Kornimate/medical-research-clean huggingface dataset:
pecs ii versus icbn block plus scnb for av fistula creation in crf patients

Conditions: Intraoperative Analgesia; Postoperative Pain

Summary: brachial plexus block (bpb) is often utilized for proximal arm arteriovenous access creation. however, the medial upper arm and axilla are often inadequately anesthetized, as the intercostobrachial nerve (which provides sensory supply to the axilla, upper medial arm, and a small area at the upper lateral chest) is not a component of the brachial plexus. this requires repeated, an intraoperative local anesthetic (la) supplementation up to conversion into ga. the intercostobrachial nerve (icbn) is a purely sensory nerve that arises primarily from the second intercostal nerve (t2) with occasional contribution from t3. therefore, it is not a component of the brachial plexus and is not anesthetized by brachial plexus blockade. the icbn can be blocked together with other nerves, such as the pectoral, intercostal, and long thoracic nerves in a recently described technique named pectoral nerves block type ii (pecs ii ).in this thesis, investigators compared the use of the pecs ii block and icbn block as a supplement to supraclavicular brachial plexus block for providing complete anesthesia of the upper arm for fistula creation surgery.


Eligibility criteria:
inclusion criteria: * esrd patients. * proximal arm arteriovenous access surgery. * elective or emergency surgery * american society of anesthesiology (asa) physical status ii to iii. exclusion criteria: * inability of the patient to provide informed consent, communicate or cooperate * history of allergy to local anesthetics. * preexisting upper limb neurological disease at the side of the surgery. * patients on anticoagulant therapy or with history of coagulopathy. * previous surgery at or near the site of the study. * the presence of skin infection at the puncture site.
study to evaluate the efficacy and safety of shr6390 combined with pyrotinib in her2+ advanced breast cancer

Conditions: Metastatic Breast Cancer

Summary: the main purpose of this study was to observe the efficacy and safety of treatment with pyrotinib and cdk4/6 inhibitor shr6390 for her2-positive metastatic breast cancer.


Eligibility criteria:
inclusion criteria: * local recurrent or metastatic breast cancer suitable for chemotherapy, confirmed histologically. * her2-positive breast cancer(according to 2018 asco/cap her2 test guideline). * patients with her2-positive metastatic breast cancer who had received ≤ 1-line treatment in the past; * 18-70 years old; * ecog ps 0-1; * life expectancy is not less than 12 weeks; * at least one measurable lesion according to recist 1.1; * anc ≥ 2.0×10\^9/l, plt ≥ 100×10\^9/l, hb ≥ 90 g/l; tbil≤1.5uln; alt and ast≤3×uln(alt and ast≤5×uln if liver metastasis); bun and cr≤1.5×uln; * lvef ≥ 50% and qtc≤470 ms. exclusion criteria: * patients with symptomatic brain metastasis; * unable to swallow, chronic diarrhea and intestinal obstruction, there are many factors affecting drug use and absorption; * patient who received radiotherapy, chemotherapy, surgery (excluding local puncture) or molecular targeted therapy within 4 weeks before admission; those who received anti-tumor endocrine therapy after screening period; * participated in other drug clinical trials within 4 weeks before admission; * tyrosine kinase inhibitors targeting her2 (neratinib, lapatinib, pyrotinib, etc.) have been used or are being used in the past; * other malignant tumors, excluding cured cervical carcinoma in situ, skin basal cell carcinoma or skin squamous cell carcinoma, have been diagnosed in the past five years; * a history of immunodeficiency, including hiv positive, hcv, or other acquired, congenital immunodeficiency disorders, or organ transplantation, is known; * has suffered from any heart disease; * female patients during pregnancy and lactation, fertile women with positive baseline pregnancy tests or women of childbearing age who are unwilling to take effective contraceptive measures throughout the trial; * according to the judgement of the researchers, there are concomitant diseases that seriously endanger the safety of patients or affect the completion of research (including, but not limited to, severe hypertension, severe diabetes, active infections, etc.); * moderate infection occurs within 4 weeks before the first administration (e.g. intravenous drip of antibiotics, antifungal or antiviral drugs according to clinical criteria), fever(\> 38.5 ℃) of unknown origin occurs during the screening period/before the first administration; * researchers believe that patients are not suitable for any other situation in this study.
effect of treatment with insulin viajecttm compared to regular human insulin and insulin lispro on mealtime blood vessel stress in patients with type 2 diabetes mellitus.

Conditions: Type 2 Diabetes

Summary: the purpose of this study is to compare the effects of insulin viaject with regular human insulin and insulin lispro on measures of mealtime blood vessel stress and blood flow.


Eligibility criteria:
inclusion criteria: 1. type 2 diabetes mellitus according to the ada criteria 2. hba1c between 6.5 % and 9.9 % 3. treatment with sulfonylurea and/or metformin in a stable dosage within the last 3 months 4. age between 40 and 75 years 5. bmi \< 40 exclusion criteria: 1. type 1 diabetes mellitus 2. pre-treatment with insulin within the last 6 months prior to screening 3. pre-treatment with ppary-agonists or glucosidase inhibitors within the last 4 weeks prior to screening 4. untreated hypertension stage ii-iii according to who criteria 5. planned or anticipated change in antidiabetic and/or concomitant medication during study participation 6. total cholesterol \> 300 mg/dl (anamnestically) 7. major micro- or macrovascular complications as judged by the investigator 8. tobacco use within the last 6 months prior to screening 9. drugs with major impact on endothelial function like nitrates etc. 10. history of drug or alcohol abuse which in the opinion of the investigator will impair subject safety or protocol compliance 11. history of hypersensitivity to the study drugs or to drugs with similar chemical structures 12. history of severe or multiple allergies 13. treatment with any other investigational drug within 3 months prior to screening 14. progressive fatal disease 15. history of significant cardiovascular, respiratory, gastrointestinal, hepatic (alat and/or asat \> 3 times the normal reference range), renal (creatinine \> 1.1 mg/dl in women and \> 1.5 mg/dl in men), neurological, psychiatric and/or haematological disease as judged by the investigator 16. pregnancy or breast feeding 17. sexually active women of childbearing potential not consistently and correctly practicing birth control by implants, injectables, oral contraceptives, hormonal intrauterine devices (iuds), sexual abstinence or vasectomised partner 18. lack of compliance or other similar reason that at the discretion of the investigator precludes satisfactory participation in the study 19. hypopotassemia (k\<3.5 mmol /l)
prospective multicenter registry study to assess the frequency of lynch syndrome among patients with colorectal cancer

Conditions: Colorectal Cancer; Lynch Syndrome; Hereditary Colorectal Cancer; MSI

Summary: prospective multicenter registry study to assess the frequency of lynch syndrome among patients with colorectal cancer in russia

blood and tumor samples will be obtained from enrolled patients. 4 ml of venous blood samples will be taken into a tube with edta and stored at -20 0c. tumor samples will be taken during endoscopy or surgical treatment, embedded in paraffin and stored at room temperature. microsatellite instability in the tumor tissue will be determined by any method available in the participating center (immunohistochemical or molecular genetic study). in case of detection of microsatellite instability/deficiency in the repair system of unpaired bases blood samples will be analyzed for the fact that germinal mutations in the dna mismatch repair genes. patients will be followed up for 5 years after enrollment. during follow up correlation of spectrum of germinal mutations with clinical data, effectiveness of therapy with immune checkpoint inhibitors, the spectrum of malignant neoplasms in the families of patients with lynch syndrome, the impact of the presence of microsatellite instability/deficiency in the dna mismatch repair genes on treatment tactics in the russian federation will be assessed.

Eligibility criteria:
inclusion criteria: * provision of written informed consent; * patients with histologically verified colon adenocarcinoma or patients with histologically verified synchronous neoplasms who have not previously received treatment for a second tumor; * age ≥ 18 years; * absence of antitumor treatment for a real tumor (it is allowed to include patients who have a history of antitumor treatment for other malignant tumors, if the period after treatment is more than 12 months). * the ability of the patient, according to the researcher, to fulfill the requirements of the protocol; exclusion criteria: - patients receiving chemotherapy or radiotherapy for colon cancer at the time of screening

Keywords: colorectal cancer lynch syndrome hereditary colorectal cancer msi frequency
perioperative time course of mmp-9 and its inhibitor during carotid artery stenting and carotid endarterectomy

Conditions: Carotid Stenosis; Ischemia Reperfusion Injury

Summary: the aim was the comparison of the perioperative time courses of matrix metalloproteinase-9 (mmp-9) and its inhibitor (timp-1) during elective carotid artery stenting (cas). the investigators used a matched, historical carotid endarteriectomy group as controls. blood samples at four time points: t1: preoperative; t2: 60 minutes after stent insertion; t3: first postoperative morning; and t4: third postoperative morning. plasma was isolated from heparin anticoagulated blood samples by low speed centrifugation at 4 °c, and stored at -80 °c until analyzed in a single batch at the end of the study. plasma concentrations of mmp-9 and timp-1 were expressed as ng/ml.


Eligibility criteria:
inclusion criteria: elective carotid artery surgery exclusion criteria: malignant diseases, inflammatory and systemic autoimmune disorders, psychiatric disorders and previous debilitating stroke

Keywords: matrix metalloproteinase carotid artery stenting carotid endarterectomy
the response of the immune system of patients with end stage kidney disease on dialysis and kidney transplant recipients vaccinated for covid-19

Conditions: End Stage Kidney Disease; Kidney Transplantion; Covid19; Vaccination

Summary: observational study of patients with end stage kidney disease on dialysis and kidney transplant recipients, before and after vaccination for sars-cov 2, after written consent, with the aim of laboratory efficacy of the vaccine and safety regarding the clinical outcome of patients and possible complications.


Eligibility criteria:
inclusion criteria: * age \>18 years * covid 19 vaccination exclusion criteria: * previous covid infection * recent infection * chronic infection * hbv, hcv, hiv * active malignancy

Keywords: end stage kidney disease kindey trasplantation immune system covid19 vaccination
clinical outcomes and equality in healthcare for emergency general surgery patients undergoing emergency laparotomy

Conditions: Abdomen, Acute

Summary: the goal of this observational cohort study is to evaluate the standard of care for general surgerical patients undergoing emergency laparotomy and assess factors affecting clinical outcomes, as well as evaluating the quality of life in the year after abdominal surgery. the main questions it aims to answer are: 1. what factors are associated with adverse post-operative events 2. are patients treated differently based on sex or age 3. how does quality of life look like and possibly change over the coarse of a year after surgery this is an evaluation of the current standard of care and the outcomes of this patient group prior to the implementation of a standardised care protocols for emergency laparotomy patients. secondly, the study aims to, over time, compare results before and after the introduction of this standardised care protocol.


Eligibility criteria:
inclusion criteria: * undergoing emergency laparotomy due to general surgical indication exclusion criteria: * children under 16 * trauma laparotomy * vascular, urological or gynaecological indication for laparotomy

Keywords: emergency laparotomy general surgery clinical outcomes
risedronate 75mg dosed on 2 consecutive days monthly in the treatment of osteoporosis in postmenopausal women

Conditions: Osteoporosis Postmenopausal

Summary: to confirm the non-inferiority of 75 mg risedronate tablets taken on 2 consecutive days per month as compared to 5 mg risedronate tablets taken daily in increasing bone mass in lumbar spine in postmenopausal women with osteoporosis. to confirm the efficacy of 75 mg risedronate tablets taken on 2 consecutive days per month in postmenopausal women with osteoporosis in increasing bone mass in proximal femur, femoral neck and femoral trochanter and decreasing bone resorption. to confirm general safety of 75 mg risedronate tablets taken on 2 consecutive days per month as compared to 5 mg risedronate taken daily.


Eligibility criteria:
inclusion criteria: subjects meeting all of the following criteria were considered for enrollment into the study : ·ambulatory, healthy postmenopausal women with : * natural menopause and more than 5 years after their last menstrual period. * or surgical menopause and more than 5 years after surgery (blood hormone tests required for subjects less than 65 years of age who had uterus removed without removal of ovaries at time of surgery). osteoporosis (lumbar spine t-score more than 2.5 sd below the mean value in normal young women or more than 2.0 sd below the mean value in normal young women and at least 1 fracture of a vertebra (thoracic-lumbar t4-l4)). exclusion criteria: subjects with any of the following criteria were not considered for enrollment into the study : ·women who have received hormone replacement therapy (with estrogen by mouth and/or progestogen and/or androgen) or raloxifene, or other bone active drugs, such as calcitonin, calcitriol/calcidiol/alfacalcidol, parathyroid hormone or any bisphosphonate within 3 months before first dose of study medication.

Keywords: treatment osteoporosis postmenopausal
antidepressant response of dmt masked with propofol

Conditions: Major Depressive Disorder; Psychedelic Experiences

Summary: the aim of this study is to elucidate if the anti-depressive effect of n,n-dimethyltryptamine (dmt) is based on a biological mechanisms including neuroplasticity and anti-inflammatory effect or due to the subjective psychedelic experience.

major depressive disorder (mdd) affects nearly 20% of people, but current treatments-both pharmacological and psychotherapeutic-have limited efficacy, especially for mild to severe cases. psychedelics like lsd, psilocybin, and dmt are being explored as alternative therapies, with studies showing promising antidepressant effects. however, it is unclear whether these benefits stem from their acute subjective (psychedelic) experience or from biological mechanisms like neuroplasticity and anti-inflammatory effects. this study aims to determine if the antidepressant effects of dmt occur independently of its psychedelic experience. to test this, dmt will be administered under sedation (with propofol) to mask subjective effects, as well as without sedation.

Eligibility criteria:
inclusion criteria: 1. participants must meet dsm-5 criteria for mdd of at least moderate severity (madrs\>20). 2. participants either currently do not use antidepressants or are treated with a stable dose for at least 4 weeks prior to randomization. 3. age ≥ 21 years old. 4. sufficient understanding of the german language. 5. able to understand the study procedures and risks and willing to adhere to the protocol and sign the consent form. 6. willing not to drive or operate heavy machinery on the treatment day. 7. willing to refrain from more than 7 standard alcoholic drinks a week, more than 10 cigarettes a day, more than 2 cups of coffee a day, and any illicit substances during study participation. 8. willing to use effective contraceptive measures throughout study participation. exclusion criteria: 1. past or present bipolar or psychotic disorder, including depressive disorder with psychotic features. 2. first-degree relative with a psychotic or bipolar disorder. 3. significant prodromal psychotic symptoms (prodromal questionnaire-16 symptoms ≥ 6). 4. borderline personality disorder. 5. current post-traumatic stress disorder. 6. post-partum depression. 7. pregnant or breastfeeding women. 8. current or recent history of significant suicide ideation or suicide behavior within the past 6 months. 9. current severe substance use disorder other than nicotine. 10. planned ketamine, other psychedelic, or electroconvulsive treatment or any such treatment within the past 3 months. 11. any lifetime use of dmt, use of any other psychedelics within last 3 month or lifetime use of any other psychedelics more than 15 times 12. patients who are treated with neuroleptics or know antagonists of 5-ht2 receptors or monoamine oxidase inhibitors (maoi) and are not willing to pause.

Keywords: n,n-dimethyltryptamine (dmt) neuroplasticity
promoting kidney recovery after acute kidney injury receiving dialysis

Conditions: Acute Kidney Injury

Summary: the overall goal of this study is to evaluate the feasibility of conducting a randomized controlled trial comparing a standardized dialysis strategy versus usual care (dialysis prescription ordered by each patient's primary nephrologist) in patients with aki-receiving dialysis.


Eligibility criteria:
inclusion criteria: * received ≥2 sessions of any dialysis modality for presumed aki * plans for continued intermittent hemodialysis or sustained low efficiency dialysis treatments exclusion criteria: 1. receipt of dialysis for ≥90 days 2. known baseline estimated glomerular filtration rate (egfr) \<15ml/min/1.73m2 3. strong clinical suspicion of urinary tract obstruction, rapidly progressive glomerulonephritis (rpgn), vasculitis, thrombotic microangiopathy (tma), myeloma related cast nephropathy, or acute interstitial nephritis (ain) as the underlying cause of aki 4. receipt of any dialysis prior to the current admission within the past 2 months 5. kidney transplant within the past 12 months 6. pregnant
an 18 week efficacy and safety study of saxagliptin and metformin xr combination in subjects with type 2 diabetes

Conditions: Type 2 Diabetes

Summary: the purpose of this study is to compare reduction in a1c for subjects taking saxagliptin and metformin xr vs. uptitrated metformin xr.


Eligibility criteria:
inclusion criteria: * type 2 diabetics taking metformin ir or xr greater than or equal to 850mg and less than or equal to 1500mg only for at least 8 weeks prior to screening * a1c: 7.5-11% (at screening) * bmi less than or equal to 45 kg/m2 exclusion criteria: * significant cardiovascular history * active liver disease, renal impairment

Keywords: t2dm metformin a1c
acetazolamide in central sleep apnea patients using medication for opioid use disorder

Conditions: Central Sleep Apnea Comorbid With Opioid Use

Summary: patients with opioid use disorder treated with either methadone or buprenorphine are at risk of developing central sleep apnea (csa) from these medications. investigators will conduct a mechanistic trial using acetazolamide, a medicine known to improve csa in other settings, to determine if acetazolamide can improve csa due to medication for opioid use disorder and whether this leads to physiologic changes that might lead to reduced drug craving. patients treated with medication for opioid use disorder and who have central sleep apnea will be randomized to treatment with acetazolamide or matching placebo for 7 days. at the end of the 7 days, they will undergo an overnight sleep study to assess the impact on breathing during sleep as well as sleep quality. in addition, measures of sympathetic tone, anxiety, arousal, cognition, and drug craving will be measured to determine if treatment of csa with acetazolamide can produce physiologic changes that might contribute to improved health.

medications used to treat opioid use disorder (moud) such as methadone and buprenorphine have been found to cause central sleep apnea (csa), but the clinical ramifications are unclear. it has been hypothesized that the sleep fragmentation and intermittent hypoxemia caused by csa from moud may lead to sympathetic activation, nocturnal arousal, increased anxiety, and cognitive impairment that may in turn increase drug craving and drug relapse. this mechanistic study will evaluate the potential adverse effect of csa in patients on moud by evaluating the impact of acetazolamide to improve csa and thereby lead to downstream physiologic changes in measures of sleep quality, sympathetic tone, nocturnal arousal, anxiety, cognitive functioning, and drug craving. eligible individuals will undergo an overnight research visit including overnight polysomnography, assessments of autonomic tone, sleep quality, nocturnal arousal, emotional distress, cognitive testing, and drug craving. individuals with opioid-induced csa will be randomized into a parallel-arm trial of acetazolamide vs. placebo with overnight research visit for outcome assessment at 7 days.

Eligibility criteria:
inclusion criteria: * patients on medication for opioid use disorder (moud) with central sleep apnea. exclusion criteria: * sleep-related hypoventilation. * other causes of central sleep apnea besides opioid use. * pregnancy. * contraindications for acetazolamide.

Keywords: acetazolamide opioid use disorder medication for opioid use disorder (moud) methadone buprenorphine
the china national copd screening program

Conditions: Chronic Obstructive Pulmonary Disease

Summary: the national copd screening program is in a cross-sectional manner at the baseline, planning to recruit a total of 800,000 participants from 160 districts or counties (5,000 for each site on average) from 31 provinces, autonomous regions or municipalities directly under the central government of china. the filtered copd high-risk population and confirmed copd patients will be managed and followed up according to the standardized clinical guidelines. the major aims of the program are to estimate the prevalences of copd high-risk population and under- or miss- diagnosed copd patients, and to manage the development and outcomes of the disease.


Eligibility criteria:
inclusion criteria: * adults aged between 35 and 75 years; * residents living in the survey area with more than 6 months in the past year. exclusion criteria: * experienced myocardial infarction, stroke or shock in the past 3 months; * experienced severe cardiac insufficiency, severe arrhythmia or unstable angina pectoris in the past 4 weeks; * experienced massive hemoptysis in the past 4 weeks; * received chest, abdominal or ophthalmic surgery in the past 3 months; * have mental disorders (e.g. auditory hallucinations, visual hallucinations, taking antipsychotics, seizures requiring medication, etc.); * have cognitive impairment (e.g. dementia, comprehension impairment, etc.); * have uncontrolled hypertension (i.e. systolic blood pressure \> 200 mmhg, diastolic blood pressure \> 100 mmhg); * present with heart rate \>120 beats/min; * have aortic aneurysm; * have severe hyperthyroidism; * are pregnant or lactating women; * experienced respiratory infectious diseases (e.g. tuberculosis, influenza, etc.) in the past month.

Keywords: chronic obstructive pulmonary disease screening spirometry