Kornimate/medical-research-clean huggingface dataset:
raff5 proposal: improve the quality and safety of patients seen in the emergency department for acute atrial fibrillation and flutter

Conditions: Atrial Fibrillation; Atrial Flutter

Summary: acute atrial fibrillation (af) and flutter (afl) are the most common arrhythmias requiring management in the emergency department (ed). they are characterized by sudden onset of a rapid heart rate which may be irregular (af) or regular (afl). our focus is on episodes of acute af or afl which are usually less than 48 hours in duration and are highly symptomatic, requiring rapid treatment in the ed. management guidelines for acute af/afl have changed substantially in recent years with several recent revisions published by the canadian cardiovascular society (ccs) and the canadian association of emergency physicians (caep). the 2021 caep acute atrial fibrillation/flutter best practices checklist (caep checklist) was very recently published to assist ed physicians in canada and elsewhere manage patients who present to the ed with acute af/afl (figure 1). the overall goal of this project is to improve the quality and safety of the immediate and subsequent care of patients seen in the ed with acute af and afl by implementing the principles of the caep checklist at both the ottawa hospital (toh) eds and by working with toh cardiologists to provide rapid cardiology follow-up processes for patients discharged from the ed. the investigators propose a before-after cohort study using an interrupted time series design to evaluate implementation involving 720 patients at the two toh eds over a 24-month period.


Eligibility criteria:
inclusion criteria: * include all eligible patient visits to the participating eds during the study period regardless of how they are managed. * include stable patients aged 18 and over, * presenting with an episode of acute af or afl of at least 3 hours duration, * where symptoms require ed management by rhythm or rate control. exclusion criteria: * the study will exclude patients who have any of: 1. permanent af; 2. deemed unstable and required immediate electrical cardioversion; or 3. primary presentation was for another condition rather than arrhythmia.

Keywords: safety emergency department management guidelines
optiscanner versus standard blood glucose monitoring

Conditions: Hyperglycemia

Summary: the study is to demonstrate the accuracy of the optiscanner in measuring blood glucose levels in critically ill patients when compared to a reference ysi 2300 stat plus and the gem 3000, the reference standard for erasme university hospital.


Eligibility criteria:
inclusion criteria: * signed informed consent. * age ≥ 18 years. * admitted to the icu of erasme university hospital. * expected icu stay of ≥ 3 days at the time of enrollment (as judged by the principle investigator). * apache ii score of ≥ 10, within the first 24 hours of icu admission. * existing central venous catheter + arterial catheter. * no participation in any other investigational interventional study while enrolled in this study. * hyperglycemia (bg \> 150 mg/dl) at the time of admission. exclusion criteria: * pregnancy.

Keywords: monitoring blood glucose intensive care unit
immunopet with an anti-cd8 imaging agent

Conditions: Metastatic Cancer; Unresectable Malignant Neoplasm

Summary: this is a single-center, single-arm, investigator sponsored trial designed to evaluate the pk of the anti-cd8 imaging agent in patients prior to and during treatment with checkpoint inhibitors.


Eligibility criteria:
inclusion criteria: 1. subjects with histologically confirmed locally advanced or metastatic cancer for the following tumor types * cancer types other than melanoma; subjects meeting the eligibility criteria as formulated in the mpdl3280a treatment study protocol (mpdl3280a-treatment-ist-umcg) are eligible for part a or part b1. * melanoma; subjects eligible to receive standard of care anti-pd1 therapy plus or minus ipilimumab, are eligible for part b2. 2. tumor lesion(s) of which a histological biopsy can safely be obtained according to standard clinical care procedures. 3. measurable disease, as defined by standard recist v1.1. previously irradiated lesions should not be counted as target lesions. 4. signed informed consent. 5. age ≥18 at the time of signing informed consent. 6. life expectancy ≥12 weeks. 7. eastern cooperative oncology group (ecog) performance status 0-1 8. ability to comply with the protocol. 9. for female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use a highly effective form(s) of contraception (i.e., one that results in a low failure rate \[\< 1% per year\] when used consistently and correctly). exclusion criteria: 1. potential subjects with cancer other than melanoma will be excluded from participation in this study if they meet exclusion criteria formulated in the mpdl3280a treatment study protocol (mpdl3280a-treatment-ist-umcg). 2. signs or symptoms of infection within 2 weeks prior to anti-cd8 imaging agent injection. 3. prior immune checkpoint inhibitor treatment, including but not limited to anti-pd1 and anti-pd-l1 therapeutic antibodies. 4. history of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins 5. any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of the anti-cd8 imaging agent, or that may affect the interpretation of the results or render the patient at high risk from complications. 6. pregnant or lactating women.
renovate palliative: hfnc vs. standard respiratory support in patients with do-not-intubate order and arf

Conditions: Care, Palliative; Respiratory Failure

Summary: randomized clinical trial in which the main objective is to compare high flow nasal cannula (hfnc) versus the standard respiratory care in the alleviation of dyspnea perception in patients with do-not-intubate (dni) order. this is a pragmatic study that will take place in 10 brazilians icu facilities which are already participating in the main study renovate nct03643939.

do-not-intubate (dni) is usually established in cases where endotracheal intubation (eti) is considered disproportionate to prognosis and/or incompatible with the expression of wishes and values of the patient. regardless of the profile of this care plan offered to patients with dni, the control of dyspnea is one of its central objectives. the approach to dyspnea includes pharmacological measures such as opioids and non-pharmacological measures, such as oxygen therapy and non-invasive ventilation, and more recently, the high flow nasal catheter (hfnc). hfnc provides high flow of heated and humidified mixed gas through a nasal cannula. in addition to the ability to generate high flows and supplemental oxygen, hfnc may generate a low level of positive airway pressure, may decrease dead space ventilation and may contribute to better patient comfort, such as the possibility of oral feeding while undergoing treatment, performing oral hygiene and allowing conversation and interaction with family members. this pilot study aims to evaluate the efficacy of hfnc in reducing dyspnea and improving comfort in patients with acute respiratory failure (arf) and dni order.

Eligibility criteria:
inclusion criteria: participants must be 18 years of age or older, with arf of any cause on admission or post-extubation with prior dni directives or dni order determined in the current hospitalization. patients must meet the following criteria below: 1. dyspnea (defined on the borg scale ≥4); 2. spo2 \<90% or pao2 \<60 mmhg in room air; 3. absence of delirium; 4. one of the following: a. signs of respiratory distress and use of accessory muscles; b. respiratory rate greater than 25 incursions per min . exclusion criteria: 1. refusal of treatment; 2. agitation or non-cooperation; 3. presence of delirium at the time of randomization; 4. anatomical abnormalities that may interfere with the adjustment of the non-invasive positive pressure ventilation mask 5. glasgow \<12; 6. psychomotor agitation that prevents adequate medical / nursing assistance requiring sedation; 7. contraindications to niv: uncontrollable vomiting, hypersecretion of the airways, facial deformities, trauma or extensive facial burn; 8. presence of pneumothorax or extensive pleural effusion; 9. expected imminent death, defined as an estimated death of less than 24 hours.

Keywords: non invasive ventilation high flow nasal cannula palliative dypnea standard care do-not-intubate acute respiratory failure
evaluation of dermatomal distribution in the erector spinae plane (esp) block

Conditions: Pain, Chronic; Pain, Postoperative

Summary: interventional study that evaluate dermatomal distribution and its demographic determinants in patients who underwent to erector spinae plane (esp) block

interventional study that evaluate dermatomal distribution with pinprick and cold, and its demographic determinants in patients who underwent to erector spinae plane (esp) block with 20 ml of bupivacaine 0.5% at the thoracic level in patients with pain in the thorax and upper abdomen.

Eligibility criteria:
inclusion criteria: * patients older than 18 years, in the acute / chronic pain service that presents pain in the thoracic region and / or upper hemiabdomen. exclusion criteria: * women in pregnancy * patients with less than 50 kg of weight * dissent of informed consent

Keywords: erector spinae plane erector spinae plane block
an observational study of infliximab in participants suffering from ankylosing spondylitis with hip involvement

Conditions: Spondylitis, Ankylosing

Summary: the purpose of this observational (a study that follows participants forward in time) study is to compare the functional improvement of hip joint using harris hip score between 2 treatment groups (infliximab and conventional therapy) at week 30 in ankylosing spondylitis (an autoimmune disease causing chronic inflammation at tendon ends and ligament attachment points) participants with hip involvement.

this is a multi-center (when more than 1 hospital or medical school team work on a medical research study), observational study to compare the effectiveness of infliximab with conventional therapies in ankylosing spondylitis participants with hip joint involvement. the study will be conducted in 3 parts: a 14-day screening, a 30-week first follow-up (follow-up 1), and an additional 22-week follow-up (follow-up 2) up to week 52. participants will be assigned to two groups based on the current treatments they are receiving: cohort 1 participants receiving infliximab with or without combination of disease modifying drugs (dmards-such as sulfasalazine, methotrexate and thalidomide) and/or non-steroidal anti-inflammatory drugs (nsaids) and in cohort 2 who are receiving dmards and/or nsaids for treatment of pain will be observed. participants will primarily be assessed for change in harris hip score. participants' safety will be monitored throughout the study.

Eligibility criteria:
inclusion criteria: * diagnosed with ankylosing spondylitis (as) (according to the modified new york criteria for as) at least 3 months prior to the day 1 in the follow-up i phase with symptoms of active disease atscreening/baseline * hip pain and duration of hip symptom less than 2 years * harris hip score less than (\<) 70 * hip involvement proven by magnetic resonance imaging (mri) * being treated with infliximab and conventional therapy for 2 weeks to 6 months exclusion criteria: * participant has a history of hip joint disability which was considered irreversible * participant has a history of hip joint replacement * participant has a history of treatment with biologics other than infliximab less than 6 months prior to study entry

Keywords: spondylitis, ankylosing infliximab non-steroidal anti-inflammatory drugs disease-modifying anti-rheumatic drugs
tumor microenvironment mechanism of ly007 for r/r b-nhl and the exploration of novel car-t translational research

Conditions: Relapsed Non-Hodgkin Lymphoma

Summary: the t cell characteristics of 12 patients treated with cd20 car-t (ly007 cell injection) were analyzed to study their relationship with car-t anti-tumor activity, tumor killing, and in vivo proliferation, and to explore the mechanisms: before single harvesting, before bridging, before pretreatment, d0, d7, d14, d21, d28, and at the time of follow-up evaluation (plus time points if taking btki inhibitors: peripheral blood specimens were collected before btki and 48h after btki discontinuation, and peripheral blood cells from patients before and after treatment were analyzed by mass spectrometry flow and single-cell sequencing. tumor tissue specimens were collected from patients at different time points (before pretreatment, during car-t expansion, and at pd) and subjected to single-cell sequencing.


Eligibility criteria:
inclusion criteria: * 18-70 years of age (include 18 and 70); * eastern cooperative oncology group (ecog) score of 0-1; * cytologically or histologically confirmed diagnosis of cd20-positive b-nhl according to who 2016 criteria, including diffuse large b-cell lymphoma (including histologically transformed) and transformed follicular lymphoma (tfl); * relapsed or refractory b-cell non-hodgkin's lymphoma, subjects must have been treated with at least anthracyclines and rituximab (or other cd20-targeted agents) and have relapsed, failed to remit, or progressed after at least second-line therapy or autologous hematopoietic stem cell transplantation (auto-hsct); exclusion criteria: * hepatitis b surface antigen (hbsag) positive or hepatitis b core antibody (hbcab) positive with peripheral blood hbv dna titer higher than the lower limit of detection; hepatitis c virus (hcv) antibody positive with hcvrna titer higher than the lower limit of detection; human immunodeficiency virus (hiv) antibody positive; positive syphilis serology. 2. lymphoma involving only the central nervous system (cns) (subjects with secondary cns lymphoma are permitted to enroll); and * lymphoma involving only the central nervous system (cns) (subjects with secondary cns lymphoma are eligible for enrollment). 3. prior carb vaccination prior to enrollment; * prior car-t therapy (except for prior targeted cd19 car-t therapy, including patients with stable disease evaluated at 3 months after cd19 car-t infusion or progressive disease evaluated at any time) or other genetically modified t-cell therapy prior to monotherapy.
neuroprognostication using optic nerve sheath diameter

Conditions: Heart Arrest; Intracranial Pressure Increase

Summary: this study investigates the relationship between optic nerve sheath diameter and increased intracranial pressure and its effect on neurologic outcome in post-cardiopulmonary arrest patients.

this study involves patients who have experienced either an in-hospital or out-of-hospital cardiopulmonary arrest, and who meet the 2015 american heart association (aha) inclusion/exclusion criteria for targeted temperature management \[i.e., they are comatose or exhibit no meaningful response to verbal commands with return of spontaneous circulation (rosc) after cardiac arrest\]. after induction of hypothermia protocol after cardiopulmonary arrest (i.e., targeted temperature management), patients will undergo ocular ultrasound at three time points.

Eligibility criteria:
inclusion criteria: * patient ≥ 18 years of age * patient has experienced either an in-hospital or out-of-hospital cardiopulmonary arrest * patient is comatose or exhibits lack of meaningful response to verbal commands with return of spontaneous circulation (rosc) after cardiopulmonary arrest * patient must meet all inclusion criteria as deemed by physician and the 2015 american heart association standards for targeted temperature management (ttm) following cardiopulmonary arrest exclusion criteria: * patient \< 18 years of age * patient does not meet inclusion criteria for targeted temperature management (ttm) * unable to obtain consent from legal authorized representative (lar) * patient has a do not resuscitate (dnr) order or a do not intubate (dni) order at the time of consent * patient has uncontrollable bleeding * patient is able to follow verbal commands * patient has another medical condition creating increased ocular pressure, as deemed by physician
doppler-guided haemorrhoidal artery ligation with suture mucopexy vs. suture mucopexy alone

Conditions: Third Degree Hemorrhoids

Summary: novel minimally invasive techniques were established for prolapsing haemorrhoids to minimise the drawbacks of the golden standard of haemorrhoidal treatment, conventional haemorrhoidectomy techniques. ligation techniques, such as doppler-guided haemorrhoidal artery ligation (dg-hal), were introduced to reduce the arterial inflow of the avp and thus prevent the haemorrhoidal zone from being part of the continence system. apart from inappropriate application of this surgical alternative for higher grade haemorrhoids, high recurrence rates of up to 38% after dg-hal are due to technical failure of the ligation technique itself. this is a prospective randomised controlled trial to evaluate the efficacy of additional doppler-guided ligation of submucosal haemorrhoidal arteries in patients with symptomatic grade iii haemorrhoids.

all consecutive patients with symptomatic grade iii haemorrhoids are randomly allocated to one of the two study arms: (a) dg-hal with mucopexy or (b) mucopexy alone. endpoints are pain, faecal incontinence, bleeding, residual prolapse and vascularisation of the anorectal vascular plexus. vascularisation of the anorectal vascular plexus is assessed by transperineal contrast enhanced ultrasound.

Eligibility criteria:
inclusion criteria: * grade iii haemorrhoids * ≥18 years of age exclusion criteria: * malignant gastrointestinal disease * inflammatory bowel disease * any type of proctological intervention (i.e., fistula surgery) * recurrent haemorrhoidal disease * anorectal trauma in the history
kinetics of biomarkers in acute pyelonephritis

Conditions: Pyelonephritis

Summary: the objective of this study is to explore the kinetics of biomarkers in 30 adult female patients with uncomplicated acute pyelonephritis.

we will measure c-reactive protein, procalcitonin, pyuria and a new blood biomarker (signature tm) everyday till normalization of these markers in 30 adult female patients with uncomplicated acute pyelonephritis.

Eligibility criteria:
inclusion criteria: * \> 18 years * flank/loin pain or tenderness, or both and fever \> 38°c during the last 48 hours and pyuria exclusion criteria: * pregnancy * presence of indwelling catheters * known polycystic kidney disease or any malformation of the urinary tract, or single kidney; renal transplant recipients; acute or chronic renal failure requiring dialysis * recent discharge from hospital (during the last 10 days); ongoing antibiotic treatment * known severe immunosuppression: receiver of solid-organ or hematopoietic stem cells transplants; neutropenia ( \ 10 mg/d of prednisone); active use of immunosuppressive therapy for the treatment of auto-immune or inflammatory disease; hiv infection with \< 350 cd4+ cells / ml or unknown cd4+ status * pyelonephritis initially identified as complicated: obstruction of urinary tract, urinary stone; history of renal infection in the last 15 days * patient with severe sepsis or septic shock
the effect of different videolaryngoscopes on intubation success in obese patients

Conditions: Difficult Airway, Videolaryngoscopes

Summary: obese patients may have difficulty in airway management.patients who have body mass index \> 35 are challenging patients for anesthesiologist. short neck, more adipose tissue may be reasons for airway difficulty. videolaryngoscopes are devices that ease the management of difficult airway.this study is designed to evaluate the differences and the effects of different laryngoscopes.


Eligibility criteria:
inclusion criteria: * body mass index\> 35 exclusion criteria: * emergency airway
clinicoepidimiological study and clinical outcome in patients with urinary bladder cancer

Conditions: Urinary Bladder Cancer

Summary: to pinpoint the clinical ,epidimiological factors and clinical outcomes in urinary bladder cancer patients attending to our department during 5 years period between 2015-2019.

bladder cancer is the ninth most common cancer throughout the world. the incidence of bladder cancer is three to four times greater in men than in women. however, women are diagnosed with more advanced disease at presentation and have less favorable outcomes after treatment. statistical data show that between 2002 and 2012, worldwide, the number of bladder cancers increased from 375.000 to about 430.000 , while the mortality increased from 145.000 patients in 2002 up to 165.000 patients in 2012. in the united states, bladder cancer is the fourth most common cancer in males with an age-adjusted incidence rate of 37.3/100,000 person years (py) using the us standard population. in developed countries, over 90% of the bladder cancer cases diagnosed are transitional cell carcinoma (tcc), with squamous cell carcinoma (scc), adenocarcinomas, and rare types of bladder cancer comprising the remaining 10% of bladder cancer cases. exposures to tobacco smoke, occupational toxins, and environmental sources of heavy metals such as arsenic are the major reported risk factors for tcc. unlike tcc, the main risk factors for scc are not environmental exposures, but exposure to infectious agents. age, smoking, tumor stage and the treatment modalities such as surgery and adjuvant chemotherapy were proved to affect the overall survival in patients with urinary bladder cancer. our study may give an important evidence about clinical, epidemiological factors and clinical outcomes in urinary bladder cancer patients at assuit university hospital.

Eligibility criteria:
inclusion criteria: * age 18 :70 * histologically proved urinary bladder carcinoma exclusion criteria: * age less than 18 or more than 70 * patient not documented having bladder carcinoma with biopsy \[cysyoscopic or operative\] * patient with synchronous or metachronous double primary