Kornimate/medical-research-clean huggingface dataset:
nosocomial covid-19 in icu (nosocovid)

Conditions: Coronavirus Infectious Disease (COVID-19); Nosocomial Infection; Nosocomial COVID-19

Summary: the current global pandemic at covid-19 is a major public health issue. transmission of the virus is primarily through direct and close person-to-person contact. the protection of health care personnel and the limitation of transmission of nosocomial covid is paramount. protective measures have already shown their effectiveness in limiting the spread of the virus: the use of masks, the wearing of protective gowns, the wearing of protective eyewear, social and physical distancing. a recent u.s. study (rhee et al. jama 2020) reported a very low incidence of 1.7% of nosocomial covid, but this was achieved with the application of rigorous infection risk management protocols. in addition to the widespread use of masks and protective measures, dedicated covid units had been created, with air treatment. the implementation of these dedicated units requires the mobilization of considerable human and material resources, which is not feasible in all hospitals over the long term. in view of the second wave of the epidemic in france, with the rising numbers of new cases of covdi-19 admitted to intensive care units since the end of the summer 2020, it is essential to organize the intensive care units to ensure the protection of personnel and limit the risk of nosocomial covid-19, while continuing to care for non-covid patients. in intensive care unit (icu) at the nantes university hospital, a strict protocol for the management of suspected or confirmed covid patients has been in place since early september 2020. the objective of this study is to evaluate the effectiveness of this protocol for managing the infectious risk of sars-cov-2 on the incidence of nosocomial covid in patients admitted in icu. the secondary objectives are to evaluate the incidence of nosocomial-associated covids contracted by caregivers, and the incidence of asymptomatic positive sars-cov-2 cases in icu.

all patients admitted in our icu since august 2020 were enrolled in the study, after they have been informed and given their consent for their participation in this observational study. data will be collected computerized patient records by the clinicians in charge of the patient. because of variants emergence, the investigators decided to had a second period from march to july. the investigators anticipate an inclusion of approximately 1000 patients. in an observational study, there is no risk to the patient

Eligibility criteria:
inclusion criteria: * all patients admitted in icu during the inclusion period (nantes university hospital) * and all healthcare workers working in icu during the inclusion period (nantes university hospital) exclusion criteria: * refusal to participate in research

Keywords: coronavirus infectious disease (covid-19) nosocomial infection sars-coronavirus-2 intensive care units (icu) personal protective equipment
sphenopalatine block versus greater occipital nerve block in pdph

Conditions: Post-Dural Puncture Headache

Summary: management of postdural puncture headache (pdph) has always been challenging for anesthesiologists. pdph not only increases the misery of the patient, but the length of stay and overall cost of treatment in the hospital also increases. although the epidural blood patch ( ebp ) is an effective way of treating the problem, the procedure itself could cause another inadvertent dural puncture (dp). moreover, sometimes patients need to have a second ebp, if the first one is not completely effective. this can be difficult to explain to the patient who has already suffered a lot. peripheral nerve blocks are well tolerated and effective as adjunctive therapy for many disabling headache disorder. sphenopalatine ganglion is a parasympathetic ganglion, located in the pterygopalatine fossa. transnasal sphenopalatine ganglion block ( spgb ) has been successfully used to treat chronic conditions such as migraine, cluster headache, and trigeminal neuralgia, and may be a safer alternative to treat pdph: it is minimally invasive and carried out at the bedside without using imaging. besides that, it has apparently a faster start than ebp, with better safety profile. another minimally invasive peripheral nerve block which has been used quite successful is greater occipital nerve block (gonb). the gonb has been in use for more than a decade to treat complex headache syndromes of varying etiologies like migraine , cluster headache and chronic daily headache with encouraging results. greater occipital nerve (gon) arises from c2-3 segments, its most proximal part lies between obliqua capitis inferior and semispinalis, near the spinous process. then, gon enters into semispinalis passing through it and after its exit; it enters into trapezius muscle. in distal region of trapezius fascia, it is crossed by the occipital artery and finally the nerve exits the trapezius fascia insertion into the nuchal line about 5-cm lateral to midline. functionally, gon supplies major rectus capitis posterior muscle, and the skin, muscles, and vessels of the scalp, but is the main sensory supply of occipital region. many providers believe that the local anesthetic produces the rapid onset of headache relief, like an abortive agent, and that the locally acting steroid produces the preventive like action of up to 6 weeks as dexamethasone possess potent anti inflammatory and immunosuppressive actions by inhibiting cytokine-mediated pathways .


Eligibility criteria:
inclusion criteria: * obstetric patients ( american society of anesthesiologists ) asa i\&ii ,body weight between 60-100kg expressing pdph after spinal anesthesia, (vas \> 4 ) with standard treatment such as intravenous fluids, abdominal binder, bed rest and caffeine. exclusion criteria: * • asa iii\& iv patients. * refusal of the patient. * patients with chronic headache or migraine. * hypertensive patients. * a patient that cannot comply with the vas. * infection at site of the block * known coagulation defect. * nasal septal deviation, polyp, history of nasal bleeding. * allergy to local anaesthetics.
pharmacogenetics of antiretroviral drugs

Conditions: HIV Infections

Summary: in this research project, we will study the genetic determinants that influence the pharmacokinetics of antiretroviral drugs used in the treatment of diseases caused by the hiv.

the development of new active substances is a continuous source of progress in pharmacotherapy. however, the search for an optimal use of existing molecules constitutes another possible way of progress. in the particular field of anti-infectious therapy, an optimization of treatments could minimize the emergence of resistance phenomena that require the continuous development of new active molecules. pharmacogenetics is the scientific discipline seeking to improve the response to drug therapies (better clinical efficiency and reduction of side effects) by taking into consideration the genetic characteristics of the patient. drugs with a narrow therapeutic index constitute a main target of this emerging field. the combination of therapeutic drug monitoring and pharmacogenetics already allows to optimize the use of some drugs among which oral anticoagulants, immunosuppressants, antiepileptics, antidepressors, antibiotics or antivirals.... in this research project, we will study the genetic determinants that influence the pharmacokinetics of antiretroviral drugs used in the treatment of diseases caused by the hiv. we will put a particular emphasis on viral protease inhibitors (atazanavir, saquinavir, lopinavir, ritonavir)and non-nucleosides reverse transcriptase inhibitors (nevirapine and efavirenz). for those drugs, the clinician often faces a double therapeutic risk, either of insufficient dosing (clinical inefficacy and emergence of resistance) or of excessive dosing (toxicity). the optimization of drug dosing is especially crucial because some of these drugs often represent the last choice in multi-resistant patients.

Eligibility criteria:
inclusion criteria: * hiv infected patients exclusion criteria: * pregnant women

Keywords: human immunodeficiency virus
elective level ib irradiation in nasopharyngeal carcinoma patients based on the international guidelines

Conditions: Nasopharyngeal Carcinoma

Summary: currently, nasopharyngeal carcinoma (npc) patients who had level ii involvement with extracapsular extension (ece), and/or had a maximum nodal axial diameter (mad) of greater than 2cm in level ii will be recommended to receive level ib-covering imrt according to the international guidelines. our previous study, which retrospectively analyzed a cohort of 390 patients, indicated that it should be safe and feasible for patients who only had at least one of the above two radiological features. thus, the investigators conduct this non-inferior phase 3, randomized trial to further determine the feasibility of sparing level ib in patients who had level ii involvement with ece, and/or had a mad of greater than 2cm in level ii.

currently, nasopharyngeal carcinoma (npc) patients who had level ii involvement with extracapsular extension (ece), and/or had a maximum nodal axial diameter (mad) of greater than 2cm in level ii will be recommended to receive level ib-covering imrt according to the international guidelines. our previous study, which retrospectively analyzed a cohort of 390 patients, indicated that it should be safe and feasible for patients who only had at least one of the above two radiological features. thus, the investigators conduct this non-inferior phase 3, randomized trial to further determine the feasibility of sparing level ib in patients who had level ii involvement with extracapsular extension (ece), and/or had a maximum nodal axial diameter (mad) of greater than 2cm in level ii.

Eligibility criteria:
inclusion criteria: 1. newly diagnosed, non-metastatic nasopharyngeal carcinoma histologically confirmed by biopsy; 2. the following conditions: ① involvement of level ii lns with extracapsular extension(ece); ② level ii lns involvement with maximum nodal axial diameter (mad) greater than 2 cm; 3. eastern cooperative oncology group (ecog) score of 0 or 1. exclusion criteria: 1. level ib involvement with positive pathological results; 2. submandibular glands (smgs) involvement; 3. involvement of structures that drain to level ib as the first echelon site (the oral cavity, anterior half of nasal cavity involvement); 4. previous malignancy or other concomitant malignant disease.
single blind randomized study to determine the sensitivity and specificity of 2 non-invasive markers of early coronary disease

Conditions: Coronary Artery Disease

Summary: diagonal ear lobe crease and microcirculatory disorder in the conjunctiva are both non invasive methods documented in the literature as early signs of coronary artery disease. we wish to study the sensitivity and specificity of both signs by conducting a single blind study involving patients with documented presence or absence of coronary artery disease via angiogram.


Eligibility criteria:
inclusion criteria: * age 20 to 70 years old * angiogram within past 12 weeks * stable during post angio period * willing to provide informed consent exclusion criteria: * previous eye surgery including cataract surgery * previous ophthalmologic disorders * previous surgeries involving ears or ear lobes

Keywords: cad microangiopathy patients more likely to have tortuosity of conjunctival vessels
safety and efficacy of art-123 in subjects with sepsis and disseminated intravascular coagulation

Conditions: Sepsis; Disseminated Intravascular Coagulation

Summary: the purpose of this study is to see if art-123 (recombinant human soluble thrombomodulin) decreases the number of people who die as a result of disseminated intravascular coagulation (dic) complication of sepsis.


Eligibility criteria:
inclusion criteria: * infection or suspected infection resulting in sepsis and dic exclusion criteria: * unable to provide informed consent, or lack of consent from an acceptable surrogate * subjects \< 18 years of age * known conditions that could confound the diagnosis of dic due to sepsis * known conditions that increase the risk of bleeding * known medical condition associated with a hypercoagulable state * known or suspected severe liver disease * history of solid organ (excluding uncomplicated kidney), bone marrow or stem cell transplantation * renal failure
obatoclax mesylate in samples from young patients with acute myeloid leukemia

Conditions: Leukemia

Summary: rationale: studying the effects of obatoclax mesylate in cell samples from patients with cancer in the laboratory may help doctors learn more about the effects of obatoclax mesylate on cancer cells. it may also help doctors identify biomarkers related to cancer. purpose: this research study is studying obatoclax mesylate in samples from young patients with acute myeloid leukemia.

objectives: * determine comprehensive gene and protein expression profiles of in vitro sensitivity and resistance to obatoclax mesylate in multiple-lineage leukemia (mll)-rearranged cell lines and primary infant acute myeloid leukemia (aml) samples. * define optimum in vitro combinations of obatoclax mesylate targeting pro-survival bcl-2 family proteins with cytotoxic drugs in mll-rearranged leukemia cell lines and primary infant aml samples. * identify synergistic combinations based on a pharmacodynamic modeling and simulation construct. * determine whether combinations of obatoclax mesylate targeting pro-survival bcl-2 family proteins with cytotoxic drugs improves survival in a xenograft model of mll-rearranged infant aml. outline: this is a multicenter study. obatoclax mesylate activity is assessed via the mtt assay. a priori features of acute myeloid leukemia (aml) blasts relating to the apoptosis and atg cell death pathways and their execution are characterized using microarray analysis and quantitative real-time (q-rt) pcr. gene and protein expression is described and quantified using q-rt pcr and western blot analysis at specific time points after obatoclax mesylate exposure to identify pharmacodynamic biomarkers of activity and characterize the cell death mechanism in multiple-lineage leukemia (mll)+ aml. the mtt assay is performed using obatoclax mesylate-cytotoxic chemotherapy combinations to determine synergy focusing on common cytotoxic drugs employed in aml treatment regimens. obatoclax mesylate efficacy is tested in a therapeutic nog xenograft model of primary mll+ infant aml.

Eligibility criteria:
disease characteristics: * diagnosis of acute myeloid leukemia (aml) * cryopreserved samples from infants with aml available patient characteristics: * not specified prior concurrent therapy: * not specified

Keywords: childhood acute myeloid leukemia/other myeloid malignancies
the effect of non-invasive brain stimulation on language production in post-stroke aphasia

Conditions: Aphasia; Stroke; Language Disorders

Summary: aphasia is a language impairment caused by brain injury such as stroke that affects the ability to understand and express language, read and write due to damage in the language regions of the brain. non-invasive brain stimulation (nibs) techniques like transcranial direct-current stimulation (tdcs) have been found to improve aphasia treatment effects in post stroke patient populations such as improved naming abilities. however, the effect of tdcs on more functional, higher level language skills such as discourse production (i.e. story telling, giving instructions) has yet to be understood.therefore the aim of this study is to determine the potential effectiveness of tdcs as an adjunct to speech and language therapy (slt) to improve discourse speech production in people with post-stroke aphasia. it is hypothesised that slt combined with tdcs will result in greater improvements in discourse language production compared to slt on its own.


Eligibility criteria:
inclusion criteria: * aphasia caused by a single stroke * at least 6 months post stroke * at least 18 years old * competent english speaker prior to stroke * right handed prior to stroke * normal aided or unaided visual acuity * willing to participate and to comply with the proposed block of intervention and testing regime. exclusion criteria: persons with * neurological symptoms or history of a neurological event other than their stroke * contraindications to tdcs including history of epilepsy or seizures and pacemakers * global/severe aphasia * cognitive impairment identified by a score less than 20/30 in the montreal cognitive assessment * left-handed dominance prior to stroke * visual problems which interfere with persons' ability to access visual materials (i.e. pictures) * inability to attend sessions
trial evaluating efficacy and safety of anticoagulation in patients with covid-19 infection, nested in the corimmuno-19 cohort

Conditions: COVID19 Pneumonia

Summary: covid-19 is a respiratory disease caused by a novel coronavirus (sars-cov-2) and causes substantial morbidity and mortality. there is currently no vaccine to prevent covid-19 or infection with sars-cov-2 or therapeutic agent to treat covid-19. this protocol corimuno19-coag will evaluate the efficacy and safety of active anticoagulation using heparin: tinzaparin (innohep®) or unfractionated heparin (calciparine®, héparine sodique choay®) in covid-19 patients hospitalized in conventional or intensive care units. it will use a phase 2 randomized open-label multicentre clinical trial, where patients will be randomly allocated to anticoagulation versus standard of care.


Eligibility criteria:
inclusion criteria: 1. group 1 : patients not requiring icu at admission with mild disease to severe pneumopathy according to the who criteria of severity of covid pneumopathy, and with symptom onset before 14 days, with need for oxygen but no non-invasive ventilation (niv) or high flow 2. group 2 : * respiratory failure and requiring mechanical ventilation * who progression scale ≥ 6 * no do-not-resuscitate order (dnr order) exclusion criteria: * patients with contraindications to anticoagulation 1. congenital hemorrhagic disorders 2. hypersensitivity to tinzaparin or uhf or to any of the excipients 3. current or history of immune-mediated heparin-induced thrombocytopenia 4. active major haemorrhage or conditions predisposing to major haemorrhage. major haemorrhage is defined as fulfilling any one of these three criteria: a) occurs in a critical area or organ (e.g. intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, intra-uterine or intramuscular with compartment syndrome), b) causes a fall in haemoglobin level of 20 g/l (1.24 mmol/l) or more, or c) leads to transfusion of 2 or more units of whole blood or red blood cells. 5. septic endocarditis * patients with need for anticoagulant therapy. for example: atrial fibrillation, venous thromboembolism, mechanical valve, etc.
monitoring allergen immunotherapy in allergic rhinitis

Conditions: Immunotherapy; Rhinitis, Allergic; Treatment Outcome

Summary: allergic rhinitis (hay fever) can be treated successfully with allergen-specific immunotherapy (ait) for 3-5 years. this relative expensive and prolonged treatment is not suitable for everyone and therefore it is important to predict who will benefit from this therapy early after the start of treatment. this project will investigate whether a bat with nasal fluid can detect inhibition during immunotherapy in comparison with a bat with blood.

allergic rhinitis (hay fever) can be treated successfully with allergen-specific immunotherapy (ait) for 3-5 years. this relative expensive and prolonged treatment is not suitable for everyone and therefore it is important to predict who will benefit from this therapy early after the start of treatment. biomarkers, like basophil activation test (bat) and ige-facilitated allergen binding (fab), using nasal fluid instead of blood, probably better reflect therapy effect (inhibition of an ige-mediated allergic reaction) as the nose is the main target organ for ait in allergic rhinitis. this project will investigate whether a bat with nasal fluid can detect inhibition during immunotherapy in comparison with a bat with blood. nasal fluid and blood samples are collected at baseline and after 8 and 16 weeks of treatment. a nasal fluid inhibition bat is developed and validated by comparison with a bat using serum and an ige-fab assay. 15 adults with birch pollen allergy, who are treated with ait (itulazax birch pollen tablet) and 10 adults with birch pollen allergy, who are treated with immunosuppressive medication (control group) will be included in the study.

Eligibility criteria:
inclusion criteria: * ige-sensitized birch pollen allergy * start of itulazax therapy or immunosuppressive therapy (nasal corticosteroid and/or antihistamine eye drops) * signed informed consent exclusion criteria: * other underlying chronic conditions (immunological (autoimmune or immunodeficiency), oncological) * unstable uncontrolled asthma * smoking
effects of a self-management course for adults on sick-leave

Conditions: Workers on Sick-leave, Insured by The Danish Welfare State

Summary: the purpose of the current study is to determine the efficacy of a self-management course for workers on sick-leave as an add-on to standard rehabilitation care and follow-up (treatment as usual). outcomes are registry based measures of return to work, and questionnaire based measures of well-being and quality of life. we thus, hypothesize that the program will improve workers return to work rates and self-reported/psychological well-being.

the intervention course is a danish adaptation of the chronic disease self-management program (cdsmp), tailored towards workers on sick-leave. the original program has been developed by the stanford patient education research center. the translation and adaptation has been conducted by the danish committee for health education. previous studies have examined the program with respect to specific chronic diseases (e.g., arthritis), quality of life, well-being and health-care utilization, though non-otherwise specified workers on sick-leave and return work have not been examined before. the framework of cdsmp is social-cognitive learning theory in which self-efficacy plays a central role.

Eligibility criteria:
inclusion criteria: * insured persons who receive sick-leave compensation from the danish state * persons who are listed as sick from a job * persons who have been categorized as "2 - risk" or "3 - chronic" case by the job-center * the health problem reflects a chronic or a long-term condition * the person acknowledges a chronic or long-term condition * the person wants to work with his or her condition * the person wants to return to work * the person volunteers to participate exclusion criteria: * persons who are listed sick for more than 16 weeks * persons who are categorized as "1 - easy" by the job-center * the person does not understand or speak danish * history or signs of aggressive behavior and violence

Keywords: sick-leave return to work self-management self-efficacy quality of life and well-being motivation