Kornimate/medical-research-clean huggingface dataset:
nurse promotion of iv to po antimicrobial conversion

Conditions: Behavior Change; Bacterial Infections

Summary: this is a prospective, quasi-experimental, historically controlled study to evaluate if a behavioural change intervention informed by the com-b model of behaviour change can improve nurses' self-perceived capability, opportunity, and motivation to engage in the assessment of patients who may be appropriate for iv to po antimicrobial conversion. this study also seeks to determine if this translates into an increase in iv to po antimicrobial conversion rates in the acute care setting.

current antimicrobial stewardship guidelines recommend appropriate and timely iv to po antimicrobial conversion in hospitalized patients. published rates of iv to po antimicrobial conversion are consistently below 50% in eligible inpatients. studies have suggested that nurses may be well positioned to provide a positive influence on prescriber behavior related to antimicrobial iv to po conversion, however, no published research has evaluated the impact of nurses on antimicrobial iv to po conversion rates. published research has described the barriers and enablers to nurse participation in promoting antimicrobial iv to po conversion using the com-b model of behaviour change. this quasi-experimental study will evaluate whether determinants of nurse behaviour and their actual behaviour can be changed to increase antimicrobial iv to po conversion rates in hospitalized patients.

Eligibility criteria:
inclusion criteria: * nineteen years of age or older * employed as a rn or lpn at kgh in any capacity (full-time, part-time or casual employee) * practicing on a medicine/thoracic surgery ward (4a) or medicine/oncology/respiratory ward (4b) exclusion criteria: * rns or lpns on orientation shifts/training * rns or lpns not engaged in patient care * student nurses/nurses in training

Keywords: nurse antibiotic step-down
phase ii evaluating efficacy of temsirolimus in 2 line therapy for patients with advanced bladder cancer

Conditions: Relapsed Bladder Cancer

Summary: in the absence of standard treatment in this indication, this test evaluates a new drug type targeted therapy in this indication, evaluating its efficacy in terms of tumor response and survival.

in the absence of standard treatment in this indication, this test evaluates a new drug type targeted therapy in this indication, evaluating its efficacy in terms of tumor response and survival. this study will also search for genes involved in the response to treatment.

Eligibility criteria:
inclusion criteria: * men or women of at least 18 years of age * histologically proven bladder cancer * locally advanced or metastatic disease (stage iv) * functional status (ecog / oms) ≤ 2 * relapse after first-line chemotherapy * measurable lesions (recist criteria) * absence of anti-neoplasic treatment in the 4 weeks preceding inclusion. * biological levels : * neutrophil count \>1,5.109/l. * platelets \>100.109/l * total serum bilirubin \< 1.5 × uln * clearance of créatinine 40 ml/mm * if not liver metastasis alanine aminotransferase (alt) and aspartate aminotransferase (ast) \<2.5 × uln * with liver alanine aminotransferase (alt) and aspartate aminotransferase (ast) \<5 × uln * signed informed consent * both women and men must agree to use a medically acceptable method of contraception throughout the study. women of childbearing potential must have a negative serum pregnancy test of or less than 7 days before the first perfusion of study. * france only : patients affiliated to a social security program exclusion criteria: * presence of metastatic brain or meningeal tumors on selection scanner, weither symptomatic or asymptomatic * chemotherapy, immunotherapy, or radiotherapy within 4 weeks of inclusion * known hypersensitivity to temsirolimus, or its metabolites (as sirolimus), or polysorbate 80 or to their excipients * previous malignancy (except for cervical carcinoma in situ, basal cell carcinoma curatively treated) or incidental (≤ pt2) prostate cancer found on a radical cystoprostatectomy material * the drugs known as cyp3a4/5 inhibitors or inducers will specifically be excluded on the 30th day ( or at least 7 halves-lives, according to the shortest duration) before the first perfusion and throughout the study. any food known to inhibit cyp3a4/5 (for example grapefruit, grapefruit juice, star-fruit or star-fruit juice) will also be purposely excluded. * auto-immune pathology, psychiatric or neurological disorder * any unstable medical condition * unstable cardiac disease * severe renal failure * unstable diabetes * pregnancy * patient enrolled in another therapeutic clinical trial * patient unable to follow and comply with the study procedures because of any geographical, social or medical condition * patient partially or totally deprived of his civil rights

Keywords: relapsed bladder cancer
broad spectrum hpv vaccine dose escalation study (v502-002)

Conditions: Human Papilloma Virus; Cervical Cancer; Vulvar Cancer; Vaginal Cancer; Genital Warts

Summary: this study will examine the safety and tolerability of octavalent human papillomavirus (hpv) l1 virus-like particle (vlp) vaccine formulated with amorphous aluminum hydroxysulfate (aahs) and iscomatrix™ (imx). reviews of safety and tolerability will be used to select the dose(s) of imx for further studies of the octavalent hpv l1 vlp vaccine.

the study was performed in 2 staggered phases, phase a and phase b. in phase a, participants were randomized to qhpv, octavalent hpv with 15 mcg imx/aahs, or octavalent hpv with 30 mcg imx/aahs. after the safety for phase a was reviewed, phase b was initiated. in phase b, participants were randomized to qhpv, octavalent hpv with 60 mcg imx/aahs or octavalent hpv with 120 mcg imx/aahs.

Eligibility criteria:
inclusion criteria: * participant is in good physical health * participant has had a lifetime history of 0 to 4 sexual partners * females between 18-to-24 years exclusion criteria: * participant has a history of abnormal pap test * participant has a history of positive test for hpv * participant has a history of recent or ongoing alcohol or drug abuse * participant is immunocompromised or has an autoimmune condition * participant has received immunosuppressive therapy within a year of screening * participant has previously received an hpv vaccine * participant is pregnant * participant has a history of external genital/vaginal warts * participant is currently enrolled in a clinical trial * participant has a history of a severe allergic reaction that required medical attention
standing behavior after installation of height-adjustable desks

Conditions: Office Workers; Sitting Occupations

Summary: the purpose of this research study is to determine whether height-adjustable desks change sitting and standing time at work and away from work, engery expenditure, dietary intake, and body composition. intermittent peroids of standing made possible by height-adjustable desks may help to impart long-term health benefits.


Eligibility criteria:
inclusion criteria: * being one of the 18 scientists and support staff who have sedentary jobs * voluntarily make the choice to replace their current fixed-height sitting desk for a sit-to-stand height-adjustable desk * consents to study conditions exclusion criteria: * cannot stand for any type of health of orthopedic reasons * do not work fulltime * pregnant at baseline or become pregnant during the study

Keywords: height-adjustable desk office workers sitting occupations energy expenditure bmi weight lower fat diet
a preference study comparing kristalose® and liquid lactulose

Conditions: Constipation

Summary: this study will evaluate whether patients have an overall preference for kristalose® or liquid lactulose based on taste, consistency, and portability.

this study will evaluate whether patients have an overall preference for kristalose® or liquid lactulose based on taste, consistency, and portability.

Eligibility criteria:
inclusion criteria: * patients with recently diagnosed chronic constipation requiring treatment. exclusion criteria: * patients with galactosemia (galactose-sensitive diet). * patients less than 18 years of age. * patients currently on lactulose therapy. * inability to understand the requirements of the study or be unwilling to provide written informed consent (as evidenced by signature on an informed consent document approved by an institutional review board \[irb\]) and agree to abide by the study restrictions.

Keywords: constipation laxative lactulose kristalose®
mhealth social support for people at risk of metabolic syndrome

Conditions: Metabolic Syndrome

Summary: this trial is to examine the feasibility, acceptability, and preliminary effect of a mhealth social support program on lifestyle modifications among people at risk of metabolic syndrome in hong kong at 3- and 6-month follow-ups.

metabolic syndrome is a cluster of unhealthy conditions that affects more than 1 billion people in the world. lifestyle modifications can reduce the risk to develop metabolic syndrome, while the report showed that over 95% of people in hong kong did not practice healthy lifestyle. this trial is to examine the feasibility, acceptability, and preliminary effect of a mhealth social support program on lifestyle modifications among people at risk of metabolic syndrome in hong kong. eighty eligible participants will be recruited from community centers and be randomized into intervention group or control group. participants in the control group will receive a mobile app with limited function, while those in the intervention group will receive a theory-guided mhealth social support program. data will be collected at baseline, 3 months, and 6 months on the outcomes of feasibility, acceptability, and lifestyle modifications. data will be analyzed using a generalized estimating equation based on the intention-to-treat principle. the findings of this study will provide valuable information for a full randomized controlled trial.

Eligibility criteria:
inclusion criteria: 1. chinese adults aged ≥ 45 years 2. with central obesity according to idf criteria 3. being treated of hypertension, dyslipidemia, or diabetes 4. able to give informed consent 5. attain at least 6 years of formal education 6. have a smartphone with internet connection and able to use whatsapp exclusion criteria: 1. concurrently participating in another clinical trial, lifestyle/dietary intervention, or weight control program 2. known history of psychiatric disorders

Keywords: mhealth metabolic syndrome lifestyle modifications
the copenhagen insulin and metformin therapy trial

Conditions: Type 2 Diabetes; Atherosclerosis; Arteriosclerosis

Summary: type 2 diabetes mellitus patients (t2dm) have an increased mortality rate due to macrovascular disease. the primary objective of the study is to evaluate the effect of an 18-month treatment with metformin versus placebo in combination with one of three insulin analogue regimens following a treat-to-target principle. the primary outcome measure is change in wall thickness of the carotic arteries(cimt)measured by ultrasound. a total of 900 patients with t2dm and hba1c above 7.5% will be included.


Eligibility criteria:
inclusion criteria: * males and females over 30 years of age * type 2 diabetes * body mass index (bmi): 25.0-39.9 kg/m2 * hba1c above 7.5 % * antidiabetic tablet-treatment during 1 year minimum and / or * insulin treatment during a minimum of 3 months * negative pregnancy test * signed, informed consent exclusion criteria: * mi, coronary revascularization, tci,or apoplexy within the last 3 months * tci with verified stenosis of above 70% * heart failure (nyha class iii or iv) * former cancer patient, unless disease-free period of more than 5 years * estimated creatinine clearance \< 60 ml/min liver disease * alcohol abuse * drug abuse * retinopathy with on-going laser treatment at start of study * other acute or chronic serious disease leading to hypoxia * pregnant or breastfeeding women * women of child-bearing potential, not using contraceptives * allergy to medication used in the study * incapable of understanding the nature of the informed consent

Keywords: carotid intima media thickness insulin metformin
effects of negative energy balance on muscle mass regulation

Conditions: Weight Loss; Obesity; Skeletal Muscle; Insulin Sensitivity/Resistance

Summary: the investigators here propose to perform a prospective randomized intervention trial in post-menopausal women to investigate the endocrine network, which contributes to the changes in skeletal muscle mass during weight loss.


Eligibility criteria:
inclusion criteria: * bmi \> 27 kg/m2 (adults) * postmenopausal state exclusion criteria: * weight loss of more than 5kg in the last 2 months x * unhealthy patients with: severe chronic diseases including cancer within the last 5 years, severe heart disease, severe impairment of hepatic or renal function, severe anaemia or disturbed coagulation * eating disorders or any other psychiatric condition that would interact with the trial intervention * malabsorption * acute or chronic infections * severe hypertension * myopathy * food allergies * any other uncontrolled endocrine disorder * changes of smoking habits, diets or medication that strongly affects energy homeostasis within the last 3 months prior to study inclusion

Keywords: weight loss muscle mass
sitagliptin added-on to insulin study (0431-051)

Conditions: Type 2 Diabetes Mellitus

Summary: a clinical study to determine the safety and efficacy of sitagliptin in patients with type 2 diabetes mellitus who have inadequate glycemic control on insulin or insulin/metformin combination therapy.


Eligibility criteria:
inclusion criteria: * patient has type 2 diabetes mellitus * patient is poorly controlled while on insulin or insulin and metformin exclusion criteria: * patient has a history of type 1 diabetes mellitus or history of ketoacidosis * patient is taking oral antidiabetic agents other than metformin during the past 3 months * patient is currently on treatment with daily use of pre-prandial short-acting or rapid-acting insulin
efficacy of rituximab and cyclophosphamide, doxorubicin, vincristine, prednisone (chop) in patients with hiv associated non-hodgkin's lymphoma

Conditions: AIDS Related Lymphoma

Summary: most treatment procedures in aids-related lymphomas disclose a relatively poor outcome for patients with low response rates, high number of relapses and aids events. the addition of rituximab to the standard regimen - chop could improve the outcome of these patients. the aim of the trial is to evaluate the safety and efficacy of rituximab when added to the chop regimen in patients with newly diagnosed aids-related non-hodgkin lymphoma.

hiv infection is associated with a high incidence of aids-related lymphomas (arl). since the use of highly active antiretroviral therapy (haart), the incidence of aids-defining illnesses has decreased, leading to a significant improvement in survival of hiv-infected patients. the incidence of arl has decreased in a lower degree and lymphoma remains the major cause of death of hiv patients. most treatment procedures disclose a relatively poor outcome of patients with low response rates, high number of relapses and aids events. since the majority of hiv-associated nhl are cd20-positive the addition of rituximab to the standard regimen - chop could improve the outcome of these patients

Eligibility criteria:
inclusion criteria: * hiv positive with a high grade ann arbor stage i to iv untreated non-hodgkin's lymphoma of b-cell origin confirmed by biopsy. the following histologies are eligible: \*burkitt's lymphoma, \*diffuse large b-cell with standard histological diagnosis, \*burkitt-like and high grade large cell immunoblastic lymphoma with immunophenotyping cd20 positive * good and intermediate prognostic group (no more than one of the following prognostic factors: \*cd4 below 100/µl, \*history of opportunistic infection, \*karnofsky index below 60 percent or ecog over 2) * written inform consent to participate exclusion criteria: * active viral hepatitis * pregnancy

Keywords: aids related lymphoma chemotherapy rituximab
once-daily oral modified release hydrocortisone in patients with adrenal insufficiency

Conditions: Adrenal Insufficiency

Summary: this is a randomised, controlled, open, two-armed, two-period cross-over, multi-centre phase ii/iii study to assess the safety, tolerability and pharmacokinetics of once-daily oral modified-release hydrocortisone in comparison to conventional thrice-daily oral hydrocortisone tablets in patients with adrenal insufficiency

adrenal insufficiency is a disease with more than 80% 1-year mortality before the availability of synthetic glucocorticoids. current replacement therapy has improved this dramatically, but recent data suggest that outcome is still compromised. patient receiving replacement therapy with hydrocortisone or cortisone acetate have compromised quality of life, reduced bone mass, increased risk factors for cardiovascular disease and premature mortality that is more than twice the mortality rate in the background population. circulating cortisol levels follow a distinct diurnal pattern with high levels in the early morning and low trough values around midnight. using available formulations for replacement therapy this circadian rhythm is had to mimic and also during the active time of the day high peaks and low troughs occur. in this trial a newly developed novel dual-, controlled release formulation of hydrocortisone that has in healthy volunteers been able to mimic the circadian pattern of circulating cortisol was studied in patients with primary adrenal insufficiency (addison's disease).

Eligibility criteria:
inclusion criteria: * previously diagnosed (e.g. more than 6 months ago) primary adrenal insufficiency with a stable daily glucocorticoid substitution dose for at least 3 months prior to study entry * signed informed consent to participate in the study. exclusion criteria: * clinical or laboratory signs of significant cerebral, cardiovascular, respiratory, hepatobiliary, pancreatic disease * clinically significant renal dysfunction * clinical or laboratory signs of significant gastrointestinal emptying or motility disease * any medication with agents which could interfere with hydrocortisone kinetics * pregnant or lactating women * regular dehydroepiandrosterone (dhea) medication for the past 4 weeks * oral oestrogen medication for the past 4 weeks * deranged mineralocorticoid status

Keywords: adrenal insufficiency primary adrenal insufficiency addison's disease hydrocortisone modified release
effect of topically administered levobupivacaine- fentanyl versus levobupivacaine- dexamethasone combination in the control of pain after endoscopic sinus surgery

Conditions: Endoscopic Sinus Surgery; Fentanyl

Summary: chronic sinusitis (crs) is a high incidence disease characterized by pus, nasal obstruction, olfactory disturbance, headache, and other symptoms, lasting for more than 12 weeks, with severe cases having ocular compression and visual impairment, which can cause cranial, eye, and lung complications. chronic sinusitis is a high-risk disease.

one of the main concerns about using packing is that the removal is usually very painful and can be very bothersome. this procedure may even result in syncope by the activation of the vasovagal reflex system. there have been a few studies suggesting that nasal packs should not be used because removal from the nose causes serious discomfort and is painful. many patients who have undergone nasal surgery report that the removal of the pack was the most painful part of the experience. postoperative pain is an acute inflammatory pain that starts with surgical trauma and ends with tissue healing. it can be harmful to organ systems by initiating inflamma¬tion through different mechanisms, and the alleviation of postoperative pain is considered important for obtaining homeostasis. pain may initiate atelectasis due to improper coughing, immobilization may cause thromboembolism and catecholamine discharge may induce cardiovascular side effects and undesired changes in neuroendocrine or meta¬bolic function

Eligibility criteria:
inclusion criteria: * • asa physical status i-ii patients * scheduled for elective fess surgery. • age from 18 to 65 years patients exclusion criteria: * • age\>18 and\<65 years patients, * previous history of fess, * patients with sensitivity to anesthetic agents in the study, * patients who will do additional septoplasty or turbinate surgery, * patients with disturbance of blood coagulation, including pro¬thrombin time (pt)/partial thromboplastin time (ptt) prolon¬gation, purpura, and spontaneous bleeding;

Keywords: dexamethasone levobupivacaine
adrenal scans with radioiodine-labeled norcholesterol (np-59)

Conditions: Adrenal Tumors; Adrenal Malignancies; Abnormal Hormonal Secretions; Electrolytes Abnormalities

Summary: the purpose of this study is to find out if your adrenal glands are normal or abnormal. this can be determined by whether or not your adrenal gland concentrates more of a labeled building block of adrenal hormone, norcholesterol. this labeled material had been used as an investigative diagnostic tool for imaging adrenal glands for many years with success in our hands. this is a diagnostic procedure. ct, mri and ultrasound can determine the size and presence or absence of tumor but cannot assess the function of the adrenal glands. to determine hormone concentrations from blood samples would involve more invasive catherization.

to investigate the feasibility of using np-59 to localize adrenal tumors and assess their functions under the influence of pharmacological manipulations.

Eligibility criteria:
inclusion criteria: * patient with clinical and laboratory suspicions of hypersecretion of adrenal cortical hormones exclusion criteria: * n/a

Keywords: adrenal tumors adrenal malignancies abnormal hormonal secretions electrolytes abnormalities imaging scanning tumor localization
integrated chiropractic and acupuncture treatment for low back pain

Conditions: Low Back Pain

Summary: this study is being conducted to compare the effectiveness of integrated chiropractic and acupuncture care for the management of low back pain.

this study is being conducted at the southern california university of health sciences. eligible subjects will be randomized to one of three treatment groups: chiropractic care alone, acupuncture care alone, and chiropractic and acupuncture care combined. subjects will be treated on pragmatic basis for 60 days and then followed up for an additional 60 days. all examinations and treatments will be provided free of charge. the expected benefits for the participants are decreased pain and improved function.

Eligibility criteria:
inclusion criteria: * are 18 years or older * have a current episode of low back pain exclusion criteria: * received chiropractic treatment or other manipulative therapies within the last month * received acupuncture treatment within the last month * visceral, systemic or joint inflammatory disease with referred pain to the back or pelvis * non-mechanical low back pain * a history of low back surgery * osteoporosis * spondylolisthesis * coagulation disorder or are taking anticoagulant medication * prolonged systemic corticosteroid medication * progressive unilateral lower limb muscle weakness * symptoms or signs of cauda equina syndrome (e.g., bowel or bladder dysfunction) * severe concurrent illness (e.g., cancer, heart diseases, psychiatric disorders) * known pregnancy

Keywords: low back pain chiropractic acupuncture integrated care