Kornimate/medical-research-clean huggingface dataset:
evaluation of vaccination for streptococcus pneumoniae in adults with an episode of invasive pneumococcal infection.

Conditions: Invasive Pneumococcal Infection

Summary: respiratory tract infections are among the leading causes of death worldwide and many of these infections are preventable through vaccination. one of the most important bacteria from an etiological and mortality point of view regarding respiratory and systemic infections is the gram-positive streptococcus pneumoniae. four types of vaccines are currently available for this pathogen: three pneumococcal conjugate vaccines (pcv13, pcv15, and pcv20) and one polysaccharide vaccine (ppsv23). in italy, people over 65 years of age and people suffering from chronic pathologies with effects on the immune system would be advised to be vaccinated with the pneumococcal conjugate vaccine and with the polysaccharide vaccine as a second dose. however, there are no data available in italy on vaccination coverage in these population categories and above all the vaccination rates in patients who have a history of an episode of invasive pneumococcal infection are not known. the aim of the study is to measure how many patients are vaccinated for s. pneumoniae after hospitalization for a systemic pneumococcal infection in order to understand patients' awareness of preventing this infection after receiving a first diagnosis.


Eligibility criteria:
inclusion criteria: * patients over 18 years old; * patients hospitalized at the manzoni hospital in lecco or at the san raffaele hospital in milan with invasive pneumococcal infection in the period between 01/01/2015 and 31/12/2019; * presence of a positive culture test for s. pneumoniae on blood cultures and/or liquor; * patients whose discharge letter or clinical documentation relating to the infectious episode is available; * patients whose vaccination record can be consulted (on paper or on siavr) and whose vaccination history is available before and after hospitalization. exclusion criteria: * patients with positive urinary antigen for s. pneumoniae as the only microbiological finding; * patients whose vaccination history or vaccination records are not available.
safety and performance study of tigr matrix surgical mesh in inguinal hernia repair

Conditions: Inguinal Hernia

Summary: this an open, uncontrolled multicenter clinical study to assess the safety and performance of the wk-6 surgical mesh in adult patients with unilateral inguinal hernia. the primary objective is to determine the safety of the wk-6 surgical mesh. data will be compared retrospectively with published studies on inguinal hernia mesh. the secondary objectives are to explore the performance of the surgical mesh by measuring the pain pre and post surgery as well as a number of relevant variables for establishing the performance of the mesh. data will be compared retrospectively with previous studies on inguinal hernia mesh with a follow-up of at least one year.


Eligibility criteria:
inclusion criteria: * patients who have given informed consent * male, 18 years and older. * patients with primary unilateral inguinal hernia * planned surgery procedure according to lichtenstein technique exclusion criteria: * patients who are unwilling and/or unable to give informed consent * hernia strangulated or irreducible * recurrent hernia * previous mesh surgery on the same side * class \>iia patients * unable to walk 500 meters * bmi \>30 kg/m2 * warfarin treatment, ongoing or within two weeks of surgery. * peripheral artery disease * chronic back pain, as judged by the investigator. * hip joint arthrosis * hypermobility syndrome, as judged by the investigator. * constipation * drug or alcohol abuse * copd (chronic obstructive pulmonary disease) * patients at increased risk of death from a pre-existing concurrent illness * patients participating in another clinical study * patients who have used any other investigational drug or device within 1 month * patients who cannot communicate reliably with the investigator * patients who are unlikely to cooperate with the requirements of the study * patients who are employees at the investigational site; relatives or spouse of the pi. * patients not suitable based upon investigator decision
electrical stimulation in women with pelvic organ prolapse

Conditions: Pelvic Organ Prolapse

Summary: the aim of this study is to search the effects of electrical stimulation on clinical symptoms such as pelvic floor muscle strength, stage of pop, symptoms of pelvic floor, quality of life and sexual function in women with pelvic organ prolapse (pop)

this study is planned as a prospective, sham radomized controlled study. individuals who volunteered to participate in the study, complying with the inclusion criteria and signed the consent paper will be randomly allocated into es and sham es groups. the study includes women aged 18-65 diagnosed with staged 1-2 pop by the physician.all patients were evaluated by the same doctor who performed the pop-q measurement, who was blinded to the baseline results. the treatment of patients will be given by the same therapist. measurements will be made 3 times at baseline (before treatment), interim period (4th week) and after treatment.

Eligibility criteria:
inclusion criteria: * being in the age range of 18-65 , * having stage1-2 symptomatic prolapse according to the pop-q system, * being a volunteer and literate exclusion criteria: * being pregnant, * being stage 3-4 prolapse, those whose evaluation parameters are missing and who do not regularly participate, * inadequate understanding and cooperation in treatment and evaluation parameters, * have malignant disease, urinary infection, * accompanying neurological disease, diabetes mellitus and cardiopathy with complications, * have electronic and metal implant, loss of sensation, sacral peripheral nerve lesion * patients with at least one of the kidney failure requiring hemodialysis

Keywords: pelvic organ prolapse electrical stimulation
prospective pediatric vesicoureteral reflux surgery database

Conditions: Vesicoureteral Reflux

Summary: the purpose of this research is to provide a clearer understanding of quality and outcomes for three types of surgical procedures performed at connecticut children's for treatment of vesicoureteral reflux. in order to consistently gather data over time, the investigators propose to establish database for surgical intervention for vesicoureteral reflux. specific aim 1: to consistently collect performance and outcomes data for the surgical treatment of vesicoureteral reflux in order to increase internal understanding of these procedures. specific aim2: to consistently collect performance and outcomes data for the surgical treatment of vesicoureteral reflux in order to perform more valuable clinical analysis for publication.


Eligibility criteria:
inclusion criteria: * subject scheduled to receive surgical intervention for the treatment of vesicoureteral reflux at connecticut children's. exclusion criteria: * subject not scheduled to receive surgical intervention for the treatment of vesicoureteral reflux at connecticut children's.

Keywords: pediatric urology vesicoureteral reflux ureteral reimplant deflux
fluoroscopy guided lumbar facet joint injection versus ultrasound guided injection in patients with low back pain due to facet syndrome

Conditions: Facet Syndrome of Lumbar Spine

Summary: the aim of this study is to compare the efficacy of fluoroscopy guided lumbar facet joint injection versus ultrasound guided injection in patients with low back pain due to facet syndrome.

all patients will be randomly classified into two equal groups (40 patients each) by using closed envelops, a computer generated random allocation codes. group 1(fluoroscopy guided group) (n =40 patients): the patient will be placed in the prone position with a pillow under the abdomen to correct the lumbar lordosis. the joint to be injected is located and marked, the x ray tube is then slowly rotated till the joint appear in profile as two parallel lines. after cleaning and drapping and administration of local anesthesia a22-g spinal needle is inserted in line with x-ray beam till bony contact is felt. all procedures will be performed under sterile conditions. each facet joint is infiltrated with a mixture containing 0.5 ml of 0.25 % bupivacaine and 0.5 ml (20mg) methylprednisolone acetate injected into the joint. group2 (ultrasound guided group) (n=40 patients): patients will be placed in a prone position. posterior paravertebral parasagittal sonograms will be obtained to identify of the different spinal levels. the spinous process and adjacent structures (lamina of the vertebral arch, facet joint, accessory process, and mammillary process) will be delineated by transverse sonograms at the target level, and the midpoint of the facet joint space will be established. after cleaning and drapping and administration of local anesthesia. if the joint is clearly or partially visible, a spinal needle is advanced under us guidance into the joint space of each lumbar facet joint. the needle is inserted 1-2 cm laterally from the midline at the lateral end of the transducer and precisely positioned in the us plane at an angle of approximately 45owith respect to the axial plane until the needle tip reached the target and bony contact is felt. this enables visualization of the needle, which appears as a bright line-shaped echo pattern on the transverse sonogram. if the needle placement is correct, a mixture containing 0.5 ml of 0.25 % bupivacaine and 0.5 ml(20mg) methylprednisolone acetate is administered intra-articular (until resistance was encountered) and injected around the posterior facet joint capsule.

Eligibility criteria:
inclusion criteria: * patients, more than 18 years old, with pain associated with lumbar hyper-extension, lateral flexion, and tenderness on paravertebral regions corresponding to facet joints but normal findings on the straight leg raise test and neurologic examination. exclusion criteria: * patient refusal and lack of consent. * local or systemic infection. * allergy to steroids or local anesthetics * patients with coagulopathies. * evidence of nerve root compression at the expected level on mri. * pregnant patients
predictive value of dynamic contrast enhancement mri on a cerebral tumor response to gamma knife treatment

Conditions: Cerebral Metastases

Summary: hypothesis: the pattern of mri contrast enhancement after gadolinium injection is different in tumors that respond well to gamma knife. we are going to acquire sequential t1-weighted images of brain lesions before, during and after injection of gd-dtpa. this will be repeated before and after a treatment with gamma knife. we will then analyse our results to see if there are common enhancement characteristics between lesions that will respond well to the radiosurgery treatment. response will be clinically assessed by tumor volume as determined by mri approximately 4 to 6 months after treatment.


Eligibility criteria:
inclusion criteria: * patient with intracerebral lesion benign or malignant wich are not concerned by the exclusion criteria exclusion criteria: * pancranial radiotherapy * residual postop lesion * gliomas * patients \< 18 years old * anterior allergic reaction to gadolinium * claustrophobia.

Keywords: cerebral metastases dynamic contrast enhanced magnetic resonance imaging dce-mri gamma knife
investigations of new markers in patients with shock

Conditions: Shock State

Summary: shock is a severe deficiency in oxygen at the cell level which could lead to the death.the study was aimed at finding markers of treatment response in patients with shock, with a better accuracy than that of lactate actually used : hypoxia-inducible factor (hif), circulating dna (cdna), and plasma from cells (mps).

shock is a severe deficiency in oxygen at the cell level which could lead to the death. the treatment strategy relies on the profile of plasma lactate level, which the kinetics and metabolism are inadequate for evaluating the treatment efficiency without delay. hence, it is now critical to identify adequate markers of dysoxia. the study was aimed at finding markers of treatment response in patients with shock, with a better accuracy than that of lactate.to this purpose, a multiple approach is undertaken with the analysis of 3 independent markers of cellular ischemia : hypoxia-inducible factor (hif), circulating dna (cdna), and plasma from cells (mps). indeed, the characteristics of hif as marker of cell dysoxia, and mps as markers of cell apoptosis, combined with cdna seem providing complementary information in order to describe the consequences of shock as well as the response to treatment. samples of patients will be collected (from rest of blood sample collected for other measurements) at each step of the management of these patients. the evolution of these markers will be compared with that of lactate plasma levels (standard of care). subgroup analysis will be undertaken in relation with the cause of shock state (septic, cardiogenic, hemorrhagic).

Eligibility criteria:
inclusion criteria: * shock state defined by a rise of plasma lactate level (\> 2 mmol/l)and/or refractory low blood pressure in the volume expansion requiring an introduction of catecholamines * admission in intensive care \< 6 hours exclusion criteria: * pregnancy * presumed survival lower than 48 hours * absence of central venous way and arterial catheter
muscle activity with the use of ankle foot orthoses in cerebral palsy

Conditions: Cerebral Palsy

Summary: the purpose of this study is to investigate the change in muscle activity during gait with the use of ankle foot orthoses in children diagnosed with hemiplegic cerebral palsy.

a small group of children with hemiplegic cerebral palsy is investigated by 3d instrumented gait analysis. muscle activity is measured by surface electromyography (semg) of selected lower limb muscle groups. kinematic, kinetic, and semg data are compared between both lower limbs walking with and without an ankle foot orthosis. data are also compared with those of an healthy control group.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of spastic hemiplegic cerebral palsy * age between 8 and 18 years * must have an equinus barefoot gait pattern * must have a heel-toe gait pattern with ankle foot orthosis * no prior operations exclusion criteria: * no botulinumtoxin treatment for at least 6 months prior to investigation

Keywords: cerebral palsy ankle foot orthosis emg surface electromyography gait analysis
efficacy of aerosal® in the treatment of sub-obstructive adenotonsillar hypertrophy and related diseases

Conditions: Sleep Apnea, Obstructive

Summary: the purpose of this study is to evaluate the efficacy of aerosal® compared to a placebo treatment in the prognosis of sub-obstructive adenotonsillar hypertrophy present for at least six months.


Eligibility criteria:
inclusion criteria: * sub-obstructive adenotonsillar hypertrophy lasting from at least six months and associated with sleep disordered breathing (respiratory pauses or sleep-apnea) and/or recurrent sero-mucus otitis * suspension for more than 3 months from the date of any immunosuppressive treatments (cyclosporin, systemic steroids) exclusion criteria: * patients with acute bronchopulmonary disease, tuberculosis, severe hypertension, hyperthyroidism, cancer (chemotherapy), intoxication, heart failure, bronchial asthma. * iodine allergy

Keywords: sleep apnea adenotonsillar hypertrophy salt sodium chloride
functionally oriented music therapy (fmt) in the treatment of long term pain

Conditions: Long Term Musculoskeletal Pain

Summary: project idea: this project aims to explore and evaluate a hitherto unexplored treatment method for people living with long-term musculoskeletal pain. the project's starting point is that it is urgent to develop evidence-based methods that can promote health and well-being, alleviate suffering and lead to an improved quality of life in the target group. the method "functionally oriented music therapy" (fmt), to be studied in the present project, can be such a method. in fmt, music and movement are combined for health-promoting purposes, which can be assumed to lead to experiences of well- being and recovery. the method is already used in primary care in region sörmland, but the method is not evidence-based in the treatment of long-term musculoskeletal pain, which is why scientific evaluation is needed. the project is urgent both from a societal and patient perspective, among other things because healthcare resources need to be used more efficiently than today. to evaluate the method, both qualitative and quantitative research methodology will be used. if the results of the project are positive, i.e., if we can find evidence that various aspects of health are specifically affected/improved, then the results can contribute to evidence based fmt support for health promotion purposes for people with long-term musculoskeletal pain. if, on the other hand, the results show that fmt has no or only little effect, that in itself is an important contribution to new knowledge about treatment and recovery in people with long-term musculoskeletal pain. today, fmt is used in, among other things, habilitation, rehabilitation and psychiatric care. however, research is needed that deals with the method's health-promoting efforts even in the case of long-term musculoskeletal pain problems.


Eligibility criteria:
inclusion criteria: * people with long-term musculoskeletal pain that occurred for at least three months. * people over 18 years of age. * people able to understand and speak swedish or english exclusion criteria: * severe hearing loss * visual impairment * cognitive impairment. pain conditions caused by: * malignancy * severe spinal pathology or * neurological disease that severely limit the ability to perform activities.
erector spinae plane block with ropivacaine for major upper abdominal surgery

Conditions: Pain, Postoperative

Summary: prospective, single-centre, randomized, controlled, open-label, evaluator-blinded, superiority trial.

the primary objective is to establish whether esp ropivacaine reduces post-operative opioid use and improves pain rating post-operatively. the secondary objectives include adverse event incidence, time to ambulation and time to discharge.

Eligibility criteria:
inclusion criteria: 1. adults who are scheduled to undergo major upper abdominal surgery (e.g. pancreato-duodenal resection). if enrollment rates are insufficient, patients undergoing other major upper abdominal surgery will be enrolled (e.g in the supraumbilical area: liver resection, colon resection; whipple procedure; gastrectomy). 2. males or females 18-70 years of age 3. american society of anesthesiologists physical status class i,ii, iii 4. signed informed consent exclusion criteria: 1. patients undergoing emergency surgery 2. decompensated cardiovascular disease (e.g. left ventricular ejection fraction ≤40%), chronic heart failure, rhythm and conduction disorders, coagulopathies) 3. comorbid obesity (bmi≥35kg/m2) 4. anomalies of vertebral column 5. use of anticoagulants and patients with hypocoagulable conditions 6. pregnancy 7. physician preference for therapeutic anticoagulation 8. infection of skin at site of needle puncture 9. known allergies to study drugs

Keywords: ropivacaine major upper abdominal surgery supraumbilical liver resection colon resection whipple procedure gastrectomy anesthetics, local erector spinae plane block
impact of a standardized alarming system on treatment times and workflow in stroke patients with interhospital transfer for thrombectomy

Conditions: Acute Ischemic Stroke

Summary: the aim of this study is to evaluate the impact of a standardized alarming system on treatment times and workflow in stroke patients with interhospital transfer for mechanical thrombectomy (mt). the main questions it aims to answer are: * is the implementation of a standardized alarming system associated with shorter transfer and treatment times? * is the implementation of a standardized alarming system associated with a better adherence on existing standard operating procedures for interhospital transfer? we will analyze data from our existing thrombectomy registry comparing time periods before and after introduction of the mt alarming system.


Eligibility criteria:
inclusion criteria: * age \>= 18 years * diagnosis of acute ischemic stroke * indication for mechanical thrombectomy * admission to one of 7 participating primary stroke centers within in the catchment area of the referral center exclusion criteria: * unclear indication for mechanical thrombectomy (patients admitted for perfusion imaging before decision for or against a mt)

Keywords: mechanical thrombectomy, telestroke, drip and ship, interhospital transfer, communication
the aries heartmate 3 pump ide study

Conditions: Heart Failure

Summary: prospective, randomized, double-blinded, placebo-controlled clinical investigation of advanced heart failure patients treated with the hm3 with two different antithrombotic regimens: vitamin k antagonist with aspirin versus vitamin k antagonist with placebo

this clinical investigation is a prospective, randomized, double-blinded, placebo-controlled study of advanced heart failure patients treated with the hm3 with two different antithrombotic regimens: vitamin k antagonist with aspirin versus vitamin k antagonist with placebo.

Eligibility criteria:
inclusion criteria: 1. subject will receive the heartmate 3 per standard of care (soc) in accordance with the approved indications for use in the country of implant. 2. subject will receive the heartmate 3 as their first durable vad. 3. subject must provide written informed consent prior to any clinical investigation related procedure. 4. in female patients of child bearing capability, subject will not be currently pregnant or breastfeeding and on appropriate contraception. exclusion criteria: 1. post-implant additional temporary or permanent mechanical circulatory support (mcs). 2. investigator mandated antiplatelet therapy for other conditions (including mandated presence or absence of antiplatelet agent). 3. patients who are nil per os (npo) post-implant through day 7. 4. subjects with a known allergy to acetylsalicylic acid (aspirin). 5. participation in any other clinical investigation(s) involving an mcs device, or interventional investigation(s) likely to confound study results or affect study outcome. 6. presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.

Keywords: heart failure ventricular assist device lvad aspirin