Kornimate/medical-research-clean huggingface dataset:
secondary prophylaxis of hepatic encephalopathy in cirrhosis

Conditions: Hepatic Encephalopathy

Summary: hepatic encephalopathy (he), a challenging complication of advanced liver disease, occurs in approximately 30-45% of patients with cirrhosis. the treatment of choice is non-absorbable disaccharides, such as lactulose and lactitol.probiotics are effective in the treatment of minimal hepatic encephalopathy which precipitates hepatic encephalopathy. the investigators will assess the effects of lactulose and probiotics for the prevention of recurrence of he (secondary prophylaxis) in patients after the recovery of an episode of overt hepatic encephalopathy.

hepatic encephalopathy, a challenging complication of advanced liver disease, occurs in approximately 30-45% of patients with cirrhosis and 10-50% of patients with transjugular intrahepatic portosystemic shunt.although the occurrence of episodes of hepatic encephalopathy appears to be unrelated to the cause of cirrhosis,increases in the frequency and severity of such episodes predict an increased risk of death.a small metaanalysis determined that lactulose and lactitol were equally effective in the treatment of he.probiotics alter the gut flora resulting in decreased ammonia production and absorption due to decreased intraluminal ph. also shown to alter the short chain fatty acid production, \& decrease intestinal permeability.various studies have shown some improvement in either the prevalence of minimal hepatic encephalopathy or results in neuropsychological tests with the use of probiotics.lactulose and probiotics improves minimal hepatic encephalopathy in cirrhotic patients and it has also been shown that minimal hepatic encephalopathy predisposes the cirrhotic patient to he.we will assess the effects of lactulose and probiotics for the prevention of recurrence of hepatic encephalopathy (secondary prophylaxis) in patients after the recovery of an episode of overt hepatic encephalopathy.

Eligibility criteria:
inclusion criteria: * patients with cirrhosis and previous history of recovery from hepatic encephalopathy exclusion criteria: * history of taking lactulose in the past 6 weeks. * alcohol intake during the past 6 weeks or during follow up * patients on secondary prophylaxis for spontaneous bacterial peritonitis * previous tips or shunt surgery * significant comorbid illness such as heart, respiratory, or renal failure * any neurologic diseases such as alzheimer's disease, parkinson's disease and nonhepatic metabolic encephalopathies.

Keywords: hepatic encephalopathy lactulose probiotics
stapled trans anal rectal resection (starr) for outlet obstruction: functional and morphological outcome

Conditions: Surgery; Constipation

Summary: this study compares pre- and postoperative (at 6 month) quality of life and pathomorphology of the pelvis (by mri defecation) after a starr procedure for outlet obstruction. * trial with surgical intervention


Eligibility criteria:
inclusion criteria: * all patients at our institution treated with the starr operation exclusion criteria: * age under 18, * chronic or acute inflammatory disease of the bowel or rectum

Keywords: surgery (starr operation)
evaluation of mood disorders under biologics in chronic inflammatory rheumatic disease

Conditions: Rheumatic Diseases; Mood Disorders

Summary: chronic inflammatory rheumatic diseases (cird) affect many organ systems. painful sensations within the joints spine, hand and foot deformities, low quality of life and psychosocial status in patients with rheumatoid arthritis, spondyloarthritis and psoriatic arthritis can lead to the development of anxiety and depression. prevalences of anxiety increase in patients suffering of cird, compared with healthy individuals. another connection has been identified by the links between depression and systemic inflammation. it is proven that higher plasma levels of pro-inflammatory cytokines such as tumor necrosis factor alpha (tnfa) affect neurotransmitter metabolism, with influence on patients mood. the purpose of emotion study is therefore to analyze thymic variation under tnfa therapy, as treatment of cirds.


Eligibility criteria:
inclusion criteria: * adult patients (≥18 ; ≤ 80) * patient with rheumatoid arthritis (ra) according to the acr 2010 criteria, axial or peripheral spondyloarthritis (spa) according to asas criteria, ankylosing spondylitis (as) according to the new york criteria or psoriatic arthritis (psa) according to caspar criteria * signature of informed consent * affiliation to a french social security or receiving such a scheme exclusion criteria: * patient having previously received anti-tnfα treatment * patient with previously diagnosed depressive or psychiatric pathology and / or receiving anti-depressant treatment * subjects with limited legal capacity. * subjects judged by the investigator to be unlikely to comply with study procedures * subjects with no social security coverage. * pregnant women. * subjects still in the exclusion period of another study, or according to the national registry of clinical trial participants.

Keywords: tnf alpha inhibitor
erector spinae plane block and spinal anesthesia for supine percutaneous nephrolithotomy

Conditions: Incidence Conversion to General Anesthesia, Interleukin-6, Total Tramadol Consumption and Pain Score After Surgery

Summary: this study aimed to compare the effectiveness of erector spinae plane block to spinal as a surgical anesthesia and analgesia in percutaneous nephrolithotomy patient

thirty subjects (who meet all inclusion criteria and do not have exclusion criteria) are given informed consent before enrolling the study and randomized into two groups: erector spinae plane block and spinal. non-invasive blood pressure monitor, electrocardiogram (ecg), and pulse-oxymetry will be set on the subjects in the operation room. peripheral venous blood samples will be taken for il-6 examination. all patients will be sedated using target controlled infusion with propofol (schnider model, effect site) to obtain mild-moderate sedation prior to the block. on erector spinae plane group, single-shot ultrasound guided block will be performed on the operated side with stimuplex 100 mm needle and 25 ml of isobaric bupivacaine 0.5% with epinephrine 1:200.000 will be administered at level th 9. on the spinal group, spinal anesthesia will be performed on lateral decubitus position at the level of l3-l4 or l4-l5 and hyperbaric bupivacaine 0.5% 16-18 mg will be given as regimen. prior to urethral manipulation, all subjects will be given fentanyl iv 50 mcg and sedation with tci propofol will be maintained throughout the procedure. sensory loss was evaluated by performing skin clamping with a scalpel at the level of the incision before the surgery. the esp block was considered successful in providing surgical anaesthesia when there was no movement and significant changes in vital signs during skin clamping and throughout the surgery.

Eligibility criteria:
inclusion criteria: * age 18 years old and above * asa 1,2 and 3 * patient who will undergo elective supine percutaneous nephrolithotomy exclusion criteria: * patient who does not agree to be included in the study * bmi \ 40 kg/m2 * patient with single functional kidney * patient who is contraindicated for local anesthetics * patient who has severe heart disorder * patient with communication disability and cognitive disorders * patient with chronic pain with history of high opioid consumption and or alcohol addiction * pregnant patient

Keywords: erector spinae plane block percutaneous nephrolithotomy interleukin-6, effectiveness tramadol patient controlled analgesia visual analog scale
a study to compare the efficacy and safety of ziprasidone and risperidone for the treatment of schizophrenia in chinese patients

Conditions: Schizophrenia

Summary: the purpose of this study is to compare the efficacy and safety of ziprasidone and risperidone for the treatment of schizophrenia in chinese patients


Eligibility criteria:
inclusion criteria: * hospitalized patients with schizophrenia * miminum panss score of 60 when randomized exclusion criteria: * planned, regular use of antipsyhotics within 1 week of randomization * previous treatment with risperidone that resulted in intolerance or lack of response to risperidone
genetic epidemiology and energy metabolism in black girls

Conditions: Cardiovascular Diseases; Obesity

Summary: to investigate the role of genes and energy metabolism in the pathogenesis of obesity in adolescent black girls.

background: the high prevalence of obesity in african-american (aa) women is of public health importance since aa women suffer higher mortality from cardiovascular and renal diseases than do white women. the reason for their marked susceptibility to obesity remains poorly understood though it is now known that aa women manifest lower resting energy expenditure than white women. design narrative: this is a multi-pronged metabolic and genetic epidemiologic study to examine two candidate genes (ucp3 and b3ar) implicated in energy metabolism. a total of 600 african american girls, aged 12-15 years, will be screened using buccal swabs as a non-invasive method of obtaining dna, to determine their ucp3 genotypes as well as b3ar genotypes. an estimated 211 girls will be recruited, selected based on their ucp3 genotype, for measurements of resting energy expenditure and body composition (using dual energy x-ray absorptiometry \[dexa\]) in a controlled setting of the clinical research center at the cincinnati children's hospital. variation in resting energy expenditure will be examined across the genotypes of ucp3 with a large sample. the 2x3 design will allow the investigators to examine whether the effects associated with ucp3 variation are due to the ucp3 locus alone or due to the additive effect or interaction between ucp3 and b3ar. the study will help to elucidate the relationship between variation in two important candidate genes for energy metabolism, ucp3 and b3ar, and inter-individual variation in the levels of resting energy expenditure in this very high risk (for obesity) population.

Eligibility criteria:
no eligibility criteria
18f-fapibiotin pet/ct: dosimetry and biodistribution study

Conditions: Malignant Neoplasm

Summary: as a new dual targeting pet radiotracer, 18f-fapi-biotin is promising as an excellent imaging agent applicable to various cancers. in this study, we observed the safety, biodistribution and radiation dosimetry of 18f-fapi-biotin in patients with various types of cancer and compared them with the results of 18f-fapi or 18f-fdg imaging to evaluate the dosimetric characteristics and diagnostic efficacy of 18f-fapi.

fibroblast activation protein (fap) is highly expressed in the stroma of a variety of human cancers and is therefore considered promising for guiding targeted therapy. the recent development of quinoline-based pet tracers that act as fap inhibitors (fapis) demonstrated promising results preclinically and already in a few clinical cases. biotin is overexpressed in various tumor cells and underexpressed in normal cells. we assume that expanding molecular probes targeting fapi and biotin with dual targets to enhance the targeting ability of the tracer, improve the sensitivity and specificity of tumor lesion detection. 18f-fapi-biotin is a novel dual targeting tracer. the present study aimed to evaluate the biodistribution, pharmacokinetics, and dosimetry of 18f-fapi-biotin, and performed a head-to-head comparison with 18f-fapi or 18f-fdg pet/ct scans in patients with various cancers.

Eligibility criteria:
inclusion criteria: * various solid tumors with available histopathological findings • signed informed consent exclusion criteria: * pregnant or lactational women • who suffered from severe hepatic and renal insufficiency
expanded access to convalescent plasma for treatment of covid-19

Conditions: COVID-19

Summary: this expanded access program will provide access to investigational convalescent plasma for patients at hackensack university medical center infected with sars-cov-2 who have severe or life-threatening covid-19, or who are judged by a healthcare provider to be at high risk of progression to severe or life-threatening disease.

this expanded access program will provide access to investigational convalescent plasma for patients at hackensack university medical center infected with sars-cov-2 who have severe or life-threatening covid-19, or who are judged by a healthcare provider to be at high risk of progression to severe or life-threatening disease. following enrollment on the protocol and provision of informed consent, patients will be transfused with approximately 200-500 ml of abo compatible convalescent plasma obtained from individuals who have recovered from documented infection with sars-cov-2 and who have been found to have high anti-sars-cov2 titers. safety information collected will include serious adverse events judged to be related to the administration of convalescent plasma. other information to be collected retrospectively will include patient demographics, resource utilization (total length of stay, days in icu, days intubated, and survival to discharge from the facility.

Eligibility criteria:
inclusion criteria: 1. age at least 18 years 2. laboratory confirmed diagnosis of infection with sars-cov-2 3. admitted to the hospital for the treatment of covid-19 complications 4. severe or life threatening covid-19, or judged by the treating provider to be at high risk of progression to severe or life-threatening disease 5. informed consent provided by the patient or healthcare proxy 6. severe covid-19 is defined by one or more of the following: * dyspnea * respiratory frequency ≥ 30/min * blood oxygen saturation ≤ 93% * partial pressure of arterial oxygen to fraction of inspired oxygen ratio \< 300 * lung infiltrates \> 50% within 24 to 48 hours life-threatening covid-19 is defined as one or more of the following: * respiratory failure/mechanical ventilation * septic shock * multiple organ dysfunction or failure

Keywords: coronavirus covid19 sars-cov-2
epidemiology of assertiveness and emotion management disorders in people with tourette's syndrome

Conditions: Tourette Syndrome

Summary: the goal of this study is to evaluate the proportion of assertiveness difficulties in tourette syndrome. participants will complete several e-questionnaires (on assertiveness, tourette severity, quality of life, self-esteem and comorbidities like depression, anxiety...).


Eligibility criteria:
inclusion criteria: * tourette syndrome * participants aged 18 years or over exclusion criteria: * participants under legal protection * inability to complete questionnaires alone
clinical classification of pain in breast cancer survivors

Conditions: Chronic Pain; Cancer Pain; Breast Cancer

Summary: breast cancer is the most common malignancy in women worldwide according to international agency for research on cancer. unfortunately, cancer survivors often face long-term symptoms that occur or persist after completion of treatment. in addition to fatigue, pain is the most common persistent symptom after cancer and cancer treatment. the diagnosis and treatment of pain in cancer survivors is not clear for many physicians. a mechanism-based classification of pain in cancer survivors might be a critical step for clinical reasoning, especially for discrimination of different pain types. the primary aim of this study is to determine the prevalence of the predominant type of pain in turkish breast cancer survivors using a recent published clinical algorithm.


Eligibility criteria:
inclusion criteria: * diagnosed with histologically confirmed invasive or non-invasive primary breast cancer * completed remission and their primary treatment at least 3 months prior to study participation * experienced pain or a sensitive disorder (like numbness, tingling, etc.) anywhere in body for which they stated a minimum score of 3 on a numeric pain rating scale exclusion criteria: * patients affected by other chronic disease, * severe psychological disorders * active metastases
are standard dosing regimens of piperacillin-tazobactam suitable in critically ill patients with open abdomen and negative pressure wound therapy? a population pharmacokinetic study.

Conditions: Laparotomy; Critical Illness; Piperacillin, Tazobactam Drug Combination

Summary: for several years, open abdomen with temporary abdominal closure using negative pressure therapy (oa/npt) has become one of the leading strategies to treat or prevent intra-abdominal hypertension in critically ill surgical patients after a wide range of complex abdominal injuries and conditions. according to current practice, piperacillin-tazobactam (ptz) is widely used as part of empirical combined antibiotic therapy to treat severe abdominal infections in the critically ill patients. on the other hand, little is known about the impact of oa/npt on antibiotics pharmacokinetics and pharmacodynamics (pk/pd) and the optimal dosing regimens in this population remain unclear. as ptz is a small hydrophilic molecule with a very low level of protein binding, invesitigators hypothesized that oa/npt should lead to significant changes in volume of distribution (vd) and/or drug clearance (cl the main objective of this study was to assess the incidence of underdosing and the pharmacokinetics of piperacillin in critically ill patients with oa/npt. the secondary objective was to assess the appropriateness of recommended regimens for empirical minimum inhibitory concentration (mic) coverage.


Eligibility criteria:
inclusion criteria: * age ≥ 18 * admitted in surgical icu for a suspected length of stay \> 3 days * receiving an antimicrobial therapy by ptz * for an intra-abdominal infection * under oa/npt during antimicrobial therapy * with urinary and arterial catheters exclusion criteria: * severe renal failure (clcr \< 30 ml/min) without indication for continuous renal replacement therapy (crrt) * known allergy to ptz * patient's refusal for participation to the research * patient unable to consent (dementia or severe psychiatric disorders, people under legal protection, people deprived of their liberty...) * pregnancy or breast-feeding

Keywords: open abdomen negative pressure therapy antibiotics piperacillin - tazobactam pharmacokinetics
evaluate the efficacy of a silk-like fabric for the prevention of pressure sores in a long term care setting

Conditions: Pressure Ulcers

Summary: the primary purpose of this research study is to evaluate if dermatherapy® bedding will significantly reduce pressure ulcer incidence by decreasing maceration, friction, and shearing among residents of nursing homes.

additional objectives of this research study are: * to evaluate healing of pressure ulcers already present or pressure ulcers that develop during the study. * to evaluate the effectiveness of dermatherapy® bedding and alternative diapers to reduce the potential for bacterial contamination associated with patients' bed linens, underpads, gowns and pajamas, and thereby help reduce the incidence of facility-acquired infections. study nurses will assess the skin of the subjects once or twice a week for the presence of pressure ulcers and measure the size of the pressure ulcers if they are present. study nurses will also obtain bacterial culture swabs of the bedding weekly for the first eight weeks of the study from five participants in each group.

Eligibility criteria:
inclusion criteria: * residents admitted for long term care. * residents admitted for hospice care with an expected length of stay greater than one week. * residents with an expected length of stay equal to or greater than 90 days.

Keywords: pressure ulcers stage 1 stage 2 stage 3 stage 4 wounds sores infection bioburden bacterial contamination bed linen sheets underpad skin assessment microclimate shear friction moisture fabrics long term care nursing home decubitus ulcer bed ridden anti-microbial
retrospective study of effect of adjuvant chemoradiation of gastric carcinoma on local control and survival

Conditions: Gastric Cancer

Summary: gastric cancer is the sixth most common cancer and the third most common cause of cancer-related death in the world. the american cancer society estimates that about 26,560 cases of stomach cancer (16,160 in men and 10,400 in women) will be diagnosed in 2021. median age at diagnosis is 68 years. decreases in gastric cancer have been attributed in part to widespread use of refrigeration. other factors likely contributing to the decline in stomach cancer rates include lower rates of chronic helicobacter pylori infection, thanks to improved sanitation and use of antibiotics, and increased screening in some countries. surgical resection is the principal therapy for gastric cancer, as it offers the only potential for cure. neoadjuvant chemotherapy has an established role in the management of gastric cancer. perioperative chemotherapy, or postoperative chemotherapy plus chemoradiation, are preferred for localized gastric cancer. because of lower toxicity, two-drug cytotoxic regimens are preferred for patients with advanced disease. adjuvant radiotherapy is associated with improvements in both overall and relapse-free survival and reductions in locoregional failure.

gastric cancer is the sixth most common cancer and the third most common cause of cancer-related death in the world. the american cancer society estimates that about 26,560 cases of stomach cancer (16,160 in men and 10,400 in women) will be diagnosed in 2021. median age at diagnosis is 68 years. decreases in gastric cancer have been attributed in part to widespread use of refrigeration. other factors likely contributing to the decline in stomach cancer rates include lower rates of chronic helicobacter pylori infection, thanks to improved sanitation and use of antibiotics, and increased screening in some countries. surgical resection is the principal therapy for gastric cancer, as it offers the only potential for cure. neoadjuvant chemotherapy has an established role in the management of gastric cancer. perioperative chemotherapy, or postoperative chemotherapy plus chemoradiation, are preferred for localized gastric cancer. because of lower toxicity, two-drug cytotoxic regimens are preferred for patients with advanced disease. adjuvant radiotherapy is associated with improvements in both overall and relapse-free survival and reductions in locoregional failure.

Eligibility criteria:
inclusion criteria: 1. age between 18 to 70 years. 2. the world health organization performance score 0-2. 3. haemoglobin at least 10g/dl. 4. white blood cells at least 3000/mm3. 5. platelets count at least 100000/mm3. 6. bilirubin concentration no more than 25% higher than upper limit of normal . 7. liver enzymes no greater than 2.5 times upper limit of normal. 8. alkaline phosphatase no greater than 2 times upper limit of normal. 9. creatinine concentration no more than 25% higher than the upper limit of normal . exclusion criteria: 1. second malignancy. 2. prior abdominal irradiation. 3. pregnant or nursing female.