Kornimate/medical-research-clean huggingface dataset:
assessing gastric motility and distention in postoperative gastrointestinal surgery using bedside gastric ultrasound: predicting risk of aspiration pneumonia, ileus, return of bowel function

Conditions: Postoperative Ileus; Postoperative Nausea; Postoperative Complications; Postoperative Nausea and Vomiting; Postoperative Vomiting; Aspiration Vomitus

Summary: point-of-care gastric ultrasound will be used to measure stomach contents postoperative in patients who underwent colorectal surgery. stomach volume and status (empty or full) will be compared retrospectively to the standard clinical criteria for diet advancement to determine if stomach volume via ultrasound is associated with successful diet advancement, nausea/vomiting, nasogastric tube replacement, length of stay, and other clinical outcomes. clinicians performing clinical care will be blinded to the ultrasound exam results.

patient population: patients undergoing colorectal surgery will be enrolled prospectively (both cancer and non-cancer patients). inclusion criteria: * patients aged \> 18 years of age * patients undergoing colorectal surgery (both cancer and non-cancer) exclusion criteria: * patients \< 18 years of age * patients with previous gastric surgery * patients with inadequate or difficult baseline gastric ultrasound images * any other patient deemed a poor study candidate by the treating physicians research design/protocol: we will perform postoperative point-of-care ultrasound examinations in colorectal surgery patients and will record gastric volumes at set time points, including preoperative and the morning of postoperative day 1. the surgical team, who will be blinded to the results of the ultrasound exam, will make decisions to advance diet, remove nasogastric tube, and begin oral medications based on standard clinical criteria. at the completion of the study we will determine if there is any association between gastric volume on ultrasound and patient complications, such as nausea/vomiting, replacement of nasogastric tube, aspiration of gastric contents, inability to tolerate solid diet, prolonged admission/length of stay, and other clinical outcomes. outcomes: our exploratory outcome measures will be tolerance of diet, replacement of ng tube, nausea/vomiting, time to flatus, aspiration pneumonia/pneumonitis, and length of stay.

Eligibility criteria:
inclusion criteria: * patients aged \> 18 years of age * patients undergoing colorectal surgery (both cancer and non-cancer) exclusion criteria: * patients \< 18 years of age * patients with previous gastric surgery * patients with difficult or poor ultrasound images at baseline * any patient deemed a poor candidate by the treating physicians

Keywords: postoperative complications postoperative ileus
the study on the clinical utility of liquid biopsy in breast cancer

Conditions: Breast Cancer

Summary: through this prospective clinical trial,the investigators will focus on the relationship between circulating tumor biomarkers (i.e. circulating tumor cells, circulating tumor dna and other biomarkers) and the status of primary tumor to discuss its application for assessing prognosis and individualized therapeutic direction. moreover, the relationship between the circulating tumor cell subpopulations based on epithelial-mesenchymal transition and molecular pathological classification of breast cancer will be determined, which may enable the determination of the value of its application in therapeutic decision making.


Eligibility criteria:
inclusion criteria: * female patients aged ≥18 years with histologically confirmed breast cancer. * the patients diagnosed with breast cancer for the first time, including postoperative patients within one month and the patients diagnosed with stage iv breast cancer for the first time. exclusion criteria: * the patients who has begun medication for breast cancer.

Keywords: liquid biopsy, breast cancer,circulating tumor biomarker
frequency and severity of pleural effusion associated with the use of dasatinib in patients with chronic myeloid leukemia. a descriptive, mexican multicenter study

Conditions: Leukemia

Summary: this is a retrospective, multicenter, descriptive analysis of patients with a diagnosis of chronic myeloid leukemia, treated with dasatinib for at least 45 days. the study will include 100 patients treated in different public centers in the mexican republic.


Eligibility criteria:
inclusion criteria: * men and women ≥15 years of age * diagnosis of chronic myeloid leukemia in any phase that used dasatinib at any time between january 2008 and november 2014 * have received dasatinib as part of their first-line or second-line treatment for at least 45 days exclusion criteria: * patients who received dasatinib as part of any clinical trial * patients who do not have complete data on the data collection sheet * patients who do not have medical records available at the moment of the data verification
terlipressin infusion alone vs terlipressin with noradrenaline infusion in the treatment of hepatorenal syndrome type 1

Conditions: Type 1 HEPATO RENAL SYNDROME(HRS)

Summary: hepatorenal syndrome (hrs) is defined as a functional renal failure in a patient with chronic liver disease, or liver cirrhosis.the splanchnic circulation undergoes severe vasodilation, as a result of portal hypertension, causing an underfilling of systemic arteries.this results in intense renal vasoconstriction and functional renal failure. the best treatment options for hrs i would be a drug which has renal vasodilator property and additional splanchnic vasoconstriction. an increase in circulating blood volume would be of additional benefit. currently terlipressin is considered superior to other drugs in the management of hrs i. other drugs in use are noradrenaline and midodrine. albumin is added to these drugs in order to expand plasma volume. terlipressin, a vasopressin analog, has agonistic activity at v1 receptors. noradrenaline acts as an agonist at α-adrenergic receptors with mild β-agonistic activity. the two major drugs used in the management of hrs act at different receptors and have completely varied mechanisms of action. thus, a combination therapy would improve the rate of response considerably. there have been multiple studies, measuring the efficacy, safety and dosing of both drugs, but none combining both terlipressin and noradrenaline. hence our study would be a pioneer in formulating a new and possibly more efficacious treatment protocol for patients of type i hrs, in whom the treatment options are otherwise very limited. if successful, this would open new horizons of therapy for terlipressin refractory hrs, which, otherwise is an ominous condition.


Eligibility criteria:
inclusion criteria: 1. age\>18 years and \<80 yrs; 2. cirrhosis as diagnosed by clinical findings, endoscopy or usg examination or by liver biopsy. 3. hrs i as defined by the following features: 1. the patient should have cirrhosis and also ascites 2. renal failure of rapid onset -initial value of scr, doubling to reach a level of more than 226mmol/l (2.5 mg/dl) in less than two weeks 3. there should be absence of shock. 4. scr value does not reduce to less than 1.5 mg/dl even after 2 days of stopping diuretics and giving inj.albumin for plasma volume expansion (1g/kg ) upto 100g/day. 5. no h/o being treated currently or recently with drugs having nephrotoxicity. 6. absence of parenchymal renal disease: * proteinuria \< 0.5g/day * absence of microhaematuria (\<50 red cells/high powered field) * normal renal ultrasonography exclusion criteria: 1. aki improved after plasma volume expansion 2. any history of coronary artery disease, peripheral vascular disease, arrhythmias, and cardiomyopathy. 3. hepatocellular carcinoma 4. septic shock 5. any severe extra-hepatic condition including respiratory and cardiac failure. 6. any contraindication which precludes the use of noradrenaline and terlipressin
study of usefulness of genotyping to predict docetaxel exposure and adverse events

Conditions: CYP3A Phenotyping; CYP3A5 and MDR1 Genotyping; Docetaxel Toxicity; Associations Between Genetic Data and Docetaxel Toxicity

Summary: twenty patients with verified high risk breast cancer will be included in the study. patients will receive three cycles of docetaxel followed by three cycles of cef for their adjuvant treatment. the phenotype of cyp3a and the genotype of cyp3a5 and mdr1 will be assessed. also the effect of docetaxel in the activity of cyp3a will be measured by peroral midazolam. primary object: the primary object of this study is to define, if it is possible to predict the clearance and/ or toxicity of docetaxel by assessing * activity of cyp3a4 by midazolam test (cyp3a4 phenotype) * cyp3a5 genotype * mdr1 genotype secondary object: the secondary object of this study is to define whether the treatment with docetaxel alters the activity of cyp3a4 enzyme in previously untreated breast cancer patients.


Eligibility criteria:
inclusion criteria: subjects may be included in the study only if they meet all of the following criteria: 1. the patient has received information on the purpose of the study and the meaning of the treatment, and has given verbal and written consent to participate in the study. the patient is accessible for treatment and follow-up. 2. histologically verified diagnosis of breast cancer 3. high risk for recurrence ( node positive or node negative if t2 with histological grade 2 or 3, or pgr negative) 4. no metastases 5. females, age =\<60 6. no concomitant regular medication which is either substrate, inducer or inhibitor of cyp3a4 exclusion criteria: subjects will be excluded from the study for any of the following reasons: 1. poor performance status,\>=2 according to who 2. inadequate bone marrow reserve defined as: * hemoglobin \< 100 g/l * leukocytes \< 3.0 x 10e9/l or neutrophiles \< 1.5 x 10e9/l * plateless \< 120 x 10e9/l 3. inadequate liver function defined as: * alat is \> 1.5 x units of normal level * elevated bilirubin (unless verified gilbert´s syndrome) * alkaline phosphatase is \> 2.5 x units of normal level 4. history of concomitant serious physical or psychiatric disease, which makes a regular cytotoxic treatment impossible 5. cardiac insufficience; severe arrhythmia; severe hypertension; cardiac infarction within one year or other active cardiac disease 6. pregnant or lactating patients 7. abuse of alcohol or any narcotic substances

Keywords: docetaxel toxicity cyp3a activity cyp3a5 mdr1 peroral midazolam
exercise cardiac magnetic resonance assessment of left atrial mechanics following ablation

Conditions: Paroxysmal Atrial Fibrillation

Summary: longitudinal, observational cohort study to evaluate changes in left atrial (la) reservoir function during exercise and overall exertional capacity in patients following catheter ablation for paroxysmal atrial fibrillation (af).

exclamatory is a longitudinal observational cohort clinical research study to evaluate the effects of catheter ablation for paroxysmal atrial fibrillation on left atrial and left ventricular performance during exercise, as well as effects on overall exercise capacity

Eligibility criteria:
inclusion criteria: * age ≥18 years * diagnosis of paroxysmal af * left ventricular ejection fraction ≥50% * scheduled for catheter ablation * able to speak, hear, and read english * willing and able to provide informed consent exclusion criteria: * persistent or permanent af * prior ablation (catheter based or surgical) for af * significant sinus node dysfunction * implanted pacemaker or defibrillator * contraindication to or inability to complete cardiovascular magnetic resonance study * contraindication to or inability to complete exercise testing * chronic kidney disease with estimated glomerular filtration rate \<30 ml/min/1.73m2 * severe left ventricular hypertrophy * unrelated cardiomyopathy that is expected to limit exercise capacity, including but not limited to: * hypertrophic cardiomyopathy * cardiac amyloidosis * constrictive pericarditis * pulmonary arterial hypertension * prior cardiac surgery * active pregnancy

Keywords: catheter ablation exercise capacity
spironolactone in ckd enabled by chlorthalidone: pilot

Conditions: Renal Insufficiency; Chronic Hypertension

Summary: highly prevalent among patients with chronic kidney disease (ckd) and poorly controlled blood pressure (bp), is a modifiable risk factor to abrogate both kidney failure progression and cardiovascular (cv) disease. spironolactone (spl), a mineralocorticoid receptor antagonist, is widely used to treat resistant hypertension, however one of the most common side effects is an increase of serum potassium (k). this side effect occurs frequently in those who suffer from ckd. alternatively, chlorthalidone (ctd) is a thiazide-like diuretic used for treating hypertension and decreases serum k. in this pilot study, our goal is to assess whether the combination of spl and ctd can improve bp control, while also reducing the risk of hyperkalemia over a period of 12 weeks. we hypothesize that among patients with ckd and poorly controlled hypertension, compared to spl and placebo, treatment over 12 weeks with ctd will counter the hyperkalemia effect of spl, and therefore the combination of spl with ctd will result in a lower bp. this pilot study will be performed at richard l. roudebush va in indianapolis, indiana.

this is a placebo-controlled, double-blind, randomized controlled trial of spironolactone (spl) and chlorthalidone (ctd) in patients with ckd and poorly controlled hypertension

Eligibility criteria:
inclusion criteria: 1. age greater than 18 years. 2. gfr estimated by ckd-epi formula \< 45 ml/min/1.73 m2 but ≥ 15 ml/min/1.73 m2 using idms-calibrated creatinine. 3. hypertension. using aobp monitoring, bp of ≥ 130/80 mmhg. 4. treatment with antihypertensive drugs: this would require the use of at least one antihypertensive drug. one of the drugs should be either an ace inhibitor or arb or a beta-blocker at the time of randomization. 5. serum k 3.5 to 5.2 meq/l at the time of randomization. in patients with egfr \ 5.2 meq/l exclusion criteria: 1. use of spironolactone, eplerenone, amiloride, triamterene, thiazides, or thiazide-like drugs or the use of k supplements or k binders in the previous 12 weeks. 2. expected to receive renal replacement therapy within the next 6 months. 3. myocardial infarction, heart failure hospitalization, or stroke ≤ 12 weeks prior to randomization. 4. pregnant or breastfeeding women or women who are planning to become pregnant or those not using a reliable form of contraception (oral contraceptives. condoms and diaphragms will be considered reliable). 5. known hypersensitivity to thiazide or spironolactone. 6. clinic aobp \<110 mmhg systolic at their first visit

Keywords: spironolactone chlorthalidone chronic kidney disease hypertension thiazide diuretic potassium sparring diuretic
tolerance and efficacy nicotinamide (vitamin b3) in dominant optic atrophy opa1

Conditions: Nicotinamide Adverse Reaction

Summary: dominant optic atrophy (hereafter known as doa) is a neurodegenerative pathology of the optic nerve inducing progressive loss of central visual field and visual acuity. there is currently no proven treatment for this disease. the metabolomics work of pascal reynier's team revealed a specific metabolomic signature of doa in the plasma of patients. this metabolomic signature revealed a relative deficiency in nicotinamide compared to a control population, a vitamin compound (vitamin b3) known to be neuroprotective for the optic nerve and mitochondria. note that the investigator have also identified this nicotinamide deficiency in primary open-angle glaucoma and leber's hereditary optic neuropathy, the other most common cause of hereditary optic neuropathy, these three optic nerve conditions sharing a common pathophysiological mechanism of mitochondrial deficit. in addition, an american team demonstrated the high neuroprotective power on the optic nerve of nicotinamide in a mouse model of glaucoma. these arguments converge towards the potential therapeutic interest of this vitamin in degenerative pathologies of the optic nerve. this is encouraged by the fact that two randomized clinical trials have confirmed a benefit of nicotinamide in glaucoma. the objective of this pilot study is to test the tolerance and efficacy of nicotinamide in doa and doa+ patients.


Eligibility criteria:
inclusion criteria: * adult patients * patients with doa or doa+ due to a heterozygous pathogenic variant in the opa1 gene * naïve patients (\> 3 months) in terms of taking nicotinamide * patients able to take oral medication and comply with specific study procedures * patients affiliated or beneficiaries of a social security scheme * signature of voluntary, free and informed consent to participate in the study exclusion criteria: * asymptomatic patients (= healthy carriers of an opa1 mutation but not having developed optic neuropathy) * patients with another associated severe ophthalmological pathology (advanced glaucoma, retinal pathology, etc.) * patients treated with idebenone * patients with a level of transaminase(s) (asat and/or alat) twice higher than the high normal value. * pregnant, breastfeeding or parturient women * patients with a contraindication to nicotinamide * persons deprived of liberty by administrative or judicial decision * patients subject to a legal protection measure * persons undergoing psychiatric treatment under duress * persons unable to express their consent
assessment of nutritional status after gastric bypass surgery

Conditions: Obesity; Nutritional Deficiencies

Summary: this study is aimed at assessing how roux-en-y gastric bypass (rygp) impacts on energy and nutrients' intake, energy expenditure, and nutritional status in obese patients. it will try quantitate energy and protein balance after rygp, and to identify how rygp effects the intake of various common dietary protein sources 16 female patients with bmi \> 40 kg/m2 and on a waiting list for bariatric surgery will be included. the following measurements will be performed before, and 1, 3, 6, 12, and 36 months after rygp * body weight * body composition (bio impedancemetry) * basal metabolic rate (open circuit indirect calorimetry) * 24-hour urinary urea excretion * fasting blood chemistry * energy and macronutrient's intake (3-day dietary recall)


Eligibility criteria:
inclusion criteria: * age 18-65 years * gender: females * body mass index \>35 kg/m2 exclusion criteria: * gi tract diseases * endocrine diseases

Keywords: obesity gastric bypass energy balance nutritional status protein balance
observation of safety and tolerability within 1 year of the use of r-ketamine / placebo in drug-resistant depression

Conditions: Treatment-Resistant Depression; Major Depressive Disorder

Summary: an observational-comparative study, without interfering with the treatment, based on an operationalized interview.

patients with treatment-resistant depression constitute a significant proportion (even 30%) of patients diagnosed with major depressive disorder (mdd. since 2014, there have been reports of a potential antidepressant effect of the r-ketamine stereoisomer. at the uck department of psychiatry, a phase 2 clinical trial (2a) has been conducted since 2022 with the use of r-ketamine in the form of an intravenous solution, administered by an infusion pump to patients with drug-resistant depression (sponsor perception neuroscience, inc., protocol pcn-101-21, nct05414422). the available data from studies indicate a potential treatment-transformative effect of the drug, but do not provide comprehensive information on the long-term effects of treatment in terms of effectiveness, tolerability, and safety of r-ketamine use. the study is cognitive and comparative study, without interfering with the diagnostics, treatment, and rehabilitation. it aims to collect effectiveness and safety observations within 12 months of participation in the pcn-101-21 study, at quarterly intervals (3, 6, 9, 12 months, +/- 4 weeks), with particular emphasis on exacerbations of the underlying disease, hospitalization, correction of psychotropic treatment or functional impairment requiring support from social security authorities. the study does not involve additional diagnostic, therapeutic or rehabilitation goals and is a retrospective analysis performed during a single visit.

Eligibility criteria:
inclusion criteria: expressing informed consent to participate in the study and earlier participation in the pcn-101-21 study on site. exclusion criteria: informed consent withdrawal.
the safety and dose response relationship of ulinastatin for acute respiratory distress syndrome(ards)

Conditions: Acute Respiratory Distress Syndrome

Summary: compared with placebo, evaluate the effects and safety of ulinastatin(uti) added to conventional treatment for ards; evaluate the dose response relationship of ulinastatin for ards.

after signed off the informed consent form by patient or surrogate, and after completing the screening phase, the patients who fulfill the inclusion and exclusion criteria will be randomized 1:1:1:1 to the 4 study arms. all the patients will receive the study treatment drugs for 7 to 14 days. use day 28 of last patient as a cut-off day, collect the follow up visit data on both day 28 and day 90 of other patients．

Eligibility criteria:
inclusion criteria: 1. have provided signed written informed consent form (icf) from the patient or the patient's legal representative; 2. male or female patients ≥18 years of age; 3. ards defined with using 2012 berlin criteria; 4. ards diagnosed ≤7 days, and patients should be mechanically ventilated(invasive and or noninvasive mechanical ventilation); 5)100mmhg \< pao2/fio2 \< 250mmhg with cpap/peep≥5 cmh2o; exclusion criteria: 1. patient with known hypersensitivity to ulinastatin/adjuvant or patient with allergic constitution; 2. patients with artificial organs replacement therapy for liver or kidney； 3. glasgow coma scale (gcs)≤8； 4. cardiogenic pulmonary edema , and the cardiogenic pulmonary edema is as the only or primary reason for respiratory failure; 5. ards caused by burning, drowning, poisoning; 6. presence of severe chronic liver diseases (child-pugh score 12-15)，or severe chronic respiratory disease with a paco2 \> 50 mmhg or the use of home oxygen; 7. neutrophils\<1.5×10\^9/l 8. moribund patients (i.e.,expected to live no longer than 24 hours) or with recent (within 7days or anytime during present hospitalization) cardiopulmonary arrest; 9. patients need long-term glucocorticoid treatment or need to be treated with immunosuppressive drugs; 10. no intent/unwillingness to follow lung protective ventilation strategy or fluid management protocol; 11. lung transplant patients; 12. patients with malignancy, expected to live no longer than 6 months; 13. pregnant or breast-feeding; 14. patients who have participated in any clinical study within 3 months prior to the screening; 15. any condition that in the opinion of the investigator would add the patient's risk or jeopardize the operation of the study.