Kornimate/medical-research-clean huggingface dataset:
predicting severe outcomes among children hospitalized with community-acquired pneumonia

Conditions: Pneumonia; Child; Prognosis

Summary: in this study, investigators aimed to develop and validate a risk score to predict severe outcomes (e.g., mortality and icu admission) in children who were admitted to the children's hospital of fudan university between 2017 and 2022 due to community-acquired pneumonia (cap). the objectives were as follows. 1. develop a risk prediction model based on demographic, comorbidity, clinical characteristics, laboratory data, and chest radiographic reports to predict severe outcomes among children hospitalized with cap; 2. develop a risk scoring system and determine the cut-off point; 3. externally validate the easy-to-use risk score.


Eligibility criteria:
inclusion criteria: 1. aged between 29 days and 18 years old; 2. admitted to hospital with signs or symptoms of acute infection (eg, fever) and acute respiratory illness (eg, cough), and radiographic evidence of pneumonia. exclusion criteria: 1. pneumonia developed 48 hours after admission or intubation; 2. chronic pneumonia, tuberculosis, tracheobronchial foreign bodies, aspiration pneumonia, parasitic lung disease, and diffuse pulmonary interstitial/parenchyma disease.
evaluation of the effectiveness and safety of supratube device

Conditions: Intensive Critical Unit; Pneumonia; Aspiration; Prevention and Control

Summary: purpose of the trial: trial design: two-parallel arm, double-blind, individually randomized controlled trial. primary endpoint: clinical evaluation of sinus, oropharyngeal, tracheal, bronchial or pulmonary infections during orotracheal intubation and hospital admission. secondary endpoints: volume of oropharyngeal secretions aspirated per unit of time (for 24 hours) by the supratube and complications during the use of the supratube device: erosions, lacerations, bleeding, displacement, migration, need for withdrawal. inclusion criteria: * adult patient * orotracheal intubation ≤ 72 hours * hospitalized in icu * integrity of upper airways exclusion criteria: * international patients * coagulopathic patients * oncology patients * patients with maxillofacial surgery * absence of close responsible family member * tracheostomy, shock, local or systemic non-controlled infection trial treatment: intervention: aspiration of secretions with the supranav device control: usual respiratory care expected sample size, enrollment and expected number of centers: sample size = 108 recruitment start date: recruitment end date: follow-up end date: number of centers: 2 statistical considerations: * intention to treat analysis * the primary outcomes will be analyzed using


Eligibility criteria:
inclusion criteria: * intubated adult patients with mechanical ventilation. * to have a closest responsible relative * integrity of the airways exclusion criteria: * need of orofacial, cervical or respiratory tract surgical procedures * patients with tracheostomy * shock, * local or systemic uncontrolled infection * blood dyscrasia, neoplastic diseases * physiological alteration * acute or chronic decompensated pathology that is not controlled at the time of selection.
optimizing vancomycin therapy in children

Conditions: Sepsis; Critical Illness; Infections; Drug Toxicity

Summary: the purpose of opt vanc is to evaluate the feasibility of bayesian dose adaptation, based on a previously-developed population pharmacokinetic (pk) model and a single optimally timed pk sample, to predict vancomycin area under the curve (auc) in critically ill children.

opt vanc is an observational study of critically ill children prescribed iv vancomycin for a suspected infection at the children's hospital of philadelphia. this study will evaluate how well bayesian dose adaptation, based on a previously-developed population pharmacokinetic (pk) model for vancomycin and a single optimally timed vancomycin concentration, can predict vancomycin area under the curve (auc) in critically ill children. eligible subjects will be prescribed vancomycin and undergo routine therapeutic drug monitoring (tdm) per standard of care. at the time of tdm, each subject will have a vancomycin concentration obtained at the most informative sampling time to estimate auc, as determined by the multiple-model optimal sampling function in pmetrics (population pk modeling program). investigators will then compare the auc determined using bayesian estimation and the subject's optimally timed vancomycin concentration to the auc determined using bayesian estimation with all available concentrations (tdm samples plus the optimally timed sample). investigators will also examine how auc estimation compares to auc calculated using standard-of-care methods (ie, log-linear equations). further, investigators will evaluate how well the population pk model, along with a subject's measured covariates and the optimally timed pk sample, can predict a subject's future vancomycin auc.

Eligibility criteria:
inclusion criteria: * administered intravenous vancomycin via intermittent infusion, * eligible for vancomycin auc monitoring, per the subject's clinical team, and * parental/guardian permission (informed consent). exclusion criteria: * receipt of renal replacement therapy, plasmapheresis, or extracorporeal membrane oxygenation (ecmo), or * unable to provide urine and blood samples.
survey conducted among early breast cancer patients treated with arimidex for evaluation of treatment adherence

Conditions: Breast Cancer

Summary: the aim of this study is to assess the patient's perception about and willingness to take his or her medication and the influencing factors interfering with taking medication.


Eligibility criteria:
inclusion criteria: * early breast cancer * post menopausal * adjuvant hormonal arimidex therapy

Keywords: adherence early breast cancer arimidex therapy adherence
near infrared spectroscopy (nirs) as transfusion indicator in neurocritical patients

Conditions: Traumatic Brain Injury; Subarachnoid Hemorrhage; Intracerebral Hemorrhage

Summary: neurocritical ill patients are frequently transfused. red blood cell transfusion (rbct) in these patients has been associated with deleterious effects, including higher rates of nosocomial infections, multi-organ failure, and mortality. therefore, it seems crucial to avoid any unnecessary rbct. most critically ill patients tolerate hemoglobin levels near 7 g/dl without an increase in morbidity or mortality rates. in this regard, a recent sub-analysis of tricc trial has showed that tbi patients may tolerate hemoglobin levels as low as 7 g/dl, but other studies including neurocritical patients suggested that severe anemia may worsen clinical outcome. therefore, optimal hemoglobin levels in neurocritical care patients remain largely unknown. some textbooks and guidelines recommend to transfuse these patients to reach hemoglobin levels near to 10 g/dl, despite the lack of a solid scientific background supporting this target. even though it has not been demonstrated, hemoglobin-based rbct prescription could result in over- or under-transfusion in neurocritical patients. alternatively, it has been suggested that more physiological transfusion triggers, using direct signals coming from the brain, will progressively replace arbitrary hemoglobin-based transfusion triggers in the neurocritical patients \[65\]. at the neurocritical units, patients are often monitored by using non-invasive methods, such as near infrared spectroscopy which indirectly measures regional cerebral oxygen saturation (rso2). changes in rso2 values have been shown to directly correlate with changes in erythrocyte mass, thus increasing with rbct and decreasing with blood losses. moreover, rso2 values also show a good correlation with clinical outcome and other variables which are often monitored in tbi patients. the purpose of this study is to ascertain as to whether rso2 levels are more efficacious than conventional hemoglobin levels in guiding rbct in patients admitted to a neurocritical care unit.


Eligibility criteria:
inclusion criteria: * severe traumatic brain injury (glasgow coma scale \< 9), subarachnoid hemorrhage (hunt and hess scale ≥ 3) or intracranial hemorrhage * moderate anemia. hemoglobin levels \> 7 g/dl and \< 10 g/dl * hemodynamical stability (mean arterial pressure \> 75 mm hg) * respiratory stability (pao2 / fio2 ratio \> 220) * expected length of icu stay \> 3 days exclusion criteria: * patient's relatives' refusal to patient's inclusion in the study * active bleeding * ongoing need for blood products * patients necessitating ongoing resuscitation * end-stage in which death is imminent * antecedents of angina or myocardial infarction (poor cardiopulmonary reserve) * deficient signal of rso2 impeding its proper valuation

Keywords: transfusion nirs cerebral oxygenation red blood cell near infrared spectroscopy
gemcitabine, cisplatin, and dexamethasone in treating patients with relapsed or refractory hodgkin's lymphoma

Conditions: Lymphoma

Summary: rationale: drugs used in chemotherapy, such as gemcitabine, cisplatin, and dexamethasone, work in different ways to stop cancer cells from dividing so they stop growing or die. combining more than one drug may kill more cancer cells. purpose: this phase ii trial is studying how well giving gemcitabine and cisplatin together with dexamethasone works in treating patients with relapsed or refractory hodgkin's lymphoma.

objectives: * determine the response rate and maximum response in patients with relapsed or refractory hodgkin's lymphoma treated with gemcitabine, cisplatin, and dexamethasone. * determine time to progression in patients treated with this regimen who are not undergoing stem cell transplantation. * determine the toxicity of this regimen in these patients. outline: this is an open-label study. patients receive gemcitabine iv over 1 hour on days 1 and 8, cisplatin iv over 3 hours on day 1, and oral dexamethasone twice daily on days 1-4. treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. patients are followed until disease progression. projected accrual: a total of 18-35 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * diagnosis of hodgkin's lymphoma * measurable disease by radiological or clinical findings * failed at least 1, but no more than 2, prior standard chemotherapy regimens * high-dose chemotherapy administered after a chemotherapy course is considered 2 courses * no evidence of cns disease * no history of myelodysplastic syndromes patient characteristics: age * over 18 performance status * ecog 0-2 life expectancy * not specified hematopoietic * wbc \> 2,000/mm\^3 * absolute neutrophil count \> 1,500/mm\^3 * platelet count \> 75,000/mm\^3 * hemoglobin \> 8.0 g/dl hepatic * bilirubin \< 2 times upper limit of normal (uln) * ast and alt \< 5 times uln renal * creatinine \< 1.5 times uln other * not pregnant or nursing * fertile patients must use effective contraception during and for 3 months after study participation prior concurrent therapy: biologic therapy * not specified chemotherapy * see disease characteristics * no prior gemcitabine * more than 6 months since prior high-dose chemotherapy endocrine therapy * not specified radiotherapy * not specified surgery * not specified

Keywords: recurrent adult hodgkin lymphoma
ep device registry

Conditions: Cardiac Rhythm Disorder

Summary: this study will provide ongoing, high quality data on the safety, performance, and clinical benefits of abbott's ep devices in a real-world setting.


Eligibility criteria:
inclusion criteria: * subject underwent an electrophysiology imaging (diagnostic procedure) and/or ablation procedure that used one or more abbott devices covered by this registry. * subject is willing and able to comply with the site's standard of care follow-up schedule. exclusion criteria: * subject is currently participating in another clinical investigation that may confound the results of this registry.
the compliance of dapt and statins on clinical outcomes in percutaneous coronary intervention patients

Conditions: Platelet Aggregation Inhibitors; Hydroxymethylglutaryl-coa Reductase Inhibitors; Compliance, Medication; Adherence, Medication; Persistence, Medication; Percutaneous Coronary Intervention

Summary: a nationwide retrospective cohort study. to investigate the real world medication compliance and the relation with clinical outcomes. the persistence and compliance to dual anti-platelet therapy(dapt) and dyslipidemia agents are important for the patients undergoing percutaneous coronary intervention. but, the discontinuation and compliance rate are unknown in the real world setting.

a nationwide retrospective cohort study. the persistence and compliance to dual anti-platelet therapy(dapt) and dyslipidemia agents are important for the patients undergoing percutaneous coronary intervention. the discontinuation and uncompliance may increase a risk. but, the discontinuation and compliance rate are not well known in the real world patients undergoing bare metal stents(bms) and drug eluting stents(des) insertion. to investigate the real world medication compliance and the relation with clinical outcomes, administrative claim data was extracted from the korean national healthcare insurance(knhi) database. all korean patient date undergoing pci from january 1, 2011 to december 2011 is extracted. 5 year clinical outcomes are investigated. primary outcomes are the mace including all-cause death, revascularization, critically ill status, and stroke) classified by the medication compliance. medication complinace is measured by proportion of days covered(pdc) secondary outcomes are the patterns of medication persistence and its outcomes to understand critical points.

Eligibility criteria:
inclusion criteria: 1. all claim of percutaneous coronary intervention using stent in the national healthcare insurance service of korea between january 1st 2011 and december 31st, 2011 exclusion criteria: 1. no use of stents 2. stent not classified into des or bms 3. use of des and bms together at the same initial day

Keywords: dapt, statin, compliance, persistence, adherence, pci
managing medication-induced constipation in cancer: a clinical trial

Conditions: Constipation

Summary: the purpose of this research is to evaluate the effectiveness of the constipation treatment protocol and to test whether management according to dose of constipation-inducing medications or according to on-going assessment is most effective.

patients will undergo a baseline assessment during their regular outpatient visit. with their permission, the investigators will audio record this visit for quality control. after the study, the recordings will be erased. patients will be asked to complete 4 questionnaires. the investigators will collect contact information so that the follow-up assessments can be done by phone.

Eligibility criteria:
inclusion criteria: * the study sample will consist of patients who are receiving outpatient care at the moffitt cancer center. * patients will be identified as those who have a diagnosis of cancer and are being treated with either opioids or vinca alkaloids, * are adults (or children 18-21 years old), * either male or female, * able to read and understand english, * and able to pass screening with the short portable mental status questionnaire and karnofsky performance status scale. exclusion criteria: * patients will be excluded: if they have non-melanoma skin cancer or colorectal or gynecological cancer as their primary diagnosis; * if they are excessively debilitated or deemed unlikely to survive for the eight weeks of the data collection period; * if they are unable to read and understand english; * if they have an ostomy that changes bowel function; * if they have a current peritoneal catheter; * if they have had abdominal surgery within the past six weeks; * or have a disease process suggestive of mechanical obstruction (tumor or adhesion); * if they have a history of chronic bowel disease (including irritable bowel syndrome, chronic constipation prior to cancer onset, crohn's disease, ulcerative colitis or diarrhea as a result of radiation to the pelvis), or report chronic laxative use prior to cancer onset.

Keywords: medication-induced constipation in cancer
efficacy of a gamified augmented reality exposure-based application in subjects with fear of spiders

Conditions: Fear of Spiders

Summary: investigation of the efficacy of a gamified augmented reality exposure app in individual with fear of spiders.

the study will be conducted as a randomized controlled between subject trial. the study consists of two visits and a home training for one group. 60 participants between 18 and 40 years with clinical or subclinical fear of spiders will take part in the study. all assessments of outcome will be conducted on one visit for each participant, including an in vivo bat. the experimental group will participate in a home training with the app, spanning over two weeks (6x30-minutes sessions), whereas the control group will not receive any treatment (untreated comparison group). six weeks after the first visit all participants undergo the assessments of outcome, including a second in vivo bat. the bat will take place 4 weeks after completion of the home training. this design allows a direct comparison and therefore an estimation of the efficacy of the gamified ar exposure therapy.

Eligibility criteria:
inclusion criteria: * fear of spiders * bat score before exposure between 1-8 * physically healthy * fluent in german exclusion criteria: * bdi-ii sumscore \>=20 and/or item 9 \>=1 * concurrent psychotherapy or pharmacotherapy * previous exposure-based therapy for spider phobia * parallel participation in another study * chronic medication intake (except oral contraceptives) * medication intake before visits (less than 24h) * alcohol intake before visits (less than 12 h) * cannabis or other psychoactive substances (including benzodiazepines) intake before visits (less than 5 days) * for women: current pregnancy
memantine and changes of biological markers and brain pet imaging in alzheimer's disease

Conditions: Alzheimer's Disease

Summary: in ad, tau protein is abnormally hyperphosphorylated. significant changes of hyperphosphorylated tau levels in csf are found in ad patients. it has been shown in vitro that memantine can reverse abnormal hyperphosphorylation of tau in hippocampal neurons of rats. a statistically significant reduction of csf phosphorylated tau at a preliminary 1-year follow-up was observed, from median 126 (interquartile range 107-153) to 108 (88-133) ng/l (p = 0.018). no statistically significant differences of total tau or aβ42 were found (gunnarsson md, 2007). fdg-pet has the unique ability to estimate the local cerebral metabolic rate of glucose consumption, thus providing information on the distribution of neuronal death and synapse dysfunction in ad in vivo (herholz k. 2003). synaptic dysfunction and loss induce a reduction in neuronal energy demand that results in decreased glucose metabolism. hypometabolism in ad is thought to reflect loss of synaptic activity and density (herholz k. 2003; mielke r, et al. 1998). another biological markers such as inflammatory factor and apoeε4 also play a part in the onset of ad (glodzik-sobanska l, 2007).

1. to investigate the effects of daily dosing of memantine for 24 weeks versus placebo on biological markers of subjects with alzheimer's disease. 2. to investigate the effects of daily dosing of memantine for 24 weeks versus placebo on 18\[f\]-fdg-pet of brain in subjects with alzheimer's disease. 3. to investigate the effects of daily dosing of memantine for 24 weeks versus placebo on cognitive function in subjects with alzheimer's disease. 4. to investigate the effects of daily dosing of memantine for 24 weeks versus placebo on measures of behavior and activities of daily living of subjects with alzheimer's disease. 5. to investigate the effects of daily dosing of memantine for 24 weeks versus placebo on short term memory.

Eligibility criteria:
inclusion criteria: 1. written informed consent 2. clinical diagnosis of alzheimer's disease which meet the dsm-iv criteria. 3. subject has moderate to severe alzheimer's disease as defined by a mmse score 4 to 20 inclusive at screening. 4. hachinski ischemia score \< 4 at screening. 5. age ≥50 and ≤90 years. 6. availability of a responsible and steady caregiver to ensure treatment compliance and provide information for assessments. exclusion criteria: 1. severe renal impairment. 2. history of seizures 3. systolic blood pressure \>160 or \ 95 or \< 60 mmhg at the time of screening. 4. diagnosis of any concomitant life threatening illness.

Keywords: alzheimer's disease tau protein pet memantine
monolithic zirconia posterior single crowns: a randomized clinical trial.

Conditions: Posterior Single Edentulous Sites

Summary: monolithic zirconia posterior single crown cost-efficiency study. objective and subjective analysis will be performed through fips and proms scales to evaluate treatment quality outcomes.

introduction posterior implant single crowns have become the treatment of choice for single tooth replacement in the posterior sectors, due to its biological implications and minimally invasive approach since it requires no preparation of the adjacent tooth and enabling a more efficient hygiene for the patient than a bridge restoration. however, implant-based restorations require more time and economical resources from the patient and the dentist compared to traditional teeth-supported restorations. currently the main interest is set upon broadening the potential patient spectrum for this kind of therapies, which can only be achieved by significally reducing the clinical treatment time and technical production time while maintaining an acceptable profit ratio and good quality treatment outcome. objectives the main goal of this study is to determine whether monolithic screw retained posterior implant crowns (test) are more time-efficient than metal ceramic screw retained posterior implant. moreover, as secondary objectives every screw retained crown will be submitted for functional implant prosthodontic score (fips) and patient related outcome measures (proms) evaluation. hypothesis monolithic screw-retained posterior single implant crowns performed through a full digital workflow are more time-efficient than conventional-digital workflow fabricated metal-porcelain screw-retained posterior single implant crowns. monolitihic single posterior screw-retained implant crowns achieve better quality outcomes than metal porcelain single posterior screw-retained implant crowns. material \& methods a total of 40 implants placed at master de integrada de adultos will participate in a time- efficiency study that will compare monolithic screw-retained posterior implant crowns to metal ceramic screw-retained posterior implant crowns ( gold standard), moreover, every restoration will be submitted for functional implant prosthetic score (fips) and patient related outcome measures (proms)

Eligibility criteria:
inclusion criteria: * restorable implants * no signs or previous history of periimplantitis * natural antagonist teeth * natural adjacent teeth exclusion criteria: * non restorable implants * signs or previous history of periimplantitis * no natural antagonist teeth * no natural adjacent teeth

Keywords: single posterior implant crowns cost efficiency monolithic zirconia crowns full digital workflow 3d printed prototype