Kornimate/medical-research-clean huggingface dataset:
effects of dobutamine on microcirculation, regional and peripheral perfusion in septic shock patients

Conditions: Septic Shock

Summary: the investigators hypothesize that dobutamine is able to revert negative redistribution of flow by inducing a selective vasodilatory effect on hypoperfused territories, particularly at the sublingual and gastric mucosa, and at the peripheral tissues. the investigators designed a randomized, cross-over, placebo-controlled study looking at the acute physiologic effects of 5 mcg/kg/min fixed-dose of dobutamine on cardiac function, microcirculation, gastric mucosal, hepatosplanchnic, and peripheral perfusion in septic shock patients.

the investigators hypothesize that dobutamine is able to revert negative redistribution of flow by inducing a selective vasodilatory effect on hypoperfused territories, particularly at the sublingual and gastric mucosa, and at the peripheral tissues. therefore, dobutamine improves microcirculatory alterations and regional perfusion in septic shock, independent of its effects on cardiac output. the relevance of this concept is that it would support a more rational use of dobutamine in septic shock patients, not only as an inotrope to increase cardiac output, but more important, as a selective vasodilator aimed at restoring perfusion. therefore, the investigators designed a randomized, cross-over, placebo-controlled study looking at the acute physiologic effects of 5 mcg/kg/min fixed-dose of dobutamine on cardiac function, microcirculation, gastric mucosal, hepatosplanchnic, and peripheral perfusion in septic shock patients.

Eligibility criteria:
inclusion criteria: * adult patients (\>18 years) * septic shock for less than 24 hours * arterial lactate \> 2.4 mmol/l * mechanical ventilation and pulmonary artery catheter in place exclusion criteria: * pregnancy * refractory hypotension * acute coronary syndrome within the last 3 months * previous use of dobutamine during the last 72 hours * cardiac index \< 2.5 l/min/m2 * non-sinus rhythm * heart rate \>140 bpm * anticipated surgery or dialytic procedure during the study period * child b or c liver cirrhosis * hemoglobin \< 8 gr/dl * uncontrollable fever \> 39ºc

Keywords: septic shock
results of safety guidewire use in ureteroscopic stone surgery

Conditions: Urinary Stone

Summary: up-to-date, urology guidelines introduce safety guidewire (sgw) as an integral tool in ureteroscopy and recommended its routine use. however, the necessity of sgw placement in endourological procedures lack evidence and is being suggested as an expert opinion. present study aimed to evaluate the use of sgw placement and its necessity in treatment of ureteral stones with semi-rigid ureteroscopy (s-urs). for this purpose patients with ureteral stones are being stratified according to ureteral stone location and prospectively randomized into two groups' according to sgw usage or not in s-urs. ureteroscopy and litotripsy is being done with a semi-rigid ureteroscope of 6.4/7.8 fr (olympus) and laser. chi-square and student t-test were used for comparing data.


Eligibility criteria:
inclusion criteria: * ureteral stone disease patients who would undergo ureteroscopy procedure exclusion criteria: * patients who have a medical condition that makes randomisation not possible * patients in whose operations safety guidewire is regarded as a necessity * patients who refuse to participate

Keywords: urinary stones semirigid ureteroscopy guidewire
efficiency of spatially distributed sequential stimulation (sdss) for functional electrical stimulation (fes) of upper motor neuron syndrome (umr) patients

Conditions: Upper Motor Neuron Disease

Summary: to determine whether spatially distributed sequential functional electrical stimulation is more effective than standard electrical stimulation during functional electrical stimulation in upper motor neuron patients

design: sced (single case experimental design) prospective, monocentric, comparative interventional study (sdss versus ses) population: patients with motor deficit due to upper motor neuron syndrome setting: neurologic rehabilitation unit interventions: 3 fes cycling sessions separated by 48h of rest. each session is comprised of 2 phases separated by 20 minutes of rest. each phase is comprised of a 3 minutes passive cycling warm-up, followed by 3 minutes of electrically stimulated cycling. participants will be evaluated before and during the training.

Eligibility criteria:
inclusion criteria: patients with upper motor neuron syndrome: * adult (\> 18 years) * motor deficit due to an acquired traumatic or neurodegenerative motor deficiency of the central nervous system (mrc\<4/5) * stable clinical condition, particularly on the cardiovascular level (recent assessment by a cardiologist with stress test) * non denervated muscles * tolerant to muscle electrical stimulation * having given written consent * able to cycle 30 minutes with fes-cycling exclusion criteria: * major cognitive comprehension disorders that could compromise understanding of the protocol and the smooth running of the study * cardiac pacemaker and other contraindications relating to the use of electrostimulation (in particularly "deep vein thrombosis") * spasticity of the lower limbs making flexion/extension movement difficult * participation in another study * pregnancy * people with the following legal and administrative states or situations: * people placed under judicial protection; * persons deprived of their liberty, persons subject to psychiatric care and persons admitted to a health or social establishment for purposes other than that of clinical investigation; * unemancipated minors; * people who are not affiliated to a social security scheme or beneficiaries of such a scheme

Keywords: functional electrical stimulation muscle fatigue rehabilitation spinal cord injury stroke multiple sclerosis
efficacy of topical rapamycin to treat chronic erosive oral lichen

Conditions: Oral Lichen Planus

Summary: the purpose of this study is to determine wether topical rapamycin is more efficient than topical steroids in the treatment of chronic erosive lichen planus.


Eligibility criteria:
inclusion criteria: * oral lichen planus * oral erosive area more than 1cm² * lichen planus pathologically proven exclusion criteria: * no previous treatment by rapamycin * non child bearing or breast feeding woman * patient who cannot be treated by rapamycin or betamethasone * chronic renal insufficiency (creatinin clearance \< 40ml/mn) * ongoing treatment by topical calcineurin inhibitors or systemic steroids or retinoids or systemic immunosuppressors or thalidomide or griseofulvin or antimalarials * cholesterolemia \>7.8 mmol/l or hypertriglyceridemia \>3.95mmol/l non responsive to medical treatments * leucopenia (\<3000/mm3) * thrombopenia (\<100 000/mm3) * hypertransaminasemia (\>3n) * hypersensitivity to macrolides

Keywords: oral lichen planus chronic inflammatory mucous membranes erosive lesions
the effect of simvastatin combined with ezetimibe in patients with stable angina and diabetes

Conditions: Coronary Heart Disease

Summary: in this study, simvastatin combined with ezeimebum was used to enhance lipid reduction, and ivus was used to evaluate the volume and composition of coronary plaque before and after treatment. the aim is to evaluate the overall intervention effect of ezeimebum on stable angina pectoris with diabetes mellitus on the basis of statins.

this study was conducted in patients with stable angina pectoris complicated with diabetes mellitus in chinese pla general hospital and coronary arteriography confirmed as critical lesion of coronary artery. the patients were randomly divided into two groups: ezeimebum combined with simvastatin group and simvastatin group. the patients of the former group were given ezeimebum 10mg combined with simvastatin 40mg for 12 months while the patients of the latter group were given simvastatin 40mg for 12 months. assessed coronary atherosclerotic plaque volume percentage (pav) and standardized total atherosclerotic plaque volume (tav) by intravascular ultrasound (ivus) at the time of entry and out of the group after 12 months. the changes of pav level in both groups were taken as the main endpoints, and the changes of tav levels in the two groups as the secondary endpoints. the changes of serum lipids and hypersensitive c-reactive protein levels were compared between the two groups before and after the treatment. major cardiovascular events (non-fatal myocardial infarction, all-cause death, readmission to acute heart failure, and revascularization of recurrent angina pectoris) were followed up for 12 months.

Eligibility criteria:
inclusion criteria: * patients aged 18-75 years * consistent with the chinese criteria for the diagnosis of chronic stable angina pectoris, stable angina pectoris symptoms in the last three months, and no more than ccs grade 3 of angina pectoris * coronary angiography showed that the degree of coronary artery stenosis was 50% and 70% * ldl-c standard: ldl-c \> 80 mg/dl (2.08 mmol/l) * the patients diagnosed with type 2 diabetes were currently using hypoglycemic drugs or insulin * sign the informed consent to join the group. exclusion criteria: * acute coronary syndromes such as myocardial infarction, unstable angina pectoris, variant angina pectoris, cardiac shock, chronic heart failure, malignant arrhythmia, etc. * patients requiring stent implantation had been treated with intensive statins prior to admission (e.g. doses of atto vastatin 40mg or resuvastatin 20mg) * there were contraindications or statins for statin lowering lipids or statins, and there was a history of adverse reactions (liver injury, rash, myolysis, etc.) in the use of ezeimebum, etc. * severe liver and kidney dysfunction, creatinine clearance \< 30ml / min, acute pancreatitis, malignant tumor, etc.

Keywords: coronary heart disease atherosclerosis acute myocardial infarction coronary intervention
assessment of coronary flow reserve in heart failure patients after ultrafiltration versus diuretics

Conditions: Acute Decompensated Heart Failure

Summary: the purpose of this research study is to compare the effects (good and bad) of ultrafiltration treatment with standard intravenous (in your vein) diuretic therapy (furosemide, torsemide, bumetanide) on your heart function and blood flow.

the standard of care to treat congestive heart failure is with a class of medication called diuretics, which remove the extra fluid from the body through urination. another way to remove extra fluid in patients with heart failure is called ultrafiltration. ultrafiltration may result in more rapid removal of excess fluid and more rapid improvement in your symptoms compared to standard diuretic treatment. currently, it is unknown what effects these therapies (diuretics or ultrafiltration) have on the small blood vessels in your heart. these small blood vessels are important to supply blood and oxygen to your failing heart. thus, the purpose of this research study is to compare the effects (good and bad) of ultrafiltration treatment with standard intravenous (in your vein) diuretic therapy on your heart function and blood flow.

Eligibility criteria:
inclusion criteria: * males and non-pregnant female patients over 18 years admitted to the hospital or treated in an outpatient heart failure clinic with the primary diagnosis of acute decompensated heart failure. * evidence of fluid overload more than 8 kg above their dry weight, and conforming to definition of hypervolemia (at least two of the following findings: more than 1+ pitting edema of the lower extremities, jugular venous pressure more than 10 cm water, pulmonary edema or pleural effusion on chest radiograph consistent with adhf, ascites, paroxysmal nocturnal dyspnea, or equal or more than 2 pillow orthopnea. exclusion criteria: * acute coronary syndrome * documented ischemic cardiomyopathy * atrial fibrillation * serum creatinine more than 3.0 mg/dl * systolic blood pressure less than 90 mmhg * hematocrit \> 45% * clinical instability likely to require intravenous vasopressors and/or intravenous vasoactive drugs (such as milrinone, dobutamine, nitroglycerin or nesiritide) during the present hospitalization * severe pulmonary hypertension or use of pulmonary hypertension drugs (such as sildenafil, bosentan or other endothelin inhibitors) * patients with documented hypertrophic obstructive cardiomyopathy or restrictive cardiomyopathy, * patients with severe valvular heart disease, * patients with recent cocaine use (within one month of presentation) * patients with heart transplant * patients with systemic infection * patients on hemodialysis * inability to obtain venous access * contraindications for anticoagulation * unable to lie flat for at least 20 minutes * pregnant and breast-feeding women.

Keywords: acute decompensated heart failure myocardial blood flow coronary flow reserve ultrafiltration diuretics
biomechanical and electrophysiological effects of duloxetine in the treatment of women with urinary stress incontinence

Conditions: Urinary Stress Incontinence

Summary: biomechanical and electrophysiological effects of duloxetine in the treatment of women with urinary stress incontinence


Eligibility criteria:
inclusion criteria: * have a diagnosis of only stress urinary incontinence * have no pelvic organ prolapse protruding more than 1 cm beyond the hymen exclusion criteria: * at visit 1, have a positive urine culture or a history of four or more urinary tract infections in the preceding year. * have had more than one continence surgery. * have a current or past urogenital cancer.
pancreatic carcinoma: chemoradiation compared with chemotherapy alone after induction chemotherapy

Conditions: Pancreatic Cancer

Summary: this randomized trial examines the effectiveness of chemoradiotherapy compared to chemotherapy alone after induction chemotherapy with 3 cycles of gemcitabine or 6 cycles of folfirinox in patients with locally advanced, non resectable and non-metastatic pancreatic cancer. chemotherapeutic agent in chemoradiotherapy is gemcitabine administered in 5 cycles, the agent and its administration for sole chemotherapy is determined by induction chemotherapy. operability of tumor is evaluated at week 11 after randomisation. patients will be followed for the duration of therapy and for 5 years after the last study treatment. overall survival at the end of follow up is defined as primary endpoint. secondary endpoints are tumor-free survival, rate of local recurrence or local progression, rate of distant metastasis, acute and late toxicity of the chemoradiotherapy, quality of life, rate of remission, rate of curative resections (r0) after chemotherapy and chemoradiotherapy. it is planned to include a total number of 830 patients.


Eligibility criteria:
inclusion criteria: * age \> 18 years * histologically confirmed adenocarcinoma of the pancreas * no evidence of distant metastasis based on computed tomography of the thorax and abdomen * non resectable pancreatic cancer * no evidence of peritoneal carcinosis * ecog-performance status ≤ 2 * signed study-specific consent form prior to therapy exclusion criteria: * fertile patients who refuse effective contraception during study treatment * synchron second malignant neoplasm except basal cell carcinoma of the skin and carcinoma in situ of the cervix after curative therapy * the inclusion of patients with prior or concurrent malignancy (≤ 5 years prior to enrolment in study) must be discussed * chronic inflammatory disease of the intestine * known allergic reactions on study medication * on-treatment participation on other trials * insufficient liver function: bilirubin \> 2,0 mg/dl; sgot, sgpt, alkaline phosphatase, ggt more than 3 times upper limit of normal (after stent implantation in case of obstructive jaundice); cirrhosis of the liver child b and c * insufficient bone marrow function: wbc \ 100 x 10\^9/l * serum creatinine \> 1,5 mg/dl, creatinin clearance \< 60ml/min (or comparable test) * preexisting uncontrolled cardiac disease, signs of cardiac failure, or rhythm disturbances requiring therapy, myocardial infarction within the past 6 months, unstable angina pectoris, congestive heart failure, new york heart association (nyha) class iii or iv heart disease * neurological and/or psychiatric diseases: stroke, dementia, epilepsy, psychosis * active intractable or uncontrollable infection, hiv-infection * prior radiotherapy or chemotherapy

Keywords: pancreatic cancer chemoradiotherapy chemotherapy folfirinox gemcitabine
fournier's gangrene in patient with uncontrolled type 2 diabetes

Conditions: Fournier Gangrene

Summary: a 66-year-old man, with a history of uncontrolled type 2 diabetes, obesity with bmi 38, chronic kidney failure and chronic heart failure, was admitted to the emergency department with a large area of necrosis involving the perineal and perianal regions.

fournier's gangrene is a potentially fatal emergency condition, supported by an infection of perineal and perianal region, characterized by necrotizing fasciitis with a rapid spread to fascial planes. fg, usually due to compromised host, may be sustained by many microbial pathogens. a 66-year-old man, with a history of uncontrolled type 2 diabetes, obesity with bmi 38, chronic kidney failure and chronic heart failure, was admitted to the emergency department with a large area of necrosis involving the perineal and perianal regions.

Eligibility criteria:
inclusion criteria: clinical diagnosis of fournier's gangrene insulin dependent diabetes (type 2) exclusion criteria: n/a

Keywords: fournier's gangrene type 2 diabetes surgical debridement
a study to evaluate the safety and efficacy of rdx5791 for the treatment of constipation predominant irritable bowel syndrome (ibs-c)

Conditions: Constipation Predominant Irritable Bowel Syndrome

Summary: this is a multi-center, phase 2, randomized, double-blind, placebo controlled study of rdx5791 in subjects with ibs-c. patients who are 18 to 75 years old, meeting the definition of ibs-c as defined by the rome iii criteria for the diagnosis of ibs will undergo a battery of screening procedures to determine eligibility for the trial. the study will consist of a 2-week treatment-free screening period, a 4-week blinded treatment period, and a 2-week treatment-free follow-up period.


Eligibility criteria:
inclusion criteria: * subject meets rome iii criteria for ibs-c * if \> 50 years old, colonoscopy evaluation within 10 years * all ages, negative colonoscopy if any "warning symptoms" * active disease during 2-week screening period * compliant with ivrs exclusion criteria: * subjects has ibs-d, ibs-m or un-subtyped ibs according to rome iii criteria * diagnosis or treatment of any clinically symptomatic biochemical or structural abnormality of the gi tract * use of medications that are known to affect stool consistency * subject has any protocol-excluded or clinically significant medical or surgical history that could confound the study assessments or prevent completion of study
the effect of the glycemic variability on macular retinal microcirculation and cognitive functions in patient with type 1 diabetes

Conditions: Microvascular Complications; Diabetic Retinopathy; Diabetes; Microangiopathy; Angiography

Summary: revadiab is case-control study aimed to demonstrate that retinal capillary density is altered in patients with type 1 diabetes with glycemic variability compared to those with comparable glycemic control without glycemic variability. an oct angiography will be used to precisely evaluate retinal capillary density. a secondary objective will be to evaluate if glycemic variability is associated with cognitive dysfunction, using a neuro psychologic evaluation.

hba1c doesn't explain all the microvascular complications of diabetes, especially microvascular complications. glycemic variability is associated with increased oxidative stress, free radicals and endothelial dysfunction; it contributes to the pathogenesis of diabetic complications. the relationship between glycemic variability and microangiopathic complications especially retinal but also neurological, needs to be studied. the principal objective of revadiab study is to demonstrate a correlation between glycemic variability and macular retinal microcirculation in patient with type 1 diabetes. the secondary objective is to search a correlation between glycemic variability and : * alteration of cognitive functions. * severity of peripheral diabetic retinopathy and retinal neuronal damage. * other micro and macro angiopathic complications. * oxidative stress and inflammation. two groups of type 1 diabetic patients will be compared: * case: patient with significant glycemic variability. * control: patients without glycemic variability. the severity of diabetic retinopathy will be evaluated by the degree of occlusion of small vessels in the central retinal region as measured by oct angiography. acts or product necessary to research : * non-invasive retinal imaging (oct and oct- angiography, retinophotography) * neuropsychological tests. * blood test.

Eligibility criteria:
inclusion criteria: * patients ≥ 18 years * type 1 diabetes (t1d) * using free freestyle * diabete evolving for 10 years or more * case: patients with glycemic variability, defined by a coefficient of variation (cv) \> 36%, calculated from continuous glucose measurements data by free style libre® (abbott) * controls: patients without glycemic variability, defined by a coefficient of variation (cv) ≤ 36%, calculated from free style libre® data and matched to patients in the case group for hba1c (+/- 0.5%) exclusion criteria: * type 2 diabetic patient * corticotherapy * comorbidity like cancer * antecedent of vitreoretinal pathology * antecedent of vitreoretinal surgery * important cataract, with an important opacity that prevents a reliable evaluation of capillary density in oct angio * pregnant or lactating woman

Keywords: diabetic retinopathy glycemic variability diabetes macular retinal microcirculation microangiopathy cognitive dysfunction
relationship between oral hygiene in newborns and candida spp.

Conditions: Candidiasis, Oral

Summary: little is known regarding the effectiveness of neonatal oral hygiene and its relationship to colonization by candida spp. in edentulous oral cavities. thus, the objective of this study is to evaluate whether the oral hygiene of edentulous infants favors colonization by candida spp. newborns with up to 48 hours of life will randomly allocated to two groups. the mothers will instructed to clean the oral cavity with gauze and mineral water three times a day, in the test group, and not to clean, in the control group.


Eligibility criteria:
inclusion criteria: * a signed statement of informed consent * newborns up to 48 hours of life * exclusive breastfeeding * edentulous oral cavity exclusion criteria: * any feeding other than breastfeeding * use of pacifier * digit sucking * systemic alterations

Keywords: pediatric dentistry mouth, edentulous