Kornimate/medical-research-clean huggingface dataset:
effect of additional nebulized amikacin in ventilator-associated pneumonia caused by gram negative bacteria

Conditions: Pneumonia, Ventilator-Associated

Summary: the purpose of this study is to determine the cure rate from ventilator-associated pneumonia (vap) caused by gram negative bacteria when administering add on nebulized amikacin to intravenous antibiotics compared to intravenous antibiotics alone.

after inclusion, the patients are randomized into two groups: nebulized amikacin plus intravenous antibiotic(s) or nebulized placebo plus intravenous antibiotic(s). the dose of nebulized amikacin is 400 mg every 12 hours for 10 days. the patients are followed up on day 3, 7, 10, and 28 for safety and efficacy. the estimate sample size is 84 subjects base on previous study of cure rate in vap and the authors expected that nebulized amikacin can improve cure rate in vap subjects for 30% when compared with intravenous antibiotic(s) alone with power of 80% at level of significance 0.05.

Eligibility criteria:
inclusion criteria: * age \>/= 18 years * on mechanical ventilator more than 7 days * vap diagnosis inclusion criteria: 1. new/progressive infiltration of chest radiography 2. 2/3 of the following: 1) fever 2) purulent sputum 3) wbc \> 12,000 cell/mm3 or \< 4,000 cell/mm3 * evidence of gram negative bacilli from sputum gram stain or previous sputum culture within 1 week exclusion criteria: * history of amikacin allergy * gfr \< 30 ml/min except dialytic patients * immunocompromised host: hiv cd4 \< 200 cells/mm3, leukemia, lymphoma, received chemotherapy within 3 weeks, absolute neutrophil count \< 500/mm3 * severe ards (p/f ratio \< 100) * endobronchial obstruction:endobronchial mass, endobronchial stenosis * atelectasis * severe bronchospasm * lung abscess * complicated parapneumonic effusion/ empyema * chest trauma * uncontrolled extrapulmonary infection(s) * received intravenous antibiotic(s) more than 48 hours * pregnancy/ lactation
effects of dual-task aerobic exercise

Conditions: Sedentary Behavior

Summary: the aim of this study was to examine the acute effect of dual-task aerobic exercise on cognitive load and myocardial oxygen consumption in healthy sedentary individuals. in this study: 1. does dual-task exercise applied in addition to aerobic training have an acute effect on cognitive load in healthy sedentary individuals? 2. does dual-task exercise applied in addition to aerobic training in healthy sedentary individuals have an acute effect on myocardial oxygen consumption, which reflects the indirect oxygen consumption of the heart? the questions were answered.

to find answers to the questions of the study, healthy sedentary participants were randomized into two groups by online randomization method. one of the groups was the group that received only double-leg aerobic exercise. the other group was the double-leg aerobic exercise group integrated with dual-task-oriented training. before and after the interventions, the blood pressure and pulse rate of the participants were measured, their cognitive functions were evaluated with the moca test, their reaction times were evaluated with the nelson reaction test, and the acute effect of the trainings was examined.

Eligibility criteria:
inclusion criteria: * volunteering to participate in the study * no comorbidities * absence of comorbid diseases of the orthopedic, neurological, cardiopulmonary system * participants who have not been involved in another clinical trial in the last 1 month exclusion criteria: * participants who had hip, pelvis, knee, ankle surgery in the last year * sensory loss * participants with leg length inequality * participants with known balance disorders in the last three months due to vestibular disorders, pregnancy, concussion * presence of systemic disease (diabetes, blood pressure, etc.) * those using bronchodilator drugs * having a neurological disease * not being in good psychological condition

Keywords: dual task aerobic training cardiovascular cognition
effect of rehabilitation programs based on eccentric exercise of knee extensor muscles in isotonic and isokinetic conditions after partial menisectomy

Conditions: Meniscal Tear

Summary: a randomized clinical trial involving 32 individuals submitted to partial menisectomy will be conducted. participants will be randomized into: group i, submitted to a muscular rehabilitation program based on eccentric isokinetic exercise; and group ii, submitted to a muscular rehabilitation program based on eccentric isotonic exercise. concomitantly with the muscular rehabilitation protocols, individuals will undergo the same physiotherapeutic protocol with analgesia, edema reduction, range of motion, proprioception and functionality goals. muscle rehabilitation programs based on eccentric isotonic and isokinetic exercise will begin 15 days after partial menisectomy. the programs will last six weeks, with training frequency of two sessions per week, separated by a minimum interval of 72 hours.


Eligibility criteria:
inclusion criteria: * young adults aged between 18 and 40 years; * recreational athletes; * unilateral partial meniscal tear; * partial meniscectomy by video-arthroscopy within 90 days after injury; * male subjects; * classification of body mass index up to pre-obese (25.0 - 29.9 kg / m2); * not undergoing any strength training program for the lower limbs in the six months prior to the study; * acceptance of individuals in participating in the procedures proposed by the research. exclusion criteria: repeated meniscal tear; associated ligament injuries; previous history (\<6 months) of musculoskeletal lesions in the thigh; patellar tendinopathy; patellofemoral pain syndrome; respiratory or cardiovascular conditions that limit the performance of exercises; users of dietary supplements or anabolic steroids
rubidium-82 position emission computed tomography (pet) versus gated, rest / stress technetium 99-m spect

Conditions: Coronary Artery Disease; Myocardial Ischemia; Heart Disease

Summary: many stress tests being done today have two parts, the stress test and the pictures of your heart. the investigators are comparing a newer technique to obtain the pictures (pet imaging) to the standard method (spect imaging). however, it is not known if the new test is better than the old test. it is important to have a standard to compare these tests to, and that is why people who will be getting a cardiac catheterization are being asked to participate. the information about your arteries from the cardiac catheterization will be used to judge which stress test is better. the investigators hypothesize that the newer method (pet imaging) will be more accurate than the old method (spect) in detecting heart disease.

a spect rest image will be obtained using a technetium based isotope. on a separate day, a rubidium rest pet image will be obtained prior to a dipyridamole stress test. subjects will receive both rubidium and technetium isotopes following the dipyridamole stress, and will undergo first pet imaging and later spect imaging following the stress test. patients will then go for cardiac catheterization as clinically ordered by their physician.

Eligibility criteria:
inclusion criteria: * referred for clinical cardiac catheterization exclusion criteria: * previous cabg * previous mi * asthma or obstructive airway disease * intolerance to dipyridamole * moderate to severe valvular disease * cardiomyopathy - (ejection fraction less than 45%)

Keywords: cad chest pain acute coronary syndrome myocardial perfusion imaging
study of new antibiotic regimen for the treatment of uncomplicated cellulitis in emergency department patients

Conditions: Cellulitis

Summary: the primary aim of this study is to quantify the effectiveness of bactrim as additional therapy for the treatment of uncomplicated cellulitis in adults, by comparing: standard therapy plus bactrim, versus standard therapy plus placebo. the primary hypothesis of this study is that, in light of increasing ca-mrsa prevalence, subjects treated with standard therapy plus bactrim will have higher cure rates than those treated with standard therapy plus placebo.


Eligibility criteria:
inclusion criteria * must have cellulitis as defined here: 1. definition a (preferred definition): recent onset of soft tissue erythema, considered by the treating clinician to be bacterial in origin, and associated with signs of infection that include at least two of the following: pain, swelling, warmth, fever, lymphangitis, induration, or ulceration. 2. definition b (only for darkly-pigmented subjects who cannot use definition a): recent onset of soft tissue color change, pain, or swelling, considered by the treating clinician to be bacterial in origin, and at least one of the following: warmth, fever, induration, or ulceration * clinical (non-research) attending physician agrees with treatment with cephalexin until 3 days after all symptoms gone, using our weight-based dosing * responsible clinical attending physician comfortable with adding trimethoprim-sulfamethoxazole vs. placebo to the above * subject understands the study and signs written informed consent. * subject agrees to drink at least 1 liter of fluid per day. * subject will commit to all follow-up appointments exclusion criteria: * age \< 12 months or weight \<15 kg * current skin infection has already been treated * allergy to sulfa drugs * history of severe allergic reaction to penicillin (defined as anaphylactoid reaction, angioedema, bronchospasm) * current use of any antibiotic (other than topicals) * diabetes mellitus * cellulitis complicated by underlying peripheral vascular disease * renal insufficiency, defined as patient report, clinical suspicion, or creatinine\>1.3 or egfr\<60 on the last-available set of chemistry results in our computer system * hospital admission required * presence of \> 1 cc of purulent discharge at any time * cellulitis involving an indwelling vascular, enteric, or urinary catheter * immunocompromise of any etiology * pregnancy * breast feeding * facial cellulitis (infection is above the clavicles) * cellulitis associated with marine or freshwater injury, or animal or human bite. (insect bites not excluded.) * history of glucose-6-phosphate dehydrogenase deficiency * taking coumadin (warfarin), methotrexate, cisapride, phenytoin (dilantin), digoxin, or dofetilide * known megaloblastic anemia due to folate deficiency.

Keywords: cellulitis bactrim trimethoprim sulfamethoxazole mrsa methicillin-resistant staphylococcus aureus
dose escalation trial of azd1775 and gemcitabine (+radiation) for unresectable adenocarcinoma of the pancreas

Conditions: Adenocarcinoma of the Pancreas

Summary: the investigators' long-term goal is to improve the survival of patients with pancreatic cancer by enhancing the efficacy of gemcitabine-radiation by adding the wee1 inhibitor mk-1775.


Eligibility criteria:
inclusion criteria: * patients must have pathologically confirmed adenocarcinoma of the pancreas. * patients will have unresectable disease, defined radiographically as \>180 degrees involvement of the superior mesenteric artery or celiac trunk or smv/portal vein impingement that cannot be surgically reconstructed, in the absence of distant metastasis.. * patients must have a zubrod performance status (measure of general well being that ranges from 0 to 5 where 0 represents perfect health) of \< 2. * patients must have adequate organ function defined as follows: absolute neutrophil count of ≥ 1500/mm3, platelets ≥ 100,000/mm3, serum creatinine ≤ 2 mg/dl, total bilirubin ≤ 3, (with relief of biliary obstruction if present (ptc tube or endobiliary stent)) and ast \< 5 times the upper limit of normal. * patients of reproductive potential must agree to use an effective contraceptive method during participation in this trial and for 6 months after the trial. patients must not be breastfeeding. * patients must be aware of the investigational nature of the therapy and provide written informed consent. * patients must be at least 18 years old. exclusion criteria: * other serious uncontrolled concomitant systemic disorders or psychiatric condition that would interfere with the safe delivery of protocol therapy. * a history of previous chemotherapy for pancreatic cancer or abdominal radiation therapy. * the use of any investigational agent in the month before enrollment into the study. * inability to discontinue a prescription or non-prescription drugs or other products known to be metabolized by cyp3a4, or to inhibit or induce cyp3a4 prior to day 1 of dosing and to withhold throughout the study until 2 weeks after the last dose of study medication. medications of particular concern are the following inhibitors of cyp3a4: azole antifungals (ketoconazole itraconazole, fluconazole and voriconazole), macrolide antibiotics (erythromycin, clarithromycin), cimetidine, aprepitant, hiv protease inhibitors, nefazodone and the following inducers of cyp3a4: phenytoin, barbiturates and rifampicin. substrates of cyp3a4 include statins (lovastatin, simvastatin), midazolam, terfenadine, astemizole, and cisapride.
use of pedometer following radical cystectomy

Conditions: Bladder Cancer; Ileus; Narcotic Use

Summary: this is a study to evaluate whether use of a pedometer following radical cystectomy decreases post-operative narcotic use and time to return of bowel function.

this is a randomized controlled prospective study looking at the effect of using a pedometer with graduated step-count goals following radical cystectomy on rate of ileus, return of bowel function and post-operative narcotic use. subjects will be randomized into a control group or study group. the control group will receive standard of care, with information provided regarding the importance of ambulation following surgery. the study group will receive a pedometer with graduated step-count goals from post-operative day 0 to post-operative day 21. both groups will be given a standardized post-operative narcotic regimen, and will be asked to record initial passage of flatus and first bowel movement. subjects will remain on the study until post-operative day 21.

Eligibility criteria:
inclusion criteria: this study will include men and women age18-75 undergoing radical cystectomy for bladder cancer at virginia mason medical center. this includes both open and robot-assisted radical cystectomy, and all types of urinary diversion will be included in the trial. subjects both with and without neo-adjuvant chemotherapy will be included in the study. exclusion criteria: * long-term opioid use, defined by cdc as use of opioids on most days for \>3 months * history of inflammatory bowel disease * prior abdominopelvic radiation * travel to europe during study period * concurrent surgery during radical cystectomy * inability to ambulate * gastroparesis or other baseline bowel dysmotility issues * inability or unwillingness of subject or legal guardian/representative to give written informed consent.

Keywords: radical cystectomy narcotic use post-operative ileus return of bowel function
percutaneous electrical stimulation, education and exercise program in patients with knee osteoarthritis

Conditions: Knee Osteoarthritis

Summary: the purpose of this study is to compare the effectiveness of percutaneous electrotherapy treatment with transcutaneous and placebo.

there is evidence of the benefit of therapeutic exercise on pain intensity and functionality in patients with osteoarthritis of the knee. however, there is a lack of evidence of its effectiveness when applied in combination with new treatment strategies such as percutaneous electrostimulation and therapeutic pain education.

Eligibility criteria:
inclusion criteria: * age ≥ 45 years * have activity related joint pain * have morning stiffness ≤30 min * knee pain of at least 6 months duration * oa diagnosis by physician * current levels of moderate/vigorous physical activity (mvpa) below physical activity guideline recommendations (\< 150 min/week of mvpa; assessed using the active australia physical activity questionnaire) exclusion criteria: * health conditions that prevent safe participation in physical activity interventions as listed in the american college of sports medicine guidelines (e.g., cardiac or lung disease). * pain in other body areas that currently limits walking ability (e.g., back pain, foot pain, hip pain) * neurological disorders affecting lower limb movement (e.g., multiple sclerosis or stroke). * inflammatory arthritis (including rheumatoid arthritis) * fibromyalgia * previously operated knee is the most painful knee * any condition impacting decision-making/memory (e.g., alzheimer's, dementia) * severe depression * current moderate/vigorous physical activity levels above guideline recommendations (≥150 min/week; assessed using the active australia physical activity questionnaire) * currently undergoing regular, active intervention for the knee (e.g., seeing a physiotherapist) * unable to commit to study requirements (unable to attend study appointments or complete study outcomes)

Keywords: knee osteoarthritis physiotherapy physical therapy conditioned pain modulation temporal summation of pain knee pain pens percutaneous electrical stimulation pain education
the benefits feasibility and acceptability of extended screening testing in newborn babies who are referred for further hearing assessment

Conditions: Hearing Loss; Cytomegalovirus

Summary: this study will look at the feasibility and acceptability of testing newborn babies who are referred after their newborn hearing screen for an infection called congenital cytomegalovirus (ccmv). around 1 in every 100 to 200 babies is born with this virus, and although most remain well it causes 1 in 5 cases of childhood deafness. knowing that a baby is infected shortly after birth could have significant benefit since a treatment is now available, but screening programs need to be feasible and acceptable. this study aims to evaluate targeted screening for ccmv by taking samples (saliva and urine) from babies who do not pass their newborn hearing screening. the investigators want to see if we can find a quick, reliable and parentally acceptable way to screen babies who fail their hearing test for this virus.


Eligibility criteria:
inclusion criteria: * all infants 'referred' for one or both ears following hospital-based newborn hearing screening in north of tyne and south west london areas. babies with other known causes of snhl (e.g. hereditary) and those admitted to neonatal intensive care units will be included. exclusion criteria: * exclusions to this study will be infants with parents/guardians not willing/able to give informed consent or children known to have congenital cmv by antenatal testing or clinical features of cmv infection at birth.

Keywords: screening congenital cytomegalovirus cmv hearing loss
nourish: nourishing our understanding of role modeling to improve support and health

Conditions: Pediatric Obesity

Summary: the percentage of overweight children between the ages of 6 and 11 has nearly tripled in the last three decades, and rates are even higher among african americans.overweight children are at-risk for numerous health problems, thus effective treatments are urgently needed. this study will evaluate an innovative intervention for ethnically diverse parents (nourish), which focuses on helping parents role model and teach their children healthy behaviors.

pediatric overweight is a national public health concern. the percentage of overweight children in the u.s. between the ages of 6 and 11 has nearly tripled in the last 3 decades. african american children are particularly at risk. pediatric overweight is associated with numerous physical and psychological health problems. moreover, overweight children are at significant risk for obesity in adulthood. thus, a focus on pediatric overweight is an important step in the prevention of adult obesity. despite the urgent need for pediatric overweight interventions, outcomes of some of the most rigorous treatments are, at best, mixed. although research has found that including parents in interventions for pediatric overweight has positive effects on outcomes, parental involvement is usually limited. moreover, relatively few studies have included sufficient numbers of lower-ses, african american participants, a group at increased risk for pediatric overweight and associated complications. this study will evaluate the efficacy of an intensive intervention targeting ethnically diverse parents of overweight, children ages 6-11 (nourish-nourishing our understanding of role modeling to improve support and health).

Eligibility criteria:
inclusion criteria: * to qualify for participation, parents/caregivers must have a child between the ages of 6 and 11 with a bmi \> the 85th percentile \[128\]. * this child must also primarily reside in the participating caregiver's home. * participants also need to speak english fluently, and be able to understand and follow basic instructions and perform simple exercises. exclusion criteria: * caregivers are ineligible if they are: 1. non-ambulatory, 2. pregnant, 3. or have a clinical diagnosis that may be negatively impacted by exercise. * parents whose children have a medical condition or developmental disorder that precludes weight loss using conventional diet and exercise methods are also ineligible for participation. all parents meeting study criteria will be offered participation in the randomized trial comparing nourish with a control group.

Keywords: behavioral intervention obesity prevention