Kornimate/medical-research-clean huggingface dataset:
continuous hemodialysis with an enhanced middle molecule clearance membrane

Conditions: Septic Shock

Summary: this study aims to demonstrate equivalence in terms of molecule removal between continuous hemodialysis using an "enhanced middle molecule clearance" membrane(ultraflux emic2) and continuous hemofiltration using a standard membrane (ultraflux av1000s) in icu patients requiring continuous renal replacement therapy.

in sepsis, the removal of middle molecular weight molecules such as cytokines (also called blood purification), has shown a great interest in intensive care during the last decades. indeed, these cytokines are involved in the development of the multi-organ failure syndrome when patients are in septic shock. there is some evidence to suggest that extracorporeal therapies (hemofiltration-hemodialysis)are interesting tools to modulate the inflammatory response and to restore the immune homeostasis. however, hemodialysis using "conventional" membranes does not allow the removal of middle molecules. conversely, high-volume hemofiltration is an appropriate therapy but it has a lot of drawbacks due to the high ultrafiltration rates (removal of beneficial small molecules, technical and economical issues due to the use of large amounts of fluid replacement). finally, high cut-off hemofiltration has been reported to be associated with significant albumin loss. therefore, continuous "enhanced middle molecule clearance" hemodialysis could be an interesting alternative, making possible the removal of these middle molecules without significant albumin loss and with some theoretical advantages (reduced cost due to the possibility to produce the dialysate from a water circuit, decreased nursing workload). the aim of this study is to assess the clearances of different kind of molecules (small, middle and large) when continuous enhanced middle molecule clearance hemodialysis is applied to septic patients.

Eligibility criteria:
inclusion criteria: * male or female aged over 18 years. * icu patients with septic shock and aki requiring continuous renal replacement. * patient able to agree to be enrolled in the study with informed consent. if the patient can not provide consent, only the consent of family members will be sought if they are present and, to default, the opinion of trustworthy person under article l.1111-6 of the french health code. if there is no family present, or trustworthy person designated, the subject will not be included in the study. exclusion criteria: * pregnancy or lactation. * participation in another research protocol. * people particularly vulnerable as defined in articles l.1121-5, l.1121-6, l.1121-7, l.1121-8 et l.1122-1-2 of the french health code.

Keywords: intensive care unit continuous hemodialysis continuous hemofiltration high cut-off membrane "enhanced middle molecule clearance" membrane septic shock acute kidney injury blood purification renal replacement therapy
the randomized optimal-act trial

Conditions: Coronary Artery Disease; Ischemic Heart Disease; Anticoagulant-induced Bleeding; Coronary Syndrome

Summary: the purpose of this study is to find the ideal range of the activated clotting time (act) during percutaneous coronary intervention (pci) that is associated with lowering the rate of undesirable medical outcomes


Eligibility criteria:
inclusion criteria: * age\>18 * referred for coronary angiography with possible coronary revascularization or adjunctive invasive diagnostic testing (ivus/oct, ffr, or ifr) exclusion criteria: * receipt of lmwh at treatment dose (not dvt prophylaxis dose) within 6 hours of coronary angiography * prior gp iib/iiia use within the previous 72 hours * use of warfarin (vitamin k antagonist) or direct oral anticoagulant * patients on lmwh bridging strategy * pci within prior 30 days * planned use of bivalirudin as the procedural anticoagulant * rotational atherectomy * excimer laser coronary angioplasty * chronic total occlusions * patients with active bleeding disorders or bleeding diathesis * patients with st-segment elevation myocardial infarction * patient with clinical evidence of cardiogenic shock (defined as sbp\<90 mmhg for ≥30 min or support to maintain sbp ≥90 mmhg and evidence of end-organ hypoperfusion (urine output \<30 ml/h or cool extremities) * chronic kidney disease stage 4/5 (gfr 30 ml/min)

Keywords: activated clotting time outcomes bleeding
clinical translation of a novel albumin-binding pet radiotracer 68ga-neb

Conditions: Arteriovenous Malformation; Hemangioma; Neoplasms Lymph Nodes; Lymphedema

Summary: this is an open-label whole-body pet/ct study for investigation of radiation dosimetry, plasma pharmacokinetics, biodistribution, safety and diagnostic performance of 68ga-neb in healthy volunteers and patients with suspected infection. changes of routine blood and urine tests and any adverse events will be collected from the volunteers. adverse events will also be observed in the patients.

the labeling of albumin has advantages as drawing blood is unnecessary and the operator labeling is not exposed to potentially infectious material. evans blue (eb) dye has high affinity for serum albumin, the final obtained products neb (a nota conjugate of a truncated form of evans blue for in vivo albumin labeling) was proceeded strict quality controls. no fasting, hydration or other specific preparation was requested on the day of imaging. patients for blood pool imaging underwent whole-body pet/ct acquisitions 30-45 min after intravenous injection of 111-148 mbq (3-4 mci) 68ga-neb with each bed position lasted for 2 min and a standard routine 18f-fdg pet/ct within one week. patients for lymph node imaging including the breast nodules patients underwent a standard routine 18f-fdg pet/ct first, and were locally injected 10\~20mbq 68ga-neb, followed by dynamic chest regional pet acquisitions. a siemens mmwp workstation was used for post-processing. visual analysis was used to determine the general biodistribution and the temporal and intersubject stability. semiquantitative methods were applied for image analysis.

Eligibility criteria:
inclusion criteria: * must be able to provide a written informed consent * males and females, ≥18 years old； * diagnostic ct or mri suggesting a diagnosis of liver focal lesion(s). in suspicion of arteriovenous malformations. newly diagnosed breast cancer and lymph node metastasis is not clear. the tumor will be surgically removed and histological diagnosis will be available. evaluation of cardiac function. exclusion criteria: * females planning to bear a child recently or with childbearing potential； * known severe allergy or hypersensitivity to iv radiographic contrast； * inability to lie still for the entire imaging time because of cough, pain, etc. * inability to complete the needed examinations due to severe claustrophobia, radiation phobia, etc. * concurrent severe and/or uncontrolled and/or unstable other medical disease that, in the opinion of the investigator, may significantly interfere with study compliance.
nxc-201 (formerly hbi0101) multiple myeloma

Conditions: Dose Escalation and Safety

Summary: it is a phase one study with dose escalation and safety cart in bcma- expressing multiple myeloma and al amyloidosis patients

the intention with nxc-201 (formerly hbi0101) cart is to follow the chimeric antigen receptor t-cells (cart) approach, as for approved products, but target the b cell maturation antigen (bcma) rather than the cd19 antigen targeted by kymriahtm (tisagenlecleucel) and yescartatm (axicabtagene ciloleucel). importantly, successful results from at least three clinical trials of a bcma targeted car t therapy were published (zhao 2018, brundo 2018, raje 2019), with excellent results obtained for relapsed or refractory multiple myeloma (mm) patients, that validate the approach.

Eligibility criteria:
inclusion criteria: * ≥18 years of age * voluntarily signed informed consent form (icf) * eastern cooperative oncology group (ecog) performance status 0 - 2 * diagnosis of mm with relapsed or refractory disease and have had at least 3 different prior lines of therapy including proteasome inhibitor, immunomodulatory therapy and at least one antibody therapy. * subjects must have measurable disease, including at least one of the criteria below: * serum m-protein greater or equal to 0.5 g/dl * urine m-protein greater or equal to 200 mg/24 h * serum free light chain (flc) assay: involved flc level greater or equal to 5 mg/dl (50 mg/l) provided serum flc ratio is abnormal * a biopsy-proven evaluable plasmacytoma * bone marrow plasma cells \> 20% of total bone marrow cells * non secretory patient will be allowed provided they have measurable disease by pet-ct or bone marrow aspiration, as designated. * women of child-bearing potential (wcbp), must have a negative serum pregnancy test prior to treatment. all sexually active wcbp and all sexually active male subjects must agree to use effective methods of birth control throughout the study * recovery to ≤grade 2 or baseline of any non-hematologic toxicities due to prior treatments, excluding alopecia and grade 3 neuropathy * ability and willingness to adhere to the study visit schedule and all protocol requirements
plastic vs. covered metal vs. uncovered metal biliary stents for the management of malignant biliary obstruction

Conditions: Pancreatic Cancer

Summary: this is a single center, randomized, unblinded study to compare the rate of occlusion of plastic, uncovered metal, or fully covered metal biliary stents in patient's with surgically resectable disease or those undergoing neoadjuvant chemoradiotherapy. we will also compare occlusion rates between uncovered metal and fully covered metal biliary stents in those patients determined to have surgically unresectable disease.

malignant biliary obstruction can result from extrinsic processes, such as proximal pancreatic ductal adenocarcinoma or metastatic lesions, or from intrinsic lesions such as cholangiocarcinoma. malignant biliary obstruction is typically treated endoscopically with placement of either plastic (polyethylene) or metal biliary stents. metal stents have a wider diameter than plastic stents, and have been shown to have higher patency rates, but are also 15-40 times the cost of plastic stents. metal stents with a polymer coating have been developed to prevent tumor ingrowth into the stent, which can lead to stent occlusion. cost analysis has demonstrated an advantage to the use of metal stents in patients with unresectable disease, or who may achieve operable status following neoadjuvant chemotherapy, while either plastic stents or metal stents are used when patients are deemed to have a surgically resectable lesion. patient's determined to have resectable, or borderline resectable malignancy (those who may achieve resectability status following neoadjuvant chemotherapy) will receive either plastic, uncovered metal, or covered metal stents in a randomized fashion, while patients determined to have surgically unresectable malignancy will randomly receive either covered or uncovered metal biliary stents. the primary aim of this study is to prospectively evaluate stent occlusion rates in patients presenting with malignant biliary obstruction. secondary aims of the study will include a cost analysis of each stent type, rate of hospital admission following stent placement, days off of chemotherapy due to procedural complication, and rate of acute cholecystitis associated with stent placement.

Eligibility criteria:
inclusion criteria: 1. male or female older than 18 2. capable of providing written informed consent 3. presenting with malignant biliary obstruction requiring biliary drainage either from proximal pancreatic malignancy, metastatic disease, or intrinsic biliary malignancy. the patient must have an established diagnosis of underlying malignancy, and surgical resectability status established, prior to enrollment in this study. exclusion criteria 1. inability to undergo conscious sedation or monitored anesthesia 2. prior pancreatico-biliary surgery 3. evidence of acute cholecystitis at time of endoscopic procedure 4. intraluminal filling defect requiring endoscopic removal prior to stent placement 5. inability to provide written informed consent 6. malignancy not verified prior to stent placement
mitigating heat-induced physiological strain and discomfort in older adults via lower limb immersion and neck cooling

Conditions: Hyperthermia; Weather; Heat; Heat Stress; Heat Syncope; Aging

Summary: the incidence and severity of hot weather and extreme heat events (heat waves) is increasing. as such, there is an urgent need to develop heat-alleviation strategies that can provide targeted protection for older adults who are at an elevated risk for heat-induced illnesses or death due to impaired body temperature and cardiovascular regulation. while air-conditioning provides the most effective protection from extreme heat, it is inaccessible for many individuals and cannot be used during power outages (e.g., heat-related rolling blackouts). immersion of the lower limbs in cold water and/or the application of cold towels to the neck have been recommended as simple and sustainable alternatives to air-conditioning. however, empirical data to support the efficacy of these interventions for mitigating physiological strain and discomfort in older adults is lacking. to address this knowledge gap, this randomized crossover trial will evaluate the effect of lower limb immersion with and without application of cold towels to the neck on body core temperature, cardiovascular strain and autonomic function, dehydration, and thermal comfort in adults aged 65-85 years exposed to simulated heat wave conditions (38°c, 35% relative humidity) for 6 hours.


Eligibility criteria:
inclusion criteria: * male or female adults. * aged 65-85 years. * non-smoking. * english or french speaking. * ability to provide informed consent. exclusion criteria: * physical restriction (e.g., due to disease: intermittent claudication, renal impairment, active proliferative retinopathy, unstable cardiac or pulmonary disease, disabling stroke, severe arthritis, etc.). * use of or changes in medication judged by the patient or investigators to make participation in this study inadvisable (e.g., medications increasing risk of heat-related illness; beta blockers, anticholinergics, etc.) * cardiac abnormalities identified via 12-lead ecg during an incremental exercise test to volitional fatigue (performed for all participants). * peak aerobic capacity (vo2peak), as measured during an incremental exercise test to volitional fatigue, exceeding the 50th percentile of age- and sex-specific normative values published by the american college of sports medicine (acsm).

Keywords: heat wave cooling intervention heat strain cardiovascular strain heat and health protection extreme heat events
efficacy of s(+)-ketamine administered as a continuous infusion for the control of postoperative pain

Conditions: Postoperative Pain

Summary: background: the use of low-dose continuous infusion of s(+)-ketamine combined with target-controlled intravenous anesthesia with remifentanil and propofol may be related to the control of postoperative pain and of opioid-induced hyperalgesia. the present study aimed to evaluate the efficacy of continuous infusion of s(+)-ketamine given intraoperatively in the control of postoperative pain compared to placebo.

methods: this is a double-blind randomized controlled trial with 48 patients of both genders aged from 18 to 65 years who underwent videolaparoscopic cholecystectomy. after venipuncture, patients received intravenous parecoxib sodium (40 mg). target-controlled intravenous anesthesia was induced with propofol and remifentanil associated with rocuronium and adjusted to maintain the bispectral index between 35 and 50. the s(+)-ketamine group (sg) group received a continuous infusion of s(+)-ketamine at a dose of 0.3mg.kg-1.h-1, while the placebo group (pg) received a continuous infusion of saline at the same dose. postoperative analgesia was measured by a verbal numerical scale (vns) from 0 to 10 during 12 hours and treated with morphine when vns score was equal to or higher than 3 at a dose of 0.05 mg.kg-1 when the patient reported pain for the first time and at a dose of 0.025mg.kg-1 on subsequent occasions. pain scores were recorded in the postoperative care unit (pacu) and at 4 and 12 hours after the end of the surgery the amount of morphine used during pacu stay, from pacu discharge to 4 hours after surgery, and from 4 to 12 hours after surgery, the overall dose of morphine used, and possible adverse effects were also assessed

Eligibility criteria:
inclusion criteria: * 18 years to 65 years asa i and ii accepts healthy volunteers. exclusion criteria: alcohol or illicit drugs, h2 inhibitors, opioids, or calcium-channel blockers within the last 10 days chronic pain, myocardial ischemia, psychiatric diseases.
influence of aliskiren on proteinuria

Conditions: Chronic Kidney Disease; Proteinuria; Blood Pressure

Summary: to evaluate the proteinuria lowering efficacy as well as tolerability and safety of the renin inhibitor aliskiren compared with that of placebo and angiotensin converting enzyme inhibitor perindopril in patients with non-diabetic chronic renal disease.

proteinuria is a major risk factor for progression to end-stage renal disease in both diabetic and nondiabetic nephropathies. angiotensin ii and aldosterone are the key players in the development of renal failure, either directly by promoting tissue fibrosis or indirectly through their action on glomerular hemodynamic and proteinuria. therefore, pharmacological inhibition of the renin-angiotensin-aldosterone system (raas) may have a beneficial impact on proteinuria and chronic kidney diseases progression. recently, renin inhibitors, a new class of drugs that selectively inhibits angiotensin ii formation at the first step of the raas cascade has been introduced to clinical practice. aliskiren is the first orally bioavailable direct renin inhibitor approved for the treatment of hypertension. blood pressure (bp)-lowering effect of aliskiren is associated with a decreased generation of angiotensin i, as it blocks its generation from angiotensinogen, by inhibiting the active enzymatic site of renin. the investigators plan this study to evaluate the short-term effects of treatment with aliskiren to those of placebo and acei perindopril on proteinuria.

Eligibility criteria:
inclusion criteria: * age 18-65 years * chronic non-diabetic proteinuric nephropathy * creatinine clearance above 30 ml/min * stable proteinuria above 500 mg/ 24 hours * blood pressure above 125/75 mmhg and below 150/95 mmhg * no steroids or other immunosuppressive treatment for a minimum of six months before the study exclusion criteria: * unstable coronary heart disease * decompensated congestive heart failure in the previous 6 months * episode of malignant hypertension or stroke in the history * diabetes * creatinine clearance below 30 ml/min

Keywords: aliskiren renin inhibitor proteinuria chronic kidney diseases ace inhibitor
early vitrectomy for endophthalmitis after cataract surgery

Conditions: Endophthalmitis; Cataract; Vitreous Detachment; Retinal Detachment

Summary: post-operative infectious endophthalmitis is devastating condition that causes a diffuse intraocular inflammation and may lead to blindness. acute post-operative endophthalmitis usually presented within 6 weeks of intraocular procedure and diagnosis is confirmed by clinical examination and by the aid of b-scan ultrasonography.

there is no consensus regarding the timing of vitrectomy in cases with endophthalmitis after cataract surgery. the endophthalmitis vitrectomy study concluded that vitrectomy should be preserved for cases with only light perception. the advances in posterior segment machines and small gauge cannulas decrease the incidence of intra-operative complications and encourage for early intervention in cases with endophthalmitis after primary cataract surgery.

Eligibility criteria:
inclusion criteria: * acute onset endophthalmitis within 6 weeks after primary cataract surgeries. * patients had undergone early pars-plana vitrectomy within 48 hours of their confirmed diagnosis. exclusion criteria: * patients were diagnosed as endogenous or chronic endophthalmitis. * patients with a previous history of rupture globe surgery or trauma. * patients who didn't complete the follow up period.

Keywords: endophthalmitis cataract vitrectomy retinal detachment
evaluation of the effectiveness of a flu vaccination campaign for healthcare workers of a teaching hospital: a pre-post study

Conditions: Influenza Vaccination

Summary: the goal of this observational study is to evaluate the effectiveness of the vaccination strategy implemented during the 2019/2020 flu vaccination campaign compared with the previous one. the main question it aims to answer is whether there are differences in the total coverage of influenza vaccination, in different categories of professionals and in different operating units.


Eligibility criteria:
inclusion criteria: * health personnel employed by the fondazione policlinico universitario "a. gemelli" irrcs exclusion criteria: -
human epidermal growth factor receptor 2 (her-2) status in gastric and gastro-esophageal junction (gej) carcinoma

Conditions: Gastric Cancer, Gastroesophageal Junction Cancer

Summary: the primary objective is to evaluate the concordance between human epidermal growth factor receptor 2 (her2) status determined by the participating laboratory and by the centralized laboratory. her2 status of samples was tested by the participating laboratories (investigator's choice of immunohistochemistry \[ihc\] and in situ hybridization \[ish\] methods) and by the centralized laboratories (ihc using the 4b5 anti-her antibody and silver ish). positive her2 status was defined as a score of ihc3+ or ihc2+/ish+.


Eligibility criteria:
inclusion criteria: * tumor samples with histologically confirmed gastric or gastro-esophageal junction (gej) adenocarcinoma, any stage * samples with sufficient tumor material for centralized analysis * samples fixed and embedded in paraffin (formalin-fixed paraffin-embedded tissue \[ffpet\] samples). exclusion criteria: - fixatives not allowed: bouin's solution
whatsapp intervention to assess the effect of messages in adherence to antiretrovirals in young people with hiv in peru

Conditions: HIV

Summary: the goal of this clinical trial is to learn which type of messages is more efficacious to improve adherence to medication in young people living with hiv. the main question is aims to answer is: -are messages designed by participants (self-designed) more efficacious than messages designed by health providers to improve adherence to antiretroviral treatment (hiv medications)? researchers will compare both types of messages to see if one is better than the other in helping participants take their medications. participants will: * receive either messages designed by themselves or by health providers for 4 months. * be able to chat with health providers at any time, with special focus regarding questions about their condition, medications and health services. * complete questionnaires via whatsapp describing how they are taking their medications, and how often they forget to take them. * complete questionnaires via whatsapp describing their opinion about receiving the messages and being able to chat with health providers.


Eligibility criteria:
inclusion criteria: * people living with hiv of age 18-29 at the moment of signing informed consent. * being a patient of the study center's infectious diseases clinic or national hiv program, between march 2024 and july 2024. * ownership of a mobile phone that supports whatsapp. exclusion criteria: * being pregnant at the moment of signing informed consent. * being illiterate at the moment of signing informed consent. * being blind at the moment of signing informed consent

Keywords: hiv mhealth messages adherence art antiretroviral therapy