Kornimate/medical-research-clean huggingface dataset:
comparison of a bilateral tap block and preperitoneal instillation of local anesthetic for a total extraperitoneal (tep) repair

Conditions: Bilateral Inguinal Hernia Repair

Summary: comparison of an ultrasound guided bilateral tap (transversus abdominis plane) block with dexamethasone and preperitoneal instillation of local anesthetic with dexamethasone under direct visualization will be compared it to a standard anesthetic technique (control) following a tep (total extraperitoneal) bilateral hernia repair. the investigators are hypothesizing that the bilateral tap block and preperitoneal instillation of local anesthetics with the addition of dexamethasone are superior in terms of patient satisfaction and post-operative pain control when compared to a standard anesthetic technique (no regional technique).


Eligibility criteria:
inclusion criteria: * 18-80 yrs of age * american society of anesthesiologists (asa) physical status 1-3 * scheduled for outpatient tep bilateral inguinal hernia repair exclusion criteria: * patients refusal to participate * inability to give consent * drug allergies to medications used in study * pregnancy * bleeding diathesis * conversion to an open procedure * any subject whose anatomy, or surgical procedure, in the opinion of the investigator might preclude the potential successful performance of a tap block * any subject whose anatomy, or surgical procedure, in the opinion of the investigator, might preclude the potential successful performance of a tap block

Keywords: ultrasound guided bilateral transversus abdominis plane block dexamethasone preperitoneal instillation local analgesic efficacy total extraperitoneal bilateral inguinal hernia repair
population pharmacokinetics of metronidazole in neonates

Conditions: Emergencies

Summary: the objective of neopopi is to conduct a population pharmacokinetic study of metronidazole in neonates, in order to evaluate and optimize neonatal dose regimen. there will be no change to the medication treatment received by participants. an opportunistic pharmacokinetic sampling approach will be followed: samples will be scavenged from blood or cerebrospinal fluid drawn for routine biochemical tests. in this way, no additional invasive tests will be needed.

* administration of the antibiotic according to the usual procedures for prescribing services: in particular, neither the indications nor the doses nor the methods of administration are fixed by the protocol * opportunistic sampling strategy: no biological samples are specifically collected for the purposes of the study (measurements of concentrations on "bottoms" or "left-over" samples); the performance of this non-invasive sampling strategy has been previously demonstrated in the neonatal population. * micro-analytical method (assay of concentrations on micro-volumes, of the order of 50μl) * population pharmacokinetic analysis

Eligibility criteria:
inclusion criteria: * in case of birth at gestational age ≥ 37 weeks of amenorrhea (sa): inclusion of children of postnatal age \<28 days * in case of birth at a gestational age \<37 sa: inclusion of post-menstrual age children (ie gestational age + post-natal age) \<44 sa 2. benefiting from metronidazole antibiotic therapy, as part of their routine independent clinical management of the study, whether the targeted infection is suspected or proven 3. social security affiliates 4. no opposition of parents to participation in the study non-inclusion critéria treatment with metronidazole initiated before arrival in the investigative center (\> 1 dose). exclusion criteria: * none
analysis of the enteric nervous system using colonic biopsies

Conditions: Parkinson's Disease; Multiple System Atrophy; Progressive Supranuclear Palsy

Summary: the aim of this project is to develop an original biomarker for parkinson's disease (pd) and other parkinsonian syndromes (multiple system atrophy and progressive supranuclear palsy) based upon the detection of pathological alpha-synuclein species in routine colonoscopic biopsies.


Eligibility criteria:
inclusion criteria: patients * patients aged 50-80 year old, both genders * parkinson's disease patients * multiple system atrophy patients * progressive supranuclear palsy patients * controls: patient at risk of colic cancer for whom a colonoscopy is required * patients who signed the informed consent controls * patients aged 50 to 80 year-old for whom a rectosigmoidoscopy or a colonoscopy is required for colorectal screening * patients who signed the informed consent * health care beneficiary exclusion criteria: patients * colonic disorder (except non-complicated diverticular disease) * other neurological disorder than parkinsonism * patients treated with either platelet antiaggregants, anticoagulants or with a known coagulation disorder * patients with a cognitive impairment that preclude them from understanding the informed consent * patients placed under legal guardianship controls * neurodegenerative disorders such as parkinson's disease, alzheimer's disease or other dementia, amyotrophic lateral sclerosis... * functional bowel disorder such as irritable bowel syndrome * patients with a cognitive impairment that preclude them from understanding the informed consent

Keywords: biopsies, enteric nervous system, biomarker
scope-study: salzburg chronic obstructive pulmonary disease- exercise and oxygen study

Conditions: Chronic Obstructive Pulmonary Disease

Summary: chronic obstructive pulmonary disease (copd) is number four of the leading causes of death in the usa and europe. moreover, among the top five causes of death, this disease is the only one with increasing mortality rates. physical training has become an evidence based therapeutic intervention in these patients. in this study the investigators aim to establish if supplemental oxygen during strength and endurance training improves exercise tolerance. furthermore, the investigators want to research, if supplemental oxygen has the ability to increase training intensity, which would lead to a greater training effect with respect to respiratory, vascular, inflammatory and anthropometric parameters, as well as quality of life. scope is a prospective, randomized, double-blinded, controlled, cross-over trial. the investigators aim to enroll 40 patients suffering from copd aged \>30 years. inclusion criteria are fev1 30-60%, and po2 at rest \>55 mmhg. at baseline, patients will undergo pre-tests including pulmonary, exercise physiological and medical investigations. prior to the exercise training, an intervention-free control period with usual care is planned. this will be followed by 2 x 6 weeks with physical training (ergometer based endurance training and strength training, using weight lifting machines) with either supplemental oxygen or usual room air (e.g.: first 6 weeks of exercise with oxygen supplementation followed by 6 weeks of room air). after the initial control period and between these two exercise periods, patients will be tested as described in pre-tests, and at the end of the second exercise training period. in addition, the investigators will assess changes in lung function and symptomatic dyspnoea, as well as in quality of life (st. george's respiratory questionnaire). within this study, the investigators hope to improve rehabilitation programs for copd patients.


Eligibility criteria:
inclusion criteria: * copd with fev1 pred. 30 to 60%, po2 at rest \> 55 mmhg and pco2 \< 45 mm hg * age: \> 30 years exclusion criteria: * musculoskeletal disease, which prohibits training * relevant neoplastic disease with cachexia * expected non compliance with the study protocol due to drug and alcohol abuse * coronary heart disease defined by angina pectoris or relevant st-changes during exercise or myocardial infarction in the last 6 months * left ventricular ejection fraction \< 40 % * renal insufficiency with creatinine \> 2 mmol/liter * symptomatic intermittent claudication or peripheral neuropathy * anaemia \< 10 mg/dl or red blood count \< 3 mio/mm3

Keywords: lung diseases, obstructive respiratory tract diseases lung diseases respiration disorders pulmonary disease, chronic obstructive copd chronic obstructive lung disease chronic obstructive airway disease chronic airflow obstruction oxygen oxygen supplementation
pilates-based core strengthening on patellofemoral pain syndrome

Conditions: Patellofemoral Pain Syndrome

Summary: patellofemoral pain syndrome (pfps) is one of the most common musculoskeletal pain conditions that tend to become a chronic problem. pfps is common among young adolescents, particularly in physically active individuals aged 12 to 17 years old with more prevalence among females, as it affects females 1.5 - 3 times when compared to males.

adolescents with pfps usually complain of retro-patellar pain (behind the kneecap) or peripatellar pain (around the kneecap) and crepitation in the knee joint, and also there is discomfort while sitting with a flexed knee for a long time. symptoms are usually exacerbated by activities that increase the load on patellofemoral joints such as weight-bearing activities, squatting, walking up or downstairs, and running. pfps takes place whenever the muscles around the knee fail to keep the kneecap properly aligned, leading to abnormal lateral tracking of the patella.overuse such as running and jumping sports, the trauma of kneecaps such as fracture, dislocation, or knee surgery may also predispose to pfps.

Eligibility criteria:
inclusion criteria: * pain felt anterior to knee joint. * pain felt retro-patellar. * pain felt during rest and increased with activities like prolonged sitting, squatting, running, and stair climbing. * insidious onset lasting for more than 6 weeks. * without any traumatic incidence. * not participating in a physical therapy program for the past three months. exclusion criteria: * if they had a meniscal tear. * cruciate/collateral ligaments involvement. * knee osteoarthritis. * rheumatoid arthritis. * a history of knee or hip surgery. * patellar dislocation/subluxation. * traction apophysitis encompassing the patellofemoral complex. * any pathology in the patellar tendon. * spinal referred pain.

Keywords: patellofemoral pain syndrome pilates exercises functional status
carbapenem and quinolone resistance in klebsiella pneumoniae

Conditions: Antibiotic Resistant Strain

Summary: klebsiella pneumoniae is an important pathogen that frequently causes nosocomial community-acquired and infections, including pneumonia, urinary tract infections, bloodstream infections, pyogenic liver abscesses, and septic shock. an emerging co-existence of carbapenems and fluoroquinolone resistance in klebsiella pneumoniae is causing major difficulty in treating infections caused by such pathogen

plasmid mediated carbapenem resistance is mainly due to production of carbapenemase which belong to three classes of β-lactamases, the ambler class a, b and d β -lactamases, among which the new delhi metallo-β -lactamase has attracted significant attention in the last five years. new delhi metallo-β -lactamase-1 is a class b metallo-β-lactamase and was first identified from a klebsiella pneumoniae strain in 2008. new delhi metallo-β -lactamase-1 is frequently associated with other resistance genes, such as extended spectrum β- lactamase genes and plasmid-mediated quinolone resistance genes, which allows bacteria to gain resistance to different classes of antimicrobial agents simultaneously. plasmids and integrons are mobile genetic elements that carry antimicrobial resistance genes. horizontal transfer of those mobile genetic elements has been considered as one of the most important mechanisms for the dissemination of multi-drug resistance among bacteria. classification of plasmids on the basis of molecular typing and phylogenetic relatedness may help understand the distribution of plasmid types, the relationships involving plasmids carrying antimicrobial resistance genes. plasmids can be classified into incompatibility groups by replicon typing or into types (clusters) by restriction fragment length polymorphism analysis. integrons act as genetic platform, which allow capture and expression of antibiotic resistance genes. there are 3 classes of integrons that are responsible for multi-drug resistance, which are classified based on the sequence of the integrase gene. class 1 integrons are the most widespread class in gram-negative bacteria. one approach to preventing multi drug resistant infections is combination of two or more antimicrobial drugs during a treatment regimen . the combination of imipenem plus ciprofloxacin had shown synergistic effect . loading of antibacterial agents into nanoparticles is one of the most promising approaches to reduce anti-microbial resistance. nano formulations could enhance the intracellular bioavailability of the antimicrobial drugs, and, thus, decreasing the development of resistance. moreover, the potential antibacterial activity of some nanoparticle-forming polymers might further increase the potency of the antibacterial drugs .

Eligibility criteria:
inclusion criteria: * admitted to intensive care unite exclusion criteria: * healthy
role of hemostatic powder (endo-clottm) in success and prevention of bleeding within gastric cancer patients with bleeding

Conditions: Bleeding at Gastric Cancer

Summary: gastrointestinal(gi) hemorrhage related with gastric cancer is prevalent in advanced cases mostly. as endoscopic hemostatic methods such as argon plasma ablation (apc) had developed, controlling gi hemorrhage in gastric cancer is much easier these days. but re-bleeding rate is still high, even after successful hemostasis with apc or electrical coagulation. furthermore patients who were experienced re-bleeding are expected poorer survival outcomes than those who are not. so excellent bleeding control in gastric cancer is most important in gi hemorrhage of gastric cancer. recently developed hemostatic powder \[endo-clot(tm)\] is easy to use and have proven its usefulness in gi hemorrhage in peptic ulcer diseases. so in this study, investigator will try to find out feasibility \& safety of endo-clot(tm) in gi hemorrhage in gastric cancer.


Eligibility criteria:
inclusion criteria: * age over 19 and less 80 yeas old * gastric cancer was diagnosed with biopsy and/or computed tomography * endoscopic hemostasis is needed upto gi hemorrhage * endoscopic examination is available in 24hours * ecog performance status(ps) \<2 exclusion criteria: * double primary caner * hypersensitivity of hemostatic power\[endo-clot(tm)\] * variceal bleeding or benign gastric ulcer bleeding * hemodynamically unstable with low systolic bp\ 120bpm * endoscopic hemostasis within 7 days before screening * contraindication for endoscopic examination * pregnant * breast feeding * bleeding tendency with low platelet count \ 2 * bacterial infection with needs for antibiotics therapy * unavailable to discontinue anti-coagulation agent for 3days * vascular shunt * cardiovascular and/or pulmonary diseases * active hepatitis or severe liver diseases * renal dysfunction * bone marrow dysfunction * neurologic deficit and/or psychotic feature * unavailable informed consent

Keywords: gastric cancer bleeding gastrointestinal hemorrhage
lung and diaphragm-protective ventilation by means of assessing respiratory work

Conditions: Diaphragm Injury; Lung Injury; Respiratory Insufficiency; Mechanical Ventilation Complication

Summary: this study is designed to test a proposed strategy for lung- and diaphragm-protective ventilation (ldpv) in patients with acute hypoxemic respiratory failure. ventilation and sedation will be titrated to evaluate whether it is feasible and safe within this patient population.

lung injury and diaphragm injury incurred by mechanical ventilation have very serious adverse effects on patients with acute respiratory failure. lung injury results from excessive mechanical stress and strain applied to the lung by the ventilator and/or respiratory muscles, while diaphragm injury results from either insufficient or excessive inspiratory effort. the objective of this study is to investigate a new ldpv strategy designed to prevent both disuse-mediated and load-induced diaphragm injury, while also preventing excess global and regional mechanical stress and strain in the injured lung. to achieve these goals, the following specific targets to be met are: (1) respiratory muscle effort similar to that of healthy subjects breathing at rest, (2) lung stress within safe limits, and (3) clinically acceptable gas exchange. targets are assessed through measurements of global lung stress, tidal recruitment, inspiratory effort, diaphragm contractile effort and adequacy of respiratory muscle and systemic tissue perfusion. measurements commence at enrollment and continue for 24 hours consecutively.

Eligibility criteria:
inclusion criteria: * diagnosed with acute hypoxemic respiratory failure * pao2:fio2 ratio less than or equal to 300 mm hg at time of screening * oral endotracheal intubation and mechanical ventilation * bilateral airspace opacities on chest radiograph or chest ct scan exclusion criteria: * liberation from mechanical ventilation is anticipated within 24 hours * intubated for traumatic brain injury or stroke * contraindication to esophageal catheterization * intracranial hypertension

Keywords: diaphragm dysfunction acute respiratory failure sedation mechanical ventilation lung stress
efficacy and safety of indacaterol plus tiotropium versus tiotropium alone in patients with chronic obstructive pulmonary disease

Conditions: Chronic Obstructive Pulmonary Disease (COPD)

Summary: this study assessed the efficacy and safety of indacaterol (150 µg once daily \[od\]) when combined with tiotropium (18 µg od) versus tiotropium (18 µg od) treatment alone in patients with chronic obstructive pulmonary disease (copd).


Eligibility criteria:
inclusion criteria: * diagnosis of chronic obstructive pulmonary disease (copd) (moderate-to-severe as classified by the global initiative for chronic obstructive lung disease (gold) guidelines, 2007) and: * smoking history of at least 10 pack-years * post-bronchodilator forced expiratory volume in 1 second (fev1) ≤ 65% and ≥ 30% of the predicted normal value * post-bronchodilator fev1/fvc (forced vital capacity) \< 70% exclusion criteria: * patients who have received systemic corticosteroids and/or antibiotics and/or was hospitalized for a copd exacerbation in the 6 weeks prior to screening or during the run-in period * patients who have had a respiratory tract infection within 6 weeks prior to screening * patients with concomitant pulmonary disease * patients with a history of asthma * patients with diabetes type i or uncontrolled diabetes type ii * any patient with lung cancer or a history of lung cancer * patients with a history of certain cardiovascular comorbid conditions other protocol-defined inclusion/exclusion criteria applied to the study.

Keywords: chronic obstructive pulmonary disease copd indacaterol tiotropium bronchodilation
prevenar (pcv-7) post-licensure safety study in russia

Conditions: Healthy Children After Vaccination

Summary: this study is planned to monitor the local and/or systemic reactions and compatibility of pcv-7 with routine vaccines in the russian national immunization schedule. consistent with the observational nature of this protocol, prevenar will be administered as standard of care. the aim of this study is to estimate the incidence of febrile reactions more than 38.0 degrees celsius, specifically (≥38 to \ 39 to \ 40 degrees c, and the frequency of other local or systemic reactions following vaccination with prevenar (pcv-7) co-administered with other routine childhood vaccines under the conditions of routine daily use in the russian federation.


Eligibility criteria:
inclusion criteria: * infants eligible for prevenar vaccination according to the regulatory approved terms of the marketing authorization in the russian federation: * infants from 3 months up to 23 months of age who may benefit from active immunization against disease caused by streptococcus pneumoniae serotypes 4, 6b, 9v, 14, 18c, 19f and 23f (including sepsis, meningitis, pneumonia, bacteraemia and acute otitis media). * parents or legal guardians willing and able to complete the diary cards. exclusion criteria: * hypersensitivity to the active substances or to any of the excipients; * hypersensitivity to diphtheria toxoid; * age less than 3 months or greater than or equal to 2 years at enrollment; * contraindications as listed in the package insert / russian smpc for either prevenar or for any concomitantly used other vaccines; * previously vaccinated with 23-valent pneumococcal polysaccharide vaccine; * prophylactic use of non-steroidal anti-inflammatory medications and/or acetaminophen (e.g., paracetamol). however, acetaminophen/paracetamol may be administered for treatment of fever, pain, etc.

Keywords: vaccine infant healthy subjects
the effect of natural molecules on hpv infection

Conditions: HPV (Human Papillomavirus)-associated

Summary: the purpose of the study is to evaluate the effect of the administration of natural molecules in the treatment of hpv infection.


Eligibility criteria:
inclusion criteria: * hpv dna test positivity * over 18 years exclusion criteria: * pregnancy * breastfeeding * assumption of other products containing egcg or green tea * primary immunodepression or pharmacological induced one
the endovascular management of visceral artery aneurysms

Conditions: Visceral Artery Aneurysm

Summary: to describe the safety, possible complications and technical success of different technical methods and different embolic materials in the endovascular management of visceral artery aneurysms.

abdominal visceral artery aneurysms (vaas) are defined as aneurysms which involve branches of the celiac, superior mesenteric, inferior mesenteric or renal arteries. owing to the improvements in imaging technology and the use of cross-sectional imaging modalities (ultrasound, computed tomography \[ct\], and magnetic resonance imaging), there is increase in the frequency of vaas diagnosis. although classically treated by open surgery, modern treatment strategies generally place interventional radiology techniques at the top of the treatment algorithm. therefore, vascular interventional radiologists must become familiar with the indications for the treatment of vaa, become experienced in the different techniques, and know when to recommend treatment of vaa by interventional radiology techniques or to advocate open surgical repair. vaas are subdivided into true and false aneurysms. a true aneurysm involves all three layers of the arterial wall. classically, a true aneurysm is defined as a localized dilatation of the artery by more than 1.5 times the expected arterial diameter. true aneurysms occur as a result of underlying arterial pathology such as atherosclerosis, fibromuscular dysplasia, and arteritis. the prevalence of true vaas is 0.1-2%, and most true vaas are asymptomatic. a minority may cause abdominal pain, which may be a harbinger of imminent rupture. vaas are almost never large enough to be palpable by examination. false aneurysms, or pseudoaneurysms, are effectively contained ruptures of the artery that are lined by adventitia or by the perivascular tissues. false aneurysms may occur as a result of inflammation, infection, or trauma.

Eligibility criteria:
inclusion criteria: * aneurysm due to inflammation or pancreatitis \[e.g., splenic, gastroduodenal (gda), superiomesenteric artery (sma), hepatic, or even renal aneurysms\]. * aneurysm due to trauma. * aneurysms occurring after surgery * aneurysm due to penetrating peptic ulcers. exclusion criteria: * in most cases with multiple, diffuse, small aneurysms related to portal hypertension should be left untreated and followed by repeat computed tomography (ct) or magnetic resonance imaging (mri) examinations. once the portal hypertension and underlying cirrhotic disease is treated (e.g., via liver transplantation), the aneurysm may spontaneously decrease and completely disappear over time. * patient refusal.

Keywords: aneurysm embolization stent graft