Kornimate/medical-research-clean huggingface dataset:
prospective multicenter study for early evaluation of acute chest pain

Conditions: Chest Pain; Acute Aortic Dissection; Pulmonary Embolism; Acute Myocardial Infarction Type 1; Acute Coronary Syndrome

Summary: in this study, clinical database and blood sample bank of acute chest pain (acp) will be established at chest pain center of multi-center hospital. to explore new biomarkers and screen clinical indicators with effective risk stratification and prognostic evaluation for acp through proteomics technology and statistics methods. risk stratification and short-term and long-term prognostic evaluation models for high-risk acp will be established using large data analysis.

in this study, acute chest pain (acp) patients will be selected from chest pain center of nine large tertiary hospitals in china from november 1, 2019 to october 31, 2021. all the selected patients will sign the informed consent. patients' characteristics, the first vital signs at the time of consultation, the first arterial blood gas, complete blood count, coagulation markers, blood biochemical results and myocardial injury markers, imaging examinations and electrocardiogram will be collected within 30 minutes at admission. meanwhile, whole blood and plasma samples will be collected and stored in - 80 ℃ refrigerator. after diagnosis according to the gold standard examination or related guidelines, patients will be admitted to different department for standard treatment. medication, surgical procedures and complications will be recorded carefully. plasma and whole blood will be used to detect proteomics and/or genomics biomarkers associated with early evaluation of acp. screening early evaluation indicators using novel protein biomarkers and easy-to-obtain clinical indicators, and establishing evaluation models for high-risk acp by data analysis methods. area under the receiver operating characteristic curves (auroc), net reclassification improvement (nri), integrated discrimination improvement (idi) and decision curve analysis (dca) will be used to evaluate the prediction ability of the model.

Eligibility criteria:
inclusion criteria: * patient aged 18-90 years old; * the time from onset of symptoms to emergency room is less than 24 hours. exclusion criteria: * patients complicate with end-stage neoplastic diseases; * pregnant women; * patients re-visit during the selection period; * patients refuse to participate in this study.

Keywords: chest pain acute aortic dissection pulmonary embolism acute coronary syndrome acute myocardial infarction risk stratification prognosis biomarkers
phosphodiesterase type 5 inhibitors in patients with group 2 pulmonary hypertension

Conditions: Group 2 Pulmonary Hypertension

Summary: the goal of this clinical trial is to test the efficacy of tadalafil in patients with group ii pulmonary hypertension with elevated pulmonary vascular resistance (pvr). the main question it aims to answer is: • can tadalafil improve patients with group ii pulmonary hypertension with elevated pvr? participants will undergo right heart catheterization (rhc) to make sure they are fulfilling the inclusion criteria, then will be asked to take tadalafil 20 mg for two weeks then 40 mg if tolerated for 12 weeks, then participants will be followed up. investigators will compare the drug group with another age- and sex- matched control placebo group.

the study aims at studying the efficacy of tadalafil in patients with group 2 pulmonary hypertension with elevated pulmonary vascular resistance guided by rhc. after fulfilling the inclusion criteria, investigators will recruit 48 patients, and do baseline echocardiography for comprehensive right ventricular (rv) study and 6 minute walk test, and then start tadalafil 20 mg then 4mg if tolerated, for 24 patients (drug group). after three months follow up, investigators will follow up the patients regarding rv function and the functional capacity, compared to matched control group.

Eligibility criteria:
inclusion criteria: * group 2 pulmonary hypertension with precapillary component with pvr more than 4 by rhc * patients should be on hf medical therapy 90 days before enrollment in the study. exclusion criteria: * anticipated cardiac resynchronization therapy within 3 months of enrollment. * hypersensitivity, allergy, or intolerable side effects of pde-5 inhibitors. * contraindication to pde-5 inhibitors, including current nitrate therapy. * all groups of ph, other than group 2 ph (isolated post capillary pulmonary hypertension). * history of heart transplant, ventricular-assist device, or any other solid-organ transplant * likely to have solid-organ transplant or any other major surgery during study enrollment/treatment period. * female subject who is pregnant, breast-feeding, or unwilling to practice an acceptable method of birth control unless postmenopausal or sterile. * unreliability as a study participant, based on the investigator's (or designee's) knowledge of the subject (e.g., alcohol or other substance abuse, inability or unwillingness to adhere to the protocol, documented noncompliance, or vulnerable population) * current enrollment, or enrollment completed \<30 days previously, in another investigational drug or device clinical study. * undergoing dialysis for end-stage renal disease. * end-stage liver disease comorbidities, limiting exercise tolerance. * morbid obesity (body mass index \> 40). * severe peripheral vascular disease with intermittent claudication. * status after amputation of lower extremity(s) at any level. * severe degenerative joint disease preventing normal walking. * cerebrovascular accident with long-term sequelae affecting ability to walk.

Keywords: pdei pulmonary hypertension pulmonary vascular resistance right heart catheterization
retrograde autologous priming and mannitol for reducing hemodilution in cardiac surgery

Conditions: Hemodilution; Coronary Artery Disease; Fluid Overload

Summary: hemodilution reduces concentrations of blood constituents: concentration of hemoglobin, red blood cells (hematocrit), physiological ions and coagulation factors that can contribute to impaired hemostasis and increasing the risk of perioperative blood transfusions. this pilot study will assess the feasibility of a large rct to evaluate 2 techniques for reducing hemodilution during cardiac surgery: 1) retrograde autologous priming and 2) intraoperative mannitol. the aim of this pilot trial is to demonstrate feasibility of a larger trial to evaluate whether retrograde autologous priming and/or mannitol are superior to conventional priming alone.

the use of large volumes of artificial priming fluids is still very high in cardiac surgery for routine cabg surgery with cardiopulmonary bypass. the resulting hemodilution is deleterious for patients and often requires counter measures to maintain fluid balance during and after surgery. retrograde autologous priming and mannitol are simple low-cost solutions to the problem of hemodilution but their effectiveness, either alone or in combination, is unclear due to a lack of high-quality evidence. rapper-man is a single-centre 2x2 factorial cluster randomized trial. participants will be randomly assigned (1:1:1:1 ratio) to the intervention groups: 1) retrograde autologous priming (≥600 ml) + mannitol (0.3 g/kg bolus), 2) retrograde autologous priming (≥600 ml) alone, 3) conventional priming + mannitol (0.3 g/kg bolus), and 4) conventional priming alone. the primary outcome is the change in hemoglobin concentration during cardiopulmonary bypass. retrograde autologous priming will be performed within 10 minutes before, and mannitol will be added to the venous reservoir of the cpb machine within 5 minutes before, the start of cardiopulmonary bypass. the results of the larger trial are expected to have broad implications for fluid management in cardiac surgery in canada.

Eligibility criteria:
inclusion criteria: 1. ≥18 years of age. 2. undergoing a first-time cardiac surgical procedure (i.e. isolated cabg, isolated single cardiac valve surgery or a combination of both or isolated ascending aorta replacement) with the use of cardiopulmonary bypass (cpb) and median sternotomy. exclusion criteria: 1. left ventricle ejection fraction \<25% 2. emergency surgery 3. history of bleeding disorder 4. inherited thromboembolic or infective endocarditis (active) 5. previous cardiac surgery 6. severe renal impairment (serum creatinine \>250 μmol/l) 7. hemoglobin \<80 g/l 8. thrombocytopenia (\<50,000 platelets per μl) 9. expected circulatory arrest 10. body weight ≤50 kg 11. allergy to mannitol 12. pregnancy or breast feeding

Keywords: retrograde autologous priming mannitol cardiopulmonary bypass cardiac surgery hemodilution
evaluate the efficacy, safety, pharmacokinetics and pharmacodynamics of ever001

Conditions: Primary Membranous Nephropathy

Summary: ever001 is a highly selective, oral, reversable, covalent bruton tyrosine kinase (btk) inhibitor with high selectivity over other kinases, which is being developed to treat proteinuric glomerular diseases. the overall aim of the study is to evaluate the efficacy, safety, pharmacokinetics and pharmacodynamics of ever001 in subjects with selected proteinuric glomerular diseases. the first targeted disease is primary membranous nephropathy.


Eligibility criteria:
inclusion criteria: 1. having clinical diagnosis of primary membranous nephropathy, as verified by biopsy. 2. have positive anti-pla2r autoantibody test results \> 20 relative units (ru)/ml. 3. during screening at least one testing of proteinuria must be \>3.5 g/24h. 4. have nephrotic range proteinuria for at least 8 weeks prior to day 1 and no improvement (\<50% reduction) despite supportive therapy of ace inhibitor or arb unless contraindicated, for patients who have two tests of proteinuria during screening ≥8.0g/24h, the duration of nephrotic range proteinuria for at least 8 weeks is not required. exclusion criteria: 1. non-primary membranous nephropathy or other condition affecting the kidney. 2. egfr at screening \< 45 ml/min/1.73m2 or kidney function not stable . 3. uncontrolled hypertension . 4. serum albumin level at screening # 25g/l. 5. have received: b-cell targeted therapy except rituximab at any time;rituximab and the biosimilars within 2 years (participants with rituximab treatment between 1 and 2 years prior to day 1 are eligible if there is documented evidence of b-cell repopulation to \>90% of lower limits of normal range.); cyclophosphamide or chlorambucil within 180 days;other immunosuppressive/immunomodulatory agents within 90 days;greater than 30mg/day prednisone or equivalence within 30 days. 6. acute or chronic infection,including positivity of tuberculosis infection test. 7. positive serology for tp,hiv, hbv, or hcv. 8. lab testing abnormality as: wbc\ 1.5×uln, activated partial thromboplastin time ≥1.5×uln, aspartate aminotransferase (ast) and alanine aminotransferase (alt) ≥ 1.5×uln, alkaline phosphatase and bilirubin \>1.5×uln. 9. judged by the investigator that the participant is unlikely to comply with study procedures, restrictions, and requirements.
prognostic factor in the patients with benign prostatic hyperplasia who undergo holmium laser enucleation of the prostate

Conditions: Benign Prostatic Hyperplasia (BPH)

Summary: prognostic factor in the patients with benign prostatic hyperplasia (bph) who undergo holmium laser enucleation of the prostate


Eligibility criteria:
inclusion criteria: * male patient scheduled to undergo prostatectomy using holmium laser exclusion criteria: * urethral stricture, large bladder diverticulum, bladder neck contracture
cpi-006 plus standard of care versus placebo plus standard of care in mild to moderately symptomatic hospitalized covid-19 patients

Conditions: Covid-19

Summary: this is a phase 3, randomized, placebo controlled, double-blind, multicenter, stratified study of cpi-006 plus standard of care (soc) versus placebo plus soc in mild to moderately symptomatic hospitalized covid-19 patients with the primary objective to compare the proportion of participants alive and respiratory failure free between cpi-006 plus soc versus placebo plus soc.


Eligibility criteria:
inclusion criteria: * confirmed positive by polymerase chain reaction (pcr) or antigen test for sars-cov-2 with sample collection ≤ 10 days prior to randomization * covid-19 illness of any duration of symptoms * hospitalized for covid-19 for ≤ 5 days with mild to moderate covid-19 symptoms and meets criteria for either category 4, category 5, or category 6 per 8-point ordinal scale * adequate organ function * participants of child-bearing age must agree to use adequate contraception for 6 weeks after study treatment administration exclusion criteria: * signs of acute respiratory distress syndrome or respiratory failure necessitating mechanical ventilation at time of screening/randomization or anticipated need for mechanical ventilation * history of severe chronic respiratory disease and requirement for long-term oxygen therapy * uncontrolled active systemic infection or hemodynamic instability requiring admission to an intensive care unit * malignant tumor receiving treatment, or other serious systemic diseases affecting life expectancy within 29 days of screening * receipt of cancer chemotherapy or immunomodulatory drugs during preceding 2 months (steroids for treatment of covid-19 are acceptable) * convalescent plasma (ccp) or anti-sars-cov-2 monoclonal antibodies administered \<24 hours prior to randomization. must have recovered from any adverse events related to ccp treatment. received chloroquine or hydroxychloroquine within last 7 days or during the study * current participation in other clinical trials including extended access programs * active deep vein thrombosis or pulmonary embolism within last 6 months * anticipated discharge from hospital or transfer to another hospital which is not a study site within 48 hours of admission * active uncontrolled co-morbid disease that may interfere with study conduct or interpretation of findings * known to be positive for hiv or positive test for chronic hbv infection or positive test for hepatitis c antibody * pregnancy or breast feeding

Keywords: sars-cov-2 covid coronavirus covid19 covid-19
multichannel tdcs to reduce hypertonia in patients with prolonged doc

Conditions: Vegetative State; Minimally Conscious State; Spasticity, Muscle; Disorder of Consciousness

Summary: previous studies showed that transcranial direct current stimulation (tdcs) transiently improves performance of motor function in stroke patients, as well as decrease muscle hypertonia. in severely brain injured patients with disorders of consciousness (doc), a single stimulation over the left dorsolateral prefrontal cortex has shown to improve patients' sign of consciousness. nevertheless, other brain areas could be stimulated in order to manage other symptoms occurring in this population of patients, such as muscle hypertonia. in this study, investigators will assess the effects of bilateral fronto-central tdcs on spasticity as measured with the modified ashworth scale (mas) and on the coma recovery scale-revised (crs-r) scores in patients with doc in a double-blind sham-controlled experimental design.

following severe brain damage and coma, some patients may remain in a vegetative state (vs) or minimally conscious state (mcs). at present, there are no evidence-based guidelines regarding the treatment of patients with disorders of consciousness (doc). a previous study showed that a single stimulation (using transcranial direct current stimulation - tdcs) of the left prefrontal cortex induces an behavioral improvement in some patients in doc. nevertheless, patients with doc suffer from other invalidating dysfunctions such as spasticity (muscle hypertonia). in sroke patients, the inhibition of the motor cortex through cathodes placed over the motor region showed to reduce spasticity. in this study, investigators aim to assess the effect of single session of transcranial direct current stimulation (tdcs) over right and left fronto-central areas (using 2 anodes and 2 cathodes), on the level of hypertonia and the level of consciousness of patients with doc, in a double blind randomized sham controlled study. the anodes will be placed over f3 and f4, and the cathodes over c3 and c4. tdcs is a form of safe non-invasive cortical stimulation, modulating cortical excitability under the electrodes, via weak polarizing currents. it has been reported that anodal tdcs transiently improves motor functions in healthy subjects and patients with stroke or parkinson's disease. by reducing the activity of the motor cortex (cathodes) and increasing the activity of the prefrontal cortex (anodes) we expect to observe a better motor function in patients with doc.

Eligibility criteria:
inclusion criteria: * post comatose patients * patients in minimally conscious state * patients with stable condition * patients free of sedative drugs and na+ or ca++ blockers (e.g., carbamazepine) or nmda receptor antagonist (e.g., dextromethorphan) exclusion criteria: * premorbid neurology antecedent * patients in coma * patients \< 28 days after the acute brain injury * patients with a metallic cerebral implant * cranioplasty * shunt

Keywords: transcranial direct current stimulation disorder of consciousness muscle hypertonia spasticity vegetative state minimally conscious state
postoperative patient comfort and quality of micturition in suprapubic tube vs. transurethral catheterization after rarp

Conditions: Prostate Cancer

Summary: the purpose of the study is to determine, whether the postoperative quality of micturition and continence can be improved depending on the urinary drainage catheter and retention after robot assisted radical prostatectomy. another finding could be the study of the pain assessment of the patient, as well as the pain medication at the various derivatives. further check whether infections and the presence of bacteriuria can be reduced or avoided by the form of urinary drainage.


Eligibility criteria:
inclusion criteria: * minimum age of 18 years * voluntarily agreement to participate in this study * filled in and signed informed consent * release of medical records for regulatory or research purposes * clinically organ-confined prostate cancer * recommended and planned robot-assisted radical prostatectomy exclusion criteria: * participation in other interventional trials that could interfere with the present study * international prostate symptom score (ipps) \> 18 * history of radiation or chemotherapy * history of transurethral prostate resection * unable to provide informed consent * unwillingness to storage and forwarding of pseudonymous data

Keywords: urinary drainage urethral catheter suprapubic tube pain discomfort radical prostatectomy robotic surgery urinary infection
treatment of severe depressive illness by targeted brain surgery

Conditions: Major Depressive Disorder

Summary: this study will report on the outcome of a clinical program, operational since 1998, that has used surgery targeting an emotional pathway in the brain in the treatment of severe depressive illness that has failed to respond to all other available interventions. benefit from surgery was anticipated on the basis that the lesion (bilateral anterior capsulotomy) is a well established surgical target for treating severe treatment resistant depression.

since 1998 bilateral anterior capsulotomy (bac) has been available to patients in british columbia canada who have treatment refractory severe depressive illness. this study will report on the outcome of patients who have received this intervention. bac is achieved by stereotactic radiofrequency lesioning. to date 8 patients have received bac. for all patients there is follow-up data of at least 24 months. the purpose of this retrospective study is to report on the surgical protocol and to demonstrate the efficacy and safety of bac in severe depression.

Eligibility criteria:
inclusion criteria: * severe treatment resistant depression of at least 5 years duration * older than 18 years exclusion criteria: * comorbid organic mental disorder * delusional disorder * substance disorder * neurological disease * cluster b personality disorder

Keywords: limbic surgery stereotactic surgery major depressive disorder: treatment refractory
the relationship between nk cell and graves' disease

Conditions: Graves Disease

Summary: graves' disease (gd) is one of organ specific autoimmune diseases, the pathogenesis is not elucidated.natural killer (natural killer, nk) cells is a kind of important immune regulator, several abnormalities of nk cell function and number in gd patients have been described in the investigators' previous study. it is remain unclear whether the nk cell disfunction is a consequence of gd.based on the investigators' previous study, the investigators plan to monitor nk cell function in participants in the whole course of disease, analyze the association with relevant factors, such as thyroid function, immune state or treatment,to find out influences of thyroid hormones and thyroid receptor antibody affecting the function of nk cell. the investigators will reveal whether the disfunction of nk cell secondary to gd abnormal thyroid function and/or immune disorders, and realize the mechanics.


Eligibility criteria:
inclusion criteria: * new gd patients without any treatment * aged of 18 to 75 years old exclusion criteria: * pregnant or lactating woman; * known autoimmune disease; * receiving psychotropic or hormonal drugs; * taking drugs that affect the body's immune function; * obviously poor compliance.

Keywords: atuoimmune thyroid disease graves' disease natural killer cell