Kornimate/medical-research-clean huggingface dataset:
nitric oxide in cardiopulmonary bypass for renal protection in cardiac surgery

Conditions: Coronary Artery Disease; Heart Valve Diseases; Cardiomyopathies; Acute Kidney Injury

Summary: this prospective randomized study evaluates the nephroprotective effects of exogenous nitric oxide delivered to the extracorporeal circulation circuit during cardiac surgery with cardiopulmonary bypass.

the aim of this work is to study nephroprotective effects of nitric oxide (no) supplementation to the cardiopulmonary bypass (cpb) circuit during cardiac surgery with normothermic cpb in adult patients. the prospective randomized study is performed in the settings of federal cardiology center. a total of 96 adult patients who underwent cardiac surgery with cpb are enrolled in the study. patients are randomized to two groups: main group receive no treatment; control group undergoes sham procedure. in the main group, no is supplied to the cpb line in a dose of 40 ppm throughout the entire cpb period. the primary endpoint is the frequency of acute kidney injury (aki). the secondary endpoints are urine output during cpb; ungal level 4 h after surgery; plasma concentration of free hemoglobin (hb); concentrations of no metabolites (nitrite (no2-) and nitrate (no3-)) and the total concentration of metabolites of no (nox, μm/ml) in blood plasma in the intraoperative period; concentration of proinflammatory (tnf-α, il-1β, -6, and -8) and anti-inflammatory mediators (il-1ra, il-4) in blood plasma in the intraoperative period. cumulative fluid balance, diuresis, and lasix doses are assessed within the first 48 h of the postoperative period. the dynamics of serum creatinine is assessed during the first week following the intervention.

Eligibility criteria:
inclusion criteria: age above 18 years; planned primary cardiac intervention with cardiopulmonary bypass including coronary artery bypass grafting, valve surgery, and surgical reconstructions of the left ventricle. exclusion criteria: preoperative anemia; the intake of nephrotoxic drugs or the use of x-ray contrast within 72 h before surgery; active phase of endocarditis; emergency surgery; chronic kidney disease; hematologic diseases accompanied by hemolysis; complications of the surgery and the early postoperative period.

Keywords: cardiopulmonary bypass nitric oxide kidney function tests renal insufficiency protective agents coronary artery bypass cardiac surgery
monitoring salivary gland injury in nasopharyngeal carcinoma patients after radiotherapy using multi-modal radiomics

Conditions: Nasopharyngeal Carcinoma ,Xerostomia,Radiotherapy

Summary: this prospective observational study aims to evaluate the role of intravoxel incoherent motion (ivim) imaging and magnetic resonance fingerprinting (mrf) techniques in monitoring salivary gland injury in nasopharyngeal carcinoma (npc) patients undergoing radiotherapy. the study will recruit patients diagnosed with npc who are receiving standard radiotherapy, and quantitative imaging data will be collected using ivim and mrf techniques at multiple time points, including pre-treatment, during radiotherapy, and post-treatment. the primary objective is to analyze changes in salivary gland structure and function and to identify early imaging biomarkers indicative of radiation-induced injury. the findings are expected to provide new insights into the dynamic progression of salivary gland damage, establish predictive models for the risk of xerostomia, and guide the development of personalized therapeutic strategies to mitigate long-term complications.

this is a prospective study designed to investigate the application of intravoxel incoherent motion (ivim) and magnetic resonance fingerprinting (mrf) imaging techniques in monitoring salivary gland injury in nasopharyngeal carcinoma (npc) patients after radiotherapy. the study aims to quantify and assess salivary gland function changes during and after radiotherapy using advanced imaging technologies, with the goal of identifying early imaging biomarkers associated with radiation-induced damage. patients diagnosed with npc and receiving standard radiotherapy will be recruited. imaging data will be acquired at three time points: prior to radiotherapy (baseline), during radiotherapy (mid-course), and after radiotherapy (post-treatment). ivim and mrf sequences will be performed to collect data on salivary gland microstructure, perfusion, and relaxation properties. these parameters will be analyzed to detect early changes in salivary gland function and correlate them with the development of xerostomia. this study is expected to provide valuable insights into the utility of ivim and mrf imaging in predicting and monitoring radiation-induced salivary gland damage. the findings may facilitate early intervention strategies and contribute to personalized radiotherapy planning aimed at minimizing xerostomia risk in npc patients.

Eligibility criteria:
inclusion criteria: 1. histologically or cytologically confirmed diagnosis of nasopharyngeal carcinoma. 2. scheduled to undergo radiotherapy as part of standard treatment. 3. aged 18 years or older. 4. no contraindications to mri scans (e.g., no implanted metallic devices). 5. written informed consent has been provided. exclusion criteria: 1. contraindications to mri, such as metallic implants or claustrophobia. 2. severe comorbid conditions, including significant renal or hepatic dysfunction. 3. concurrent participation in another interventional clinical trial. 4. pregnant or breastfeeding. 5. any condition that may impair compliance with study procedures.
crohn's disease - inflammation and microbial proteolytic activity

Conditions: Crohn's Disease of Both Small and Large Intestine

Summary: this study postulates that altered microbiota associated with areas of mucosal inflammation in cd, can be characterized by an increased proteolytic profile. this is clinically important as it may be possible to modulate the proteolytic activity of the cd-associated bacteria by using other bacteria that produce protease inhibitors, such as serpins.

crohn's disease (cd), characterized by discontinuous intestinal injury and inflammation, has been associated with changes in the luminal microbiota and impaired barrier function. previously, the investigators have shown that in patients with cd, the mucosa-associated microbiota is altered. additionally, it has been shown that in patients with active cd, areas of intestinal injury are associated with impaired barrier function, but the mechanisms remain unclear. increased host proteolytic activity has been reported in both cd and ulcerative colitis (uc). the microbiota is an important source of proteases with potential inflammatory and barrier disrupting capacity. indeed, preliminary data indicate that in uc patients the gut microbiota contributes to proteolytic imbalance. it is unknown whether this is also the case in cd. specifically, this study postulates that the altered microbiota associated with areas of mucosal inflammation in cd, is characterized by an increased proteolytic profile. this is clinically important as it may be possible to modulate the proteolytic activity of the cd-associated bacteria by using other bacteria that produce protease inhibitors such as serpins. in this prospective observational study, patients booked for routine white light colonoscopy under the care of the division of gastroenterology, hamilton health sciences at the mcmaster university medical centre and juravinski hospital endoscopy units will be invited to participate. patients previously diagnosed with crohn's disease who have a clinical indication for undergoing a standard white light colonoscopy, as determined by the gastroenterologist, will be invited to participate; biopsy samples and mucosal brushings will be taken from inflamed and non-inflamed areas in the ileum or colon.

Eligibility criteria:
inclusion criteria: * be aged between 18 - 70 years old * have a confirmed diagnosis of crohn's disease * have a clinical indication for standard, white light colonoscopy to assess disease activity and extent exclusion criteria: * inability to provide written informed consent * presence of serious life-threatening co-morbidities * evidence of toxic megacolon, jaundice, cirrhosis, renal dysfunction, acute gi bleeding * history of difficult colonoscopy, strictures or extensive diverticulosis * antibiotics in the last month * probiotics in the last week

Keywords: proteolytic activity serpin crohn's disease
endostar combined with concurrent chemoradiotherapy for locally advanced cervical carcinoma

Conditions: Cervical Carcinoma

Summary: a total of 120 patients with pathologically confirmed locally advanced cervical carcinoma were enrolled. patients were randomly divided into two groups, with 60 patients in each group. one group was treated with concurrent chemoradiotherapy combined with endostar and the other group was treated with concurrent chemoradiotherapy. the short term efficacy and the toxic of these treatments were evaluated. the 1-year, 3-year, 5-year overall survival and progression-free survival of patients were analyzed. the investigators data may provide an alternative option for the treatment of locally advanced cervical carcinoma with high efficacy and low toxicity.

this study was a multicenter, randomized controlled clinical trial. a set of unified standards were used, including the clinical research program, inclusion criteria, exclusion criteria, chemoradiotherapy regimen and evaluation criteria. nine medical centers participated in this study and 120 patients with pathologically confirmed locally advanced cervical carcinoma were enrolled. these patients were randomly divided into two groups: concurrent chemoradiotherapy combined with endostar group ( imrt 45-50gy, ddp 40mg/m2, per week for 5cycles, endostar: 7.5mg/m2 d1-10, repeat every 15 days, for 4 cycles) and concurrent chemoradiotherapy group ( imrt 45-50gy, ddp 40mg/m2, per week, for 5cycles). after treatment, follow-up was performed every 3 months. the treatment toxicity, local control rate, distant metastasis-free survival, overall survival, progression-free survival were observed and assessed.

Eligibility criteria:
inclusion criteria: * patients of either gender and aged from 18 to 65 years old. * patients with histologically confirmed cervical carcinoma. * patients at stage ib, iia2, iib-iva by figo 2009 staging. * kps ≥ 70 (appendix i) * patients with available mri or ct data of cervical and measurable tumor lesions. * patients did not receive any treatment before enrollment. * patients with expected survival longer than 6 months. * biochemical indexes: wbc \> 4,000/mm3, and blood platelet ≥ 100,000 mm3; pt≤unl; levels of indicators for hepatic and renal function was 1.5 folds of the upper limit of normal value. * the informed content was obtained from every patient. * patients with effective follow-up. exclusion criteria: * those with malignant tumors other than cervical carcinoma. * those received treatments before enrollmment. * lactating women and pregnant woman. * those who were undergoing other drug trials. * those with severe complications, including myocardial infarction, severe arrhythmia, severe cerebrovascular disease, ulcer disease, mental illness and uncontrollable diabetes. * those who were treated with tumor targeting drugs. * those who could not subject to mri or ct examination. * those who could not meet the requirements of the prescribed dose.

Keywords: cervical carcinoma endostar concurrent chemoradiotherapy
impact of enzyme replacement therapy on cardiac function in patients with fabry's cardiomyopathy (recafture trial)

Conditions: Fabry's Disease

Summary: the purpose of this study is to evaluate the impact of ert on lv diastolic function and flow in patients with fabry's cardiomyopathy using diastolic stress echocardiography, lv vortex flow and cmr.

1. objectives -the purpose of this study is to evaluate the impact of ert on lv diastolic function and flow in patients with fabry's cardiomyopathy using diastolic stress echocardiography, lv vortex flow and cmr. 2. primary / secondary endpoint 1) primary endpoint * changes of peak exercise e/e' by diastolic stress echocardiography (recap-f stress trial) and lv vortex flow parameters (recap-f flow trial) at 1 year follow up. 2) secondary endpoint * changes of extracellular volume by cmr(t1 mapping) at 1 year follow up (recap-f trial) ② evaluation of the degree of the resting lv diastolic function ③ other echo-parameters; lv mass index at baseline, 1 year follow up, reduction of peak exercise e/e prime at 1 year follow up * changes of quality of life using questionnaire ⑤ change of peak vo2, exercise time, at by diastolic stress echocardiography at 1 year follow up ⑥ change in t1 baseline(myo, ms) \& t1 baseline(blood, ms) t1 postcontrast(myo, ms) \& t1 baseline(blood, ms) by cmr 3. study methods 1) study design : 28 patients with newly diagnosed genetically confirmed anderson-fabry's disease will undergo diastolic stress echocardiography, lv vortex flow analysis, and cardiac mri before enzyme replacement therapy(ert) (baseline study) and after 1 year of treatment with agalsidese beta at the dose of 1mg/kg (follow-up study). 2) study procedures : examinations as described below will be done before ert and 1 year later

Eligibility criteria:
inclusion criteria: * patients aged 16\~75 years with fabry's disease who were confirmed by enzyme assay and gene study * all patients should have lv hypertrophy in 2d echocardiography (end diastolic septum and posterior wall thickness ≥12mm) * patients provided with the written, informed consent to participate in this study exclusion criteria: * contraindication for agalsidase beta enzyme replacement treatment * patients who cannot perform supine bicycle stress echocardiography, contrast echocardiography or cardiac mri * hemodynamically significant valvular heart disease or arrythmias * history of acute myocardial infarction or congestive heart failure with reduced lv ejection fraction of less than 35% * cva in the prior 6 months * scheduled or planned surgery in the next 6 months * chronic liver cirrhosis * allergy to contrast agent (definity®, lantheus medical imaging, north billerica, ma, usa)
candida host defense response after septic shock in the critically ill

Conditions: Septic Shock; Candidiasis

Summary: septic shock is associated with acquired immunoparalysis which is associated with a high risk of nosocomial acquired infection. nosocomial candidiasis is associated with a 50% rate of mortality but is difficult to diagnose. the use of colonization indexes and risk factors on the other hand expose to unnecessary use of antifungals. the aim of the present study is to evaluate whether the host response to infection associated with candida biomarkers would help to anticipate the candidiasis onset.

single center prospective observationnal study. inclusion: all consecutive patients subsequently to a septic shock with no candida infection. measured parameters: host response (hladr, cd64, inflammatory cytokines consecutive to lps exposition) and candida biomarkers (beta d glucan, mannan ag and ig), demographics, outcome (occurence of candida nosocomial infection, morbidity and survival)

Eligibility criteria:
inclusion criteria: age \> = 18 years * the patients in toxic shock defined according to the bone criteria * informed consent of the patient or his reliable person (poursuit consent in this case). possibility of inclusion according to the emergency procedure with the obligation of research for the consent with the reliable person and with the patient. * obligation of membership or beneficiary to have a national insurance exclusion criteria: * pregnant or breast-feeding women according to the article l1121-5 of the csp * vulnerable people according to the article l1121-6 of the csp 9358 _ " * neutropénie 500 / mm3 * infection by the hiv, the hepatitis c or b active column * biotherapics (anti-cd20, anti-tnfa, anti-il-6) * treatments immunosuppresseurs (methotrexate, azathioprine, cyclophosphamide, mycophenolate mofétil, cyclosporine, tacrolimus) * corticosteroid therapy = 1mg / kg of equivalent prednisone for more than a month * toxic shock due to a deep candidiasis in the admission in resuscitation * congenital deficits of th17 (cutanéo-mucous candidiasis chronicles, syndrome of hyper ige)

Keywords: septic shock candidiasis candidemia bacteremia immunoparalysis
incident chronic obstructive pulmonary disease cohort study (iconic)

Conditions: Smokers; Chronic Obstructive Pulmonary Disease

Summary: chronic obstructive pulmonary disease (copd), , secondary to smoking, is a major public health issue with very high direct and indirect costs. the impact on the health system of undiagnosed patients, up to 70% of patients, is increasingly documented. however, systematic spirometry screening remains controversial among smokers in the absence of data to link the detection of new patients with improved management and clinical events and health goals. more generally, there is little data on the evolution of patients in real life once they have entered the care system. the premise is that with systematic screening in general medicine, it is possible to identify the evolution of newly diagnosed copd patients, to distinguish the different possible evolutions according to the initial phenotype and the management.

a description of the population from which the groups or cohorts will be selected smokers who have a screening spirometry for copd, either in general medicine, at a pulmonologist or in the chic or henri mondor hospital respiratory function tests department. after screening, an equal number of men and women copd will be included (150 men and 150 women). 1500 smokers will be included to reach 300 smokers with copd.

Eligibility criteria:
inclusion criteria: inclusion criteria of smokers with spirometry (pre-inclusion) * age\> 35 years * smoking \> 20 pa * active smoking (cessation \< 1 month) * signature of consent to participate in phase i of the study inclusion criteria for patients with incidental copd * fev1 / fvc \<70% of the theoretical value and / or \<lln (lower limit of normal) * signature of consent to participate in phase ii of the study exclusion criteria: * known copd * cancer being treated * no affiliation to the social security or other social protection scheme * pregnant or lactating woman * patient deprived of liberty or under legal protection (under tutorship or curatorship

Keywords: incident chronic obstructive pulmonary disease comorbidities trajectories
impact of poplar propolis on metabolic disturbances of insulin resistance

Conditions: Insulin Resistance

Summary: propolis, a natural resinous mixture rich in polyphenols, produced by bees from a variety of plant sources, has shown significant therapeutic effects and may prevent the development of certain chronic diseases. current evidence supports the beneficial effect of these bioactive phytochemicals on the management of type 2 diabetes mellitus (t2dm) and other chronic diseases. the objective of this study is to evaluate the effect of poplar propolis extract powder (ppep) on glucose homeostasis and other clinical parameters in insulin-resistant patients (diagnosed by homa-ir index \> 1.85 for men and \> 2.07 for women).

backgroud: propolis, a natural resinous mixture rich in polyphenols, produced by bees from a variety of plant sources, has shown significant therapeutic effects and may prevent the development of certain chronic diseases. current evidence supports the beneficial effect of these bioactive phytochemicals on the management of type 2 diabetes mellitus (t2dm) and other chronic diseases. the objective of this study is to evaluate the effect of poplar propolis extract powder (ppep) on glucose homeostasis and other clinical parameters in insulin-resistant patients (diagnosed by homa-ir index \> 1.85 for men and \> 2.07 for women). methods: the trial was a randomized, controlled, crossover, intervention study. insulin-resistant patients (n=9) (8 women, 1 man), with a mean ± sd age 49 ± 7, were subjected to two periods of supplementation (propolis and placebo) for 3-months, separated by a 2-week washout period. the quantity of propolis administered was determined individually to reach 6 mg of polyphenols/kg. fasting blood test and oral glucose tolerance test (ogtt) were performed before and after each treatment.

Eligibility criteria:
inclusion criteria: * body mass index (bmi) ≥ 30 kg/m2 * insulin resistance defined as a homa-ir index \> 1.85 for men and \> 2.07 for women exclusion criteria: * presence of diabetes * recent weight change (≥ 5% in the last 3 months) * documented allergy to bee products and/or fish products * positive serology for human immunodeficiency virus or hepatitis * high blood pressure * elevated transaminases (ast \> 40 iu/l ; alt \> 45 iu/l) * low creatine clearance (estimated glomerular filtration rate \< 90 ml/min) * interfering treatment (cholesterol-lowering treatment, intestinal absorption modulating treatment, absorption modulating treatment and/or insulin sensitivity) * gastrointestinal tract surgery * pregnancy and / or lactation.

Keywords: propolis
effect of the intensity of continuous renal replacement therapy

Conditions: Optimal Intensity of Renal Replacement Therapy on Sepsis Patients

Summary: in patients with sepsis and aki, increasing the intensity of renal replacement therapy from 50 ml/kg/h (hvhf) to 85 ml/kg/h (ehvhf)will increase the survival at 28 days and 90 days.


Eligibility criteria:
inclusion criteria: met at least one of the following criteria: oliguria (urine output less than 100 ml in a 6 h period and unresponsive to fluid resuscitation), serum potassium concentration more than 6.5 mmol/l, severe acidemia (ph \< 7.2), serum creatinine more than 250 µmol/l, or presence of severe organ edema (e.g. pulmonary edema). exclusion criteria: * were presence of a malignant tumor, chronic renal insufficiency (serum creatinine \>133 µmol/l), or receiving any kind of renal replacement therapy before randomization.

Keywords: high volume hemofiltration sepsis acute kidney injury survival