Kornimate/medical-research-clean huggingface dataset:
painful breastfeeding and bacterial or yeast infection

Conditions: Breast Infection

Summary: the aim of this study is to investigate the prevalence of yeast and bacteria in women with breastfeeding pain and to identify signs and symptoms.

painful breastfeeding is one of the most common reasons for early weaning. persistent pain associated with breastfeeding can sometimes be difficult to diagnose and is a source of frustration for the breastfeeding women as well as for healthcare providers. the diagnosis of candida infection in breastfeeding women is generally based on signs and symptoms identified in case reports and without any culture. breastfeeding pain has been described as superficial or deep in some studies. this deep pain syndrome as caused by candida or bacteria has been questioned. a few studies have cultured breast milk from women with deep breast pain and found candida albicans infections or bacterial infections usually caused by staphylococcus aureus. there still remains controversy and lack of evidence for candidiasis affecting the lactating breast as well as bacteria causing the pain. ensured diagnostic methods are important due to the resistant problem with both antibiotics and antifungals. only one study has described five key symptoms associated with candida. it was shiny, flaky nipple/areola, burning pain on the nipple/areola, non-stabbing pain or stabbing pain in the breast. the objective of this study was to investigate the prevalence of candida and bacteria in women with superficial or deep breastfeeding pain and to identify signs and symptoms linked to candida or bacteria in breast milk and nipple/areola.

Eligibility criteria:
inclusion criteria: * scored pain \> = vas 4 exclusion criteria: * breastfeeding technique problems * clinical signs of mastitis * muscular pain * breast surgery * use of antibiotic or antifungal treatment during the last preceding week * temperature \> = 37 degree celsius

Keywords: pain breast feeding yeast candida albicance staphylococcus aureus signs and symptoms
effect of captopril on gls in duchenne myodystrophy

Conditions: Effect of Drug

Summary: to outline the intermediate term effect of prescribing captopril as an add on therapy on left ventricular functions as measured by global longitudinal strain in patients with duchenne myodystrophy (dmd)

acei slowing down the onset and the progression of dystrophinopathic cardiomyopathy. to outline the intermediate term effect of prescribing captopril as an add on therapy on left ventricular functions as measured by global longitudinal strain in patients with duchenne myodystrophy (dmd

Eligibility criteria:
inclusion criteria: * genetically confirmed duchenne myodystrophy (dmd) patients with abnormal gls \< -18% with minimum age of 6 years old. exclusion criteria: * any patient who refuses to sign an informed consent. * contraindication to acei: hypersensitivity - renal impairment - bilateral renal artery stenosis - aortic valve stenosis - hyperkalemia - hypotension. * reduced ejection fraction below 50%.
collagen cross-linking for keratoconus/ectasia with and without intacs

Conditions: Keratoconus; Ectasia

Summary: this study will determine the efficacy of collagen cross linking for progressive keratoconus and ectasia after lasik. it will try and determine which is a more effective treatment: collagen cross linking alone or collagen cross linking combined with intacs, a treatment which has already been proven to be effective in decreasing corneal curvature in patients with keratoconus.

in this study we will attempt to determine whether collagen cross linking alone, one combined with insertion of intacs is the most effective treatment for patients with progressive keratoconus in patients who have progressive disease. these treatments have been widely used outside of the united states for the treatment of progressive keratoconus. corneal collagen cross linking was recently approved in the united states for the treatment of progressive keratoconus. we will attempt to study 600 patients total. 300 patients will be assigned to cross linking only while another 300 will be assigned to cross linking and intacs. once adequate number of study subjects have been recruited data will be analyzed to determine which treatment is more effective. the following parameters from topography, oct and tomography will be studied(these are max k(pentacam) kvalue(tomey topography)i-svalue(tomey topography astigmatism(tomey topography) and min oct(corneal pachymetry) any one of these metrics that achieve a value of 1 or more will be included in the analysis since the cornea is so irregular that values less than one could be artifact

Eligibility criteria:
inclusion criteria: * progressive keratoconus or ectasia exclusion criteria: * cornea thinner than 400um * k readings greater than 60d * central corneal scarring
dimercaptosuccinic acid (dmsa) treatment of children with autism and heavy metal toxicity

Conditions: Autism

Summary: many children with autism have a reduced level of glutathione and a reduced ability to excrete mercury, resulting in elevated levels in their bodies as demonstrated by blood, hair, provoked urine, and baby tooth testing. our earlier studies have demonstrated that dmsa, an fda-approved medication for treating lead poisoning in children, is effective in increasing excretion of mercury and other toxic metals. based on many clinical reports, we hypothesize that a 3-month treatment with glutathione and dmsa will result in a reduction of autistic symptoms in some children with autism.

this study will assess the safety and efficacy of the use of dmsa (an fda-approved medication for treating lead poisoning in children) for the off-label treatment of symptoms of autism in children with autism and significant body burden of toxic metals.

Eligibility criteria:
inclusion criteria: phase one 1. children with autism spectrum disorder 2. age 3-8 years (up to the day before the ninth birthday). 3. at least a two-month history of taking a multi-vitamin/mineral supplement with at least the rda of zinc, and continuing to take that during phase one and two. phase two: 1. excretion of high amounts of toxic metals in phase one 2. normal kidney/liver function, serum transaminases, and complete blood count (cbc) (based on a blood test which will be conducted as part of phase two) 3. no changes in medication, supplements, diet, or behavioral interventions during the study exclusion criteria: phase one and two: * no mercury amalgam dental fillings. * no previous use of dmsa or other prescription chelators (except for 1-time challenges). * no anemia or currently being treated for anemia due to low iron. * no known allergies to dmsa * no liver or kidney disease

Keywords: autism toxic metals dmsa dimercaptosuccinic acid chelation
post operative pain and oral health related quality of life following pulpotomy vs extraction of permanent first molar

Conditions: Irreversible Pulpitis

Summary: the goal of this clinical trial is to compare between post operative pain and oral health related quality of life in participants receiving two treatments for first permanent mandibular molars with poor prognosis. group i (experimental group): complete pulpotomy with the use of mta followed by stainless steel crown. group ii (control group): non-surgical extraction.

the principal investigator will carry out all treatment procedures, and the patients will be assigned. for both interventions: 1. informed consent from participating parents. 2. baseline records photographs, percussion test, periapical and panoramic radiographs, and personal data collection. 3. a diagnostic chart with personal, medical, and dental history will be filled 4. baseline oral health related quality of life questionnaire for each participant. 5. a clinical examination will be performed to assess the clinical inclusion criteria. (pulpal and periapical diagnoses are established after clinical examination). 6. preoperative and postoperative photographs will be taken. 7. the radiographic examination will be performed by taking a periapical radiograph and a panoramic radiograph through a machine to assess the inclusion criteria. the preoperative radiograph will serve as a reference for the follow-up radiographs. standardization of the technique to avoid any distortion in the vertical dimension and to provide reproducible images using an x-ray holding device. 8. preoperative and postoperative radiographs in the pulp therapy group will be taken by a parallel technique using an xcp film holder (super bite, hawe neos dentalsa, switzerland). 9. participants will then be allocated into either one of the groups according to the indicated intervention needed as follows: 10. administration of inferior alveolar nerve block and long buccal infiltration: septocaine® and epinephrine 1:100,000 (articaine hcl. 4% and epinephrine 1:100,000 injection) at the side of the affected tooth.

Eligibility criteria:
inclusion criteria: children aged between 8 years and 9.5 years. * decayed mandibular permanent first molars. * symptomatic mandibular permanent first molar (caries-related pulpal symptoms or hypersensitivity relating to enamel hypo mineralization) exclusion criteria: * children who are not apparently healthy. * lack of informed consent by the child patient's parent. * patients who are allergic to any of the materials used in the procedure. * unable to attend follow-up visits. * refusal of participation.

Keywords: first permanent molar pulpotomy extraction oral health related quality of life post operative pain visual analog scale
duplex ultrasonography performed by nurses

Conditions: Catheter Related Complication

Summary: catheter-related thrombosis (crt) has been found as the major complication of the established central venous catheter in intensive care unit (icu) patients. its reported incidence varies from 5 to 66 %. although most cases are asymptomatic, in up to 10 - 15 % of the patients pulmonary embolism occurs. in addition, crt is associated with the risk of infection, post-thrombotic syndrome and with general disruption of the management of the underlying disease. the most accessible diagnostic method for crt recognition is duplex ultrasonography. however, screening of crt by duplex ultrasonography is not common approach in icus. normally, duplex ultrasonography is performed by physicians. in this setting, implementation of the screening in icu would be time consuming and practically unrealizable. delegating this competence to icu nurses can increase availability of this screening method. therefore, as a first step, investigators decided to perform a validation clinical study to verify the diagnostic accuracy of duplex ultrasonography of the venous system for crt screening performed by a general nurse.

approximately 150 patients with central venous catheter will be enrolled in this study. investigators: 1. general nurses - trained and able to perform duplex ultrasonography examination of venous circulation 2. doctors - experienced specialists in intensive care or urgent medicine every patient with central venous catheter enrolled in clinical study is examined with duplex ultrasonography within 24 hours by both investigators, doctor and nurse. each examination includes ultrasonography of a whole vena cava venous system with central venous catheter, bilaterally. results of both examinations are blinded until the end of study, with one exception. in case of positive result - catheter related thrombosis is present, investigator ( nurse )informs patients attending physician. results of investigations are recorded in investigation form with some other routine medical data. timetable: 18.3.2019 - 30.6.2020: enrolling, collection of data 1.7.2020 - 30.9.2020: finalization od database, statistic analysis 1.10.2020 - 31.1.2021: preparation of publications 1.2. 2021 - 31.12.2021: result presentation

Eligibility criteria:
inclusion criteria: * central venous catheter more than 48 hours in situ * consent of a patient exclusion criteria: * technical difficulties of ultrasound machine * unfavorable local findings - inflammation of skin, excoriation etc.
comparison of the pharmacodynamics of imipenem in patients with febrile neutropenia

Conditions: Patients With Febrile Neutropenia

Summary: this is prospective and randomized study to compare the pharmacodynamics (t\>mic) of 0.5 g every 6 h of imipenem in twelve patients with febrile neutropenia following administration by a 4 h infusion or bolus injection. concentration of imipenem in plasma will be measured by hplc method and simulated in monte carlo technique (computer model) to get pk/pd index (40%t\>mic) and reported to %pta (probability target attainment) and %cfr (cumulative faction response.


Eligibility criteria:
inclusion criteria: * patients aged \> or = 20 years * patients who have febrile neutropenia with gram negative bacilli infections which are sensitive to imipenem by the disk diffusion * patients who are likely to survive 3 days exclusion criteria: * patients who have documented hypersensitivity to imipenem or other carbapenems * patients who have an estimated creatinine clearance of \< 50 ml/min * patients who are in circulatory shock or hypotension (systolic \< 90 mmhg) * patients who are pregnant

Keywords: imipenem febrile neutropenia gram-negative infection pharmacodynamic monte carlo simulation
evaluate the efficacy and safety of d-0120 in primary hyperuricemia patients

Conditions: Hyperuricemia

Summary: this is a randomized, open-label, parallel-controlled, multicenter clinical trial in primary hyperuricemia patients with or without gout.


Eligibility criteria:
inclusion criteria: 1. subject voluntarily takes part in the study after being fully informed,signs a written icf, and agrees to follow procedures specified in the study protocol; 2. subject who meets one of the following criteria: i. history of gout attack: meeting 2015 acr/eular gout classification criteria and fasting serum uric acid ≥ 480 μmol/l at screening (local laboratory of study site) ii. for asymptomatic hyperuricemia, it is acceptable to meet either of the two criteria: 1. serum uric acid ≥ 420 μmol/l for at least 3 months (subject to hospital medical record or test report), diagnosis with hyperuricemia before screening, and fasting serum uric acid at screening ≥ 540 μmol/l (local laboratory of study site); 2. serum uric acid ≥ 420 μmol/l for at least 3 months (subject to hospital medical record or test report), diagnosis with hyperuricemia before screening, and fasting serum uric acid at screening ≥ 480 μmol/l (local laboratory of study site), with concomitant primary hypertension or primary hyperlipidemia or type 2 diabetes mellitus, which is treated with a stable dose of antihypertensive or lipid-lowering or hypoglycemic treatment for at least 3 months; 3. at screening, 18.0 kg/m2 ≤ body mass index (bmi) ≤ 32.0 kg/m2; 4. hematology, blood chemistry and urinalysis examination were basically normal. exclusion criteria: 1. prior intolerance to benzbromarone or contraindication to medication; 2. secondary hyperuricemia caused by tumor, chronic kidney disease, blood disease or drugs, etc.; 3. arthropathy caused by arthritis rheumatoid, purulent arthritis, traumatic arthritis, psoriatic arthritis, pseudogout or systemic lupus erythematosus, etc.; 4. arthropathy caused by chemotherapy, radiotherapy or chronic lead poisoning; 5. urinary calculi confirmed by b-ultrasound during screening period;
famotidine and antacids for treatment of dyspepsia

Conditions: Dyspepsia; GERD; Acid Reflux

Summary: the aim of this study is to compare intravenous famotidine, an h2 receptor antagonist, and maalox/ mylanta, an oral antacid, in treatment of dyspepsia in the emergency department. the goal of this study is to reduce patients' pain based on the verbal numerical pain scale. the anticipated outcome is for pain levels in both groups to decrease. it is expected that antacids will improve symptoms more quickly and to a greater degree within an hour of taking medication based on the results of similar studies.

this study will be conducted in the emergency department at stony brook university hospital. investigators intend to enroll approximately 80 patients who present to the emergency department with dyspepsia symptoms. the patients will be randomized to one of two groups: one group will receive 20 mg of intravenous famotidine and the other will receive 30 ml of oral maalox/ mylanta. the verbal numeric pain score (vnp) will be used to measure pain at 0 minutes, 15 minutes, 30 minutes, 45 minutes, and 60 minutes after administration of the study drug. pain severity assessments will be performed by an investigator blinded to study treatment. data will also be collected regarding demographic, clinical information, patient satisfaction and the need for rescue medications in each of the two study groups at the end of the 60-minute study period. at the end of the study period, the patients may be treated with additional analgesia at the discretion of their ed provider.

Eligibility criteria:
inclusion criteria: 1. subject age ≥ 18 years of age 2. patient diagnosed with dyspepsia 3. present at the ed with upper abdominal pain score of at least 3 exclusion criteria: 1. hypersensitivity to an ingredient in maalox/ mylanta or famotidine 2. moderate to severe renal insufficiency (precaution) 3. kidney failure 4. pregnant or nursing 5. verbal pain score less than 3 6. inability to tolerate oral medications 7. bowel obstruction 8. proton pump inhibitor within 2 hours of study treatment

Keywords: dyspepsia gerd acid reflux h2 receptor antagonist antacid maalox mylanta famotidine
access program with denileukin diftitox for the treatment of patients currently receiving treatment with commercially available (ontak)

Conditions: Cancer

Summary: the purpose of this study is to provide continued therapy with denileukin diftitox (ontak) to patients who are currently on therapy and who have no other suitable treatment options, where therapy is requested by their physician.

the access program will be provided as long as appropriate according to the judgment of the provider. if denileukin diftitox (ontak) becomes commercially available without restriction, then the access program will be discontinued.

Eligibility criteria:
inclusion criteria: to receive denileukin diftitox (ontak) under this protocol, the patient's physician must request this therapy for the specific patient. patients may continue treatment with denileukin diftitox if they: * are currently on therapy with denileukin diftitox and require ongoing therapy to maintain control of their disease. * are willing and able to comply with all aspects of the access protocol * provide written informed consent to participate exclusion criteria: patients are not eligible for the access program with denileukin diftitox if they: • are not currently on denileukin diftitox therapy

Keywords: cancer ontak denileukin diftitox persistent or recurrent disease requiring continued delivery of essential cancer therapy
mk0457 in patients with leukemia (0457-003)

Conditions: Chronic Myelogenous Leukemia in Blast Crisis; Lymphocytic Leukemia, B Cell, Acute; Myelodysplastic Syndromes; Myelogenous Leukemia, Chronic

Summary: in this study participants with relapsed/refractory leukemia will be given mk-0457 in sequential cohorts and with varying treatment duration to determine the maximum tolerated dose (mtd) for mk-0457.


Eligibility criteria:
inclusion criteria: part 1: * patients with relapsed/refractory acute myelogenous leukemia (aml), poor risk myelodysplastic syndrome (mds), b-cell acute lymphocytic leukemia (all), myeloproliferative diseases, or chronic myelogenous leukemia (cml) in blast crisis part 2: * acute myelogenous leukemia (with flt-3 mutation ), and myeloproliferative diseases only * at least 2 weeks since the last cytotoxic therapy * acceptable renal and hepatic function * ambulatory, capable of all self-care, and out of bed for more than 50% of waking hours * more than 2 months since autologous bone marrow or peripheral blood stem cell transplantation exclusion criteria: * not fully recovered from previous anti-leukemia therapy * previous allogeneic bone marrow transplant * uncontrolled congestive heart failure * myocardial infarction within the last 3 months * active or uncontrolled infection * pregnancy or lactation * currently active second malignancy, other than non-melanoma skin cancer * history of hepatitis b or c, known hiv positivity, or aids related illness

Keywords: myelodysplastic syndrome[refractory anemia with excess blasts-1 or 2 (who classification)] chronic myelogenous leukemia in blast crisis
randomized comparison of skeletonized versus pedicled left internal thoracic artery

Conditions: Coronary Artery Disease

Summary: internal thoracic arteries can be harvested in skeletonized or pedicled technique. latest research has posed a potential adverse effect of skeletonizing the internal thoracic arteries on graft patency rates and clinical outcome. prospective, randomized, multi-centre trials are necessary to investigate the impact of harvesting technique of left internal thoracic artery (lita) on graft patency rates and clinical outcome after coronary artery bypass grafting. the harvita trial compares skeletonized and pedicled harvesting technique of lita regarding graft patency rates and patient survival.


Eligibility criteria:
inclusion criteria: primary isolated cabg patients with multi-vessel disease (defined as ≥70 % stenosis of the left anterior descending artery (lad) and ≥50% stenosis of circumflex and right coronary territory, with or without a ≥50% stenosis of the left main artery). exclusion criteria: * age \> 80 years * planned cabg without lita use * preoperative mediastinal radiation therapy * emergency operation * minimal invasive coronary artery bypass surgery * any concomitant cardiac or non-cardiac procedures * previous cardiac surgery * known contrast agent allergy * severe stenosis of the left subclavian artery/ left-sided subclavian steal syndrome * chronic kidney disease (gfr \<60ml/min/1.73m²) * life expectancy of less than 5 years * pregnancy * hyperthyroidism * iodine allergy intraoperative exclusion criteria: * y/t graft off the lita graft * lita sequential grafting * lita target vessel other than lad

Keywords: cabg lita graft patency skeletonized vs. pedicled