Kornimate/medical-research-clean huggingface dataset:
a comparison between conventional throat packs and pharyngeal placement of tampons in rhinology surgeries

Conditions: Pain; Postoperative Pain; Bleeding; Nose Bleed

Summary: post-operative, throat pain, nausea and vomiting is a common occurrence in rhinology surgeries due to the use of throat packs during the procedure. in order to optimize quality of care and patient satisfaction, the aim of this study to evaluate the incidence of post-operative, throat pain, nausea and vomiting in patients that have been packed with either conventional gauze throat packs or pharyngeal tampons.

the nose and para nasal sinuses are anatomically known to be highly vascular and a substantial amount of bleeding is expected from rhinology surgeries, ingested blood is known to be a power full emetic, and the risk aspiration of blood is present due to the fact that an endotracheal tube is not 100% effective in protecting the airway. post-operative nausea and vomiting is a frequent problem that is encountered in surgical patients with a 4th to 6th fold increase in nasal and endoscopic sinus operations. posterior throat pack is an often-used in rhinology surgery, it is said to help in protecting the air way against aspiration and also helps in the reduction of post-operative nausea and vomiting, however many studies concluded that posterior throat pack is associated with higher amount of post-operative pain, nausea,, vomiting and in some rare cases even forgotten in the patient leading to mortality. however, despite poor evidence the placement of posterior throat packs is commonly practiced by surgeons and anesthetists because the possible risk of aspiration is worrisome to the latter and the former. a conventional throat pack consists of gauze, but an alternative practice involves the pharyngeal placement of tampons. in marais and prescott posterior pharyngeal placement of tampons is associated with a decrease amount of post-operative throat pain, when compared to conventional gauze throat packs, however they did not compare the incidence of post-operative nausea and vomiting in both groups.

Eligibility criteria:
inclusion criteria: * adults patients ( above the age of 18 years) * admitted under dr. hiba al-reefy * underwent a rhinology procedure that required the use of a throat pack exclusion criteria: * pediatric patients * pt who underwent a procedure without the use of throat packs
direct lysis of staph aureus resistant pathogen trial of exebacase

Conditions: Staphylococcus Aureus Bacteremia; Staphylococcus Aureus Endocarditis

Summary: the purpose of this superiority study is to evaluate the efficacy and safety of exebacase in addition to standard of care antibiotics (soca) compared with soca alone for the treatment of patients with staphylococcus aureus (s. aureus) bloodstream infections (bsi), including right-sided infective endocarditis (ie). patients will be randomized to receive a single intravenous dose of exebacase or placebo. patients will receive soca selected by the investigators based on the protocol. exebacase, a direct lytic agent, is an entirely new treatment modality against s. aureus. exebacase is a recombinantly-produced, purified cell wall hydrolase enzyme that results in rapid bacteriolysis, potent biofilm eradication, synergy with antibiotics, low propensity for resistance, and the potential to suppress antibiotic resistance when used together with antibiotics. exebacase represents a first-in-field, first-in-class treatment with the potential to improve clinical outcome when used in addition to soca to treat s. aureus bsi including ie.


Eligibility criteria:
inclusion criteria: * male or female, 12 years or older * blood culture positive for s. aureus * at least two signs or symptoms attributable to s. aureus bsi/ie * known or suspected complicated s. aureus bsi and/or right-sided ie based on modified duke criteria * not pregnant or breastfeeding and not of reproductive potential or agrees to remain abstinent or use contraception if of reproductive potential exclusion criteria: * previously received exebacase * known or suspected left-sided ie * treatment with effective systemic anti-staphylococcal antibiotic for more than 72 hours within 7 days before randomization * presence of prosthetic valve or cardiac valve support ring, or presence of known or suspected infected hardware (orthopedic), prosthetic joint, or cardiac device * known polymicrobial bsi, or known ongoing systemic infection caused by other bacterial and/or fungal pathogen(s), and/or known to have coronavirus disease 2019 (covid-19)

Keywords: s. aureus bloodstream infection s. aureus bacteremia s. aureus right-sided infective endocarditis
follow-up of abnormal and inadequate smear-test results

Conditions: Carcinoma in Situ of Uterine Cervix

Summary: denmark has a higher incidence of cervical cancer than other nordic countries, although all danish women (aged 23-65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. annually 40 000 women receives an abnormal or inadequate test result and a follow-up recommendation. however problems with delayed follow-up may threaten the effectiveness of the danish cervical cancer screening program, as 20% of women are delayed and dysplasia potentially can progress into cancer. delayed follow-up is found in situations where women either consciously or unconsciously postpone follow-up, or because of organizational aspects of the screening program, where communication regarding test results can fail either in content or with delay.this study will evaluate two interventions designed to increase follow-up: 1. a letter with the test result and potential recommendation for follow up will be sent to the women (rct). the intention is to ensure that all women will be notified about the test result, quickly, homogenously and in layman's written language, still with the opportunity to contact or be contacted by the general practitioner, if there is special needs. furthermore, it is assumed that general practitioner consultations regarding delivery of normal test results will decrease, so that cost savings is a potential side benefit 2. electronic reminder to the general practitioner if women have not had the recommended follow up, giving the general practioner´s an opportunity to remind the women (retro perspective cohort study). the results will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in denmark, but will also have international interest because of their similar challenges.


Eligibility criteria:
inclusion criteria: * woman with a pap-smear test exclusion criteria: * less than 23 years

Keywords: risk communication follow-up organisation of screening
the stronger at home study

Conditions: Hip Fractures

Summary: hip fracture is a major health problem facing older adults. hip fractures result in higher mortality, morbidity, and costs than all other osteoporotic fractures combined. when returning home following hip fracture surgery, patients are at high risk of adverse outcomes (e.g., secondary fractures, institutionalisation, and death). objectives: this study aims to finalize and pilot test a new program of care including a user-friendly toolkit containing a home-based physiotherapy exercise and pain management program to help community-dwelling older adults recover after hip fractures. methods: this study will be two stages: first, finalizing the program. the investigators have created a self-explanatory toolkit that includes an illustrated exercise program based on a critical analysis of previous programs for hip fracture patients. the investigators will organize focus groups and conduct semi-structured interviews with patients, caregivers, policymakers, and healthcare providers to review the program and provide feedback. second, conducting a feasibility study. the investigators will pilot the program in a randomized trial with community-dwelling hip fracture patients and compare the intervention with conventional care. expected outcomes: while the number of hip fracture survivors is increasing, they are becoming frailer, and their functional recovery has not improved, making this study timely and relevant. with the current focus on helping older adults "age in place," the proposed project addresses a vital health system challenge: helping older hip fracture patients access proper rehabilitation, so they can stay independent in their homes.


Eligibility criteria:
inclusion criteria: * hip fracture patients who are 65 years or older * being discharged to home or retirement home . exclusion criteria: * participants with a terminal illness or significant contraindications preventing exercising (e.g. rapidly progressing neurological disease), * live away more than 30 km from the centre of the city, and * cannot sign the consent form and no proxy available to sign.
sialic acid supplementation in n-acetylneuraminic acid synthase (nans) deficiency

Conditions: N-Acetylneuraminic Acid Storage Disease

Summary: this study is aimed at assessing the impact of short-term (3 days) exogenous sialic acid supplementation on endogenous biomarkers of sialic acid metabolism in nans deficient patients.

nans deficiency is a genetic disorder presenting clinically with intellectual development disorder, skeletal dysplasia and dysmorphic features. it has recently been described in 9 patients (4 children and 5 adults). biallelic mutations in the nans (n-acetylneuraminic acid synthase) gene cause a block in the endogenous synthesis of sialic acid and accumulation of the precursor, n-acetyl mannosamine (mannac). in a cell culture model, this block results in hyposialylation of glycoproteins and glycolipids. it seems likely that in human, this enzyme deficiency impairs the sialylation of glycolipids and glycoproteins, known to be essential for brain development. exogenously added sialic acid partially rescued the phenotype of nans-deficient zebra fish. currently there is no approved treatment for patients with nans deficiency. the investigators concluded that exogenous sialic acid supplementation might be useful for nans patients. given that sialic acid is found as both, a free sugar and in a bound form in standard nutrition as well as in high quantities in breast milk, it can be considered as a safe nutritional ingredient; this notion is fully supported by animal toxicity studies. the use of sialic acid in nans deficiency is in line with oral supplementation of specific sugars for treatment of other glycosylation and sialylation defects such as congenital disorders of glycosylation (cdg) and myopathy with mutation in the gene gne. this novel monosaccharide therapy represents an opportunity to address fundamental biochemical questions about the relative contribution of endogenous and dietary sources on sialic acid metabolism and its potential role as a future therapy for nans patients.

Eligibility criteria:
inclusion criteria for controls: * 4 healthy adults aged 18 to 60 years (inclusion in switzerland) inclusion criteria for subjects with nans deficiency: * 4 adults aged 18 to 60 years with genetically proven nans deficiency (inclusion in italy) * 2 children aged 1 to 18 years with genetically proven nans deficiency (inclusion in switzerland) exclusion criteria for controls: * medication, restrictive diet (e.g. lactose free diet), obesity or other co-morbidities (e.g. neurological disease, developmental delay) no exclusion criteria for subjects

Keywords: sialic acid monosaccharide
sleep extension for metabolic health

Conditions: Short Sleep

Summary: the study aims to examine the effects of a sleep extension intervention on the metabolic and cardio-vascular profile of obese people who present traditional diabetes risk factors, and who are habitually sleep deprived. participants randomized to the intervention arm will complete a 6-week sleep extension intervention, whilst the control group will maintain their habitual sleep schedule. it is hypothesized that the sleep extension intervention will significantly increase total sleep time, and will be accompanied by significant metabolic-related changes.

recent epidemiological (survey) research, conducted in both in healthy populations and among those with existing chronic disease, shows that insufficient sleep can significantly contribute to ill health (including diabetes, heart disease and obesity). these findings have also been accompanied by credible explanatory mechanisms emphasising the role of sleep in regulating appetite, satiety, glucose and daytime stamina. sleep extension, therefore, is a largely unexplored pathway for improving individual health, and reducing an existing risk of diabetes. if successful, increased sleep duration and quality could be adopted as an achievable public health intervention. the study aims to recruit a total of 20 men, overweight, presenting traditional risks of developing diabetes, who are habitually short sleepers. participants are then randomized, stratified by weight status, to a sleep extension group, or a control sleep monitoring group. baseline measures include sleep actigraphy, continuous glucose monitoring, blood pressure, and a mixed-meal tolerance test; after the 6-week intervention, the same measures are repeated.

Eligibility criteria:
inclusion criteria: * age: 25 to 55 years (inclusive) * gender: men * bmi \> 25kg/m2 * average self-reported sleep duration of ≤ 6h per 24h * stable daily sleep/wake schedule * health risk screening score ≥ 2 exclusion criteria: * diagnosed sleep disorder as per dsm-5: e.g. insomnia, restless legs syndrome, moderate/severe obstructive sleep apnoea; epworth sleepiness score: \<5 * diagnosed chronic conditions, or medication, likely to interfere with regular sleep: t2d, chronic fatigue syndrome, fibromyalgia, copd, uncontrolled depression/anxiety, other severe psychiatric illness, substance abuse. * night/evening shift work , regular time-zone travel, other circumstances preventing regular sleep schedule (e.g. very young children, carer at night for sick relatives etc)

Keywords: short sleep insufficient sleep sleep extension diabetes risk
aromatherapy versus gum chewing on preoperative anxiety

Conditions: Anxiety

Summary: investigators hypothesized that the use of blend aromatherapy and gum chewing before surgery would reduce preoperative anxiety as assessed by the speilberger state-trait anxiety inventory (stai) questionnaire and provide non pharmacological methods to decrease postoperative sore throat, postoperative nausea \& vomiting and postoperative pain.

a written informed consent will be taken from the patients.patients will be assigned randomly to three groups (30 subjects each) either with preoperative aromatherapy (group a) or gum chewing (group g) or control group (group c) to assess the preoperative anxiety and postoperative sore throat, nausea \& vomiting and pain control between the three studied groups.

Eligibility criteria:
inclusion criteria: * educated adult females * american society of anesthesiologists (asa) physical status i-ii * listed for elective gynecological laparoscopy surgery under general anesthesia and endotracheal tube (ett) exclusion criteria: * impaired pharyngeal or esophageal function * phenylketonuria (contraindication to the sweetener aspartame in chewing gum) * a fall upper or lower denture (not feasible to chew gum) * a history of preoperative sore throat, upper respiratory tract illness * using steroid or analgesia within the last 48 hour * chronic smokers * receiving warfarin, heparin, full dose 325 mg aspirin, or clopidogrel * a history or diagnosis of bleeding diatheses * any known allergies to ginger or lavender * having head or neck surgery * history of difficult intubation * pregnant women
s.k.a.t.e.: safety of keppra as adjunctive therapy in epilepsy

Conditions: Epilepsy

Summary: the purposes of the study were to obtain further information about the optimal dose and the efficacy of keppra in daily clinical practice, and to confirm the favorable safety and tolerability profiles of the drug observed during clinical development.


Eligibility criteria:
inclusion criteria: * partial onset seizures, whether or not secondarily generalized; * at least 1 partial seizure and no more than 14 partial seizures per month as measured by historic baseline; * using 1, but no more than 2 concomitant marketed antiepileptic drugs (aeds) at the time of study entry. exclusion criteria: * presence of known pseudoseizures within the last year; * presence or history of allergy to the components of keppra (levetiracetam, lactose, cornstarch, and excipients) or other pyrrolidine derivatives; * on felbamate with less than 18 months exposure; * on vigabatrin, but visual field had not been assessed as per recommendation of the manufacturer, i.e., every 6 months; * uncountable seizures (clusters) or history of convulsive status epilepticus within the last 5 years.

Keywords: levetiracetam keppra
closure of skin in chorioamnionitis research pilot study

Conditions: Chorioamnionitis; Pregnancy Complications, Infectious; Complications; Cesarean Section; Postoperative Complications

Summary: the purpose of the cscar pilot study is to improve the design of a full-scale trial by determining the patient recruitment rate and participation rate. the objective of the full-scale trial is to determine the optimal method of skin closure after caesarean delivery in women with chorioamnionitis, which is an acute inflammation of the membranes and chorion of the placenta, seen typically after rupture of membranes with ascending polymicrobial bacterial infection. women in labour with chorioamnionitis will be randomized at the time of caesarean delivery to skin closure with either staples or sutures. the women will be followed at 6 weeks and 6 months post-partum in order to establish the occurrence of surgical site infection and wound disruption, as well as evaluation of the scar and other secondary questions. the investigators hypothesis is that closure of skin with sutures will have a rate of wound infection that is no higher than the rate of wound infection when closing skin with staples. the investigators also hypothesize that closure with sutures will have a decreased rate of wound disruption, increased patient satisfaction and decreased length of hospital stay compared to skin closure with staples.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of chorioamnionitis (fever ≥ 38.0°c and at least two of: maternal tachycardia: heart rate \> 100bpm, fetal tachycardia: baseline heart rate \> 160bpm, uterine tenderness, foul smelling / purulent vaginal discharge, white blood cell count \> 15,000 cells/mm3) * caesarean delivery with pfannenstiel incision * pregnancies \>24 weeks * scheduled or non-elective procedures * primary or repeat caesarean delivery * no restrictions based on bmi * no exclusions due to dm (gdm or non gdm) * no exclusions due to multiple gestation pregnancy exclusion criteria: * non-pfannenstiel incision * immune compromising disease * history of keloid formation * chronic steroid use * allergy to staples * planned postpartum care at another facility

Keywords: suture techniques sutures surgical staplers
capecitabine/tesetaxel versus capecitabine/placebo as second-line therapy for gastric cancer

Conditions: Gastric Carcinoma

Summary: this study is being performed to evaluate the efficacy and safety of capecitabine in combination with tesetaxel versus capecitabine in combination with placebo as second-line treatment for patients with gastric cancer.


Eligibility criteria:
key inclusion criteria: 1. histologically or cytologically confirmed gastric adenocarcinoma, including gastric or gastroesophageal-junction adenocarcinoma (histologically confirmed adenocarcinoma of the lower esophagus acceptable with radiographic or endoscopic documentation of gastroesophageal-junction or proximal-stomach involvement.) 2. measurable disease (revised recist) based on computed tomography, or nonmeasurable disease 3. ecog performance status 0 or 1 4. treatment with only 1 prior regimen (as first-line therapy) that must have included a fluoropyrimidine and a platinum-containing agent (prior adjuvant or neo-adjuvant chemotherapy acceptable provided 6 months elapsed between the end of this therapy and the start of first-line therapy.) 5. disease progression after the start of the 1 prior regimen based on computed tomography 6. adequate bone marrow, hepatic, and renal function 7. ability to swallow an oral solid-dosage form of medication key exclusion criteria: 1. squamous cell gastric carcinoma 2. bone-only metastatic disease 3. history or presence of brain metastasis or leptomeningeal disease 4. operable gastric or gastroesophageal-junction cancer 5. her2-positive disease if the patient has not previously been treated with an anti-her2 agent 6. uncontrolled diarrhea, nausea, or vomiting 7. known malabsorptive disorder 8. significant medical disease other than gastric cancer 9. presence of neuropathy \> grade 1 (nci common toxicity criteria) 10. prior treatment (including adjuvant therapy) with a taxane or other tubulin-targeted agent (indibulin, eribulin, etc.) 11. prior radiation therapy to more than 25% of the bone marrow 12. need to continue any regularly-taken medication that is a potent inhibitor or inducer of the cyp3a pathway 13. pregnancy or lactation
study of diagnosis of color power doppler combined minimally invasive sampling for endometrial diseases

Conditions: Endometrial Diseases

Summary: the postmenopausal women with vaginal bleeding were selected in this cross-sectional study. the basic characteristics information and endometrial blood flow energy index of endometrium were detected by color power doppler ultrasound, and the energy histogram of endometrium was obtained. the specimen of uterine cytology and endometrial tissue were obtained through minimally invasive endometrium sampler, which were diagnosed by pathology. the statistical data were used to detect endometrial and precancerous lesions to observe the endpoint, and to provide the energy histogram model of the early warning endothelial diseases.

the postmenopausal women with vaginal bleeding are selected in this cross-sectional study. the uterine bleeding in patients with blood system diseases, reproductive organ outside the uterus, other organs cancer metastasis to the uterus are excluded. the objects are divided into two groups(patients with endometrial benign diseases and patients with endometrial cancer and precancerous diseases) according to endometrial cytological and histological pathology. the endometrial thickness, basic characteristics information and endometrial blood flow energy index, endometrial vascularization index, blood flow index are detected by color power doppler and the energy histogram of endometrium is obtained using a voluson e8 (ge medical systems, usa) ultrasound system. moreover,the specimen of uterine cytology and endometrial tissue are obtained through minimally invasive endometrium sampler, which were diagnosed by pathology.

Eligibility criteria:
inclusion criteria: * postmenopausal women with vaginal bleeding exclusion criteria: * vaginal bleeding caused by hematological system diseases or genitals outside the uterus * uterine bleeding caused by other organ cancers metastasize to the uterus