Kornimate/medical-research-clean huggingface dataset:
analysis of exploring optimized sequential treatment strategies of antibody-drug conjugates (adcs) in her2-low-expressing breast cancer

Conditions: Antibody-drug Conjugates; HER2-low Breast Cancer; Breast Neoplasms

Summary: this study retrospectively analyzes the clinical data of her2-low breast cancer (ihc 1+/2+ and fish-negative) patients treated with sequential antibody-drug conjugates (adcs). key variables include patient demographics, tumor characteristics, adc regimens (e.g., trastuzumab deruxtecan, sacituzumab govitecan), treatment sequencing, survival outcomes, and safety profiles. genomic data (e.g., her2 expression dynamics, trop2 levels) are integrated to explore resistance mechanisms and prognostic biomarkers.mechanisms. this study aims to investigate the efficacy of different adc sequential regimens in her2-low breast cancer patients.

breast cancer is one of the most common malignancies in women, posing a significant threat to female health. according to current molecular subtypes, breast cancer is classified into hormone receptor-positive, her2-positive, and triple-negative breast cancer. however, with the development of novel therapeutic strategies such as antibody-drug conjugates (adcs), increasing attention has been directed toward her2-low breast cancer (defined as her2 immunohistochemistry \[ihc\] 1+ or 2+/fish-negative), which accounts for approximately 60%-70% of breast cancer cases. adcs can exert potential therapeutic effects in her2-low breast cancer through the "bystander effect" and have been widely adopted in clinical practice. nevertheless, the optimal sequential treatment strategy for her2-low patients remains unclear, with a lack of definitive clinical guidelines and limited understanding of resistance mechanisms. this study aims to investigate the efficacy of different adc sequential regimens in her2-low breast cancer patients and explore potential resistance mechanisms. by conducting a retrospective analysis of clinical data from her2-low patients treated with sequential adcs, the investigators will evaluate the therapeutic outcomes and safety profiles of various adc sequencing approaches. additionally, integrating genomic profiling with routine clinical data, the investigators seek to identify prognostic biomarkers and elucidate resistance pathways. the findings are expected to guide personalized treatment strategies for her2-low breast cancer patients, ultimately improving clinical outcomes.

Eligibility criteria:
inclusion criteria: * diagnosed with her2-low breast cancer, defined as immunohistochemistry (ihc) score of 1+ or ihc score of 2+ with negative in situ hybridization (fish-negative) * received sequential administration of two or more adcs * complete data for patient's character, laboratory and imaging test, treatment and follow-up are available. exclusion criteria: * concomitant with other tumor components at the time of diagnosis; * have a history of any other malignant tumors; * lack of complete data

Keywords: antibody-drug conjugates her2-low breast cancer retrospective studies
smell exploration in patients with nasal polyposis : study by functional magnetic resonance imaging

Conditions: Nasal Polyposis

Summary: nasal polyposis (np) is a disease affecting 4% of the population. this disease is frequently accompanied by olfactory disorders (41%-84% of patients) that affect patients' quality of life. the aim of this study is to show brain activity differences in olfactory areas before and after surgery in each patient and between patient groups (normosmic, hyposmic and anosmic one) using functional magnetic resonance imaging (fmri). brain activity will be measured by the intensity of brain signals and of the size of olfactory areas during olfactory stimulation before and after surgery. we suppose that fmri could predict whether or not the patient will be able to recover smell after surgery.


Eligibility criteria:
inclusion criteria: * patients with nasal polyposis managed in the department of otorhinolaryngology and head and neck surgery of nancy university hospital, * adult patients, * justifying a surgical treatment for nasal polyposis, * present hyposmia, anosmia or normosmia before surgery (confirmed by threshold and identification tests of the sniffin' stick kit), * affiliated with or beneficiary of a social security scheme, * having received complete information about the study and having signed an informed consent form. exclusion criteria: * general contraindications to magnetic resonance imaging, * female of childbearing age without effective contraception, * persons referred in articles l. 1121-5 to l. 1121-8 and l1122-2 of the public health code, * qualitative sense of smell disorder (cacosmia, hyperosmia, phantosmia, parosmia), * smell disorders with neurological, post-traumatic, or neurodegenerative origin.
deep brain stimulation of nucleus accumbens for opioid relapse prevention

Conditions: Addiction

Summary: nucleus accumbens plays important roles in the process of opiate addiction and initial of relapse after detoxification.according to the single-centered preliminary open-labeled prospective trial results, the investigators hypothesize that bilateral stimulation of the nac will effectively reduce the relapse of the opiate dependence.


Eligibility criteria:
inclusion criteria: * 18 years old \< age \< 50 years old * moderate to severe opiates abuse disorders (fulfilled diagnostic-criteria according to dsm-5) 1. history of opiates abuse no less than 3 years 2. failure of at least three addiction treatments ( in hospital or compulsive rehabilitation）, among which failure of methadone maintenance treatment must be met 3. completion of detoxification ( negative urine test for morphine, methamphetamine, ketamine and buprenorphine) * free patient's decision/informed consent (existing comprehensive ability in meaning, methodology and execution of the study and ability of acceptance, known the benefit and risk of the treatment) exclusion criteria: * clinical relevant psychiatric comorbidity (schizophrenic psychoses, bipolar affective diseases, severe personality disorder) * contraindications of a mri-examination, e.g. implanted cardiac pacemaker/heart defibrillator * abuse of other type of drugs * severe cognitive impairments * enrollment in other clinical trials * stereotactic respectively neurosurgical intervention in the past * contraindications of a stereotactic operation, e.g. increased bleeding-disposition, cerebrovascular diseases (e.g. arteriovenous malfunction, aneurysms, systemic vascular diseases) * serious and instable organic diseases (e.g. instable coronal heart disease) * tested positively for hiv * pregnancy and/or lactation * severe disorders for coagulation and liver function * epilepsy or other severe brain trauma or neurological impairments

Keywords: opiate dependence deep brain stimulation nucleus accumbens
short term effects of a hibiscus sabdariffa and stevia rebaudiana drink on cardiac relaxation and urinary albumin excretion in a group of diabetic type 2 subjects

Conditions: Benefits of a Hibiscus Sabdariffa and Stevia Rebaudiana Drink in Patients With Type 2 Diabetes Mellitus Before and After 8 Weeks of add-on Therapy

Summary: the aim of this study is to evaluate the effects of a hibiscus sabdariffa and stevia rebaudiana drink on cardiac relaxation and urinary albumin excretion in a group of diabetic type ii patients.

the investigators performed a non-randomized single-arm clinical trial with a before and after design, carried out from november 2016 and may 2017. intervention consisted of the administration of a hibiscus-stevia drink at a dose of 4 mg / kg / day for stevia and 4 g / day for hibiscus for a period of 8 weeks. before and after intervention, the following were done by the participants: bioelectrical impedance analysis (bia), blood pressure measurements, fasting blood sugar, hba1c, lipid profiles, liver function tests, kidney function tests, urinary excretion of albumin tests and full blood counts. these were followed by morphological workup including electrocardiograms (ecgs), transthoracic heart ultrasounds and ambulatory blood pressure measurements (abpm), also done before and after intervention. clinical evaluation with fasting blood sugar control, blood pressure controls and urinary excretion albumin tests were done at the 30th and 60th days for safety purposes.

Eligibility criteria:
inclusion criteria: * known t2dm patients aged above 21years no change in anti-diabetic medication during the last three months hba1c between 42 to 64mmol/mol (6-8% clearance of creatinine calculated according to the modification of diet in renal disease equation\> 60ml/min/1.73 m2 exclusion criteria: * patient already on hibiscus or stevia supplementation or other herbal medication drugs that could interact with hibiscus or whose effects may be amplified, as far back as 1 month before study. cardiac, renal disease and liver pathologies sensitivity, intolerance or allergy to hibiscus or stevia discontinued intervention withdrawal of consent

Keywords: diastolic function blood pressure diabetes mellitus hibiscus sabdariffa stevia rebaudiana
results of cross-leg free vascularized fibular graft

Conditions: Tibial Fractures

Summary: this study aims to evaluate the new technique of cross-leg vascularized fibular graft for reconstruction of post-traumatic long tibial bone defects in terms of restoring normal anatomy and function of the traumatized limb in a series of cases admitted in assiut university hospital, orthopedics and trauma surgery department.

reconstruction of post-traumatic long tibial bone defects is still a major therapeutic challenge faced by orthopaedic surgeons on both anatomical and functional concerns, and it is usually associated with significant long-term morbidity. historically, amputation was the treatment of choice for long tibial bone defects because of difficulty of reconstructove management of such cases. over the last few decades, limb salvage procedures have been developed. during the second world war, massive cancellous bone autograft has been the preferred treatment. but traditional bone graft procedures in many cases may be limited by uncontrollable graft resorption. to overcome this disadvantage different management options have been developed to address bone defects of various lengths as vascularized fibular grafts, ilizarov technique using bifocal or trifocal bone transport, acute limb shortening and masquelet procedure. however, in some cases long bone defects are associated with extensive soft tissue lacerations together with poor ipsilateral blood supply. for those cases previous surgical options are associated with many complications and may end up with failure of reconstruction and amputation, in this situation cross-leg vascularized fibular graft may be a good treatment option because it can provide a blood supply away from that of the extensively traumatized limb.

Eligibility criteria:
inclusion criteria: - patients who were admitted into assiut university hospital, orthopedics and trauma surgery department with big tibial bone defects ranging from 12 cm to 26 cm, associated with extensive soft tissue damage and poor ipsilateral blood supply confirmed by ct angiography and treated with cross-leg free vascularized fibular graft. exclusion criteria: * patients with bilateral extensive soft tissue damage and poor blood supply. * patients with medical conditions preventing them from general anesthesia for long periods (\>10 hours).

Keywords: cross-leg flap vascularized fibular transfer open grade iii tibial fractures
aliskiren plus hctz compared to aliskiren in metabolic syndrome patients with stage 2 systolic hypertension

Conditions: Hypertension

Summary: the purpose of the study is to evaluate the blood pressure lowering effect and safety of aliskiren in combination with hydrochlorothiazide (hctz) compared to aliskiren monotherapy when given to metabolic syndrome patients with stage 2 systolic hypertension (mean sitting systolic blood pressure \[mssbp\] ≥ 160 mm hg and \< 200 mm hg).


Eligibility criteria:
inclusion criteria: * patients who are eligible and able to participate in the study, and who give written informed consent before any assessment is performed. * male or female outpatients ≥ 18 years old. * patients with stage 2 systolic hypertension. patients must have a mssbp ≥160 mmhg and \<200 mmhg at study visit 5 (randomization). * patients who have stage 2 systolic hypertension that meet at least 2 additional components of the metabolic syndrome as defined by the national \*cholesterol education program (ncep) criteria: * abdominal obesity (waist circumference \> than 102 cm for men and \> 88 cm for women) * current triglycerides ≥ 150 mg/dl or medical treatment for this condition. * current hdl- cholesterol \<40 mg/dl in men and \<50 mg/dl in women or medical treatment for this condition. * fasting glucose \>100 mg/dl and \<126 mg/dl exclusion criteria: * office blood pressure measured by cuff (msdbp ≥ 110 mmhg and or mssbp ≥ 200 mmhg) at any visit. * use of other investigational drugs at the time of enrollment, or within 30 days or 5 half-lives of enrollment, whichever is longer. * use of aliskiren and/or a fixed dose combination of aliskiren hctz or participation in a clinical trial that had aliskiren and/or aliskiren hctz as treatment within 30 days of visit 1. * history of hypersensitivity to any of the medications or to drugs belonging to a similar therapeutic class (diuretics or renin inhibitors) as the study drugs. * history or evidence of secondary form of hypertension. * refractory hypertension, defined as unresponsive to triple drug therapy at the maximum dose of each drug, one of which must be a diuretic, and not at blood pressure goal (140/90mmhg). therapy with a fixed dose combination of two active substances represent two drugs. * patients on 4 or more antihypertensive medications.

Keywords: hypertension metabolic syndrome aliskiren hydrochlorothiazide systolic blood pressure diastolic blood pressure stage 2
spectral characteristics of memory transformation

Conditions: Healthy

Summary: sometimes, it is necessary to re-learn a previously learned movement behavior, for example, a bad posture during the golf drive or while playing the piano. unlearning or relearning an intensively trained behavior is particularly important if the behavior is hampering recovery, for example, in chronic pain or after a stroke. with this pilot study, the brain mechanisms that control the change of pre-existing stable memories of a motor skill will be tested with electroencephalography (eeg). non-invasive brain stimulation will be used to modulate these brain mechanisms and test if it is possible to change the pre-existing motor memory and the learning of a new motor skill.


Eligibility criteria:
inclusion criteria: * age 18 years or older (2/3 of the final sample will be ≥60years of age) * no previous stroke, brain tumor, neurodegenerative disease, or trauma to the head * ability to give consent for study participation * who have access to a personal computer with internet exclusion criteria: * • pregnancy * inability to use all ten fingers to type on a standard computer keyboard * uncorrected vision, hindering perception of visual cues presented on a standard computer screen * medication use at the time of study that may interfere with learning or the effect of tacs, including but not limited to carbamazepine, flunarizine, sulpiride, rivastigmine, dextromethorphan; * neuromuscular disorders affecting hand and finger movements necessary for 10-finger keyboard typing * presence of neurological or psychiatric disorders * presence of scalp injury or disease * prior history of seizures * prior intracranial surgery * prior brain radiotherapy * prior history of intracranial tumor, intracranial infection, or cerebrovascular malformation * metal in head or neck * contraindications to mri (such as severe claustrophobia, implanted medical devices)
efficacy of enhanced external counterpulsation on ventricular function

Conditions: Coronary Heart Disease

Summary: the purpose of this study is to investigate the efficacy of enhanced external counterpulsation (eecp) therapy on ventricular function in patients with coronary heart disease

patients with coronary heart disease will be randomized into two groups: standard medical treatment and standard medical treatment plus eecp intervention. ventricular structure and function will be measured and compared.

Eligibility criteria:
inclusion criteria: * more than 50% stenosis of left main trunk and 3 epicardial coronary arteries and their large branches showed by coronary angiography * or history of myocardial infarction * or history of prior revascularization * signed informed consent to participate in the study exclusion criteria: * clinically significant valvular heart disease * aortic aneurysm * congenital heart disease * acute myocarditis * arrhythmias significantly interfere with the triggering of the eecp device * history of cerebral hemorrhage * hemorrhagic disease * lower limb infection, phlebitis * deep venous thrombosis * malignant disease * international normalized ratio (inr) \> 2.5 * uncontrolled hypertension, defined as systolic blood pressure \> 180mmhg or diastolic blood pressure \> 110mmhg * pregnancy

Keywords: coronary heart disease ventricular function vascular endothelium counterpulsation, external
glucagon-like peptide 1 agonist exenatide for improved glucose control and cardiac function in patients with aortocoronary bypass

Conditions: Coronary Artery Disease; Decreased Left Ventricular Function

Summary: glp-1 has not only beneficial effects on glucose metabolism but also direct positive effects on cardiac function and metabolism in both experimental models and in patients with type 2 diabetes mellitus. clinical data on the effects of glp-1 agonists on cardiac function and glucose control in patients undergoing cardiac surgery are not known. based on the results of experimental studies there is a potential for exenatide to positively influence both cardiac function and glucose metabolism in cardiac surgery patients with and without type 2 diabetes mellitus. the primary endpoint of this study is to examine whether pre- and peri-operative administration of exenatide affects perioperative hemodynamics, echocardiographic parameters, necessity of antiarrhythmic and inotropic treatment and glucose control in patients with coronary atherosclerosis and decreased left ventricular function undergoing elective coronary artery bypass grafting operation (cabg). in addition, safety and tolerability of peri-operative administration of exenatide in these patients will be examined as a secondary study objective.


Eligibility criteria:
inclusion criteria: * elective coronary artery bypass grafting operation (cabg) * decreased left ventricular (lv) systolic function (ef lv ≤ 50%) * age 18 to 85 * signed informed consent * females with childbearing potential have to use appropriate contraceptive measures during the whole study period and 6 months after terminating exenatide infusion (hormonal contraception or double-barrier contraception for both partners) exclusion criteria: * allergy to exenatide * allergy to insulin * mental incapacity or language barrier * use of incretin-based therapies \<3 months before inclusion in the study * diabetic ketoacidosis * established autonomic neuropathy * history of acute pancreatitis or severe disease of digestive tract * renal failure (preoperative creatinine ≥ 180 umol/l) * liver failure (coagulation times more than 1.5 times higher without use of anticoagulants) * cardiac surgical procedure on valve, thoracic aorta or maze procedure * pregnancy and lactation
slv308 for treatment of patients with early parkinson's disease

Conditions: Early Stage Parkinson's Disease

Summary: this study is a multicenter, randomized, double blind, parallel group study of 6 months' treatment with slv308 administered as a monotherapy in patients with early stage pd. an open label safety extension to this study is planned as a separate protocol for patients who are willing and eligible to participate.


Eligibility criteria:
inclusion criteria: * diagnosis of idiopathic parkinson's disease, * early stage of disease, modified hoehn \& yahr up to stage iii, * updrs motor score (part iii) 10 at baseline. exclusion criteria: * diagnosis is unclear or a suspicion of other parkinsonian syndromes, * patients who have undergone surgery for the treatment of pd, * presence of dyskinesias, * motor fluctuations or loss of postural reflexes, * clinically significant abnormalities, * patients treated with l-dopa or dopamine agonists currently or in the past (for more than 3 months in total), * antipsychotic.

Keywords: parkinson's disease
chiropractic treatment for headache among children aged 7-14

Conditions: Chronic Headache

Summary: the primary aim of the study is to assess the effectiveness of chiropractic manipulation treatment versus placebo treatment in children suffering from headache for more than six months.

the study is a two-armed parallel, randomized controlled clinical trial where children suffering from chronic headache and at the same time having one or more biomechanical dysfunctions of the spine are randomized to either chiropractic manipulation treatment or placebo manipulation treatment. the outcome is based on weekly sms responses collecting the number of days with headache the past week, intensity of headache and use of medication for headache. these are answered four weeks prior to initiation of treatment and 16 weeks thereafter. after the 16 weeks follow-up, a final questionnaire is completed including information about the course and the present headache status. the primary outcome is the number of days with headache. secondary outcomes are intensity of headaches and use of medication for headache. covariates are collected via baseline questionnaires on patient demographics; medical history; factors known to initiate, worsen or ease the headache; prevalence of headache in the nearest family; and behavioral patterns known to influence headache.

Eligibility criteria:
inclusion criteria: * headaches for at least half a year. * headache for at least 4 days pr. month. * at least one musculoskeletal dysfunction as identified by an experienced chiropractor as a movement restriction in one or more of the spinal joints and painful on manual palpation suitable for chiropractic manipulation treatment at the time of the initial screening. * able to report information on headache via cell phone either by him- or herself or with help from the parents. exclusion criteria: * contraindications for chiropractic treatment * ongoing treatment for headache at another practitioner, except medical treatment 3 months prior to inclusion. * lack of reporting baseline data via sms 4 weeks prior to inclusion. * acute neck or head trauma during the trial period which is estimated to influence the headache

Keywords: chiropractic spinal manipulation children pediatric headache