Kornimate/medical-research-clean huggingface dataset:
rapid identification of minoca based on novel biomarkers

Conditions: Myocardial Infarction With Non-obstructive Coronary Arteries; Grow Stimulation Expressed Gene 2; Copeptin; Identification; Prognosis

Summary: among the patients diagnosed as acute myocardial infarction by coronary angiography, 5%-25% of the patients did not find coronary artery obstructive lesions. these patients do not need pci. the discovery and verification of clinical protocols for accurate identification of myocardial infarction in the absence of obstructive coronary artery disease（minoca）is a major issue that needs to be addressed.novel biomarkers like grow stimulation expressed gene 2（st2）can indicate the degree of coronary artery obstruction, copeptin is a biomarker of cardiac emergency state. no clinical studies have been conducted to evaluate whether the novel biomarkers combination regimen can diagnose or exclude minoca. our research aims to establish and validate a model for the recognition of minoca based on novel biomarkers (st2, copeptin) and to evaluate the prognostic value of novel biomarkers among patients with acute chest pain.

a cross-sectional study design will be used to evaluate the correlation between baseline novel biomarkers（st2 and copeptin）and minoca, and to establish a discriminant model for the identification of minoca, and to verify its discriminant efficacy. a cohort study design will be used to evaluate the prognostic role of novel biomarkers in patients with acute chest pain. on the basis of precision cohort (bipass), the project team will adopt the method of cross-sectional diagnostic experimental study design. ①blood samples of minoca and ami were extracted. according to the new biomarkers（st2 and copeptin）reported in literature, the team will detect and combine them with troponin, and correct the covariate. and then establish the multivariate joint discriminant model. ②at the same time, according to the propensity score, patients will be selected from ua in a 1:1 matching ratio for modeling. the discriminant model for rapid recognition of minoca will be verified by internal cross validation and external validation. based on this discriminant model, whether the combined application of three biomarkers in minoca diagnosis is superior to that of a single biomarker will also be evaluated. patients with acute chest pain from multi-center will be selected to verify the accuracy of the rapid discriminant model of minoca applied to patients with acute chest pain.

Eligibility criteria:
inclusion criteria: * the clear diagnosis of minoca, acute myocardial infarction（ami) and unstable angina（ua) in bipass * the clear diagnosis of minoca from the multi-center cohort exclusion criteria: * prior surgery (cardiac or non-cardiac), trauma or clinically evident coagulopathic bleeding (e.g. gastrointestinal, genitourinary, et al) * patient with non-cardiac co-morbidities with life expectancy less than 12 months * patients unwilling or unable to comply with all clinical follow-up schedules
open vs robotic assisted partial nephrectomy

Conditions: Renal Cancer

Summary: to demonstrate that robotic-assisted partial nephrectomy is superior to open partial nephrectomy in reducing the number of 30 day post-operative complications (clavien-dindo type i-v) for patients with intermediate to high complexity kidney tumors.

partial nephrectomy is the surgical removal of a kidney tumor while unaffected tissue remains intact so that the kidney function is maintained as far as possible. the more radical procedure would be the complete removal of the kidney, which is not examined in this trial. surgery will be randomized either to an open technique involving a large incision or the robotic assisted technique with a few small incisions (keyhole surgery). with robotic assisted surgery the movements of the surgeon are translated into the movement of the instruments. it is not clear which of the two procedures, open or robotic assisted, has less complications. it is expected that these are different due to the different level of invasiveness and the level of direct access to the organ. this study aims to show that robotic assisted surgery results in less complications than open surgery.

Eligibility criteria:
inclusion criteria: * age 18 years or older * patient with a renal tumor that is a candidate for open surgery and robotic assisted surgery (ras) partial nephrectomy (pn) * r.e.n.a.l. score ≥ 7 * egfr ≥ 50 ml/min/1.73 m² * anticoagulation is accepted according to the surgeon's practice exclusion criteria: * solitary kidney or functionally solitary kidney * prior surgery at the affected kidney excluding endoscopic kidney stone surgery * bilateral tumors * multiple renal tumors requiring excision * renal vein tumor thrombus * likely insufficient volume of remaining parenchyma after partial nephrectomy to maintain viable kidney remnant * metastatic disease with life expectancy of less than 1 year * pregnancy or suspected pregnancy * planned concomitant procedure * subject who is unable or unwilling to comply with the protocol requirements * subject considered to be from a vulnerable population according to is0 14155:2011

Keywords: robotic-assisted surgery open surgery partial nephrectomy minimal invasive surgery ras mis
long-term low-molecular-weight heparin versus oral anticoagulants in deep venous thrombosis

Conditions: Venous Thromboembolism

Summary: the purpose of this study is to evaluate whether low-molecular-weight heparin could be equally or more effective than oral anticoagulation in the long-term treatment of deep venous thrombosis.

the open-label prospective randomized clinical trial compares subcutaneous lmwh (tinzaparin)administered for 6 months versus initial treatment using subcutaneous lmwh followed by oral anticoagulants given for a similar period of time in patients with proximal venous thrombosis.

Eligibility criteria:
inclusion criteria: * consecutive, symptomatic patients with a first or recurrent episode of acute proximal-vein thrombosis of the lower limbs. * either sex and over 18 years of age * referred to the vascular surgery department of the hospital * onset of symptoms less than 2 weeks * documented by compression ultrasonography, exclusion criteria: * received heparin, low-molecular-weight heparin or oral anticoagulant therapy for more than 2 days for the present disease * pulmonary embolism requiring thrombolytic therapy * need of surgical thrombectomy or vena cava interruption * receiving oral anticoagulant treatment or antiplatelet agents for other conditions * contraindication to anticoagulant treatment (active bleeding, severe blood pressure or allergy to the study drugs) * platelet count lower than 100x103 /μl or hemoglobin concentration lower than 7 g/dl or history of heparin-associated thrombocytopenia * severe renal failure necessitating dialysis * pregnancy * lumbar puncture within the previous 24 hours

Keywords: venous thromboembolism low molecular weight heparin vitamin k antagonist longterm
a study to find out if daridorexant is safe and efficacious in patients with insomnia and comorbid nocturia

Conditions: Insomnia Disorder; Nocturia

Summary: a study to find out if daridorexant is safe and efficacious in patients with insomnia and comorbid nocturia


Eligibility criteria:
inclusion criteria: * signed and dated informed consent form (icf) prior to any study-mandated procedure. * male or female subjects ≥ 55 years old at the time of signing the icf. * insomnia complaints for at least 3 months prior to visit 1. * insomnia severity index© (isi©) score ≥ 13 at visit 1. * nocturia severity: on average ≥ 3 nocturnal voids per night reported by the subjects for at least 1 month prior to visit 1. * ability to communicate well with the investigator, to understand the study requirements and judged by the investigator to be alert and oriented to person, place, time, and situation. exclusion criteria: * woman of childbearing potential, pregnant or plans to become pregnant. * planned travel across ≥ 3 time zones during study. * life time history of suicidality assessed via columbia suicide severity rating scale© (c-ssrs©). * regular caffeine consumption after 4 pm. * unable to refrain from smoking during the night. * known and documented diagnosis of narcolepsy, periodic limb movement disorder, moderate to severe obstructive sleep apnea, restless legs syndrome, circadian rhythm sleep-wake disorder, or rapid eye movement (rem) sleep behavior disorder. * known and documented diagnosis of type 1 diabetes mellitus, uncontrolled type 2 diabetes mellitus, central or nephrogenic diabetes insipidus, and primary/secondary polydipsia. * known and documented nocturia linked to urinary tract infection, neoplasms of bladder, prostate or urethral cancer, bladder or urethral calculi, or neurogenic voiding dysfunction within the last 6 months prior to visit 1. * any known factor or disease that might interfere with treatment compliance, study conduct, or interpretation of the results, such as drug or alcohol dependence or psychiatric disease.
immunogenicity and tolerability of broad spectrum human papillomavirus (hpv) vaccine in adult and young adult women (v503-004)

Conditions: Cervical Cancer; Vulvar Cancer; Vaginal Cancer; Genital Warts; Human Papillomavirus Infection

Summary: this study will assess the safety and immunogenicity of gardasil®9 (v503) in 16- to 45-year-old women. the primary hypothesis of the study states that anti-hpv 16, 18, 31, 33, 45, 52, and 58 geometric mean titers (gmts) at 4 weeks postdose 3 are non-inferior in adult women as compared with gmts in young adult women.


Eligibility criteria:
inclusion criteria: * good physical health exclusion criteria: * history of an abnormal pap (papanicolaou) test or abnormal cervical biopsy results * history of hpv-related condition * history of known prior vaccination with an hpv vaccine * pregnant * user of recreational or illicit drugs * history of severe allergic reaction, including known allergy to any vaccine component * immunocompromised * history of certain medications or is currently taking or has taken certain medications (details will be discussed at the time of consent) * has thrombocytopenia or other coagulation disorder * concurrently enrolled in a clinical study of investigational agent
a pharmacokinetic study of erlotinib in cancer patients with advanced solid tumors, with adequate and moderately impaired hepatic function

Conditions: Advanced Solid Tumors

Summary: this is a multicenter, open-label, 2-arm study comparing erlotinib exposure in cancer patients with adequate hepatic function versus cancer patients with moderate hepatic impairment. all patients will receive a single 150 mg dose of erlotinib on day 1 followed by 96 hours of plasma sampling for pk and protein binding studies. patients may then enter the maintenance phase of the study and continue to receive erlotinib until disease progression or unacceptable toxicity.


Eligibility criteria:
inclusion criteria: * histologically confirmed advanced solid tumor (measurable or nonmeasurable) that is potentially responsive to erlotinib or for which no effective therapy is available, * cohort 1: adequate hepatic function: bilirubin \<= uln, alt (sgpt) and ast (sgot) \<= 1.5 x uln or cohort 2: moderate hepatic function: 7-9 as assessed by the child-pugh system, ecog performance status 0-2 * life expectancy \>= 12 weeks, * prior radiation permitted provided that 4 weeks (or 2 weeks for palliative radiation) has elapsed and patients have recovered from acute toxic effects of radiotherapy, * prior chemotherapy permitted provided that 4 weeks has elapsed and patients have recovered from acute toxic effects of chemotherapy, * adequate hematopoietic and renal function: anc \>= 1.5 x 10\^9/l, platelets \>= 75 x 10\^9/l, and creatinine \<= 1.5 x uln, exclusion criteria: * use of tobacco or nicotine-containing products within 4 weeks of day 1 and while on study, * use of a cyp3a4 inhibitor or inducer within 14 days prior to day 1 and until day 5, * use of a warfarin-derivative anticoagulant within 14 days prior to day 1 and until day 5, * encephalopathy \>= grade 2, * significant history of cardiac disease unless well-controlled, * active or uncontrolled infections or serious illnesses or medical conditions that could interfere with the patient's ongoing participation, * concurrent anticancer therapy or any other investigational agents within 4 weeks of day 1 and while on study, * symptomatic brain metastases that are not stable, require steroids, are potentially life-threatening, or that have required radiation within the last 4 weeks, * gastro-intestinal abnormalities, including inability to take oral medication, requirement for iv alimentation, active peptic ulcer or prior surgical procedures affecting absorption.

Keywords: advanced cancer, solid tumor
impact of muscular fatigability on spastic co-contractions after stroke patients

Conditions: Stroke; Spasticity, Muscle; Muscle Fatigue; Gait, Hemiplegic

Summary: this study evaluates the effects of an isokinetic fatigue protocol of the quadriceps on the amount of co-contractions of this last with the hamstrings during a maximal isometric flexion movement in hemiparetic stroke patients. the effect of such a protocol on gait parameters and spasticity of the quadriceps will be evaluated also.


Eligibility criteria:
inclusion criteria: * age between 18 and 80y * hemiparesis after a first-ever stroke \> 3 months * spasticity of the quadriceps muscle * quadriceps strength at least at 3/5 (mrc testing) * subject able to walk at least 2min without rest * informed consent * social security affiliation exclusion criteria: * severe comprehension troubles (language, cognitive or psychiatric disorders) * history of previous stroke, locomotor or other neurological disorders * locomotor troubles affecting the paretic arm * contraindication to efforts : cardiac insufficiency, severe aortic valvular stenosis, recent heart failure, non treated high blood pressure, severe peripheral arterial disease * pregnancy or breastfeeding * adult subject to guardianship
extended oral tranexamic acid after total knee arthroplasty

Conditions: Osteo Arthritis Knee; Pain, Postoperative

Summary: the utilization of intraoperative tranexamic acid (txa), whether administered intravenously or orally, has become a standard practice in total joint arthroplasty (tja). multiple studies have demonstrated the positive impact that txa application has on clinical outcomes, including decreased blood loss and transfusion rates, decreased early swelling and ecchymosis, improved early recovery, and potentially superior long-term outcomes. its ability to mitigate risk of blood loss made ambulatory total knee arthroplasty (tka) safer for patients. the safety of intraoperative txa use has also been documented. sabbag et al. showed that txa does not increase the risk of venous thromboembolism (vte), even in those patients who are deemed high-risk. multiple routes of txa administration have been studied with each route demonstrating effectiveness in reducing blood loss. findings showed that oral txa is noninferior to intravenous txa, though the median time to reach a target concentration is longer via the oral route and bioavailability is lower. with the benefits of intraoperative txa clearly documented in literature, multiple centers investigated the utilization of extended txa postoperatively in hopes of enhancing patient safety and reducing length of stay and healthcare cost. however, these studies reported conflicting outcomes and mostly focused on estimated blood loss, instead of patient reported outcomes. the purpose of this study is to assess the effectiveness and safety of a varying extended oral txa regimen during the postoperative period. further, the investigators aim to determine the optimal duration of the txa regimen to maximize its impact. the investigators hypothesize that an extended oral txa regimen is safe and effective in improving clinical outcomes in tka patients.


Eligibility criteria:
inclusion criteria: 1. 18 years of age and older. 2. primary tka at a campbell clinic surgery center, with implant at the discretion of the treating surgeon. 3. willing to participate in the study. 4. fluent in oral and written english. exclusion criteria: 1. revision tka. 2. preoperative use of anticoagulants (81mg aspirin is allowed). 3. prior history of deep vein thrombosis. 4. prior history of cancer (with the exception of non-melanoma/metastatic skin cancers, low-grade non-metastatic benign soft tissue tumors, thyroid cancers and low grade, non-metastatic prostate cancers). 5. known allergy or hypersensitivity to txa. 6. patients who are using combination hormonal contraception. 7. history of seizure disorder. 8. history of adult onset colorblindness.
randomized controlled trial of intravenous magnesium sulfate versus terbutaline for children in the management of acute exacerbation of asthma

Conditions: Acute Exacerbation of Asthma

Summary: this study aimed to fill this gap by comparing the effectiveness of intravenous magnesium sulfate versus terbutaline in children with acute asthma exacerbations, providing evidence-based guidance for clinicians in emergency settings.

despite the established roles of both magnesium sulfate and terbutaline in the management of severe asthma exacerbations, there is limited comparative data on their efficacy and safety in the pediatric population. understanding the relative benefits and risks of these therapies is crucial for optimizing treatment strategies and improving patient outcomes.

Eligibility criteria:
inclusion criteria: * known cases of asthma * minimum duration of asthma as 6 months * presenting with acute exacerbation of asthma * requiring emergency treatment. exclusion criteria: * children having chronic respiratory diseases (cystic fibrosis, bronchopuonary dysplasia) * children with cardiac diseases * children who were hospitalized in the past 2-weeks due to any reasons * children using oral or intravenous corticosteroids or other systemic medications * children who were unable to undergo pefr measurements due to any reasons

Keywords: asthma intravenous magnesium sulfate terbutaline
erector spinae block versus caudal block for perioperative analgesia in pediatric cancer patients

Conditions: Analgesia

Summary: the study aim to compare ultrasound guided erector spinae plane block versus ultrasound guided caudal block in perioperative analgesia for pediatric cancer patients


Eligibility criteria:
inclusion criteria: * asa i and ii * age \>1 and \<12 * patients undergoing nephrectomy surgeries exclusion criteria: * patients parental refusal * local infection at the puncture site * coagulopathy with inr\> 1.6 * unstable cardiovascular disease * patients allergic to medication used * development or mental delay * impaired liver and renal functions
impact of the double-trunk mask on oxygenation titration in covid-19

Conditions: COVID; Hypoxemia

Summary: this study will investigate the impact of the double-trunk mask (dtm) on the reduction of oxygen titration in patients with severe hypoxemia.

the double-trunk mask (dtm) is a device designed to increase the fraction of inspired oxygen in patients who receive oxygen therapy. the mask is composed of a regular aerosol mask with corrugated tubing (15 cm length) inserted into two lateral holes. each included patient will wear standard nasal cannula in addition to the double-trunk mask for 30 minutes, then only their standard oxygen interface for the next 30 minutes. while maintaining the oxygen saturation by pulse oximetry (spo2) at a target value of 94%, the impact of the dtm will be assessed by measuring the change of oxygen flow given to the patient.

Eligibility criteria:
inclusion criteria: * covid-19 * spo2 between 92 and 96% with low-flow oxygen therapy (\< 15 l/min). exclusion criteria: * chronic obstructive pulmonary disease or other chronic respiratory disease * confusion * hypoxemia corrected (spo2 ≥ 96%) with o2 flow ≤ 3 l/min * contra-indications to arterial blood gas sampling (peripheral arteriopathy, bleeding disorder)
automatic periodic stimulation and continuous electromyography (emg) for facial nerve monitoring during parotidectomy

Conditions: Parotid Gland Disorders

Summary: the purpose of this study is to document the safety of the medtronic automatic periodic stimulating (aps) electrode stimulator during a parotidectomy and potentially prevent post-operative facial nerve weakness, which is a relatively common outcome after parotid surgery.

this study will be conducted in two phases. in the first phase the investigators will use the same monitoring system currently used during parotidectomy and requires placement of the aps electrode as the only additional piece of equipment. during this phase, the investigators will record intraoperative emg data generated by the monitoring system as well as document intra-operative maneuvers that precede adverse emg events. in the second phase of the study the investigators aim to allow the surgeon to alter his or her techniques, with the information provided by the aps electrode, to reverse adverse emg changes.

Eligibility criteria:
inclusion criteria: * parotidectomy: planned parotid gland surgery (superficial or total parotidectomy) * benign or malignant disease exclusion criteria: * current pregnancy * preoperative facial nerve dysfunction * revision surgery * history of preoperative radiation to the surgical field * retrograde or extracapsular dissection * intentional nerve sacrifice (i.e., due to nerve involvement by tumor) * tumors with proximity to main trunk of facial nerve * inability to place electrode * presence of electrode alters surgical technique

Keywords: parotidectomy
comparison of telerehabilitation vs clinical setup rehabilitation in tkr patients

Conditions: Knee Injuries

Summary: this study examines the feasibility, attainability, and patient satisfaction of telerehabilitation and clinical consultation rehabilitation.

the objective is to assess whether telerehabilitation can provide comparable or significantly better outcomes in terms of functional recovery, pain management, improved range of motion, and patient satisfaction for total knee replacement (tkr) patients. if telehealth interventions prove successful, they can be implemented to increase access to high-quality rehabilitation treatments and enhance healthcare delivery. evidence-based findings from this study can help healthcare providers make educated decisions about incorporating telerehabilitation into post-operative rehabilitation protocols, thereby enhancing patient care and optimizing resource utilization in orthopedic settings.

Eligibility criteria:
inclusion criteria: * male and female patients diagnosed with tkr * older age above 65 * patient communicates with medical staff * patient with cemented tka * patients who underwent tka owing to degenerative arthritis exclusion criteria: * older patients aged \>75 years * patient with a history of knee joint surgery before tka * patient who possibly had a systematic inflammatory disease such as rheumatoid arthritis. * patients with difficulty in seeing, hearing, and walking independently * patients having a history of mental illnesses (stroke, multiple sclerosis, parkinsonism, alzheimer's disease) * patient history of severe mobility disorder * systemic illness (liver failure, active cancer, cardiopulmonary distress)