Kornimate/medical-research-clean huggingface dataset:
additive anti-inflammatory action for critically ill patients with cardiovascular surgery (xuebijing) iv

Conditions: Cardiovascular Disease; Aortic Dissection; Coronary Artery Disease; Valve Heart Disease; Congenital Heart Disease; Critical Illness

Summary: xuebijing, a chinese herbal derived therapeutic, has been approved to treat severe infections (sepsis) in critically ill patients (china food and drug administration; beijing, china, number z20040033). cardiopulmonary bypass (cpb) will produce large amounts of inflammatory mediators and oxygen free radicals, which causes the lipid peroxidation damage and mononuclear cell migration, thus aggravating organ inflammation and damage. therefore, exploring new methods to prevent and alleviate organ injury caused by cpb is an important topi in clinical practice. however, little knowledge is regarding the effect of xuebijing injection on cpb-related organ injury. to answer these questions, the authors conducted this randomized trial to compare xuebijing with placebo in critically ill patients with cardiovascular surgery.


Eligibility criteria:
inclusion criteria: 1. patients who received cardiovascular surgery fulfilled three or more of the following criteria: * pao2/fio2 ratio less than or equal to 250mm hg, * respiratory rate greater than or equal to 30 breaths/min, * blood urea nitrogen greater than 20mg/dl, * wbc count \ 15 000 cells/mm3 not due to other causes, * core temperature \ 38.5°c, * receiving treatment with vasopressors at therapeutic doses after adequate fluid resuscitation, * radiographic findings of new pulmonary infiltrate(s). 2. agree to participate in the study and sign the informed consent. exclusion criteria: 1. pregnant and lactating women. 2. allergic to xuebijing and its ingredients, or have severe allergies. 3. mental illness with poor compliance. 4. severe primary disease (active pulmonary tuberculosis, asthma, cystic pulmonary fibrosis, pulmonary sarcoidosis, pulmonary interstitial fibrosis, unresectable tumors, blood diseases, alzheimer s disease, or hiv). 5. participation in other clinical trials in the previous 30 days. 6. patients who are unsuitable for participation or unable to participate in this trial according to the judgment of the investigators (existing risk of potential medical disputes, and severe heart failure limiting the amount of liquid intake).
short course terlipressin for control of acute variceal bleeding

Conditions: Hemorrhage; Esophageal Varices; Portal Hypertension

Summary: the purpose of this study is to determine whether 24 hours of terlipressin is as effective as 72 hours of terlipressin in preventing re-bleed once esophageal variceal bleed has been controlled with endoscopic therapy (variceal band ligation or sclerotherapy) in low to moderate risk variceal bleed patients and hence can save cost and may decrease length of hospital stay especially in the i.c.u or high dependency units.

the esophageal variceal bleeding is usually controlled with endoscopic treatment of variceal band ligation or sclerotherapy along with vasoactive drugs like terlipressin or octreotide. the risk of re-bleeding is highest during the initial 5 days from first presentation. terlipressin is usually given for 3 days (72 hours). in this study we are trying to prove that among low to moderate risk patients, a short course of 1 day (24 hours) of terlipressin is as effective as 3 days (72 hours) in preventing re-bleed once bleeding has been controlled with endoscopic therapy. this intervention will save 2 days cost incurred on the terlipressin and may also help in decreasing the length of hospital stay in future.

Eligibility criteria:
inclusion criteria: * acute esophageal variceal bleed * liver cirrhosis * child's score \</= 11 exclusion criteria: * patient on mechanical ventilator and or ionotropic support * active angina, recent myocardial infarction or dynamic ekg changes * failure to control variceal bleed on initial endoscopy * gastric variceal bleed * spontaneous bacterial peritonitis at presentation * hepatocellular carcinoma or other liver metastatic malignancy * portal vein thrombosis

Keywords: esophageal varices portal hypertension melena hematemesis gastrointestinal hemorrhage terlipressin efficacy safety
a head-to-head comparison of a new perfusion tracer, 99mtc-4boh vs. 13n-nh3 to evaluate diagnostic efficacy of ischemic heart disease

Conditions: Coronary Artery Disease

Summary: the objective of the study is to assess the diagnostic efficacy (specificity and sensitivity) of 99mtc-4boh spect myocardial perfusion imaging (mpi) compared to 13n-ammonia pet mpi in the detection of significant coronary artery disease (cad) as defined by invasive coronary angiography (ica).

the goal of this trial is to evaluate whether spect myocardial perfusion using the novel tracer 99mtc-4boh is non-inferior to 13n-ammonia pet in diagnosing myocardial ischemia in patients with fractional flow reserve (ffr) as the diagnostic gold standard. in this study, 13n-ammonia pet imaging will be used as the positive control. patients with diagnosed cad who are scheduled for myocardial perfusion imaging will be assigned to undergo head-to-head spect imaging with 99mtc-4boh and pet imaging with 13n-ammonia, with no more than 7 days between scans. all participants will subsequently undergo coronary angiography with ffr measurement within 30 days of imaging. the diagnostic performance of 99mtc-4boh will be compared to that of 13n-ammonia, using ffr as the reference standard.

Eligibility criteria:
inclusion criteria: * age between 18 and 80 years. presence of angina symptoms, such as chest tightness or chest pain. coronary ct angiography (cta) indicating ≥50% stenosis in at least one coronary artery. able and willing to provide written informed consent. exclusion criteria: * underwent coronary revascularization (pci or cabg) within the past 6 months. presence of non-ischemic heart disease or left ventricular ejection fraction (lvef) \<35%. contraindications to adenosine stress (e.g., bronchial asthma, second-degree or higher atrioventricular block, severe hypotension). pregnancy or lactation. unable or unwilling to sign the informed consent form.

Keywords: myocardial blood flow quantification novel spect tracer myocardial perfusion imaging
an examination of cognitive and sensorimotor processes in patients with epilepsy

Conditions: Epilepsy

Summary: the overall goal of this project is to better understand the micro-physiology of human epilepsy and cognition using the intracranial electroencephalogram (ieeg), electrical brain stimulation, functional magnetic resonance imaging (fmri), and histology.

the overall goal of this project is to better understand the micro-physiology of human epilepsy and cognition using ieeg, electrical brain stimulation, fmri, and histology. specific aim 1: mapping cognitive networks using intracranial electrodes, functional magnetic resonance imaging, and cognitive tasks. to identify brain areas and mechanisms involved in cognitive function we will ask participants to perform tasks while their brain activity is measured with intracranial electrodes or functional magnetic resonance imaging (fmri). specific aim 2: using microelectrodes to better understand the mechanisms of seizure genesis/spread and human cognitive function. we will use microelectrodes to measure activity within single neurons, data that will allow us to tease apart incoming and outgoing activity to a brain area. specific aim 3: using macroscale measures of brain connectivity to map functional and epileptogenic brain areas. we will measure connectivity between macroscale brain regions via variety of techniques: diffusion tensor imaging (dti), fmri, cortico-cortical evoked potentials (ccep), and intracranial electrophysiology. we believe that epileptogenic and functional regions will be mutually segregated by their connectivity patterns. specific aim 4: using eeg/ieeg source localization to better identify the sources of epileptiform activity. we will construct models of participants' heads via mri and ct, which will potentially allow us to localize the neural generators of eeg and ieeg recordings. specific aim 5: investigating the effects of transcranial and direct electrical stimulation on cortical excitability and cognitive function. we will apply direct electrical brain stimulation to epileptogenic and functional brain regions and evaluate the effects of this stimulation on electrode recordings, cceps, and cognitive tasks. electrical stimulation may be applied with consideration of endogenous cognitive biomarkers to probe and elucidate the function of these biomarkers as they relate to cognitive function. specific aim 6: studying local connectivity of epileptic brain tissue with histology. we will reserve a small portion of resected brain tissue from patients who have undergone surgical resection for histological analysis to better understand altered patterns of neural connectivity in epilepsy.

Eligibility criteria:
inclusion criteria: * subjects are selected on the basis of intractability of their seizures to medical intervention by antiepileptic drugs and following a noninvasive workup that indicates the patient would be an excellent candidate for resective surgery. exclusion criteria: * patient is under the age of 5

Keywords: epilepsy fmri electrophysiology cortical mapping neurosurgery
rheumatic diseases: evaluation of health literacy, medication adherence and knowledges

Conditions: Rheumatic Diseases; Treatment Adherence

Summary: a medication non-adherence is reported in chronic rheumatic diseases, in a context of complex and long-term treatments (injectable/per os targeted therapies, biosimilar...). understanding and integrating the patient into a shared medical decision are key factors for adherence. from this perspective, the level of literacy (an individual's ability to find, understand and use health information) must be explored in order to adapt the communication of information. these are currently insufficiently adapted to the individual understanding of patients. in practice, literacy assessment is very poorly integrated into routine care, while several tools are validated in french. in rheumatology, foreign studies have shown that literacy is positively related to knowledge level. the results remain contradictory regarding its association with medication adherence. today, the literacy level of patients with rheumatic diseases and its impact on adherence has not been studied in france, although these evaluations would be useful to adapt interventions individually. the acceptance of patients to complete a literacy assessment questionnaire during their care should also be analysed as a condition of its deployment.


Eligibility criteria:
inclusion criteria: * patient older than 18 years * having at least 6 months of disease-modifying rheumatic treatment (methotrexate and/or targeted treatment (anti-jak) and/or subcutaneous biotherapies) * understanding french, * with good visual acuity. exclusion criteria: * patients with cognitive disorders * pregnant, parturient and lactating women * persons deprived of their liberty * major persons who are subject to a legal protection measure (guardianship, curators) * persons not affiliated to a social security system
evaluation of new hemodynamic indices

Conditions: Septic Shock

Summary: the objective is to determine the sensitivity and specificity via receiver operating characteristic (roc) curve of global longitudinal strain (gls) the secondary objectives are the same for the change in the amount of carbon dioxide exhaled (δetco2) and dynamic arterial elastance (eadyn). it will also determine the sensitivity and specificity of these indices, either individually or combined to determine persistent responders to volemic expansion.

the best practice recommendations are to evaluate the preload dependence before performing a vascular filling test. this evaluation is based on the analysis of dynamic hemodynamic indices such as the variation of pulsed pressure (vpp), the variation of the volume of ejection (vve) or the variation of the cardiac output during the realization of a test of rising of passive leg (eljp). however, these indices require strict validation conditions. new hemodynamic indices have appeared recently and appear promising in the evaluation of preload dependence. among them, the analysis of longitudinal myocardial deformity by speckle tracking (gls) and its variation during an eljp (δgls). the analysis of changes in the amount of co2 exhaled (δetco2) reflects cardiac output in ventilated patients or the analysis of dynamic arterial elastance (eadyn) calculated by comparing the vpp and the evv which is a reflection of the coupling between the left ventricle and the arterial network. in this work the assumption that the analysis of δ gls, δetco2 and eadyn can predict the response to volume expansion in the ventilated patient, in septic shock under vasopressor. the investigators include at least 51 patients, ventilated, under vasopressors with septic shock. gls, cardiac output, vvp, vve, blood pressure, eadyn, etco2 will be measured before and after eljp. in the event of an increase of more than 10% in cardiac output during the eljp, patients will receive a volume expansion of 500ml of balanced crystalloids. the same measurements will be repeated immediately at the end of the volume expansion and 20 minutes after the end of the infusion. patients with a 15% increase in cardiac output at the end of volume expansion will be classified as responders. patients with a 15% increase in cardiac output 20minutes after the end of volume expansion will be classified as persistent responders.

Eligibility criteria:
inclusion criteria: * patient presenting a shock whose etiology is considered as septic. * patient whose hemodynamic state justifies the infusion of vasopressor. * patient monitored by a cardiac output measurement system calibrated by transpulmonary thermodilution. * intubated patient with expired capnia monitoring * patient with signs of low cardiac output exclusion criteria: * patient with a contraindication in the leg lift test. * patient with abdominal compartment syndrome. * patient with amputation of one or both lower limbs. * pregnant woman eliminated by a systematic pregnancy test at the entrance to the intensive care unit. * minor patient. * refusal to participate in the study.
oral dexamethasone for the treatment of cervical radiculopathy

Conditions: Cervical Radiculopathy

Summary: the purpose of this study is to determine whether dexamethasone is effective in the treatment of pain and disability resulting from a compressed spinal nerve in the neck (cervical radiculopathy).

cervical radiculopathy is causes both short and long term pain and diability. the current proven treatments include pain killers or surgery if there if patients experience progressive weakness or signs or spinal cord compression. observations in both animal models and humans indicate that there is an inflammatory component to it. corticosteroids (such as dexamethasone)are potent anti-inflammatories which may benefit people suffering from this condition. there is some evidence to support neck injections of drug directly onto the nerve root. this mmethod of drug delivery has been implicated with some serious complications such as paralysis and stroke. delivering these medications in a pill form may provide a similar benefit without some of the serious complications.

Eligibility criteria:
inclusion criteria: * ages 18 - 60 * arm and neck pain consistent with cervical radiculopathy * neck disability index score of at least 15 (moderate) * symptom onset between 2 weeks and 6 months prior to enrollment exclusion criteria: * actively immunosuppressed state * clinical red flags consistent with possible infection or malignancy * acute febrile illness or infection requiring antibiotics * upper motor neuron signs consistent with myelopathy * previous orthopedic neck surgery in the area of that nerve root * known hepatic dysfunction * schizophrenia * pregnancy/nursing mothers * previous chronic corticosteroid use * diabetes mellitus on treatment * rapidly improving course * osteoporosis * hypersensitivity to product components * systemic fungal infection * recent administration of live vaccine * active tuberculosis * glaucoma * peptic ulcer disease

Keywords: cervical radiculopathy dexamethasone corticosteroid oral
the effects of z-338 in subjects with and without functional dyspepsia

Conditions: Dyspepsia

Summary: to assess in subjects with and without functional dyspepsia the effects of z-338 on: 1. type and severity of symptoms a standardized nutrient challenge 2. the gastric nutrient distribution and gastric emptying of a standardized nutrient challenge 3. the association of the above with the manifestations of symptoms and symptom pattern


Eligibility criteria:
inclusion criteria: 1. subjects with functional dyspepsia positive documented diagnosis of fd via romeii criteria and three or more moderate symptoms of gastrointestinal score 2. subjects with no history of functional dyspepsia clinical assessment, physical examination and laboratory testing without evidence for relevant abnormality. other protocol-defined inclusion/exclusion criteria may apply.
combination of benazepril plus hydrochlorothiazide in chinese patients with mild to moderate essential hypertension

Conditions: Hypertension

Summary: this study will evaluate efficacy and safety data for benazepril/hydrochlorothiazide in adult chinese patients with mild to moderate essential hypertension. patients whose blood pressure is not adequately controlled with benazepril monotherapy during a 4 week run-in period will be randomly allocated to double blind treatment over 8 weeks with either a combination of benazepril/hydrochlorothiazide per day or continuation of benazepril per day.


Eligibility criteria:
inclusion criteria: * male or female patients, age 18 or older * given informed consent * diagnosed as having mild to moderate essential hypertension exclusion criteria: * severe hypertension * significant preexisting cardiovascular and cerebrovascular disease * diabetes mellitus type 1 or poorly controlled diabetes mellitus type ii * advanced renal impairment other protocol-defined inclusion/exclusion criteria may apply.

Keywords: hypertension, benazepril, hydrochlorothiazide, fixed combination
the effect of remifentanil on ed95 of remimazolam for loss of consciousness in adult patients

Conditions: Remimazolam

Summary: this study prospectively uses the biased coin technique to investigate the effect of concomitant administration of remifentanil on the 95% effective dose of intravenous remimazolam (effective dose 95 \[ed95\]) required for loss of consciousness during anesthesia induction. .


Eligibility criteria:
inclusion criteria: * the adult patients who are scheduled to surgery under general anesthesia exclusion criteria: * severe obesity (bmi \> 30 kg/m2) * allergy to remimazolam or remifentanil * under conditions which make it difficult to respond to the investigator's verbal commends like hearing impairment, etc. * patients with general conditions are more than asa class iii * patients with brain disease (dementia, cerebral infarction, etc.)
safety of secretrol® in the short-term management of patients undergoing endoscopic mucosal resection (emr)

Conditions: EMR Ulcer

Summary: evaluate the safety of secretrol® in patients undergoing endoscopic mucosal resection for early adenocarcinoma of the esophagus.


Eligibility criteria:
inclusion criteria: * category 4-high-grade intraepithelial neoplasia * ages 18 or older * signed informed consent form * signed health insurance portability and accountability act (hipaa) authorization form exclusion criteria: * clinically relevant data suggesting an unknown disease and requiring further evaluation by the primary investigator. * patients with renal failure or organ transplants. * patients who have known allergic reactions to proton pump inhibitors (ppi). * participation in another study that would interfere with study endpoints within 30 days prior to screening. * previous enrollment into the current study. * patient is the investigator, his family member or employee at the investigational site. * patient known or suspected to be involved in alcohol or drug abuse. * known or suspected history of non-compliance with medications. * inability to follow the procedures of the study (e.g., due to language problems, psychological disorders) * patients receiving prohibited concomitant medications including ppis, h2-blockers, sucralfate, misoprostol. * patients receiving prohibited concomitant medications including clopidogrel, ketoconazole, digoxin, diazepam, warfarin, phenytoin, emtricitabine/nelfinavir/tenofovir, atazanavir, citalopram, emtricitabine/rilpivirine/tenofovir, rilpivirine, nelfinavir, tricyclic antidepressants, baclofen, tacrolimus, cyclosporine, cilostazol, disulfiram, methotrexate, voriconazole. * pregnancy or intention to become pregnant during the course of study, breast feeding, or unwillingness to use a highly effective means of contraception (oral contraception or intrauterine device). * prescription non-steroidal anti-inflammatory drug (nsaid) or aspirin use: the patient must be able to stop these meds 1 week prior to screening and during treatment. * history of upper gastrointestinal surgery, zollinger-ellison syndrome, esophageal stricture, peptic stricture, duodenal and ⁄ or gastric ulcer, esophageal motility disorders, inflammatory bowel disease (ibd), aids, pancreatitis, malabsorption, severe cardiovascular or pulmonary disease, liver disease, active malignant disease, scleroderma, diabetes mellitus, autonomic or peripheral neuropathy, myopathy, functional bowel disorder or any underlying disease or medication that might affect the lower esophageal sphincter pressure or increase the acid clearance time. * subject unable or unwilling to fully complete all stages of the study. * unable to sign informed consent or inability to give fully informed consent due to language problems, psychological disorder or mental deficiency.
misoprostol as a treatment for endometrial polyps in infertile patients

Conditions: Endometrial Polyps in Infertile Patients

Summary: endometrial polyps are one of the main causes of infertility in women. in this work we propose an alternative, effective, economical and safe treatment: the use of misoprostol

the prevalence of uterine polyps has been estimated in the general population at 10-15%, while in infertile patients it ranges from 6-32%. its etiology is considered as multifactorial. polyps induce a local inflammatory response in the endometrial cavity, causing infertility. the treatment of choice considered "gold standard" is the excision by hysteroscopy, however, improvement has been shown in patients with conservative management due to the regression rate of 27%. there are no recommended drugs to provide a definitive treatment for uterine polyps. misoprostol is a synthetic analogue derived from prostaglandin e1 that has stimulating effects on the smooth muscle fibers of the uterus, causing contractions of the myometrium, which cause endouterine evacuation. the present study shows a possible utility of misoprostol for the conservative treatment of uterine polyps.

Eligibility criteria:
inclusion criteria: * women with uterine polyps diagnosed by endovaginal ultrasound and/or hysterosonography, female ≤ 45 years of age exclusion criteria: * patients older than 45 years, polyps larger than 60 mm, who did not perform surveillance and/or minimum assessment 6 months after medical management