Kornimate/medical-research-clean huggingface dataset:
enteral and parenteral feeding in critically ill patients

Conditions: Critical Illness

Summary: supplementation of insufficient enteral nutrition with parenteral nutrition may optimize nutritional support and avert negative energy balance in critically ill patients, thereby improving outcome.

malnutrition is a common and serious problem in intensive care units. negative energy balance has been associated with increased morbidity and mortality in critically ill patients. the increased incidence of complications related to malnutrition correlates with increased length of hospital stay and overall health care costs. although early enteral nutrition is the preferred method of feeding critically ill patients, enteral nutrition alone often fails to supply adequate calories and nutrients to critically ill patients, who are frequently hypermetabolic. artificial nutrition support has evolved into a primary therapeutic intervention to prevent metabolic deterioration and loss of lean body mass with the aim to improve the outcome of critically ill patients. apart from the timing of initiation and the targeted amount of macronutrients, the route of delivery is viewed as an important determinant of the effect of the nutritional intervention. using the enteral route is considered to be more physiologic, providing nutritional and various non-nutritional benefits including maintenance of structural and functional gut integrity as well as preserving intestinal microbial diversity. the disadvantage of enteral nutrition is related to a potential lower nutritional adequacy particularly in the acute disease phase and in the presence of gastrointestinal dysfunction. in contrast, parenteral nutrition may better secure the intended nutritional intake but is associated with more infectious complications, most likely due to hyperalimentation and hyperglycemia. supplementation of insufficient enteral nutrition with parenteral nutrition may optimize nutritional support and avert negative energy balance in critically ill patients, thereby improving outcome. combining parenteral nutrition with enteral nutrition constitutes a strategy to prevent nutritional deficit but may increase risk of overfeeding, which has been associated with liver dysfunction, infection, and prolonged ventilatory support.

Eligibility criteria:
inclusion criteria: * all patients admitted to ccu (critical care unit)who are in need for either enteral or parenteral during duration of the study will be included exclusion criteria: * no exclusion criteria
transversus abdominis plane block versus ilioinguinal nerve block for pain management in inguinal herniorraphy

Conditions: Pain, Postoperative

Summary: this study compares efficacy of transversus abdominis plane block and ilioinguinal nerve block for postoperative pain in patients undergoing inguinal herniorraphy with spinal anesthesia. one-third of the patients will receive standard postoperative pain regimen(control group), one-third will receive a transversus abdominis plane block (with ultrasound guidance) and the last group will receive an ilioinguinal nerve block(with ultrasound guidance) in addition to standard postoperative pain regimen. this study is a randomized prospective open-label controlled study.


Eligibility criteria:
inclusion criteria: * patients over 18 years old * having asa (american society of anesthesiologists) 1 or 2 physical status score preoperatively * not having a neuromuscular disease * scheduled for elective single sided inguinal herniorraphy operation exclusion criteria: * being under 18 years of age * patient refusal * having a neuromuscular disease or sensorial neurological deficit covering similar area of effect with peripheral nerve block interventions or the surgical site * having asa 3 or 4 physical status score preoperatively * having one of the contraindications to spinal anesthesia and/or to peripheral nerve blocks as listed by nysora (new york school of regional anesthesia) * having emergency surgery or scheduled for bilateral inguinal herniorraphy
clinical trial of intravenous alvespimycin in patients with her2 positive breast cancer

Conditions: Breast Cancer

Summary: the purpose of this study is to determine the anti-tumor activity (via objective response rate) of alvespimycin in patients with breast cancer who have not previously received trastuzumab (except as adjuvant therapy).


Eligibility criteria:
inclusion criteria: * kps performance status of \>= 80% ("normal activity with effort") * metastatic breast cancer with her2 amplification by fish or 3+ her2 overexpression by immunohistochemistry ("ihc") * must have received no more than one prior cytotoxic chemotherapy regimen in the metastatic setting * measurable disease by recist criteria exclusion criteria: * received prior lapatinib, an investigational erbb-2 and/or an investigational egfr dual tyrosine kinase inhibitors * administration of any other chemotherapy, biological, immunotherapy or investigational agent within 14 days prior to receipt of study medication * pregnant or breast-feeding women. known cns metastases, unless treated and without clinically significant neurological deficits * moderately severe dry eye * congestive heart failure, or a left ventricular ejection fraction * myocardial infarction or active ischemic heart disease within 12 months prior to study drug administration * previous malignancies unless free of recurrence for at least 5 years
misoprostol for cervical priming before office hysteroscopy

Conditions: Misoprostol Allergy

Summary: the objective of the present study is to evaluate the appropriate route of administration of misoprostol, either oral or vaginal, for cervical priming to facilitate the procedure of office hysteroscopy and reduce patient discomfort to minimum

sample size calculation was done using the comparison of pain sensation represented through vas between oral and vaginal misoprostol for cervical ripening before office hysteroscopy. as reported in previous publication (sordia-herna'ndez et al., 2011), the mean ±sd of vas in oral misoprostol group was approximately 6.04 ± 1.5, while in vaginal misoprostol group was approximately 2.8 ± 1.2. accordingly, we calculated that the minimum proper sample size was 23 women in each arm to be able to detect a real difference of 1 unit with 80% power at α = 0.05 level using student's t test for independent samples. sample size calculation was done using stats direct statistical software version 2.7.2 for ms windows, statsdirect ltd., cheshire, uk however, the study population consists of 100 patients in reproductive age that requires diagnostic hysteroscopy for investigation of infertility or aub. the patients will be recruited from office hysteroscopy clinic of the obstetrics and gynecology department, faculty of medicine, cairo university from october 2017 to march 2018. the patients will be allocated equally into 2 groups ( each group contain 50 patients) groups will be as follows: 1. group a: 50 patients receive 200 mg oral misoprostol (misotac; sigma pharm) 3h before the procedure. 2. group b: 50 patients receive 200 mg misoprostol (misotac; sigma pharm) 3h before the procedure moistened with saline solution will be inserted in posterior fornix of vagina.

Eligibility criteria:
inclusion criteria: 1. patients indicated for diagnostic hysteroscopy for infertility or aub. 2. reproductive age \>19 - 45yrs. 3. postmenstrual between days 7 and 11 of the cycle ( except in irregular bleeding) exclusion criteria: contraindicating the use of prostaglandins such as:- 1. cardiovascular disease 2. severe bronchial asthma. 3. hypertension. 4. renal failure. 5. known sensitivity to prostaglandins contraindication to office hysteroscopy such as:- 1. pelvic inflammatory disease. 2. marked cervical stenosis. 3. known cervical malignancy. 4. pregnancy 5. profuse uterine bleeding 6. recent uterine perforation. neurological disorders affecting the evaluation of pain. previous cervical surgery.

Keywords: misoprostol ,office hysteroscopy
cocaine effects in humans: physiology and behavior - 1

Conditions: Cocaine-Related Disorders

Summary: the purpose of this study is to compare the effects of buprenorphine or methadone maintenance on cocaine taking and on the physiological and subjective effects of cocaine, including cocaine craving, in opiate-dependent cocaine users.


Eligibility criteria:
please contact site for information.

Keywords: self-administration
effect of compound sodium chlorate and aminophylline tablets on chronic obstructive pulmonary disease(copd).

Conditions: Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Summary: acute exacerbation of chronic obstructive pulmonary disease (aecopd) is an important event in the management of chronic obstructive pulmonary disease. compound sodium chlolate and aminophylline tablets are one of the most widely used drugs for the treatment of bronchial asthma and chronic bronchitis.

acute exacerbation of chronic obstructive pulmonary disease (aecopd) is an unignorable event in the management of chronic obstructive pulmonary disease. it is crucial to seek for effective management strategy. compound sodium chlolate and aminophylline tablets are one of the most widely used drugs for the treatment of bronchial asthma and chronic bronchitis. compared with the local bronchodilator recommended by the guidelines, it has the advantages of convenient use and good patient compliance. for the purpose of optimize the management of acute exacerbation of chronic obstructive pulmonary disease and provide more convenient options, we compared the efficacy of combined compound sodium chlolate and aminophylline tablets with nebulized ipratropium bromide inhalation plus systemic glucocorticoids in the treatment of chronic obstructive pulmonary disease ranging from moderate degree to severe degree. we hope this research would benefit patients with chronic obstructive pulmonary, especially those in the grassroots.

Eligibility criteria:
inclusion criteria: - (1)all subjects must sign an informed consent form before participating in the clinical trial. (2)clinical diagnosis of aecopd. (3)must be able to swallow tablets. exclusion criteria: * (1)heart disease. (2)insulin dependent diabetes. (3)tumor disease. (4)thyroid disease. (5)infectious diseases such as hepatitis b, active tuberculosis, etc. (6)active peptic ulcer. (7)allergic to related treatments. (8)participate in other clinical trials within three months. (9)women who are breast-feeding, pregnant or preparing for pregnancy.
studying the association between folic acid deficiency and social isolation for elderly patients

Conditions: Folic Acid Deficiency; Social Isolation; Elderly Patients

Summary: social isolation among elderly people is a frequent and major determinant for health. the risk of premature death is 2 to 5 time higher for socially isolated people, similarly for morbidity, duration of healing and complications rate. denutrition is also frequent for elderly people with potentially serious consequences. vitamin deficiency, especially in b9 and b12 vitamins, are often associated with denutrition among elderly people. folic acid (vitamin b9) is not influenced by inflammation and folic acid income are necessarily exogene. vitamin b9 is provided by fresh fruits and vegetables, and giblets. the investigators observed a high prevalence in folic acid deficiency for socially isolated elderly patients. the investigators made the hypothesis that a folic acid defiency is associated with social isolation for elderly people. the primary purpose is the study of the association between folic acid deficiency (measured by dosing of plasma concentration of vitamin b9) and social isolation evaluated by lubben social network scale in 6 questions. the secondary purposes are the study of the correlation between folic acid deficiency and social conditions, nutritional status, biological data, poly pharmacy, cognitive functions, dependency and length of stay at hospital.


Eligibility criteria:
inclusion criteria : * patients hospitalized in geriatric rehabilitation care in strasbourg university hospital * age \> 75 years * patient has given his consent exclusion criteria : * digestive malabsorption disorder : gastrectomy, extended intestinal resection, crohn disease, celiac disease, parenteral nutrition * chronic alcoholism * treatment with sulfamids, methotrexate, anti epileptic treatment (hydantoin) * hemodialysis * patients under protection measure (curatorship, guardianship, judicial protection) * patient refuses to participate
optimization strategy of carotid artery stenosis

Conditions: Carotid Artery Stenosis

Summary: the goal of this observational study is to learn about how to utilize multiple evaluation techniques in carotid artery stenosis patients for optimizing assessment of diagnosis and treatment strategy. the main questions it aims to answer are: * identify best strategy that use multi-modal mri and ct to assess patients' cerebral lesions and perfusion. * identify best strategy that use multi-modal mri, pet-mri ultrasound and ct to assess components and characters of patients' carotid plaques. participants will accept imaging examination before and after surgery. and doctors will collect basic characteristics, imaging results and biological samples of patients for analysis.


Eligibility criteria:
inclusion criteria: 1. patients with severe stenosis (≥50%) or near-occlusion diagnosed by computed tomographic angiogram; 2. patients received carotid endarterectomy at peking union medical college hospital exclusion criteria: (1) any contraindication to image examination; (3) refuse to sign the informed consent.

Keywords: carotid artery stenosis perfusion plaque mri ct pet/mri ultrasound
drug use evaluation of clindamycin in critical care units in alexandria main university hospital

Conditions: Infection, Bacterial

Summary: irrational use of antibiotics is a one of the main health system problems,it leads to antibiotic resistance,increasing antibiotics side effects and the total cost. this study is a medication use evaluation study aims to evaluate intravenous clindamycin prescribing practice in critical care units in alexandria main university hospital.


Eligibility criteria:
inclusion criteria: * adults 18 years old or more . * patients on clindamycin as an empirical treatment. * patients started clindamycin as an emperical treatment in other departments but the physician approved to continue it in critical care. exclusion criteria: * children (less than 18 years old) * patients started clindamycin as a defenitive treatment (based on microbiological culture results).
dose range finding study of mk-0941 in patients with type 2 diabetes mellitus on insulin (mk-0941-007 am3 ext1 am1)(terminated)

Conditions: Diabetes Mellitus, Type 2

Summary: the purpose of this study is to test the effect of mk-0941 as add-on therapy for participants taking insulin for type 2 diabetes mellitus. the primary hypotheses of this study are that treatment with mk-0941 added to insulin will provide greater reduction in hemoglobin a1c (hba1c) level than will placebo added to insulin at 14 weeks, and that mk-0941 will be well-tolerated at 1 or more doses that demonstrate efficacy.

this study is a 54-week randomized, double-blind base study with an optional 104-week extension study (mk-0941-007-11). beginning on week 16, participants not randomized to the maximum dose of mk-0941 could up-titrate to mk-0941 40 mg three times daily. participants who complete the 54-week base study are eligible to enter the extension study and will remain in the treatment group to which they were assigned in the base study.

Eligibility criteria:
inclusion criteria: * has type 2 diabetes mellitus * has body mass index \>20 and \<43 kg/m\^2 * is a male, or a female who is unlikely to conceive * currently on a stable dose of insulin with or without metformin for type 2 diabetes mellitus extension study inclusion criteria: * completed the base study either on double-blind study medication or as part of the post-treatment follow up population * had ≥85% compliance with double-blind and open-label medication during the base study double-blind treatment period exclusion criteria: * has any history of type 1 diabetes mellitus or ketoacidosis * has received more that 1 week of thiazolidinedione (such as pioglitazone or rosiglitazone) therapy or injectable increatin-based therapy (such as byetta) within the prior 8 weeks * has had ≥2 episodes during their lifetime or \>1 episode within the past year resulting in hypoglycemic seizures, comas, or unconsciousness * is on a weight loss program and is not in the maintenance phase, or patient is taking a weight loss medication (e.g., orlistat, sibutramine, rimonabant) within 8 weeks of visit 1 * has undergone surgery within 30 days prior to visit 1 or has planned major surgery
adjuvanted influenza vaccination in u.s. nursing homes

Conditions: Influenza; Influenza-like Illness

Summary: this study is powered to prospectively evaluate the relative effectiveness of adjuvanted trivalent influenza vaccine (ativ; fluad) in preventing influenza mortality, hospitalization, and functional decline in a nursing home population in the u.s., compared to the commercially available, standard dose trivalent seasonal influenza vaccine (tiv; fluvirin).

summary: a random study sample of up to 1000 nhs within 75 miles of the local area of the 121 cities where the cdc performs weekly influenza surveillance (estimated n= 11,239) may be offered the opportunity for participation; the first 1000 eligible to participate and accepting the offer will be enrolled. participating facilities will be offered vaccine education for residents and staff, but will be randomly allocated to receive ativ (fluad) vaccine or usual care (tiv) vaccination for their residents. background: lower respiratory tract infection (lri), including pneumonia, bronchitis, and tracheobronchitis, is the leading cause of infectious mortality and hospitalization in older adults , and nursing home (nh) residents. pneumonia and infection often produce attenuated signs and symptoms in older adults, leading to delayed or even misdiagnosis for this population. diagnosis is further compromised due to few and sporadic clinician visits with nursing home residents, and reduced access to radiology. lri may or may not directly lead to hospitalization, but lris are associated with considerable other morbidity than can result in hospitalization, including exacerbation of underlying cardiopulmonary diseases. hospitalization rates for nh residents vary considerably between facilities, but the majority of hospitalizations occur during the 12 weeks during which influenza peaks each year. objectives: the primary objective is to estimate the differences in hospitalization rates during influenza season experienced by long-stay nursing home residents, between facilities using adjuvanted trivalent vaccine vs. standard trivalent vaccine. the secondary objective is to estimate the differences in the likelihood of activities of daily living (adl) functional decline and mortality rates in the study nursing homes, and influenza outbreaks.

Eligibility criteria:
inclusion criteria: * long-term care facilities within 75 miles of one of the 121 cities that serve as cdc surveillance sites exclusion criteria: * facilities that used high dose influenza vaccine in residents over age 65 in previous influenza season (2015-16) * facilities having fewer than 50 long-stay residents * hospital-based facilities * facilities with more than 20% of the population under age 65 * facilities not submitting minimum data set (mds) data

Keywords: influenza vaccine vaccination nursing home cluster randomized trial respiratory-related hospitalization
severe legionellosis cases admitted to grenoble university hospital, 2006-2011.

Conditions: Legionnaires' Disease

Summary: the study aimed at further describing the epidemiological, clinical, diagnostic and prognostic features in legionellosis cases admitted to grenoble university hospital during the 2006-2011period. the investigators also tested lower respiratory samples collected from these patients during their routine medical care, using a number of molecular tools allowing determination of the involved legionella species, the bacterial load, and the presence of antibiotic resistant mutants. our primary goal was to define biological markers that could predict severity and outcome of infection in legionellosis cases requiring hospitalization.

patients admitted to grenoble university hospital between 2006 and 2011 for severe legionellosis were retrospectively included in the study. clinical, epidemiological, diagnostic and prognostic data of these patients were recorded retrospectively. lower respiratory samples collected from these patients on a routine basis for microbiological analysis, especially legionella culture, were tested using traditional microbiological methods. the remaining part of these samples was stored at -80°c fur further molecular analyses. the molecular tools developed by our bacteriology laboratory included the following: a real-time polymerase chain reaction (qpcr) test allowing detection and differentiation of l. pneumophila and other legionella species; a qpcr test allowing determination of the legionella dna load in lower respiratory samples; a qpcr allowing detection of gyra (the gene encoding subunit a of dna gyrase) mutations that the investigators previously determined to be correlated with fluoroquinolones resistance in l. pneumophila; a high-throughput sequencing approach allowing confirmation of gyra mutations and determination of the percentage of mutated alleles. the microbiological data, especially those obtained with the developped molecular tools, were tentatively correlated with the severity and outcome of infection in our patients' cohort.

Eligibility criteria:
inclusion criteria: * age higher than 18 years * proven legionellosis case (positive culture and/or pcr and/or urinary antigen test) * severe case requiring hospitalization exclusion criteria: * age under 18 years * pregnant women

Keywords: legionella legionnaires' disease diagnosis prognosis
efficacy and safety study to evaluate combination therapy with nebivolol and lisinopril vs. placebo and monotherapy in patients with stage 2 diastolic hypertension

Conditions: Stage 2 Diastolic Hypertension

Summary: this study will evaluate the safety and efficacy of first-line treatment with a free combination (as two separate pills) of nebivolol and lisinopril in patients with stage 2 diastolic hypertension (dbp\>= 100 mmhg).


Eligibility criteria:
inclusion criteria: * male and female outpatients 18 to 64 years of age * females must be post-menopausal, or not pregnant and using an approved contraceptive regimen * stage 2 diastolic hypertension (dbp \>= 100 mmhg) exclusion criteria: * secondary hypertension * evidence of other concurrent disease or conditions that might interfere with the conduct of the study * participation in an investigational drug study within 30 days or 5 half-lives, whichever is longer, of screening (visit 1). * have a history of hypersensitivity to nebivolol or other β-blockers, or any contraindication to β-blocker use