Kornimate/medical-research-clean huggingface dataset:
predictors of successful extubation in critically ill patients: multicentre observational study

Conditions: Intubation; Extubation; Weaning; Mechanical Ventilation; Liberation From Mechanical Ventilation; Critical Care

Summary: extubation failure can directly worsen patient outcomes. therefore, the decision to extubate is a critical moment during an intensive care unit (icu) stay. the decision to extubate is usually made after a weaning readiness test involving spontaneous breathing on a t-piece or low levels of ventilatory assistance. however, extubation failure still occurs in 10 to 20% of patients. the investigators focused on previously reported physiological risk factors, and were able to obtain from common clinical practice: 1) age, 2) underlying cardiovascular disease, 3) underlying respiratory disease or occurrence of pneumonia, 4) rapid shallow breathing index (rsbi), 5) positive fluid balance during the previous 24 hours, 6) the ratio of arterial oxygen partial pressure to fractional inspired oxygen, 7) glasgow coma scale, 8) respiratory tract secretions. the investigators aimed to assess the incidence and risk factors for extubation failure among critically ill patients who passed the 30 min spontaneous breathing test (sbt) using a low level of pressure support (ps) with positive end-expiratory pressure (peep), in a prospective multicenter study.

primary outcome measures: reintubation within 48 hours after extubation (logistic regression will be used to assess the risk factors) secondary outcome measures: * use of non-invasive positive pressure ventilation or nasal high flow within 48 hours after extubation. * risk factors for extubation failure, with quantitative variables expressed as means (standard deviation) or medians (interquartiles 25%-75%) and compared using the student t test or wilcoxon test as appropriate * length of icu and hospital stay, vital status at icu and hospital discharge, 28-day mortality

Eligibility criteria:
inclusion criteria: * mechanically ventilated for longer than 24 hours in intensive care units * extubated after successful the 30 min spontaneous breathing test using a low level of pressure support with positive end-expiratory pressure exclusion criteria: * decision not to reintubate * unplanned extubation * extracorporeal circulation * patients who died within 48 hours after extubation
the important project of obese pregnant women

Conditions: Overweight and Obesity

Summary: obesity is a globally growing public health problem. in 1993, about 25% of women in sweden were overweight (bmi over 25) or obese (bmi over 30) on the first visit to maternal health care. twenty years later, in 2013, the corresponding proportion was 38%. being fat increases the risk of several severe complications during pregnancy and childbirth, such as miscarriage, premature birth, congenital disabilities, intrauterine fetal death, thromboembolism, gestational diabetes, pregnancy-induced hypertension. purpose of the project: to assess whether the introduction of new guidelines for overweight pregnant women (bmi\>35) affects the outcome of pregnancy and childbirth, such as the frequency of cesarean sections or labor inductions.

a prospective cohort study involving all women with a bmi \>35 who give birth at the women's clinic, soder hospital, stockholm, between 2019-2023. new guidelines for this group are being developed using niceguidelines (uk) as a model and will be tested in clinical practice. information from births will be collected from medical files. the information will be handled on a group basis. internationally, there are guidelines for how pregnancy should be handled when a woman has a high bmi. this is currently lacking in swedish maternity care. these international guidelines have now been translated and adapted to swedish conditions and will be tested for a 2 year period at the women's clinic.

Eligibility criteria:
inclusion criteria: * : pregnancy where the woman has a bmi\>=35 when enrolling to prenatale care exclusion criteria: * pregnant women with bmi\<35

Keywords: bmi, obesity
efgartigimod for the treatment of guillain-barré syndrome

Conditions: Guillain-Barre Syndrome (GBS)

Summary: the goal of this clinical trial is to evaluating the efficacy and safety of efgartigimod in the treatment of guillain-barré syndrome and exploring the immunological mechanisms of efgartigimod therapy in guillain-barré syndrome. the main questions it aims to answer are: will efgartigimod improve the symptoms of participants? what medical problems do participants have when using efgartigimod? participants will: on day 1 and day 5 of the treatment period, drug a was administered intravenously. keep a diary of their symptoms


Eligibility criteria:
inclusion criteria: 1. aged 18 years or older; 2. meet the diagnostic criteria as specified in the \*european guidelines for the diagnosis and treatment of guillain-barré syndrome 2023 edition\*; 3. onset of gbs symptoms within 2 weeks prior to enrollment; 4. gbs-ds score of 3-5; 5. written informed consent obtained. exclusion criteria: 1. patients with gbs symptoms for more than 2 weeks; 2. known hypersensitivity of the study subject to any component of the investigational drug or any other anti-neonatal fc receptor (fcrn) agent; 3. any uncontrolled active infection or severe infection within 8 weeks prior to screening; 4. patients with other autoimmune diseases, such as sjögren's syndrome, systemic lupus erythematosus, neuromyelitis optica, myasthenia gravis, multiple sclerosis, etc., requiring treatment with immunosuppressive agents; 5. vaccination within 4 weeks prior to screening or planned vaccination during the study period; 6. pregnant or breastfeeding, or planning to become pregnant during the study period, or women of childbearing potential not using effective contraception; 7. currently participating in another clinical trial of similar investigational agents (fcrn antagonists); 8. use of the investigational drug within 3 months prior to screening or within five half-lives of the drug (whichever is longer); 9. patients with a history of malignancy, including malignant thymoma, myeloproliferative or lymphoproliferative disorders, unless considered cured by adequate treatment and without evidence of recurrence for ≥3 years prior to screening. patients with completely resected non-melanoma skin cancer (e.g., basal cell carcinoma or squamous cell carcinoma) or carcinoma in situ of the cervix are eligible at any time; 10. patients with clinical evidence of other significant severe diseases or who have recently undergone major surgery, which may confound study results or place the patient at undue risk. patients with severe renal/hepatic impairment may be included.
impact of initial diagnosis on mortality for patients hospitalised with acute myocardial infarction

Conditions: ST-elevation Myocardial Infarction; Non ST-elevation Myocardial Infarction

Summary: the aim of the study is to investigate the impact of an initial non-specific / non-cardiac diagnosis on mortality among patients hospitalised with acute myocardial infarction.


Eligibility criteria:
inclusion criteria: * patients aged between 18 and 100 years * patients discharged alive with stemi or nstemi exclusion criteria: * patients who die in hospital * patients not discharged with stemi or nstemi
implementation of non-size markers derived from 4d flow mri of patients with aortic disease.

Conditions: Aortic Valve Disease; Aortic Aneurysm

Summary: the aim of the investigator is to implement 4d flow mri technique into a clinical setting and evaluate the blood flow pattern and wall sheer stress in patients with aortic and/or aortic valve diseases.

currently, the timing of the replacement of the ascending aorta is solely based on the aortic diameter and concomitant valvular dysfunction and the most recent esc guideline proposes surgical intervention of ascending aortic aneurysm in patients who have a maximal aortic diameter ≥ 55mm, regardless of etiology. on the contrary, a recent publication by rylski et al showed that most of the dissections occur at diameters smaller than 55 mm. several publictions have shown that the flow profile and wall sheer stress derived from 4d flow mri are significantly different between the valve morphology, the type of the aneurysm (tubular or diffuse enlargement) and pre and postoperative patients. clinical implementation of 4d flow may enable us to stratify the patients with aortic and/or aortic valve diseases, especially in regard to the risk of ruptures. the patients with aortic/aortic valve disease will be referred to 4d flow mri and contrast-enhanced angiografie from the aorta clinic. phase 1: 6 healty adult volunteers will be scanned prior to the scan of the patients and settings would be optimised for 4d flow mri and the contrast will not be given. phase 2: 30 patients either scheduled for surgical treatment of their aortic disease, post-operative patients and patients under surveillance for known aortic root and/or aortic valve disease will be imaged. only patients having a clinical indication for an mri of the aorta/aortic valve will be included.

Eligibility criteria:
inclusion criteria: - patients with aortic aneurysm and/or aortic valve disease older than 18 years. exclusion criteria: * patients \<18 years * pregnancy. * patients who have known contraindiction of mri (ex claustrophobia, icd, insulin pump etc)

Keywords: 4d flow
omega-3 fatty acids efficacy in first-episode of schizophrenia

Conditions: Schizophrenia

Summary: there is accumulating experimental evidence to suggest the role of essential fatty acids (efa) in neuronal migration, pruning and synaptic plasticity. these processes are implied to be dysfunctional on early stages of schizophrenia, according to neurodevelopmental hypothesis. numerous epidemiological and clinical trial data support the benefit of efa rich diets in reducing symptoms in schizophrenia. an efa rich diet might be of particular importance at the beginning of the illness. as a relatively safe option, efa supplementation would be a preferable add on therapy in treating individuals with a first episode of schizophrenia (fes) and a short duration of psychotic symptoms. no long term follow-up studies of efa supplementation in fes patients were carried out. the demonstration of the efficacy of the prophylactic properties of efas in relapse prevention in fes patients would be a strong basis for further studies and prescribing efas for a large population of patients who are in the early stages of that debilitating illness.


Eligibility criteria:
inclusion criteria: * patients diagnosed with schizophrenia using diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv) criteria * patients aged between 16-35 years * signed informed consent (parallel parents consent for individuals under 18 years of age) exclusion criteria: * patients taking fish oil supplements (a washout period of 6 months is required) * patients diagnosed with epilepsy or suffering from epileptic seizures * patients receiving anticoagulant medication e.g., warfarin * patients receiving psychotherapy * chronic somatic diseases * psychoactive substance dependence * pregnancy and lactation * mental retardation or diagnosed organic brain injury

Keywords: early psychosis chronic schizophrenia first episode psychosis omega-3 and omega-6 essential fatty acids relapse prevention efficacy
time to appropriate antibiotic between using microarray assay and mass spectrometry technique

Conditions: Septicemia

Summary: this is an experimental study of participants who had positive blood culture to compare time to appropriate antibiotic between using microarray assay and mass spectrometry to bacterial identification.

between june to dec 2018, 200 participants those met the eligibility criteria were enrolled in this study that is a quasi experimental study. all participants were empirical antibiotic therapy by infectious physician. 100 patients in pre-intervention group had bacterial identification by mass spectrometry technique from bacterial colony and 100 patients in post-intervention group had bacterial identification by microarray assay from blood culture. antibiotic adjustment were considered after bacterial identification and result of antibiotic susceptibility testing. then all participants were re-evaluated outcome after treatment. finally, the results were ready to analysis in january 2019.

Eligibility criteria:
inclusion criteria: * age ≥ 18 year old with positive hemoculture between june 2018 and dec 2018 * internal medicine wards patients at maharaj nakorn chiang mai hospital * ability to provide informed consent exclusion criteria: * suspected contaminated positive blood culture * bacteremia cause by more than two species of bacteria, as suspected from the gram staining examinations * terminally ill patients

Keywords: microarray assay technique mass spectrometry technique time to appropriate antibiotic
lidocaine gel 2% and muscle traction pain during squint surgery in pediatrics

Conditions: Squint

Summary: assessing the efficacy of lidocaine gel 2% application 10 minutes before surgery on post operative pain and the use of analgesics postoperatively

after inhalational induction of anesthesia and applying the pulse oximeter to the patient's finger but and before cannulating or managing the patient's airway lidocaine gel 2% is efficiently applied to the surgical eye (to give more time for the gel to act without delaying the surgery) then cannulation and laryngeal mask inserted to maintain ventilation properly. applying lidocaine gel 2% should be filling the upper and lower 10 minute fornices before disinfecting the eye and starting the surgery the primary outcome is assessing postoperative pain and need for postoperative systemic analgesia the secondary outcome is to monitor the oculocardiac reflex intraoperatively and the need for intraoperative atropine.

Eligibility criteria:
inclusion criteria: * age 3 to 12 years * squint surgery exclusion criteria: * below 2 years or more than 13

Keywords: squint muscle traction pain
the resplash study

Conditions: Resistant Hypertension

Summary: to assess the safety and effectiveness of renal artery denervation with subsequent splanchnic nerves denervation via catheter-based radiofrequency ablation in improving blood pressure and glycemic control in patients with resistant hypertension and type 2 diabetes.

the investigators propose a multicenter, prospective, single blind, randomized controlled pilot study. patients with treatment-resistant hypertension and diabetes mellitus type 2 will be enrolled to undergo renal artery denervation with subsequent splanchnic nerves denervation for lowering blood pressure and glycemic levels. 20 patients will be randomly selected from outpatient cardiology clinics and will be assigned (1:1) to receive an fda approved catheter-based denervation (cdn) of the renal arteries or cdn of the renal arteries with subsequent cdn of the splanchnic nerves at the level of the celiac artery and sma. all patients will receive non-selective renal and mesenteric artery angiography prior and post cdn. all patients will undergo office systolic and diastolic blood pressure measurements, glycemic indices (hba1c, fasting plasma insulin, c-peptide), and other laboratory assessments (plasma norepinephrine, renin, aldosterone, angiotensin ii, lipids, and liver biochemistry) at baseline and outpatient follow-up visits (months 1, 3 and 6 post procedure).

Eligibility criteria:
inclusion criteria: * patients aged 18-75. * history of type 2 diabetes mellitus at least 5 years prior to enrollment. * hba1c level ≥6.5%. (is there an upper limits cutoff?) * use of at least 1 oral antidiabetic agent and no changes in the last 30 days. * history of essential hypertension with systolic blood pressure of 160 mmhg or more (≥150 mmhg in patient with type 2 diabetes mellitus), despite compliance with three of more antihypertensive drugs. * stable drug regimen of at least 3 antihypertensive medications with no changes for 2 weeks before enrollment. exclusion criteria: * estimated glomerular filtration rate of less than 30 ml/min per 1.73m2. * type 1 diabetes mellitus. * history of aortic pathologies such as aneurysm or dissection confirmed by immediate preprocedural angiography that would preclude the endovascular denervation (edn) procedure. * orthostatic hypotension. * acute or severe systemic infection. * history of myocardial infarction, unstable angina, or cerebrovascular accident in the previous 3 months. * history of previous renal artery cdn. * pregnancy or planned pregnancy during the study period. * unable to provide informed consent.

Keywords: renal sympathetic denervation splanchnic sympathetic denervation hypertension diabetes mellitus catheter-based radiofrequency ablation lowering blood pressure control of glycemic levels
use of lung ultrasound in evaluating physiological response to awake self proning

Conditions: Covid19

Summary: the primary objective of this study is to explore the physiological mechanism of awake, self proning among patients with acute hypoxemic respiratory failure induced by covid-19, using lus in the first three days and explore the predictive value of lus in patients' outcome.

lung ultrasound (lus) has recently gained popularity among the imaging methods to perform bedside assessment of critically ill patients to guide clinical management. lus is a non-invasive and easy-to-perform procedure that provides precise data on lung aeration, lung recruitment, lung morphology, and lung perfusion. studies have shown that lus is a useful tool in monitoring lung reaeration in intubated patients diagnosed with traditional ards undergoing prone positioning; however there are mixed findings in terms of the use of lus in predicting potential prone positioning response. a recent study found that the non-intubated covid-19 patients who responded to prone positioning had more pronounced disturbances of aeration in posterior regions, however, they only investigated patients' response to the first prone positioning and the information for the patients' outcome is lacking. in our previous study with intubated covid-19 patients, we found that patients' response to the subsequent prone positioning had higher predictive value than the response to the first prone positioning. therefore, the primary objective of this study is to explore the physiological mechanism of awake, self proning among patients with acute hypoxemic respiratory failure induced by covid-19, using lus in the first three days and explore the predictive value of lus in patients' outcome.

Eligibility criteria:
inclusion criteria: 1. adult subjects 18 years and older, 2. confirmed covid-19 diagnosis 3. acute hypoxemic respiratory failure (spo2/fio2 or pao2/fio2 \<300) 4. ordered self-prone positioning per medical team exclusion criteria: 1. pregnant 2. palliative care

Keywords: awake prone self prone
analysis the vocs in upper gi bleeding patients

Conditions: Upper GI Bleeding

Summary: this project aims to collect the exhaled breath of patients with acute upper gastrointestinal bleeding clinically, divide them into large, small and no bleeding groups according to the results of gastroscopy, analyze the characteristics of volatile organic compound components in exhaled breath, construct a discriminant model, and then analyze the sensitivity and specificity, and the target sensitivity and specificity reach more than 0.7, and formulate diagnostic criteria.

upper gastrointestinal bleeding is one of the most common gastrointestinal emergencies and has a high mortality rate. its clinical manifestations are hematemesis and melena, gastroscopy is the gold standard for diagnosing upper gastrointestinal bleeding, but due to its expensive equipment, long training cycle of personnel, gastroscopy itself is an invasive operation, poor patient tolerance, high risk of examination, often lead to the diagnosis of upper gastrointestinal bleeding is not timely, missing the best treatment time. volatile organic compound analysis in exhalation is based on the patient's metabolic component analysis technology, a new means of disease diagnosis, due to its advantages of convenient collection, non-invasive, rapid detection, etc., it has been applied in the diagnosis of various diseases such as drunken screening and helicobacter pylori infection, but has not been studied in the diagnosis of upper gastrointestinal bleeding. this project aims to collect the exhaled breath of patients with acute upper gastrointestinal bleeding clinically, divide them into large, small and no bleeding groups according to the results of gastroscopy, analyze the characteristics of volatile organic compound components in exhaled breath, construct a discriminant model, and then analyze the sensitivity and specificity, and the target sensitivity and specificity reach more than 0.7, and formulate diagnostic criteria. this study will improve the timeliness of upper gi bleeding detection, which is of great significance for effectively reducing the mortality rate of upper gi bleeding.

Eligibility criteria:
inclusion criteria: upper gi bleeding patients - exclusion criteria: severe cardiopulmonary disease -
sp-304 dose ranging study in patients with chronic idiopathic constipation

Conditions: Chronic Idiopathic Constipation

Summary: this is a phase 2a, randomized, double-blind, placebo-controlled, 14-day repeat oral, dose ranging study to determine the safety, pharmacokinetics (pk) and pharmacodynamics (pd) effects of sp-304 in patients with chronic idiopathic constipation.

this is a phase 2a, randomized, double-blind, placebo-controlled, 14-day repeat oral, dose ranging study to determine the safety, pk and pd effects of sp-304 in patients with chronic idiopathic constipation. patients diagnosed with chronic idiopathic constipation (cic) will be screened for the anticipated 4 cohorts, to yield 80 randomized patients for enrollment. four dose cohorts are planned (0.3 mg, 1.0 mg, 3.0mg, and 9.0 mg) with 20 patients per dose cohort \[randomization ratio 3:1 (15 receive sp-304:5 receive placebo)\]. patients who continue to meet all the entry criteria and complete the pre-treatment bowel movement (bm) diary will receive, in a double-blind, randomized fashion, sp-304 or matching placebo. it is expected that each patient will complete all 14 days of dosing (including making accurate bm diary entries for all 14 days in the treatment period). all patients receiving at least one dose of sp-304 or matching placebo will be considered evaluable for the safety endpoints. if a patient receives at least 5 doses per treatment week (1 dose per day for 7 days) and has completed bm diary entries for those 5 dosing days in each corresponding treatment week, he/she will be considered evaluable.

Eligibility criteria:
inclusion criteria: * subject is able to understand and willing to sign the informed consent form (icf) and capable of providing written authorization for use and disclosure of protected health information per requirements of 45 cfr 164.508 (health insurance portability and accountability act \[hipaa\]). * subject is male or non-pregnant, non-breastfeeding female, between 18 and 75 years of age (inclusive) at the time of first dose. * subject has a body mass index (bmi) between 18 and 35 kg/m2. * subject meets the rome iii diagnostic criteria for constipation (drossman, 2006) for the past 3 months with symptom onset \> 6 months prior to diagnosis. exclusion criteria: * subject reports loose stool (fluffy pieces with ragged edges, a mushy stool) or watery stool (no solid pieces, entirely liquid; bsfs score of 6 or 7, respectively) in the absence of any laxative, enema, suppository or prohibited medicine for \> 25% of bms during the 3 months prior to the screening visit and during the 14 day pre-treatment period. * subjects who meet the rome iii criteria for ibs. * subject has failed to complete the pre-treatment bowel movement diary accurately and completely during the pre-treatment period prior to day 1 dosing.

Keywords: chronic idiopathic constipation constipation irritable bowel syndrome