Kornimate/medical-research-clean huggingface dataset:
aerosolized plus intravenous vs. intravenous colistin for vap due to pandrugs-resistant a. baumannii in neonates

Conditions: Pneumonia, Ventilator-Associated; Colistin Adverse Reaction; Infection Due to Multidrug Resistant Acinetobacter; Infection Resistant to Multiple Drugs

Summary: this study is planned to compare the clinical efficacy and safety of aerosolized plus intravenous colistin vs. intravenous colistin as adjunctive therapy for the treatment of ventilator-associated pneumonia (vap) due to pandrugs-resistant (pdr) acinetobacter baumannii in the neonates.

this study will evaluate the neonates with vap due to pdr-acinetobacter baumannii who receive aerosolized plus intravenous colistin compare with intravenous colistin as adjunctive therapy. the efficacy and safety after study will be evaluated.

Eligibility criteria:
inclusion criteria: * neonates who are admitted to the neonatal intensive care unit, hat yai hospital during the study period. * neonates who were complicated with vap due to pdr-acinetobacter baumannii susceptible to colistin (by minimal inhibitory concentration (mic) \< 2 mcg/dl). exclusion criteria: * neonates who have a major anomaly or chromosomal abnormality. * neonates who receive colistin prior 7 days prior to study. * neonates who have a significant renal dysfunction defined as a serum creatinine (scr) \>1.5 mg/dl or a decrease in urine output to \< 1 ml/kg/h;

Keywords: aerosolized colistin intravenous colistin
safety and immunogenicity of prime-boost vaccination of sars-cov-2 in patients with cancer

Conditions: Patients With Cancer; Vaccine Reaction; COVID-19

Summary: severe acute respiratory syndrome coronavirus 2 (sars-cov-2) infection has caused a global pandemic since late 2019 that resulted in more than 360 million population infection. patients with cancers may be at higher risk of infection and severity than those without cancer. mass vaccination has been carried out, but reinfection and vaccine breakthrough cases still occur. now, the prime-boost regimen was identified safe and efficient, but the reactogenicity and immunogenicity of prime-boost vaccine strategy in cancer patients were not known.

this study is a prospective, single-arm, open-label clinical trial. a total of 100 patients with different cancers including breast cancer, hepatocellular carcinoma, lung cancer, esophageal cancer, gastric cancer and colorectal cancer were included in this heterologous prime-boost vaccination study. all of the patients will further accept 12 months follow-up study after prime-boost vaccination. safety, reactogenicity and immunogenicity of the prime-boost vaccination in those patients will be carefully recorded and detected.

Eligibility criteria:
inclusion criteria: 1. age above 18 years. 2. patients with diagnosed cancers including breast cancer, hepatocellular carcinoma, lung cancer, esophageal cancer, gastric cancer and colorectal cancer. 3. patients who have received local or systemic anti-cancer therapies according to the treatment guidelines previously or currently, and have a stable condition with the ecog score below 2. 4. the functions of multi-organs were normal or basically normal, and there are no contraindications for vaccination. exclusion criteria: 1. patients with acute attack of chronic diseases. 2. patients have history of convulsion, epilepsy, encephalopathy and psychosis. patients who are allergic to any component of the vaccine, or have a serious history of vaccine allergy. 3. pregnant or lactating women. 4. sufferring serious cardiovascular diseases, such as arrhythmia, conduction block, myocardial infarction, and severe hypertension can not be well controlled by drugs. patients have severe chronic diseases or diseases can not be controlled well during the progress, such as asthma, diabetes, thyroid disease, etc. congenital or acquired angioedema / neuroedema. 5. systemic cytotoxic drugs, cell therapies including nk cells, cytokine induced killer cells, dendritic cells, ctl and stem cells infusion are required during vaccination.
clinical trial comparing negative pressure wound therapy and standard dry dressings

Conditions: Arthroplasty Complications; Amputation; Prosthesis-Related Infections

Summary: negative pressure dressings are currently widely used in wound management. their use is gradually being extended to surgical scars. however, studies demonstrating a clear benefit are rare, particularly in terms of postoperative discharge, the need for surgical revision due to prolonged oozing and cost. the aim of this study is to evaluate the benefit of such a device in post-operative revision prosthesis surgery (hip and knee), as well as lower limb amputations.


Eligibility criteria:
inclusion criteria: * signed informed consent * age ≥ 18 years old * planned surgery : 1. revision of a hip or knee prosthesis, in 1 or 2 stages, at explantation and/or reimplantation, where 2. elective amputation of a lower limb (transmetatarsal, trans-tibial (burgess) or trans-femoral (gritti-stokes) level (nb: patients for whom amputation of both lower limbs is planned will be excluded) exclusion criteria: * known allergy to dry dressings * patient already included in another clinical trial * inability to discern and/or inability to follow study procedures * known allergy to silver or another component of the system prevena™ * amputation for tumor pathology

Keywords: prevena negative pressure wound therapy revision arthroplasty lower extremity amputation surgery
axillary reverse mapping for invasive carcinoma of the breast

Conditions: Breast Cancer

Summary: primary objectives: * to determine the feasibility of axillary reverse mapping (arm) in patients undergoing axillary lymph node dissection for breast cancer therapy. * to determine the incidence of breast cancer metastasis in lymph nodes draining in the arm as identified by axillary reverse mapping. * to determine the safety of axillary reverse mapping.

lymphazurin is a blue dye used usually in breast cancer surgery to trace the drainage pathway that flows to lymph nodes. the dye will travel to the lymph system and will end up in the lymph nodes that are draining the arm. in this study, lymphazurin will be used to find the drainage routes from your arm, rather than your breast. axillary reverse mapping: before axillary lymph node surgery, your surgeon will inject lymphazurin into your arm. your surgeon will watch how the dye flows and find the channels and nodes draining the arm. you will then have standard axillary lymph node (lymph nodes found under the arm) surgery. any lymph nodes found that are dyed blue (lymph nodes that have traveled down the drainage pathways) that would normally be removed will be removed and sent to the pathology department. pathologists will check the nodes to see if they have breast cancer cells in them. also as part of routine care, all other axillary lymph nodes draining the breast will be removed and checked for breast cancer cells. this is an investigational study. lymphazurin is fda approved and commercially available. the use of lymphazurin with axillary reverse mapping is investigational. up to 30 patients will take part in this study. all will be enrolled at m. d. anderson.

Eligibility criteria:
inclusion criteria: * patients with invasive carcinoma of the breast planning to undergo axillary lymph node dissection at m. d. anderson cancer center. * eastern cooperative oncology group (ecog) performance status of equal to or less than 3. exclusion criteria: * patients with known allergies to blue dye or other contraindications to lymphazurin.

Keywords: breast cancer carcinoma of the breast lymph nodes lymphazurin axillary reverse mapping
home care for the patient with heart failure: can caregiver education prevent hospital admissions?

Conditions: Heart Failure

Summary: the study is aimed to evaluate if the education of the caregiver is able to reduce hospital admissions of patients with heart failure assisted at home.

the primary objective of the study is to assess whether an educational intervention aimed at increasing the caregiver's skills is able to reduce hospital admissions for any cause in patients with heart failure assisted at home. the general practitioners who agree to participate are randomized in two groups: a) intervention group, whose patients are assisted in accordance with the procedures established by the project; b) control group, whose patients continue to be assisted in the usual modality. the intervention consists of an educational session for each caregiver aimed at improving his ability to recognize early symptoms and signs of heart failure.

Eligibility criteria:
inclusion criteria: * adults of any age and gender in nyha (new york heart association) classes ii, iii, iv, assisted exclusively at home; * willingness and ability to sign a written informed consent; * presence of a person who cared for the patient in a prevalent and regular way; * willingness of the caregiver to attend a training meeting.

Keywords: home care services comorbidity heart failure caregivers health education patient admission
post-stroke cognitive impairment

Conditions: First-ever Ischemic Stroke; Cognitive Performance

Summary: present study aims to track the post-stroke cognitive trajectories and to investigate its inter-individual variability.

the study aim is to establish a model capturing patients' inter-individual variability in susceptibility to stroke damage to predict stroke-induced cognitive trajectories. this is a prospective longitudinal observational national monocentric study for 6 years (recruitment during the first 3 years). the investigators perform comprehensive neuropsychological testing in i) acute stroke phase (0-10 days post-stroke), ii) sub-acute stroke phase (3 months post-stroke), and iii) chronic stroke phase (12 months and 3 years post-stroke). at each time point, cognitive performances as well as clinical and functional status will be assessed. furthermore, the investigators will assess the proxies of cognitive reserve and the level of post-stroke physical activity.

Eligibility criteria:
inclusion criteria: * age ≥18 years old * first-ever anterior circulation ischemic stroke confirmed by routine mri * time of enrollment: ≤ 10 days from stroke onset. exclusion criteria: * previous stroke anamnestic or based on clinical imaging * additional stroke in posterior circulation * conditions that preclude the cognitive testing (e.g. delirium, intubation, reduced vigilance * neurological or psychiatric conditions that preclude the data interpretation (e.g. pre-stroke dementia, schizophrenia, brain tumor, regular intake of benzodiazepine, depression) * mri contraindication * native language other than german, french or italian

Keywords: ischemic stroke cognitive reserve
periarterial injection versus multiple periveural injection

Conditions: Contusion Wrist or Hand; Crush Injury Wrist or Hand

Summary: in the transarterial technique for axillary brachial plexus block, the axillary artery is intentionally punctured to indicate placement of the needle within the neurovascular sheath; local anesthetic is then injected deep and superficial to the axillary artery.

to lessen the risk for hematoma and intravascular injection, several modifications, such as the multi-injection perineural technique, have become popular. these techniques require a high degree of technical skill and multiple needle passes, and also carry potential for injury. in this study, the investigators will compare an ultrasound-guided equivalent of the transarterial technique (periarterial injections) to a commonly used multi-injection perineural technique.

Eligibility criteria:
1. inclusion criteria: - patients (asa physical status i-iii) scheduled to undergo hand or wrist surgery under axillary brachial plexus block 2. exclusion criteria: * patients with pre-existing neuropathy * patients with allergy to local anesthetics * patients with prior surgery in the ipsilateral axilla * pregnant patients * patients with difficulties in communication
dexmedetomidine in sonographic guided erector spinae plane block

Conditions: Pain Management

Summary: to investigate the postoperative analgesic effect of dexmedetomidine addition with different doses as an adjuvant to bupivacaine to erector spinae plane block after renal surgeries.


Eligibility criteria:
inclusion criteria: * age between 18 and 70 years. * both sexes, males and females. * patients with the american society of anesthesiologists (asa) physical status i/ii. * body mass index (bmi) of 18-35 kg/m2 * patients scheduled for elective renal or percutaneous nephrolithotomy. exclusion criteria: * patients under 18 years. * patient refusal of nerve block. * infection at the site of injection. * coagulopathy. * allergy to used medications. * psychiatric disorder or chronic pain syndromes. * chronic opioid use or substance abuse. * quadriplegic patients.
optimal analgesia in acute gastroenteritis

Conditions: Gastroenteritis

Summary: the purpose of this study is to find out an optimal way of analgesia in case of acute infectious gastroenteritis the investigators are going to compare two medicines that are used on everyday basis (without being ever before subject to scientifical study): dipyrone and papaverine the study is done in the emergency department setting. thus, only first 6 hours of treatment is included in study


Eligibility criteria:
inclusion criteria: * acute gastroenteritis * vas scale of pain perception at least 4 exclusion criteria: * pregnancy * allergy to any one of study preparations * blood pressure less than 85 on admission * surgical condition (acute abdomen) suspected or diagnosed

Keywords: gastroenteritis analgesia emergency department
effect of artemisia dracunculus on glucose intolerance, insulin sensitivity and insulin secretion

Conditions: Glucose Intolerance

Summary: the term prediabetes has been used to encompass the first alterations on glucose metabolism such as impaired fasting glucose and glucose intolerance, and its early detection and treatment could prevent the appearance of diabetes mellitus type 2, a high prevalence disease worldwide. artemisia dracunculus, also known as estragon, has been used in ayurvedic medicine for the treatment of diabetes. different in vitro and in vivo studies have shown that artemisia dracunculus increases insulin signaling and improves insulin sensitivity. the aim of this study is evaluate the effect of artemisia dracunculus on glucose intolerance, insulin sensitivity and insulin secretion.

a randomized, double-blind, placebo-controlled clinical trial will be carried out in 24 patients with diagnosis of glucose intolerance in accordance with the criteria of american diabetes association (ada). glucose, insulin levels, lipid profile, creatinine, uric acid, and transaminases will be evaluated. an oral glucose tolerance test with 75 g of dextrose will be held. 12 participants will receive artemisia dracunculus, 1000 mg, twice per day (2000 mg) before breakfast and dinner during 3 months. and other 12 patients will receive placebo with the same prescription. area under de curve of glucose and insulin will be calculated as well as total insulin secretion (insulinogenic index), first-phase of insulin secretion (stumvoll index) and insulin sensitivity (matsuda index). this protocol is approved by a local ethics committee and written informed consent will be obtained from all volunteers. results will be presented as mean and standard deviation. intra an inter group differences will be tested using the wilcoxon signed-ran and mann whitney u- test respectively; p\<0.05 will be considered significant.

Eligibility criteria:
inclusion criteria: * patients both sexes * age between 30 and 60 years * glucose intolerance according ada criteria (blood glucose leve ≥140 mg/dl and ≤199 mg/dl after an oral glucose tolerance test with 75 of oral glucose * informed consent signed exclusion criteria: * women with confirmed or suspected pregnancy * women under lactation and/or puerperium * hypersensibility to artemisia dracunculus * physical impossibility for taking pills * known uncontrolled renal, hepatic, heart or thyroid disease * previous treatment for glucose * diabetes diagnosis * bmi ≥39.9 kg/m2

Keywords: glucose intolerance artemisia dracunculus insulin
nitrate consumption and gingival inflammation

Conditions: Gingivitis

Summary: the aim of this investigation is to evaluate the impact of the 14- day consumption of a nitrate-rich diet on the the extent of gingival inflammation in a cohort of periodontal aftercare patients. recorded parameters were gingival index, plaque control record, salivary nitrate/nitrite level and vascular parameters

this investigation evaluated the impact of a nitrate-rich diet on the extent of gingival inflammation in a cohort of periodontal aftercare patients. forty-four (23 test/21 placebo) periodontal aftercare patients with chronic gingivitis were enrolled. at baseline, gingival index (gi), plaque con- trol record (pcr) and salivary nitrate level (snl) were recorded, followed by sub- and supragingival debridement. subsequently, participants were randomly provided with 100 ml bottles of a lettuce juice beverage to be consumed 39 daily over 14 days, containing either a standardized amount of nitrate resulting in an intake of approximately 200 mg nitrate per day (test) or being devoid of nitrate (placebo).

Eligibility criteria:
inclusion criteria: * number of teeth ≥ 10 * body mass index (bmi) ≥ 24 ≤ 30 * presence of mild to moderate gingivitis (gingiva index \> category gi 0 ≤ category gi 2) at a minimum of 3 teeth * history of periodontal disease and inclusion in a regular scheme of supportive periodontal therapy (regularly repeated subgingival biofilm removal 2-4 x/year) exclusion criteria: * manifestation of severe gingivitis (gingiva index = 3) at any tooth * manifestation of inflammatory oral mucosal diseases other than gingivitis * xerostomia (salivary flow ≤ 0.1 ml/minute) * inability for regular oral home care * known allergies and intolerances to any of the ingredients of the experimental juice beverages * inability to follow the study protocol due to intellectual or physical handicaps
individual patient data meta-analysis of csii vs. mdi in type 2 diabetes

Conditions: Diabetes Mellitus, Type 2

Summary: this study aims to compare glycaemic control during continuous subcutaneous insulin fusion (csii, insulin pump therapy) and multiple daily insulin injections in type 2 diabetes and to identify patient-level characteristics that predict the best improvement in control and any change in insulin dose or other outcome.

the investigators will identify randomised controlled trials without language restriction that meet the inclusion criteria by searching the cochrane database, ovid medline, google scholar and other sources. the investigators will exclude observational studies, short-term trials \<2 months duration, studies in pregnant diabetic subjects, newly diagnosed type 2 diabetes, trials in type 1 diabetes and extensions of previous studies. data on individual participants will be obtained directly from trialists and from funding sponsors who hold the trial data and will include age, sex, duration of diabetes, treatment group, baseline and final hba1c, baseline and final insulin dose, baseline and final bmi. a 'two-step' meta-analysis will be performed to estimate overall mean differences in hba1c, insulin dose and weight/bmi for the trials. then, a 'one-step' meta-regression analysis will be conducted by creating a single large dataset from the individual patient data. determinants of final hba1c, bmi/weight and insulin dose will be explored using bayesian approaches with covariates that include baseline hba1c, age, diabetes duration, bmi, insulin dose and interactions between the covariates.

Eligibility criteria:
inclusion criteria: * rcts of csii vs. mdi in type 2 diabetes, study duration at least 2 months, non-pregnant exclusion criteria: * type 1 diabetes, studies \<2 months duration, pregnant women, newly diagnosed type 2 diabetes and extensions of previous studies.

Keywords: type 2 diabetes continuous subcutaneous insulin infusion meta-analysis insulin pump therapy multiple daily insulin injections
dilated versus non-dilated wavefront corrections for patients with down syndrome

Conditions: Down Syndrome; Refractive Errors

Summary: individuals with down syndrome (ds) live with visual deficits due, in part, to elevated levels of higher-order optical aberrations (hoa). hoas are distortions/abnormalities in the structure of the refractive components of the eye (i.e. the cornea and the lens) that, if present, can result in poor quality focus on the retina, thus negatively impacting vision. hoas in the general population are overall low, and thus not ordinarily considered during the eye examination and determination of refractive correction. however, for some populations, such as individuals with ds, hoas are elevated, and thus the commonly used clinical techniques to determine refractive corrections may fall short. the most common clinical technique for refractive correction determination is subjective refraction whereby a clinician asks the patient to compare different lens options and select the lens that provides the best visual outcome. given the cognitive demands of the standard subjective refraction technique, clinicians rely on objective clinical techniques to prescribe optical corrections for individuals with ds. this is problematic, because it may result in errors for eyes with elevated hoa given that these techniques do not include measurement of the hoas. the proposed research evaluates the use of objective wavefront measurements that quantify the hoas of the eye as a basis for refractive correction determination for patients with ds. the specific aim is to determine whether dilation of the eyes is needed prior to objective wavefront measurements. dilation of the eyes increases the ability to measure the optical quality of the eye and paralyzes accommodation (the natural focusing mechanism of the eye), which could be beneficial in determining refractions. however, the use of dilation lengthens the process for determining prescriptions and may be less desirable for patients.


Eligibility criteria:
inclusion criteria: * diagnosis of down syndrome * able to be dilated * able to fixate for study measures * able to respond for visual acuity testing exclusion criteria: * ocular nystagmus * history of ocular or refractive surgery (strabismus surgery is okay) * corneal or lenticular opacities * ocular disease