Kornimate/medical-research-clean huggingface dataset:
the application and analysis of diaphragm electrical impulse in adult patients with spontaneous breathing trial

Conditions: Tracheostomy

Summary: the aim of this study is to investigate the use of edi in patients under the endotracheal tube and tracheostomy, and analysis of cardiopulmonary parameters in adult patients.

tracheostomy is a utilitarian surgical procedure of access; therefore, it should be discussed in light of the problem it addresses: access to the tracheobronchial tree. the trachea is a conduit between the upper airway and the lungs that delivers moist warm air and expels carbon dioxide and sputum. failure or blockage at any point along that conduit can be most readily corrected with the provision of access for mechanical ventilators and suction equipment. in the case of upper airway obstruction, tracheostomy provides a path of low resistance for air exchange.

Eligibility criteria:
inclusion criteria: * patents under planning tracheostomy will enroll to this study. exclusion criteria: * pregnant women, age under 18 and unable to insert nasogastric tube

Keywords: tracheostomy diaphragm electrical impulse diaphragm activity endotracheal tube
comparison between results of 2 laparoscopic surgical procedures in operable colon cancer cases in upper egypt

Conditions: Colon Cancer Stage I; Colon Cancer Stage II

Summary: the investigators will assess and compare surgical, pathological and oncological outcomes between two laparoscopic procedures conventional colectomy versus complete mesocolic excision for operable colon cancer cases in upper egypt

colon cancer is considered a huge clinical surgical burden accounting for 10% of cancer cases and deaths all over the world with consideration that surgery and adjuvant chemotherapy(if indicated) are the main lines of treatment . when werner hohenberger and colleagues described complete mesocolic excision (cme) in 2009; resection along the embryological and lymphovascular planes with appropriate resection margins, they did it for years before describing it with suggestion of improved disease outcomes and overall survival compared to the conventional colectomy (cc). the principles of cme were described after the significant improvement of rectal adenocarcinoma surgical outcomes with establishment of total mesorectal excision (tme) in which tumor resection is associated with dissection of mesorectal fascial embryologic and lymphovascular planes. cme includes the same principles of the cc with maximizing lymph node dissection level into (d3 extended lymphadenectomy instead of d1 and d2 in conventional colectomy) and central vascular ligation (cvl) of the main feeding vessel(s) at their origin, with suggested improved disease-free and overall survival with suggested superior pathological and oncological results in the specimen. some surgeons consider that cme; with d3 extended lymphadenectomy and cvl is the optimal or standard surgical method in primary cancer colon based on suggested reduced local recurrence and improved disease-free and overall survival. although cme has a theoretical advantages and promising early results, it is not widely adopted as the standard in some areas. cme is technically more demanding than cc and suggested to be associated with more intraoperative visceral injuries and non-surgical complications and many doubts persist about safety and efficacy of the procedure. the questions of interest and research, should cme be regarded as the optimal procedure for colon cancer cases? and also another question; is conventional colectomy suboptimal?

Eligibility criteria:
inclusion criteria: 1. both sexes will be included. 2. age: all adult patients. 3. all diagnosed patients with operable cancer colon. 4. cancer at cecum, appendix, ascending colon, hepatic flexure or at splenic flexure, transverse and descending colon and sigmoid colon. 5. fit patients. exclusion criteria: 1. irresectable colon cancer. 2. inoperable colon cancer. 3. rectal cancer. 4. unfit patients.

Keywords: colon cancer colectomy mesocolic conventional laparoscopic surgical pathological
a study to determine the efficacy and safety of deucravacitinib compared with placebo in participants with active psoriatic arthritis (psa) who are naïve to biologic disease-modifying anti-rheumatic drugs

Conditions: Psoriatic Arthritis

Summary: the purpose of this study is to evaluate the efficacy and safety of deucravacitinib versus placebo in participants with active psoriatic arthritis who are naïve to biologic disease-modifying anti-rheumatic drugs. the long term extension period will provide additional long-term efficacy and safety information.


Eligibility criteria:
inclusion criteria * diagnosed to have psoriatic arthritis (psa) of at least 3 months duration at screening. * meets the classification criteria for psoriatic arthritis at screening. * active plaque psoriatic skin lesion(s) or documented medical history of plaque psoriasis (pso) at screening. * active arthritis as shown by ≥ 3 swollen joints and ≥ 3 tender joints at screening and day 1. * participant has high sensitivity c-reactive protein (hscrp) ≥ 3 mg/l at screening. * ≥ 1 psa-related hand and/or foot joint erosion on x-ray during screening period that is confirmed by central reading. * must have completed the week 52 treatment for the optional open-label long-term extension period. exclusion criteria * nonplaque psoriasis at screening or day 1. * other autoimmune condition such as systemic lupus erythematous, mixed connective tissue disease, multiple sclerosis, or vasculitis. * history of or current inflammatory joint disease other than psa (e.g., gout, reactive arthritis, rheumatoid arthritis, ankylosing spondylitis, lyme disease). * active fibromyalgia. * received an approved or investigational biologic therapy for the treatment of psa or pso. * other protocol-defined inclusion/exclusion criteria apply.

Keywords: biologic-naive bms-986165 deucravacitinib disease-modifying anti-rheumatic drugs dmards joint disease psoriatic arthritis psa
metabolic and inflammatory responses to hemodialysis and the effect of a meal

Conditions: Kidney Failure, Chronic

Summary: the objective of this study is to characterize the hormonal and inflammatory responses to hemodialysis, and to determine the effect of a meal versus fast on the metabolic changes in the post-dialytic phase.

studies show that hemodialysis (hd) is a protein catabolic event per se and probably contributes to the high prevalence of protein-energy wasting among hd patients. the muscle catabolic effect of hd is probably caused by loss of amino acids (10-12 grams per dialysis session) and by exacerbation of the inflammatory and hormonal disorders already present. activation of the immune system during hd has been linked to the contact of blood cells with the dialyzer membrane and to bacterial-derived dna fragments in the dialysis fluid. an intradialytic increase in interleukin-6 (il-6) has been shown to correlate with muscle protein catabolism, and because il-6 continues to increase for 2 hours after hd has ended, there might be a considerable "carry-over effect" to the post-dialytic period. moreover, hd induces significant changes in the insulin/insulin-like growth factor i (igf-i) signaling pathways. plasma insulin is cleared by hd, and the bioactivity of igf-i is reduced by 50% during a 4-hr maintenance hd due to an up-regulation of igf-binding protein 1 (igfbp-1), the only acutely regulated igfbp.

Eligibility criteria:
inclusion criteria: * \> 18 years * stable maintenance hemodialysis for at least 3 months * well-functioning arteriovenous shunts with recirculation less than 5% * informed consent exclusion criteria: * diabetes mellitus * body mass index below 18.5 or above 30.0 kg/m2 * malnutrition (global assessment score c) * active malignant disease * immunosuppressive treatment (including glucocorticoid treatment) * evidence of an ongoing inflammatory disease (including infection and autoimmune disorders) * pregnancy exclusion criteria during the study: * myocardial infarction or arrythmia with hemodynamic derangements * permanent thrombosis in the arteriovenous (av) shunt * severe infectious disease * renal transplantation

Keywords: dialysis protein-energy wasting insulin-like growth factor i insulin-like growth factor binding protein 1 inflammation
the association of warfarin dosage and plasma enantiomer concentration with the gene polymorphisms of cyp and vkor

Conditions: Deep Venous Thromboembolism

Summary: oral warfarin anticogulation for the prevention and treatment of patients with venous thromboembolism is one of the most used therapies in clinical practice. patients require different dosage to achieve the target therapeutic anticoagulation. optimal dosage and bleeding complication are two most clinical concerns. besides of multiple individual factors (e.g. age, dietary intake, vitamin supplement, drug compliance etc.), some genetic factors may determine the drug requirement and safety. the cytochrome p450 cyp2c9 is a liver enzyme required for the oxidative metabolism of warfarin. the vitamin k epoxide redutase (vkor) is a liver enzyme associated with the reuse of the oxidative hydroquinone form of vitamin k. the vkor enzyme is the target of warfarin. recent studies revealed both genes may determine the pharmacodynamic of warfarin anticogualation. to date, there are more than thirteen identified polymorphism at cyp2c9 gene. majority of those variant polymorphisms may decrease the warfarin requirement. the vkor complex subunit 1 (vkorc1) is a newly identified gene. some polymorphisms also were reported. as we know, the chinese patients need a lower dosage of warfarin in comparison with the caucasian patients. we are interested in finding the genetic causes of taiwneses chinese patients. in our study we will first identify the polymorphism patterns of these two genes in normal population. then, we will try to find the association between these polymorphism and patient warfarin requirement. our pharmacogenetics study will be valuable for prevention of bleeding complication of warfarin treatment in chinese population.


Eligibility criteria:
inclusion criteria: * use warfarin therapy for at least two months before study * stable inr value during recent three months exclusion criteria: * higher age(\>80 y/o) * liver and renal dysfunction * alcohol abuse * bmi\<18kg/m2 * coadministered medicine that can affect pharmacokinetics or pharmacodynamics of warfarin

Keywords: cyp2c9 vkorc1 polymorphism warfarin
resilience among individuals with opioid use disorder

Conditions: Opioid Use Disorder

Summary: the goal of this clinical trial is to develop a human laboratory model of resilience in people with opioid use disorder (oud). the investigators aim to learn if objective tasks that measure cognitive, emotional, and control aspects of resilience match up with self-reported resilience during stress and non-stress situations.

this study is an outpatient, within-subject, randomized controlled trial designed to develop and validate a novel laboratory-based model for assessing resilience in individuals with opioid use disorder (oud). the study employs a dual-condition design where participants complete two experimental sessions administered in a randomized order: one under a stress condition and under a non-stress condition. in each session, participants will perform a series of standardized laboratory tasks aimed at evaluating cognitive, emotional, and control aspects of resilience. objective measures (e.g., task performance data and physiological indices) and subjective ratings of stress reactivity will be collected to capture both behavioral and self-perceived responses.

Eligibility criteria:
inclusion criteria: 1. can provide informed consent and can comply with study procedures 2. adults aged ≥18 years 3. meet diagnostic and statistical manual (dsm-5) criteria for current opioid use disorder or are currently receiving pharmacotherapy for the treatment of oud (e.g. methadone or buprenorphine maintenance treatment \[remission\]) 4. urine sample that tests positive for opioids 5. test negative for pregnancy at screening (females only) exclusion criteria: 1. being pregnant or breastfeeding 2. significant mental health or physical disorder, or life circumstances, that is judged by the investigators to interfere with study participation

Keywords: opioids opioid use disorder stress
management of anemia in patients with endocarditis infectious candidates for cardiac surgery: the america study

Conditions: Infective Endocarditis

Summary: infective endocarditis (ei) is an extremely serious disease requiring prolonged hospitalisation, complex management by multidisciplinary teams and high healthcare costs. anemia is also emerging as a virtually constant condition associated with endocarditis, as evidenced by its inclusion in the variables used to calculate risk scores.anemia associated with infective endocarditis (ei) has a remarkably complex and multifactorial pathogenesis.it is essential to treat anaemia in patients with ei as an integral part of their overall therapy, in what is now called patient blood management. blood transfusion is not the only approach available to treat this condition. it is essential to correct any deficiencies, whether iron or vitamins. in addition, some patients may benefit from the administration of erythropoiesis-stimulating agents.


Eligibility criteria:
inclusion criteria: patients with endocarditis who are candidates for elective surgery; male and female patients aged \> 18 years; patients who have given written consent to participate in the study and to have their clinical data processed for the purposes of the study. exclusion criteria: age \< 18 years; patients with hypersensitivity (bronchial asthma, urticaria, allergic phenomena) to preparations of intravenous iron, folic acid, vitamin b12, erythropoietin; patients who have not given written consent to participate in the study and who have specifically refused the use of their clinical data for the purposes of the study; patients participating in other investigational trials; any other clinical condition that in the opinion of the investigator would make the patient unsuitable for the study
pilot study of imaging human skin with high-speed spectrally encoded confocal microscopy

Conditions: Pigmented Lesions; Pigmented Skin Lesion; Pigmented Moles; Skin Lesion

Summary: the aim of this study is to evaluate the imaging performance of spectrally encoded confocal microscopy (secm) for imaging human skin and skin diseases.

secm provides an order of magnitude faster imaging speed than conventional confocal microscopy devices. the investigators have previously utilized the secm technology for imaging large area of human esophagus in vivo. they have also developed endoscopic capsule devices which have been used to safely image over 60 human subjects, healthy volunteers and subjects with eosinophilic esophagitis, using secm technology, rapidly. when used for skin imaging, secm can provide real-time three-dimensional confocal imaging and significantly reduce the imaging time. while secm has been successfully used for imaging human esophagus in vivo, its utility in skin imaging needs to be tested in a new pilot study. the investigators will be taking images with a dermatoscope as well. this will the control to compare the experimental images to, as the dermatoscope is the standard of care diagnostic tool for dermatologists.

Eligibility criteria:
inclusion criteria: * healthy adults * 18 years of age or older * capable of giving informed consent * pigmented lesions (such as moles) present on the forearm exclusion criteria: * unable to provide consent * open cuts/sores on the skin, skin infection, or any contagious skin condition * pregnant women (according to subject) * employees under the direct supervision of the investigator

Keywords: secm spectrally encoded confocal microscopy rcm reflectance confocal microscopy
a pilot study of intermittent calorie restriction in multiple sclerosis

Conditions: Relapsing Remitting Multiple Sclerosis

Summary: experimental studies of the experimental autoimmune encephalomyelitis (eae), a mouse model of multiple sclerosis, indicate that the number of calories fed to mice prevent eae and are also associated with less severe disease in mice who do develop the disease. currently, whether these results translate favorably in humans is unknown. this is a pilot trial of testing two caloric restriction (cr) diets versus a control diet in multiple sclerosis (ms) patients: one continuous caloric restriction (cr) diet where a small number of calories will be restricted every day or another intermittent cr diet where a caloric intake will be restricted more severely 2 days per week. participants are randomized to one of the diets, and for the first 8 weeks, will receive standardized, prepared meals tailored to the specific diet. at the conclusion of the controlled feeding study, all participants will transition to an unblinded phase for an additional 40 weeks where they are provided with instructions to follow an intermittent cr diet.


Eligibility criteria:
inclusion criteria: * aged 18-50 * capable of storing food safely, willing to follow diet/eat provided food, and able to receive shipments at home or work * meets 2010 criteria for mcdonald ms; * relapse or new lesion in previous 2 years * expanded disability status score (edss) \< 6 * disease duration ≤15 years * untreated or on stable on first-line ms therapy \[injectable\] for at least 6 months, with no anticipated changes in the next 10 weeks * unchanged vitamin d dose or thyroid replacement dose (for those on it) with no anticipated changes or in supplement use for the next 10 weeks. * non-regular smoker (average no more than 1 cigarette/day) for at least 2 months * stable weight, by self report, for past 3 months (± 8 lbs) * body mass index (bmi) \> 23 kg/m2 exclusion criteria: * pregnant or nursing, or unwilling to prevent pregnancy (if of childbearing to potential) * history of gastrointestinal disease causing malabsorption * history of diabetes requiring medication * history of stage iv/v chronic kidney disease or vascular disease * history of major surgery in past 3 months * current use of warfarin * history of eating disorder * currently on a special diet for ms/other diet (provided diet will be pork free) * chemotherapy within the past year
the impact of high-fat ketogenic diet and low-fat diet in women body weight

Conditions: Overweight and Obesity; Healthy

Summary: the aim of this study is investigated the effect of high fat ketogenic diet (hfkd) in weight reduction compared to the low-fat diet (lfd) among saudi overweight and obese women. a randomized acute controlled trial of twenty-eight healthy overweight or obese women in saudi arabia, aged between 18 and 40 with a body mass index between 25 and 34.5 kg m2 and fat parentage above 30% . the participants have followed ether hfkd or lfd for 12 weeks.

obesity is associated with an increased risk of high blood pressure and heart muscle damage, which leads to cases that increase the chances of developing cardiovascular diseases, and if weight gain is not controlled, these results lead to obesity is the main cause of cardiovascular disease and causes dyslipidemia, high blood pressure and diabetes. recently, there have been followed systems and programs food some of which are beneficial for health and some of them are unhealthy systems. the diet is one of the most controversial issues. the aim of this study is investigated the effect of high fat ketogenic diet (hfkd) in weight reduction compared to the low-fat diet (lfd) among saudi overweight and obese women. a randomized acute controlled trial of twenty-eight healthy overweight or obese women in saudi arabia, aged between 18 and 40 with a body mass index between 25 and 34.5 kg m2 and fat parentage above 30% . the participants have followed ether hfkd or lfd for 12 weeks. our primary outcome of this study to investigated the effective diets hfkd and lfd on reduction of body weight, the percentage of body fat, the secondary outcomes have evaluated at the percentage of body fat, blood glucose, lipid profile.

Eligibility criteria:
inclusion criteria: * healthy overwight and obese wonen * aged 18 and 40 * bmi 25 and 34.5 kg m2 * fat parentage above 30% . exclusion criteria: * man * women in normal weight or bmi less than 25 and 34.5 kg m2 * breastfeeding and pregnant women
financial navigation intervention in improving financial and clinical outcomes in patients with newly diagnosed gastric or gastroesophageal junction adenocarcinoma

Conditions: Gastric Adenocarcinoma; Gastroesophageal Junction Adenocarcinoma

Summary: this trial studies how well a financial navigation intervention works in improving financial and clinical outcomes in patients with newly diagnosed gastric or gastroesophageal junction adenocarcinoma. financial toxicity is a term used to summarize cancer-related financial hardship, including both the material (e.g. debt) and psychological (e.g. anxiety about costs) aspects. cancer patients who experience financial toxicity are at greater risk for treatment non-adherence, poorer quality of life, and worse survival. caregivers also share in this experience of financial toxicity and often spend money on food, medications, and other patient needs in addition to taking time off from work to provide logistical, emotional, and medical support. financial navigation interventions that address the shared household financial concerns of patients and their caregivers may not only improve the patient outcomes but also improve caregiver burden, quality of life, and ability to perform caregiver roles more effectively.

outline: participants are randomized to 1 of 2 arms. arm i (financial navigation program): patients and caregivers watch a web-based financial literacy video and receive information about financial counseling, direct medical cost and healthcare coverage assistance, and indirect and non-medical cost assistance. arm ii (usual care): patients and caregivers participate in usual clinic procedures and utilize any available clinic or community-based financial resources.

Eligibility criteria:
inclusion criteria: * patient: english-speaking * patient: diagnosis of gastric and/or gastroesophageal junction (gej) adenocarcinoma within 6 months of consent (any stage) * patient: eastern cooperative oncology group (ecog) performance status (ps) 0-2 * patient: receiving (or will receive) chemotherapy, radiation, or other systemic therapy (including targeted drug or immune checkpoint inhibitor) * caregiver: english-speaking exclusion criteria: • patient: enrolled in hospice care at the time of enrollment