Kornimate/medical-research-clean huggingface dataset:
short therapy for febrile uti in childhood

Conditions: Urinary Tract Infections

Summary: febrile urinary tract infections (utis) are common in children, but there is no consensus concerning the duration of the antibiotic treatment. current recommendations include the use of an oral antibiotic, chosen between amoxicillin and clavulanic acid or a third-generation cephalosporin (ceftibuten), for a minimum of seven to a maximum of 14 days. in an antibiotic overuse-sparing model, proper evaluation of a shorter therapy in the treatment of febrile uti in childhood is lacking. the objective of this randomized controlled trial is to assess the non inferiority of a five days oral course of amoxicillin and clavulanic acid vs the standard 10-day regimen in the treatment of febrile utis in children. the trial results might provide evidence of the non-inferiority of a short duration of the antibiotic course for the treatment of febrile uti in childhood, contributing to a reduction in the over-use of antibiotics and consequently limiting the emergence of antibiotic resistance.


Eligibility criteria:
inclusion criteria: 1. age from 3 months to 5 years; 2. clinical diagnosis of febrile uti, defined by fever ≥38°c and positive result of urinalysis (nitrite and/or leukocyte esterase positivity) in two consecutive urine samples collected by bladder catheterization or clean catch (19). the diagnosis of uti will be then confirmed by positive urine culture for a single type of bacterium with a charge\> 105 cfu /ml as per the recommendations of the italian society of pediatric nephrology (sinepe) (19). exclusion criteria: 1. "complicated" febrile uti (septic appearance, repeated vomiting impeding oral administration of the antibiotic, severe-moderate dehydration with the need for intravenous antibiotic therapy) 2. presence of an inserted urinary catheter 3. immunodeficiency 4. hypersensitivity to the active substance or other beta-lactam antibiotics 5. any antibiotic treatment received in the previous 15 days. 6. presence of another poorly controlled chronic medical condition (diabetes, inflammatory bowel disease, etc.) 7. presence of neurological bladder 8. presence of phenylketonuria or glucose-galactose malabsorption 9. intestinal malabsorption 10. poor compliance 11. history of jaundice or liver failure positive

Keywords: short antibiotic therapy urinary tract infection children
convergent ablation plus left atrial appendage isolation for the treatment of persistent atrial fibrillation

Conditions: Persistent Atrial Fibrillation; Atrial Fibrillation, Persistent; Atrium; Fibrillation; Atrial Arrhythmia

Summary: a randomised controlled clinical trial to assess efficacy of convergent ablation with the lariat procedure, as compared to standard endocardial catheter ablation in patients with long-standing persistent atrial fibrillation (af).

atrial fibrillation is the commonest arrhythmia and is a major cause of morbidity and mortality, often causative in ischaemic strokes and compounded by heart failure. treatment options are limited for persistent long-standing af (peaf), with pulmonary vein isolation by endocardial ablation being insufficient and further additive endocardial lesions with repeated ablations yield mixed results resultant in further atrial arrhythmias. currently success rates for catheter ablation are moderate at 40 to 70% in a single procedure. if this was improved, patient quality of life and readmission rates would significantly improve as well as a reduction in anti-arrhythmic drug use. the convergent procedure - is a two stage minimally invasive hybrid approach. the first stage employs surgical ablation to the posterior wall of the left atrium in combination with the lariat procedure to isolate the left atrium appendage (laa). the second stage involves endocardial catheter ablation to confirm the surgical ablation lesions, and perform further endocardial catheter ablation to leverage both epicardial and endocardial lesions to create durable, transmural lesions. patients with long-standing persistent af will be randomised in a 1:1 ratio to either the convergent ablation with the lariat procedure or the standard endocardial catheter ablation. this feasibility study would assess recruitment to the trial, safety and efficacy of the convergent procedure, in combination with a left atrial appendage system.

Eligibility criteria:
inclusion criteria: * age \> 18 years; \< 80 years * persistent af \> 1-year duration * left atrium size \< 6cm * pts should be able to provide written informed consent. exclusion criteria: * subjects currently enrolled in another investigational study except in case of observational registry with no associated treatments. * subject has a reversible cause of af or transient af * subject is absent of laa or if the laa is previously surgically ligated * subject has had previous cardiac surgery or abdominal surgery. * subject has contraindication to anticoagulation. * patients with hypertrophic cardiomyopathy. * patients with significant valve disease. * subject has had previous catheter or surgical ablation

Keywords: catheter ablation convergent procedure left atrial appendage hybrid ablation cardiac arrhythmias
detection of circulating osteosarcoma tumor cells in the blood of patients using the polymerase chain reaction

Conditions: Osteosarcoma

Summary: this study focusses on finding out if osteosarcoma can be detected in blood. the cells will be measured by a new laboratory technique called the polymerase chain reaction. this new technique can identify one tumor cell among one million normal cells. using this technique memorial sloan-kettering cancer center research doctors may be able to detect tumor cells that could not be identified any other way. this test will be in addition to cancer treatment and will not replace any other test used normally. as this technique is still unproved the results will not be given to patients or patient's doctors and will not be used to change cancer treatment.


Eligibility criteria:
inclusion criteria: * patients with osteosarcoma are the study group * patients with malignant diagnoses other than osteosarcoma, neuroblastoma, ewing's sarcoma or synovial sarcoma may participate as controls * histologically proven osteosarcoma or a history of histologically proven osteosarcoma are eligible for participation. the patient does not need to be newly diagnosed for enrollment on this protocol * patients with malignant diagnosis other than osteosarcoma, neuroblastoma, ewing's sarcoma or synovial sarcoma are eligible to participate if they have a central venous catheter and routine blood work is being drawn exclusion criteria: * patients less then three years of age * patients with ewing's sarcoma, neuroblastoma and synovial sarcoma will be excluded from this protocol

Keywords: sarcoma bone
prevention of preterm birth using cervical pessary in pregnant women with short cervix in twins

Conditions: Preterm Birth

Summary: placement of a vaginal pessary reduces significantly the rate of spontaneous preterm birth in pregnant women with twins and a short cervical length at 18-22 weeks scan.

this trial includes pregnant women with twins undergoing routine ultrasound examination at 18.0 to 22.6 weeks of gestation.

Eligibility criteria:
inclusion criteria: * twins * minimal age of 18 years exclusion criteria: * major fetal abnormalities (requiring surgery or leading to infant death or severe handicap) * spontaneous rupture of membranes at the time of randomization * cervical cerclage in situ * active vaginal bleeding * placenta previa

Keywords: short cervix preterm birth cervical pessary twins
the effect of dexmedetomidine of the immune system

Conditions: Breast Cancer

Summary: the goal of this research study is to learn about how dexmedetomidine (a standard of care sedative) affects your immune system (your defenses against cancer) by measuring your white blood cell levels before and after surgery.

dexmedetomidine is a type of sedative used as part of anesthetic care. it is sometimes used to help lower the amount of pain killers and other anesthetics that are given to a patient during surgery. researchers want to study how this drug works in cancer patients and review the patient's chart for pain levels and medication use after surgery. part of this research involves studying the immune system of surgery patients. if you agree to take part in this study, blood (about 1 tablespoon) will be drawn before you have surgery and the morning after surgery while you are still in the hospital. this blood will be used to learn more about how your immune system works. after your second blood draw, your participation in this study will be over. this is an investigational study. up to 20 participants will be enrolled in this study. all will take part at md anderson.

Eligibility criteria:
inclusion criteria: 3.1.1 - women undergoing unilateral mastectomy for malignancy at md anderson cancer center. 3.1.2 - patients 18 years of age and older. there will be no upper age restriction. 3.1.3 - patients must sign a study-specific consent form. exclusion criteria: 3.2.1 - asa 4 3.2.2 - contraindication to the use of dexmedetomidine. 3.2.2.1. decompensated congestive heart failure. 3.2.2.2. second and third degree heart block. 3.2.2.2. known allergy to dexmedetomidine or any of the medications used in the study 3.2.3 - patients taking clonidine for treatment of arterial hypertension. 3.2.4 - patients that are pregnant. 3.2.5 - patients taking opioids at the time of surgery. 3.2.6 - patients having plastic surgical reconstruction. 3.2.7 - recent chemotherapy (\< 4 weeks). 3.2.8 - active autoimmune or immunological disease including but not limited to systemic lupus erythematous, rheumatoid arthritis and sjogren's disease 3.2.9 - patient refusal to participate in the study.

Keywords: breast cancer dexmedetomidine unilateral mastectomy blood sample collections immune system white blood cell levels
hypoglycemia prediction model

Conditions: Hypoglycemia

Summary: our goal for this learning healthcare system demonstration project is to reduce the rate of inpatient hypoglycemia. hypoglycemia can result in longer lengths of stay and increased morbidity and mortality (ie falls and cardiovascular or cerebral events). the group at washington university (wsl) developed a predictive hypoglycemia risk score. using current glucose, body weight, creatinine clearance, insulin type and dosing, and oral diabetic therapy, they identified patients at high risk for hypoglycemia and then provided in-person education to the providers of these patients. this resulted in a 68% reduction in severe hypoglycemia (blood glucose \< 40 mg/dl). this approach required significant personnel hours and is difficult to replicate in other systems. the investigators will implement an ehr-based intervention at ucsf to predict which patients are at high risk of inpatient hypoglycemia and take action to prevent the hypoglycemic event. in real time, all adult (non ob) patients with a glucose \< 90, and a high risk of future hypoglycemia (based on the wsl formula) will be identified. patients will be randomly assigned to intervention or no intervention (current standard care). the intervention will consist of an automated provider alert with recommendations on what adjustments could be made to avoid a potentially serious hypoglycemic event. the outcomes that will be measured include: 1) reductions in serious hypoglycemic events, 2) monitor the changes made by providers as a result of alerts in order to study provider behavior and identify future areas of intervention, and 3) provider satisfaction with the alert system.


Eligibility criteria:
inclusion criteria: * all adult inpatients having glucoses measured (point of care) exclusion criteria: * adults admitted to obstetrics

Keywords: inpatient diabetes hypoglycemia
ozone therapy for masticatory muscle pain (otmmp)

Conditions: Orofacial Pain; Temporomandibular Joint Disorders

Summary: this study investigates the efficacy of bio-oxidative ozone application in the treatment of tmd of muscular origin.

ozone is a natural pale blue gas that can be found in the atmosphere. medical grade ozone is a powerful oxidizing agent which can be produced commercially in ozone generators. ozone can have effects on blood components and positively affect oxygen metabolism, cell energy, immunomodulation and microcirculation.

Eligibility criteria:
inclusion criteria: * diagnosis of myofascial pain according to the research diagnostic criteria for temporomandibular disorder (rdc/tmd) * natural posterior occlusion. exclusion criteria: * any tmj internal derangement * inflammatory connective tissue disease * psychiatric problem * tumour * hearth disease or pacemaker * pregnancy * other orofacial region disease symptoms (e.g. toothache, neuralgia, migraine) * treatment or medication use for headache or bruxism in the last 2 years * local skin infection over the masseter or temporal muscle

Keywords: ozone
a multi-center data system and collaborative network in china for severe infection and sepsis children

Conditions: Critical Illness; Severe Sepsis

Summary: 1. to research the current situation of severe infection in children in china, and to investigate the incidence, prognosis and disease burden of severe infection in children in different regions of china. 2. establish the risk prediction model and diagnosi model of severe infection in children, and verify the accuracy of the model in multi-center; 3. to study the effectiveness and safety of different treatments in real diagnosis and treatment, and to evaluate the efficacy of subgroups under different ages and high risk factors.

1.children between 0 and 18 years old. 2.severe pneumonia and/or sepsis.patients were included who meet the guidline for diagnosis and treatment of community-acquired pneumonia in children (2019) issued by the national health commission of the people's republic of china and/or who meet the international guide to the 2020 campaign to save sepsis: management of septic shock and sepsis-related organ dysfunction in children. 3.notifiable infectious diseases.4.the researcher believes that he is not suitable to participate in other situations in this study.5.participants in other clinical trials in the same period.

Eligibility criteria:
inclusion criteria: 1. children between 0 and 18 years old. 2. severe pneumonia and/or sepsis. exclusion criteria: 1. notifiable infectious diseases. 2. the researcher believes that he is not suitable to participate in other situations in this study. 3. participants in other clinical trials in the same period.

Keywords: sepsis critical illness severe infection
prospective cohort study of 4,837 post-myocardial infarction patients (alpha omega cohort)

Conditions: Cardiovascular Diseases; Mortality; Type 2 Diabetes Mellitus; Cognitive Decline; Mental Well-being; Kidney Function

Summary: the alpha omega cohort is a prospective study of 4,837 state-of-the-art drug-treated dutch patients aged 60-80 years who had a clinically diagnosed myocardial infarction up to 10 years before enrolment. during the first 40 months of follow-up, patients took part in an experimental study of low doses n-3 fatty acids (alpha omega trial, clinicaltrials.gov nct00127452). at baseline (2002-2006), data on medical history, medication use, diet, lifestyle and other factors were collected by means of questionnaires. patients were physically examined by trained research nurses and blood samples were obtained. follow-up for vital status and cause-specific mortality is ongoing. the trial was approved by a central medical ethics committee (haga hospital, the hague, the netherlands) and all patients provided written informed consent.

details are reported in publications.

Eligibility criteria:
the alpha omega cohort is a prospective cohort study. the cohort originated from the alpha omega trial, a 40-month intervention study of low doses of n-3 fatty acids (in margarine spreads) and cardiovascular events (nct00127452). the in/exclusion criteria were defined for the alpha omega trial. inclusion criteria: * men and women * aged 60 through 80 y * verified clinically diagnosed myocardial infarction up to 10 y before entry into the study * written informed consent exclusion criteria: * living in a nursing home or other institution * participation in another scientific study * habitual margarine intake \< 10 g per day * habitual fish intake \> 150 g per day * habitual alcohol intake \> 6 drinks per day * use of fish oil capsules or other supplements containing omega-3 fatty acids * presence of cancer with \< 1 y of life expectancy * cognitive impairment, as indicated by the mini mental state examination (score \<= 21) * unintended weight loss \> 5 kg in the past year * lack of facilities for cooled margarine storage at home * inability or unwillingness to comply with study procedures

Keywords: myocardial infarction cardiovascular diseases mortality post-myocardial infarction patients risk prediction kidney function mental well-being cardiovascular drug treatment
the effect of a smartphone application self-management programme on clinical health outcomes in patients with chronic obstructive pulmonary disease.

Conditions: Chronic Obstructive Pulmonary Disease

Summary: chronic obstructive pulmonary disease (copd) has a significant impact on one's quality and quantity of life resulting in increased morbidity and mortality. in ireland, copd has the highest hospital admissions in comparison to other countries within the organisation for economic cooperation and development (oecd). there is a need to improve knowledge and self-management behaviour in order to improve recognition of early signs of an exacerbation thereby seeking early treatment from the general practitioner (gp) thus reducing hospital admissions among this cohort . there are limited studies pertaining to the use of a comprehensive self-management programme via a smartphone app for people with copd on a longitudinal basis.the aim of this study is to investigate the effectiveness of a smartphone application self-management programme on clinical health outcomes in patients with copd.


Eligibility criteria:
inclusion criteria: * over the age of 18 years of age * confirmed copd diagnosis defined as the presence of post- bronchodilator fev1/fvc \<0.70. * copd category gold a, b, c \& d. * those who are able to give informed consent * has a smart phone and is capable of using a smartphone app to input data? * good dexterity to use the spirometer and pulse oximeter exclusion criteria: * n/a
efficacy of vonoprazan versus intravenous proton pump inhibitors for prevention of rebleeding in high risk peptic ulcers bleeding after successful endoscopic hemostasis

Conditions: Peptic Ulcer With Haemorrhage

Summary: upper gastrointestinal hemorrhage (ugih) is common urgency condition.the estimate mortality rate about 7 percent from peptic ulcers disease(pud). a proton pump inhibitors (ppis) intravenous infusion are standard treatment for high risk ulcer bleeding. vonoprazan,subclass of potassium-competitive acid blockers (p-cabs), have beneficial effects including rapid, long-lasting and strong acid suppression.the investigators design a randomized-controlled trial comparison between 72 hours of intravenous ppis infusion and oral vonoprazan in high risk ulcer ugih after achieve endoscopic hemostasis. outcome measurement are re-bleeding rate in 30 days as primary and re-bleeding rate in 3 days, 30 days mortality, rate of angioembolisation, unit of blood transfusion, hospital cost and length of stay as secondary outcome.


Eligibility criteria:
inclusion criteria: * high risk peptic ulcers bleeding (forrest class ia,ib,iia,iib) exclusion criteria: * patients were not achieve endoscopic hemostasis * end stage cancer disease * severe critical illness and icu setting * uncorrectable coagulopathy * pregnancy or breast feeding * allergy to ppis or vonoprazan
statin therapy in asymptomatic aortic stenosis

Conditions: Aortic Valve Stenosis

Summary: there is evidence that the degenerative changes leading to aortic stenosis are caused by a chronic inflammatory process. furthermore the development of aortic stenosis is partially dependent on typical cardiovascular risk factors. an inflammatory process as well as those risk factors are amenable for medical therapy. as such the use of statins (hmg coa reductase inhibitors) would be an appealing concept to reduce both those risks for development of aortic stenosis. aim of this study is to evaluate the usefulness of statin therapy on the progression of aortic stenosis.

this study will be a prospective, double-blind, placebo-controlled, two-armed clinical trial trial to test the influence of statin therapy on the progression of calcified aortic stenosis in patients with asymptomatic mild to moderate aortic stenosis. after completion of all baseline investigations patients will be randomly assigned to the verum group (fluvastatin group) or to the control group (placebo group). patients in the verum group will receive fluvastatin in a starting dose of 40 mg per day. the dose should be increased up to 80 mg per day. the treatment should be continued until the study end (24 months). follow up investigations will be performed after 6, 12, and 18 months. after 24 months the final investigations will be performed.

Eligibility criteria:
inclusion criteria: 1. age ≥ 21 years 2. mild to moderate aortic stenosis 3. no symptoms caused by aortic stenosis 4. written informed consent to participate in the study 5. aortic valve leaflet thickening with reduced systolic opening 6. reduced aortic valve area \> 0,8 cm2 and \< 1,5 cm2 7. maximum aortic jet velocity at rest \> 2,5 m/s exclusion criteria: 1. symptoms caused by aortic stenosis 2. aortic valve area \< 0,7 cm2 3. severe aortic regurgitation 4. reduced left ventricular ejection fraction (\< 50%) 5. any valve disease with indication for surgery 6. coronary artery disease 7. therapy refractory arterial hypertension 8. comorbid noncardiac diseases or other reasons which make a regular follow-up impossible 9. other indication for treatment with statins 10. women of childbearing potential not using the contraception method(s) specified in this study (specify), as well as women who are breastfeeding 11. known sensitivity to study drug(s) or class of study drug(s) 12. patients with severe medical condition(s) that in the view of the investigator prohibits participation in the study (specify as required) 13. use of any other investigational agent in the last 30 days

Keywords: aortic valve stenosis statin therapy
detection of microplastics in cardiac surgery patients

Conditions: Cardiac Surgery; Microplastics; Nanoplastics; Cardiovascular Diseases

Summary: the exponential growth in plastic production/use translates into a parallel increase in environmental plastic waste, which is constantly degraded into microplastics and nanoplastics. information on the effects of microplastics on human health is still preliminary. cardiac surgery patients is a population high exposed to plastics. this observational study will obtain biological samples of cardiac surgery patients as a reference and vulnerable group of individuals highly exposed to microplastics and potentially more susceptible. the objective of this research is to be able to detect microplastics on blood and operation samples of cardiac surgery patients as well as their potential genotoxic and immunological damage.


Eligibility criteria:
inclusion criteria: * age ≥18 years * elective cardiac surgery exclusion criteria: * emergency surgery or limited-term surgery * previous cardiac surgery * previous severe liver disease * pregnant or planning to become pregnant * have a malignant tumor