Kornimate/medical-research-clean huggingface dataset:
analgesic effects of perioperative propranolol administration for spine surgery

Conditions: Lumbar Disc Disease; Spinal Fusion; Degenerative Disc Disease

Summary: the purpose of this study is to determine if treatment with low-dose oral propranolol in the days before and after surgery decrease postoperative pain and improve pain scores.

this study is a randomized, double-blind, placebo controlled clinical trial.the main purpose of this study is to determine if postsurgical opioid use and pain scores are decreased with oral propranolol treatment. the treatment period will last for six days and the observation period will last for three months. effectiveness of treatment will be assessed by means of post-operative opioid consumption as primary outcome measure.

Eligibility criteria:
inclusion criteria: * male or female patients age \>18 undergoing elective spinal fusion surgery, with plans to remain inpatient for ≥ 48hrs and receive iv or oral opioids; * females of child bearing potential must test negative on a pregnancy test at visit 1 and utilize acceptable means of birth control for the duration of the study; * patients must be judged by the study team to be likely to be reliable and to agree to keep all appointments for clinic visits, tests, and procedures required by the protocol; * patients must have the ability to fully participate in the informed consent process. exclusion criteria: * disease-related: history of exercise- or exertion-induced asthma or current treatments for asthma; unstable medical or neurological illness; heart block greater than first degree (ekg); history of coronary artery disease, or history of congestive heart failure; baseline heart rate or blood pressure that in the opinion of the investigator would constitute too great a risk when considered in the context of the patient's medical comorbidities and health history; significant suicidal or homicidal ideation, or current dsm-iv diagnosis of bipolar disorder, schizophrenia or other psychotic disorder, or cognitive disorder due to a general medical condition; history of diabetes * exposure-related: history of β-blocker use within six months of enrollment in the trial; total baseline preoperative opioid consumption greater than 50 oral milligram morphine equivalents (mme) per day; current use or use within the past two weeks of methadone, levorphanol, buprenorphine, butorphanol, pentazocine, tramadol, nalbuphine, naloxone, or naltrexone. * patient characteristics: female patients who are pregnant or breast-feeding; known allergy to study medication; alcohol/substance abuse within past six months; ongoing or anticipated disability compensation or litigation issues, in the best judgement of the investigator; presence of any factors/conditions, medical or other, that in the judgment of the investigator may interfere with performance of study outcome measures, such as treatment-refractory history; non-ambulatory or require the use of crutches or a walker; no access to a telephone

Keywords: lumbar fusion propranolol beta-blockers post-surgical pain opioid-sparing
a trial of shr-1701 in combination with and without famitinib malate in patients with extensive stage small cell lung cancer

Conditions: Lung Cancer

Summary: the study is being conducted to evaluate the efficacy and safety of shr-1701 in combination with or without famitinib malate for the treatment of extensive stage small cell lung cancer after the failure of previous systemic chemotherapy


Eligibility criteria:
inclusion criteria: 1. patients voluntarily participated in the clinical study, understood the study procedures and are able to sign the informed consent form. 2. 18 to 75 years old, male or female. 3. histologically or cytologically confirmed extensive stage small cell lung cancer（ed-sclc）. 4. ecog performance status of 0 or 1. 5. adequate hematological, hepatic and renal function. 6. female subjects of child-bearing potential must have a negative serum hcg test before treatment. exclusion criteria: 1. histologically or cytologically confirmed mixed sclc and nsclc. 2. untreated central nervous system metastases. 3. cancerous meningitis (meningeal metastasis). 4. uncontrolled pleural effusion, pericardial effusion or ascites. 5. tumor infiltration into the great vessels on imaging; 6. hemoptysis symptoms and maximum daily hemoptysis ≥ 2.5ml occurred within 1 month. 7. uncontrolled tumor-related pain. 8. malignancies other than sclc within 5 years. 9. systemic antitumor therapy was received 4 weeks prior to trial treatment. 10. history of autoimmune diseases. 11. significant cardiovascular disease. 12. inadequately controlled hypertension. 13. known history of testing positive test for hiv or known aids. 14. patients with active hepatitis b or hepatitis c 15. severe infections within 4 weeks prior to trial treatment. 16. active tuberculosis.
prenatal exposure to emerging contaminants and children's atopic dermatitis

Conditions: Atopic Dermatitis

Summary: this prospective cohort study aims to investigate the association between prenatal blood levels of emerging contaminants and the five-year incidence of atopic dermatitis (ad) in offspring.

this prospective birth cohort study, conducted within the shanghai prenatal population, involves the collection of maternal blood samples during gestation to directly measure the biological exposure levels of emerging contaminants, including per- and polyfluoroalkyl substances (pfas), organophosphate flame retardants (opfrs), and microplastics. serum and whole blood levels of these contaminants are evaluated during pregnancy at 12-14, 22-26, and 31-34 gestational weeks. subsequently, the study assesses skin barrier function in infants at 24-48 hours, 42 days, and 6 months of age. during a five-year period, the occurrence of atopic dermatitis (ad) in offspring is assessed. the objectives of this cohort study are twofold: (1) to elucidate the relationship between maternal exposure to emerging contaminants and the development of ad in offspring, and (2) to evaluate the impact of such exposure on the skin barrier function of infants. this research aims to provide substantial evidence for the prevention of ad, offering a unique and meaningful approach to mitigating the incidence of ad.

Eligibility criteria:
inclusion criteria: * mother plans to proceed prenatal care and delivery in minhang maternal and children health care hospital * 12-14 weeks of singleton pregnancy, non-stillborn or miscarrying, offspring without familial hereditary skin diseases * offspring plans to stay in shanghai until 5 years and proceed follow-up at the dermatology department of children's hospital affiliated with fudan university * signed informed consent. exclusion criteria: * multiple pregnancies * perinatal death * a fetus with congenital skin or appendages disorders

Keywords: skin barrier microplastics organophosphate flame retardants, opfrs perfluoroalkyl and polyfluoroalkyl substances, pfass contaminants of emerging concern, cecs emerging contaminants, ecs atopic dermatitis maternal cohort birth
prognostic model of rituximab in the treatment of mn

Conditions: Idiopathic Membranous Nephropathy

Summary: the goal of this observational study is to explore the factors that can predict the prognosis difference in patients with idiopathic membranous nephropathy (imn) under the treatment of rituximab. the main questions it aims to answer are: * to explore the factors that can predict the prognosis difference in patients with imn under the treatment of rituximab * to establish a clinical prediction model and verify it to provide a reference for the early participants will receive standard the treatment of rituximab treatment and will then be divided into remission and non remission groups based on the treatment effect after the standard treatment cycle. blood, urine, and fecal samples were collected from patients to explore possible factors influencing treatment efficacy. researchers will compare \[remission group and non-remission group\] to see if the gut microbiota and its metabolites are factors that influence the efficacy of treatment.


Eligibility criteria:
inclusion criteria: 1. aged 18-75 years, the patient was diagnosed as idiopathic membranous nephropathy or anti phospholipase a2 receptor (pla2r) antibody positive by renal puncture biopsy, and the clinical data were complete; 2. according to the kidney disease: improving global outcomes (kdigo) guidelines in 2020, it conforms to the medium and high risks in the risk level of progression of renal function loss. 3. in general, they are in good condition, have a good understanding of their own conditions and physical conditions, have self-awareness, and can communicate well with others; 4. volunteer to participate in the study, understand the significance of this experiment and the indicators to be measured, and sign the informed consent form. exclusion criteria: 1. there are factors causing secondary membranous nephropathy, such as immune diseases (systemic lupus erythematosus), tumors/infections (viral hepatitis), drugs or toxins; 2. at the same time, immunoglobulin a nephropathy (igan), interstitial nephritis, acute nephritis and other renal pathological types were combined; 3. the medication was not standardized during the treatment process, accompanied by serious infection, acute renal injury and other complications, and serious cardiovascular, cerebrovascular, digestive and blood system diseases; 4. during follow-up, the patient cannot actively cooperate or accurately understand and express.
tocilizumab dose-tapering and interruption in patients with giant cell arteritis achieving the clinical remission.

Conditions: Giant Cell Arteritis

Summary: interleukin-6 (il-6), a pro-inflammatory cytokine, has been found to have a crucial role in the pathogenesis of giant cel arteritis (gca). based on this rationale, several recent studies demonstrated the efficacy of tocilizumab (tcz), an anti-il-6 targeted monoclonal antibody, for the treatment of patients with refractory gca. confirming previous reports,in a recent retrospective study the investigators successfully treated 10 patient with refractory gca with tcz. all patients achieved a complete disease remission evaluated by clinical, laboratory, and positron emission tomography (pet). in a considerable number of gca patients treated with corticosteroids (cs) the therapy may be interrupted with no disease flares. no data are available on the management of patients achieving the remission with tcz.

study design. open-label, prospective, pilot study on patients with giant cell arteritis (gca) resistant to corticosteroids (cs) . setting. rheumatology department, hospital of prato, prato, italy. treatment. all refractory gca patients with or without involvement of aorta and its thoracic branches treated with intravenous tcz at the dose of 8 mg/kg/monthly or subcutaneous tcz at the dose of 162 mg/weekly who achieved a stable remission over a 6-month period should receive reduced tcz doses with the following schedules: intravenous tcz tapering to 2 mg/kg/monthly with drug withdrawal at month 4, and subcutaneous tcz monthly reduction through the lengthening of injection intervals every 2, 3 , and 4 weeks, and with drug interruption at month 4. primary end-point. to investigate the maintenance of clinical remission after tcz interruption over a 6-month follow-up period. secondary end-points. to assess the maintenance of clinical remission during the treatment, to evaluate the role of acute-phase reactants and pet in predicting the relapse and remission, and to assess the occurrence of adverse event (aes).

Eligibility criteria:
inclusion criteria: - all consecutive patients meeting the 1990 acr classification criteria for gca. exclusion criteria: * corticosteroid treatment during the previous 6 months. * uncontrolled diabetes. * uncontrolled hypertension. * history of cancer within the past 5 years. * history of frequent infections in the past. * positivity of screening procedures for latent tuberculosis infection. * uncontrolled dyslipidemia at baseline. * known intestinal diverticulosis. * concomitant hematologic disorders.

Keywords: giant cell arteritis, tocilizumab aortitis remission
quality of life during treatment of chronic hepatitis c (p05278/mk-4031-336)

Conditions: Hepatitis C, Chronic; Genotype 1; HCV-1

Summary: the primary objective of this study is to evaluate the impact of chronic hepatitis c (chc), and the treatment thereof with peginterferon alpha-2b (peg) and ribavirin (rbv) according to standard clinical practice, on the health-related quality of life (hrql) of a cohort of participants throughout 72 weeks of follow-up. hrql was assessed using the 36-item short-form health survey (sf-36) and the chronic liver disease questionnaire-hepatitis c virus (cldq-hcv).

as widely shown in previous reports hepatitis c virus (hcv) patients commonly experience fatigue, anxiety, and depression. these symptoms negatively affect patients' functional health, ability to work, self-perceived health, hrql and well-being. psychosocial issues and reduced hrql are frequently experienced by hcv patients. hcv patients have more hrql impairment than the general population. there is some evidence that hcv patients who experience greater fatigue, greater psychiatric symptoms, and poorer hrql are more likely to discontinue treatment prematurely, with a negative impact on virological response. in addition to well-known side effects of interferon, one important determinant of hrql during anti-viral therapy for hcv is development of rbv-induced anemia. treatment of anemia improves hrql, potentially impacting adherence to antiviral regimen and improving virologic response. these issues emphasize the importance of investigating the physical and psychosocial experiences and hrql of hcv patients. the sample size of the study must allow evaluating hrql of hcv patients based on the sf-36 before peg treatment and at each of the following study visits. to be able to detect differences of or over 4.2 points in the vitality dimension between the basal visit and following visits, estimating a standard deviation of 22 points, a statistical power of 80%, and a level of significance of 0.05, 216 patients will be needed. considering a loss of follow up of 15%, a total of 238 patients are planned for this study.

Eligibility criteria:
inclusion criteria: * participants diagnosed with chronic hepatitis c (chc) * participants with hcv genotype 1 * participants who, at the time of the study, are referred to the hospital pharmacy service to begin treatment with peg and rbv for 48 weeks * available to understand and to give informed consent exclusion criteria: - participants co-infected with human immunodeficiency virus (hiv) or hepatitis b virus (hbv)
environmental and genetic determinants of nasopharyngeal carcinoma (npc)

Conditions: Nasopharyngeal Carcinoma

Summary: nasopharyngeal carcinoma (npc) is one of the most common malignant tumors in southern china and southeast asia. while infection with epstein-barr virus (ebv) is believed to be necessary for the development of npc, non-viral environmental factors have also been implicated to increase the risk of npc including consumption of salted fish and other nitrosamine containing preserved foods, formaldehyde and wood dust exposure, and cigarette smoking. in addition to environmental factors, it is widely accepted that genetic susceptibility also plays an important role in the pathogenesis of npc. polymorphisms in genes involved in nitrosamine metabolism and dna repair have been suggested to be associated with npc risk, and various chromosomal regions linked to npc development have been reported. these associations highlight the role of both environmental and genomic components in the etiology of npc. there is a longstanding history of international collaborative studies to elucidate the role of environmental and genetic factors associated with npc between investigators in taiwan and the usa. a case-control study (375 cases; 327 controls) was conducted in the early 1990s, and a large multiplex family study that was completed in 2006 (358 families; 3,216 individuals). results from these studies have provided some of the most comprehensive epidemiological evidence regarding factors linked to npc development to date. as a next logical step, the opportunity now exists to undertake a genome-wide association study of npc in taiwan with carefully collected environmental exposure data to systematically examine environmental and genetic factors associated with npc, and to evaluate gene-gene and gene-environment interactions. the investigators propose a case-control study of 2000 npc cases (both retrospective \[n=800\] and prospective \[n=1,200\]) and 2,000 age-gender-matched hospital controls in northern taiwan. the study objectives are to: 1) evaluate putative environmental exposures and npc; 2) assess the effect of genetic factors, including both single nucleotide polymorphism and copy number variation through analysis of both main effect and gene-gene interaction; 3) investigate gene-environment interactions by testing for interactions between significant genome-wide genetic variations and ebv and other identified environmental risk factors; and 4) examine the natural history of ebv infection.


Eligibility criteria:
inclusion criteria: * patients diagnosed with npc exclusion criteria: * case group and control group younger than 18 age. control group, the reasons for hospitalization for the eb virus-related disease

Keywords: npc environmental and genetic evaluate putative environmental exposures and npc assess the effect of genetic factors investigate gene-environment interactions examine the natural history of ebv infection
influence of alfacalcidol on falls in osteopenic/osteoporotic postmenopausal women (alfa study)

Conditions: Osteoporosis, Postmenopausal; Osteopenia; Falls

Summary: the purpose of this study is to evaluate the effect of alfacalcidol 1 µg daily on the number of fallers in postmenopausal, alendronate-treated, osteopenic or osteoporotic women. primary outcome = number of fallers (patients with at least one locomotor fall incl.mixed falls)


Eligibility criteria:
inclusion criteria: * age \> 65 years * postmenopausal women * osteopenia/osteoporosis as defined by who criteria exclusion criteria: * neoplasm or other severe diseases with life expectancy less than one year or expectation of rapid worsening within one year * chronic inflammatory rheumatoid disease * arthritis with continuous pain and influence on locomotion * inflammatory or metabolic bone disease, excluding osteoporosis. * subjects with antiosteoporotic medications who are not willing to switch over to alendronate treatment. estrogen treatment can be continued * 25-oh-vitamin d3 \< 12 ng/ml (12 ng/ml = 30 mmol/l) * systemic corticosteroid treatments of more than one month within previous 12 months * intolerability for alfacalcidol * hypercalcaemia (\>2,7 mmol/l) * milk alkali syndrome * uncorrected, severe visual impairments * creatinin \> 2.5 mg/dl (\>220 µmol/l)

Keywords: osteoporosis frailty falls
gait, memory, dietary and vitamin d

Conditions: Memory Complaint Without Cognitive Decline

Summary: gait and posture disorders are very common in subjects aged 65 and over, and result mainly from neuromuscular and cognitive disorders. many studies have shown that 1) vitamin d deficiency is very common in women aged 65 and over, 2) individuals with hypovitaminosis d have lower muscle, gait and executive performances and are more prone to fail than individuals with no hypovitaminosis d, 3) the intake of vitamin d combined or not with calcium may improve muscle strength and cognitive performance. the investigators hypothesized that the daily intake of 2 yogurts containing 200 iu of vitamin d and 400 mg of calcium 1) can improve spatiotemporal gait parameters, posture and executive performance, 2) and that this improvement depends of the initial level of vitamin d deficiency.


Eligibility criteria:
inclusion criteria: * woman aged 65 and over * to have hypovitaminosis d (i.e. serum 25-hydroxyvitamin d \[25ohd\] concentration ≤ 30ng/ml) * to have no hypercalcemia (defined as serum calcium concentration ≥ 2,65mmol/l) * ability to walk a distance of 15 meters unaided * ability to eat 2 yogurts per day * memory complaint without cognitive decline * to have given and signed an informed consent to participate in the trial * to be affiliated to french social security * to have no vitamin d supplementation during inclusion exclusion criteria: * existence of dementia according to dsm-iv and nincds-adrda criteria and others cognitive disorders: untreated thyroid dysfunction, chronic ongoing ethylism, history of syphilis, stroke with sequelae, depressive symptomatology (geriatric depression scale \> 5/15) * osteoarticular diseases of the lower members and / or spine altering the biomechanical characteristics of the body. * vitamin d supplementation during inclusion * contraindications to vitamin d * unstable medical condition * dairy allergy * taste of dairy products not supported * enrolment in another simultaneous clinical trial * civil defense measures underway * refusal to participate of the subject
systematic: naats of pooled selftaken versus clinicantaken swabs 1

Conditions: Infection

Summary: routine screening for gonorrhoea and chlamydia involves urine samples in males and selftaken vulvovaginal swabs (vvss) in females. as well as infecting the urethra (pee tube) and cervix (neck of womb), gonorrhoea and chlamydia may also infect the rectum (bottom) and throat (both called extragenital sites), often with no symptoms. in some people infection will be found at more than one site, but in others it will only be in one, and if all anatomical sites are not tested some infections will be missed. in certain women one third of infections may be missed, in men who have sex with men (msm) up to 90% may be missed, if extragenital swabs are not taken. currently, routine community testing does not include extragenital sites. until recently these samples could not easily be taken outside clinical settings (hospitals, clinics or surgeries), but new dna tests for gonorrhoea, called naats, now make this possible. however, they are expensive, and taking samples from extragenital sites would treble the costs. we propose that swabs from the three sites per person are pooled and analysed together rather than tested separately. this method would identify whether the person had the infection but not the anatomical site; this would not alter the management of the individual. swabs from the rectum and throat have historically been taken by clinicians (doctors or nurses). the main attraction of community screening is that it is client led using selftaken samples. recent studies suggest that selftaken swabs from the rectum and throat are acceptable to clients and may be as good as swabs taken by clinicians, but the costeffectiveness of this approach has not been investigated. our aim is to establish whether in msm and females selftaken samples that are pooled and processed by naats are as effective as the individual tests taken by clinicians.


Eligibility criteria:
inclusion criteria: * attending the leeds centre for sexual health for an appointment where diagnostic tests for gonorrhoea and chlamydia will be taken aged 16 or over exclusion criteria: * attending the leeds centre for sexual health for an appointment where diagnostic tests for gonorrhoea and chlamydia will be taken aged 16 or over