Kornimate/medical-research-clean huggingface dataset:
diagnostic stewardship for ventilator associated pneumonia

Conditions: Ventilator Associated Pneumonia

Summary: the goal of this pragmatic cluster-randomized crossover trial is to test if less unnecessary antibiotics are prescribed when the lab reports respiratory culture test results in a specific way for patients who have respiratory cultures obtained, but do not meet clinical criteria for ventilator associated pneumonia (vap). the main question it aims to answer is: does a modified culture reporting intervention reduce unnecessary antibiotics for ventilated patients in the intensive care unit (icu)? researchers will compare antibiotic use outcomes between eligible patients whose test results are communicated using the modified reporting and those with standard reporting of results.

the specific aims of this project are: specific aim 1: in a cluster-randomized crossover trial among 6 icus across 3 medical centers, evaluate the impact of a vap diagnostic stewardship intervention on antibiotic use, vap diagnoses, and adverse events. hypothesis: a change in unnecessary antibiotics for vap and in vap clinical diagnoses in the intervention vs. control periods across all sites, without a change in adverse events, is expected. specific aim 2: evaluate overall impact of intervention including clinical and antibiotic outcomes using the "desirability of outcome ranking (door)/ response adjusted for duration of antibiotic risk (radar)" methodology. hypothesis: a change in overall patient outcomes (better door ranking, accounting for duration of antibiotic use) in the intervention vs. control period is expected.

Eligibility criteria:
inclusion criteria: * patient located on icu unit included in the study * patient is mechanically ventilated * patient had respiratory culture sent \>48 hours after admission * patient age ≥ 18 years exclusion criteria: * extra corporeal membrane oxygenation (ecmo) at time of respiratory culture * heart or lung transplant * culture rejected by lab per standard lab protocol * prisoners * severe immunosuppression as defined by: * \<6 months from solid organ transplant (sot) or \<6 months from treatment for acute rejection following sot * active treatment for lymphoreticular malignancies * neutropenic \< 1000 * receiving lymphodepleting chemotherapy * allogeneic stem cell transplants \<6 months * autologous stem cell transplants or chimeric antigen receptor t-cell (car-t) therapy \<6 months out * allogeneic stem cell transplant with graft vs host disease (gvhd) or receiving 2 or more immunosuppressants * advanced or untreated human immunodeficiency virus (hiv) infection with cd4 \< 200 * receiving biologics within 6 months
umblical incision for neonatal surgery

Conditions: Neonatal Surgery

Summary: abdominal exploration leave an ugly scar that live with the baby forever, laparoscopy can solve the problem to some extent by making a smaller scar but takes more time and need special surgical skills. umbilical incision can combine the advantage of open and laparoscopy and avoid the drawbacks of both.

six cases were subjected to the study 2 cases have duodenal atresia, one case has annular pancreas, one case has jujenal atresia chritmas tree, one case has jujenal web and a case of malrotation. all of them had made exploration by the umbilical incision, and no drains had been used.

Eligibility criteria:
inclusion criteria: * neonate diagnosed radiologically exclusion criteria: * unclear diagnosis
visual outcomes and patient satisfaction after bilateral implantation of non-diffractive edof iol made of a new hydrophobic acrylic material

Conditions: Cataract

Summary: the objective is to measure the range of vision and patient reported visual disturbances after bilateral implantation for this unique non-diffractive extended depth of focus (edof) intraocular lens (iol) made from the clareon material.

this study is a single-arm unmasked clinical evaluation study of binocular distance-corrected distance (6m) and intermediate (66cm) visual acuity after successful bilateral cataract surgery. subjects will be assessed pre-operatively, operatively and at 1 day, 1 month and 3 months post-operatively. clinical evaluations will include administration of a visual disturbance questionnaire (quvid), and a satisfaction questionnaire (iolsat), as well as measurement of bilateral visual acuity and manifest refraction.

Eligibility criteria:
subjects are eligible for the study if they meet the following criteria: note: ocular criteria must be met in both eyes. * visually significant age-related cataracts bilaterally. * best monocular corrected distance visual acuity predicted to be (20/25) or better after cataract removal and iol implantation as determined by surgeon. * gender: males and females. * willing and able to provide written informed consent for participation in the study. * willing and able to comply with scheduled visits and other study procedures. * clear intraocular media other than cataract. * planned bilateral implantation of the clareon vivity and vivity toric iols. * iol powers between 6d and 30d, t2-t6. if any of the following exclusion criteria are applicable to the subject or either eye, the subject should not be enrolled in the study. * previous ocular or refractive surgery * ocular surface disease/dry eye disease * intraoperative complications during procedure * glaucoma, including well-controlled * any disorders that reduce binocular vision (ie strabismus) * any ocular comorbidity that, in the opinion of the investigator reduce post-op visual acuity (e.g. amd etc) the principal investigator reserves the right to declare a patient ineligible or non- evaluable based on medical evidence that indicates they are unsuitable for the trial. pregnancy has a known effect on the stability of refractions and visual acuity. as such, subjects who become pregnant during the study will not be discontinued but their data may be excluded from analyses of effectiveness.
a study evaluating the efficacy and safety of pegozafermin in participants with mash and fibrosis (enlighten-fibrosis)

Conditions: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASH) / Nonalcoholic Steatohepatitis (NASH) With Fibrosis

Summary: the study will assess the efficacy and safety of 2 dose regimens of pegozafermin for the treatment of liver fibrosis stage 2 or 3 in adult participants with mash (previously known as nonalcoholic steatohepatitis \[nash\]).


Eligibility criteria:
key inclusion criteria: * males or non-pregnant females aged between 18 and 80 years (inclusive) at time of signing the informed consent form (icf) * biopsy-confirmed mash (previously named nash) with fibrosis stage f2 or f3 per nash clinical research network (crn) system and nas ≥4, with a score of at least 1 in each of steatosis, ballooning degeneration, and lobular inflammation or nas \<4 and/or a ballooning degradation score of 0 with fibrosis stage f3 and a score of at least 1 in steatosis. a historical biopsy must be within 6 months of screening visit (with additional requirements). * body mass index (bmi) at screening ≥25.0 kilograms (kg)/meters squared (m\^2) (≥23 kg/m\^2 for asian countries) key exclusion criteria: * chronic liver diseases other than mash/nash * evidence of cirrhosis on screening liver biopsy * have type 1 diabetes or poorly controlled type 2 diabetes * alanine aminotransferase (alt) or aspartate aminotransferase (ast) ≥250 units per liter (u/l) * participants taking vitamin e (\>400 international units \[iu\]/day) or pioglitazone must be on stable dose for at least 6 months prior to screening other inclusion and exclusion criteria may apply.

Keywords: liver diseases fatty liver digestive system diseases metabolic diseases metabolic dysfunction-associated steatohepatitis mash nonalcoholic steatohepatitis nash metabolic dysfunction-associated steatotic liver disease masld nonalcoholic fatty liver disease nafld fibrosis
pcos patients' immune alterations

Conditions: Polycystic Ovary Syndrom; Metformin; Immune Function

Summary: in this study, the investigators will include pcos patients and healthy women who meet the trial criteria from the clinical research centers of 3 hospitals, introduce the content of this study to participants, and invite participants to participate. flow cytometry was used to detect the immune function of peripheral blood samples of pcos patients, to clarify the immune function characteristics of pcos patients, and to try to establish an evaluation method of the immune function of pcos patients.

pcos patients and healthy women were recruited in outpatient clinics of three hospitals, and peripheral blood was retained for flow cytometry after completing relevant examinations. in this study, flow cytometry was used to detect the antigenic antibody reaction between the surface differentiation antigen of lymphocyte membrane and fluorescence-labeled antibody in human peripheral blood, and the unlabeled cells were dissolved. the number and percentage of cell groups expressing different markers were counted by the fluorescence detection system on flow cytometry.

Eligibility criteria:
inclusion criteria: * female subjects aged 18-45 years; * voluntarily participate in the experiment, willing to sign the informed consent. * according to the rotterdam consensus, polycystic ovarian syndrome (pcos) needs to meet the presence of two of three of the following criteria: oligo-anovulation, hyperandrogenism, and polycystic ovaries (≥ 12 follicles measuring 2-9 mm in diameter and/or an ovarian volume \> 10 ml in at least one ovary). exclusion criteria: * female patients younger than 18 years old or older than 45 years old; * ovulation disorders caused by premature ovarian failure, pituitary amenorrhea, hypothalamic amenorrhea, and thyroid dysfunction (hyperthyroidism, hypothyroidism); * congenital adrenal hyperplasia, cushing's syndrome, hyperprolactinemia, adrenal tumors, and other diseases causing hyperandrogenemia; * severe liver and kidney dysfunction (more than 3 times the normal value) * type 1 diabetes, monogenic mutation diabetes, diabetes due to pancreatic injury or other secondary diabetes; * history of malignant tumor; * severe infection, severe anemia, neutropenia, and other chronic diseases of the system; * patients undergoing total hysterectomy or ovarian adnexectomy; * mental illness, dementia, or other cognitive behavioral problems; * hypoglycemic drugs that may affect insulin resistance and androgen levels, including thiazolidinedione, metformin, sglt-2i, acarbose, and glucagon-like peptide-1 receptor agonist (glp-1ra), have been used in the past 3 months; * take letrozole, clomiphene, oral contraceptives, glucocorticoids, gonadotropins, gonadotropin-releasing hormone agonists, antiandrogens (spironolactone, cyproterone acetate, flutamide, etc.), and other medications for pcos treatment within the last 3 months. * pregnant or lactating patients; * female patients with a bmi less than 20kg/m2.
a study comparing hypofractionated dose escalated vmat to conventional ccrt in locally advanced head and neck cancer

Conditions: Locally Advanced Head and Neck Cancer

Summary: to compare efficacy and toxicity between hypofractionated dose escalated vmat versus conventional concurrent chemoradiation in locally advanced head and neck cancer

patients were randomized to receive either: 70gy in 35fx in 7wks at 2gy/fx concurrently with weekly cisplatin 40mg/m2 (arm a) or 74gy in 33 fractions (fx) in 6.5 weeks at 2.24gy/fx (arm b). volumetric modulated arc therapy (vmat) plans were created for both treatment arms

Eligibility criteria:
inclusion criteria: 1. age ≥18 years and ≤70 years old. 2. histopathologically confirmed squamous cell carcinoma of head and neck. 3. locally advanced tumors (t3-t4 \&/or n1-3) (stage iib, iii and stage iv-a: staging by ajcc 7th edition). 4. patients not exposed to radical surgery for current disease. 5. performance status (ecog) 2 or less. 6. no associated co-morbidity with contraindication to chemotherapy. 7. normal hemogram. (anc ≥1.5x109/l, platelets count ≥100x109/l, hemoglobin ≥80 g/l) 8. accepted renal functions. (bun \& serum creatinine \<1.5x upper limit of normal value with normal gfr). 9. accepted liver functions. (total bilirubin and direct bilirubin \< 1.5 x uln \& alanine aminotransferase and aspartate aminotransferase \< 3 x uln) 10. informed consent. exclusion criteria: 1. patients with distant metastatic lesions, as detected by imaging techniques. 2. patients with history of other head and neck malignancies. 3. patients with history of previous head and neck irradiation. 4. patients with a serious concomitant illness, such as active cardiac disease, severe uncontrolled hypertension, or uncontrolled infection. 5. women who are pregnant or breast feeding.

Keywords: hypofractionation vmat head and neck cancer
comparing efficacy of intravenous dexmedetomidine and lidocaine on postoperative analgesia in patients undergoing fracture hip surgery

Conditions: Fracture Hip Surgery

Summary: perioperative pain management has been a major challenge for anesthesiologists, and there have been persistent efforts to bring out the best possible analgesic technique with the least side effects. hip fractures are devastating injuries, constituting a global public health burden and remain one of the largest healthcare challenges of the 21st century. the incidence increases with advancing age and the number of hip fractures is expected to increase to 6.26 million per year in 2050. hip fractures impact on patient's psychological, functional, and social wellbeing, and account for substantial healthcare system costs. drugs of potential interest such as intravenous (i.v.) lidocaine and dexmedetomidine have been administered both intra and/or postoperatively to decrease perioperative pain and improve other outcomes. lidoocaine has analgesic, anti inflammatory, and anti hyperalgesia properties. several studies have demonstrated that perioperative lidocaine infusion reduces postoperative pain intensity and opioid consumption . ease of availability, cost effectiveness, simplicity of administration, safety, and analgesic action make lignocaine an attractive option. dexmedetomidine is a highly selective and specific α2 adrenoceptor agonist with useful analgesic, sedative, anxiolytic, and sympatholytic properties. i.v. dexmedetomidine has gained immense popularity owing to its efficacy as an analgesic adjuvant, translating into reduced opioid consumption. intraoperative dexmedetomidine and lignocaine also confirm the enhanced recovery after surgery protocol advocating the reduction of opioid use. while numerous studies have analyzed i.v. lidoocaine and dexmedetomidine versus placebo regarding postoperative analgesia and outcomes, researches and evidence in the context of minimally invasive surgeries regarding adverse effect profile, postoperative analgesic requirement, perioperative analgesia, anesthesia recovery, and opioid requirements are always welcome(rephrase). our study was conducted to analyze the effects of intraoperative i.v. lidocaine and dexmedetomidine on pain relief, intra- and postoperative opioid consumption, and effects of these infusions on intraoperative hemodynamic parameters and to evaluate the side effect profiles the aim of the study to analyze the effects of intraoperative intravenous lignocaine/dexmedetomidine on postoperative pain relief and analgesit consumption


Eligibility criteria:
inclusion criteria: * age more than 18 years old. * patients with both sex * patients who are american society of anesthesiologists class i or ii exclusion criteria: refusal. * body mass index (bmi) ≥40 kg/m2. * history of hypersensitivity to the drugs being evaluated * inability to comprehend postoperatively the pain assessment scale/neuropsychiatric disorders. * chronic use of opioids and opioid addiction
evaluation of comfilcon a and senofilcon a lenses

Conditions: Myopia

Summary: evaluation of comfilcon a and senofilcon a lenses

non-dispensing, single-masked, randomized, contralateral study comparing the test lens against the control lens. each subject will be randomized to wear the test lens in one eye and the control lens in the other eye.

Eligibility criteria:
inclusion criteria: subjects must satisfy the following conditions prior to inclusion in the study: * has had an oculo-visual examination in the last two years * is at least 18 years of age and has full legal capacity to volunteer * has read and understood the information consent letter * is willing and able to follow instructions and maintain the appointment schedule * is correctable to a visual acuity of 20/30 or better (in each eye) with their habitual vision correction * currently wears soft contact lenses at least 3 days a week, 8 hours a day * has clear corneas and no active ocular disease * has not worn lenses for at least 12 hours before the examination * have normal eyes with no evidence of abnormality or disease. for the purposes of this study a normal eye is defined as one having: * no amblyopia * no evidence of lid abnormality or infection (e.g. entropion, ectropion, chalazia, recurrent styes) * no clinically significant slit lamp findings (e.g. infiltrates or other slit lamp findings grade 2 or above: corneal edema, tarsal abnormalities, and conjunctival injection). * no other active ocular disease (e.g. glaucoma, history of recurrent corneal erosions, cornea \[infiltrates\], conjunctiva, lids, and intraocular infection or inflammation of an allergic, bacterial, or viral etiology) * no aphakia * has prescription to match the available power range. exclusion criteria: any of the following will render a subject ineligible for inclusion: * greater than 0.75 of refractive astigmatism in either eye * has never worn contact lenses before * wears contact lenses on an extended wear basis * has any systemic disease affecting ocular health * is a known sufferer of ocular allergies * is taking medication, such as oral antihistamines, antihistamine eye drops, oral and ophthalmic beta-adrenergic blockers (e.g. propanolol, timolol), anticholinergics, oral steroids and any prescribed or over-the-counter eye medication, except artificial tears or eye lubricants * has any clinically significant lid or conjunctival abnormalities, neovascularization, corneal scars or corneal opacities * is aphakic * has undergone corneal refractive surgery. * is wearing monovision * is participating in any other type of clinical or research study * female who is currently pregnant or is breast-feeding * has \> grade 1 ocular corneal staining in both type and extent by \> grade 2 in either type or extent
association of carotid arterial circumferential strain with left ventricular function and hemodynamic compromise during off-pump coronary artery bypass surgery

Conditions: Three Vessel Coronary Artery Disease

Summary: this study is aimed to evaluate the association of common carotid artery circumferential strain with the echocardiographic parameters of left ventricular function and the degree of actual hemodynamic deterioration in patients undergoing multi-vessel off-pump coronary artery bypass with preserved left ventricular ejection fraction.


Eligibility criteria:
inclusion criteria: 1. three vessel coronary artery disease 2. sinus rhythm exclusion criteria: 1. new york heart association functional class ≥3 2. known pulmonary hypertension 3. known valvular heart disease 4. serum creatinine ≥2.0 mg/dl 5. myocardial infarction within 1 week before the surgery 6. history of cerebral or peripheral arterial occlusive disease

Keywords: off-pump coronary artery bypass surgery common carotid artery speckle tracking analysis peak strain
efficiency of home-based pulmonary rehabilitation in adults with asthma

Conditions: Pulmonary Rehabilitation; Asthma; Home-based Pulmonary Rehabilitation

Summary: asthma is a serious global health problem affecting people of all ages in every country in the world. despite the presence of effective medications, many studies have reported poor asthma control in patients. therefore, new approaches are needed to improve asthma control. pulmonary rehabilitation is recommended as an alternative approach in patients with chronic lung disease including asthma. also, home-based type of pulmonary rehabilitation can be preferred because it is more cost-effective and patients can spend more time with their families. there are a limited number of studies in the literature evaluating the efficacy of home-based pulmonary rehabilitation in asthmatic patients. the aim of this study was to investigate the efficacy of home-based pulmonary rehabilitation program with simple equipment in asthmatic patients.


Eligibility criteria:
inclusion criteria: * diagnosed with asthma * acceptance of persons to participate in the study * being in the 18-65 age range exclusion criteria: * presence of an orthopedic, neurological, systemic disease that prevents the exercise * having mental, communicative and behavioral disorders that may cause problems in understanding commands and questions or practicing exercises. * exercising 3 or more days a week

Keywords: asthma pulmonary rehabilitation home-based pulmonary rehabilitation home-based rehabilitation
role of rotational guided growth in management of increased femoral anteversion

Conditions: Increased Femoral Anteversion

Summary: efficacy of guided growth in coronal plane deformity correction and limb length discrepancy has been well-established. recently, studies have explored the validity of guided growth in correction of rotational deformity through a modified method of application. this concept has been validated in animal studies, biomechanical studies and two limited human case series through different methods. this study evaluates the efficacy of rotational guided growth in management of increased femoral anteversion using three different constructs.

the purpose of this study is: 1. evaluate the efficacy of different constructs in correcting increased femoral anteversion clinically and radiographically. 2. asses possible complications of this new concept including lld, undesired coronal, sagittal plane deformity and stiffness.

Eligibility criteria:
inclusion criteria: * children with increased femoral anteversion causing in-toeing with decreased agility. * aged 8 years and above with at least two years of bone growth remaining. exclusion criteria: * any patient who underwent previous femoral osteotomy. * any patient with sick physis (skeletal dysplasias, post traumatic / post infective physeal damage, active rickets). * cerebral palsy (cp) patients

Keywords: rotational guided growth torsional deformities guided growth rotational deformities
comparison of intravascular ultrasound with venography in the diagnosis and treatment of iliac vein compression syndrome

Conditions: Iliac Vein Compression Syndrome

Summary: the aim of this study is to compare intravascular ultrasound with venography in the diagnosis and treatment of iliac vein compression syndrome.


Eligibility criteria:
inclusion criteria: * age: 18 to 90 years * willing to participate in and sign the informed consent * patients with suspicious iliac vein stenosis or compression presented by preoperative magnetic resonance venography (mrv) * patent common femoral vein and/or femoral vein of the study leg * undergoing iliofemoral venography with the intend to treat potential iliac vein compression syndrome exclusion criteria: * not providing informed consent * venous compression caused by pelvic tumors or fibroid uterus * previous stent implantation or venovenous bypass surgery of the study leg * known metal allergy precluding the possibility of stent implantation * known iodine allergy or severe renal insufficient function which are unsuitable for venography * pregnant or planning to be pregnant recently * acute deep vein thrombosis or tumor thrombus involving the study leg * know history of thrombophilia (e.g. protein c or s deficiency, anti-thrombin iii deficiency, etc ) * any concurrent disease, for example, heart failure, might make the patients unsuitable for surgery