Kornimate/medical-research-clean huggingface dataset:
cholesterol lowering and residual risk in type 2 diabetes

Conditions: Type 2 Diabetes

Summary: the purpose of this study is to investigate why individuals with type 2 diabetes are at increased risk for heart disease and stroke. this study will investigate risk factors for heart disease and stroke, including platelet (involved in clotting) activity, inflammation, blood vessel wall function, and genetic information (blueprints of your cells), in participants with type 2 diabetes and elevated cholesterol. this study will also include a control group - subjects with elevated cholesterol who do not have diabetes. all participants will be given cholesterol-lowering medicines (pcsk9 inhibitor and statin or ezetimibe) for 1 month with the same risk factors being measured following cholesterol reduction. this study will help understand why individuals with type 2 diabetes are at higher risk for heart disease and stroke before and even after cholesterol reduction.

as part of this sfrn investigating repair (non-progression of clinical events or regression of atherosclerosis) in t2d, this project will reveal mechanisms behind the platelet mediated increased cardiovascular risk in patients with t2d by focusing on the platelet transcriptome in those with clinical progression and subsequent cardiovascular events versus those without clinical progression. a prospective clinical study will investigate platelet activity and transcriptome before and after significant cholesterol reduction to better understand mechanisms of increased residual risk observed in patients with t2d, even when cholesterol is not elevated. by combining prospective studies on the platelet phenotype in humans with t2d, mechanistic mouse models of diabetes-accelerated atherosclerosis in the fisher, basic project, and the human plaque and genomic data available data from the giannarelli, population project, the investigators believe the research will fill an important and clinically significant gap in the understanding of how diabetes attenuates cardiovascular repair and to identify new treatment and prevention strategies.

Eligibility criteria:
inclusion criteria: subjects with type 2 diabetes: * age ≥ 18 \& \< 90 * ldl-c \>100mg/dl * able and willing to provide written informed consent for the study control subjects without known diabetes: * age ≥ 18 \& \< 90 * ldl-c \>100mg/dl or lp(a) \>50 mg/dl * able and willing to provide written informed consent for the study exclusion criteria: subjects with type 2 diabetes: * established cardiovascular disease on antithrombotic therapy * triglycerides \>250mg/dl * use of a pcsk9 inhibitor * hba1c \>10% * recent infection in the past 30 days * any hospitalization in the past 30 days * use of immunosuppressive therapy * use of any antithrombotic therapy * use of aspirin * use of nsaid within the past 72 hours * pregnancy * anemia (hemoglobin \ 600) * a history of severe bleeding or bleeding disorders * chronic kidney disease (crcl \< 30ml/min) control subjects without known diabetes: * diabetes (type 1 or type 2) * all other exclusions are identical to the type 2 diabetes group.
impact of infectious diseases specialists on the appropriateness of antimicrobial therapy in emergency wards

Conditions: Patients Under Antimicrobial Therapy

Summary: context: antibiotics are frequently used in hospital but the appropriateness of prescriptions ranged between 25-50%. the intervention of infectious disease specialists (ids) could improve the appropriateness of prescriptions and reduce their use. the impact of ids has not been yet fully estimated using a randomized trial to compare the quality of care of patients who will benefit of the intervention. objectives: to show using a randomized trial that patients hospitalized in emergency wards with ids advice will receive more appropriate antimicrobial therapy but less exposure to antibiotics, as compared to patients who will not receive ids advice. methods: prospective randomized trial comparing antibiotic exposure and appropriateness of prescriptions in two groups of patients admitted in emergency wards: control group: antibiotic prescriptions will be initiated and managed by the attending physicians intervention group: antibiotic prescriptions will be systematically evaluated by the ids and changed if judged necessary by the attending physicians, following ids' advice. study process: the study will took place in the emergency wards of 4 university hospitals. for each ward, the period of the study will be 2 x 4 weeks.total duration of the study: 12 months.


Eligibility criteria:
inclusion criteria: * adults hospitalized in emergency wards receiving antimicrobial therapy for active infection or prolonged surgical prophylaxis therapy prescribed by the attending ward physician exclusion criteria: * patients receiving antimicrobial therapy not prescribed by the attending ward physician

Keywords: emergency wards hospitalization adults antimicrobial therapy
total versus subtotal thyroidectomy in graves' disease at auh

Conditions: Thyroid Goiter

Summary: the main aim of work is to compare between subtotal and total thyroidectomy intra and postoperatively to identify which technique is better for patient of graves disease

graves' disease is an autoimmune disease that affects the thyroid gland\[1\] and it's the most common cause of hyperthyroidism. \[2\] treatment of graves' disease includes antithyroid drugs ; radioiodine ; and thyroidectomy . patients with graves' hyperthyroidism can be treated with any of these treatment options. there is a wide geographic variation in the choice of therapy.\[3\] medical treatment with antithyroid drugs is often accepted as first-choice modality in europe, followed by radioiodine in case of recurrence. although surgery offers the advantage of quick control and low morbidity in experienced hands, it is infrequently recommended as initial treatment. therapy with radioiodine is the most common treatment in the united states, while antithyroid drugs and/or thyroidectomy are used more often in europe, japan, and most of the rest of the world.recent literature shows that the relapse rate was the highest among patients who received antithyroid drugs (40%) as compared to those who received radioiodine (21%) or surgery (5). \[4\] two different surgical techniques are used for the treatment of graves' hyperthyroidism: a total thyroidectomy (tt) in which the entire gland is removed and a subtotal thyroidectomy (stt) , in which most of the gland is removed leaving a small unilateral or bilateral remnant in situ about 4-5 grams. although thyroidectomy has been broadly considered as a viable alternative theapy for patients with graves' disease , the resection extent and remnant size of thyroid gland remains controversial.\[6\] although total thyroidectomy has a lower recurrence rate it has raised a concern that a more radical operation would increase the complications.\[7\] we intend to perform this analysis based on the published literatures of randomized controlled trials to evaluate the specific risks of thyroid surgery including recurrent hyperthyroididm , post-operative bleeding , recurrent laryngeal nerve injury , hypoparathyroidism and opthalmopathy progression.

Eligibility criteria:
inclusion criteria: * patients diagnosed clinically, biochemically and immunologically with graves' disease who will undergo thyroidectomy at general surgery department in auh. exclusion criteria: * 1- previous thyroid or parathyroid surgery. * 2- recurrent hyperthyroidism after radioiodine therapy. * 3- preoperative recurrent laryngeal nerve palsy. * 4- patients unfit for operation. * 5- inability to comply with the follow-up protocol. * 6- suspicious thyroid nodules.
clottriever outcomes (clout) registry

Conditions: Deep Vein Thrombosis Leg; DVT; Chronic DVT of Lower Extremity; Acute DVT of Lower Extremity

Summary: evaluate real world patient outcomes after treatment of acute, subacute, and chronic proximal lower extremity deep vein thrombosis (dvt) with the clottriever thrombectomy system.


Eligibility criteria:
inclusion criteria: * proximal lower extremity dvt involving the femoral, common femoral, iliac veins, or inferior vena cava (ivc), alone or in combination. * willing and able to provide informed consent. exclusion criteria: * prior venous stent in the target venous segment * ivc aplasia/hypoplasia or other congenital anatomic anomalies of the ivc or iliac veins * ivc filter in place at the time of the planned index procedure * allergy, hypersensitivity, or thrombocytopenia from heparin or iodinated contrast agents, except for mild to moderate contrast allergies for which pretreatment can be used * life expectancy less than 1 year * chronic non-ambulatory status * known hypercoagulable states that, in the opinion of the investigator, cannot be medically-managed throughout the study period * unavailability of a lower extremity venous access site

Keywords: clottriever thrombectomy
rwe,nis,prospective study for the effectiveness, tolerability and adherence of asciminib in saudi arabia. (asc4real)

Conditions: Chronic Myelogenous Leukemia in Chronic Phase

Summary: this is a non-interventional, prospective, observational single arm study describing the real-world effectiveness, tolerability, adherence, healthcare resource utilization (hcru) and patient-reported outcome (pro) data of asciminib in patients with ph+ chronic myelogenous leukemia - chronic phase (cml-cp) previously treated with ≥2 tyrosine kinase inhibitor (tkis) in routine clinical practice in kingdom of saudi arabia.

patients who have been receiving asciminib for up to 6 months prior to study start will be enrolled over a period of approximately 6 months and followed up for 12 months to assess study outcomes. each patient will be followed from baseline up to the earliest of death, loss to follow-up or end of the 12-month follow-up. the study aims to enrol approximately 40 patients in a single arm design from a total of 6 centers in kingdom of saudi arabia (ksa) over an enrollment period of approximately 6 months. these patients must have been prescribed asciminib for a maximum of 6 months before enrolling in the study. the prescription of asciminib should align with its approved label use. importantly, the decision to prescribe asciminib to these patients should have been made independently by the physician and not influenced by the study. data will be collected from patient electronic medical records in the sites chosen.

Eligibility criteria:
inclusion criteria: patients eligible for inclusion in this study must meet all the following criteria: 1. signed and dated patient informed consent form obtained. 2. male or female patients with a diagnosis of ph+ cml-cp ≥18 years of age with the following laboratory values: 1. \<15% blasts in peripheral blood and bone marrow 2. \<30% blasts plus promyelocytes in peripheral blood and bone marrow 3. \<20% basophils in the peripheral blood 4. ≥50 x 109/l (≥50,000/mm3) platelets 4. prior treatment with a minimum of 2 prior tkis: e. first-generation tki imatinib f. 2g-tki dasatinib, nilotinib and bosutinib g. 3g-tki ponatinib 4. patients are currently receiving asciminib as per approved local label and independently of study participation. patients must have started asciminib therapy no more than 6 months prior to their enrollment in the study. exclusion criteria: patients meeting any of the following criteria are not eligible for participation: 1. asciminib based treatment regimen in first or second line. 2. patients are currently participating in any other clinical trials. 3. patients who refused to sign informed consent. 4. according to the investigator's opinion, the patient is an unlikely candidate to provide an accurate medical history and/or to obtain long-term follow-up information for any reasons such as unavailability or severe concomitant illnesses.

Keywords: chronic myelogenous leukemia in chronic phase cml-cp asciminib
ctdna-guided curb for opd mnsclc on tki (curb-tki)

Conditions: Metastatic NSCLC - Non-Small Cell Lung Cancer; OligoProgressive Metastatic Disease

Summary: this is an open-label, prospective single arm phase ii trial that investigates the role of ablative stereotactic body radiation therapy (sbrt) in oncogene driven metastatic non-small cell lung cancer (mnsclc) patients with oligoprogressive disease (opd) on targeted therapy (tki) followed by circulating tumor dna (ctdna) analysis for tailoring targeted therapies.


Eligibility criteria:
inclusion criteria: 1. age 18 or older. 2. able to do most daily activities (ecog 0-2). 3. able and willing to sign an informed consent form to join the study. 4. metastatic non-small cell lung cancer (nsclc) with either an egfr mutation or alk rearrangement confirmed by imaging and biopsy. 5. eligible for second-line therapy or targeted treatment (tki) if in group b. 6. willing to give a blood sample for ctdna analysis. 7. no limit to how many metastatic sites, but up to 5 progressive lesions that do not require immediate treatment. 8. prior radiation therapy near progressive lesions is allowed if applicable. 9. cancer lesions must be treatable with specific radiotherapy methods (like sbrt or ablative therapy). 10. oligoprogressive disease is evaluated independently for each lesion using specific criteria. 11. stable brain metastases allowed if asymptomatic and do not require corticosteroids. 12. prior treatment with radiation for oligoprogressive lesions is allowed as long as they remain asymptomatic and re-treatment is possible. 13. prior non-stereotactic radiation for palliative purposes is allowed, and if the lesion later progresses but is still asymptomatic and does not require immediate therapy, it can count towards the 5 oligoprogressive lesions. 14. able and willing to complete quality of life and health utility questionnaires in english, french, or spanish. 15. accessible for treatment and follow-up. exclusion criteria: 1. more than 5 extracranial sites of progressive disease. 2. pregnant. 3. leptomeningeal disease. 4. serious health issues that prevent radiotherapy, like ataxia-telangiectasia or scleroderma. 5. prior radiation therapy near the progressive lesion that would prevent treatment with sbrt due to exceeding limits of healthy tissue tolerance. 6. any psychological, social, or geographic issues that could make it difficult to comply with the study. 7. any other condition that the investigator believes makes participation in the study inappropriate.
study of carbon dioxide exchange patterns during robotic prostatectomies

Conditions: Prostate Cancer; Pneumoperitoneum

Summary: the airseal® system will allow for lower carbon dioxide (co2) absorption rates than the standard endopath system.

the primary observation to be made is the level of carbon dioxide in the arterial blood, specifically when the patient is insufflated and deflated during the surgery. as a result of the consistent pressure that the airseal® system maintains, carbon dioxide will be absorbed in lower levels when compared to the standard of care systems in which fluctuations in intra-peritoneum pressure are seen.

Eligibility criteria:
inclusion criteria: * age\>18 * eligible and elect to undergo robotic prostatectomy surgery @ ohiohealth dublin methodist hospital exclusion criteria: * age \< 18 * emergency surgery * ascites * bmi\>44 or \<18

Keywords: airseal trocar carbon dioxide exchange and absorption
transfusion strategy in hematological intensive care unit

Conditions: Transfusion Related Complication

Summary: patients with acute hematological disease (acute leukemia, aplastic anemia, hematopoietic stem cells autologous or allogeneic ...) and hospitalized in an intensive care unit hematology require compensation of anemia and thrombocytopenia by blood transfusions of red blood packed cells (rbp) or platelet concentrates (pc).the afssaps (agence française de sécurité sanitaire des produits de santé) recommendations (2002) specify the need to transfuse 2 rbp in case of symptomatic anemia usually for a hemoglobin between 6 and 10 g / dl. these recommendations allow to transfuse a single rbp for very elderly patients or in cases of associated heart disease (heart failure). a recent development (2012) on post-transfusion pulmonary edema overload recommends transfusion unit by unit for high risk patients. more recently, a swiss team has historically compared transfusion policies in 2 139 patients with hematological malignancies. the first group received 2 rbp transfusion in case of symptomatic anemia or hemoglobin level \<6 g / dl. the other group only received 1 rbp at each transfusion. in total 2212 units in 1548 transfusions were performed and the 1 rbp transfusion policy has resulted in a 25% decrease in the number of rbp used without any complication. in a prospective single-center pilot study, we showed that transfusing a single rbp was possible without increasing the side effects of anemia, without complications and allow an overall reduction in consumption of red blood cell units. several meta-analyzes reported in intensive care or bleeding situations that a restrictive use of transfusions significantly reduces cardiac events, bleeding, bacterial infections and mortality. the number of patient to be treated to prevent one death is 33. the main objective is to demonstrate in a randomized trial that the restrictive strategy (transfusion of a single unit at each transfusion) is not inferior to the liberal strategy (transfusion of 2 unit at each transfusion) in terms of severe complication. transfusion are performed in case of hemoglobin level \<8g/dl. key secondary objectives are to reduce the number of rbp used and the cost of hospitalization with a comparison of complications/mortality in the 2 groups.


Eligibility criteria:
inclusion criteria: * inpatients with either acute leukemia patient receiving intensive chemotherapy or autologous transplantation for lymphoma, allogeneic stem cell transplantation exclusion criteria: * ischemic heart failure * acute promyelocytic leukemia * alkeran autologous conditioning (myeloma patient) * disseminated intravascular coagulation * hemorrhagic syndrome * stroke * any vital distress at diagnosis * creatinine clearance \<50 ml/min * liver disease with alt (alanine aminotransferase)/ast(aspartate aminotransferase) ≥2.5 uln (upper limit of normal) (except if related to tumor) * pregnant female * autoimmune hemolytic anemia
construction of citic xiangya assisted reproduction data repository

Conditions: Assisted Reproductive Technology; Infertility

Summary: human assisted reproductive technology (art) has become a very effective and nearly irreplaceable clinical treatment for infertility, helping millions of women achieve fertility. however, art may still have potential health risks to mothers and offspring. to better research and monitor the efficacy and safety of art, the investigators established cxardr based on the real medical data in reproductive and genetic hospital of citic-xiangya, which is the world's largest art single treatment center. cxardr covers the art full-cycle treatment records since the hospital perfected its electronic medical record system in 2016, as well as biological samples from the citic-xiangya genetic resource bank. from the preoperative investigation of art to the 1-year follow-up of art offspring, cxardr provides the details of the whole process of treatment and the follow-up outcomes of art patients, making up for the gap in the data of reproductive and obstetric institutions. the huge biological samples with clinical information also provide more possibilities for in-depth basic researches in the field of reproduction and genetics. during the past five years (january 2016 to november 2020), the cxardr has accumulated data concerning more than 223,000 art treatment cycles from 120,000 infertile couples. the cxardr also links more than 180,000 blood samples, 65,000 follicular fluid samples, 80,000 semen samples, and 31,000 granulosa cell samples from 75,000 couples. the data volume is substantial with over 800 variables being documented, and most variables are designed as structured fields. the whole process of data access, data extraction, data processing and data analysis was conducted through a dedicated server inside the citic-xiangya data center. all investigators cannot access sensitive information, are required to sign data confidentiality agreement, and need to be approved by the citic-xiangya ethics committee.


Eligibility criteria:
inclusion criteria: * all infertile couples undergoing art treatment in our hospital (citic-xiangya) were enrolled. exclusion criteria: * none.

Keywords: population-based database registry infertile couple and offspring longitudinal study
mr imaging of the 3d inguinal hernia scaffold proflor

Conditions: Inguinal Hernia

Summary: demonstrating through mri sequuences the regenerative features of the 3d inguinal hernia scaffold proflor

the biological response of the 3d inguinal hernia scaffold proflor has been evaluated through mri signal intensity (si) at three defined post-implantation stages: short, mid and long term. the si of proflor has been compared to the si of the neighbouring muscles and fat. as additional proof, histology of tissue specimens excised at the identical post-implantation stages from porcine models in the fame of a previous experimental attempt were also evaluated. the results of this experimental trial have ben already published in 2011 - ref: a new prosthetic implant for inguinal hernia repair: its features in a porcine experimental model. artificial organs 2011;35(8):e181-e190

Eligibility criteria:
inclusion criteria: * patients who underwent inguinal hernia repair with the 3d inguinal hernia scaffold proflor exclusion criteria: * all individuals who underwent inguinal hernia repair withouth the 3d inguinal hernia scaffold proflor
erap1,2 in recalcitrant warts

Conditions: Warts

Summary: the exact mechanisms underlying the contribution of cellular immunity in the eradication of human papillomavirus (hpv) infections remain obscure. individuals who have treatment-resistant warts frequently have immune deficiencies. amino-peptidases (erap1, erap2) of endoplasmic reticulum are essential for production of antigenic epitopes that attach to the major histocompatibility complex (mhc) class i and activate t-lymphocytes or natural killer (nk) cells. aim: to assess erap1 and erap2 serum concentrations in patients with resistant warts.


Eligibility criteria:
inclusion criteria: • patients who had a history of incomplete clearance or recurrence following two or more electrocautery sessions and four or more cryocautery treatments and intralesional bleomycin. exclusion criteria: * patients with genital warts * patients on systemic steroids or other immunosuppressive treatments * immunocompromised individuals * patients suffering from chronic systemic diseases * pregnant women
pregnancies complicated by fetal anomalies

Conditions: Pregnancy; Congenital Abnormalities

Summary: the focus of this research is to create a repository of ultrasonographic images and their corresponding medical data from pregnant women (the mothers of the fetuses that are imaged), focusing on fetal anomalies. these women will visit the obstetrical clinics at regional one health and the le bonheur fetal center.

1. repository data will be collected from the medical record and entered into the data base after the patient has completed the appointment. 2. data collection will continue into the postpartum period for each participant. 3. data collection will continue for the child during the treatment of the medical condition, up to approximately 6 months of age if required by the condition.

Eligibility criteria:
inclusion criteria: * pregnant females * age 8 years to 50 years * who have referred to the clinic for high risks pregnancies * infants (male and female) born with anomalies exclusion criteria: * non-pregnant females.