Kornimate/medical-research-clean huggingface dataset:
emergence of fluoroquinolone resistance in commensal flora

Conditions: All Types of Infections

Summary: the emergence of resistance to fluoroquinolone (fq) is a major problem worldwide. the commensal flora is the main reservoir for antibiotic resistance. understanding the factors (environmental, patient-related, dosis-related, drug-related...) involved in the emergence of resistance to fluoroquinolones in the commensal flora of patients treated with a fq, may help prevent it and preserve the efficiency of these important antibiotics. samples of rectal, nasal and pharyngeal flora will be collected from hospitalized patients before receiving a fq, at the end of the treatment and 1 month after the end of treatment. clinical data will be collected. the incidence and risk-factors associated with the emergence of resistance to fq will be assessed by comparing groups with and without resistance both at the end of treatment and 1 month later.

population involved: patients hospitalized (\>1day) in one of the two participating university hospitals and receiving a treatment by a fluoroquinolone (fq) antibiotic. number of centers : 2 (saint louis and beaujon hospitals, assistance publique hopitaux de paris, paris, france). expected number of patients : 720 aim : to study the incidence and risk-factors involved in the emergence of resistance to fq in the commensal flora during and after treatment by a fq. methods: nasal, rectal and pharyngeal swabs were performed before, during, and one month after the end of fq treatment. microbiological analysis will focus on 3 target bacterial species: escherichia coli from the faecal flora, alpha-haemolytic streptococci from the pharyngeal flora and non-coagulase staphylococci in the nasal flora. patients carrying resistance at day 0 in all three flora will be excluded. the incidence and risk-factors of the emergence of resistance to fq will be assessed at the end of treatment by fq and 1 month after the end of treatment. patients having resistant bacteria in their flora at the end and/or after treatment will be compared with those with no resistance. the same swabs will be collected from a reference group of patients not receiving fq treatment, but hospitalized in the same wards at the same time as the case patients in order to eventually detect horizontal transmission of fq-resistant strains in the hospital ward.

Eligibility criteria:
inclusion criteria: * hospitalisation \>24hours in one of the participating wards treatment by a fluoroquinolone antibiotic. exclusion criteria: * pregnancy or breast feeding patients refusal to participate

Keywords: fluoroquinolone -resistance commensal flora emergence of resistance
comparison of interfascial injection versus subpectineal injection on ultrasound-guided obturator nerve block

Conditions: Bladder Neoplasm

Summary: this study aimed to assess the effectiveness of the ultrasound-guided interfascial injection approach with the subpectineal injection technique for obturator nerve block in bladder cancers undergoing transurethral resection of bladder tumor (turbt) under spinal anesthesia.


Eligibility criteria:
inclusion criteria: * lateral wall bladder tumour * asa i-ii patients exclusion criteria: * contraindications for spinal anesthesia, * tumors that disrupt the integrity of the bladder, * coagulation disorders, * uncooperative patients, * allergy to local anesthetics.

Keywords: obturator nerve block ultrasound guided block bladder tumor
clinical study of lbbp

Conditions: Bradyarrhythmias; Heart Failure

Summary: at present, cardiac pacing has been widely used in the treatment of bradyarrhythmias and heart failure, which can effectively improve the survival rate of patients. with the rapid development of technology, you can choose to pace the heart in different parts. the atrium can choose the right atrial appendage, the atrial septum and the right ventricular side wall. the right ventricle can choose to be paced in the his bundle, right ventricular apex and ventricular septal outflow tract. the right ventricle can choose the pacing positions including left bundle branch pacing and left ventricular pacing via coronary vein. there are few studies comparing the long-term efficacy and safety of different pacing programs in daily practice. this study is to observe the short-term and long-term effects and safety of different parts of cardiac pacing, and compare the advantages and disadvantages of different parts of cardiac pacing.


Eligibility criteria:
inclusion criteria: * patients who received pacemaker implantation in the second hospital of zhejiang medical university by pan xiaohong and other surgeons. * patients who have the ability to understand the test and can cooperate with investigators. exclusion criteria: * patients who unable to understand or unwilling to fill in informed consent forms or follow visitors
intensive control of blood pressure in acute ischemic stroke after endovascular therapy on clinical outcome (crisis i)

Conditions: Acute Ischemic Stroke

Summary: crisis i is a prospective, multicenter, randomized controlled trial, to asses the impact of intensive blood pressure control on clinical outcome of acute ischemic stroke patients with successful recanalization after endovascular therapy.

crisis i aims to determine the effectiveness of more intensive bp lowering target (\<120 mmhg) compared to standard bp management target (\<140mmhg) on functional outcome in patients with successful recanalization post-mt for ais due to anterior circulation large vessel occlusion (lvo).

Eligibility criteria:
inclusion criteria: * age ≥18 years * diagnosis of ais with anterior circulation lvo confirmed by brain imaging * to receive mt \<24 hours after ais onset according to local guidelines * successful recanalization (tici score ≥2b) after mt * sustained systolic bp ≥140 mmhg (defined as 2 successive readings \<10 mins) within 60 minutes after recanalization * provide written informed consent (or approved surrogate) * perform cta or mri before endovascular therapy * signed an approved informed consents exclusion criteria: * significant pre-stroke disability (mrs scores 2-5) * definite indication/contraindication to different intensities of bp lowering treatment * specific contraindications to any of the bp agents to be used (eg, patients who are hypersensitive (allergic) to any of the ingredients) * unlikely to potentially benefit from therapy (e.g. advanced dementia) or very high likelihood of death within 24 hours post-mt, judged by responsible treating clinician * other medical illness that interferes with outcome assessments and follow-up (e.g.advance cancer and renal failure); women who are lactating * other conditions inappropriate for inclusion judged by investigators

Keywords: mechanical thrombectomy blood pressure management
paclitaxel liposome and cisplatin as first-line chemotherapy in patients with metastatic esophageal cancer

Conditions: Esophageal Cancer

Summary: there are no standard chemotherapy regimens for metastatic esophageal cancer. cisplatin plus 5-fluorouracil is widely used as first-line treatment with a response rate ranged from 30% to 40%. combination of paclitaxel and cisplatin has been investigated in small size clinical trial, producing promising outcome.liposome capsuled paclitaxel has been proved to be as effective as paclitaxel.the usefulness of the the regimen of paclitaxel liposome with cisplatin is evaluated by median survival time, progression free survival,and response rate.


Eligibility criteria:
inclusion criteria: * histologically confirmed metastatic esophageal tumors with no previous treatment for advanced disease or recurrent disease after previous treatment for at least one year. * at least one measurable lesion according to the recist1.1 (response evaluation criteria in solid tumors recist version 1.1) criteria. minimum indicator lesion size: \> 10 mm measured by spiral ct or \>20mm measured by conventional techniques. * patients aged between 18 and 70 years, inclusive, at the time of acquisition of informed consent * patients with performance status(ecog) 0 to 1. * abnormal hematologic values (wbc ≥ 3.0 x 109/l, hemoglobin ≥ 10.0g/dl, platelet count ≥ 100 x 109/l) * creatinine clearance ≥ 60 ml/min, serum creatinine ≤ 1.5mg/dl * serum bilirubin ≤ 1.5mg/dl. alt(alanine transaminase ), ast(aspartate transaminase) ≤ 2.5 x upper normal limit (or ≤ 2.5 x upper normal limit in the case of liver metastases) * life expectancy ≥ 3 months * patients who have given written informed consent to participate in this study exclusion criteria: * patients with active multiple cancers; or even if the multiple cancers are metachronous, have a disease-free period of less than 5 years (but excluding cancer in situ and skin cancer) * serious, uncontrolled, concurrent infection(s) or illness(es) * patients with no serious concurrent complications (such as heart disease, intestinal pneumonia) * patients with brain metastasis * patients receiving continuous administration of steroids * patients who have experienced serious drug allergy in the past * patients with retention of body fluid(pleural effusion, ascites, pericardial effusion) necessitating treatment * patients who are pregnant and lactating or hope to become pregnant during the study period * patients with prior taxane treatment (paclitaxel) * others, patients judged by the investigator or coinvestigator to be inappropriate as subject
dog-assisted therapy in dentistry

Conditions: Dental Anxiety; Pediatric Dentistry; Animal Assisted Therapy

Summary: dog-assisted therapy (dat) is used in several contexts within various areas of health care. one documented effect is that the proximity of a dog may lower anxiety in perceived stressful situations. many individuals are afraid to visit the dentist, and someone to the extent that they need medication or anesthesia in order to complete their dental treatment. based on the literature and own empirical observations, the investigators believe that dog-assisted therapy in connection with dental care may have a positive effect on children with dental anxiety or children that avoid dental care. it is desirable to restrict the use of drugs for these patients because of associated risk and side effects. the purpose of this pilot study is to evaluate whether using a specially trained therapy dog can have a positive effect on children who are afraid in a dental care setting. eligible participants (n=16) will meet twice at the dental clinic; one treatment session with a therapy dog in the dental clinic and one without. the therapy dog will be accompanied by a certified dog handler. the investigators will measure physiological variations before, during and after the treatment session. the guardian will complete validated questionnaires portraying the participant's experience of previous dental care. the participant and their guardian will also complete validated questionnaires describing their reactions from the two treatment sessions. a descriptive log for each session will be completed by the investigators.


Eligibility criteria:
inclusion criteria: * children who are afraid of visiting the dental office / children who avoid dental treatment, * children who accept the presence of a dog, * parents or guardians who accept the presence of a dog exclusion criteria: * children or parent/guardian that are afraid of dogs, * children or parent/guardian with known dog allergy, * children who are immunocompromised, * children who cannot understand or complete the patient-questionnaire

Keywords: animal-assisted intervention dog-assisted intervention dental care questionnaire pilot project dental clinic
routine antibiotic vs. directed antibiotic treatment in snake bite

Conditions: Snake Bites

Summary: clinicians tend to overuse antibiotics in snake bite despite evidence from three previous clinical trials that failed to show a benefit. but, none of these trials was done in india. further, the species of snake in two of these trials was quite different from that seen in the indian setting limiting generalization of these findings. hence, home-grown evidence is needed to persuade clinicians to use antibiotics rationally.

snake bite is a common clinical problem in india and elsewhere, affecting agricultural workers and rural population, resulting in thousands of deaths every year. apart from causing systemic manifestations such as coagulopathy, acute renal failure, and neuroparalysis, local effects of the venom manifest as swelling of the bitten limb. despite administration of adequate antivenom, the limb swelling progresses in the first 48-72 hours accompanied by considerable pain. often the limb swelling is accompanied by formation of blebs and gangrenous skin changes. at times, the limb swelling is severe enough to result in compartment syndrome, necessitating surgical interventions such as fasciotomy and debridement. animal bites are typically associated with a risk of infection by the oral flora. likewise, apart from releasing the venom, inoculation of oral flora as a result of snake bite could result in local infectious complications adding to the deleterious effects of the snake venom. observational studies suggest that the risk of infection following simple bites on the lower limbs is much less than what is often believed, and evidence from clinical trials also does not support routine use of antibiotics in snake bite. for this reason, clinical practice guidelines do not recommend routine prophylactic use of antibiotics in snake bite. but, in reality, many clinicians continue to use antibiotics routinely in all venomous snake bites hoping to prevent a local infection. while such a strategy may not reduce the risk of infection, it would result in overuse of antibiotics promoting antimicrobial resistance and escalating treatment costs. the investigators hypothesize that clinically-directed use of antibiotics would be non-inferior to routine use in preventing local infectious complications of snake bite, while being superior in reducing the antibiotic consumption. non-inferiority would be inferred if the one-sided 95% ci of the difference does not exceed 10% in favour of the routine use arm.

Eligibility criteria:
inclusion criteria: * age 18-65 years * history of snake bite with features of local envenomation with/without systemic features * less than 24 hours since bite, and * no prior antibiotic treatment exclusion criteria: * upper limb bites * multiple (\> 1) bites * wound manipulation * extensive local necrosis or blebs * seriously-ill patients with hypotension/capillary leak/life threatening bleeding. * suspected cobra bite, or * pregnant/breast-feeding women

Keywords: snake envenomation antibiotic prophylaxis viperidae
evaluation of the potential drug-drug interactions between gemfibrozil or dabigatran etexilate and camlipixant

Conditions: Cough; Healthy

Summary: this is a phase 1, 2-part, open-label, fixed-sequence study evaluating potential drug-drug interactions between gemfibrozil (part 1) or dabigatran etexilate (part 2) and camlipixant (blu-5937) 50 mg tablet in healthy participants under fasting conditions.


Eligibility criteria:
inclusion criteria: * healthy males or non-pregnant, non-lactating healthy females exclusion criteria: * history of clinically significant history of neurological, endocrine, cardiovascular, respiratory, hematological, immunological, psychiatric, gastrointestinal, renal, hepatic, and metabolic disorder, as judged by the investigator.
kaiser permanente vaccination improvement with nudge-based cardiovascular targeted engagement

Conditions: Cardiovascular Diseases; Influenza; Behavior, Social

Summary: in randomized clinical trials and observational studies, influenza vaccination is effective in reducing influenza-related illness and hospitalizations and potentially cardiovascular (cv) events and mortality in select populations. however, the potential population-level benefit of influenza vaccination is limited by its uptake. novel implementation strategies to improve vaccination uptake are needed. kp vaccinate is a multicenter, sequential, individual-level randomized controlled implementation trial examining the effectiveness of a cv-focused nudging communication vs. usual care communication on influenza vaccination uptake among kaiser permanente northern california (kpnc) and kaiser permanente mid atlantic states (kpmas) eligible members during the 2024-2025 influenza season.

in randomized clinical trials and observational studies, influenza vaccination is effective in reducing influenza-related illness and hospitalizations and potentially cardiovascular events and mortality in select populations. however, the potential population level benefit of influenza vaccination is limited by its uptake. novel implementation strategies to improve vaccination uptake are needed. kp vaccinate is a multicenter, sequential, individual-level randomized controlled implementation trial examining the effectiveness of a cv-focused nudging communication vs. usual care communication on influenza vaccination uptake among kaiser permanente northern california (kpnc) and kaiser permanente mid atlantic states (kpmas) eligible members during the 2024-2025 influenza season. the study will evaluate an operational directive at kpnc and kpmas. eligible participants will be randomized into 4 study arms, corresponding to the messaging received at two different vaccine communication touchpoints (touchpoint 1/touchpoint 2) during the 2024-2025 influenza season: 1. cv-focused nudge communication/cv-focused nudge communication 2. cv-focused nudge communication/usual care communication 3. usual care communication/cv-focused nudge communication 4. usual care communication/usual care communication

Eligibility criteria:
inclusion criteria: 1. age ≥18 years 2. active kpnc or kpmas member 3. ≥6 months of continuous health plan coverage and prescription drug benefit before september 1, 2024 4. evidence of member access to the kp healthconnect® portal and/or a listed registered email address 5. no documented influenza vaccination during the 2024-2025 influenza season prior to randomization exclusion criteria: 1. unable to receive or opted out of receiving health system messaging 2. other exclusion that prevents messaging outreach. 3. unknown service area or medical center affiliation.

Keywords: vaccination nudges behavioral science cardiovascular disease myocardial infarction heart failure implementation science
post traumatic stress disorder (ptsd), sleep disordered breathing and genetics: effects on cognition

Conditions: Stress Disorders, Post-Traumatic

Summary: the current research program aims to study how sleep disordered breathing, age and genetics affect memory in older adult veterans with posttraumatic stress disorder (ptsd). the study will help researchers and clinicians better understand the relationship among ptsd, sleep disordered breathing, genetics and memory function.

the research project will clarify how sleep disordered breathing and apolipoprotein (apoe) status affect cognitive decline in a population already at risk for accelerated decline-veterans with ptsd. to fill this knowledge gap properly, we will conduct a longitudinal study and data include analytic techniques designed specifically to identify moderators and mediators of clinical change.

Eligibility criteria:
inclusion criteria: 1. age 55 years or older, male or female veterans of any racial or ethnic group. 2. ptsd subjects will be positive for lifetime ptsd, related to any past lifetime traumatic experience and have a diagnosis of current, chronic ptsd by the clinician administered ptsd scale (caps) criteria with current caps score \> 40 3. capable of giving informed consent for the study 4. sufficient visual and auditory acuity for cognitive testing exclusion criteria: psychiatric exclusions: 1. current or lifetime history of any psychiatric disorder with psychotic features 2. current or lifetime bipolar disorder or delusional disorder 3. prominent suicidal or homicidal ideation 4. current exposure to trauma or recent exposure to trauma in the past 3 months. 5. currently or have within the past six months met dsm-iv criteria for drug or alcohol abuse or dependence (except nicotine). 6. presence of alcohol intoxication (by breathalyzer) or alcohol withdrawal (by exam) during testing 7. diagnosis of probable or possible dementia 8. mini-mental state exam (mmse) \< 23 9. history of seizure disorder. medical/medication exclusions: 1. acute illness or unstable chronic illness (e.g., history of severe liver disease (cirrhosis, esophageal varices, ascites, portal hypertension, hepatic encephalopathy). clinical or laboratory evidence of active hepatic disease will be recorded. 2. history of neurologic (e.g., multiple sclerosis, seizure disorder, stroke, history of transient ischemic attacks) or systemic illness affecting central nervous system (cns) function (e.g. liver failure, kidney failure, congestive heart failure, systemic cancer) 3. unstable or severe cardiovascular disease 4. unstable gastrointestinal disorder 5. uncontrolled hypertension 6. head injury within one year 7. loss of consciousness \>24 hrs 8. use of systemic steroid medication (with the exception of estrogen replacement therapy which is permissible) 9. illiterate or unable to read or write english or are judged by the investigator to be unable or unlikely to follow the study protocol 10. toxicology evidence of illicit substance use.
comparison of medical therapies in marfan syndrome.

Conditions: Marfan Syndrome

Summary: the investigators are looking at the different impacts of atenolol, verapamil and perindopril on large artery and lv function in marfan syndrome. it is a double-blind, randomised cross-over trial.

the investigators recruited 21 patients with confirmed diagnosis of marfan syndrome from two centres. the investigators performed radial artery applanation tonometry and pulse wave analysis to derive central aortic pressure and haemodynamic indexes pre-and post administering atenolol 75mg, perindopril 4mg and verapamil 240mgs each for four weeks with a two week wash-out between medications. all patients underwent detailed functional and anatomical echocardiographic assessments at each visit. inclusion criteria were ages 16-60 years with no treatment or β-blocker or other monotherapy only for marfan syndrome. patients with previous aortic dissection or aortic surgery, severe valvular regurgitation, aortic diameter at the sinotubular junction ≥ 5.0cm, contraindications to specific drug treatment, e.g. asthma and β-blocker, or those who were pregnant or at risk of pregnancy were excluded.

Eligibility criteria:
inclusion criteria: * ages 16-60 years old with no treatment or β-blocker or other monotherapy only for marfan syndrome exclusion criteria: * previous aortic dissection or aortic surgery * severe valvular regurgitation * aortic diameter at the sinotubular junction ≥ 5.0cm * contraindications to specific drug treatment, e.g. asthma and β-blocker * those who were pregnant or at risk of pregnancy

Keywords: marfan syndrome large arterial function lv function atenolol perindopril verapamil central arterial pressure