Kornimate/medical-research-clean huggingface dataset:
ankle - brachial index measurement in atrial fibrillation

Conditions: Atrial Fibrillation Fluttering

Summary: consecutive patients with atrial fibrillation will be admitted to the hospital for electrical cardioversion. ankle brachial index will be measured three times with oscillometric method and three times with doppler method. two study sessions will be performed: the first before and the second after electrical cardioversion. the first session will be ended before anesthesia. the second session will be started before a conscious patient will be transported from intensive care unit to general ward. all the measurements will be taken in the intensive care unit at an ambient temperature of 21° c, after patients will give their written informed consent to participate in the study. all patients will be awake, fasting and in the supine position. abi will be measured according to the guidelines issued by aha. systolic blood pressure will be measured using a doppler device (echo sounder es-101ex, hadeco, japan) and a validated and calibrated aneroid sphygmomanometer (minimus ii, rister, germany). measurement of abi using oscillometric method will be performed using watchbp office abi system (microlife watchbp ag, widnau, switzerland). the appropriate cuff size will be used with the width of the cuff being at least 40% of the limb circumference. the arm with higher systolic blood pressure will be used to calculate the abi. higher systolic blood pressure measured on the posterior tibial or dorsalis pedis artery will be used to calculate the abi. during both study sessions abi measurements will be repeated 3 times with each method in the reverse order of the preceding measurement e.g., in the case of the initial counterclockwise sequence: right arm, right popliteal, right dorsalis pedis, left popliteal, left dorsalis pedis, left arm, right arm, the clockwise sequence will be used, starting and ending with the left arm. the same sequence of limb pressure measurements will be used used during the study. a sample size calculation was based on the preliminary observations made by the study team. it was calculated that the study sample size of 79 subjects would be needed to detect a difference of 0.1 in the abi measured in sinus rhythm and during atrial fibrillation, with a two-tailed α of 0.05 and a (1-β) of 0.90. the investigators initial estimate of sample size of 115 patients incorporated an assumption of dropout due to non-effective electrical cardioversion, patient decision to quit study or failure to obtain adequate abi. the measurements will be repeated three times with each method and for the each method the mean will be used for the calculations. investigator - study nurse, trained at the vascular department, will perform all abi measurements.


Eligibility criteria:
inclusion criteria: * patients undergoing electrical cardioversion due to atrial fibrillation exclusion criteria: * circulatory instability * use of vasoconstrictive agents * limb trauma * upper limb artery stenosis

Keywords: ankle - brachial index
the optimal width of gastric conduit for minimally invasive esophagectomy: wide or narrow?

Conditions: Anastomotic Leakage

Summary: the study hypothesized that a narrow gastric conduit(less than 3cm in width) would minimize anastomotic leakage following minimally invasive esophagectomy. therefore we raise this random-controlled research, and investigate the leakage ratio from different widths of gastric conduit formed during the operation.

patients underwent minimally invasive esophagectomy in zhongshan hospital of fudan university will be enrolled and be assigned to wide or narrow gastric conduit group randomly. intra-operative blood supply and vascular sao2 will be observed during the operation, and the rate of anastomotic leakage, together with its clinical details will be recorded in the two groups.

Eligibility criteria:
inclusion criteria: 1. patients underwent minimally invasive esophagectomy(three-hole procedure) 2. clinical staged t1-3n0m0 esophageal cancer patients or: patients who were restaged as t1-3n0m0 esophageal cancer after neo-adjuvant therapy exclusion criteria: 1. with previous cancer history 2. severe co-morbidity

Keywords: minimally invasive esophagectomy anastomotic leakage gastric conduit
snc115 injections in patients with recurrent/refractory small cell lung cancer and lung large cell neuroendocrine carcinoma

Conditions: Recurrent/Refractory Small Cell Lung Cancer Lung Large Cell Neuroendocrine Carcinoma

Summary: this study is a fih dose escalation clinical study, with single arm, open label and design, in order to observe the preliminary safety and pharmacokinetic of snc115 injection in participants with recurrent/refractory small cell lung cancer and lung large cell neuroendocrine carcinoma.

the study will enroll at most 35 participants diagnosed with recurrent/refractory small cell lung cancer or lung large cell neuroendocrine carcinoma. there will be about 5 preset dose groups in this clinical trial, participants will be enrolled from low dose group to high dose group. dose escalation will be decided by the src (safety review committee). there will be expanded cases in the aim dose group. the protocol will be performed into screening period (-30+ days), mononuclear cells acquisition, lymphodepletion (-5\~-3 days), snc115 injection infusion and dlt observation period (day 0\~28days), and follow-up period (1-5 years). according to the administration strategy, we will start from single administration.

Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years old, regardless of gender; 2. histological or cytological diagnosis of sclc or pulmonary lcnec (who 2021) 3. relapse or refractory after receiving at least first-line standard therapy, or inability to tolerate first-line standard therapy 4. eastern cooperative oncology group score 0-1; 5. at least one measurable tumor lesion (other than brain metastases) according to solid tumor response criteria 1.1 (recist1.1) 6. measurable lesions with an expected survival of more than 3 months; 7. expected survival ≥12 weeks. 8. adequate organ and bone marrow function. 9. the subjects agreed to use reliable contraceptive methods for contraception within 1 year from the signing of informed consent to reinfusion. 10. voluntarily participate in clinical trials and sign informed consent. exclusion criteria: 1. known allergic reaction, hypersensitivity, intolerance or contraindication to snc115 injection or any component of drugs that may be used in the study (including fludarabine, cyclophosphamide and tocilizumab). 2. have received any previous car-t therapy or other gene-modified cell therapy. 3. have received any previous treatment targeting dll3. 4. uncontrolled pleural effusion, pericardial effusion, and ascites (uncontrolled refers to repeated drainage). 5. untreated (including new lesions or progression after previous treatment) or symptomatic brain metastases. 6. have medical history of study excluded thrombosis, systemic autoimmune disease, cardiopathy, cancer, infection disease and so on.

Keywords: dll3 car-t small cell lung cancer lung large cell neuroendocrine carcinoma
treatment of idiopathic thrombocytopenic purpura (itp) with subcutaneously administered anti-d

Conditions: Idiopathic Thrombocytopenic Purpura

Summary: the purpose of this study is to describe the effect of anti-d on symptoms and platelet count in children suffering from unexplainable low platelet counts, when anti-d is administered as an injection under the skin. the hypothesis is that the injection with anti-d under the skin is as effective as anti-d given in a vein.

background: idiopathic thrombocytopenic purpura (itp) in children is considered a benign hematological disease. the incidence is approximately 50 cases a year in denmark. approximately 25 % will experience chronic disease. follow up and treatment of these patients is not centralized. the drug of choice is intravenous igg (ivig) for treatment of itp. the side effects are flu-like symptoms, and in rare cases aseptic meningitis. another option is intravenous anti-d, if the child is rhesus positive. anti-d is primarily used in north america. the effect of anti-d is comparable with ivig when considering the time it takes to bring the platelet count above 50,000/μl. anti-d also causes flu-like symptoms. establishing an i.v. access is a disadvantage to both ivig and anti-d. for both treatments mechanism of action is not finally described. subcutaneous igg substitution therapy is used for patients suffering from agammaglobulinaemia. it is therefore known, that immunoglobulin uptake is possible after subcutaneous administration. subcutaneous anti-d has been tried in few patients suffering from chronic thrombocytopenia with positive results. ivig treatment is expensive compared to anti-d. treatment of a 20 kg child costs approximately 17,000 dkr for ivig and 2,500 dkr. for anti-d. hypothesis: * subcutaneous administered anti-d is as effective as ivig/i.v. anti-d; * subcutaneous administered anti-d has fewer less severe side effects than ivig/i.v. anti-d. purpose: * to document the effect of subcutaneous anti-d; * describe complications; * describe aspects of the mechanism of action. material and methods: children are eligible if admitted to a pediatric department in denmark for diagnosis, observation or treatment of acute or chronic itp. examination and diagnostic work up is similar throughout the country, but not identical. no specific tests are required for diagnosis. if treatment is indicated rhesus positive children are treated with subcutaneous anti-d. rhesus negative children are treated according to local guidelines. specified follow-up on all children is mandatory. for research purposes one blood sample form all children is collected, and from children, who receive medical treatment, several blood samples are collected. analysis for changes in immunological signaling peptides will be performed with special attention to the mechanism of action of anti-d.

Eligibility criteria:
inclusion criteria: * idiopathic thrombocytopenic purpura (itp)

Keywords: idiopathic thrombocytopenic purpura treatment anti-d subcutaneous clinical evaluation platelet count ivig
assessing lung inhomogeneity during ventilation for acute hypoxemic respiratory failure

Conditions: Acute Respiratory Distress Syndrome; Mechanical Ventilation Pressure High; Hypoxemic Respiratory Failure

Summary: mechanical ventilation can cause damage by overstretching the lungs, especially when the lungs are collapsed or edematous. raising ventilator pressures can reduce lung collapse and this can prevent overstretching from mechanical ventilation. it remains uncertain how much pressure (peep - positive end-expiratory pressure) should be used on the ventilator and how to identify patients who will benefit from higher ventilator pressures vs. lower ventilator pressures. the investigators are using a unique new imaging technology, electrical impedance tomography (eit), to study this problem and to determine the safest and most effective ventilator pressure level. the results of this study will inform future trials of higher vs. lower peep strategies in mechanically ventilated patients.

patients participating in this physiological cross-over randomized trial will undergo a series of peep maneuvers designed to assess lung recruitability, peep responsiveness, and optimal peep. eit imaging and esophageal manometry will be employed throughout the protocol to quantify the effect of peep on lung function. patients will be randomized to be ventilated at peep levels supplied by the express strategy or by the eit hyperdistention/collapse algorithm. the biological response will be assessed by measuring serum cytokines.

Eligibility criteria:
inclusion criteria: * acute (≤7 days) hypoxemia with pao2:fio2 ratio less than or equal to 200 mm hg * oral endotracheal intubation and mechanical ventilation * bilateral airspace opacities on chest radiograph or ct exclusion criteria: * contraindication to eit electrode placement (burns, chest wall bandaging limiting electrode placement) * contraindication to esophageal catheter placement (recent upper gi surgery, actively bleeding esophageal varices) * respiratory failure predominantly due to cardiogenic cause or fluid overload * ongoing hemodynamic instability (requiring 2 vasopressor agents by continuous infusion and rising vasopressor infusion rate requirements in the previous 8 hours) * ongoing ventilatory instability (p/f \< 70 mm hg, ph \< 7.2; ventilator driving pressures, peep, or fio2 increasing by more than 25% in previous 30 minutes) * intracranial hypertension (suspected or diagnosed by medical team) * known or suspected pneumothorax recognized within previous 72 hours * bronchopleural fistula * bridge to lung transplant * recent lung transplantation (within previous 6 weeks) * attending physician deems the transient application of high airway pressures (\>40 cm h2o) to be unsafe
effectiveness of pain relief between adductor canal block and femoral nerve block in total knee arthroplasty

Conditions: Osteoarthritis

Summary: this study aims to compare the effectiveness of adductor canal block and femoral nerve block in total knee arthroplasty in general anesthesia. two block techniques were proved safe and effective in pain control after total knee arthroplasty. but some authors insist that quadriceps muscle power was decreased by femoral nerve block. the study design is a double-blind randomized controlled trial. fifty patients planed to undergo simultaneously bilateral total knee arthroplasty are randomised to receive ultrasound-guided femoral nerve block on one leg and adductor canal block on the other, in addition to combined general anaesthesia. the primary outcome was comparative postoperative pain in either extremity at four, eight, 12, 24, 72 hours and 7days postoperatively. secondary comparative outcomes included motor strength by cybex test.

total knee arthroplasty(tka) is very popular in nowadays. but almost patients complained of postoperative pain and it affect the delay of early mobilization which prevent knee stiffness, lessens hospital stay and improves overall patient satisfaction and outcome of tka. intravenous patient-controlled analgesia (pca) or epidural analgesia is a conventional postoperative analgesia. recently other block techniques like a adductor canal block and femoral nerve block were known for good methods of pain relief after tka. however, femoral nerve block reduces quadriceps muscle strength thereby potentially compromising postoperative mobilization. therefore, it is necessary to evaluate the effectiveness of pain treatment and the preservation of muscle function after the procedure of adductor canal block and femoral nerve block. the present study aimed to determine and compare the efficacy of adductor canal block and femoral nerve block combined with general anesthesia on (1) postoperative pain control, (2) early patient ambulation and functional recovery and (3) change of muscle power after total knee arthroplasty.

Eligibility criteria:
inclusion criteria: * patients for total knee arthroplasty having medicare insurance exclusion criteria: * alcohol, drug abuser narcotics addiction
ptns vs botox of refractory oab

Conditions: Overactive Bladder (OAB)

Summary: this is a prospective cohort study of women with overactive bladder oab (dry or wet) who have failed 2 prior treatments, including behavioral modification, pelvic floor physical therapy, and/or oab medication (anticholinergics or mirabegron), and have chosen either onabotulinumtoxina (btx) injection or percutaneous tibial nerve stimulation (ptns) as their next treatment. oab-dry refers to patients with oab who do not have urge urinary incontinence; oab-wet refers to patients with oab and urge urinary incontinence. eligible patients will be approached for study participation after they have decided to proceed with btx or ptns.

prior to initiation of btx or ptns, patients will undergo a standardized evaluation including urodynamics study (uds) if not previously done in the past year and pelvic organ prolapse quantification (popq) exam if not previously done in past 6 months. subjects will also complete quality of life questionnaires and 3-day voiding diary prior to initial treatment. follow up questionnaires will be completed at 3 months either in office, if patient has a routine visit scheduled with provider and questionnaires can be completed at that visit or questionnaires will be mailed with return postage for participant to mail completed questionnaires back.

Eligibility criteria:
inclusion criteria: 1. women with refractory oab (dry or wet) 2. oab will be defined by a positive response and bother of "somewhat, quite a bit, a great deal, or a very great deal" to question #3 or #8 on the oab-q (see appendix b) regarding urinary urgency and urgency incontinence. 3. refractory will be defined as failure of 2 prior treatments, including behavioral modification, pelvic floor physical therapy, and oab medication (anticholinergics or mirabegron). trial of 2 medications that did not improve symptoms after 2 weeks or could not be tolerated due to side effects will constitute 2 treatment failures. 4. women with mixed urinary incontinence that is urge predominant will also be included. 5. age ≥ 18 years 6. english speaking 7. available for 1 year follow-up 8. able to complete study questionnaires exclusion criteria: 1. neurologic disease known to cause oab including, but not limited to, multiple sclerosis, parkinson's disease, and spinal cord injury. 2. pregnancy by self-report or pregnancy test 3. contraindication to ptns and/or btx * ptns: pacemaker * btx: myasthenia gravis, allergy to btx, urinary retention (post void residual \>200cc) 4. planned surgery for pelvic floor disorder during the study period 5. prior treatment with btx, ptns, or sacral nerve stimulation (sns) for refractory oab/urinary urge incontinence (uui)
pace4 in thyroid cancer

Conditions: Thyroid Nodule

Summary: the investigation of thyroid nodules is limited by the fact that up to 49% of the fine needle aspirations (fna) performed are of "indeterminate cytological signification". moreover, no fully reliable molecular marker for thyroid cancer have been described. the goal of this project is to study the expression of a specific kind of protein convertase in benign and in malignant thyroid nodules to determine its potential as a biomarker.

patients that underwent thyroidectomy at the ciusss de l'estrie-chus will be recruited and classified according to the pathological diagnosis. an immunohistochemistry technique, developed and calibrated for the specific protein convertase studied, will be undertaken. results will be interpreted by a specialized pathologist.

Eligibility criteria:
inclusion criteria: * men of women, aged 18-100 y.-o. * history of subtotal or total thyroidectomy at the "centre intégré universitaire de santé et de services sociaux de l'estrie - centre hospitalier universitaire de sherbrooke" (ciusss de l'estrie - chus) between january 2010 and may 2016. exclusion criteria: * refusal to participate to the study. * unavailability of the formalin-fixed, paraffin-embedded tissues. * uncertain pathological diagnosis.

Keywords: thyroid neoplasm thyroid cancer bethesda classification biomarkers protein convertase
unified protocol for emotional problems in victims of the armed conflict in colombia

Conditions: Emotional Disorder

Summary: the present study aims at evaluating the effects of a cbt intervention, a cultural adaptation of the unified protocol for the trans-diagnostic treatment of emotional disorders (up) in victims of the colombian armed conflict. a randomized clinical trial aimed at evaluating the effects of the up in a group of 100 internally displaced victims of armed conflict living in bogotá is being implemented. participants are recruited from several governmental, non-governmental agencies as well as community organizations of victims. participants are being randomly assigned to treatment condition (n=50) or to waiting-list control (n=50). treatment consists in 12 biweekly sessions covering the 8 modules of the original up. the effects of the up is evaluated through patient health questionnaire (phq) and several measures of co-morbid emotional disorders, anxiety, depression, ptsd as well as level of functioning and quality of life.

specific objectives * to translate and adapt the up, taking into account the cultural, social, economic and political context of individuals exposed to political violence in colombia. * develop and adapt a set of assessment tools to identify victim's symptoms of anxiety, depression, and related disorders. * conduct a randomized clinical trial comparing outcomes of 12 biweekly sessions of the culturally adapted up in a group participants randomized to immediate treatment to a waiting list control receiving delayed (6-week) treatment. * to identify potential variables that mediate or moderate the effects of treatment with the up. methodology design. allocation randomized participants. 100 individuals presenting emotional sequelae of exposure to violent events of armed conflict in colombia, 50 of which are being randomly assigned to treatment group and 50 to control group (waiting list).

Eligibility criteria:
inclusion criteria: * inclusion criteria. individuals registered as victims in colombian victims unit, 18 years or older, who meet the diagnostic criteria for one or more anxiety disorder(s), depressive disorder(s) or post-traumatic stress and related disorder(s) according to the diagnostic and statistical manual (dsm-5, 2013) as determined by the international neuro-psychiatric interview m.i.n.i. exclusion criteria: * exclusion criteria. individuals diagnosed with psychotic disorders, bipolar affective disorders, intellectual disability, dementia, substance abuse (as primary diagnoses, with hospitalization requirement for treatment) as well as individuals who endorse acute suicidal risk. those that do not meet the inclusion criteria, but are in need of mental health attention, will be referred to entities of the health system, so that they receive the pertinent treatment.

Keywords: anxiety depression emotion ptsd randomized clinical trial