Kornimate/medical-research-clean huggingface dataset:
dietary habits and sleep in childhood obesity

Conditions: Childhood Obesity; Life Style; Circadian Rhythms

Summary: recruitment of obese children, classification according to sleep questionnaire and randomization in two groups to perform nutritional and sleep intervention. . one group receives dietary intervention through recommendations. a group receives dietary and sleep intervention through recommendations. an analysis of the melatonin profile and metabolic and inflammatory status is performed by biochemistry at the beginning and end of the intervention. determine if the intervention has improved the health of obese children.

this study is carried out in children aged 7 to 14 years who are overweight or obese, in which their state and circadian rhythm variation are related by means of melatonin, biochemistry and dietary and sleep questionnaires. an intervention is performed in which patients are classified in evening and morning. after the classification, a randomized randomization is carried out in which one group receives dietary recommendations and another group receives dietary and sleep recommendations. after 6 months of follow-up the analyzes are performed again to observe possible differences with the initial values and compare it between both groups.

Eligibility criteria:
inclusion criteria: * children between 7 and 14 years old * overweight or obese (body mass index superior to 97th percentile for age and sex). exclusion criteria: * medicine intake, * hyperactivity, * infectious inflammatory processes, * elite athletes.
investigating the novel observation of right-left difference in uterine artery vascular resistance in pre-eclampsia

Conditions: Pre-eclampsia

Summary: the investigators previously demonstrated that epidural ropivacaine reduces uterine artery vascular resistance in a dose dependent manner in pre-eclampsia. the investigators also noted a marked right-left difference in vascular resistance between paired uterine arteries, which was almost completely abolished following epidural ropivacaine. however, this novel observation was not a stated outcome variable before the study began. this study assesses right-left difference in vascular resistance between paired uterine arteries as a primary end-point, assesses the dose-response effect of epidural lidocaine and compares the effect observed in pre-eclampsia with that in two control populations (term normal pregnancy and non-pregnant controls).


Eligibility criteria:
inclusion criteria: * pre-eclampsia patients and normal pregnancy controls scheduled to receive epidural catheterization for induction of labor or cesarean delivery. non-pregnant controls receiving epidural catheterization for elective surgery. pre-eclampsia group: 1. gestational age between 35 to 40 completed weeks 2. uterine artery notching or evidence of reduced uterine artery blood flow 3. resting systolic pressure \> 140mmhg or diastolic pressure \> 90mmhg measured twice at least 6 hours apart 4. proteinuria (at least 0•1 g/l in two random samples at least 6 hours apart or at least 0•3g in a 24 hour collection). * normal pregnancy control group: 1. gestational age between 35 to 40 completed weeks 2. absence of other inclusion factors for the pre-eclampsia group. non-pregnant control group: non-pregnant women of reproductive age. exclusion criteria: * active labor, resting blood pressure ≥ 160/110 (recorded on at least two occasions 6 hours apart), coagulopathy or other contraindications for epidural catheterization, abnormal fetal heart tracing, known fetal anomaly, intrauterine infection, placental anomalies, twins, and refusal of consent.

Keywords: pre-eclampsia pregnancy uteroplacental blood flow epidural anesthesia
markers of prognosis and response to therapy in patients with metastatic brain tumors undergoing stereotactic radiosurgery (srs)

Conditions: Metastatic Brain Tumor

Summary: this registry study will evaluate patients with metastatic brain tumors undergoing, or having undergone, stereotactic radiosurgery (srs) at swedish medical center. clinical outcomes will be evaluated at the 3, 6 and 12-month time points. clinical data, srs treatment data, and imaging data (including anatomic and advanced imaging sequences obtained prior to and serially following srs) will be archived in an online informatics platform, specifically a metastatic brain tumor registry known as the comprehensive neuro-oncology data repository for metastatic tumors (condr - mets).


Eligibility criteria:
inclusion criteria: * adult patients (\>18 yo) with a pathological diagnosis of metastatic brain cancer * participants must have \>4 tumors felt to require stereotactic radiosurgery * karnofsky scale of \> 70 at the time of initial treatment * age \< 80 exclusion criteria: * karnofsky scale \<70 * age \> 80 * inability to undergo mr imaging studies

Keywords: sterotactic radiosurgery
use of a behavioral economic intervention to reduce antibiotic prescription for upper respiratory infections

Conditions: Antibiotics; Upper Respiratory Infections; Safety-Net Hospitals; Behavioral Economics; Choosing Wisely

Summary: in an effort to implement choosing wisely guidelines and decrease patient harm, we will implement and evaluate a clinician audit-feedback and behavioral "nudge" initiative to reduce low-value antibiotics for uris. using a quasi-experiment (pre-post) design, antibiotic prescriptions for uri at lac+usc urgent care center (intervention site) vs. olive view-ucla urgent care center (control site) will used to test the effects of behavioral "nudge" on antibiotic prescribing.

national prescription rates for low-value antibiotics for uncomplicated upper respiratory infections (uris) remain unacceptably high, including at lac+usc medical center-one of the largest safety net medical centers in the u.s. using a quasi-experiment (pre-post) design, antibiotic prescriptions for uri at lac+usc urgent care center (intervention site) vs. olive view-ucla urgent care center (control site) will be compared. a three-part intervention at lac+usc consists of (1) the urgent care medical director emailing choosing wisely® guidelines and presented journal club to all 16 urgent care clinicians, and then (2) leveraging ehr performance data to provide individual clinicians with case-specific audit-feedback (both via emails and in-person while precepting nurse practitioners) on low-value antibiotic prescribing, and (3) using a behavioral "nudge", urgent care clinicians will sign a large poster committing to avoid prescribing low-value antibiotics for uncomplicated uris, which will be displayed in the clinic. in contrast, the control site (urgent care center at olive view-medical center) will receive centers for disease control prescription pads for non-antibiotic treatments (e.g., decongestants) that offer patients alternatives to antibiotics, in a broader health system effort to reduce antibiotic prescribing. patient with uris (e.g., acute bronchitis, bronchitis nos, excluding guideline-based red flags such as copd, hiv) will be identified using electronic health record clinical billable data and low-value antibiotic prescriptions rates per visit will be monitored at both sites. differences in prescriptions rates will be determined using an interrupted time-series analysis comparing utilization between sites using a repeated measures logistic regression model. .

Eligibility criteria:
inclusion criteria: * all patient receiving treatment for upper respiratory infections (defined by icd codes ehr billable codes) at both lac+usc medical center urgent care or olive view-ucla medical center exclusion criteria: * patients not receiving treatment for upper respiratory infections at both lac+usc medical center urgent care or olive view-ucla medical center
china stemi care project phase 2

Conditions: ST-Elevation Myocardial Infarction

Summary: the program is to improve stemi medical care quality in china. with the documents issued by national health and family planning commission of the people's republic of china, the program was initialed in at least 200 primary pci capable hospitals together with hundreds of adjacent non-primary pci capable hospitals in 15 provinces. stemi patients with symptom onset within 30 days will be enrolled in 3 periods. in each period with 6-month interval, 30 patients will be enrolled consecutively from each pci-capable center initially and from non-primary pci capable hospitals later, thus at least 18,000 stemi patients from primary pci capable hospitals will be enrolled and all of them will be followed up for 1 year. key performance indicators (kpis) in stemi care will be collected using both national pci online registry and a program stemi online registry database for the purpose of improvement of medical care. hospital kpis rank report and problem-based resolution will be feedback to each hospital after data analysis in each period. comparison of every two cross-sectional data (self) and within one cross-sectional (inter-hospital) data will be used to evaluate the improvement of medical quality.


Eligibility criteria:
inclusion criteria: * stemi patients with symptom onset within 30 days exclusion criteria: * none
randomized control trial comparing prokinetics and their influence on endoscopy outcomes for upper gi bleed.

Conditions: Upper Gastrointestinal Bleeding

Summary: this is a study comparing the effect of erythromycin or metoclopramide, 2 prokinetic drugs (drugs which are known to speed up the emptying of the stomach or in other words to move the blood out of the stomach faster) given before endoscopy to patients with upper gastrointestinal bleeding compared to patients who will not receive either of these medications before their endoscopy.

to compare the efficacy of pre-endoscopic interventions namely erythromycin, metoclopromide vs control in improving the outcomes of endoscopy in icu patients admitted upper gi bleeding. specific aims: 1. wither erythromycin, metoclopromide vs control can enable visualization of the entire gastric mucosa . 2. wither erythromycin, metoclopromide vs control can improve the quality of stomach and duodenum visualization: using the scoring system by fossard et al

Eligibility criteria:
inclusion criteria: * adult patients (18-80) * who are admitted to the icu for hematemesis, or coffee ground emesis exclusion criteria: 1. patients younger than 18 yrs old or older than 80 yrs 2. patients who refuse to consent to be in our study 3. pregnant patients 4. prior use of prokinetics in the last 48 hours 5. history of cardiac arrhythmia 6. allergy to erythromycin or metoclopromide 7. patients with qt prolongation (query 7) -

Keywords: upper gastrointestinal bleeding melena hematemesis
detection of borrelia bacteria in early stage lyme borreliosis using the t2lyme panel

Conditions: Lyme Disease

Summary: the t2lyme assay will be compared to borrelia culture from erythema migrans (em) biopsy and/or detection of the c6 antigen in serum collected prospectively from patients suspected of early lyme disease.

the objective of this study is to demonstrate the clinical performance of the t2lyme panel on the t2dx instrument. the assay will be compared to borrelia culture from erythema migrans (em) biopsy and/or detection of the c6 antigen in serum collected prospectively from patients suspected of early lyme disease. the data from this study will be used to support a de novo application for the t2lyme panel to the u.s. food and drug administration (fda) for product approval. the t2lyme panel is an investigational use in vitro diagnostic (ivd) designed to qualitatively detect and identify the major causative agents of lyme disease (borrelia burgdorferi, borrelia afzelii, borrelia garinii, as well as an inclusive borrelia spp. detection channel) from k2edta human whole blood samples.

Eligibility criteria:
inclusion criteria: * presence of erythematous skin lesion, consistent with erythema migrans (em). * age 18 or older. * ability to read, comprehend, and sign the informed consent form. * two (2) or more signs/symptoms of lyme disease exclusion criteria: * subject has medically diagnosed bleeding disorder. * having had taken antibiotics in the past 30 days. * em located on face or neck. * unable to provide consent.
vacuum assisted closure as a treatment for draining hematomas

Conditions: Draining Hematoma

Summary: this project is designed as a prospective, randomized, comparative study evaluating the use of a negative pressure vacuum device in treating draining hematomas following traumatic injury.

application of the vac device may significantly decrease the incidence of draining hematomas that require surgical irrigation and debridement. the aim of this project is to perform a prospective, randomized study evaluating the vac negative pressure device as a treatment for draining hematomas. we will also analyze the cost of treating a hematoma with a vac compared with currently employed treatments. additionally, we will document the incidence of infection of the hematoma with and without use of the vac device. patients who have a draining hematoma five days following surgery and who give informed consent to enter the study will be randomized into two groups. group a will be patients treated with a pressure dressing and observation, which is the most common current method of treatment. group b will be patients treated with a vac negative pressure device. patients will be carefully monitored for continued drainage by evaluating the wounds and dressings clinically. patients in either group that are still draining at ten days following surgery will be taken to the operating room for irrigation and debridement. patients in either group who develop infection will be immediately treated with irrigation and debridement.

Eligibility criteria:
inclusion criteria: * patient who has had an orthopaedic surgical procedure following trauma and has a draining wound for at least five days * no clinical evidence of infection * adult patient (19 years and older) exclusion criteria: * an infected hematoma. infection will be defined by clinical signs and symptoms of infection that include increasing drainage, increasing pain, purulent drainage, and increasing erythema. any hematomas that are thought to be infected will be cultured to confirm the diagnosis * a surgical incision that can not be covered with vac sponges and a water impermeable sheet (such tegaderm) to achieve a closed vacuum environment over the wound * wounds associated with the surgical incision that are intentionally left open to heal with either a delayed primary closure or secondary granulation * abnormal coagulation leading to an expanding hematoma that will require surgical debridements * prisoners * pregnant women * inability to comply with protocol * patients or family members who are unable or unwilling to sign study consent

Keywords: draining hematoma vacuum assisted closure (vac) negative pressure wound therapy (npwt) draining hematoma following orthopaedic surgery
special drug use-results survey of lipitor tablets

Conditions: Hypercholesterolemia

Summary: this study is to evaluate the controlling effect of atrovastatin on plasma lipid to achieve the category-specific targeted lipid levels.

to confirm the low-density lipoprotein cholesterol (ldl-c)-lowering effect of 24 weeks of treatment with lipitor®(generic name : atorvastatin calcium) tablets and determine the rate of achievement of the category-specific target ldl-c level in patients with hypercholesterolemia; and to confirm the usefulness (efficacy and safety) of atorvastatin in patients who have not responded sufficiently to other statin therapies

Eligibility criteria:
patients with hypercholesterolemia who have not achieved the category-specific target lipid level

Keywords: lipitor hmg-coa reductase inhibitor
oral antimicrobial treatment vs. outpatient parenteral for infective endocarditis

Conditions: Endocarditis Infective

Summary: non-inferiority trial to determine whether partial oral treatment is non-inferior to opat(outpatient parenteral therapy) in patients diagnosed with infective endocarditis

the trial will include patients diagnosed with left-side infective endocarditis according to the modified duke criteria, with ≥10 days of appropriate parenteral antibiotic treatment overall and at least one week of appropriate parenteral treatment after valve surgery the patients will be randomized in two arms, one with oral antibiotic therapy and the other one with outpatient parenteral therapy this trial aims to demonstrate the non-inferiority of outpatient oral antibiotic therapy in comparison with outpatient parenteral antibiotic treatment (opat), to improve the quality of life of infective endocarditis (ie) patients, and to reduce the cost of the intervention without increasing morbidity and mortality rates

Eligibility criteria:
inclusion criteria: * left-sided native or prosthetic infective endocarditis based on the modified duke criteria infected with one of the following nonresistant microorganisms: non-resistant streptococci and other gram positive cocci,e.g., granulicatella and abiotrophia; enterococcus faecalis; staphylococcus aureus;coagulase-negative staphylococci and hacek group. * male or female 18 years old or older. * 10 days or more of appropriate parenteral antibiotic treatment overall and at least one week of appropriate parenteral treatment after value surgery. * temperature inferior to 38ºc for more than two days. 5. c-reactive protein dropped to \<25% of peak value or \<20 mg/l, and white blood cell count \<15x10\^9/l during antibiotic treatment * transthoracic / transesophageal echocardiography performed within 48 hours of randomization exclusion criteria: * body mass index \>40 * concomitant infection requiring intravenous antibiotic therapy * inability to give informed consent to participation * suspicion of reduced absorption of oral treatment due to abdominal disorder * microorganisms with no oral combinations for treatment (two active antibiotics of different families) * any immunosuppressive disease or any medical condition at the discretion of the investigator that may preclude oral or opat therapy * no family or appropriate home support * reduced compliance * women of childbearing potential with a positive pregnancy test, or participants (male or female) who wish to plan a pregnancy during the trial period * women in lactancy period
endoscopic mucosal resection and cellular matrix

Conditions: Barretts Esophagus With High Grade Dysplasia; Barrett Adenocarcinoma

Summary: this study is being done to test the usefulness of extracellular matrix (ecm) a thin sheet placed over the site after endoscopic mucosal resection to promote healing of the esophagus.


Eligibility criteria:
inclusion criteria * able to provide consent * scheduled for standard of care endoscopy that may require initial emr evaluation of esophageal lesions * histological evidence of intestinal metaplasia with dysplasia or intramucosal carcinoma exclusion criteria * pregnant women * prior esophageal emr or esd in the same region * anyone unable to provide informed consent * medical co-morbidities precluding egd evaluation * history of chemoradiotherapy to the neck/esophagus * unable to stop anticoagulation therapy (non-steroid anti-inflammatory medications are permissible)

Keywords: barrett's esophagus endoscopic mucosal resection
spanish retrospective study to evaluate the efficacy and safety of targeted therapies after pazopanib as first-line therapy

Conditions: Metastatic Renal Cell Carcinoma

Summary: the purpose of this retrospective observational study was to analyze the effect of targeted therapies administered as second-line treatment after failure of pazopanib as well as increase the amount of information available on efficacy and safety of pazopanib as a first-line therapy in practice usual for the clinical treatment of metastatic renal carcinoma.


Eligibility criteria:
inclusion criteria: * patients ≥ 18. * metastatic renal cell cancer of any histology. * patients treated with pazopanib for metastatic cell renal cancer outside the context of clinical trials (clinical practice) in spanish centers from 1 april 2011 until 30 june 2014. shall be included all patients who received pazopanib as first-line treatment in each participating center, whether had experienced treatment failure with pazopanib or were still in first-line treatment. the inclusion of patients who are also allowed received cytokine as first-line treatment followed by pazopanib as well as patients who received sunitinib as first-line treatment and have changed pazopanib for toxicity or intolerance, provided they have not received more a cycle of sunitinib. * centers that agree to participate must commit to: · include all patients meeting the inclusion criteria to reduce by possible selection bias. because it supplies only pazopanib hospital pharmacy service (not outside hospitals), the identification of patients will be performed at the hospital pharmacy records in each participating center. exclusion criteria: * patients who received pazopanib in clinical trials or treatment second line, with the exceptions noted above. * patients with the diagnosis and / or treatment of malignancies of importance other than cell renal cancer.
evaluation of glycocalyx in major abdominal and thoracic surgery

Conditions: Major Elective Abdominal and Thoracic Surgery

Summary: background: the glycocalyx is a fundamental component of the endothelial barrier and alterations at this level have been shown to exacerbate the inflammatory response in the microcirculation. its degradation in the surgical patient, has been tested in interventions that involve regional or general ischemia, for example in cardiac surgery, major vascular surgery or transplantation. on interventions that do not involve ischemic events the literature is limited, such is the case of those patients undergoing major abdominal and thoracic surgery. objective: assess whether there is a glycocalyx degradation in major elective abdominal and thoracic surgery, measured as an increase in plasma syndecane-1 levels during the first 24 hours of postoperative care. methodology: prospective observational study in patients undergoing major elective thoracic and abdominal surgery at the university hospital vall d´hebrón. measurement of the syndecane-1 plasma levels are going to be done during the first 24 hours after the intervention. it is intended to evaluate whether its elevation is related to anesthetic perioperative factors, and if it has an impact con morbildity and mortality in the following 6 months after the procedure.


Eligibility criteria:
inclusion criteria: * patients older than 18 years old * patients that are scheduled to major abdominal and thoracic elective surgery in universtity hospital vall d´ hebrón. * patients asa i, ii and iii. * patients that after the intervention have their recovering in the surgical icu exclusion criteria: * patients asa iv and v. * patients that are hospitilized previous to the surgery. * patients that undergo emergent surgery. * patients with chronic or acute renal failure previous to the surgery. * patients with past medical history of autoinmune disseases. * patients with an active infection previous to the surgery. * patients in treatment with steroids previous to the surgery