from retrospective studies. in this investigation treatment of uncomplicated malaria with artemether / lumefantrine, quinine, where side-effects on hearing are known, or atovaquone / proguanil, where no such effects have been reported, are compared. auditoy function is examined (auditory brainstem response, pure-tone audiometry, otoacustic emissions) before treatment, after 7, 28, and, for determination of irreversibility, after 90 days.

Eligibility criteria:
inclusion criteria: * patients aged above 5 years * uncomplicated falciparum malaria * axillary temperature ≥37,5°c or history of fever within the previous 24 hours * ability to tolerate oral therapy * informed consent by the patient or by parent/guardian for children * residence in study area exclusion criteria: * known or suspected hearing deficits * adequate anti-malarial treatment within the previous 7 days * mixed infection * danger signs and signs of severe malaria as defined by the who * presence of severe underlying disease (cardiac, renal, hepatic diseases, malnutrition, known hiv infection) * concomitant disease masking assessment of response * history of allergy or intolerance against study medications * pregnancy
evaluate the efficacy and security of darunavir/ritonavir 900/100 mg once a day as an antiretroviral treatment simplification strategy

Conditions: HIV Infections

Summary: basing in studies which have related the darunavir (drv) virtual inhibitory quotient (viq) with the virological response, it is possible to think in the possibility of simplifying the rescue treatment with drv/ritonavir to 900/100 mg once a day in those patients who are being treated with drv/ritonavir 600/100 mg twice a day and who, besides having undetectable viral load, have a viq over 2. this strategy would not jeopardize the efficacy of the antiretroviral treatment and would have less impact in the lipid profile of the patients as well as less pharmaceutical expenditure.

the probability of achieving viral replication suppression during the treatment with drv has been related to both the extent of viral resistance to drv (inhibitory concentration 50%, ic50) and the drug concentration. moreover, the drv virtual inhibitory quotient (viq) has been related significantly with the virological response to drv treatment. so patients with a drv viq \>= 1,5 had a 8-times higher probability of having viral load \< 50 copies/ml after 24 weeks of treatment than those having a viq \< 1,5. considering the previous arguments, it is possible to think in the possibility of simplifying the rescue treatment with drv/ritonavir to 900/100 mg once a day in those patients who are being treated with drv/ritonavir 600/100 mg twice a day and who, besides having undetectable viral load, have a drv viq over 2. this strategy would not jeopardize the efficacy of the antiretroviral treatment and would have less impact in the lipid profile of the patients as well as less pharmaceutical expenditure.

Eligibility criteria:
inclusion criteria: 1. age \>= 18 years. 2. hiv-infected patients. 3. stable antiretroviral treatment including darunavir/ritonavir 600/100 every 12 hours for at least 4 weeks. 4. hiv viral load \< 50 copies/ml for at least 12 weeks. 5. resistance test (genotype or virtual phenotype) before starting tipranavir treatment. 6. darunavir viq \>= 2. 7. subject able to follow the treatment period. 8. in women, negative pregnancy test or not in fertile age (defined as at least one year from menopause or undergoing any surgical sterilisation technique), or undertaking to use a barrier contraceptive method during the study. 9. signature of the informed consent. exclusion criteria: 1. aids-defining illness in the last 4 weeks. 2. suspicion of unsuitable antiretroviral treatment compliance. 3. in women, pregnancy or breastfeeding. 4. record or suspicion of incapability to cooperate as appropriate.

Keywords: darunavir/ritonavir virtual inhibitory quotient dose reduction
cortisone injection vs trigger point dry needling fin the treatment of greater trochanter pain syndrome: a pilot study

Conditions: Hip Injuries

Summary: the purpose of this study is to determine if trigger point dry needling (tdn) is as effective as cortisone injection (ci) in reducing pain and improving function in patients with greater trochanteric pain syndrome (gtps).

this study aims to investigate the potential of tdn as an effective alternative to ci for patients with gtps by directly comparing pain and functional outcomes of patients receiving tdn or ci for the treatment of gtps over a 6 week period. the investigators hypothesize that patients treated with tdn will be equally improved in pain and function as those treated with ci. if tdn is demonstrated to be equally or more effective than steroid injection in this pilot study, then the investigators have the basis to launch larger studies. ultimately, the investigators want to determine if tdn is an effective treatment alternative for gtps for providers and patients who want to avoid the potential detrimental side-effects of steroids. approach: prospective, randomized, partially-blinded design aim: to determine if administration of tdn is as effective as ci in reducing lateral hip pain and improving function in patients diagnosed with greater trochanteric pain syndrome. the investigators expect to demonstrate effectiveness of tdn in the treatment of gtps to a degree that is equal to ci. doing so would prompt further outcomes research for tdn. supportive research and subsequent clinical acceptance of tdn as a primary treatment for this condition would offer an alternative to patients who want or need to avoid steroids. based on the literature, this is the first study to investigate the effectiveness of tdn in the treatment of gtps and directly compare pain and functional outcomes of patients receiving tdn versus ci for the treatment of gtps. methods. fifty patients with gtps will be randomized into a ci or tdn group. treatment will be administered according to standard of care for up to 6 weeks. numerical pain and functional ratings for each patient will be collected at 0, 1, 3, and 6 weeks of treatment. data analysis will determine if tdn is as effective as cortisone.

Eligibility criteria:
inclusion criteria: * 18+ years old * lateral hip pain (anywhere from iliac crest to mid itb) * active email account exclusion criteria: * low back pain associated with the hip pain * motor and/or sensory impairment consistent with radiculopathy * active infection/malignancy of the hip * connective tissue disease * pregnancy * non-english speaking
evaluation of the effectiveness of resistance training in patients with psoriatic arthritis

Conditions: Psoriatic Arthritis

Summary: the aim of this study was to assess the effectiveness of resistance training in improving functional capacity, muscle strength, quality of life and disease activity in patients with psa.

the ig patients performed resistance exercises for the following muscles group: upper limbs, lower limbs and trunk. it was used a machine "leg extension" for the training on the lower limbs. for upper limbs we used a pulley triceps machine and front pull in addition to free weights (dumbbells). in order to perform the exercise program the study followed all the recommendations established by the american college of sports medicine (acsm) (ratamess et al., 2009). it was carried out two exercises for major muscle groups and one exercise for small muscles. the exercises were divided in 3 sets of 12 repetitions for each muscle group. the intensity of the exercises were 60% of one-maximum repetition (1rm). the exercise program involved pectoral exercises: crucifix and seat supine; biceps: alternated screw; triceps: triceps pulley; back: standing handsaw and pulled ahead; quadriceps: leg extensor and finally gluteo: standing hips extension. control group (cg) the control group was kept in a waiting list while continued with the standard pharmacological treatment during all the study. the patients were instructed to maintain their daily activities and to avoid any other non-pharmacological treatment. the exercise program was offered to the control group in the end of the study.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of psoriatic arthritis, according to the caspar criteria * between 18 and 65 years of age, of both genders who agreed and signed the consent form. * patients should be-modifying drugs (dmards) on stable doses for at least three months and doses of non-steroidal anti-inflammatory drugs and corticosteroids stable for at least 4 weeks exclusion criteria: patients were excluded: * uncontrolled cardiovascular disease * decompensated diabetes mellitus; diseases * severe psychiatric * fibromyalgia * other medical conditions that most disabling ea * history of regular exercise (at least 30 minutes 2 times per week) during the last 6 months * arthroplasties of the hip and / or knee in the last 12 months; and * any other medical condition that prevents the patient from performing resistance exercises

Keywords: physical exercise psoriatic arthritis quality of life
a four session online occupational therapy group traninig for mothers of children with feeding problems

Conditions: Feeding and Eating Disorders; Child Behavior Problem; Feeding Behavior; Online Intervention; Occupational Therapy

Summary: feeding problems such as selective eating, loss of appetite, and mealtime behavior problems are common in childhood. parents play a primary role in learning about feeding, and difficulties experienced in this process may cause the parent to experience stress, despair and exhibit incorrect attitudes. the aim of this study is to examine the effect of online occupational therapy group training for mothers on mothers' attitudes and stress levels, and children's eating behaviors. mothers of children aged 3-6 years with feeding problems (n=29) were randomly divided into groups. early childhood adaptive eating behavior scale, feeding process mother attitudes scale and state-trait anxiety inventory scales were used for evaluation. the mothers in the research group participated in the 4-week training. as a result of the research, positive effects were found on mothers' attitudes and children's eating behaviors (p\ 0.05). this study shows that online group training to mothers can support existing therapies and guides clinicians working in the field.


Eligibility criteria:
inclusion criteria: * being a mother with a child between 37-72 months of age, * experiencing feeding problems with their child, * having the ability to understand the training and comprehend the scale items, * volunteering to participate, * having the competence to use online platforms, tools, and the internet connection. exclusion criteria: * receiving special education and/or occupational therapy sessions due to any risk, * having any chronic disease or disability in their child.

Keywords: feeding and eating disorders mother-child relations online group intervention occupational therapy
comparison between neosorb plus and neosorb

Conditions: Skin Reaction to Suture Material

Summary: this study is to investigate whether neosorb plus antibacterial suture (chlorhexidine diacetate coated pgla910) is not inferior to neosorb suture (pgla910) in the points of intraoperative handling.

1. enrollment 1. urologic surgery which needs fascia and subcutaneous tissue repairs 2. clean and clean-contaminated surgery 3. patients aged more than 18 years and under 80 years 2. randomization 1. neosorb plus (chlorhexidine diacetate coated pgla910) or neosorb (pgla910) suture 2. stratification by operative methods: open surgery vs. laparoscopic or robot-assisted laparoscopic surgery 3. follow-up with 30 days 1. primary endpoint: intraoperative handling during operation 2. secondary endpoint: wound healing assessment on postoperative 1st (+1) days and 11th (± 4) days 3. safety evaluation: counting adverse events within postoperative 30 days

Eligibility criteria:
inclusion criteria: * urologic surgery which needs fascia and subcutaneous tissue repairs * clean and clean-contaminated surgery exclusion criteria: * contaminated surgery * wound requiring retention suture * suspicious malnutrition status * active infection status or aids * incision sites prone to expand, stretch, distend, or require support * allergy or hypersensitivity to chlorhexidine diacetate * significant active medical illness which in the opinion of the investigator would preclude protocol treatment
endoscopic transcanal tympanoplasty with attico-antrostomy versus endoscopic-assisted canal wall up mastoidectomy in management of localized cholesteatoma: a randomized clinical trial

Conditions: Cholesteatoma

Summary: the main objective of the study is to compare endoscopic transcanal tympanoplasty with attico-antrostomy with endoscopic assisted canal wall up mastoidectomy in treatment of limited attic cholesteatoma.


Eligibility criteria:
inclusion criteria: * cases of cholesteatoma limited to the middle ear and/or attic but not extending beyond the posterior end of the lateral semicircular canal (lscc) proved radiologically with computed tomography (ct) scan exclusion criteria: * cases in which cholesteatoma extended beyond the attic were excluded as being potentially beyond the limits of the tees approach
sleep apnea and vascular function

Conditions: OSA

Summary: obstructive sleep apnea (osa) is associated with endothelial dysfunction and the development of cardiovascular disease. it is unclear how osa results in endothelial dysfunction, but given the association between osa and obesity, adipose-derived hormones (adipokines) are likely to be involved. leptin, an adipokine upregulated in patients with osa, has been shown to be associated with deleterious effects on vascular function resulting in impaired endothelial function. this proposal is directed at investigating the molecular mechanisms of endothelial dysfunction in osa patients. we hypothesize that endothelial dysfunction associated with osa is a result of molecular alterations within endothelial cells. as a part of these studies we will look at no signaling pathways in adipose tissue and microvessels from normal and osa subjects.


Eligibility criteria:
inclusion criteria: * non osa, and newly diagnosed osa subjects, naïve to cpap treatment, aged 18-65 years, with bmi less than or equal to 55 kg/m2, who are free of all chronic diseases including diabetes, and cardiovascular diseases, will be recruited for our study. subjects with dyslipidemia and hypertension will be allowed to participate in the study. subjects taking anti-depressents, and anithypertensives will be allowed to participate in the study. also, subjects taking beta blockers and beta agonists will be allowed to participate in the study. if a subject is on aspirin or any other anti-inflammatory medication but free of known vascular disease and depending on the indication, the study doctor may ask the subject to suspend aspirin or anti-inflammatory therapy for 7 days prior to participation in the study. in the event that the subjects does not stop the aspirin or other anti-inflammatory medication, they will not be able to participate in the study because of the risk of bleeding during the fat biopsy. exclusion criteria: * body weight \>450 pounds (204.5kg) * pregnancy. * anemic (hemoglobin \<13.5 g/dl for men and \<12.0 g/dl for women. * postmenopausal * smoking * use of chronic medications (aspirin, statins, anti-inflammatory drugs)