Kornimate/medical-research-clean huggingface dataset:
efficacy of extracorporeal shock wave therapy, ultrasound and phonophoresis treatments in lateral epicondylitis

Conditions: Lateral Epicondylitis

Summary: the aim of this study; to determine the effectiveness of eswt, ultrasound and phonophoresis treatments on pain, grip strength, functionality and quality of life in patients with lateral epicondylitis and to determine the superiority of the treatments to each other.

lateral epicondylitis is the most common cause of elbow lateral pain in adults. pain that occurs in le and radiates to the humerus and forearm is characteristic of this disease. the main complaints being pain and decreased grip strength, both of which may affect activities of daily living. the patient's complaints regress with rest,but but can increase again during daily activities such as grasping, repetitive hand movements, holding door handles, turning keys, lifting heavy loads. diagnosis of lateral epicondylitis is largely based on clinical history and examination. conservative treatment is the first line treatment. generally, %90 of patients with le benefit from conservative and medical treatment, and only a few need surgery. these treatment methods include many options such as activity modification, topical and oral nsaids, splinting, stretching and strengthening exercises, various injections, prolotherapy and electrotherapy modalities. laser, tens, ultrasound, phonophoresis, iontophoresis and eswt are electrotherapeutic agents that can be used in therapy to relieve pain and promote healing. research on physical treatments for le has not yet proven superiority of one specific approach. although many studies have been done for eswt, ultrasound and phonophoresis, there is not any study that compares these three modalities.in addition, there ara fewer studies about measuring the effect of these treatment methods which contain control groups. in this study, our aim is to investigate the efficacy of eswt, ultrasound therapy and phonophoresis methods used in the treatment of le and to compare the efficacy of these three treatments against each other and control group.

Eligibility criteria:
inclusion criteria: * aged between 18-65 years * pain on the lateral side of the elbow for at least 4 weeks * tenderness over the lateral epicondyle * positive in at least two of the lateral epicondylitis spesific tests (cozen test, maudley test and mills test) exclusion criteria: * be younger than 18 * having had eswt treatment in the elbow area before * history of injection, surgery, physical therapy in the elbow area in the last 3 months * previous elbow surgery * history of radius/ulna fracture * a history of cervical and shoulder problems * having bilateral symptoms * concomitant medial epicondylitis * malignancy * pregnancy * systemic rheumatologic disease or systemic infection * inserted cardiac pacemaker * presence of coagulation disorders * cognitive disfunction

Keywords: lateral epicondylitis extracorporeal shock wave therapy ultrasound phonophoresis
the effect of grape seed extract on estrogen levels of postmenopausal women

Conditions: Breast Cancer

Summary: the role of estrogens in the pathogenesis of breast cancer has been well documented. this has led to the development of "anti-estrogens" (selective estrogens receptor modulators and aromatase inhibitors), used for treatment and prevention of breast cancer. these agents, however, have significant side effects, which are not acceptable to many healthy high-risk women. there is preliminary evidence that grape seed extract acts as "natural" aromatase inhibitor (1). this study has the potential to quantify the effectiveness of a natural substance that mimics the action of pharmaceutical aromatase inhibitors.

early detection of breast cancer with screening mammography and the use of more effective medical therapies have led to a decrease in breast cancer mortality. however, breast cancer is still the second leading cause of cancer death in women (2). therefore, the future lies in not only early detection but prevention of breast cancer. currently available chemopreventive agents are associated with potentially serious side effects and can be quite costly, especially when taken for extended periods of time. therefore, they are usually targeted only to women at high risk of disease. identification of an inexpensive, efficacious preventive therapy with few or no side effects would represent a major advance in reducing the morbidity and mortality due to breast cancer. one exciting possibility is grape seed extract. grapes and grape seeds contain procyanidins, a highly active subclass of flavonoids with actions similar to pharmaceutical aromatase inhibitors (ais). these procyanidin dimers have been found to suppress estrogen biosynthesis both in vitro and in animal models (1). based upon this knowledge we proposed this dose finding pilot study.

Eligibility criteria:
inclusion criteria: * age 55 - 75 years * able to understand and sign a consent form * postmenopausal (no menstrual period for 1 year or more) * no personal cancer history (except for non-melanoma skin cancer) * no hormone replacement therapy or anti-estrogens within 6 months of baseline exclusion criteria: * known allergy to grapes or grape products * currently on ace inhibitors, methotrexate, allopurinol, coumadin (warfarin, jantoven), heparin, clopidogrel (plavix), or cholesterol lowering medication

Keywords: grape seed extract breast cancer estrogen levels aromatase inhibitor
study of different concentrations of epidural bupivacaine for the effects on vasodilatation and sensory block

Conditions: Intraoperative Complications

Summary: this study aims to compare human subjects receiving epidural bupivacaine local anesthetic at different doses and concentrations and to assess the effect on vasodilatation (sympathectomy), sensory and motor block. the hypothesis is that the drug concentration is more important than drug dose in the determination of the extent and intensity of differential sympathetic, sensory and motor block following epidural local anesthetic.

there is controversy regarding the factors that determine the extent and intensity of epidural drug action. most studies have focused on the inter-related triad of dose, concentration and volume. we compare three groups: group a: 10ml of 0.5% bupivacaine; group b: 10ml of 0.25% bupivacaine and group c: 40ml of 0.0625% bupivacaine. when comparing these groups, groups a \& b have the same volume of epidural drug, and groups b \& c have the same total dose. in particular this study compares different methods of assessing the sympathetic block (causing vasodilatation). these methods include skin temperature changes, hemodynamic changes and photoplethysmography.

Eligibility criteria:
inclusion criteria: * patients scheduled for extracorporeal shock wave lithotripsy (eswl) under epidural anesthesia between march to september 1999 exclusion criteria: * graded as asa 3 or higher, below 18 or above 70 years of age, if they had peripheral vascular disease, baseline neurological deficit, or had any other contraindication for regional anesthesia.

Keywords: anesthesia, epidural pharmacology dose-response relationship, drug sympathectomy photoplethysmography
efficacy and safety study of thioctacid oral tablets 600mg to treat chinese diabetic patients with distal symmetric polyneuropathy

Conditions: Diabetics

Summary: the purpose of the study is to evaluate the efficacy on overall neuropathic sensory symptom improvement of thioctacid tablet 600mg once daily vs. placebo in 6-weeks' treatment in chinese diabetic patients with distal symmetric polyneuropathy (dsp).


Eligibility criteria:
inclusion criteria: * subjects must fulfil all of the following criteria to be appropriate to enter into registry (visit 2) 1. provision of informed consent 2. females and males aged from 18 to 75 (inclusive), who were definitely diagnosed with diabetes 3. hba1c\< 10％ 4. moderate neuropathy according to neuropathy disability score (nds) \>= 4 points. difference in score between left and right foot is not to be higher than 2 points 5. total symptom score (tss) \> 6.5 points 6. at least one of the four symptoms of the tss has occurred continuously over the last 3 months before screening 7. other concomitant treatments (the drugs and their dosage) have been stable over 1 month before screening subjects must fulfil all of the following criteria before randomization： 8. tss \> 5 points 9. tss range (maximum tss - minimum tss during run-in period) \< 3 points during the run-in period 10. compliance in run-in period \> 85% exclusion criteria: 1. neurologic disease other than diabetic neuropathy that may produce weakness, sensory loss, or autonomic symptoms or test abnormality 2. peripheral vascular disease severe enough to cause intermittent claudication or ischemic ulcers 3. patients who have been hospitalized due to glucopenia or ketoacidosis in the last 3 month 4. present ulcers on lower limbs of any cause 5. antioxidant therapy within the last 1 month before screening (vitamin e\> 400iu, vitamin c\> 200mg once daily for continuous 2 weeks) 6. any ala therapy within the last1 month before screening 7. opioid analgesic therapy within the last 1 month before screening 8. history of mental, psychological or behavioral conditions rendering the patient unable to follow the protocol 9. history of malignant tumors in the past 5 years except for basal cell carcinoma 10. any severe systematic diseases, at the investigator's discretion, which will make it undesirable for the patient to participate in the trial or which could jeopardize compliance with the trial protocol, 11. alt or ast \> 2.5 ´ upper limit of reference range 12. cr \> 1.8mg/dl ( \> 159µmol/l) for males or \> 1.6mg/dl ( \> 141µmol/l) for females 13. history of hypersensitive to the active ingredients or excipients of ala 14. participation in a clinical study or treatment with a non-approved experimental medication in the last 1 month 15. pregnant or breast-feeding women, or women of childbearing age without appropriate contraception measures
reduction of starvation time prior to gastroscopy

Conditions: Habile Adult Patients Referred to the Elective Gastroscopy

Summary: the primary objective is to investigate whether intake of approximately 200 ml of sugary fluid 2 hours before the scheduled gastroscopy of the abdomen can reduce the discomfort of fasting period for patients without reducing the quality of the study. current standard for fasting and fluid intake before gastroscopy is completely fasting 6 hours before the study. studies in patients in general anesthesia has been found that it does not increase the risk of aspiration of stomach content during the operation by allowing the patient to drink up to 2 hours prior to anesthesia induction. there are no studies that have examined the quality gastroscopy using this fasting procedure. some studies show that intake of sugary liquids do not have significant effect on gastric emptying. there are not deemed to be ethical problems with this study, as it seeks to show that a more lenient standard procedure in endoscopy is as safe as the established. the study is considered safe.


Eligibility criteria:
inclusion criteria: * age over 18 years * sufficient knowledge of danish to understand the written information * legally competent patients exclusion criteria: * patients with a history of pyloric stenosis (narrowing of the transition from stomach to the duodenum) * incapacitated patients * patients with daily vomiting.
a short-term comparative study of aerosure for airway clearance in patients with cystic fibrosis

Conditions: Cystic Fibrosis

Summary: this is a double-blind randomised controlled crossover study to investigate whether high frequency airflow oscillation (hfao), delivered using aerosure, improves sputum clearance in patients admitted to hospital with infective exacerbations of cystic fibrosis (cf). this study will test the hypothesis that the wet weight of sputum expectorated is greater following the use of aerosure than following the use of a sham aerosure device.


Eligibility criteria:
inclusion criteria: * a diagnosis of cf (established by genotype or sweat sodium \>70mmol/l or sweat chloride of \>60 mmol/l * admitted to king's college hospital within 48 hours of an acute infective pulmonary exacerbation characterised by an increase in respiratory symptoms requiring intravenous antibiotics exclusion criteria: * acute respiratory failure * haemodynamic instability (including severe right heart failure with hypotension) * current severe haemoptysis * ineffective cough * rib fractures * pregnancy * current or recent pneumothorax * epilepsy * current pulmonary embolism * oesophageal varices * recent thoracic upper gastro-intestinal tract or facial surgery * active tuberculosis * recent brain, eye, ear, ent surgery * myocardial infarction * ascending aortic aneurysm * acute diarrhoea * pulmonary embolism * angina * severe hypertension (systolic \>200 mm hg, diastolic \>120 mm hg) * confusion/dementia * inability to give consent

Keywords: cystic fibrosis neural respiratory drive airway clearance technique expectoration positive expiratory pressure device
effects of intermittent fasting on polycystic ovary syndrome (pcos) compared to standard treatment

Conditions: Polycystic Ovary Syndrome; Insulin Resistance

Summary: the purpose of this study is to assess the effects of time restricted eating in patients diagnosed with polycystic ovary syndrome, comparing it to the standard hormonal treatment.

after being informed about the study and potential risks, all patients were given a written informed consent. patients were recruited through social media and digital questionnaires, to make sure they met the criteria. there was a semi aleatory distribution of the patients into three different groups, one group underwent time restricted eating with no hormonal treatment (tre group), the second group received hormonal treatment combined with time restricted eating (combined group) and the last group received only hormonal treatment (ht). pcos was diagnosed using rotterdam criteria, which were evaluated according to the ultrasound, blood samples and self reported menstrual cycle. blood samples and transvaginal ultrasound were taken at day 0 and 90 to evaluate hormonal status, including insulin and glucose. homeostatic assessment for insulin resistance (homa-ir) was calculated to determine insulin resistance, as well as metabolic disfunction. after data collection, statistical analyses was done to determine the effect of the different approaches.

Eligibility criteria:
inclusion criteria: * age: 20 - 35 years * mild to moderate exercise at least 4 times per week * body mass index (bmi) of 20-24.9 * diagnosis of pcos by rotterdam criteria * type of oral contraceptives: combined (estrogens and progestins) in group 1 and 2. * pcos phenotype a, b, c * nulliparity * signed informed consent letter exclusion criteria: * menopause or perimenopause * night work shifts * phenotype d (without hyperandrogenism) * associated pathologies such as diabetes mellitus, arterial hypertension, metabolic syndrome, neoplasms, autoimmune diseases. * intake of medications on a regular basis, not including oral contraceptives for group 1 and 2.
lymphedema evaluation after adjuvant hypofractionated radiotherapy for 1-2 macrometastatic sentinel lymph nodes

Conditions: Arm Lymphedema; Breast Cancer; Radiotherapy Side Effect

Summary: in this observational prospective studi patients with invasive breast cancer no more than 5 cm and clinically node negative, scheduled for conservative surgery and sentinel node biopsy (snb), are enrolled in the protocol if they have 1-2 sentinel lymphnodes (slns) with macrometastases. sln status will be checked on definitive sections.

in recent years, breast oncologic surgery has aimed to omit axillary dissection in cases where no more than two sentinel lymph nodes are positive, particularly when complementary radiotherapy to the whole breast is planned. radiation therapy to the axillary lymph nodes ensures excellent locoregional control in patients with primary tumor no more than 5 centimeter and 1-2 macrometastatic sentinel lymph nodes, and appears to carry fewer side effects than axillary dissection. arm lymphedema is indeed one of the most well-known long-term complications of breast cancer treatment, impacting the quality of life for patients undergoing lymphadenectomy. in this scenario, the study proposes a treatment of hypofractionated intensity-modulated radiotherapy (imrt) to the breast and axillary lymph nodes with the aim of further containing the risk of developing ipsilateral arm lymphedema. imrt improves the dosimetric profile of surrounding organs at risk in the treated area, with better dose conformity to the target volume compared to tangential fields used in conventional 3d conformal techniques (as employed in most trials described so far).

Eligibility criteria:
inclusion criteria: 1. histological proven invasive breast cancer 2. breast conserving surgery with no axillary dissection 3. tumor dimension no more then 5 cm and no more than 2 positive sentinel node 5) negative surgical margin (no tumor cell on ink) 6) performance status (ps) \ 18 8) written informed consent exclusion criteria: 1. previous thoracic rt 2. mixed connective disorders 3. distant metastases 4. severe lung or cardiac diseases 5. neoadjuvant systemic therapies 6. axillary dissection 7. no surgical axillary investigation 8. mastectomy 9. axillary micrometastasis or isolated tumor cell
sleep, diet, exercise and older persons

Conditions: Cognitive Change; Cognitive Decline

Summary: to examine the impacts of a cognitive yoga program and circuit resistance training on cognitive and physical performance with nutrition and sleep as modulating factors in healthy, older adults.


Eligibility criteria:
inclusion criteria: * montreal cognitive assessment \> 23 * no memory loss complaints exclusion criteria: * uncontrolled cardiovascular or neuromuscular disease that prevents participation in a training program * musculoskeletal impairments or injury that may impact exercise participation * visual or hearing impairments * neurological disease * stroke

Keywords: circuit resistance training yoga cognition
tablet-based cognitive behavioral intervention for older adults with arthritis fatigue

Conditions: Arthritis; Fatigue

Summary: the purpose of this project is to pilot test a long-term effect of tab-g (tablet-based cognitive behavioral group education intervention). the investigators will evaluate the effect of tab-g, relative to usual care group, on (a) daily steps, (b) fatigue level, (c) self-efficacy and (d) quality of life. tab-g participants will receive 4 weekly cbt-based group education focusing on shared goal setting and mutual reinforcement in a group with 5 members. the outcomes will be measured baseline, week 4 (intervention completion) and week 8 (follow-up). the investigators hypothesize that older adults receiving tab-g will have greater improvements on outcomes compared to those receiving usual care at week 4, the intervention completion and at week 8 follow-up.


Eligibility criteria:
inclusion criteria: 1. diagnosis of osteoarthritis or rheumatoid arthritis; 2. presence of greater than minimal fatigue scoring ≥13 (t-score\>55) on the patient reported outcomes measurement information system (promis) short form (sf) v1.0-fatigue 6a; and 3. having wi-fi at home exclusion criteria: 1. currently engaging in regular exercise; 2. non-ambulatory or presence of a condition that would limit the ability to walk (e.g., foot deformity, lower extremity joint surgery in past 6 months, stroke, severe chronic obstructive pulmonary disease, etc.); and 3. delirium, dementia, or any conditions indicating deteriorating cognitive status as determined by the mini-cog.

Keywords: arthritis fatigue cognitive behavioral therapy group education older adults tablet simple walking
longitudinal assessment of bariatric surgery sub-study

Conditions: Obesity; Diabetes Mellitus

Summary: the goal of this project is to examine the physical mechanisms that contribute to improvements of glucose tolerance in type 2 diabetes mellitus (dm) following certain types of bariatric surgery.

the goal of this project is to examine the physiological mechanisms that contribute to improvements of glucose homeostasis in type 2 diabetes mellitus (dm) following gastric bypass roux-en-y bariatric surgery (gbp). the central hypotheses are: 1) that surgical changes in the anatomy of nutrient absorption achieved by gbp change incretin hormone secretion which in turn improves pancreatic islet function; and 2) that improvement in insulin secretion induced by the changes in incretin function, together with improvement in insulin resistance induced by weight loss, normalize glucose homeostasis in type 2 dm. funds are not available to pay for the surgery for patients, only to address research questions.

Eligibility criteria:
inclusion criteria: * patients who are at least 18 years of age and undergo bariatric surgery by a labs certified surgeon. * enrollment in labs-1 or labs-2. * documented type 2 diabetes (fasting plasma glucose greater than 125 mg/dl) that is treated with lifestyle efforts (drug naïve) or taking acceptable oral medications (see appendix) with a hga1c less than or equal to 8.5% and a fasting blood glucose less than or equal to 180 mg/dl. this will be one group. * non-diabetic (nd) with normal values for fasting glucose and hba1c. this will be the second group. * adequate iv access. exclusion criteria: * informed consent not obtained. * patient with diabetes with an hba1c greater than 8.5% or a fasting blood glucose greater than 180 mg/dl. * creatinine greater than 1.7. * unlikely to comply with the 6 month follow-up (post-surgical) protocol (i.e. geographically inaccessible for study visits) or unable to communicate with local study staff. * use of unacceptable diabetic medications (see appendix) at baseline (see appendix).
morphological pancreatic features in diabetes mellitus type 2

Conditions: Diabetes Mellitus, Type 2

Summary: hypothesis: type 2 diabetes mellitus is associated with pancreatic fibrosis that can be evaluated by minimally invasive imaging techniques. that fibrosis is associated with alteration of exocrine pancreatic function, defined as a reduced secretion of pancreatic enzymes and the development of nutritional deficiencies. to test that hypothesis, a prospective, observational, cross-sectional, comparative, case-control study has been designed. pancreatic fibrosis will be evaluated by endoscopic ultrasound and quantitative elastography in cases (type-2 diabetes) and age-gender-matched controls without diabetes. pancreatic function will be explored by fecal elastase test and nutritional evaluation. calculated sample size is 94 patients (47 cases and 47 controls). study period is 2 years.


Eligibility criteria:
inclusion criteria: * patients older than 18 years. * undergoing an upper endoscopic ultrasound for any indication other than pancreatic disease. * signed informed consent- * patients: previous diagnosis of type-2 diabetes mellitus. * controls: nondiabetic subjects, matched by age, gender, alcohol consumption, and smoking with patients. exclusion criteria: * history of pancreatic disease or surgery. * history of upper gastrointestinal surgery. * diabetes type other than type-2. * severe cardiovascular or respiratory disease. * lack of informed consent.

Keywords: pancreatic fibrosis endoscopic ultrasound elastography fecal elastase