Kornimate/medical-research-clean huggingface dataset:
risk-factors for multidrug-resistant bacteria colonization among patients at high risk of stis

Conditions: Bacterial Infections; HIV Infections

Summary: the aim of this study is to identify risk factors and prevalence of multidrug-resistant (mdr) and extensively drug-resistant (xdr) bacteria colonization among patients at high risk of stis

the spread of multidrug-resistant (mdr) and extensively drug-resistant (xdr) bacteria have become a worldwide public health concern. infection with mdr/xdr bacteria is associated with increased morbidity, increased risk of therapeutic failure and healthcare costs. the largest burden is from extended-spectrum betalactamase-producing enterobacteriaceae (esbl) and carbapenem-resistant enterobacteriaceae (cre). the world health organization (who) has considered the epidemic of mdr/xdr bacteria as a major health concern and has registered these bacteria in the "priory pathogens list." this list includes pathogens for which new antibiotics are urgently needed. moreover, in their recent report on esbl, the french national authorities of health (has) has recommended that additional studies be conducted to improve knowledge about colonization risk factors. some risk factors have been already identified: antibiotic intake and travel to countries with high mcr/xdr bacteria prevalence; however, many others are poorly identified. patients visiting the cegidd (free information, screening and diagnosis center for sexually transmitted infections) and those receiving pre-exposure prophylaxis (prep) to prevent hiv infection are more exposed to stis (including methicillin-resistant staphylococcus aureus, mrsa) and receive antibiotics for sti treatment. moreover, an increase of stis has been recently observed in men who have sex with men and in patients receiving prep. as antibiotic use is likely considerably increased in this population, we anticipate a high proportion with mdr/xdr colonization. the objective of the "bmr-ist" study is to identify risk-factors (i.e. sexual behaviors, hiv status, antiretroviral prep, stis, antibiotic use and travel to epidemic countries) of mdr/xdr bacteria colonization among patients at high risk of acquiring stis and to determine the prevalence of mdr colonization in the studied population.

Eligibility criteria:
cohort 1 - inclusion criteria: * age ≥ 18 years * consulting at the sti clinic of saint-antoine hospital * signed the informed consent form non-inclusion criteria: - no fluency in french cohort 2 - inclusion criteria: * men who have sex with men * seeking care at saint-antoine hospital * hiv-positive non-inclusion criteria: - no fluency in french

Keywords: mdr, xdr, esbl, esbl, mrsa, cre hiv, prep, cegidd, sti, bacteria colonization
study of different therapeutic strategies in hydatidiform mole with lung nodule

Conditions: Hydatidiform Mole; Gestational Trophoblastic Neoplasia

Summary: the purpose of present study is to provide clinical evidences for the appropriate management of molar pregnancy with lung nodule. the hydatidiform mole patients with lung nodule ≥1.0cm will be randomized into 2 groups: a. treated with chemotherapy immediately, b. follow up until hcg level met figo diagnostic criteria of gtn (b1) or hcg level declined to normal spontaneously (b2). lung nodule \<1.0cm will directly treated as group c

the hydatidiform mole patients with lung nodule ≥1.0cm will be randomized into 2 groups: a. treated with chemotherapy immediately, b. follow up until hcg level met figo diagnostic criteria of gtn (b1) or hcg level declined to normal spontaneously (b2). the clinical characteristics of patients were compared, especially chemotherapy cycles to achieve hcg normalization and failure to first-line chemotherapy. lung nodule \<1.0cm will directly treated as group c: follow up until hcg level met figo diagnostic criteria of gtn (c1) or hcg level declined to normal spontaneously (c2)

Eligibility criteria:
inclusion criteria eligible patients have to meet all of the following criteria: 1. pathologically confirmed hm. 2. the lung nodules are detected by lung ct and metastatic lesions could not be excluded (before or after the suction dilation and curettage). 3. the hcg level does not meet figo diagnostic criteria (2018) of gtn. 4. the patients are willing to compliant with the study protocol and be followed up at regular intervals. 5. the patients agree to sign an informed consent form. exclusion criteria 1. the patients with a previous history of lung nodules. 2. the imaging impression of lung nodules suggested definitely caused by other diseases, such as tuberculosis, pneumonia, etc. 3. the patients have undergone prophylactic hysterectomy or chemotherapy. 4. pathologically confirmed gestational trophoblastic neoplasia before and at enrollment. 5. patients have immunosuppressive diseases or take immunosuppressants. 6. patients are participating in other clinical trials at same time. 7. patients were unable or unwilling to provide written informed consent.

Keywords: pulmonary nodule chemotherapy chorionic gonadotrophin
study to evaluate the efficacy and safety of intravenous infusion with nemonoxacin malate sodium chloride

Conditions: Pneumonia

Summary: the purpose of this study is to evaluate the efficacy, safety and pharmacokinetics of intravenous nemonoxacin compared with intravenous moxifloxacin in adult patients with community-acquired pneumonia (cap).

community-acquired pneumonia (cap) remains a leading cause of death in both developing and developed countries. in the choice of antibacterial agents used to treat cap, fluoroquinolones have received considerable attention because of their wide spectrum of bactericidal activity. tg-873870 (nemonoxacin), a non-fluorinated quinolone (nfq), is a selective bacterial topoisomerase inhibitor. this study will evaluate the clinical efficacy, microbiological efficacy and safety of intravenous nemonoxacin compared with intravenous moxifloxacin in adult patients with community-acquired pneumonia. besides, the pharmacokinetics (pk) of nemonoxacin in adult patients with cap after continuous iv infusion and the pharmacokinetic (pk)/pharmacodynamic (pd)are to be determined.

Eligibility criteria:
inclusion criteria: 1. ages between 18 and 75; 2. weighs between 40 \~ 100 kg, and bmi ≥ 18 kg/m2; 3. must have a clinical diagnosis of cap 4. chest x-ray and /or ct scan show new or persist/progressive infiltrates 5. patients with port/psi score ii, iii or iv. 6. if female, non-lactating and at no risk or pregnancy (post-menopausal or must use adequate birth control) 7. the patient is able to receive an intravenous infusion of the drug . exclusion criteria: 1. patients with port/psi score i or vi. 2. severe cap is present if a patient needs invasive mechanical ventilation or requires vasopressors. 3. known or suspected severe bronchiectasis, cystic fibrosis, active pulmonary tuberculosis or infection with other mycobacteria or fungi, known bronchial obstruction, a history of post-obstructive pneumonia, other confounding respiratory diseases, such as lung cancer, malignancy metastatic to the lungs, lung abscess, empyema, suspected aspiration pneumonia due to vomiting, or non-bacterial respiratory infection (chronic obstructive pulmonary disease \[copd\] is not exclusionary) 4. clinically significant conduction or other abnormality on 12-lead ecg, or qtc interval 5. potassium is \< 3.5 mmol/l 6. any known disease that seriously affect the immune system 7. active hepatitis or decompensated cirrhosis; 8. have used quinolones or fluoroquinolones within 14 days before enrollment 9. patients who are being or will be on a long-term medication of steroids

Keywords: moxifloxacin
testosterone antidepressant augmentation in women

Conditions: Depression

Summary: the investigators' hypotheses are: low-dose testosterone augmentation improves depressive symptoms in women with major depressive disorder (mdd) and antidepressant partial/nonresponse, adjunctive low-dose testosterone is safe and well-tolerated in women with mdd and antidepressant partial/nonresponse, and low-dose testosterone augmentation improves fatigue and sexual dysfunction.


Eligibility criteria:
inclusion criteria: 1. female, age 21-75 2. major depressive disorder including madrs\>/=12 3. currently treated with an antidepressant monotherapy (1st, 2nd or 3rd trial in current episode), that has been taken at an adequate dose for at least six weeks. exclusion criteria: 1. serious suicide or homicide risk, as assessed by evaluating clinician 2. unstable medical illness including cardiovascular, hepatic, renal, respiratory, endocrine, neurologic 3. substance use disorder active within last six months, or clinical suspicion of ongoing substance use disorder at the discretion of the study clinician at time of screening based on history and/or laboratory results. 4. any history of psychotic features, bipolar disorder, or primary obsessive compulsive disorder, as assessed by scid 5. currently treated with typical or atypical antipsychotic medications, or lithium 6. untreated hypothyroidism. if treated hypothyroidism, change in levothyroxine dose within the prior 3 mos 7. use of androgens, including testosterone, dehydroepiandrosterone (dhea) and methyltestosterone, within the prior three months 8. any investigational psychotropic drug within the last thirty days 9. in the judgment of the study clinician, unlikely to be able to participate safely throughout the study period (three or more episodes of self-harm in the past year, documented history of poor treatment adherence, or frequent missed appointments (\>50%) in the past year) 10. alt \> 3x upper limit of normal or creatinine\> 3x upper limit 11. history of a hormone-responsive cancer

Keywords: depression major depressive disorder (mdd)
protein balance and body composition in preterm infants

Conditions: PreTerm Birth; Human Milk

Summary: the adequacy of the quality of protein supply could influence the rate and the relative composition of weight gain in very low birth weight preterm infants. aim of the study is to investigate protein balance according to feeding regimen and the association between human milk feeding and fat free mass content at term corrected age in a cohort of very low birth weight infants.

nutritional management of preterm infants aims to approximate tissue growth and body composition of a foetus of same postconceptional age. the adequacy of the quality of protein supply could influence the rate and the relative composition of weight gain. aim of the study is to investigate protein balance according to feeding regimen and the association between exclusive human milk feeding and fat free mass content at term corrected age in a cohort of very low birth weight infants. a prospective observational study. infants are included according to inclusion criteria. enrollment is performed at hospital discharge. infants are divided into two groups (exclusively human milk or exclusively formula) according to own mother's milk availability. at enrollment macronutrients' intakes and protein balance are determined. anthropometric measurements and body composition are also assessed. nutritional composition of human milk is calculated by infrared spectroscopy (miris® ab, uppsala, sweden). protein balance is determined according to nitrogen balance standard method. body composition is assessed by an air-displacement plethysmography system system (pea pod infant body composition system, cosmed srl, roma, italy). at term corrected age anthropometry and body composition assessments are repeated.

Eligibility criteria:
inclusion criteria: * gestational age ≤32 weeks * birth weight \< 1500 grams * birth weight ≥10th percentile according to fenton's growth chart * stable clinical conditions at discharge * feeding by mouth with either exclusively human milk or formula at discharge exclusion criteria: * congenital or chromosomal abnormalities * conditions that could interfere with growth such as chronic lung disease, neurological disorders, metabolic, cardiac disease and abdominal surgery, renal failure and/or sepsis (defined as a positive blood culture).

Keywords: protein accretion body composition
insulin resistance and intramyocellular lipid content in glucose intolerant subjects receiving rosiglitazone

Conditions: Insulin Sensitivity

Summary: this study will include subjects with an abnormal glucose tolerance test. using a crossover design, we will evaluate the insulin sensitivity and intracellular lipid content of the heart, liver and skeletal muscle of subjects before and after therapy with rosiglitazone and placebo. we hypothesize that rosiglitazone will improve insulin sensitivity in association with reduced muscle lipid content that may arise either from increased lipid oxidation or enhanced storage of fat in adipose tissue.

this protocol is a crossover study that will include subjects with an abnormal glucose tolerance test. participants will be treated in a community-based practice setting and will receive detailed instruction on diet and glucose self-monitoring. the patients will be randomly assigned to treatment with 4 mg daily of rosiglitazone or placebo. they will return to the clinic after 4 weeks to monitor changes in glucose levels, hba1c and liver enzymes. the drug dose will be increased as indicated to 8 mg daily and the patients will be reevaluated every 4 weeks. the participants will all be admitted to the general clinical research center at ut-southwestern medical center at the end of 16 weeks to measure changes in the following primary endpoints: 1) insulin sensitivity, 2) lipid content of heart, liver, and skeletal muscle, 3) lipid oxidation. additional noninvasive hmrs measurements will be made to quantify the muscle lipid content and respiratory gas exchange will be used to assess lipid oxidation. following the gcrc admission, patients will switch to the alternative therapy for 16 additional weeks before the studies are repeated. we expect rosiglitazone to improve insulin sensitivity in association with reduced muscle lipid content that may arise either from increased lipid oxidation or enhanced storage of fat in adipose tissue.

Eligibility criteria:
inclusion criteria: * age 30-65 * fasting plasma glucose \ 140 mg/dl and \<200 mg/dl two hours after a challenge with 75 gm of glucose exclusion criteria: * taking drugs known or suspected to affect intermediary metabolism (e.g. thyroid supplements, oral glucocorticoids, anabolic steroids or androgens, antidepressants, anorexic drugs, xanthine derivatives, sympathomimetics, beta-agonists) * taking any other investigational drugs within 30 days of starting the study * alcohol consumption more than 7 drinks per week * recreational drugs or iv drug abuse * acute or chronic liver diseases (sgot \>42 u/l, sgpt \>48 u/l, ggt \>45 u/l) * chronic renal insufficiency (serum creatinine \>1.5 mg/dl) * uncontrolled hypertension (systolic/diastolic blood pressure \>160/95mmhg) * anemia (hematocrit \<35%) * congestive heart failure * metallic prostheses precluding the use of magnetic resonance imaging * premenopausal women without definitive measures to prevent pregnancy

Keywords: insulin sensitivity magnetic resonance spectroscopy (mrs) lipotoxicity lipid oxidation thiazolidinediones intracellular triglyceride content
clinical performance of lithium disilicate crowns restoring endodontically treated teeth with two occlusal preparation schemes

Conditions: Fracture of Lithium Disilicate (e.Max) Crowns

Summary: the aim of this study is to evaluate the clinical performance of lithium disilicate crowns restoring endodontically treated teeth with two occlusal preparation schemes.

statement of the problem: the endodontically treated teeth need to be restored back to form, function and aesthetics. the quality of the coronal restoration will directly impact on their survival and success. the aim of the coronal restoration of endodontically treated teeth is to provide the necessary strength for the restoration/tooth complex through tooth preparation in order to withstand functional stress and prevent crown and/or root fracture. the use of ceramic crowns has increased substantially in recent years because of their superior esthetics and high mechanical properties. long term success of all ceramic crowns is affected by many factors and the failure patterns of these all ceramic crowns should be inspected closely to detect their clinical performance. rationale for carrying out the trial: endodontic treatment weakens posterior teeth and ought to be covered by crowns.the capability of these crowns to bear load relies on the preparation of an appropriate design and the selection of a crown material with adequate fracture strength and thickness. in vital teeth, the anatomic occlusal preparation design is followed such that the occlusal surface is reduced uniformly, maintaining the cusps and normal inclined planes but at a reduced height. this aids in minimizing the risk of pulp injury. in contrast, in non-vital teeth, this design can be modified such that the occlusal surface is prepared in two planes (buccal and lingual planes). a flat prepared occlusal surface provides less quantitative and better qualitative stresses when compared to an anatomically prepared surface

Eligibility criteria:
inclusion criteria: * have no active periodontal diseases or periapical pathosis * no tooth mobility or furcation involvement with sufficient occluso-gingival height * psychologically and physically able to withstand conventional dental procedures * patients with good endodontically treated teeth indicated for full coverage restorations * able to return for follow-up examination and evaluation exclusion criteria: * patient with active resistant periodontal diseases * patients with poor oral hygiene and uncooperative * pregnant women that won't be able to come for follow-up visits * patients in the growth stage with partially erupted teeth * psychiatric problems or unrealistic expectations * lack of opposing dentition in the area of interest * patients with poor root canal treatment * patients with parafunctional habits (eg. bruxism)

Keywords: e.max occlusal scheme endodontically treated teeth
effect of three-dimensional lemon video on thirst perception and dehydration-related discomfort

Conditions: Thirst in Intensive Care Unit (ICU) Practice

Summary: this study will be conducted to investigate the effects of a three-dimensional lemon video shown to intensive care patients undergoing colorectal surgery on thirst perception and thirst-related discomfort. the study will be conducted as a randomized controlled, single-blind experimental design. the universe of this study, which will be conducted in the general surgery intensive care unit of the necmettin erbakan university medical faculty hospital, will consist of volunteer patients who will be admitted to the intensive care unit. the sample of the study will consist of 70 patients. in the study, patients will be divided into two groups as virtual reality glasses and control groups. the virtual reality glasses group will be shown a three-dimensional lemon video. standard care will be provided to patients in the control group. patients will be assigned to the groups using the block randomization method. randomization will be performed using a random number table in a computer environment (www.random.org). research data will be collected using the descriptive characteristics form, numerical rating scale, and surgical period thirst-related discomfort scale (cdsbrö). ethics committee approval and institutional permission will be obtained before collecting research data. appropriate statistical tests will be used in the evaluation of the data.


Eligibility criteria:
inclusion criteria: * patients between the ages of 18-65, * those who have undergone colorectal surgery, * those who are oriented to time and place, * those who are literate, * those who have been admitted to the general surgery intensive care unit, * those who are being monitored in the postoperative period, * those who volunteer to participate in the study, * those who can communicate verbally, * those who are open to communication and cooperation, * those who do not have visual and auditory impairments, * those who do not use glasses or have no visual impairments, * those who do not have cognitive-psychological disorders, * those who are not diagnosed with renal failure, * those who do not have oral intake according to the physician's order, * those who are not connected to a mechanical ventilator will be included in the study. exclusion criteria: * patients who have undergone a second surgical procedure during their hospitalization, * patients who have open wounds on their mouth or lips, * patients who have been diagnosed with migraine or vertigo, * patients who have nausea and vomiting will be excluded from the study.
platelet rich plasma in hiatal hernia repair

Conditions: Hiatal Hernia Large; Reflux, Gastroesophageal

Summary: rationale: gastroesophageal reflux disease (gerd) is a common disease caused by a dysfunctional lower esophageal sphincter and an abnormal esophageal hiatus or hiatal hernia. approximately 30% of large hiatal hernias will recur after surgery, in part due to weak connective tissue at the hiatus. platelet rich plasma (prp) is a promising autologous therapy that may address this shortcoming by substantially enhancing wound healing of the hiatus after repair. intervention: prp will be applied to mesh used in hiatal hernia repair. objectives: the objective of this study is to determine the efficacy of prp in hiatal hernia compared to traditional hernia repair without prp. study population: 150 patients 18 years and older with large (\>5cm) paraesophageal hernias. study methodology and study arms: a 1:1 allocation ration will be used to randomly assign 75 patients to the experimental arm (prp with mesh) and 75 patients to the control arm (mesh only). study outcomes: the primary outcome will be 1-year postoperative hernia recurrence based on video esophagram and/or upper endoscopy. the secondary outcome will be gerd-health related quality of life (gerd-hrql) scores and dysphagia scores at 6 and 12 months. follow-up: patients who undergo fundoplication and hiatal hernia repair with mesh are seen in clinic for follow-up at two weeks, six weeks, six months, one year, and annually thereafter. video esophagram or upper endoscopy will be performed at 1 year after surgery to assess the primary outcome. the investigators secondary outcome of reduction in gerd-hrql score will be determined by a difference in the gerd-hrql score from the preoperative score to the postoperative scores taken at 6 months and 1 year. the investigators secondary outcome of dysphagia will be determined by eat-10 scores taken at 6 months and 1 year. statistics/analysis: descriptive statistics will be used. intention to treat and per protocol analyses will be performed. frequentist and bayesian statistical analyses will be used to determine statistically and clinically important outcomes.


Eligibility criteria:
inclusion criteria: - documented hiatal hernia \> 5cm on preoperative video esophagram or upper endoscopy exclusion criteria: * non-english speaking patients * prior antireflux surgery * platelet count less than 100,000 * history of platelet dysfunction * antiplatelet therapy up to ten days prior to surgery * corticosteroids use up to one month before surgery * diabetes * active malignancy or treatment for cancer within the last year * pregnancy or active breastfeeding * active smoking

Keywords: platelet rich plasma hiatal hernia fundoplication mesh