Kornimate/medical-research-clean huggingface dataset:
negative beta glucan in icu patients

Conditions: Candidemia

Summary: this is a prospective study aimed at testing a strategy of early initiation of an antifungal agent to patients admitted to intensive care units (icus) at risk for invasive candidiasis. score system have been developed to identify groups at very high risk for the development of candidemia/invasive candidiasis in the icu. these scoring system have used clinical information with or without data on candida colonization, and have shown reasonable correlation with candidemia/invasive candidiasis. more recently, a biomarker - detection of 1,3-beta-d-glucan in the serum - has been tested in the early diagnosis of candidiasis. the incorporation of biomarkers such as beta-d-glucan could help clinicians to select a group at higher risk for candidemia, and despite the fact that these tests may give false-positive results, their negative predictive value could be of great help. therefore, the objectives of this study are: 1. to assess the frequency of positive biomarkers in icu patients at high risk to develop invasive candidiasis/candidemia; 2. to test the strategy of early discontinuation of antifungal therapy based on repeatedly negative blood cultures and 1,3 beta-d-glucan in the serum.

entry criteria are: in the icu for \>2 days and systemic antibiotics \>2 days or central venous catheter for \>days and at least two of the following: total parenteral nutrition, dialysis, surgery, pancreatitis, receipt of corticosteroids, receipt of other immunosuppressive agents. in addition, patients must have a clinical sign of infection (either one of the following): fever, hypothermia, hypotension, unexplained acidosis, or unexplained elevation in c-reactive protein. eligible patients will be enrolled after signing an informed consent and will have blood obtained for culture and determination of 1,3 beta-d-glucan serum levels for 3 days, and will start anidulafungin iv. if all tests are negative, anidulafungin will be discontinued on day 4. if 1,3 beta-d-glucan is positive (\>80 pg/ml) and / or blood cultures are positive for candida species, anidulafungin will be continued for \>14 days.

Eligibility criteria:
inclusion criteria: * in the icu for \>2 days and * systemic antibiotics on days 1-3 of icu or * central venous catheter on days 1-3 of icu * and at least 2 of: * total parenteral nutrition on days 1-3 of icu * any dialysis on days 1-3 of icu * major surgery in the 7 days before admission in the icu * pancreatitis in the 7 days before admission in the icu * use of corticosteroids for at least 3 days in the 7 days before admission * use of other immunosuppressive agents in the 7 days before admission in the icu * in addition, the patient must have at least one of the following: * fever (axillary temperature \>37.5 oc) * hypothermia (axillary temperature \<35 oc) * hypotension * unexplained acidosis * unexplained elevation in c-reactive protein exclusion criteria: * antifungal for \>3 days * allergy to an echinocandin

Keywords: candidemia intensive care unit 1,3 beta-d-glucan
effect of esketamine on postoperative depression、gut microbiota、bispectral index data of depression patients undergoing breast cancer operation (espod-bi)

Conditions: Depression

Summary: this study is a prospective, randomized, controlled (randomized, parallel group, concealed allocation), double-blinded trial. all depression patients undergoing breast cancer operation will be randomized 1:1 to the treatment intervention with general anesthesia as an adjunct to esketamine or saline. the objective of the trial is to evaluate the postoperative depression、gut microbiota、bispectral index data of patients undergoing breast cancer operation with esketamine or saline.

for female patients, breast cancer patients have a high risk of developing depression, and approximately 20%-45% of breast cancer patients suffer from postoperative depression. esketamine is an anesthetic in analgesia, and has presently become more and more popular for treating anti-depression, particularly for resistant depression. this study is a prospective, randomized, controlled (randomized, parallel group, concealed allocation), double-blinded trial. all depression patients undergoing breast cancer operation will be randomized 1:1 to the treatment intervention with general anesthesia as an adjunct to esketamine or saline. the objective of the trial is to evaluate the postoperative depression、gut microbiota、bispectral index data of patients undergoing breast cancer operation with esketamine or saline

Eligibility criteria:
inclusion criteria: * at least18 years and pre-menopausal; * scheduled to undergo elective breast cancer operation; * american society of anaesthesiologists (asa) risk classification i-ii. * montgomery-asberg depression rating scale (madrs) score ≥22 exclusion criteria: * cognitive difficulties * partial or complete gastrectomy * previous esophageal surgery * inability to conform to the study's requirements * ongoing participation or participation in another study \<1 month ago

Keywords: depression sleep deprivation gut microbiota bispectral index
association between multiple coagulation-related factors and lymph node metastasis in patients with gastric cancer: a retrospective cohort study

Conditions: Gastric Cancer Stage; Lymph Node Metastasis

Summary: we initially selected a total of 1128 patients with primary gastric cancer who presented at shandong provincial hospital between january 2018 and october 2022, and retrospectively collected their clinical and pathological data. and retrospectively analyzed preoperative baseline characteristics, preoperative laboratory tests, and postoperative pathological results for these patients


Eligibility criteria:
inclusion criteria: 1. patients with primary gastric malignant tumors, 2. patients who underwent radical resection of gastric cancer, 3. patients with a postoperative pathology of adenocarcinoma or signet ring cell carcinoma according to the wto pathological classification, exclusion criteria: 1. patients who have distant metastases, such as liver or lung metastases, were found on preoperative ultrasound and computed tomography (ct) examinations, 2. patients who have received preoperative neoadjuvant chemotherapy, 3. patients who take anticoagulant drugs (such as aspirin) prior to surgery, 4. patients who had any previous coagulation disorder.

Keywords: gastric cancer lymph node metastasis maximum amplitude prognostic factor
results of retrograde titanium elastic nails for fixation of proximal third tibial shaft fractures in children.

Conditions: Proximal Third Tibial Shaft Fractures in Children

Summary: pediatric tibial shaft fracture is the third most common pediatric long bone fracture after fracture of femur and forearm, representing 15% of all pediatric fractures. closed reduction and casting is the standard of care for stable and minimally displaced fracture of the tibia in pediatric age group. treatment of pediatric fractures dramatically changed in 1982. the goals are to stabilize the fracture, control limb length, alignment, rotation, instability, promote bone healing, and minimize the morbidity and complications for the child and his/her family. titanium elastic nails (tens) fixation was originally meant as an ideal treatment method for femoral shaft fractures, but was gradually applied to other long bones diaphysial fractures in children, as it represents a compromise between conservative and surgical therapeutic approaches with satisfactory results and minimal complications. over the past 20 years, pediatric orthopedic surgeons have tried a variety of methods to treat pediatric lower limb fractures to avoid prolonged immobilization and complications. each method has had its own complications: cast immobilization alone or following traction had resulted in limb-length discrepancy, angulations, rotational deformity, psychological and economic complications. external fixation had resulted in pin-tract infection, loss of knee range of motion, delayed union, non-union, and refracture after fixator removal. tens work by balancing the forces between the two opposing flexible implants. to achieve this balance, the nail diameter should be 40% of the narrowest canal diameter or more. the nails should assume a double-c construct. they should have similar smooth curve and same level entry points. ligier et al and flynn et al have reported that tens can give rotational stability if good care is taken intra-operatively during nail insertion and postoperatively, especially for comminuted, spiral, and long oblique fractures.


Eligibility criteria:
inclusion criteria: * inclusion criteria included children are patients presented with traumatic proximal shaft tibia fracture closed or open up to gustillo grade ii and patients between 4 and 12. exclusion criteria: * exclusion criteria excluded children presented with gustillo grade iii a, b \& c open fractures and pathological fractures.
musical intervention and patient's anxiety during central venous catheter insertion in the intensive care unit

Conditions: Anxiety; Pain

Summary: intensive care unit patients who have to undergo central venous catheter insertion and are able to hear explanations and to gave consent, will be randomized to either usual care during catheter insertion or to a musical intervention added to usual care. the primary objective will be to assess the patient's anxiety just after catheter insertion. secondary outcome measures will be the patient-reported pain, the duration of catheter insertion, and the need for additional anxiolytic or sedative drugs during catheter insertion.

patient informed consent will be obtained before any other study specific procedure. computer-generated randomization with 1:1 allocation ratio will be stratified by the site of catheter insertion (superior vena cava or femoral), and by the ventilatory status (patient mechanically ventilated or not). block size, not known by the investigators, of 4 or 6 will be used. randomization group for each patient will be kept concealed into sealed opaque envelops until inclusion once consent obtained. anxiety, the primary outcome measure, and pain related to the catheter insertion will be assessed using two distinct visual analogic scales. in the usual care group, the catheter will be inserted using the seldinger method, under local anesthesia with 2% lidocaine, with ultrasound guidance, after proper skin antisepsis, surgical operator's hand washing and antisepsis, and use of sterile drapes, gowns and gloves. in the intervention group, in addition to the usual care procedures as described above, a musical u-shaped session will be delivered to the patient through headphones, using a tablet computer and the "music care" music program, a validated program for use in health care.

Eligibility criteria:
inclusion criteria: * patient hospitalized in the intensive care unit or high-dependency unit * patient for whom a central venous catheter insertion is envisaged * patient capable of hearing and understanding explanations and able to consent exclusion criteria: * severe hearing loss * allergy to local anesthetic drug * pregnancy * lack of social security number * patient under guardianship * previous participation to the study

Keywords: central venous catheter intensive care music therapy
study of pexacerfont (bms-562086) in the treatment of outpatients with generalized anxiety disorder

Conditions: Generalized Anxiety Disorder

Summary: the purpose of this study is to learn about the safety and efficacy of pexacerfont in outpatients diagnosed with generalized anxiety disorder


Eligibility criteria:
inclusion criteria: * outpatient women ages 18-65 meeting diagnostic and statistical manual of mental disorders manual, fourth edition, text revision (dsm-iv tr) criteria for generalized anxiety disorder (gad), either moderate or severe (300.02) exclusion criteria: * males * patients who report a history of inadequate response to three or more adequate trials of any selective serotonin reuptake inhibitors (ssris) for gad within the last three years
italian study of patients with lymphoma

Conditions: Lymphoma

Summary: it is an observational, non-interventional, prospective, monocentric study, whose objective is to enroll 1500 patients with lymphoma in 5 years within the institute of hematology "seragnoli".

the study is aimed at enriching the data on the prognostic role of genetic and epidemiological factors associated with clinical and epidemiological data of patients; to identify factors that influence the evolution of the disease, such as lifestyle and occupational factors, as well as the type of treatment; to document the impact of the disease on quality of life and to provide a platform for future research projects. study-specific questionnaires will be administered to patients, both at baseline and during follow-up, which methodologically represent a useful tool in order to achieve these objectives.

Eligibility criteria:
inclusion criteria: * age greater than or equal to 18 years at enrollment * diagnosis of lymphoma within 3 months of enrollment * patients may have been treated, as long as the initial diagnosis of lymphoma is within 3 months of enrollment * signing of the informed consent form exclusion criteria: * none

Keywords: questionnaire
a phase 2b study of dalfampridine 10mg extended release tablet in subjects with chronic deficits after ischemic stroke

Conditions: Ischemic Stroke

Summary: this is a multi-center, safety and tolerability study in subjects with chronic stable sensorimotor deficits after ischemic stroke. it has been designed as a double-blind, placebo-controlled, 2-period crossover study.


Eligibility criteria:
inclusion criteria: * history of a stable sensorimotor deficit due to an ischemic stroke, as confirmed by the investigator with supportive prior imaging findings (mri/ ct scan) * ≥ 6 months post-stroke * have a body mass index (bmi) ranging between 18.0 - 35.0 kg/m,2 inclusive * stable concomitant medication therapy regimen within 4 weeks of screening visit exclusion criteria: * history of seizures, except simple febrile seizures * moderate or severe renal impairment as defined by a calculated creatinine clearance of ≤ 50 ml/minute using the cockcroft-gault equation * botulinum toxin use within 2 months prior to the screening visit * orthopedic surgical procedures in any of the extremities within the past 6 months * diagnosis of multiple sclerosis
teleguidance-facilitated airway management

Conditions: Telemedicine; Intubation; Difficult or Failed; Emergencies

Summary: the advent of telemedicine has introduced teleguidance as a promising support to enhance endotracheal intubation skills among inexperienced operators. several studies showed the effectiveness of supervisor assisted eti using the various vl devices and commercial videoconferencing softwares. however, recent developments in vl technologies introduced the vl integrated videoconferencing features for this purpose. scoper vl device (technomedicare inc, turkiye) developed a real-time teleconsultation feature for difficult airway scenarios to be assisted by experts during the procedure. however, the literature is very limited about the effectiveness and feasibility of teleguidance-facilitated airway management. this high-fidelity simulation study aims to assess impact of teleguidance-facilitated airway management on the success of eti performed by inexperienced operators in a mobile ambulance.


Eligibility criteria:
inclusion criteria: * all paramedic students who completed their airway management training exclusion criteria: * the trainees who did not consent to participate * the trainees who did not complete the vl training
colchicine and spironolactone in patients with mi / synergy stent registry

Conditions: ST Elevation Myocardial Infarction; Non ST Elevation Myocardial Infarction

Summary: the clear synergy trial will study the long term effects of treatments following pci to treat myocardial infarction. these treatments address both the culprit artery (pci with synergy stent) as well as the non-culprit arteries (randomization to routine colchicine and spironolactone).

this is a multicenter, international synergy stent registry that is embedded within a randomized, blinded, double-dummy, 2x2 factorial design trial of colchicine versus placebo and spironolactone versus placebo in patients with myocardial infarction who have undergone primary percutaneous coronary intervention (pci).

Eligibility criteria:
inclusion criteria: 1. a) patients with stemi referred for pci within 12 hours of symptom onset, have a culprit lesion amenable to stenting, and with planned synergy stent implantation for synergy registry or b) patients with stemi referred for pci within 48 hours of symptom onset, not prospectively enrolled in synergy stent registry or c) patients with diagnosis of non stemi with ischemic symptoms and either hs troponin \> or = 300x uln or troponin \> or = 200x uln who have undergone pci with one of the following: i. lvef\ 60 years 2. able to be enrolled/randomized within 72 hours of index pci (however patients should be randomized as soon as possible after pci) 3. written informed consent exclusion criteria: 1. age ≤18 years 2. pregnancy, breastfeeding, or women of childbearing potential who are not using an effective method of contraception 3. any medical, geographic, or social factor making study participation impractical or precluding required follow-up 4. systolic blood pressure \<90 mm hg 5. active diarrhea 6. known allergy or contraindication to everolimus, the synergy stent or any of its components 7. unable to receive dual antiplatelet therapy 8. any contraindication or known intolerance to colchicine or spironolactone 9. requirement for colchicine or mineralocorticoid antagonist for another indication 10. history of cirrhosis or current severe hepatic disease 11. current or planned use of any of: cyclosporine, verapamil, hiv protease inhibitors, azole antifungals, or macrolide antibiotics 12. creatinine clearance \<30 ml/min/1.73 m2 13. serum potassium \>5.0 meq/l
a prospective study of application of platelet mapping in chronic liver disease complicated with ali and/or ad in china

Conditions: Thrombelastography, Acute Liver Injury, Acute Decompensation, Platelet

Summary: ineffective hemostasis or a paradoxical prothrombotic state of acute-on-chronic liver disease (aclf) has been well established. thrombelastography measures the dynamics of thrombin production and provides a global assessment of coagulation incorporating the cumulative effect of the interactions at various levels between plasma components and cellular component of coagulation. through the previous studies(nct03281278 and nct04119973), we found that aclf patients with high adp inhibition rate had high 28-day mortality.this study aims to validate that high adp inhibition rate only occurs in patients with liver failure and is related to the severity of the disease.


Eligibility criteria:
inclusion criteria: 1. chronic liver disease: including chronic liver hepatitis patients without cirrhosis, compensated cirrhosis patients, decompensated cirrhosis patients and non-alcoholic fatty liver disease patients. 2. ali(acute liver injury): including \[alt \> 3 uln(upper limited of normal),ast \> 3 uln or tb \> 2 uln within 1 week before enrollment\] or ad(acute decompensation) : including \[(having ascites, hepatic encephalopathy and/or bacterial infection within 1 month before enrollment)\]. exclusion criteria: 1. those who had hepatocellular carcinoma or other types of malignancies; 2. obstructive biliary diseases or other disease lead to bilirubin evaluation; 3. those who had acute hemorrhage one week before admission 4. those who received platelet, cryo transfusion or plasmapheresis one week before admission 5. pregnancy and breastfeeding 6. those who received liver transplantation or kidney transplantation; 7. combine with other disease lead to organ failure including heart failure (nyha iv),respiratory failure（pao2\<60mmhg),renal insufficiency(ckd 5) and conscious disturbance (gcs\<8) 8. readmission; 9. death within 24 hours.
a clinical study of precision tace (p-tace) with surefire

Conditions: Unresectable Hepatocellular Carcinoma

Summary: the purpose of this research study is to learn about 2 types of fda-approved catheters used in angiographic (x-ray of blood vessels, with radiopaque substance) procedures like deb-tace treatment. the principal investigator will check the beads given during the deb-tace. they will compare the way in which they are spread out in the tumor and density (how condensed something is).


Eligibility criteria:
inclusion criteria: 1. patients \> 18 years with confirmed diagnosis of unresectable hepatocellular carcinoma who are candidates for tace therapy 2. barcelona clinic liver cancer classification (bclc) a or b 3. child-pugh class a or b 4. eastern cooperative oncology group (ecog) performance status 0 or 1 5. 1 to 5 target tumors that are \< 6cm with at least one tumor ≥ 3cm in size 6. vessel size ≥ 1.5 mm 7. subject must be able to provide written informed consent exclusion criteria: 1. extra-hepatic spread of the cancer 2. macrovascular tumor invasion 3. diffuse hcc (\>50% liver involvement) 4. previous chemotherapy, radiotherapy, transarterial embolization or ablations in the targeted tumor(s) 5. advanced liver disease (bilirubin \> 3 mg/dl, aspartate aminotransferase (ast) or alt \> 5x upper limit of normal or \> 250 u/i 6. extrahepatic supply to the tumor 7. hypovascular tumors 8. heart failure with reduced ejection fraction or left ventricular ejection fraction (lvef) ≤ 40 percent 9. any serious medical or psychiatric illness/condition that will interfere or limit compliance with study requirements/treatments.

Keywords: chemoembolization (tace) hcc liver cancer
circulating tumor dna detection in surveillance of surgical lung cancer patients

Conditions: Carcinoma; Non-small-cell Lung Cancer; Lung Neoplasms

Summary: conduct a prospective study to confirm blood and urine ctdna detection value in non-small-cell lung cancer patients.

studies have shown the feasibility of detecting mutation status by blood and urine circulating tumor dna (ctdna)in non-small cell lung cancer (nsclc) patients. however, no prospective has been conducted for usage of ctdna in postoperative surveillance of nsclc patients. we plan to compare tumor makers and radiographic approaches with blood and urine ctdna in surveillance to assess the lead time of postoperative tumor relapse in stage ⅲa nsclc patients. and evaluate the correlation between ctdna level with tumor relapse or metastasis.

Eligibility criteria:
inclusion criteria: * aged 18 to 80 years * undergo radical surgery（r0 resection） * histologically confirmed diagnosis of stage ⅲa non-small cell lung cancer * positive driver mutation(egfr、pten、pik3ca、braf、k-ras、her2) in tumor tissue * blood or urine circulating tumor detect the driver mutation detected in tumor tissue * patients must have given written informed consent exclusion criteria: * unable to comply with the study procedure * malignant tumor history within the past 5 years * patients who received any treatment prior to resection * r1 or r2 resection * coexisting small cell lung cancer * received target drug therapy after surgery * unqualified blood or urine samples

Keywords: circulating tumor dna lung cancer lead time