Kornimate/medical-research-clean huggingface dataset:
prophylaxis with intranasal mupirocin for prevention of s. aureus infections

Conditions: Cross Infection; Staphylococcal Infections

Summary: in order to evaluate the effect of eliminating nasal carriage by mupirocin prophylaxis on subsequent staphylococcus aureus infection, a prospective randomized trial was performed particularly including patients with predisposing risk factors for s. aureus infections.

in a past study, we showed that there is a strong correlation between strains colonizing the anterior nares, strains isolated from the presumed foci of infection, and strains isolated from blood in patients with staphylococcus aureus bacteremia. these results suggested that a substantial proportion of cases of systemic s. aureus infections appear to be of endogenous origin and that eradication of nasal colonization should be the chief strategy for reducing the incidence of hospital-acquired s. aureus infections. in order to evaluate the effect of eliminating nasal carriage by mupirocin prophylaxis on subsequent s. aureus infection, a prospective randomized trial was performed particularly including patients with predisposing risk factors for s. aureus infections. all patients admitted to selected units in clinics for anaesthesiology, hemato-oncology, cardiac surgery, and orthopedics at the university hospital of muenster were regularly screened for nasal carriage, i.e. at admission and, subsequently, on a weekly basis. s. aureus carrying patients were prospectively randomized, to be either treated with mupirocin for 5 days, or left untreated. patients infected with s. aureus at admission and patients detected to be mrsa carrier were excluded from randomization. patients were regularly seen during the course of their hospital stay and predisposing/conditional risk factors were systematically documented. in both groups (untreated patients and patients with mupirocin prophylaxis), all nosocomial infections were documented according to cdc guidelines. if infected, specimens were taken for microbiological diagnosis. all s. aureus isolates (from the anterior nares as well as from the focus of infection) were collected and were genotyped.

Eligibility criteria:
inclusion criteria: * all patients admitted to selected units in clinics for anaesthesiology, hemato-oncology, cardiac surgery, and orthopedics at the university hospital of muenster (following information on the study and agreement of the patient). exclusion criteria: * patients infected with s. aureus at admission * s. aureus infection within 48 hours following admission * patients detected to be carrier of methicillin-resistant s. aureus * hospital stay shorter than 72 hours * patients with anatomic abnormalities in the anterior nares * allergy or hypersensitivity to mupirocin or other substances of the nasal ointment * persons younger than 18 years * known pregnancy * persons with psychiatric diseases * persons with limited contractual capability and judiciousness

Keywords: mupirocin staphylococcus aureus nasal cavity preventive measures
sleep quality and pain medication use following arthroscopic rotator cuff repair

Conditions: Sleep Disturbance

Summary: the purpose of this study is to investigate if oral melatonin reduces postoperative sleep 18 disturbances and narcotics use. we will enroll patients undergoing primary arthroscopic rotator 19 cuff repair (arcr) at the rothman institute.


Eligibility criteria:
inclusion criteria: * patients who undergo primary arcr * patient willing and able to complete postoperative surveys exclusion criteria: * daily melatonin use for \> 1 week during the last 3 months * irreparable tears * revision rotator cuff repairs * severe glenohumeral arthritis * concurrent adhesive capsulitis * age less than 18 * pregnancy * history of substance abuse (drug or alcohol) * workman's comp patient or patient has current litigation pending * allergy to melatonin * history of delirium/psychiatric/depression/ on antidepressants * history of insomnia/ on sleep aid medication * use of prescription sedatives * use of zelboraf (vemurafenib) * use of all blood thinning medications besides aspirin (warfarin, plavix, lovenox, etc.) * sleep apnea
home monitoring in pediatric heart failure

Conditions: Pediatric Heart Failure

Summary: heart failure is a complex clinical syndrome, representing the final evolution of many cardiac diseases that may differ for etiology and pathophysiology. in pediatric population, it is particularly challenging to manage because of the heterogeneity in age, primary cardiac disease, and the broad range of clinical signs and symptoms. frequent hospitalizations are current problem. hospitalization within the first year since the first episode, lack of adherence to medical therapy and diet difficulties are the main issues in this population of patients, and they rebounds on prognosis and public health costs. actions aimed to prevent and manage these matters will improve outcome in patients with chronic heart failure. telemedicine proved its usefulness in adult population, but, nowadays, no studies have been conducted in children. from the beginning of 21th century, remote monitoring attempts have been adopted, initially by phone calls. currently, the e-care monitoring fits in the context of telemedicine 2.0 based on new communication models. the aim of this study is to affirm the feasibility and efficacy of a new model of tele monitoring in pediatric population. high-risk patients need a strict clinical control normally difficult to adopt. a telematics system capable to detect vital parameters as heart rate, body temperature, blood pressure, oxygen saturation, breathe frequency, weight, arrhythmias and cardiac index may offers to physician valuable information able to strictly monitoring the clinical status of patients. all of these data permits to physician to early detect critical signals of a deteriorated status, modify adherence to care and implement therapeutic strategies in order to prevent frequent hospitalizations. our project provides a system of continuous tele-monitoring of vital parameters through a patch applied on the chest of the baby. data are sent to a service center, "virtual clinic" and daily analyzed in multiparametric system by a specialized nurse. on the basis of pre-established alarms, the virtual clinic will notify to physician. feasibility and tolerability of this new monitoring system will be evaluated after a 3 months period on a cohort of 20 patients affected by chronic, high-risk, heart failure.


Eligibility criteria:
inclusion criteria: * nyha/ross class iii or iv * severe impairment of ventricular function (ef \< 40%) both for left or univentricular * prior hospitalization for acute heart failure within 1 year * at least 2 prior hospitalization for acute heart failure * patients on waiting list for orthotopic heart transplantation (unos 1b,2) * informed consent obtained exclusion criteria: * pmk or icd * hospitalized patients * neurological or psychiatric impairment * urgent waiting list for heart transplantation (unos 1a)
frequency of female athlete triad among elite female athlete of iran in different sport in 2007

Conditions: Menstruation Disturbances; Eating Disorder; Bone Loss

Summary: women's evermore presence in professional and athletic sports has revealed sound evidence on the existence of female athlete triad among the world's elite female athletes. this triad consists of eating disorders, amenorrhea and osteoporosis. it has been stated that all female athletes are potentially at risk, but it is not clear to what extent those exercising at different levels are at risk of this syndrome/triad. since the manifestation of this triad is often denied, or under-reported, appropriate screening methods are required to identify the symptoms. there is still no clear-cut information available on the incidence of this triad in iran. and there are religious and cultural differences between iran's elite female athletes and those in other countries. therefore, in order to meet iranian female athletes' needs, the investigators decided to determine the frequency of the female athlete triad in iran.


Eligibility criteria:
inclusion criteria: * all elite female athletes who play in international teams in sport federation or champion team in tehran between 13-45 years old. exclusion criteria: * the 13-15 year old female athletes who are not manarch with secondary sex charactristics.

Keywords: female athlete triad syndrom eating disorder osteoprosis
study evaluating "real world" treatment pattern in previously treated hemophilia a patients receiving kovaltry (octocog alfa) for routine prophylaxis

Conditions: Hemophilia A, Congenital

Summary: the primary objective of this study is to investigate weekly prophylaxis dosing regimens used in standard clinical practice. in addition the study will capture reported bleed rate, pattern of change in kovaltry prophylaxis dose \& dosing frequency, reason for choice of treatment regimen, fviii product switch pattern, patient treatment satisfaction and adherence, kovaltry pharmacokinetic data (if performed), kovaltry consumption, as well as safety data.

open label, prospective, non-interventional, single arm study in patients receiving kovaltry as prophylaxis therapy.

Eligibility criteria:
inclusion criteria: * male patients diagnosed with moderate to severe hemophilia a (≤ 5% fviii:c (factor viii coagulant activity)) * any age * ≥ 50 exposure days (eds) to any fviii product * patients with or without history of inhibitors * patient with previous history of inhibitors, with at least 2 consecutive negative inhibitor tests and on standard prophylaxis therapy for at least 1 year prior to study entry * no current evidence of fviii inhibitor or clinical suspicion of fviii inhibitor * evidence of fviii inhibitor as measured by the nijmegen-modified bethesda assay \[\<0.6 bethesda units (bu/ml)\] or bethesda assay \[\< 1.0 bu/ml\] in 2 on consecutives samples * documented or clinical suspicion of shortened fviii half-life (\< 6 hrs) * currently on or plan to start prophylaxis therapy with kovaltry * written informed consent exclusion criteria: * patients participating in an investigational program with interventions outside of routine clinical practice * patients with an additional diagnosis of any bleeding/coagulation disorder other than hemophilia a * patients on immune tolerance induction (iti) treatment at the time of enrollment

Keywords: previously treated patients
mobile health delivered lifestyle intervention program in patients with nash

Conditions: Non-alcoholic Steatohepatitis

Summary: there is a clear unmet clinical need for effective lifestyle intervention in patients with nonalcoholic steatohepatitis (nash). patients have self-identified multiple barriers to effective lifestyle intervention can be removed with a mobile health (mhealth) platform. this study will be a proof of concept study to evaluate weight loss efficacy of noom healthy weight (hw), a mhealth lifestyle intervention, in patients with nash.


Eligibility criteria:
inclusion criteria: * adults age \>18 years * nash defined as: * liver biopsy with evidence of steatohepatitis (nas \>=4) or; * imaging study (e.g., ultrasound, ct, mri) with hepatic steatosis and one of the following: * fibroscan kpa \>8.2 or; * fast \> 0.35 or; * fib-4 \>= 1.45 or; * possession of a smartphone exclusion criteria: * active or recent (\<90 days) participation in lifestyle intervention program, including weight-loss program * active weight-loss supplement use * cirrhosis * inability to provide informed consent * institutionalized/prisoner * other chronic liver disease (e.g., viral hepatitis) * recent noom use (\<180 days) * secondary cause of hepatic steatosis, including significant alcohol consumption (men \>30g/d, women \>20g/d) * severe medical comorbidities/psychiatric illness at the discretion of the study pi
reproductive outcome affected by two adjunctive treatments in patients with severe intrauterine adhesions

Conditions: Asherman's Syndrome

Summary: the purpose of this study is to compare the outcome of loop intrauterine contraceptive device and heart-shaped intrauterine balloon for the adjunctive treatment of severe intrauterine adhesions in patients with infertility.

intrauterine adhesion, also known as asherman's syndrome, is the partial or complete occlusion of the uterine cavity as a result of endometrium damage. most intrauterine adhesions patients manifest amenorrhea, reduced menstrual pattern, infertility, and intrauterine growth restriction, which seriously affect their reproductive health. currently, hysteroscopy is the preferred method of intrauterine adhesions diagnosis and treatment. however, because intrauterine adhesions patients generally have poor endometrium repair capability, the incidence rate of reformation of intrauterine adhesions ranging from 20%-62.5% in those with severe adhesions. the successful pregnancy rate after treatment in severe asherman's syndrome is reported to be consistently lower, only 33%. the prevention of intrauterine adhesions recurrence after trans-cervical resection of adhesion is clinically important but difficult. therefore, this study was conducted.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of severe intrauterine adhesions * infertility exclusion criteria: * endometrial tuberculosis * grossly abnormal semen analysis * ovarian failure, hydrosalpinx fluid * patients who did not proceed to second-look hysteroscopy within the specified time frame * women with no desire to pregnancy

Keywords: intrauterine contraceptive device intrauterine balloon
caloric vestibular stimulation for modulation of insight in obsessive-compulsive spectrum disorders

Conditions: Obsessive-Compulsive Disorder; Body Dysmorphic Disorders; Illness Anxiety Disorder

Summary: this study investigates whether caloric vestibular stimulation can modulate a measure of insight in obsessive-compulsive spectrum disorders.

obsessive-compulsive and related disorders (ocrd), including obsessive compulsive disorder and body dysmorphic disorder, are chronic and disabling conditions characterized by recurrent intrusive thoughts and associated compulsive behaviors that affect millions of individuals in the us each year. individuals affected by ocrd differ in insight, or the degree to which they understand their intrusive thoughts to reflect illness. impairments in insight limit individuals' motivation to engage in care and predict worse outcome in those who access treatment. this study seeks to explore whether unilateral stimulation of the vestibular system, which activates cortical areas hypothesized to underlie clinical insight, may beneficially modulate insight in individuals with ocrd.

Eligibility criteria:
inclusion criteria: * age 18-65 * primary diagnosis of obsessive-compulsive disorder, body dysmorphic disorder, illness anxiety disorder or somatic symptom disorder (excluding "with predominant pain") * strongly held ocrd-related concerns meeting babs score criterion. * no recent change in psychopharmacological treatment, if any * capacity to provide informed consent exclusion criteria: * psychiatric or medical conditions (eg, vertigo, history of otological surgery) that might make participation unsafe * pregnant or nursing women * active or recent substance use

Keywords: caloric vestibular stimulation insight
the effects of spirulina platensis on insulin resistance in hiv-infected patients

Conditions: Insulin Resistance; HIV/AIDS

Summary: spirulina, a widely used food supplement, improves the lipid profile and glycemic control in people living with diabetes, suggesting that it could have some effects on insulin sensitivity. since hiv-infected patients develop metabolic abnormalities due to the virus and/or to antiretroviral (arv) drugs, the investigators therefore proposed to evaluate the effect that spirulina can have on hiv/haart-associated insulin resistance

even though antiretroviral therapy (art) has dramatically improved the health of people living with hiv/aids, the prospect of maintaining patients long term on art can be severely restricted by the development of serious long term effects in their metabolism. these abnormalities include dyslipidemia, lipodystrophy and disorders of glucose metabolism with insulin resistance believed to be the underlying pathophysiological mechanism. spirulina, has recently drawn attention on its cholesterol and blood pressure lowering effects, including improvement of glycaemic control in diabetics subjects, suggesting it can have some effects on insulin sensitivity. the aim of this three month, experimental, prospective, randomised trial was to evaluate the effect of spirulina on hiv/haart-associated insulin resistance on 33 subjects. primary outcome was change in insulin sensitivity during the trial, over two time periods; t=0 and t=12 weeks. the second objective was to compare between the two groups, the percentage of subjects who improved insulin sensitivity by the end of the study. recruitment started in october 2008 and the trial ended in february 2009.

Eligibility criteria:
inclusion criteria: * confirmed hiv infection * accepted to participate in the study exclusion criteria: * acute intercurrent infection * treatment that modifies glucose or lipid profile * pregnancy * known diabetic patient * chronic renal failure with calculated creatinine clearance \< 60ml/min

Keywords: spirulina platensis insulin resistance hiv/aids haart soya beans
the effectiveness of mini-fluid challenge in predicting fluid responsiveness during video assisted thoracic surgery

Conditions: Mini-fluid Challenge in Video-Assisted Thoracic Surgery

Summary: perioperative fluid management is crucial for patients' outcome. muller et al developed a "mini-fluid challenge method " to predict fluid responsiveness and the efficacy. the investigators design the study to investigate the effectiveness of mini-fluid challenge test in video assisted thoracic surgery.

perioperative fluid management is crucial for patients' outcome. series of studies have indicated that adequate fluid management optimizes the cardiac out put, improves tissue perfusion, thus decrease the risk of postoperative morbidity. muller et al developed a "mini-fluid challenge method " to predict fluid responsiveness and the efficacy. fluid status and proper perfusion condition in patients undergo thoracic surgery are especially crucial for the vulnerability of lung toward fluid overload. to the best of our knowledge, the efficacy of the test was not discussed in the perioperative care in video assisted thoracic surgery. the investigators design the study to investigate the effectiveness of mini-fluid challenge test in video assisted thoracic surgery.

Eligibility criteria:
inclusion criteria: * patients receiving scheduled video assisted thoracic surgery * bmi 18.5\~30 kg.m-2 exclusion criteria: * age younger then 20 yrs or elder than 80 yrs * pregnant women * patients in intensive care units * patients with the underlying disease including respiratory failure(fev1/fvc \< 70 % and fev1 \< 50%), heart failure(nyha score =iii、iv), kidney failure(egfr\< 60 ml.min-1.1.73m-2), liver failure * patients with ongoing infection * patient allergic to voluven
preliminary longitudinal validation of biomarkers predictive of barrett's esophagus

Conditions: Barrett's Esophagus

Summary: barrett's esophagus can progress to esophageal cancer, but it doesn't always. current treatment is frequent surveillance via upper endoscopy with multiple biopsies to look for changes (dysplasia). pathologists vary dramatically in their interpretation of barrett's metaplasia versus dysplasia and consensus is very difficult to achieve. the investigators propose a longitudinal study of subjects with confirmed barrett's intestinal metaplasia without dysplasia to look for predictive factors for transformation to dysplasia or cancer. potential biomarkers can be found in serum, plasma, urine, frozen or fixed barrett's and normal esophageal mucosa. in addition, the investigators are testing a brushing technique from cdx, inc. for predictive factors. subjects must have pathologically confirmed barrett's intestinal metaplasia without history of dysplasia to be on this longitudinal study.


Eligibility criteria:
inclusion criteria: * adults (\> 18 years old) * subjects with pathologically confirmed barrett's esophagus, including: * intestinal metaplasia without dysplasia, long and short segments (\>1 cm) * intestinal metaplasia without dysplasia, long and short segments (\>1 cm), previously in glne 003 * intestinal metaplasia without dysplasia with indefinite-for-dysplasia (or history of indefinite-for-dysplasia) provided there is no history of hgd, or eac. * intestinal metaplasia without dysplasia or indefinite-for-dysplasia with a history of lgd provided the last surveillance endoscopy showed im alone, the lgd history was at least 12 or more months ago and there is no history of hgd or eac. * able to physically tolerate removal of 34 ml of blood * tolerate extra research related biopsies and brushings * willing to permit extra biopsies at future endoscopic procedures * ability and willingness to complete questionnaires * willing to sign informed consent exclusion criteria * subjects with a pathologically confirmed history of barrett's, hgd or eac * subjects with pathologically confirmed history of barrett's lgd within the last 12 months. * subjects in whom esophageal biopsy would be contraindicated (eq. varices) * subjects with serious infections requiring iv antibiotics * subjects with known hiv or chronic viral hepatitis * subjects on active chemotherapy or radiation treatment * subjects who have had an esophagectomy * subjects with an active malignancy diagnosed or treated within 3 years except for squamous cell carcinoma of the skin, basal cell carcinoma of the skin; carcinoma in situ, stages ia or ib invasive squamous cell carcinoma of the cervix treated by surgery and/or radiation therapy; stage ia grade 1 adenocarcinoma of the endometrium treated with surgery

Keywords: barrett's intestinal metaplasia
bilateral recession or unilateral recession-resection as surgery for infantile esotropia

Conditions: Strabismus

Summary: infantile esotropia is corrected in most cases by bilateral recession of the medial rectus muscles (br) or by unilateral recession of the medial rectus muscle and resection of the lateral rectus muscle (rr). we compared the outcome of these techniques in a randomized prospective study.

we randomly assigned 124 patients (average age 5.8) from twelve participating clinics in germany and the netherlands to either br or rr. patients did not have demonstrable binocular vision at baseline. the angle of strabismus was measured pre- and postoperatively in a standardized fashion. the primary parameter to assess difference between br and rr was the variation of the latent angle of strabismus at distance at three months postoperatively, secondary outcomes were reduction of convergence excess and binocular vision.

Eligibility criteria:
inclusion criteria: * eligible were all children aged three to eight years with a normal psychophysical development, and onset of esotropia before age one who visited one of the clinics during the study period. exclusion criteria: * previous strabismus surgery, an angle of strabismus larger than 24° or smaller than 10°, any normal binocular vision, convergence excess with angle of strabismus at near fixation 1.5 times larger than the angle at distance, more than 1 line logmar acuity difference between the two eyes, hypermetropia over 6 diopters or myopia over 3 diopters, up- or downshoot in (25°) adduction more than 8°, v-pattern (25° up and down gaze) over 8°, a-pattern (25° up and down gaze) over 5° and manifest vertical strabismus over 4°

Keywords: strabismus esotropia surgical techniques