Kornimate/medical-research-clean huggingface dataset:
the effects of local infiltration versus epidural following liver resection 2

Conditions: Open Liver Resection

Summary: the investigators plan to compare epidurals versus wound catheters for effects on pain relief and recovery following open liver surgery.


Eligibility criteria:
inclusion criteria: * patients undergoing open hepatic resection for benign or malignant conditions. exclusion criteria: * patients with contraindication to either epidural or wound catheter techniques. * inability to give written, informed consent. * jaundice (bilirubin \> 100 μmol/l) * liver resection combined with secondary surgical procedure. * age \< 18 years * pregnant women * patients on long term opiates for chronic pain

Keywords: epidurals wound catheters liver resection liver surgery
evaluate the efficacy of selenium for the prevention of chemotherapy-induced mucositis during autologous stem cell transplantation.

Conditions: Mucositis Oral; Stem Cell Transplant Complications

Summary: chemotherapy-induced mucositis is an important complication after autologous stem cell transplantation. it is mainly responsible for pain and dysphagia requiring opioids and artificial nutrition. it can also induce infectious complications. a few medication has demonstrated efficacy in this setting. it has been suggested that selenium can reduce the intensity of mucositis due to its antioxydant activity. the investigators therefore perform a randomized study to confirm this preliminary data.


Eligibility criteria:
inclusion criteria: * adult patients receiving autologous stem cell transplantation for lymphoma or myeloma. * signed informed consent. exclusion criteria: * autologous stem cell transplantation for another medical condition than lymphoma or myéloma. * intolerance to selenium. * high selenium levels before study. * pregnancy or patients breast-feeding.
a study to determine the number of participants with rheumatoid arthritis (ra) who meet the requirements for treatment with anti-tumor necrosis factor α (tnfα) in a general hospital setting in korea

Conditions: Rheumatoid Arthritis

Summary: this is an observational study to estimate the proportion of patients diagnosed with ra visiting a medical internist in a general hospital in korea who are candidates for anti-tnf α therapy.


Eligibility criteria:
inclusion criteria: * diagnosed with ra * visiting a medical internist in a study site during the study period on out patient basis * able to give written informed consent voluntarily exclusion criteria: none

Keywords: rheumatoid arthritis anti-tnf α
genetic studies in breast cancer

Conditions: Breast Cancer; Ovarian Cancer

Summary: the purpose of this study is to determine the specific genetic alterations associated with breast cancer. this will leat to a better understanding of the genetic causes of breast cancer.

it is estimated that 175,000 new breast cancer cases and 44,5000 cancer deaths will result from female breast cancer in 1991. one of the most important risk factors is a family history of breast cancer. a susceptibility allele which accounts for a large proportion of familial breast cancer has been localized to chromosome 17q and attempts to clone the susceptibility are proceeding rapidly. the existence of recognized susceptibility loci and the awareness of a significan proportion of genetic predisposition and the associated penetrances remain unknown and are impossible to estimate without bias from previous studies. this study is designed to estimate heterogeniety and prenetrance in a series of unslected families, identify additional breast cancer susceptibility locs, as well as provide resources for gene isolation and mutation analysis studies.

Eligibility criteria:
inclusion criteria: * patient with breast cancer under age 41 * patient with bilateral breast cancer 41-50 years old or 41-50 years old with a first degree relative (mother, sister, daughter) with breast cancer diagnosed under age 50 * patient with ovarian cancer with first degree relative with either ovarian cancer diagnosed at any age or breast cancer diagnosed under age 60 * patient any age with either ovarian or breast cancer who have 2 first degree rleatives with either ovarian cancer diagnosed at any age or breast cancer diagnosed under age 50 * relatives of any of the above patients will be included in this trial if a genetic abnormality is found in the patient's blood sample exclusion criteria: n/a

Keywords: breast cancer ovarian cancer family history genetic studies
acupuncture in the management of post operative symptoms in breast cancer patients

Conditions: Breast Cancer

Summary: this study is for the woman who will have axillary (armpit) surgery as part of their breast cancer treatment. the purpose of this project is to evaluate if acupuncture is helpful to control pain and improve range of motion (arm movement). another goal is to find out if women have an improvement in their quality of life. this study is being done in collaboration with the oregon college of oriental medicine (ocom).


Eligibility criteria:
inclusion criteria: * female subjects * expected survival at least 6 months or greater * has had surgery with axillary dissection * greater than 6 nodes removed during surgery * greater than 21 years of age exclusion criteria: * previous mastectomy * double mastectomy at the time of current axillary surgery * any diagnoses of autoimmune disease * pregnant or lactating women * unable to provide written informed consent * suspected or diagnosed fibromyalgia * previous shoulder injuries for the specific arm that will undergo axillary dissection * known or suspected drug or alcohol abuse as determined by the investigator * decreased range of motion (rom) as evidenced on standard preoperative exam * previous acupuncture (lifetime)

Keywords: acupuncture range of motion quality of life
a pilot study to examine efficacy of peer mentoring in promoting medication adherence among people living with hiv/aids

Conditions: HIV

Summary: this study aims to investigate the effectiveness of an in-person peer mentoring and health literacy intervention on improving medication adherence, hiv-1 viral load, cd4+ t lymphocyte counts, and hiv medical appointment attendance among newly-diagnosed and/or medication non-adherent hiv-positive individuals, compared to standard of care provider/staff-delivered education.


Eligibility criteria:
inclusion criteria: all of the following criteria must be met for a participant to be eligible for the study: * confirmed diagnosis of hiv-1 * newly diagnosed and initiating treatment (e.g., treatment naive) or off medications for more than fourteen consecutive days (2 weeks) and re-initiating treatment or currently on antiretroviral therapy with demonstrated ongoing adherence problems (missing more than 3 doses per month) * has a detectable (greater than 50 copies/ml) hiv-1 viral load * is able to obtain hiv medications during the entire study period (e.g., if uninsured, is enrolled in aids drug assistance program). exclusion criteria: subject is ineligible for this study if: * he/she suffers from cognitive impairment, active psychosis, or has a known history of harming others, or * he/she has a severe mental health and/or substance abuse condition that requires residential or inpatient treatment, or * the medical provider believes participation would not be in the best interest of the subject for other reasons.

Keywords: hiv/aids peer mentoring medication adherence medication non-adherent newly diagnosed hiv-positive individuals hiv viral load cd4 lymphocyte cell counts treatment adherence health literacy self-efficacy
incentive programs for female substance abusers who smoke - 3

Conditions: Tobacco Use Disorder

Summary: the purpose of this study is to examine the effects of incentive programs for the treatment of nicotine dependence in women who have problems with substance dependence.

this study will determine the influence of voucher-based cm on reducing smoking (and other drug) use during pregnancy or in post-partum women with children under 1 year of age living with them, or in non-pregnant females who smoke. we are targeting smoking cessation since cigarette use is so prevalent in our service. we will compare a control group to two different voucher-based contingent-reinforcement procedures: one that targets smoking abstinence alone vs. one that offers additional incentives for negative bal and urinalysis results.

Eligibility criteria:
inclusion criteria: * pregnant and or post-partum with at least one child under 1 year old living with them, or non-pregnant, non-post-partum females or previous participant in this study protocol * nicotine dependent as confirmed by dsm-iv checklist * current cigarette smoker * breath co reading of at least 8 ppm at the time of the initial study screening * current client with the shields for families (shields) treatment programs exclusion criteria: * non-smoker

Keywords: nicotine dependence
prednisone in cystic fibrosis pulmonary exacerbations

Conditions: Cystic Fibrosis Pulmonary Exacerbation

Summary: this will be a 5 year randomized, double blind, placebo controlled trial of 7 days of oral prednisone in cystic fibrosis (cf) patients receiving intravenous (iv) antibiotic treatment for a pulmonary exacerbation at the hospital for sick children and other study sub-sites across canada. the intervention will be oral prednisone 2 mg/kg/day (max 60 mg) divided twice daily for 7 days as an adjunctive therapy for pulmonary exacerbations in cf patients who have not recovered their baseline forced expiratory volume in 1 second (fev1) after 7 days of iv antibiotic treatment. the primary outcome will be the proportion of subjects who achieve \>90% of their baseline fev1 % predicted at day 14 of iv antibiotic treatment for a pulmonary exacerbation in each treatment arm.


Eligibility criteria:
inclusion criteria: 1. diagnosis of cf by newborn screening or at least one clinical feature of cf, and either (a) or (b) as follows: 2. a documented sweat chloride ≥ 60 meq/l by quantitative pilocarpine iontophoresis 3. a genotype with two identifiable cf-causing mutations 4. age \> 6 years old. 5. acute pulmonary exacerbation treated with iv antibiotics as previously defined 10% relative drop in fev1 from baseline at the time of exacerbation 6. informed consent by patient or parent/legal guardian 7. ability to reproducibly perform pulmonary function testing 8. ability to comply with medication use including the ability to take capsules, study visits and study procedures as judged by the site investigator exclusion criteria: 1. a respiratory tract culture positive for burkholderia cenocepacia in the 12 months prior to enrollment 2. a respiratory tract culture positive for mycobacterium abscessus in the 12 months prior to enrollment 3. treatment with iv or oral corticosteroids within 2 weeks of enrollment or from day 0-day 7 of the pulmonary exacerbation 4. active allergic bronchopulmonary aspergillosis (abpa) at the time of enrollment as determined by treating physician 5. asthma related exacerbation at enrollment as defined by the treating physician based on clinically compatible symptoms (eg. wheeze) 6. history of avascular necrosis or pathologic bone fracture 7. uncontrolled hypertension with end organ damage 8. active gastrointestinal bleeding 9. status post lung or other organ transplantation 10. pregnancy 11. lactose intolerance (contained in placebo) 12. on lumacaftor-ivacaftor (orkambi) at the time of exacerbation 13. investigational drug use within 30 days prior to enrollment visit 14. physical findings that would compromise the safety of the subject or the quality of the study data as determined by site investigator
two us-guided techniques for greater occipital nerve blocks

Conditions: Primary Headache

Summary: headache is one of the most common reasons for patients to access healthcare. greater occipital nerve (gon) block with local anesthetic and steroid has been described for the management of primary headache refractory to conventional treatment. two ultrasound (us)-guided techniques for greater occipital nerve (gon) block have been described for the management of refractory headache syndromes: a proximal technique performed at the level of the second cervical vertebra and a distal technique performed at the level of the superior nuchal line. our airm is to compare the accuracy, efficacy and safety of these two techniques in patients with refractory headaches.

we conducted a double-blinded, randomized control trial to compare accuracy, efficacy and safety of these two techniques in patients with refractory headache syndromes. following reb approval, 40 patients with moderate or severe refractory headaches (intensity score\>4/10) will be randomized to the "proximal" or "distal" groups with a 1:1 allocation. each patient receives an injection of 2ml of 0.5% bupivacaine with 40mg of methylprednisolone. the null hypothesis is that there is no difference in intensity scores for headache at one month after the interventions. outcomes related to efficacy (numbness immediately after the injection, reduction in episodes of severe headache, sleep quality), performance (time taken for and discomfort during procedure), and safety (incidence of hematoma, intravascular injection) are measured after one month.

Eligibility criteria:
inclusion criteria: 1. features suggestive of occipital neuralgia: pain that begins in the upper neck and back of the head with radiation forward toward the eye and has an aching or burning character. 2. diagnosis of refractory primary headache, any type 3. baseline nrs headache score of \> 4 refractory to conventional oral analgesic therapy (anti-inflammatory drugs, migraine prophylaxis and treatment drugs, opioids). exclusion criteria: 1. ongoing litigation issues related to the patient's pain 2. pregnancy 3. allergy to steroids or local anesthetics 4. multiple serious comorbidities 5. age \< 18 or age ≥ 80 years 6. gon injection within last 3 months at time of entry into the trial

Keywords: primary headache greater occipital nerve ultrasound chronic pain cervicogenic occipital neuralgia migraine tension type headache cluster headache
correlation between comt val158met polymorphism and dopaminergic transporter density (dat) in obese women

Conditions: Obesity

Summary: the present study aims to evaluate the correlation between the presence of comt val158met polymorphism and the density of dopaminergic transporters (dat) in young obese women.

the prevalence of obesity remains increasingly alarming in brazil and worldwide. the most widely recommended therapy for obesity is lifestyle modification, however, implementing these changes that can lead to weight loss is difficult and maintaining a long-term weight loss is even more challenging. consequently, an academic effort is required to understand the pathophysiology and treat obesity for the establishment of new approaches to reducing food intake. recent evidence in the field of obesity and brain-based integration indicates a potential for designing new therapeutic interventions. noninvasive neuromodulation of brain activity has been shown to be a technique that can help reduce food cravings and food intake and, more recently, body weight, offering a new way to treat obesity. however, recent studies have shown that this biomedical intervention could have a paradoxical effect related to comt val158met polymorphism, which impacts dopamine levels in the prefrontal cortex. the potential mechanisms underlying this effect are unclear and future studies are needed to promote this clarification. this study aims to verify the influence of the comt val158met polymorphism on the density of dopaminergic transporters in the presynaptic membrane of dopaminergic neurons, exploring the 3 dopaminergic pathways: via nigroestrital, mesolimbic and mesocortical. this investigation will be carried out through the cerebral spect using the radiopharmaceutical 99mtecnécio-trodat-1 in young obese women with and without comt val158met polymorphism. in baseline conditions, the investigators will compare the spect 99mtc-trodat-1 of obese women with and without the comt val158met polymorphism with a database of non-obese volunteers. our hypothesis is that the study will facilitate understanding of the variability of the individual response of carriers and non-carriers of the met allele of the comt val158met polymorphism, affecting dopamine levels in the brain and to design, in the future, for the treatment of obesity based on the individuals' genotypic differences.

Eligibility criteria:
inclusion criteria: * women with obesity (bmi 30-35kg/m2), with and without comt val158met polymorphism. exclusion criteria: * pregnancy * any active psychiatric or neurological condition at the time of joining the study * any other significant medical condition

Keywords: obesity genetic polymorphism dopamine
effect of pollen extract on urinary incontinence

Conditions: Urinary Incontinence

Summary: study with food supplement to assess the eficacy of pollen extract on urinary incontinence


Eligibility criteria:
inclusion criteria: * moderate, severe or very severe urinary incontinence, according to the severity index incontinence severity index (isi) \* of sandvik * healthy patients from 18 to 75 years of age * normal cytology in the last year and normal urological culture at inclusión * negative result in urine culture and normal vaginal canal (no evidence of dysplasia and / or infection) * external vaginal area (vestibule and introitus) free of wounds or bleeding exclusion criteria: * surgery for urinary incontinence * acute or recurrent infections of the urinary tract or genital infections (herpes or candida) in the last 3 months * malignant neoplasm or history of neoplasia in the last 5 years * concomitant disease such as a cardiac disorder, uncontrolled type i or ii diabetes, lupus porphyria, relevant neurological disorders, any disease that in the opinion of the doctor could interfere with the treatment or resolution of the disease * anticoagulant alteration or thromboembolic alteration or taking anticoagulant drugs one week before treatment or during treatment for possible drug interaction (to allow inclusion, temporary cessation of use at the discretion of the doctor) * history of immunosuppression or immunodeficiency (including hiv infection or aids) or use of immunosuppressive medications * hormonal imbalance, related to the thyroid, hypophysis or androgen not controlled * having a significant alteration in the areas under treatment or inflammatory alterations including but not limited to lacerations, abrasions or ulcers prior to treatment (time of resolution at the discretion of the doctor) or during treatment * dysplastic nevus in the treatment área * prolapse grade ii according to the classification of the "pelvic organ prolapse quantification (ics-pop-q) system" * kegel exercises or electrostimulation at least 30 days before the start of treatment are not allowed
a study of tirzepatide (ly3298176) in adult participants with type 2 diabetes switching from dulaglutide (surpass-switch)

Conditions: Type 2 Diabetes

Summary: the main purpose of this study is to investigate the efficacy and safety of switching from weekly dulaglutide to weekly tirzepatide compared to increasing the dulaglutide dose in adults with type 2 diabetes.


Eligibility criteria:
inclusion criteria: * have type 2 diabetes * have hba1c ≥7.0% (≥53 mmol/mol) to ≤9.5% (≤80 mmol/mol) * are currently on a stable dose of dulaglutide weekly (0.75 mg or 1.5 mg) for at least 6 months prior to screening. * no treatment with oral antihyperglycemic medication (oam), or on a stable dose of up to 3 oams, which may include metformin, sodium glucose cotransporter-2 inhibitors (sglt-2i), and/or sulfonylurea, for at least 3 months before screening. * have had stable body weight (±5%) during the 90 days preceding screening * have bmi ≥25 kilogram/square meter (kg/m²) exclusion criteria: * have type 1 diabetes * have a history of chronic or acute pancreatitis * have a history of * proliferative diabetic retinopathy, or * diabetic maculopathy, or * nonproliferative diabetic retinopathy that requires acute treatment. * have any of these cardiovascular (cv) conditions within 60 days prior to screening: * acute myocardial infarction, * cerebrovascular accident (stroke), or * hospitalization due to congestive heart failure (chf). * have new york heart assocation (nyha) functional classification class iv chf * have family or personal history of medullary thyroid carcinoma (mtc) or multiple endocrine neoplasia syndrome type 2 (men2). * have within 90 days prior to screening received treatment with medications intended to promote weight loss. this includes prescribed, over-the-counter, or alternative remedies * have an estimated glomerular filtration rate (egfr) \<30 ml/minute/1.73 m2 (or lower than the country-specific threshold for discontinuing metformin therapy per local label) * have been treated with insulin prior to screening * exception: use of insulin for gestational diabetes or short-term use (\<14 days) for acute conditions such as acute illness, hospitalization, or elective surgery. * have a history of reduction of dose of dulaglutide, due to intolerability, without successful reescalation
administration of low-level laser on muscles of mastication following the induction of initial fatigue

Conditions: Muscle Fatigue

Summary: orofacial pain encompasses painful conditions, such as temporomandibular disorder. multidisciplinary health teams seek to control such musculoskeletal disorders to improve the quality and functional capacity of the muscles of mastication. the aim of the proposed study is to evaluate the effect of low-level laser therapy as a form of treatment for the prevention of initial fatigue of the muscles of mastication (masseter and anterior temporal muscles) as well as the recovery of these muscles after induced exhaustion (caused by isometric contraction) in young adults. the participants will be 78 (n obtained from calculation of the sample size with p \< 0.05) healthy male and female volunteers between 18 and 34 years of age. the volunteers will be randomly allocated to a laser group (n = 26), sham group (n = 26) and control group (n = 26). all participants will be submitted to a clinical evaluation to record mandibular movements, bite force, muscle sensitivity to palpation and initial muscle fatigue. initial fatigue will be induced by isometric contraction of the jaws. maximum voluntary contraction will be performed to record the time until initial exhaustion of the masseter muscle (determined by electromyography). the groups will then be submitted to the interventions: 1) active laser therapy (wavelength: 780 nm; fluence: 134 j/cm2; power: 50 mw; irradiance: 1.675 w/cm2; exposure time: 80 seconds per point) on three points of the masseter and one point on the anterior temporal muscles on each side, 2) sham laser (placebo effect) or 3) no intervention (control). maximum voluntary contraction will be performed again after the interventions to record the time until initial exhaustion of the masseter muscle (determined by electromyography). differences in individual time until exhaustion between the pre-intervention and post-intervention evaluations will be measured to determine the effect of low-level laser therapy.


Eligibility criteria:
inclusion criteria: * will be included in this study young people in the age range between 18-34 years, without diagnosis of temporomandibular disorder (tmd) and with the signed free informed consent term. exclusion criteria: * will be excluded from the study individuals who are in orthodontic or orthopedic treatment of the jaw, psychological and / or physiotherapy. also excluded are those who are taking anti-inflammatory drugs and anti-inflammatory drugs and occlusal plaques.

Keywords: masseter muscle initial fatigue low-level laser