Kornimate/medical-research-clean huggingface dataset:
diagnostic performance and impact of a multiplex pcr pneumonia panel in icu patients with severe pneumonia.

Conditions: Community-acquired Pneumonia; Hospital-acquired Pneumonia; Ventilator Associated Pneumonia

Summary: the objective of this study is to assess the diagnostic performance of multiplex respiratory pcr (pcr-rm) compared to standard microbiological tests and its potential impact on the early adaptation of antibiotic treatment in intensive care patients with severe pneumonia.

this is a prospective, observational, multicenter icu study. adult patients with severe pneumonia requiring invasive mechanical ventilation will be included. severe pneumonia consists of 3 categories of pneumonia: community-acquired pneumonia (cap), hospital-acquired pneumonia (hap), and ventilator-acquired pneumonia (vap). the microbiological testing will be performed before antibiotic initiation on tracheobronchial aspirations, protected distal sampling, or mini-bronchoalveolar lavage as part of routine care. no additional samples will becollected for this study. respiratory samples will be simultaneously tested by conventional microbiological techniques and multiplex respiratory pcr \[pcr-rm\] (biofire® filmarray® pneumonia panel plus). classical microbiological culture (cmc) will be considered the gold standard for microbiological pneumonia diagnosis. the agreement between the results of the pneumonia plus® panel and the results of conventional microbial culture (cmc) will be assessed. an empiric antibiotic therapy will be prescribed according to the local ecology and the protocols of each icu unit. two senior experts in each participating center will have to approve the antibiotic prescription. the antibiotic therapy could be modified after the reception of the mutilpex pcr results by the two senior experts. after the reception of the results of the classic microbiological culture, the previous antibiotic changes will be judged as appropriate or inappropriate by a multidisciplinary team including intensivists, infectious disease specialists, and microbiologists. appropriate changes include adequacy, de-escalation, and optimization of antibiotic therapy, and inappropriate changes include inadequacy, escalation, and de-optimization.

Eligibility criteria:
inclusion criteria: * critically ill adult patients * clinical, biological, and radiological signs of severe pneumonia. * community-acquired pneumonia, hospital-acquired pneumonia, or ventilator-associated pneumonia * invasive mechanical ventilation. exclusion criteria: - non-invasive mechanical ventilation.

Keywords: community-acquired pneumonia hospital-acquired pneumonia ventilator associated pneumonia multiplex pcr antibiotic stewardship
vitamin e, c and zinc in patients with skin cancer: influence on oxidative stress and inflammatory state

Conditions: Skin Neoplasms

Summary: the objective of this study was to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers and inflamatory citocines in patients with a previous history of non-melanoma skin cancer treated with surgery. this was a double-blind, randomized, placebo-controlled trial. patients were randomized into two groups, one receiving placebo (n=34) and the other receiving supplementary antioxidant therapy (n=26) with vitamin c (50 mg), vitamin e (60 mg), and zinc (40 mg) for 60 days. blood samples were obtained from patients, and the levels of oxidative stress biomarkers, including 8-isoprostane, nitrite, thiobarbituric acid reactive substances, and total antioxidant capacity, were measured, as well as the inflamatory citocines (il-1, il-6, il-10, tnf alfa) and it was evaluated at two different times: (1) one day before the start of supplementation or placebo administration and (2) at 60 days after intervention. statistical analyses were performed with the sas system for windows 9.3 program and data were analyzed using anova for repeated measures test.


Eligibility criteria:
inclusion criteria: * patients who had non-melanoma skin cancer (squamous cell carcinoma or basal cell carcinoma) and who were treated with surgery * age ≥20 years * absence of comorbidities such as type 1 diabetes, severe heart disease, hepatic dysfunction, renal failure requiring dialysis, hiv infection, and melanoma skin cancer * no history of chemotherapy or radiotherapy in the previous 6 months * absence of severe psychiatric disease that limited comprehension * not taking any vitamin and/or mineral supplementation. exclusion criteria: * subjects did not complete the entire course of supplemental therapy.
laparoscopic guided peri-wound transversus abdominis plane block with bupivacaine versus local wound infiltration on post-op opioid use in laparoscopic sleeve gastrectomy

Conditions: Morbid Obesity; Laparoscopic Sleeve Gastrectomy; Transversus Abdominis Plane Block; Local Wound Infiltration; Bupivacine; Opioid Use

Summary: the goal of this randomized controlled trial is to compare laparoscopic guided peri-wound transversus abdominis plane block and bupivacaine versus local wound infiltration effect on reducing post-op opioid use in laparoscopic sleeve gastrectomy. the main questions it aims to answer are: • can laparoscopic guided peri-wound transversus abdominis plane block reduced post operative morphine usage when comparing with local wound port site infiltration. participants will be randomize into 2 group * peri-wound transversus abdominis plane block * local wound port site infiltration


Eligibility criteria:
inclusion criteria: * patient undergoing lsg at sringarind hospital as indicated by thai guideline exclusion criteria: * allergic/contraindicated to bupivacaine, morphine, fentanyl, nsaids or nefopam * unable to describe pain score opioid addict * denied consent
tqlb for postoperative pain after laparoscopic partial nephrectomy

Conditions: Laparoscopic Renal Surgery; Pain Management; Nerve Block

Summary: this prospective, randomized study,control study aims to compare the analgesic effect,opioids consumption,quality of recovery,length of hospital stay，et al. between single-injection qlb(quadratus lumborum block)+ intravenous patient-controlled analgesia (ipca) and intravenous patient-controlled analgesia (ipca) alone in patients undergoing laparoscopic partial nephrectomy.


Eligibility criteria:
inclusion criteria: * age 18-70 yrs * american society of anesthesiologists physical statusⅰ-ⅲ * undergo laparoscopic partial nephrectomy * informed consent exclusion criteria: * a known allergy to the drugs being used * coagulopathy, on anticoagulants * analgesics intake, history of substance abuse * participating in the investigation of another experimental agent * inability to properly describe postoperative pain to investigators (eg, language barrier, neuropsychiatric disorder)
comparison of the eradications rates of sequential therapy versus concomitant therapy

Conditions: Helicobacter Pylori Infection

Summary: comparison of the eradications rates of sequential therapy versus concomitant therapy of treatment of helicobacter pylori infection in korea. single center, randomized trial 1. (pantoprazole 40 mg + amoxicillin 1.0g + clarithromycin 500 mg + metronidazole 500 mg) twice for 10 days 2. (pantoprazole 40 mg + amoxicillin 1.0g + clarithromycin 500 mg + metronidazole 500 mg) twice for 14 days 3. (pantoprazole 40 mg + amoxicillin 1.0g) twice for 5 days and subsequent pantoprazole 40mg + clarithromycin 500 mg + metronidazole 500 mg) twice for 5 days 4. (pantoprazole 40 mg + amoxicillin 1.0g) twice for 7 days and subsequent pantoprazole 40mg + clarithromycin 500 mg + metronidazole 500 mg) twice for 7 days 1st endpoint : helicobacter pylori eradication rates (intention to treatment, per-protocol) 2nd endpoint : adverse event(nausea, vomiting, dizziness, bitter sense) drug compliance


Eligibility criteria:
inclusion criteria: * 20\~80 patients * agreement of informed consent * h.pylori positive (biopsy, clo) * peptic ulcer disease, mucosa associated lymphoid tissue lymphoma, post endoscopic submucosal dissection status due to early gastric cancer exclusion criteria: * h.pylori eradication history * severe hepatic, renal, cardiac failure * pregnancy, participant of other study

Keywords: helicobacter eradication rates
speech processing in stuttering

Conditions: Stuttering; Stuttering, Childhood; Stuttering, Adult

Summary: this research is being done to better understand stuttering, specifically how people who stutter may process and/or produce speech. eligible participants enrolled will complete a variety of computer and speech-based tasks on up to 2 visits.

the study team will update the record to include the secondary identification number once the nih has released the funds.

Eligibility criteria:
inclusion criteria (adults who do not stutter): * 18-65 years old * english as primary language * normal speech, language, hearing, cognition exclusion criteria: (adults who do not stutter) * personal or family history of stuttering * major medical or psychiatric illness inclusion criteria: (adults who stutter) * aged 18-65 years * english as primary language * normal speech, language, hearing, cognition (other than stuttering) * currently stutters exclusion criteria: (adults who stutter) * speech therapy within the past year * major medical or psychiatric illness inclusion criteria: (children who do not stutter) * aged 6 to 17 years * english as primary language * normal speech, language, hearing, cognition exclusion criteria: (children who do not stutter) * personal or family history of stuttering * major medical or psychiatric illness * language/motor delay inclusion criteria: (children who stutter) * aged 6 to 17 years * english as primary language * normal speech, language, hearing, cognition (other than stuttering) * currently stutters exclusion criteria: (children who stutter) * major medical or psychiatric illness * language/motor delay

Keywords: healthy children healthy adults
bitter chocolate or orange juice for non-reactive non-stress test (nst) patterns

Conditions: Nonreassuring Fetal Status

Summary: there are multiple factors affecting the variability and acceleration pattern of fetal heart rate (fhr) pattern. however, fetal activity is considered as the main determinant. any factor decreasing fetal activity causes a decrease in fhr variability. fetal activity may be stimulated by manual manipulation, sound, light, change in maternal position and maternal ingestion of glucose. among those, ingestion of any kind of food or juice is most frequently practiced in outpatient settings. this is not only medical but also a social routine. in this study the investigators have chosen the two most popular so-called 'fetal accelerators', chocolate and orange juice against no intervention and tried to find any usefulness of these on non-reactive nst patterns.


Eligibility criteria:
inclusion criteria: * singleton pregnancies at 36 to 41 completed gestational weeks that have a non-reactive nst pattern without decelerations. exclusion criteria: * multiple pregnancies, fetal anomaly, hypertension, intrauterine growth restriction, active labor, contractions or decelerations on nst, absence of a first or second trimester ultrasonography for accurate gestational dating, pre-gestational or gestational diabetes and known allergy to chocolate or orange

Keywords: non-stress test
a study of the combination of pemetrexed and irinotecan every two weeks in metastatic colorectal cancer

Conditions: Metastatic Colorectal Cancer

Summary: a non-randomized phase ii study to determine the efficacy and safety of the combination of pemetrexed and irinotecan every two weeks in metastatic colorectal cancer patients.


Eligibility criteria:
inclusion criteria: * diagnosis of metastatic colorectal adenocarcinoma that is not amenable to curative therapy. * patient must have at least one unidimensionally measurable lesion. * prior radiation therapy to less than 25% of bone marrow. radiation must be completed at least 4 weeks prior to study enrollment. * performance status 0 to 2 * patient must have received 1 prior course of chemotherapy (folfox regimen) for metastatic disease exclusion criteria: * treatment with any drug within the last 30 days that has not received regulatory approval. * serious systemic disorder (cardiac or pulmonary disease, active infection) * documented brain metastases not amenable to surgery or unstable after radiation * inability or unwillingness to take folic acid or vitamin b12 supplementation. * presence of fluid retention that can not be controlled by drainage.
tips vs endoscopic therapy for variceal rebleeding in cirrhotic patients with portal vein thrombosis

Conditions: Portal Vein Thrombosis; Liver Cirrhosis

Summary: portal vein thrombosis may be a negative prognostic marker of variceal bleeding in liver cirrhosis. compared with conventional endoscopic and pharmacological therapy, transjugular intrahepatic portosystemic shunt may further improve the outcomes of portal vein thrombosis in liver cirrhosis with variceal bleeding.

portal vein thrombosis may be a negative prognostic marker of variceal bleeding in liver cirrhosis. compared with conventional endoscopic and pharmacological therapy, transjugular intrahepatic portosystemic shunt may further improve the outcomes of portal vein thrombosis in liver cirrhosis with variceal bleeding. however, the safety of transjugular intrahepatic portosystemic shunt remains uncertain in patients with portal vein thrombosis.

Eligibility criteria:
inclusion criteria 1. liver cirrhosis (histological or clinical); 2. significant variceal bleeding \>5 days and ≤ 42 days 3. successful treatment of the index bleed by means of vasoactive drugs and/or endoscopic treatment 4. portal vein thrombosis occlusion\>=25% of the vessel lumen; 5. presence of ascites 6. child-pugh score 8-12 at inclusion 7. age 18 to 70 years exclusion criteria 1. bleeding from isolated gastric or ectopic varices 2. contraindications to non-selective beta blockers (chronic obstructive pulmonary disease, asthma, aortic stenosis, atrioventricular block, intermittent claudication, and psychosis) 3. contraindications to tips : extensive potral vein thrombosis, fibrotic cord replacing original main portal vein; bilirubin\>3.5 mg/dl, plasma creatinine\>2.1 mg/dl, child-pugh score \>=13points 4. a history of significant heart failure (new york heart association class iii and iv) 5. overt hepatic encephalopathy, 6. prehepatic portal hypertension 7. malignancy (including hepatocellular carcinoma) or a concomitant disease with reduced life expectancy 8. uncontrolled infection and sepsis 9. previous treatment to prevent rebleeding with a portosystemic shunt,tips or with pharmacological therapy with non-selective beta blockers and endoscopic variceal ligation 10. pregnancy or lactation
diagnostic accuracy of x ray kub in diagnosing renal calculi keeping ct scan as gold standard

Conditions: Renal Calculi

Summary: in clinical practice both xray and ct scan kub are reliable,however, ctscan is superior to x ray kub in detecting renal and ureteric calculi,the reson being stone that are missed by xray kub are usually small and sould pass spontenously while other are usually with improper bowel preparation


Eligibility criteria:
inclusion criteria: * female who will be advised x ray kub and ct scan kub for suspected renal \& uretrric calculi(flank pain )for \<24 hours . * age 18-49 years (because this is common age group for renal \&ureteric calculi). exclusion criteria: * female patients with pregnancy. * morbidly obese patients (men\>129 kg women\>113kg) * patients with history of any abdominal trauma
her2 expression in gynecological malignant tumors in chongqing area of china

Conditions: Cervical Cancer; Endometrial Cancer; Ovarian Cancer; HER2 Expression

Summary: this study aims to retrospectively analyze the her2 expression of gynecological malignant tumors in chongqing by immunohistochemical detection, and explore the correlation between her2 level, therapy response and prognosis based on patient clinical information.


Eligibility criteria:
inclusion criteria: * patients with primary gynecological malignant tumor confirmed by histopathology * women aged 18-75 * the expected survival time is greater than 12 weeks * kps \> 60, ecog score is 0-2 * all subjects voluntarily joined this study with informed consents, and had good compliance of follow-up exclusion criteria: * pregnant and lactating women * suffering from other malignant tumors in the past 5 years * patients who are not suitable for this study according to the investigator's judgment

Keywords: cervical cancer endometrial cancer ovarian cancer her2 expression therapeutic efficacy prognosis
locally advanced rectal cancer - exfoliated peritoneal tumor cells

Conditions: Rectal Cancer

Summary: during the course of tumor growth and possibly by manipulation during the surgical procedure, cells from rectal tumors may be shed into the peritoneal cavity. such cells may give rise to local recurrence or contribute to the formation of metastatic disease, specifically in the form of peritoneal carcinomatosis. detection of cancer cells in the peritoneal cavity at the time of surgery might therefore be of value for prediction of disease recurrence with subsequent prognostic implications for these patients. in this study the investigators aim to determine the presence of exfoliated tumor cells in peritoneal lavage samples from patients undergoing surgery for larc.

the investigators recently published a study investigating the incidence of exfoliated cancer cells in peritoneal lavage fluid after resection of locally advanced rectal cancer (larc). dna isolated from cells obtained by peritoneal lavage was analyzed by denaturing capillary electrophoresis with respect to mutations in hotspots of the k-ras gene. this gene is mutated in 30% of rectal tumors. exfoliated tumor cells (as assessed by the presence of mutated dna) were found in lavage fluid from 19/237 of the patients, and the presence of tumor cells was associated with poor overall survival. based on these encouraging results the investigators have designed a more comprehensive prospective study, using a novel, validated set of cancer specific dna methylation - based biomarkers present in the vast majority of all colorectal tumors (sensitivity 94%, specificity 98%).using these tumor cell associated biomarkers, the investigators aim to determine the presence of exfoliated tumor cells in peritoneal lavage samples from patients undergoing surgery for larc. lavage will be performed prior to and after manipulation of the tumor to provide data regarding both spontaneous and iatrogenic tumor cell exfoliation and their respective contribution to patient outcome. if detection of exfoliated tumor cells is predictive of tumor recurrence, this would support an active approach to postoperative chemotherapy, possibly in the form of intraperitoneal chemotherapy.

Eligibility criteria:
inclusion criteria: * patients scheduled for surgical removal of a primary locally advanced rectal tumor at the norwegian radium hospital. * age \> 18 years * written informed consent exclusion criteria: -

Keywords: rectal cancer locally advanced rectal cancer peritoneal carcinomatosis exfoliated peritoneal cells peritoneal lavage
systemic and peritoneal inflammatory response in robotic-assisted and laparoscopic surgery for colon cancer

Conditions: Colonic Neoplasms; Colon Cancer; Systemic Inflammatory Response Syndrome; Inflammation; Robotic Surgical Procedures; Laparoscopy; Peritoneal Inflammation

Summary: the current hypothesis is that robotic-assisted surgery results in a reduced systemic and peritoneal inflammatory response (sirs) compared to laparoscopic surgery in the treatment of colon cancer. the purpose is to evaluate differences in the peritoneal and systemic inflammatory response in robot-assisted and laparoscopic surgery of patients undergoing resection for colon cancer in a randomized, blinded controlled trial.


Eligibility criteria:
inclusion criteria * elective robotic-assisted or laparoscopic surgery for right-sided, left-sided and sigmoid colon cancer * aged ≥ 18 * asa-score ≤ 3 * tumor-stage (tx-t4a) * endoscopic suspected colon cancer * histological verified adenocarcinoma, signet ring cell carcinoma, undifferentiated cancer, medullary carcinoma, or another malignant tumor type originating from colon * patients must give informed written consent * patients must be able to understand danish language exclusion criteria * carcinoma of the transverse colon or synchronous colorectal cancer * previous history of colon cancer * previous open major abdominal surgery with exception of open appendectomy and cholecystectomy. * metastatic disease * pregnancy * history of psychiatric or addictive disorder that would prevent the patient from participating in the trial * emergency colon surgery * co-existing inflammatory bowel disease * co-existing immunological disease that requiring ingestion of systemic immunomodulatory drugs (dmard - disease modifying anti-rheumatic drugs), corticosteroids and biologic disease-modifying anti-rheumatic drugs. * daily consumption of nsaid drugs

Keywords: systemic inflammatory response colonic neoplasm robotic assisted surgery laparoscopy
nesiritide and vo2 max in heart failure patients

Conditions: Heart Failure

Summary: this research study, funded by scios, inc., and conducted by the cardiology division of the department of medicine at the university of rochester school of medicine and dentistry investigates the potential benefit of nesiritide (brand name is natrecor(tm))in improving exercise capacity in patients with heart failure (hf). previous studies have shown beneficial hemodynamic and neurohumoral effects of nesiritide infusion in the therapy of decompensated heart failure. other studies have demonstrated increases in endogenous bnp levels (normalized for exercise workload) in hf patients during and after exercise. however, trials involving the measurement of exercise capacity in this population following bnp administration are lacking. this is an experimental prospective, non-blinded, pilot study with a sample size of 20 patients, all serving as their own controls. this study involves off-label use of the drug nesiritide (indicated for iv treatment of nyha class ii and iii patients, and this study is enrolling class ii and iii patients) and has received fda approval, and an ind. subjects are recruited from the population of referrals to the strong memorial hospital heart failure and transplantation clinical service, who meet all the inclusion criteria and none of the exclusion criteria may participate in the study. enrolled study subjects perform an exercise vo2 max test, receive a 24 hour infusion of nesiritide and perform a second exercise vo2 max test.

see above comments.

Eligibility criteria:
inclusion criteria: * aged 18-65 with nyha class ii or iii heart failure * referred to strong memorial hospital for consideration of heart transplant * male or female and infertile or using effective contraception with negative pregnancy test * capable of iv access * able to perform a maximal bicycle test and tolerate mouthpiece and nose clip * fully understands and has signed informed consent form before study begins * endogenous bnp level of at least 100 pg/ml * current smokers smoking \< 3 cigarettes / day. smoking is not permitted within the hospital, ergo subjects would not be permitted to smoke during study participation. exclusion criteria: * nyha class i or iv heart failure * creatinine clearance \< 30 ml/min, as determined within 2 weeks of the start of the study * ef \> 40% * evidence of primary lung disease * hypersensitivity to nesiritide or any of its' components * current smokers as defined by \> 3 cigarettes / day * stroke within 3 months, myocardial infarction within 2 months, or any evidence of active myocardial ischemia * unwillingness ir inability to remain in the hospital overnight * clinical condition or laboratory abnormality which may increase risks associated with participation or interfere with result interpretation * any condition which would preclude heart transplantation.