Kornimate/medical-research-clean huggingface dataset:
antimicrobial stewardship for primary care pediatricians

Conditions: Acute Sinusitis; Streptococcal Pharyngitis; Pneumonia; Viral Infection

Summary: the purpose of the study is to determine if physician education coupled with audit and feedback of antibiotic prescribing can improve antibiotic prescribing by primary care clinicians.

using a large, diverse pediatric primary care network sharing a comprehensive electronic health record (ehr), a cluster-randomized trial will be performed to determine the effectiveness of an outpatient antimicrobial stewardship bundle, including treatment guidelines coupled with audit and feedback of physician prescribing, to curb inappropriate antibiotic prescribing for respiratory tract infections. aim 1: to determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on antibiotic prescribing for conditions for which antibiotics are not indicated. hypothesis: antimicrobial stewardship will decrease rates of antibiotic prescribing for conditions for which antibiotics are not indicated. aim 2: to determine the impact of an outpatient antimicrobial stewardship bundle within a pediatric primary care network on broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated. hypothesis: antimicrobial stewardship will decrease the rate of broad-spectrum antibiotic prescribing for conditions for which narrow-spectrum antibiotics are indicated.

Eligibility criteria:
inclusion criteria: * primary care pediatric practices within the chop care network exclusion criteria: * academic primary care pediatric practices within the chop care network * providers entering a practice after the start of the intervention * providers with less than 25 antibiotic prescriptions in the 6 months prior to the start of the intervention

Keywords: antimicrobial stewardship program inappropriate prescribing of antibiotics physician prescribing antibiotic prescribing for respiratory tract infections respiratory tract infections
telephone-based motivational interviewing for smoking cessation in crohn's disease patients

Conditions: Crohn Disease

Summary: quitting smoking unequivocally improves the course of crohn's disease (ec), and therefore, it should be one of the main therapeutic targets in the treatment of this disease. the goal of the study was to know the effectiveness of motivational intervention 5 r for smoking cessation in patients with crohn's disease performed by telephone by nursing, in relation to those who did not receive such intervention. for this purpose, a controlled, randomized, parallel and open clinical trial was designed. the subjects were patients with crohn's disease that were actively smoking ec. they were all \>18 years old and they had internet access and e-mail. those who were already in a process of smoking cessation were excluded from the study. experimental intervention consisted of a motivational intervention for smoking cessation through telephone every 3 months for one year.


Eligibility criteria:
inclusion criteria: * smokers crohn's disease patients * \>18 age exclusion criteria: * smokers crohn's disease patients who are receiving treatment of tobacco cessation at the time of inclusion * do not have email

Keywords: inflammatory bowel disease smoking cessation tobacco smoking advanced practice nurse motivational intervention
eswl vs flexible uretroscopy in management of upper ureteric stones a prospective randomized study

Conditions: Stone Ureter

Summary: this comparison between eswl and flexible ureteroscopy aims to explore the efficacy, safety, and outcomes of these treatments for upper ureteric stones under 15 mm, focusing on stone-free rates, procedural risks, recovery times, and recurrence rates. a thorough understanding of these techniques is essential for optimizing patient outcomes and personalizing treatment strategies. study aim to evaluate the effectiveness, safety, and cost of swl compared to flexible uretroscopy in management patients with upper ureteric stone less than 15 mm in size

the management of upper ureteric stones, particularly those less than 15 mm in size, has seen significant advancements with the development of minimally invasive techniques. urolithiasis is a common condition, and selecting the most appropriate treatment is crucial for effective stone clearance and minimizing complications. two widely used approaches in treating upper ureteric stones are extracorporeal shock wave lithotripsy (eswl) and flexible ureteroscopy (furs). eswl, a non-invasive procedure, uses focused shock waves to fragment the stone into smaller pieces that can be passed naturally through the urinary tract. its non-invasiveness makes it an attractive option for many patients; however, its success is influenced by factors such as stone composition, location, and patient anatomy. in contrast, flexible ureteroscopy (furs) is a minimally invasive endoscopic technique where a flexible ureteroscope is passed through the urinary tract to directly visualize and fragment the stone using a laser (usually a holmium: yag laser). this method allows for a more targeted approach and is often used when eswl is less effective or contraindicated. eswl and furs have distinct advantages and limitations, and the choice between them depends on factors including stone size, density, location, and patient-specific considerations such as body habitus and anatomical variations.

Eligibility criteria:
inclusion criteria: * patients age\>18 years old. stone site: upper ureteric stone. stone side: unilateral stones stone size: stones diameter up to 1cm stone number: single or multiple radio-opaque stone exclusion criteria: * patients with solitary kidney or only function kidney renal impairment present of distal obstruction pregnancy, current breast feeding. bleeding tendency or anticoagulation. ipsilateral ureterolithiasis, acute or chronic nephritis, or renal tuberculosis aneurysm of the aorta or renal artery. inability to position the patient on the swl table (eg, due to severe skeletal deformity or morbid obesity). radiolucent stones that are not visible on ultrasound. severe metabolic disturbances (eg, cystinuria, primary hyperparathyroidism, or renal tubular acidosis)

Keywords: upper ureteric stones eswl flexible uretroscopy
grazax asthma prevention

Conditions: Allergic Rhinitis

Summary: investigation of the effect of grazax (grass tablet) on asthma prevention in children with grass pollen allergy

investigation of the effect of grazax (alk produced grass tablet) on asthma prevention in children with grass pollen allergy. children in the age of 6-12 years will be randomised to either placebo or grazax treatment. grazax has been approved for treatment of grass pollen allergy in adults and children, diagnosed with a positive skin prick test and/or specific immunoglobulin (ige) test to grass pollen and with clinically relevant symptoms. this study will explore prevention of asthma in children with grass pollen induced allergy.

Eligibility criteria:
inclusion criteria: * a history of grass pollen allergy * positive skin prick test to grass * positive specific ige to grass exclusion criteria: * asthma

Keywords: rhinitis allergic seasonal grass asthma
human c1 esterase inhibitor (c1-inh) in subjects with acute abdominal or facial hereditary angioedema (hae) attacks

Conditions: Hereditary Angioedema

Summary: hae is a rare disorder characterized by functional c1 esterase inhibitor deficiency. if not treated adequately, the acute attacks of hae can be life-threatening and may even result in fatalities, especially in case of swelling of the larynx. this clinical phase 2/phase 3 study was designed to provide clinically relevant data on dosing, efficacy and safety in subjects with hae.

for each subject, only a single abdominal or facial attack was treated and evaluated. after receiving treatment, subjects were observed for a minimum of 4 hours, after which they could be discharged from the study center if they reported onset of symptom relief. starting from 4 hours after treatment, subjects who reported insufficient or no symptom relief could receive a second dose of double-blind treatment (called "rescue medication") as follows: c1-inh 20 u/kg bw for subjects initially receiving placebo, c1-inh 10 u/kg bw for subjects initially receiving c1-inh 10 u/kg bw, and placebo for subjects initially receiving c1-inh 20 u/kg bw. the study was defined to be successful if the primary outcome measure and at least one of the secondary outcome measures were met in the comparison between the c1-inh 20 u/kg bw group and the placebo group.

Eligibility criteria:
key inclusion criteria: * documented congenital c1-inh deficiency * acute facial or abdominal hae attack key exclusion criteria: * acquired angioedema * treatment with any other investigational drug within the last 30 days before study entry * treatment with any c1-inh concentrate within the previous 7 days

Keywords: c1 inhibitor hereditary angioedema acute hae attack
impact on pct+ filmarray rp2 plus use in lrti suspicion in emergency department

Conditions: Respiratory Tract Infections

Summary: the real-time reporting of pct results along with viral pcr data from the filmarray® respiratory panel 2 plus in conjunction with an antimicrobial stewardship plan will aid in the proper withholding or withdrawing of antibiotics (atb) when the collective data is indicative of a viral lower respiratory tract infection (lrti). the addition of the filmarray® rp2plus diagnostic test indicating the presence of a viral infection in subjects presenting with respiratory symptoms could improve the confidence to care-providing physicians to withhold prescribing antibiotics.

in the emergency room a nasopharyngeal swab sample will be collected from subjects with a suspected lrti for the filmarray respiratory panel assay plus a blood sample for the pct assay if the pct measurement has not been already prescribed. the filmarray® respiratory panel 2 plus (rp2plus) is a multiplexed nucleic acid test intended for use with filmarray® 2.0 or filmarray® torch systems for the simultaneous qualitative detection and identification of multiple respiratory viral and bacterial nucleic acids in nasopharyngeal swabs (nps) obtained from individuals suspected of respiratory tract infections. both results will be reported in real-time to the treating physicians with the recommendation to withhold or withdraw antibiotics if: 1. pct\<0.10 µg/l with either a positive (with a viral respiratory pathogen) or negative filmarray assay or 2. pct\<0.25 µg/l and filmarray positive with a viral respiratory pathogen. for the control arm, patients will benefit from the usual care of patients with suspected lrti at the discretion of the attending physician. care may entail a crp and/or a pct measurement, but no nasopharyngeal swab sampling.

Eligibility criteria:
inclusion criteria: * 1. subject is ≥ 18 years of age attending the ed with lrti symptom defined as at least one among: 1. sweats, chills, body aches and pain, temperature \>38°c) and at least one among: 2. cough, sputum production, dyspnea, chest pain, altered breath sounds at auscultation. * 2. subject signs informed consent exclusion criteria: 1. subject is a prisoner 2. subject is a pregnant 3. subject has no social insurance 4. subject is enrolled in end of life care 5. subject refuses to participate in study procedures 6. subject is already enrolled (each patient will only be tested one time with the filmarray® rp2plus) 7. subject has a contraindication (per the discretion of the attending physician) to a nasopharyngeal swab (for example, nose bone fracture or recent history of maxilla-facial surgery)

Keywords: respiratory tract infections emergency department procalcitonin
identifying barriers to implementing sensory strategies in the classroom setting

Conditions: Sensory Disorder

Summary: the goal of this clinical trial is to determine barriers to implementing sensory strategies in the classroom setting as well as potential supports needed in teachers and paraprofessionals 18 years and older who are actively working in the classroom setting. the main questions it aims to answer are: 1. what are common themes that limit classroom staff from implementing sensory strategies within the classroom setting? 2. what support do classroom staff need from an occupational therapist to feel confident in implementing sensory strategies within their classroom? participants will be asked to participate in a 17-item electronic survey via google forms. they will be asked to provide informed consent prior to participating.


Eligibility criteria:
inclusion criteria: * 18 years or older * active teacher or paraprofessional working in the classroom exclusion criteria: * younger than 18 years old * teachers or paraprofessionals no longer actively working in the classroom setting

Keywords: sensory processing classroom setting sensory strategies or sensory treatment maladaptive behaviors or challenging behaviors
optamise: clinical effectiveness of teriparatide after alendronate or risedronate therapy in osteoporotic postmenopausal women

Conditions: Osteoporosis, Postmenopausal

Summary: to determine how prior therapy with alendronate or risedronate in postmenopausal women with osteoporosis influences the clinical effectiveness of teriparatide; the primary objective of the study is to compare the teriparatide (human, recombinant pth\[1-34\])-associated change from baseline in a marker of bone formation, n-terminal propeptide of type i collagen (p1np), between subjects previously treated with risedronate and those previously treated with alendronate.

all subjects will be treated with teriparatide (human, recombinant pth\[1-34\])(human, recombinant pth\[1-34\]), 20 microgram subcutaneously daily for 12 months. subjects will consist of 290 postmenopausal women previously treated with either risedronate or alendronate for at least 24 months. an approximately equal number of subjects will have been previously treated with risedronate and alendronate, and the subjects will be balanced with regard to duration of previous treatment.

Eligibility criteria:
eligibility criteria include: * post-menopausal women who have used risedronate or alendronate continuously for at least 24 mos prior to enrollment * dosing regimens allowable are continuous (ie, uninterrupted) daily or weekly formulations of risedronate (5 mg once daily \[od\] or 35 or 30 mg once a week \[oaw\]) or alendronate (10 mg od or 70 mg oaw), for a minimum of 24 months prior to enrollment into study * lumbar spine or total hip bmd t-score 1ess than or equal to -2.0 and \>/= 1 prevalent osteoporotic fracture, or lumbar spine or total hip bmd t-score less than or equal to -2.5 with or without and \>/= 1 prevalent osteoporotic fracture. the qualifying values must be documented prior to enrollment * vitamin d (25-hydroxyvitamin d) between 16 ng/ml and 80 ng/ml * urine ntx \<50 nmol/mmol creatinine (to assure treatment compliance and bone turnover is in the pre-menopausal range) exclusion criteria include: * impaired renal function, demonstrated by creatinine clearance \< 30 ml/min * any condition or disease that may interfere with the evaluation of at least 2 lumbar vertebrae (not necessarily contiguous), determined in a screening radiograph by a radiologist at the central facility (eg, confluent aortic calcifications, severe osteoarthritis, spinal fusion, lumbar spine fractures) * depot injection vitamin d \>10,000 iu in the past 9 months prior to starting the investigational product * treatment with antiresorptive agents other than risedronate, alendronate, and hormone replacement therapy within the last 36 months before study entry (ie, ibandronate, pamidronate, etidronate, raloxifene, clodronate, or zoledronate) * use of combination alendronate and risedronate, either simultaneously or sequentially, within 60 months prior to enrollment, or use of any anti-resorptive agent in combination with risedronate or alendronate
aberrant myeloid lineage differentiation in hiv/aids patients

Conditions: HIV Infections; Leukemia

Summary: the investigators included 782 hiv-infected patients from january 2016 to october 2020 zhongnan hospital of wuhan university, whose aids diagnosis criteria met the "aids diagnosis and treatment guide (2018 edition)" of chinese medical association.


Eligibility criteria:
inclusion criteria: * hiv-infection exclusion criteria: -
a study of mabthera (rituximab) addition to regularly prescribed chemotherapy in patients with untreated mantle cell lymphoma.

Conditions: Diffuse Large B-Cell Lymphoma

Summary: this multicenter, open-label study will assess the efficacy and safety of mabthera (rituximab) added to standard chemotherapy in participants with untreated mantle cell lymphoma not eligible for autologous stem cell transplantation. participants will receive mabthera (372 mg/m\^2 intravenously) on day 1 of each 28-day treatment cycle in addition to standard chemotherapy for 6 cycles. in participants experiencing complete or partial response, mabthera will be continued as consolidation therapy for 2 more cycles.


Eligibility criteria:
inclusion criteria: * adult participants, \>/=18 years of age * untreated mantle cell lymphoma, not eligible for autologous stem cell transplantation * known mantle cell lymphoma international prognostic index (mipi) at diagnosis * eastern cooperative oncology group (ecog) performance status 0-2 * adequate hematological, renal and hepatic function exclusion criteria: * known hypersensitivity to murine proteins or chemotherapy regimen * previous first-line therapy * history of other malignancy within the last 5 years, except for squamous cell carcinoma, basal cell carcinoma of the skin or in situ cervical carcinoma * active infection * clinically significant cardiac disease * regular corticosteroid treatment in the 4 weeks prior to first dose of study drug
tobacco intensive motivational and estimate risk

Conditions: Severe Mental Disorder; Smoking Cessation; COPD

Summary: randomized, open label, prospective study with a 12-month follow-up period. the primary objective evaluates the effectiveness of an intensive anti-smoking programme that informs patients of their individual risk of lung damages and the possibilities of prevention. the main measurement will be having given up smoking in month 12, measurement of self-reported abstinence on the 7 previous days and confirmed by a co-oximeter test\< 10 ppm, between the intervention and control group. a total of 9 urban and rural mental health centres will participate in the study. the intervention group will undergo spirometry and presence and the degree of respiratory obstruction will be assessed. participants will be given individual information to generate a motivational message about the possibilities of prevention and the information will be maintained for three months by sending text messages (sms) to their mobile phones. the efficacy of the method and the pulmonary damage variables will be evaluated: smoking cessation at the end of follow-up will be confirmed by cooximetry, and the copd diagnosis and the severity of the staging for disease will be assessed


Eligibility criteria:
inclusion criteria: * patients aged between 40 and 70 * confirmed diagnosis of bipolar disorder or schizophrenia according to diagnostic and statistical manual of mental disorder iv (dsm-iv-tr) * active smokers who currently consume at least 10 cigarettes a day, with a cumulative consumption of 10 packets/year or more. exclusion criteria: * previous respiratory diagnosis of: asthma, cystic fibrosis, tuberculosis, simple chronic bronchitis, restrictive pulmonary disease or bronchiectasis * acute respiratory symptoms * heart disease or advanced oncological processes * existence of a pathology which makes it advisable not to perform spirometry (recent pneumothorax, recent thoracic or abdominal surgery, aortic aneurysm, unstable angulation, retinal detachment, facial hemiparesis or oral/dental problems) * patients who, due to their intellectual disability or mental pathology, do not understand or cannot be forced to perform spirometry * clinical instability with results of over 14 points on the hamilton depression rating scale (hdrs), a young mania rating scale (ymrs) of over 6 or a positive and negative syndrome scale (panss) of over 70

Keywords: schizophrenia bipolar disorder tobacco copd
observational study of swallowing function after treatment of advanced laryngeal cancer

Conditions: Squamous Cell Carcinoma; Laryngeal Cancer

Summary: the purpose of this prospective, multi-institutional, observational cohort study is to determine if an initial surgical approach leads to better function and quality of life than primary chemoradiation in a subset of patients with advanced hypopharyngeal and laryngeal cancers.

at the time of registration patients will be categorized into 2 groups based on the initial treatment plan as either chemoradiation-based or surgically-based (laryngectomy). treatment will be assigned by the patient's physician, it will not be assigned by the study. patients will be asked to complete a series of 4 questionnaires addressing swallowing function, generic health status, head and neck cancer-specific quality of life, and self-reported speech function at 3 time points (baseline, 6 months and 12 months after the end of treatment). the treating physician will provide basic clinical information at these same time points. in centers where swallowing and voice assessments are done as part of standard of care, data from these studies will also be provided. study entry is open to all adults regardless of gender or ethnic background. specific information regarding the definitive treatment (surgery or chemoradiation) will be provided to the patient by the treating physician as part of the routine standard of care. any treatment related side effects, as well as the duration of therapy and follow-up will be managed by the treating physician. participation in this study will have no effect on the initial treatment decisions or the course of care.

Eligibility criteria:
inclusion criteria: * willingness and ability to complete self-administered follow-up questionnaires over the course of one year as determined by a member of the research team * voluntary written informed consent with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care * must be at least 18 years of age exclusion criteria: * require a resection that would involve more than the standard laryngectomy (total pharyngectomy, esophagectomy) * undergo partial laryngectomy, when open or endoscopic * have previously altered anatomy of the upper aerodigestive tract * have pre-existing dysphagia unrelated to the tumor, or neurologic disorders that could affect swallowing (parkinson's, cerebrovascular accidents) * have prior malignant disease of the upper aerodigestive tract * have prior radiation therapy to the head and neck region * metastatic disease * unable to complete self-administered questionnaires written in simple english for cognitive, psychiatric, or other reasons that in the opinion of the enrolling investigator is likely to interfere with participation in this clinical study.

Keywords: laryngectomy larynx hypopharynx