Kornimate/medical-research-clean huggingface dataset:
antibiotic regimens tailored by clinical pharmacist suppored by intensivist enhanced rational use of antibiotics

Conditions: Critical Illness

Summary: adding pharmaceutical services to patient care and changing the professional activity of pharmacists from drug-focused to patient-oriented care,in the current study, clinical pharmacists will be assigned to monitor pharmacotherapy regimens, participate in patient care, and cooperate in educating the staff and evaluating care.

during the intervention period, the pharmacist attended daily unit rounds with icu intensivist with a focus on optimization of antibiotic regimens. pharmacist consultative services were also available by phone calls 24 hours x 7 days if needed. for every patient surgical prophylactic antibiotic initiated immediately before surgery and continued for 48 hours following surgery. antibiotic therapy had given as either directed or empiric. directed therapy was defined as treatment of a documented infection based on culture and sensitivity. empiric therapy was defined as any antibiotic therapy administered when no documented infection was present, and the patient had clinically suspected infection following surgery. empiric antibiotic administration was required in majority of our sicu patients. antibiotics had given after exclusion of allergy by history and intradermal sensitivity test.

Eligibility criteria:
inclusion criteria: * all admitted patients to the icu between age 18-80 years old exclusion criteria: * patient admitted for less than 24 hours (including deaths and transfers) will be excluded from the study. pediatric patients weighted less than kilograms.
feasibility of pulsed field ablation under mild conscious sedation

Conditions: Atrial Fibrillation

Summary: prospective case-control study comparing pulsed field ablation for atrial fibrillation under mild conscious sedation vs standard of care (general anaesthesia).

this study will prospectively assess 40 patients (20 per arm). those in the general anaesthesia arm will undergo routine clinical practice. those in the mild conscious sedation arm will undergo pulsed field ablation with intravenous sedation but without general anaesthesia, though conversion to general anaesthesia is allowed if the patient does not tolerate the procedure.

Eligibility criteria:
inclusion criteria: * patients clinically referred for and undergoing catheter ablation of atrial fibrillation using pulsed field ablation exclusion criteria: * inability to provide informed consent
a clinical registry of spontaneous intracranial hypotension

Conditions: Spontaneous Intracranial Hypotension

Summary: the purpose of this research is to determine the efficacy of paraspinal vein embolization for treatment of digital subtraction myelography (dsm) or ct myelography (ctm) confirmed cerebrospinal fluid (csf)-venous fistulas so that researchers can inform the development and design of future clinical trials of this technique.


Eligibility criteria:
inclusion criteria: * study subjects will be patients who meet the international classification of headache - disorders 3rd edition (ichd-3) criteria for a diagnosis of sih or the schievink criteria with imaging confirmed csf-venous fistulas on dsm or ctm. * availability of a clinically prescribed contrast enhanced mri positive for sih. * negative urine or serum pregnancy test at time of study consent and three-months. exclusion criteria: * patients who have a contraindication or inability to undergo the procedure (i.e., severe contrast allergy). * inability to provide informed consent. * expected inability to complete the follow-up assessment. * current pregnancy or breast-feeding during study enrollment (from consent to study conclusion approximately 90-days).
a study to demonstrate the equivalence of the tofacitinib oral solution to the tablet formulation in healthy participants.

Conditions: Healthy

Summary: this is a phase 1, randomized, open label, 2 period, 2 sequence, cross over, single dose study to evaluate the auc equivalence, and safety of tofacitinib 5 ml oral solution (1 mg/ml) and 5 mg tablet in healthy participants. participants will be randomized to 1 of the 2 treatment sequences. a total of approximately 12 healthy male and/or female (non-childbearing potential) participants will be enrolled in the study so that approximately 6 participants will be enrolled in each treatment sequence. each treatment sequence will consist of 2 periods. in both sequences, participants will remain in the cru for a total of 5 days and 4 nights (including period 1 and period 2).


Eligibility criteria:
inclusion criteria: * male and female participants of non childbearing potential must be 18 to 55 years of age, inclusive, at the time of signing the informed consent document (icd). * male and female participants of non-childbearing potential who are overtly healthy as determined by medical evaluation including medical history, physical examination, laboratory tests, blood pressure (bp), pulse rate, oral temperature, and 12 lead electrocardiogram (ecg). * body mass index (bmi) of 17.5 to 30.5 kg/m\^2; and a total body weight greater than 50 kg (110 lb). exclusion criteria: * evidence or history of clinically significant hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic (including alcoholic liver disease, nonalcoholic steatohepatitis (nash), autoimmune hepatitis, and hereditary liver diseases), psychiatric, neurological, or allergic disease (including drug allergies, but excluding untreated, asymptomatic, seasonal allergies at the time of dosing). * clinically significant infections within the past 3 months prior to the baseline visit (for example, those requiring hospitalization or parenteral antibiotics, or as judged by the investigator), evidence of any infection within the past 7 days prior to the baseline visit, history of disseminated herpes simplex infection or recurrent (\>1 episode) herpes zoster or disseminated herpes zoster. * any condition possibly affecting drug absorption (eg, gastrectomy). * history of human immunodeficiency virus (hiv) infection, hepatitis b, or hepatitis c; positive testing for hiv, hepatitis b surface antigen (hbsag), hepatitis b core antibody (hbcab), or hepatitis c antibody (hcvab). hepatitis b vaccination is allowed. * malignancy or a history of malignancy, with the exception of adequately treated or excised non metastatic basal cell or squamous cell cancer of the skin or cervical carcinoma in situ. * a positive urine drug test.
gabapentin compared to standard of care in preventing mucositis in patients with stage iii-iv head and neck cancer undergoing primary or adjuvant chemoradiation therapy

Conditions: Malignant Head and Neck Neoplasm; Mucositis; Radiation-Induced Disorder

Summary: this randomized phase iii trial studies how well gabapentin plus standard of care work compares to standard of care without gabapentin in preventing inflammation of the mucous membranes (mucositis) in patients with stage iii-iv head and neck cancer that are undergoing primary or subsequent (adjuvant) chemoradiation therapy. radiation therapy to the head and neck may cause a burn involving the inside of the mouth, throat, and nasal passages, resulting in pain. gabapentin may help prevent (or minimize) pain associated with radiation-induced mucositis in patients with head and neck cancer.

primary objectives: - to determine whether gabapentin used as a preventive measure during chemoradiation can reduce radiation-induced mucositis associated pain in head and neck cancer patients as measured by: 1) pain scores on the vanderbilt head and neck symptom survey (vhnss version 2.), and 2) analgesic use. secondary objectives: * to assess the safety (grade 3 or 4 adverse events) and tolerability of using gabapentin (discontinuation of drug due to side effects - yes or no) * to correlate pain severity with frequency and severity of general systemic symptoms. exploratory objectives: - to determine whether pain control is associated with weight loss (in pounds) and duration of use of percutaneous endoscopic gastrostomy utilization (in days). outline: patients are randomized to 1 of 2 arms. arm i: standard of care (usual care) - patients receive consisting of oral health measures, oral rinsing, miracle mouthwash, nonsteroidal anti-inflammatories, and opioid analgesics. patients also undergo an education session at the beginning of chemoradiation treatment to review foundations of oral care and pain management. arm ii: standard of care plus gabapentin - patients receive standard of care and undergo an education session as in arm i. patients also receive gabapentin orally (po) three times a day throughout chemoradiation treatment (approximately 5-7 weeks) and until mucositis resolves and pain subsides. after completion of study treatment, patients are followed up monthly for 3 months.

Eligibility criteria:
inclusion criteria: * histologically proven cancer of the head and neck cancer * stage 3 or 4 * planned primary or adjuvant chemoradiation therapy * willing and able to provide informed consent * english speaking exclusion criteria: * currently on gabapentin * prior non-tolerance of gabapentin * history of seizure disorder
fluvoxamine to augment olfactory recovery for long covid-19 parosmia

Conditions: COVID-19; Olfactory Disorder; Parosmia

Summary: this study will investigate the efficacy of oral fluvoxamine in olfactory improvement following covid-19- associated parosmia. this is a randomized, double-blinded, placebo-controlled trial.

the drug will be given over a 14 weeks with six weeks titrating up, six weeks maintaining highest dose, and up to two weeks tapering down. assessments will be collected following week 12 to measure change in olfactory function from baseline between the two study groups.

Eligibility criteria:
inclusion criteria: * men and women between the ages 18 to 70 years * residing within the states of missouri or illinois * complaints of odors of certain things or everything are distorted * olfactory dysfunction that has persisted for \>2 months after suspected covid-19 infection * ability to read, write, and understand english exclusion criteria: * history of olfactory dysfunction prior to covid-19 infection * any use of concomitant therapies specifically for the treatment of olfactory dysfunction * history of olfactory dysfunction of longer than 12 months * history of bipolar disorder as ssris can theoretically destabilize bipolar disorder * participants with symptoms of depression as evidenced by a score of 10 or greater on the patient health questionnaire-9 (phq-9).95 the phq-9 is a nine-item questionnaire designed to assess and aid in diagnosing patients with depression in clinical and community settings. * history of neurodegenerative disease (i.e., alzheimer's dementia, parkinson's disease, lewy body dementia, frontotemporal dementia) * history of chronic rhinosinusitis or sinus surgery * pregnant or breastfeeding mothers. * already enrolled in another covid 19 medication trial or receipt of monoclonal antibody infusion. * taking donepezil or fluoxetine (rationale: these drugs are s1r agonists) or sertraline (a s1r antagonist). * participants taking theophylline, tizanidine, clozapine, or olanzapine (drugs with a narrow therapeutic index that are primarily metabolized by cyp 1a2, which is inhibited by fluvoxamine. * taking another ssri, unless at a low dose (e.g., escitalopram 5mg) such that adding fluvoxamine would not put patient at risk for serotonin syndrome. * taking coumadin based on theoretical risk of increased bleeding with fluvoxamine. * unable to provide informed consent. * unable to perform the study procedures.
efficacy of nsaid and acetaminophen in the control of post-operative pain in patients undergoing total knee replacement

Conditions: Pain; Hispanics; Opioid Use; Multimodal Analgesia; Total Knee Arthroplasty

Summary: an alternate perioperative pain control protocol composed of intravenous ketorolac and oral acetaminophen for patients who underwent total knee replacement was designed with the aim to determine its efficacy when compared to pain control with intravenous morphine and oral oxycodone combined with acetaminophen. in addition, the study will evaluate the differences and similarities in the hispanic population that could predict protocol efficacy.

acute pain after a surgical procedure may occur secondary to trauma from the procedure itself or from procedure-related complications. appropriate peri-operative acute pain management is an important phase of patient's recovery since it's under-treatment can lead to adverse outcomes such as: thromboembolic and pulmonary complications, additional time spent in an intensive care unit or hospital, hospital readmission for further pain management, needless suffering, impairment of health-related quality of life, and development of chronic pain. furthermore, it's over-treatment with opioid medications is associated with an increased risk of thromboembolic, infectious and gastrointestinal complications as well as increased length of hospital stay, cost of care and risk of opioid addiction. perioperative administration of intravenous (iv) non steroidal anti-inflammatory drugs (nsaid), such as ketorolac, has been shown to effectively decrease opioid requirements and pain levels while demonstrating tolerable side effects. its use after total knee replacement has been associated with a 27% decrease in the use of morphine. when nsaid is combined with acetaminophen 1000mg every six hours, an additional benefit in terms of improved pain scores on post-operative day three was shown in patients who underwent total hip or knee arthroplasty. therefore, the purpose of this study is to provide an effective alternative for pain management in hispanic patients who underwent total knee replacement and evaluate the role of ketorolac and acetaminophen.

Eligibility criteria:
inclusion criteria: * hispanic american patients undergoing primary total knee arthroplasty * older than 21 years of age * classified with an american society of anesthesiologist classification (asa) of i or ii. exclusion criteria: * hypersensitivity to any components of analgesic drugs * impaired renal, cardiac, or hepatic function * baseline serum creatinine level higher than 1.2mg/dl * history of gastrointestinal bleeding * neuromuscular deformities * inability to consent

Keywords: total knee arthroplasty postoperative pain opioid use hispanics clinical outcomes multimodal analgesia
effectiveness and safety of respiratory training in the prevention and severity of covid-19

Conditions: Disease, Infectious; Respiratory Disease; Safety Issues; Effectiveness

Summary: a randomized controlled clinical trial will be carried out using inspiratory and expiratory training devices on healthy subjects recruited in social networks and university environments. the aim will be to determine the effectiveness and safety in the prevention and severity of covid-19 disease by a respiratory training with inspiratory and expiratory devices.


Eligibility criteria:
inclusion criteria: * healthy subjects exclusion criteria: * drugs * surgery * neurology diseases * rheumatic diseases * systemic diseases * smokers
efficacy of manual therapy for the treatment of migraine.

Conditions: Migraine

Summary: introduction according to the world health organization (who) at least 47% of adults have suffered from headache in the last year. the headache is not only painful but also disabling, it can be accompanied by social and personal problems, with a decrease in the quality of life and with economic losses. migraine affects a large number of people and, if the predisposing factors are not controlled, it can become chronic. once the chronification point of migraine has arrived, it seriously affects the quality of life of people, both in the workplace, social and leisure. objective perform the application of a manual therapy treatment based on protocols that include techniques already proven to improve different areas of impact in patients with migraine. to evaluate various aspects, we will include the intensity of pain, the frequency of episodes, anxiety and depression, quality of life, etc ... and the limitations or disability that it produces. material and methods this is a prospective, single-blind, randomized study with patients diagnosed with migraine. the sample will be distributed in 4 groups: a) experimental group that will receive combined treatment of soft tissues with techniques evidenced independently; b) group that will receive independent structural techniques; c) the group that will receive the set of protocols a and b; d) and the placebo control group. evaluation an initial assessment will be carried out, another at the end of the treatment and another follow-up one month after the end of the treatment. in addition, the evaluation will include the following instruments: the hdi scale (headache disability inventory), the midas scale (migraine disability assessment scale), the sf-36 questionnaire, the eva scale (visual-analogue scale), the hit-6 questionnaire, the bdi questionnaire (beck inventory depression), the stai questionnaire (the state-trait anxiety inventory), the change perceived after the treatment and medication intake.


Eligibility criteria:
inclusion criteria: * have at least 4 migrainous crises per month, following the criteria established by the ihs * history of episodes of more than a year of evolution * use of stable medication during the four weeks prior to the start of the study * between 18 and 60 years old exclusion criteria: * currently being in physiotherapy preventive treatment * being in the process of pharmacological adaptation * have artery-vertebral involvement problems (bone degeneration, metabolic or musculoskeletal problems that involve vertebral artery risk) * suffer from dizziness * suffering dizziness or unbalanced tension.

Keywords: migraine manual therapy
vascular effect of estradiol valerate versus placebo evaluated by flow-mediated dilatation of brachial artery

Conditions: Flow-mediated Dilation Evaluation of the Brachial Artery

Summary: the aim of this study is to evaluate the vascular effects of estradiol valerate on climacteric women measured by flow-mediated evaluation of the brachial artery using high resolution ultrasound and compare to placebo.

the interruption of the secretion of sex steroids that occurs after menopause, determines a change in vascular pattern at various levels. as a result, several side effects might appear and interfere with women's quality of life and health. the use of hormone replacement therapy has contributed to the improvement in these effects. it has been observed vascular beneficial effects of sex steroids in premenopausal women, and of hormone replacement therapy (hrt) in climacteric women, on the central retinal arteries. the objective of this study is to evaluate the effects of estradiol valerate on flow-mediated dilation of the brachial artery.

Eligibility criteria:
inclusion criteria: * women without menstrual cycles within the last 12 months and follicle stimulating hormone (fsh)\>30international units / liter * healthy women * women that were not using drugs with potential vascular effect within the last 1 year * women that never used hormone replacement therapy exclusion criteria: * smoking * blood pressure \> 160/90 mm hg. * breast and or endometrial cancer * history of acute myocardial infarction * diabetes * vaginal bleeding of any origin * hepatic disease * thrombophlebitis or thromboembolic disorders

Keywords: hormone replacement therapy dopplervelocimetry flow-mediated dilation menopause estradiol valerate
one-1 oral grand est 1

Conditions: Dental Decay; Periodontal Abscess; Periodontitis; Gingivitis; Dental Plaque; Calculus, Dental; Missing Teeth

Summary: this study is about the assessment of two oral telemedecine tools compared to an intra oral clinical examination used as a reference among elderly persons living in nursing home. our hyposthesis is that the diagnostic performance of the two devices will be similar. the main goal of the study is to assess the performances of two intra-oral cameras compared to an intra oral clinical examination to detect at least one decayed tooth. the secondary objectives of this study are : at patient's level: 1. to assess the performances of two intra-oral cameras types compared to an intra oral clinical examination for detecting each of the following conditions: (i) at least one filled tooth, (ii) at least one missing tooth, (iii) gingivitis, (iv) an abscess, (v) dental plaque and (vi) calculous 2. to assess the concordance between each intra oral cameras and the intra oral clinical examination in the evaluation of the number (i) of decayed teeth, (ii) filled teeth and (iii) missing tooth 3. from video acquisitions of each intra oral cameras, to assess the inter-observer concordance for the diagnostic of each dental pathologies (presence of at least one decayed tooth, filled or missing) and periodontal (presence of gingivitis, abscess, dental plaque or scale) 4. from video acquisitions of each intra oral cameras, to assess the inter-observer agreement of the number of teeth: (i) decayed, (ii) filled and (ii) missing at tooth level : 5. to assess the performances of two intra-oral cameras types compared to an intra oral clinical examination for detecting each of the following conditions: (i) a cavity, (ii) a filled tooth and (iii) missing tooth in all patients : 6. to assess patient's feelings about the use of each intra oral cameras 7. to compare the time required for video acquisitions between each of intra oral cameras for patients with dental or periodontal pathologies observed during the intra oral examination: 8 to assess, 2 months after initial evaluation, the proportion of patients attended dental or periodontal care and for which an appointment with a dentist has been scheduled


Eligibility criteria:
inclusion criteria: * be an adult person * be affiliated of granted of health insurance * be resident of a nursing home * people (or the guardian) who received complete information about the research and who signed the consent form. exclusion criteria: * people deprived of their liberty by justice's decision, or people following psychiatric treatment according to articles l. 3212-1 et l. 3213-1 of the french law * people with insufficient skills in french * people with total bimaxillary prosthesis * people without any teeth

Keywords: telemedecine dental camera nursing home dental decay oral status