Kornimate/medical-research-clean huggingface dataset:
pulmonary and renal support during acute respiratory distress syndrome

Conditions: Acute Respiratory Distress Syndrome; Acute Renal Failure

Summary: in patients presenting with the acute respiratory distress syndrome (ards), mechanical ventilation with low tidal volume (6 ml/kg predicted body weight) is the current gold standard for supportive care. however, despite a relative low tidal volume, approximatively one third of patients will experienced tidal hyperinflation, a phenomenon known to induce pulmonary and systemic inflammatory response. a further reduction of the tidal volume to 4 ml/kg (pbw) will prevent pulmonary area from tidal hyperinflation. as a result, hypercarbia and respiratory acidosis are commonly observed with such very low tidal ventilation. extra corporeal co2 removal is one of a mean to normalize arterial co2 tension. patients with ards also frequently develop acute renal failure which may required renal replacement therapy. some data suggests that starting early the rrt may favor outcome. the investigators hypothesized that a strategy combining eccor and rrt early in the course of patients presenting ards and acute renal failure will allow the tidal volume to be further reduced, providing lung protection, while avoiding the arterial co2 tension to be increased. for this purpose, the investigators sought to evaluate the safety and efficacy of adding a membranel oxygenator within an hemofiltration circuit, either upstream or downstream of the hemofilter.


Eligibility criteria:
inclusion criteria: * acute respiratory distress syndrome according to the aecc definition * acute renal failure according to the rifle definition exclusion criteria: * age \< 18 years * pao2/fio2 \ 18 cmh2o * dnr order or death expected within the next 3 days * intracranial haemorrhage or hypertension * heparin allergy

Keywords: acute respiratory distress syndrome acute renal failure
eye movement desensitization and reprocessing (emdr) in alcohol dependent patients

Conditions: Alcohol Dependence

Summary: one interesting approach to the treatment of addiction is the use of eye movement desensitization and reprocessing (emdr) (shapiro, 1989). although research on the feasibility and efficacy of emdr on addiction is limited and often lacks methodological rigor, the results are promising and suggest that further research on this subject is warranted. this proposal consists of two studies to test and determine the acceptability, feasibility and efficacy of emdr as an intervention to reduce craving and alcohol use in alcohol dependent outpatients as well as to gain further understanding in underlying working mechanisms.


Eligibility criteria:
inclusion criteria: * a primary diagnosis of alcohol dependence or abuse (meeting the diagnostic and statistical manual of mental disorders (dsm)-iv-tr criteria (american psychiatric association, 2000); * age of at least 18 years or older; * can speak and read dutch language; * consent (written) to postponed information given. exclusion criteria: * meeting the dsm-iv-tr (american psychiatric association, 2000) criteria for current (in the past 2 weeks) addiction and regular use (at least once per week in the last two weeks before baseline screening) of drugs other than alcohol or nicotine (relative exclusion: decision on case-by-case basis whether it leads to therapy-interference); * meeting the dsm-iv (american psychiatric association, 2000) criteria for current (in the last two weeks before baseline screening) regular alcohol use (at least \> 21e (women) or \> 28e (men) per week) (relative exclusion: decision on case-by-case basis) (relative exclusion: decision on case-by-case basis whether it leads to therapy-interference); * meeting the dsm-iv (american psychiatric association, 2000) criteria for current post-traumatic stress disorder (ptsd); * severe, current (since the start of regular treatment) psychiatric symptoms (especially manic, psychotic, suicidal and aggressive symptoms) that may endanger participants or others and jeopardize study adherence.

Keywords: emdr alcohol relapse craving
understanding angioplasty by the chocolate pta balloon catheter compared to conventional pta balloons via oct imaging

Conditions: Infrainguinal Peripheral Arterial Disease

Summary: the purpose of this study is to compare the chocolate pta balloon to standard percutaneous transluminal angioplasty (pta) catheters. the investigators will use optical coherence tomography (oct) and quantitative vascular angiography to evaluate the acute vascular response of vessels treated with the chocolate balloon to a standard balloon catheter, with the primary endpoint being luminal gain assessed by oct lumen volume measurements.

subjects will be randomized to treatment with either the chocolate balloon catheter or a standard balloon angioplasty catheter. all angioplasty procedures will be conducted with treatment balloon at the full discretion of the physician and according to the standard practice at the hospital and the device instructions for use. all patients will undergo baseline oct imaging in addition to standard angiography. post-pta, all patients will then undergo repeat oct imaging immediately post-procedure and then again at 10-minutes post-procedure to assess for vascular recoil.

Eligibility criteria:
inclusion criteria: * reference vessel diameter (rvd) between 2.5 and 6.0mm and within treatment range of available balloon at target lesion * intermittent claudication or critical limb ischemia (rutherford 3-5) * de novo stenosis (≥70%) or occlusion in the infrainguinal arteries, including superficial femoral artery (sfa), popliteal, and infrapopliteal arteries. * lesion successfully crossed with a guide-wire * patient has given informed consent to participate in this study exclusion criteria: * lesion requiring ablative procedures (i.e. atherectomy or laser) as part of treatment * lesion length \>75mm * previous bypass or stent at target vessel or proximal to target vessel * significant in-flow disease at target lesion * known inadequate distal outflow disease or planned treatment of vessel distal to target lesion * acute limb ischemia or need for thrombolytic therapy * known intolerance to required study medications, contrast media, or nitinol * known impaired renal function with glomerular filtration rate (gfr) \<45 ml/min per 1.73m2 * known bleeding disorder or uncontrolled hypercoagulable disorder.

Keywords: oct pta balloon
pain trajectories and predictors after noncardiac surgery in elderly patients

Conditions: Acute Postoperative Pain; Trajectory

Summary: this study will use group-based trajectory modeling to identify the different postoperative pain trajectory groups that exist in a mixed surgical population (non-cardiac surgery) of elderly patients during the first seven days after surgery. the aim of this study is to explore the diversity in the development of postoperative pain among elderly patients and to identify the risk factors for acute pain trajectory after surgery by investigating demographic, psychological, and clinical variables. the predictive effect of different trajectories of early postoperative acute pain on postoperative chronic pain will also be explored.


Eligibility criteria:
inclusion criteria: 1. scheduled for thoracic, urologic, gastrointestinal, gynecological, liver, biliary/pancreatic, or major orthopedic surgery under general anesthesia 2. age ≥ 65 years 3. the american society of anaesthesiologists(asa) i to iii 4. duration of hospitalization ≥ 72 hours exclusion criteria: 1. language disorder; 2. hearing impairment; 3. visual impairment; 4. the expected postoperative intubation time is more than 24 hours; 5. critical events occurred during the perioperative period.

Keywords: acute postoperative pain, pain trajectory, chronic pain, elderly patient
quality of life after abdominoperineal resection for rectal cancer, comparing two surgical techniques

Conditions: Rectal Cancer

Summary: the purpose of the study is to compare self-reported health related quality of life after two different operating techniques for low rectal cancer operated by rectal amputation, using a specific and detailed questionnaire. the population has been operated over a 6 year period in one university hospital.

low rectal cancer treated by abdominoperineal resection (apr, rectal amputation)has worse prognosis than other rectal cancers, both regarding local recurrence and cancer specific survival. with a view to improve local recurrence rates a more extensive perineal operation (excision of the levator muscle) has been suggested. in our university hospital thie technique was introduced for all surgeons january 2007. a population of all patients operated from 1 january 2007 to 31 december 2009 was compared to all patients operated from 1 january 2004 to 31 december 2006 using the traditional, less extensive method, in all a six year period and 158 patients. a specific questionnaire was developed after in depth interviews, and was face-validated by patients who had undergone an apr. this questionnaire will be sent out to all patients in our population who are still alive. the patients will be contacted first by a letter of invitation, later called by telephone to be given more information and asked for permission to send the questionnaire. the send out of invitation letters will start march 2011.

Eligibility criteria:
inclusion criteria: * rectal cancer operated by abdominoperineal resection 2004-2009 exclusion criteria: * no informed consent

Keywords: rectal cancer
the relationship between the flow of arteriovenous fistula and cardiac function in haemodialysis patients

Conditions: Complication of Hemodialysis

Summary: a prospective longitudinal surveillance for a period of 2 months. sample - identify suitable chronic kidney disease (ckd) patients who undergo hd with functioning avf. participants at various age range and both sexes are recruited to observe their access flow, access recirculation and cardiac function and assess their relationship.

all patients recruited who met the inclusion criteria were investigated access flow, access recirculation and cardiac function(including cardiac output,cardiac index,central blood volume,et al).measurement time is the beginning of hd session (first 30min to 1 hr),middle of hd session (optional),and the end of the hd session (1hr to 30 min prior to end of session). the follow-up duration is 6 months and 12 months.repeat the assessment at the above time points.

Eligibility criteria:
inclusion criteria: * patients undergo hd with native avf * af of avf between 300ml/min and 1800ml/min exclusion criteria: * patients whose avf developed access recirculation (ar) which cannot be resolved at the time of measurement * patients developed access or systemic infection during the study period

Keywords: access flow access recirculation cardiac output cardiac index hemodialysis
manage-af registry -management of atrial fibrillation outcomes registry (manage-af)

Conditions: Atrial Fibrillation

Summary: the purpose of this research is to learn more about the normal care of patients with a new or pre-existing diagnosis of atrial fibrillation (af). these abnormal and irregular heartbeats place patients at increased risk of developing clots in their bloodstream that could potentially lead to stroke. normal care is designed to help prevent this from happening and to lessen or eliminate the symptoms patients may have. there are many different types of af as well as numerous ways in which a variety of patients are treated. the investigators are interested in gathering more information to better keep track of patient treatment patterns (trends) that may differ from physician to physician, hospital to hospital, medication to medication, patient to patient and if necessary, procedure to procedure.

the objective of this research is to establish a contemporary and simple to construct af management registry that expands progressively over the continuum of care for each individual patient. the registry will be used to determine the course and progression of af management in preventing thrombo-embolic events using rhythm and rate control interventions. primary endpoints: 1. atrial fibrillation natural history 2. thrombo-embolic event 3. death secondary endpoints: 1. bleeding 2. pro-arrhythmia 3. patient adherence 4. treatment complication

Eligibility criteria:
inclusion criteria: 1. diagnosis of valvular or non valvular atrial fibrillation 2. ecg documented atrial fibrillation a. 12 lead b. rhythm strip c. event monitor d. holter monitor e. implantable loop recorder exclusion criteria: 1. age below 18 years. 2. clinical evidence that death within 6 months is possible 3. inability to consent to the research or sign a consent form 4. inability to follow up at the research clinic at least annually for continuity of af care and management

Keywords: atrial arrhythmia atrial fibrillation stroke bleeding left atrial appendage occlusion
effect of butorphanol combined with flurbiprofen axetil on preventing hyperalgesia induced by remifentanil in patients

Conditions: Pain; Anesthesia

Summary: purpose: to explore and compare antihyperalgesic effects of butorphanol, flurbiprofen axetil, and a combination of both received before anesthesia induction. to evaluate and examine the incidence of adverse effects with the purpose of selecting the optimum dose. .

there are a dramatically increasing number of evidences that administration of the potent, ultra-short-acting opioid remifentanil seems to cause opioid-induced hyperalgesia (oih) more frequently and predictably compared with the others, likely due to its rapid onset and offset. therefore, prophylaxis of remifentanil induced hyperalgesia is indispensable to postoperative comfort and satisfaction. there is no denying the fact that oih is related to central glutaminergic system and n-methyl-d-aspartate (nmda) receptor-activation induced central sensitization. prostaglandins can promote glutamate release from both astrocytes and spinal cord dorsal horns with subsequent activation of the nmda receptors, and flurbiprofen axetil, as non-steroidal anti-inflammatory drugs (nsaids), not only functionally antagonizes the nmda receptor activation via inhibition of prostaglandins, but also is a targeted drug which gathers at the site of inflammation, thus greatly enhances the analgesic effect. while butorphanol has both spinal analgesic and sedative functions because of predominantly central κ-receptor agonist activation, other advantages of butorphanol include few side effects, very low addiction potential, and low toxicity on account of a partial agonist-antagonist activity to μ-receptor. moreover, antihyperalgesic activity of κ opioids at the site of inflammation has been reported in various acute pain models. the following study is carried out to evaluate whether butorphanol combined with flurbiprofen axetil can be safely and effectively applied to preventing postoperative hyperalgesia induced by remifentanil in patients undergoing lower abdominal surgery.

Eligibility criteria:
inclusion criteria: 1. subject is scheduled to undergo lower abdominal surgery under a short general anesthesia of less than 2 hours 2. subject's american society of anesthesiologists physical status is i-ii. 3. the subject's parent/legally authorized guardian has given written informed consent to participate. exclusion criteria: 1. subject has a diagnosis of renal or liver failure. 2. subject has a diagnosis of insulin dependent diabetes. 3. subject is allergy and contraindication to butorphanol or nsaids. 4. subject has a history of chronic pain, a history of alcohol or opioid abuse, pre-existing therapy with opioids, intake of any analgesic drug within 48 hours before surgery. 5. subject has any contraindication for the use of patient-controlled analgesia (pca). 6. subject is pregnant or breast-feeding. 7. subject is obese (body mass index \>30kg/m\^2).

Keywords: remifentanil opioid-induced hyperalgesia postoperative pain pain intensity
repetitive brake activation

Conditions: Eating; Obesity; Ileal Brake

Summary: the appearance of intact macronutrients in the small intestine induces an intestinal brake; a negative feedback mechanism from different parts of the intestine to the stomach, the small intestine and to the central nervous system. these processes inhibit food processing, appetite sensations and food intake, and furthermore they increase feelings of satiety and satiation. several studies showed that intraileal infusion of nutrients resulted in a reduction in food intake. however only acute effects were investigated in these studies and thus far it is not known whether repetitive (intermittent) infusion results in adaptation to repeated exposure and, thus, a lowered ileal brake response.


Eligibility criteria:
inclusion criteria: * based on medical history and previous examination, no gastrointestinal complaints can be defined. * age between 18 and 65 years. a higher age comes with a higher chance of comorbidities. these could influence our study outcomes and therefore this age range was chosen. furthermore, we think this study would be too invasive for subjects over the age of 65. this study will include healthy adult subjects (male and female). women must be taking contraceptives. * bmi between 18 and 25 kg/m2) * weight stable over at least the last 6 months (≤5% weight change) exclusion criteria: * history of severe cardiovascular, respiratory, urogenital, gastrointestinal/ hepatic, hematological/immunologic, heent (head, ears, eyes, nose, throat), dermatological/connective tissue, musculoskeletal, metabolic/nutritional, endocrine, neurological/psychiatric diseases, allergy, major surgery and/or laboratory assessments which might limit participation in or completion of the study protocol. the severity of the disease (major interference with the execution of the experiment or potential influence on the study outcomes) will be decided by the principal investigator. * use of medication, including vitamin supplementation, except oral contraceptives, within 14 days prior to testing * administration of investigational drugs or participation in any scientific intervention study which may interfere with this study (to be decided by the principle investigator), in the 180 days prior to the study * major abdominal surgery interfering with gastrointestinal function (uncomplicated appendectomy, cholecystectomy and hysterectomy allowed, and other surgery upon judgement of the principle investigator) * dieting (medically prescribed, vegetarian, diabetic, macrobiological, biological dynamic) * pregnancy, lactation * excessive alcohol consumption (\>20 alcoholic consumptions per week) * smoking * blood donation within 3 months before the study period * self-admitted hiv-positive state * evidence of casein or hypersensitivity

Keywords: ileal brake
a retrospective study on the systemic treatment of lpp and ffa

Conditions: Cicatricial Alopecia; Lichen Planopilaris; Lichen Plano-Pilaris; Frontal Fibrosing Alopecia; Hair Diseases; Scarring Alopecia; Hair Loss/Baldness

Summary: this retrospective study aims to assess the effectiveness of systemic treatments for lichen planopilaris (lpp) and frontal fibrosing alopecia (ffa) in patients treated at the erasmus mc university medical center. lpp and ffa are chronic inflammatory hair disorders leading to irreversible hair loss. the study evaluates treatment responses to systemic medications, including hydroxychloroquine, methotrexate, cyclosporine a, and retinoids.

cicatricial alopecia, also known as scarring alopecia, refers to a group of rare chronic inflammatory hair disorders resulting in irreversible hair loss. lichen planopilaris (lpp) and frontal fibrosing alopecia (ffa) are the most common forms of primary lymphocytic cicatricial alopecia, affecting predominantly postmenopausal women. these conditions lead to significant quality of life impairment due to their chronic nature and the lack of effective, standardized treatment protocols. the study aimed to address the gap in evidence-based treatment guidelines by investigating the effectiveness of various systemic therapies currently used in clinical practice. the retrospective cohort study reviewed medical records of patients diagnosed with lpp or ffa at the department of dermatology, erasmus mc university medical center, from july 2016 to july 2022.

Eligibility criteria:
inclusion criteria: * diagnosis of lpp or ffa * 18 years or older exclusion criteria: * other forms of cicatricial alopecia than lpp or ffa

Keywords: systemic treatment
endothelial hyperpolarization in humans

Conditions: Hyperlipidemia

Summary: the purpose of this study is to elucidate the role endothelium-derived hyperpolarizing factor (edhf) plays in dilating blood vessels and whether it differs between healthy people and those with high cholesterol. a second purpose of the study is to determine the identity of edhf.

the vascular endothelium synthesizes at least four potent vasodilator substances: nitric oxide (no), prostacyclin, carbon monoxide and endothelium-derived hyperpolarizing factor (edhf) that contribute to vasodilator tone, and to inhibition of platelet activation and inflammation. edhf release is stimulated by receptor-dependent agonists such as acetylcholine and bradykinin (bk), and leads to hyperpolarization of the underlying smooth muscle cells presumably by opening ca2+-activated k+ channels. indirect pharmacological evidence suggests that edhf is a cytochrome p450-derived arachidonic acid metabolite, presumably an epoxide. although the pivotal role of no to conduit vessel dilation in response to acute increases in shear stress is well known, its' contribution to dilation with sustained increases in flow are minimal, and may be due to edhf release.

Eligibility criteria:
inclusion criteria: * hyperlipidemic (ldl \> 140) * healthy volunteer exclusion criteria: * pregnancy * diabetes mellitus * cardiovascular disease * hypertension * use of any regular medications * renal insufficiency * smoking (current or within the past 5 years) * bleeding disorder

Keywords: hyperlipidaemia edhf fmd
intranasal ketamine with dexmedetomidine for the treatment of children with autism spectrum disorder

Conditions: Autism Spectrum Disorder

Summary: autism spectrum disorder (asd) is a life-long neurodevelopmental disorder characterized by qualitative abnormalities in reciprocal social interactions and patterns of communication, and by a restricted, stereotyped, repetitive repertoire of interests and activities. the use of medications in adolescents and young adults with asd is extremely common. however, few data address the effectiveness and harms of medications specifically in this population. the purpose of the study is to determine the efficacy and safety of intranasal ketamine with dexmedetomidine in children with asd.

the use of medications in adolescents and young adults with asd is extremely common. few data address the effectiveness and harms of medications specifically in this population. a previous study reported the first case study demonstrating clinical improvement in mood and eye fixation scores from intranasal ketamine treatment in a "complicated" subject with autism spectrum disorderhowever,the purpose of the study is to determine the efficacy and safety of intranasal ketamine with dexmedetomidine in children with asd.

Eligibility criteria:
inclusion criteria: 1. meet autism diagnostic criteria based on dsm-5/adi-r/ados 2. children aged 2 years through 15 years of age 3. parents/guardians can cooperate with the study and sign informed consent 4. asa score i or ii exclusion criteria: 1. with epilepsy or other genetic diseases 2. changes in drugs or in any intervention during the study 3. presence of cardiac disease including coronary artery disease, congestive heart failure, or uncontrolled hypertension per medical history 4. airway instability, tracheal surgery, or tracheal stenosis per medical history. 5. history of drug or alcohol abuse 6. central nervous system masses or hydrocephalus per medical history

Keywords: autism spectrum disorder ketamine dexmedetomidine