Kornimate/medical-research-clean huggingface dataset:
treatment of hemodialysis catheter-related bacteremia

Conditions: Hemodialysis Catheter-related Bacteremia

Summary: patients who undergo hemodialysis via a tunneled catheter often develop bloodstream infections that arise from the catheter. there are several management options for treatment of such an infection, though the best option is not clearly delineated. standard of care options include exchanging the catheter for a new one over a guide-wire and instilling a high concentration of an antibiotic directly into the catheter lumen. the investigators are planning to treat hemodialysis catheter bloodstream infections by one of two strategies: 1. use of a novel antibiotic lock solution or 2. changing out the infected catheter for a new one. both these options have comparable cure rates as shown in the medical literature. after obtaining informed consent, patients will be randomized to either treatment arm and will continue to receive all other standard medical care. specific aim: to conduct a randomized clinical trial to demonstrate that the use of a novel antibiotic lock solution (consisting of n-acetylcysteine, tigecycline and heparin) is non-inferior to guide-wire exchange in the treatment of hemodialysis catheter-related bacteremia.


Eligibility criteria:
inclusion criteria: * any adult (≥ 18 years of age) who has esrd and a prevalent or incident tunneled hemodialysis catheter with bacteremia will be eligible for enrollment. exclusion criteria: * the following patients will be excluded: 1) patient is unable (and no guardian or legal representative is available) or unwilling to provide informed consent, 2) patient is allergic to nac, tigecycline, minocycline, or heparin, 3) patient has evidence of a complicated bacteremia such as endocarditis, septic thrombophlebitis, septic emboli, osteomyelitis, deep seated abscess, or hypotension requiring use of vasopressors, 4) patient has evidence of an exit site infection around the catheter such as a pus pocket, purulent drainage, or erythema, 5) patient is pregnant or will become pregnant, 6) the infection is due to an organism that is resistant to tigecycline such as candida or pseudomonas species.
ards - clinical epidemiology and the role of the inflammatory response - scor in acute lung injury

Conditions: Acute Respiratory Distress Syndrome; Lung Diseases

Summary: to investigate the epidemiology of adult respiratory distress syndrome (ards) and the evolution of the inflammatory process in patients with acute lung injury.

background: the results provided: a) a better understanding of the evolution of inflammation in clinical conditions leading to lung injury; b) a better understanding of the mechanisms of the initial injury and its propagation; and c) information that will help predict the course and outcome in individual patients. these data should be useful in guiding the choice and timing of specific therapeutic interventions. design narrative: the study was a subproject within a specialized center of research (scor) in acute lung injury. leonard hudson was the subproject principal investigator. the epidemiological aspects focussed on refining clinical criteria that predicted patients at high risk for the onset of ards, and identifying these patients as early as possible before the onset of lung injury. the major hypothesis was that uncontrolled and sustained alveolar inflammation increased the severity of ards and prolonged its course, and that sustained inflammation was more likely to occur when ards followed sepsis syndrome than multiple trauma. the investigators also tested the hypothesis that the pattern of the inflammatory response in blood and lungs was an important determinant of whether lung inflammation persisted or resolved. important components of the inflammatory response studied included; 1) a coordinated sequence of cytokines in blood and lung lavage fluid; 2) the expression of adhesion molecules on blood leukocytes; 3) circulating markers of diffuse endothelial injury (vwf and elam1); 4) products of the arachidonic acid cascade; 5) the induction of endogenous proteins that modified the host response to bacterial products such as endotoxin; and 6) inflammatory cell populations and proteins in the lung. patterns of inflammation were correlated with clinical risks, critical clinical events, and outcome measures. the study was renewed in 1999 to : develop clinical prediction tools that provide individual risk assessment for the onset and outcome of lung injury; determine the incidence and outcome of acute lung injury / adult respiratory distress syndrome (ali/ards) in populations beyond a single institution; determine the relationship between inflammatory responses and injury to the lung endothelial and epithelial barriers; and investigate determinants of host susceptibility that modulate the occurrence of ali/ards in patients at risk.

Eligibility criteria:
no eligibility criteria
necessity of antibiotics for prevention of delivery-associated infections after spontaneous vaginal delivery at term

Conditions: Perineal Wound Infection

Summary: the purpose of this study is to determine amoxicillin is effective in the prevention of wound infection in normal labor.

when the pregnant women is admitted due to first stage of labor , the investigator will inform the patients. if the patients give consent, the patient's data will be collect in case record form. the patients will be swab at posterior fornix and around anus to collect specimen and send to microbiology lab before per vaginal examination. after the patients finish in labor, perineal wound will be swab to collect specimen and send to microbiology lab. then the patients are randomized in two group, the first one will receive amoxicillin and the second one will receive placebo. during admission the patients will be exam by investigator every day. after the patients are discharge, the follow up will be appoint on 6 weeks later. the infant will be swab at rectum to collect specimen and send to microbiology lab when the patient's discharge day. every specimen will be culture for bacteria and perform antimicrobial susceptibility test for amoxicillin.

Eligibility criteria:
inclusion criteria: * term pregnancy * normal labor exclusion criteria: * penicillin allergy * previous history antibiotic using within 2 weeks * patients cannot take oral medication * patients have underlying disease eg. diabetes mellitus, hypertension, hiv infection * premature rupture of membranes

Keywords: amoxicillin postpartum infections puerperal infection
edwards pascal transcatheter valve repair system registry

Conditions: Mitral Valve Insufficiency

Summary: this registry will collect prospective and retrospective clinical data on patients treated with the edwards pascal transcatheter valve repair system outside of the post-market clinical follow-up (pmcf) study.

patients treated per standard of care at their medical facilities and a written informed consent will be collected to allow the data to be collected. this registry intends to enroll patients under commercial usage and will serve as a mechanism to collect clinical data to further characterize the safety, performance and effectiveness of the pascal transcatheter valve repair system.

Eligibility criteria:
inclusion criteria: * patient signs informed consent to participate in the registry * patient is intended to or has received the pascal device exclusion criteria: * patient does not consent to participate * patient is part of an ongoing edwards pre or post market clinical study for the pascal transcatheter valve repair system.
efficacy of self - adjustable clavicular brace versus standard clavicular brace for treatment of mid shaft clavicle fracture: a randomized controlled study

Conditions: Clavicle Fracture

Summary: a randomized control trial was conducted to compare the outcomes of conservative management for closed midshaft clavicular fractures using self-adjustable clavicular brace and standard clavicular brace.

ten patients aged 18-75 years with midshaft clavicle fractures were enrolled in the study during february 2022 to february 2023. 6 patients were managed with standard clavicular brace and 4 patients with self-adjustable clavicular brace. all patients were scheduled for follow-up appointments at 1 week, 2 weeks, 4 weeks, 6 weeks and 12 weeks. results were assessed based on clinical, functional and radiographic outcomes using the dash questionnaire, pain, measured by vas, analgesic usage, displacement, shortening, time to union, and patient satisfaction,

Eligibility criteria:
inclusion criteria: * patient with aged between 18 - 75 years old * closed isolated fracture midshaft of clavicle within 9 days after the injury date exclusion criteria: * after bracing, fracture displacement and/or shortening \> 2 cm or fracture comminution \> 3 fragments * segmental fracture * open fracture * impending open fracture (soft tissue compromise/skin lesion) * ipsilateral upper extremities fracture which disturbs clavicular bracing * floating shoulder which surgical treatment is indicated. * patients with other injuries (e.g. head injury, chest and abdomen injury) which interrupted clavicular bracing * pathologic fracture * patient has limitation for clavicular brace application * pregnant women

Keywords: clavicle fracture, treatment of clavicle fracture, clavicular brace, figure of eight bandage
immune response for patients with metastatic breast cancer treated by everolimus

Conditions: Breast Cancer

Summary: this study evaluates the immune response for patients affected by metastatic breast cancer treated by everolimus


Eligibility criteria:
inclusion criteria: * patients eligible for a treatment by everolimus in association with the exemestane * performance status of 0,1 or 2 according to the who * patients affected of a breast cancer advanced and\\or metastatic her2 negative expressing the hormonal receptor rh + * menopausal patients exclusion criteria: * psychiatric disease compromising the understanding of the information or the realization of the study * vulnerable people according to the law (minors, adults under protection, private persons of freedom) * histories of cancer in 5 years preceding the diagnosis (except breast cancer, squamous-cell) * not menopausal women * unaffiliated people to the social security * people being for the period of exclusion from another study * hypersensitivity in the active substance, in the other by-products of the rapamycin or in one of the excipients. * symptomatic visceral achievement * legal incapacity or limited legal capacity
brace versus casting in pediatric radial head fractures

Conditions: Radial Fracture

Summary: commare the pain and function of brace versus casting in pediatric radial head fractures after 1 month

radial head fractures are common injury in children. in this study, healthy children with mason type i or ii radial head fractures are planned to be included. outcome measures: the primary outcome measure will be an assessment of functional daily activities as measured by the mayo score at four weeks post injury. secondary outcomes will include an assessment of pain scores using vas. sample size and analysis: assuming a standard deviation of 10%, alpha = 0.05, beta = 0.2 and 10% dropout rate yields a sample size of 150 patients. secondary analyses will include fisher's exact test to compare proportions of children with full range of motion of the injured ankle at four weeks and with full baseline activity level at four months, and the area under the curve of a pain-time profile curve will be compared using a student's t-test.

Eligibility criteria:
inclusion criteria: 5 to 18 years of age with one of the following fracture undisplaced maoson types i and ii fractures of the radial head exclusion criteria: the diagnosis of elbow sprain or contusion; they occur primarily in adolescents with closed epiphyseal plates. all open fractures which require surgical debridement. all children at risk for pathological fractures such as those with congenital or acquired generalized bony disease. congenital anomalies of the elbow. patients with coagulopathies. multisystem trauma and multiple fractures of the same or opposite limb. patients cognitively and developmentally delayed with inability to express pain and/or difficult assessment of baseline activity level. injuries greater than 72 hours old. past history of surgery or closed reduction of the same elbow within the last 6 months or ankle trauma of the same ankle within 3 months.

Keywords: pediatric elbow fractures management
perinatal research on improving sleep and mental health

Conditions: Insomnia; Depression

Summary: the goal of this clinical trial is to compare two sleep programs in pregnant people with insomnia. the main questions it aims to answer are: 1. what is the efficacy of digital cognitive behavioral therapy for insomnia (cbt-i) versus digital sleep hygiene education (she) for preventing perinatal depression? 2. is the effect of digital cbt-i on perinatal depression mediated through prenatal insomnia symptom improvement? 3. is the effect of digital cbt-i on perinatal depression moderated by baseline depressive symptom severity? participants will receive one of two sleep programs - she or cbt-i. both involve six weekly online sessions. participants will complete surveys and interviews until 1 year postpartum.


Eligibility criteria:
inclusion criteria: * pregnant 14-28 weeks gestation * 18 years or older * daily access to a web-enabled computer, smart phone, or tablet * current elevated insomnia symptom severity and insomnia disorder * english speaking exclusion criteria: * current major depression * taking or planning to take antidepressant medication (adm) * other diagnosed or suspected sleep disorder * other psychiatric or medical issues (e.g., bipolar disorder, active suicidality, bed rest) * night shift worker
assessing virtual reality for perioperative anxiolysis and postoperative pain modulation in adolescents undergoing mirpe surgery

Conditions: Pectus Excavatum; Pectus Deformity

Summary: the goal of this clinical trial is to test virtual reality in adolescents undergoing minimally invasive repair of pectus excavatum surgery. the main questions it aims to answer are: * can virtual reality decrease anxiety in adolescents on the day of the surgery? * can virtual reality be used as a pain modulator in adolescents in postoperative care? participants will be asked to wear a vr headset for a minimum of 1 hour before and after the surgery. patients will be asked to fill out three anxiety tests: on admission, in the operating room and on the surgical ward on the day after surgery. researchers will compare vr group to control group to see if anxiety and pain was different among those who recieved the vr headset.


Eligibility criteria:
inclusion criteria: * patient between 14-18 years old * reported chest deformity (pectus excavatum/ carinatum) * patients undergoing mirpe surgery in general anesthesia * hungarian fluency * willing to comply with study procedures. exclusion criteria: * gross cognitive impairment that would interfere with the ability to consent or complete study procedures. * head injury * head infection * altered mental status (independently from midazolam) * scabies or louse * dizziness or vertigo * blindness or severe vision loss * lack of parental/ guardian or patient consent * those, who has a head deformity, so vr headset does not fit well
study of gemcitabine maintenance treatment in patients with extensive sclc patients

Conditions: Small Cell Lung Cancer

Summary: the purpose of this study is to evaluate and compare safety and efficacy of gemcitabine maintenance treatment in patients with extensive sclc patients receiving etoposide combined with platinum based first-line chemotherapy

from the first cycle of treatment (day one) to two month after the last cycle

Eligibility criteria:
inclusion criteria: 1. ≥18 years 2. ps=0,1,2 3. patients who were diagnosed by the histologic, cytologic diagnosis of extensive small cell lung cancer 4. patients received etoposide combined with platinum based first-line chemotherapy 6 cycles and there is evidence show the patent is pr/cr/sd 5. expected lifetime\>12 weeks 6. signed written informed consent exclusion criteria: small cell lung cancer non small cell hybrid women during pregnancy or lactation previously treated with two or more than two kinds of treatment any non remission of \>ctcae caused tumor treatment past grade 2 toxicity ccr\<30 ml/min (calculated by cockcroft-gault formula) hepatic insufficiency： 1. tbil\> 1.5×uln 2. alt and ast \> 2.5×uln (patients with liver metastasis\>5×uln) alkaline phosphatase\>2.5 ×uln(patients with liver metastasis\>5×uln) 3. severe symptomatic heart disease 4. symptomatic brain metastases 5. in the last 5 years have been or are suffering from other histological types of malignant tumor 6. there are serious or uncontrolled systemic diseases 7. during the study period planned radiotherapy on target lesion 8. during the study period, plans to use other antineoplastic therapy 9. clinical study on treatment of 30 days beginning period prior to participate in any study drug

Keywords: progression free survival
effects of the soluble mediators of mastocytes on the intestinal epithelial barrier and of the enteric nervous system during the syndrome of the irritable bowel

Conditions: Irritable Bowel Syndrome

Summary: patients with irritable bowel syndrome (ibs) have increased intestinal permeability. in addition, mucosal soluble mediators are involved in the pathophysiology of pain in ibs. the investigators aimed to investigate: 1. paracellular permeability in colonic biopsies of ibs patient 2. the ability of soluble factors from colonic biopsies to reproduce in vitro these alterations


Eligibility criteria:
inclusion criteria: * patients needing coloscopy exclusion criteria: * disrupted coagulation results * cancer even healed * known food allergy. * alcohol consumption \>30g/day
specimens for septin 9 performance

Conditions: Colorectal Cancer

Summary: epigenomics has identified methylated gene regions that are specific for colorectal cancer (crc). through epigenomics' marker discovery and validation process septin 9 was identified as a particularly robust methylation marker for detection of crc. epigenomics is currently developing a blood based crc screening test based on septin 9 and is performing a large prospective clinical trial showing its clinical utility in a population at average risk for crc. parallel to this trial further activities are needed to evaluate, optimize, and develop pre-analytical and analytical workflows as well as molecular assays making possible the use of septin 9 methylation in the clinical routine.


Eligibility criteria:
inclusion criteria: * 50 years of age or older at the time of the blood draw * histologically confirmed or strong clinical suspicion of adenocarcinoma of the colon or rectum * crc defined as invasive adenocarcinoma exclusion criteria: * previous personal history of colorectal cancer * any cancer specific treatment (e.g. polypectomy, chemotherapy, radiation, or surgery) prior to blood draw, including neoadjuvant treatment * known infection with hiv, hbv or hcv * subject concurrently receiving intravenous fluid at the time of the specimen collection

Keywords: stability of the septin 9 biomarker epi pro colon test crc
impact of a focal muscle vibration protocol in front of the the anterior tibial muscle in the subacute post-stroke period on motor recovery in hemiplegic patients.

Conditions: Stroke

Summary: in about 40 percent of cases, after a stroke, neuromotor impairment leads to activity limitations and the development of chronic functional disorders, which have a significant impact on patient autonomy. in the early subacute phase, motor deficit in foot lifters is one of the factors limiting standing posture and ambulation, which is ultimately difficult to rehabilitate due to the lack of available techniques for obtaining early onset of useful active voluntary contraction. the use of muscular focal vibration therapy, applied to relaxed muscle, may be of interest due to the portability and availability of the system and the neuromotor benefits demonstrated in healthy subjects and in acute and chronic post-stroke patients.


Eligibility criteria:
inclusion criteria: * having had a stroke (with or without previous stroke) and being in the early subacute phase (between 14 days and 3 months of stroke). * responsible for a motor deficit in the right or left lower limb. * no neurological history other than stroke. exclusion criteria: * multifocal stroke * patient having received a botulinum toxin injection to the lower limb to be vibrated

Keywords: muscle vibration protocol anterior tibia muscle hemiplegic patient
the effect of medical cannabis on tics, premonitory urge and psychiatric comorbidity in adults with tourette syndrome

Conditions: Tourette Syndrome; Cannabis

Summary: medical cannabis (mc) is a standard treatment in israel to adults with resistant gilles de la tourette syndrome (gts). while small randomized control trials assessed thc efficacy on tics and premonitory urge, only small retrospective studies assessed mc efficacy and tolerability in gts. herein, by using an open-label, prospective design, our aim is to determine the preferred method of use, efficacy and tolerability of 12 weeks of treatment with mc in adult patients with gts.

gilles de la tourette syndrome (gts) is a childhood onset neuropsychiatric disorder characterized by the presence of multiple motor and one or more phonic tics continuing for at least one year. in israel, although consumption of cannabis is outlawed, there is an option to allow patients to consume the drug under supervision. medical cannabis (mc) consumed by inhalation of smoked or vaporized dried female buds, or subligual oil extract of whole plant, has been an approved treatment by the ministry of health (moh) for resistant gts since 2013. previous studies suggested that mc has a good effect on tics, quality of like and with good tolerability among patients with resistant gts. in the current study, we prospectively followed-up patients eligible for mc according to moh restrictions, at our gts clinic at the tel-aviv sourasky movement disorders unit (mdu). each subject signed a written informed consent before inclusion in the trial. also, since driving under the influence of cannabis is forbidden by the israeli law, patients were instructed and gave their oral commitment to avoid driving. the study was approved by the research ethics (helsinki) committee at our center. mc was consumed as oil extract, vaporized, or smoked dried buds. the treating neurologist (s.a.) and patient together decided on the method of consumption during the visit before initiating treatment. patients were assessed 4 and 12-weeks following treatment initiation to gather data regarding treatment efficacy, tolerability and ses.

Eligibility criteria:
inclusion criteria: * age 18 - 65 years * diagnosis of gts confirmed by the treating neurologist based on the dsm-v criteria * eligibility to receive moh mc license for gts * provided written informed consent exclusion criteria: * regularly use cannabis in any form for self-medication prior to entering the study * pregnant or lactating women * have a tic disorder other than gts * have concurrent physical or mental disease that could interfere with the study

Keywords: cannabidiol cannabis medical cannabis delta(9)-tetrahydrocannabinol tourette syndrome