Kornimate/medical-research-clean huggingface dataset:
clinical characteristics for the critical ill patients with klebsiella pneumoniae infection

Conditions: Drug Resistance

Summary: the detection of klebsiella pneumoniae virulence gene and antibiotics resistance gene takes a long time and high cost with equipment requirements. distinguishing the klebsiella pneumoniae by gene were late for clinical treatment. therefore, the investigators aim to study the clinical characteristics of critically ill patients with klebsiella pneumoniae infection which expressed different drug sensitivity test results.

clinical data of adult patients in integrated icus of 6 hospitals of fujian province china from january 2015 to july 2019 were collected, who had been examined for sputum, urine, blood, pleural effusion, ascites, cerebrospinal fluid and wound secretions and other body fluid samples. and the results showed that klebsiella pneumoniae was positive, including demographic data, underlying disease status, drug sensitivity test, infection-related indicators, life support, prognostic indicators.

Eligibility criteria:
inclusion criteria: * adult whose body fluid were sampled during icu stay and klebsiella pneumoniae was detected, followed by drug sensitivity test (including reporting the test results after the patient was transferred out of icu or died). exclusion criteria: * age were less than 18 years old; * patients stayed in icu was less than 48 hours.
efficacy of an intravitreal dex implant in retinal vein occlusion following treatment with anti-vegf injections.

Conditions: Retinal Vein Occlusion; Macular Edema

Summary: to test the efficacy of a 0.7 mg intravitreal dexamethasone implant (ozurdex®) on macular function and recalcitrant macular edema associated with retinal vein occlusion following treatment with 2 or more prior intravitreal anti-vegf drug injections.

the efficacy of the dex implant on macular edema for rvo is well established in multiple clinical trials. however, the duration and frequency of re-treatment have not been extensively explored. in addition, no prior studies have tested the efficacy of the dex implant on retinal and macular function using diagnostic testing measurements such as multi-focal erg, microperimetry and ram testing. since va and oct outcomes do not always correlate, these other assessments (mf-erg, microperimetry, ram testing) may be useful as early predictors of when or if patients should be retreated. this study will assess 2 groups (0.7mg prn and 0.7mg q16 weeks) and assess high resolution oct, ram testing, microperimetry, and multi-focal erg outcomes. for the prn group retreated based on any fluid on oct, we will investigate if microperimetry or multifocal erg changes would have been an earlier predictor of fluid returning.

Eligibility criteria:
inclusion criteria: * presence of central retinal vein occlusion (crvo) or branch retinal vein occlusion (brvo) * prior treatment with \>= 2 intravitreal anti-vegf injections but no treatment in last 45 days. * age 18 years or older * etdrs visual acuity between 3 and 72 letters and approximate snellen equivalent of 20/25 to 20/800 * central foveal thickness \>275 microns or presence of cystic edema on oct studies. * for sexually active women of childbearing potential, agreement to the use of an appropriate form of contraception (or abstinence) for the duration of the study. * ability to provide written informed consent • capable of complying with study protocol exclusion criteria: * history of steroid-related glaucoma (steroid response) requiring more than one topical glaucoma medication. * intraocular injection of steroid medication within prior 4 months * evidence of significant retinal ischemia on fluorescein angiography in the opinion of the treating physician. * previous laser photocoagulation within 4 months of study * concurrent ocular disease (e.g proliferative diabetic retinopathy, geographic atrophy) that would limit visual acuity in the opinion of the treating physician * patients who are pregnant. * unwilling or unable to follow or comply with all study related procedures.

Keywords: brvo crvo macular edema anti-vegf ozurdex
morphological and functional evaluation of adult flat foot before and after corrective surgery

Conditions: Flat Feet

Summary: morphological weight bearing computed tomography parameters and gait analysis can implement the evaluation of the flat foot. weight bearing ct is useful to verify the severity of the 3d deformities typical of flat foot, while kinematic and kinetic variables of gait is able to quantify the functional improvements of the foot after surgery.


Eligibility criteria:
inclusion criteria: * patients with idiopathic flat foot with indication for corrective surgical treatment according to grice (arthrodesis of the subtalar joint) * age between 18 and 65 years * bmi less than 40 * signature of informed consent. exclusion criteria: * patients with severe alterations or other pathologies affecting the foot and lower limb * severe vascular and neurological systemic diseases * systemic diseases that can compromise bone consolidation
the effect of music therapy on delirium

Conditions: Delirium

Summary: the purpose of this study is to test the effect of a twice daily, 30-minute, interdisciplinary, music therapist developed, nurse initiated, music listening intervention on acutely ill older patients as compared to patients who receive care as usual. half of the participants will receive music therapy and the other half will receive care as usual.

delirium is a complex, preventable, neuropsychiatric syndrome that is associated with higher mortality rates post discharge, increased hospital stays, increased mortality and an increased risk for developing dementia. early, nonpharmacological treatment of delirium is preferable and supported by the literature to preserve patient safety. music therapy is an evidence based, goal directed treatment process in which the music therapist and the patient maintain a state of well-being to achieve individualized patient goals. music interventions are therapist developed and nurse initiated, in accordance to individual patient needs to maintain well-being, and show promise for improving attention and engagement. understanding the effect of an individualized music intervention on the incidence, duration and severity of delirium has the potential to facilitate the use of cost-effective methods to modify individual environments to deliver appropriate care for acutely ill older adults. purpose: the purpose of this study is to test the effect of an interdisciplinary music intervention on the incidence, severity and duration of delirium in older acutely ill adults. methods: a randomized control pilot study will be used to test the effect of a music therapist-developed, music listening intervention on delirium. acutely ill patients will be randomized into a usual care control group or an experimental group receiving the music intervention twice daily for 30 minutes. data analysis: descriptive statistics will be used to describe the sample. independent t-tests will be used to examine group differences in delirium severity and duration. chi-square analysis will be used to assess group differences in delirium incidence. implications: for patients exposed to the stress of hospitalization, a music intervention may enhance delirium care and promote care that is safe and efficient.

Eligibility criteria:
inclusion criteria: age 65 or older admitted to the progressive care unit (pcu), must be able to speak english must be able to hear music through headphones. must not have a documented history of dementia must not have a documented history of permanent cognitive impairment, must not be delirious at the beginning of the study (cam negative) must be able to sign a consent form. exclusion criteria: age less than 65, not admitted to the progressive care unit, positive for delirium (cam positive) does not speak english, has a hearing impairment, documented history of dementia documented history of permanent cognitive decline expected death within 24 hours of enrollment, transferred off the floor unable to sign consent. -

Keywords: delirium elderly music therapy elderly music therapy
promoting early detection of breast cancer in rural rwanda: impact of community health worker and nurse training

Conditions: Breast Cancer

Summary: this project proposes a pilot intervention in burera district to train rural rwandan community health workers (chws) in breast awareness, and to train primary care nurses at rural health centers in the assessment and management of breast complaints, with a focus on when patients must be urgently referred for more advanced evaluation. the project will randomize health centers to receive the intervention and will evaluate the impact of these trainings on nurse and chw knowledge and skills. in order to help rwanda prepare for national early detection efforts, the investigators will also assess the impact of these trainings on patient volume at the health center level, and visits and further diagnostic testing at the district hospital level. the investigators will also examine the impact on the length of diagnostic delays experienced by patients with a breast problem. among those patients diagnosed with breast cancer, the investigators will also assess their stage at diagnosis.


Eligibility criteria:
inclusion criteria * community health workers or health center nurses affiliated with a designated intervention health center * interested in participating exclusion criteria * not interested in participating * not available for training

Keywords: early detection rwanda
intra-articular i-prf injections in patients with temporomandibular joint dysfunction

Conditions: Temporomandibular Joint Disorders; Temporomandibular Joint Pain

Summary: the aim of the study will be to analyze the results of injection treatment in patients diagnosed with temporomandibular joint dysfunction manifested by pain and/or limited jaw mobility. the treatment will consist in the administration of autologous blood products into the cavities of the temporomandibular joints.

the aim of the study is to analyze the results of injection treatment in patients diagnosed with temporomandibular joint dysfunction manifested by pain and/or limited jaw mobility. the analyzed treatment will consist in the administration of autologous blood products into the cavities of the temporomandibular joints. we intend to conduct a prospective study without a control group. patients suffering from pain in the temporomandibular joints and/or limited jaw mobility, in whom injection treatment is the treatment of choice, and patients in whom first-line therapies (pharmacotherapy, physiotherapy, splint therapy) did not bring the desired results, and intra-articular injections are a generally accepted continuation of the therapeutic protocol. qualified patients will be treated with autologous blood products (injectable platelet-rich fibrin). data from specialist literature support the safety and effectiveness of administering the above-mentioned substance to the cavities of the temporomandibular joints. the use of blood products in the form of intra-articular injections is medically justified both in the case of pain in the temporomandibular joints and/or in clinical conditions with limited jaw mobility. currently available scientific publications on the comparison of the effectiveness of therapy with the use of various autologous substances are not numerous and do not give a clear answer to the question of what therapeutic protocol (type of substance, dose, number of administrations, joint compartment) is the most effective in the given observation period. this study aims to clarify some of these issues in regard to the above-mentioned blood product, and thus to obtain valuable clinical data that may help clinicians in choosing the appropriate use of intra-articular injections in patients with temporomandibular joint dysfunction.

Eligibility criteria:
inclusion criteria: * age over 18; * informed consent to participate in the study; * the possibility of discontinuing the current treatment of the temporomandibular joints; * generally accepted indications for injection therapy. exclusion criteria: * bleeding diathesis; * mental illness; * temporomandibular joint prosthesis; * temporomandibular joint ankylosis; * skin disease of the preauricular area of the affected side.
impact of oral diets on postoperative fluid collection

Conditions: Postoperative Complications

Summary: patients after the surgical removal of axillary lymphnodes suffers from prolonged fluid collections. the aim of the study is to assess the impact of oral immunonutrition and high-protein diets on the reduction of fluid collection.

patients after the surgical removal of axillary lymphnodes suffers from prolonged fluid collections, which requires either prolonged drainage or multiple punctuations. the aim of the study is to assess the impact of oral immunonutrition and high-protein diets on the reduction of fluid collection.

Eligibility criteria:
inclusion criteria: * confirmed breast cancer or melanoma * scheduled surgery with axillary lymph nodes resection * informed consent * eligible for surgery exclusion criteria: * benign disease * no consent
therapeutic play in children with mild intellectual disability

Conditions: Intellectual Disability; Intellectual Disability, Mild; Motor and Developmental Delay; Motor Delay; Adaptive Behavior; Physical Disability

Summary: the aim of this study is to determine the effectiveness of a designed therapeutic play activities program on improving motor adaptive behavior in a sample of egyptian children with mild intellectual disabilities. the main question it aims to answer is: what is the effect of therapeutic play activities in improving adaptive motor skills (fine-gap) of children with mild intellectual disability? a quasi-experimental design will be used as researchers will compare therapeutic play exercise program to standard treatment to find its effect on motor adaptive behavior in the selected sample of children with mild intellectual disability participants will: take play-based activity program for 24 sessions in 2 months have a pre- and post-intervention evaluation of motor adaptive behavior by vineleand adaptive behavior scale ii

the research sample consists of twenty children whose ages range between 5 and 9 years of children with mild intellectual disabilities, with intelligence coefficients ranging between 50 and 70 on the stanford binet scale, 5th edition (sb-5). the sample will be divided into two groups: 10 children in the control group and 10 children in the experimental group. methods for intervention experimental group therapeutic play activities program for children with mild intellectual disability the validation of the current research hypotheses required the preparation and design of a program of therapeutic play activities aimed at improving the adaptive motor skills of children with intellectual disabilities. the program consists of 24 sessions of play-based activities that will be applied in 2 months on a day-by-day basis. therapeutic play programs include activities that address core strength, bilateral coordination, motor skills, visual skills, body awareness, outdoor sensory activities, vestibular, and balance skills. activities will be simulated for the child by the therapist to ensure the child understands them. all children will be evaluated by vabsii before and after implementation of the program.

Eligibility criteria:
inclusion criteria: the child should be between 5 and 9 years of age of both sexes - the child should be of mild intellectual disabilities according to stanford binet scale 5th edition the child should not be suffering from any apparent physical deformity in upper limbs, lower limbs or spine the child should not suffer from any visual or auditory disorder exclusion criteria: children out of age range children with moderate or severe intellectual disabilities children with physical deformities in upper limb, lower limb or spine children suffering from visual or auditory disorders

Keywords: play play therapy therapeutic play motor adaptive behavior adaptive behavior intellectual disability
immune heterogeneity before and after cardiopulmonary bypass in children

Conditions: Ventricular Septal Defect

Summary: the goal of this observational study is to learn about functional heterogeneity of immune cells before and after cardiopulmonary bypass (cpb) in children with congenital heart disease (chd). the main question\[s\] it aims to answer are: * does cpb cause immune paralysis after chd surgery? * how does the functional heterogeneity of immune cells change before and after cpb in children undergoing chd surgery? participants will receive 3ml of peripheral blood before cpb, 2 hours after cpb, and 3 days after cpb, and the peripheral blood samples will be sequenced by single cell to explore the immune heterogeneity before and after cpb.

cpb-induced immune paralysis is the main cause of postoperative infection in chd, which seriously affects the prognosis of children. the underlying mechanism of cpb-induced immune paralysis has not been fully determined. this study intends to use scrna-seq to describe gene transcription profiles of immune cells in peripheral blood of children undergoing chd surgery before and after cpb, and explore the differences within and between different immune cell populations including t cells and the changes of immune cells in different sequences. to fill the gap in the study of immune mechanism in cpb-induced immune paralysis microenvironment at single-cell resolution.

Eligibility criteria:
inclusion criteria: 1. birth weight range: 2500-6000g; 2. operation duration \>90min; exclusion criteria: 1. preterm infants or preoperative infections; 2. systemic immune diseases and serious complications: such as rheumatoid arthritis, systemic lupus erythematosus, severe liver and kidney function damage, leukemia, etc.; 3. patients who have received an organ transplant; 4. patients who have received immunomodulatory drugs: patients who have received immunomodulatory drugs before surgery; 5. parents refused to participate or were unable to provide sufficient samples: parents or legal guardians refused to participate in the study.
aci-c versus amic. a randomized trial comparing two methods for repair of cartilage defects in the knee

Conditions: Osteochondritis Dissecans; Osteoarthritis; Cartilage Injury; Osteonecrosis

Summary: aci-c versus amic: a controlled randomized trial comparing autologous chondrocyte implantation ( aci) and autologous matrix induced chondrogenesis (amic) for repair of cartilage defects in the knee. eighty patients (forty in each group) having symptomatic cartilage defects in their knee are planned to include in this study. both techniques will use the chondrogide membrane from geistlich to cover the defects. aci includes an arthroscopy to harvest cartilage for cell cultivation in our lab located in tromso. 3-4 weeks later using a mini arthrotomy the cells will be implanted under the chondrogide membrane. the amic group will be listed for a mini arthrotomy, cleaning of the defect, microfracture and cover of the defect using the same chondrogide membrane. in both groups stitches and fibrin glue will be used to fix the membrane. inclusion criteria: age between 18-60, informed consent signed by patient, symptomatic cartilage defect. size more than 2 square cm. exclusion criteria alcohol or drug abuse during the last three years, inflammatory joint disease, serious illness preoperative examination and follow up: clinical examination and registration of koos (a validated knee score), vas (visual analog pain scale) and lysholm knee score. radiographs of the involved knee including weightbearing standing radiographs of both knees. kellgren- lawrence classification will be used for grading of oa. patients will be checked after 1, 2, 5 and 10 years following surgery. symptomatic patients having a new cartilage resurfacing operation or prosthesis will be listed as failures of the initial treatment. hypothesis: amic will be equal to aci, and if that is the case this would be a benefit for the patients and the society. amic is much cheaper compared to aci (needing an expensive cell cultivation and two surgeries). data will be analyzed using the spss statistical package.

please see referenced articles (1-3) for details regarding aci and amic

Eligibility criteria:
inclusion criteria: * age between 18-60 yrs * informed consent signed by patient * symptomatic cartilage defect in the knee \> 2 square cm exclusion criteria: * alcohol or drug abuse during the last three yrs * inflammatory joint disease * serious illness

Keywords: cartilage repair chondrocytes stemcells
pharmacokinetic and biomarker study of pioglitazone in adolescents with severe sepsis and septic shock

Conditions: Severe Sepsis; Septic Shock

Summary: the purpose of this study is to evaluate the pharmacokinetics of pioglitazone and to determine the effect on inflammatory biomarkers for pioglitazone in patients with severe sepsis and septic shock.

severe sepsis is a major cause of morbidity and mortality among adults and children. few clinical trials have demonstrated clinical benefit in sepsis. severe sepsis is a systemic inflammatory syndrome in response to infection that is associated with acute organ dysfunction. the nuclear receptor peroxisome proliferator-activated receptor-gamma (pparg) is involved in the regulation of the sepsis-induced inflammatory response. the central hypothesis is that pioglitazone reduces the inflammatory responses in children with severe sepsis and septic shock.

Eligibility criteria:
inclusion criteria: * weight range between 30 to less than or equal to 90kg * have a known or suspected infection and meet criteria for severe sepsis or septic shock as defined according to the international pediatric sepsis consensus conference guidelines exclusion criteria: * are in a moribund state in which death is perceived as imminent * have an advanced directive or do not resuscitate order to withhold life-sustaining * have a history of cyanotic heart disease or congestive heart failure * have a serum transaminase level (alt) that exceeds about 2.5 times the upper limit of normal (\>112 unit/l) * are or become pregnant * are already on or have a history of taking pioglitazone or rosiglitazone * have type 1 or 2 diabetes * have total body weight below 30 kg or above 90 kg * have a serious condition, in addition to sepsis, which in the opinion of the investigator would compromise the participant