Kornimate/medical-research-clean huggingface dataset:
pd-1 combined with dasatinib for as third-line treatment for arid1a mutation advanced nsclc

Conditions: NSCLC Stage IV; ARID1A; PD-1

Summary: the purpose of this study is to evalute the efficacy and safety of pd-1 antibody combined with dasatinib as third-line therapy for nsclc patients with arid1a mutation until disease progression or intolerable toxicity or patients withdrawal of consent. the target sample size is 30+individuals. the primary endpoint of this study is pfs、orr、os and the secondary endpoint is toxicity.


Eligibility criteria:
inclusion criteria: - 1. provision of signed and dated written informed consent by the patient or legally acceptable representative prior to any study-specific procedures 2. over 18 years old 3. metastatic (stage iv) nsclcwith arid1a mutation underwent 2 lines of prior treatment. 4. world health organization (who) performance status 0-2 5. adequate bone marrow reserve and organ function as demonstrated by complete blood count, biochemistry in blood and urine at baseline 6. ecg recording at baseline showing absence of any cardiac abnormality as per exclusion criterion #5 7. female patients of childbearing potential must be using adequate contraceptive measures must not be breast feeding, and must have a negative pregnancy test prior to start of dosing. exclusion criteria: - 1. subjects with known egfr and alk mutations are excluded. 2. subjects with untreated cns metastases are excluded 3. subjects with an active, known or suspected autoimmune disease. 4. prior therapy with an anti-pd-1, anti-pd-l1, anti-pdl-2, or anti-ctla-4 antibody or any other antibody targeting t cell co-regulatory pathways. 5. prior therapy with dasatinib 6. known medical condition that, in the investigator's opinion, would increase the risk associated with study participation or study drug administration or interfere with the interpretation of safety results.
post-operative oral morphine versus ibuprofen

Conditions: Post-operative Pain

Summary: children 5-17 years of age who have undergo orthopedic day surgical procedures for definitive management of fractures, tendon release, etc. will be randomized to receive either ibuprofen or oral morphine as needed for pain relief for 48 hours post-operatively at home. pain will be assessed using the self-report faces pain scale revised (fps-r). we hypothesize that oral morphine will result in significantly lower pain scores on the faces pain scale revised (fps-r) compared to ibuprofen. it is hoped that the results of this trial will create a new option for post-operative pain management in children.


Eligibility criteria:
inclusion criteria: * all children aged 5-17 years who undergo an elective orthopedic or fracture-related surgical procedure at the children's hospital in london, ontario and have a same-day discharge. exclusion criteria: * known hypersensitivity to either ibuprofen or morphine * chronic users of nsaids or opioids * cognitive impairment * poor english fluency * pregnancy * acute or chronic renal insufficiency * bleeding disorder * obstructive sleep apnea

Keywords: oral morphine ibuprofen post-operative pain
predict transpulmonary pressure through zam

Conditions: Acute Respiratory Failure

Summary: stable patient with arf spontaneously breathing light sedation (not too awake but with stable breathing pattern) and eadi \>8 uv. four modes of mechanical ventilation were performed under different support level for the measuring of eadi, air way pressure and other parameters.

1. mode nava spontaneous breathing select a nava level that gives peak pressure about 9-10 cm h2o assist keep nava level for 15 minutes, do zam breaths every 3 minutes (make sure not to disturb the patient). insp hold after every zam. increase nava level by 50% and repeat the protocol when patient's breathing has stabilized (only one increase).do zam breaths every 3 minutes (make sure not to disturb the patient). insp hold after every zamat the end of protocol (minute 15) do one end-inspiratory hold-maneuver and one end-expiratory occlusion. 2. mode n- psv spontaneous breathing :ps level of 8-10 cmh2o, keep ps level for 15 minutes, do zam every 3 minutes (make sure not to disturb patient). inspiratory hold after every zam。at the end of protocol (minute 15) do one end-inspiratory hold-maneuver and one end-expiratory occlusion.increase ps by 50% and repeat protocol when patient's breathing has stabilized (only 1 increase). do zam every 3 minutes (make sure not to disturb patient). inspiratory hold after every zam.at the end of protocol (minute 15) do one end-inspiratory hold-maneuver and one end-expiratory occlusion. make record of rr, vt, flow, ti during both periods. 3. mode vcv no spontaneous breathing：set vt, ti and rr to match the breathing pattern observed during nava 4. mode pcv no spontaneous breathing-do zam after each ps level：increase psv level from 8 to 20 in steps of 1 cmh2o every 2 minutes.

Eligibility criteria:
inclusion criteria: * stable patient with acute respiratory failure on invasive mechanical ventilation can tolerate pressure support ventilation light sedation with rass between -2 and 1 exclusion criteria: * eadi\<8 uv contraindication for nasogastric tube insertion neuromuscular disease affecting spontaneous breathing lack of informed consent, and patients included in other intervention study
comparison between2 drugs in lupus nephritis

Conditions: Lupus Nephritis

Summary: the aim of this work is to study the effect and side effects of the cyclophosphamide versus mycophenolate in lupus nephritis

systemic lupus erythematosus (sle), also known simply as lupus, is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body. symptoms vary between people and may be mild to severe. common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face. often there are periods of illness, called flares, and periods of remission during which there are few symptoms.painless passage of blood or protein in the urine may often be the only presenting sign of kidney involvement. acute or chronic renal impairment may develop with lupus nephritis, leading to acute or end-stage kidney failure. because of early recognition and management of sle, end-stage renal failure occurs in less than 5% of cases; except in the black population, where the risk is many times.nephritis is the most severe manifestation of lupus. between 1950s and 1970s, corticosteroids were used for the treatment of lupus nephritis (ln) ,and using of cyclophosphamide(cpm), improved the outcome dramatically with 5 years survival increasing from 17% to 80%.subsequently, intravenous (iv) cpm became the standard of care in induction regimes; however, ivcpm was associated with complications such as bladder toxicity, gonadal problems, and infections. to reduce the toxicity, low-dose of 500mg iv(cpm) every two weeks for six months showed equivalent efficacy and less side effect. mycophenolatemofetil(mmf) is widely used in solid organ transplantation and it reduces the rate of acute rejection following renal transplantation. it has also been used to treat patients with other immune-mediated disorders such as immunoglobulin a nephropathy, small-vessel vasculitides and psoriasis . lupus nephritisis inflammation of the kidney that is caused by systemic lupus erythematous (sle). lupus nephritis happens when lupus involves the kidneys.its symptoms, though, are not always dramatic. for many, the first noticeable symptom is swelling of the legs, ankles and feet. less often, there can be swelling in the face or hands.

Eligibility criteria:
inclusion criteria: 1. all patients have systemic lupus erythromatosis with lupus nephritis either newly diagnosed or with history of sle with lupus nephrits 2. all stage of lupus nephritis except stage(i,v,vi) 3. patients who accepted to participate in the study. exclusion criteria: 1. patient with acute inflammatory process such as(rheumatoid arthritis or other rhumatoligical diseases). 2. patients who are taking other immunosuppressive therapy. 3. patients with malignancies. 4. patients with hcv, hbv or hiv infection. 5. patients with lupus nephritis sage(i,v,vi).
linking obesity and estrogen-responsive genes in endometrial cancer

Conditions: Endometrial Cancer

Summary: the objective is to develop an organotypic model to assess the effects of obesity on the expression and methylation status of estrogen-responsive genes in endometrial cancer. omental fat samples will be removed from participants during surgery and these fat samples will be used in laboratory analyses.


Eligibility criteria:
inclusion criteria: * age 18-80 years * any patient having abdominal surgery (laparoscopic or open technique) for benign conditions * eastern cooperative oncology group (ecog) performance status 0-2 * patients must have adequate: * hematologic function: neutrophils ≥ 1.5 x 109/l and platelets ≥ 100 x 109/l * renal function: serum creatinine ≤ uln or estimated glomerular filtration rate (egfr) \[ckd-epi formula\] ≥ 60 ml/min * hepatic function: serum bilirubin ≤ 1.5 x uln and ast ≤ 2.5 x uln and alt≤ 2.5 x uln * physically able to undergo surgery * written informed consent exclusion criteria: * confirmed gynaecological malignancy * contraindications and/or unfit for surgery: serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator); * patients who are pregnant or lactating * serious illness or medical condition but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia (patients with stable af are eligible), or psychiatric illness/social situations that would limit compliance with study requirements. * patients with disseminated intra-peritoneal malignancy or suspected ovarian cancer * hiv positive * previous bariatric surgery

Keywords: endometrial cancer obesity
stress-delta biomarkers for acute coronary syndrome risk stratification

Conditions: Acute Coronary Syndrome

Summary: acute coronary syndrome (acs) is a serious heart condition that is a leading cause of death in america. cardiac stress testing is currently the best test to non-invasively identify which patients might be having acs and may need more invasive testing such as a cardiac catheterization (placing a tube in the heart) for coronary angiogram (invasive mapping of the blood vessels of the heart). however, stress tests require imaging by highly trained specialists and even then may not correctly categorize a small minority of patients being evaluated for acs. advances in blood tests may now allow detection of the very early stages of heart blood vessel blockage via a simple blood test. the investigators seek to determine whether these blood tests can help to better identify patients with acs. the study will also store any extra blood sample that may be left over for future use.


Eligibility criteria:
inclusion criteria: * any patient presenting to the ed with clinical suspicion of acs as determined by the treating emergency physician. these include symptoms including but not limited to chest pain, pressure, or burning sensation across the precordium. * age 40 years or older. * as part of their usual clinical care, the subject is scheduled to have a cardiac stress test. this includes nuclear (adenosine, regadenosine, or other adjunct with spect), either pharmacologic (dobutamine) or exercise (treadmill) echocardiography, or cardiac magnetic resonance imaging. prior cardiac testing or observation unit evaluation is not an exclusion criterion. exclusion criteria: * patient with cardiac marker diagnosis of acute myocardial infarction or who otherwise is not a candidate for a cardiac stress test. * evidence of serious arrhythmias or acute mi or ischemia on ecg * unstable vital signs: persistent (\> 2 readings or over 2 hours) hypotension (systolic blood pressure \ 110 beats per minute. * any medical condition that would be worsened by cardiac stress * aortic aneurysm or dissection * active myocarditis or pericarditis * ventricular dysrhythmia or significant atrial dysrhythmia * severe or greater degree of aortic stenosis * acute or decompensated heart failure or pulmonary edema * pulmonary embolism * aortic aneurysm * patient is non-english speaking. * patient is incarcerated or a prisoner. * patient does not have capacity to consent.
computerized guideline in heart failure: implementation process and impact evaluation

Conditions: Chronic Heart Failure

Summary: objective: to assess the effectiveness of implementation process of an electronic heart failure guideline in primary care in the city of barcelona.

design: two types of design will be applied, according to the specific aims. on the one hand it is a cross-sectional and a qualitative study, on the other hand it is quasi-experimental study. pre-post intervention with a control group, as well as, of repeated measures in the intervention group

Eligibility criteria:
inclusion criteria: * general and nurse primary care practitioners working in barcelona and girona for the health catalan institute. * managers involved in implementation process for the computerised clinical guideline in barcelona from the health catalan institute. * patients with diagnoses of heart failure according to icd-10 according to general practice clinical records. exclusion criteria: * managers and general and nurse primary care practitioners working in barcelona health centres where there were any other quality improvement project related to heart failure at the time of the intervention which we are evaluating. managers from the control group (girona). * patients with a mental health disorder or terminal illness

Keywords: chronic heart failure computerized clinical guidelines primary care
effectiveness of treating hiv-positive patients with an hiv vaccine (remune)

Conditions: HIV Infections

Summary: the purpose of this study is to see if it is effective to add an hiv vaccine (remune) to the anti-hiv drug combination of combivir (zidovudine plus lamivudine) and nelfinavir.

all patients begin haart at study entry (day 1). patients with a plasma hiv-1 rna level less than or equal to 2,000 copies/ml at week 8 are randomized to receive remune or incomplete freund's adjuvant (ifa) at week 9. patients who do not achieve a plasma hiv-1 rna level of less than or equal to 2,000 copies/ml at week 8 are not randomized and are terminated from the study. these patients are eligible to receive funding for up to a 3-month supply of nelfinavir (viracept) and combivir. randomized patients receive remune or ifa at week 9 and approximately every 12 weeks thereafter until study completion (when the last patient reaches week 48). patients are considered virologic failures if they (1) fail to achieve a virologic response by week 48 or (2) after achieving a virologic response, have a virologic relapse. regardless of their previous response status, patients whose plasma hiv-1 rna level increases to greater than 2,000 copies/ml while they are receiving protocol-specified haart are eligible to receive salvage therapy and continue to receive remune or ifa until study completion. study visits occur at screening, day 1, weeks 4, 8, 9, 12, and then every 4 weeks thereafter until the last patient reaches week 48. patients who complete this study are eligible to participate in a rollover study.

Eligibility criteria:
inclusion criteria patients may be eligible for this study if they: * are hiv-positive. * are at least 13 years old (consent of parent or guardian required if under 18). * have a viral load of at least 10,000 copies/ml. * have a cd4 count of at least 250 cells/mm3. * have never taken any anti-hiv drugs before.

Keywords: hiv-1 drug therapy, combination hiv protease inhibitors cd4 lymphocyte count nelfinavir reverse transcriptase inhibitors anti-hiv agents viral load remune combivir
car t cells targeting cd30 positive lymphomas (4scar30273)

Conditions: Lymphomas

Summary: currently, a majority of lymphomas cannot be cured by standard chemo-radiotherapy. cluster of differentiation antigen 30 (cd30) is expressed in many lymphoma subtypes, such as hodgkin lymphoma (hl) and anaplastic large cell lymphoma (alcl). cd30 represents a very attractive target for chimeric antigen receptor (car)-based immune cell therapy. this study will evaluate a novel 4th generation cd30 car engineered with a self-withdrawal mechanism (fkbp-icasp9) for both efficacy and safety evaluation in lymphoma patients.

a large number of lymphoma patients exhaust current treatment options and die from the disease. innovative therapy is urgently needed. chimeric antigen receptor (car)-modified t cells have demonstrated unprecedented successes in treating even late stage cluster of differentiation antigen 19 (cd19) positive b cell malignancies. besides cd19 lymphomas, many lymphomas are cd30 positive and therefore, cd30-car t cells may prove to be effective in treating such patients. we have developed several generations of cd30 cars. preclinical studies have demonstrated effective killing of cd30 target cells. in this study, two versions of cd30 cars, both of which are 4th generation cars with a self-withdrawal mechanism (fkbp-icasp9), will be evaluated in cd30 lymphoma patients. the primary goal is safety assessment including cytokine storm response and any other adverse effects. in addition, tumor targeting and disease status after treatment will also be evaluated.

Eligibility criteria:
inclusion criteria: * relapsed or refractory cd30(+) lymphoma patients proved by immuno-histochemistry (ihc) or flow-cytometry. * not eligible for autologous stem-cell transplantation (asct) or relapsed after asct. * eastern cooperative oncology group (ecog) performance status of 0-2. * age≥18. * pulse oximetry of \> 90% on room air. * adequate hepatic function, defined as alanine transaminase (alt) \<3 x upper limit of normal (uln), aspartate aminotransferase (ast) \<3 x uln; serum bilirubin and alkaline phosphatase \<2 x uln. * adequate renal function, defined as serum creatinine \<2.0mg/dl. * adequate heart function with lvef≥50% * hb≥80g/l * measurable disease can be identified. * life expectancy ≥3 months. * sexually active patients must be willing to utilize one of the more effective birth control methods during the study and for 1 year after the study is concluded. the male partner should use a condom. * patients must sign an informed consent. exclusion criteria: * uncontrolled active infection. * active infection with hepatitis b virus (hbv), hepatitis c virus (hcv). * hiv positive * pregnant or lactating. * currently enrolled in another clinical trial. * concurrent use of systemic steroids.

Keywords: hodgkin's lymphoma anaplastic large cell lymphoma cd30 positive lymphoma peripheral t/natural killer (nk) cell lymphoma
protocoled quantitative assessment of aortic regurgitation using videodensitometry in a multicontinental trial in rotterdam, montreal, yamaguchi, segeberg, amsterdam.

Conditions: Aortic Valve Insufficiency; Aortic Valve Regurgitation

Summary: the assess-regurge is a multicenter, multicontinental registry on protocoled aortographic image acquisition after implantation of a transcatheter aortic valve. after the implementation of the acquisition protocol, each participating site will use the standardized approach for their center in order to identify if the images are considered analyzable via videodensitometry quantitative assessment of aortic regurgitation.


Eligibility criteria:
inclusion criteria: * eligible and undergoing tavr procedure exclusion criteria: * considered not eligible for tavr procedure by the local heart team
ultrasonographic measurement of diaphragmatic thickness in adolescents with pectus deformity

Conditions: Pectus Deformity; Pectus Excavatum; Pectus Carinatum; Pectus Abnormalities

Summary: pectus deformities are among the most common anterior chest wall pathologies. pectus excavatum is the most common chest deformity with an incidence of 0.1-0.3%. in severe deformities, a decrease in lung volume is observed. this can cause decreased pulmonary function and affect the function of the right ventricle. the diaphragm is the main respiratory muscle, and diaphragm contraction is associated with respiratory functions. so, investigators aimed to measure diaphragmatic thickness in adolescents with pectus deformity and to show whether diaphragmatic thickness is an early predictor of respiratory disorder in participants who do not show any clinical symptoms or whose respiratory functions are normal.

pectus deformities are among the most common anterior chest wall pathologies. pectus excavatum is the most common chest deformity with an incidence of 0.1-0.3%. it is more common in boys than girls at a ratio of 4:1. this deformity involves the lower part of the body of the sternum; the chest wall has shifted posteriorly. pectus excavatum is a cosmetic defect that in most cases does not have physiological consequences. in severe deformities, a decrease in lung volume is observed. this can cause decreased pulmonary function and affect the function of the right ventricle. funnel chest defects can cause chest pain, shortness of breath, decreased cardiac output, and decreased exercise capacity, depending on the depth of the deformity. the alignment of the skeletal system in the chest and its harmony with the compliance of the chest wall are related to respiratory function; changes in the rib cage lead to a decrease in lung capacity. the diaphragm is the main respiratory muscle, and diaphragm contraction is associated with respiratory functions. in recent years, ultrasonography (usg) has gained increasing utility for visualizing the diaphragm and assessing its function, with several advantages. based on this, investigators aimed to measure diaphragmatic thickness in adolescents with pectus deformity and to show whether diaphragmatic thickness is an early predictor of respiratory disorder in participants who do not show any clinical symptoms or whose respiratory functions are normal.

Eligibility criteria:
inclusion criteria: * increased thoracal kyphosis (thoracic hyperkyphosis) * being between the ages of 10-18 * patients who can cooperate with spirometry. exclusion criteria: * congenital spinal, costal and diaphragmatic anomalies * neuromuscular disease * respiratory system diseases that affect lung functions * patients who cannot cooperate with spirometry. * having surgery to the chest wall or spine

Keywords: pectus deformity pectus abnormalities diaphragma thickness ultrasonographic measurement