Kornimate/medical-research-clean huggingface dataset:
s-1 and cisplatin before surgery in treating patients with stage iv gastric cancer

Conditions: Gastric Cancer

Summary: rationale: drugs used in chemotherapy, such as s-1 and cisplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. combining more than one drug may kill more tumor cells. giving combination chemotherapy before surgery may shrink the tumor so that it can be removed. purpose: this phase ii trial is studying how well giving s-1 together with cisplatin works in treating patients who are undergoing surgery for stage iv gastric cancer.

objectives: primary * determine the efficacy and feasibility of neoadjuvant chemotherapy comprising s-1 and cisplatin in patients with stage iv gastric adenocarcinoma. * determine the overall survival of patients treated with this regimen. secondary * determine the time to progression and types of initial recurrence in patients treated with this regimen. * determine tumor response in patients treated with this regimen. * determine mortality and morbidity related to treatment in these patients. * determine the toxicity of this regimen in these patients. outline: this is a multicenter study. patients receive oral s-1 on days 1-21 and cisplatin iv over 2 hours on day 8. treatment repeats every 35 days for 2 courses in the absence of disease progression or unacceptable toxicity. patients then undergo gastrectomy with lymphadenectomy. patients resume oral s-1 after surgery. projected accrual: a total of 50 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * histologically confirmed gastric adenocarcinoma * stage iv disease meeting 1 of the following staging criteria according to japanese gastric cancer classification: * t4, n2 * t4, n3 * p1, cy1 * ct scan and laparoscopic staging required patient characteristics: age * 20 and over performance status * ecog 0-1 life expectancy * not specified hematopoietic * wbc ≥ 4,000/mm\^3 and \< 12,000/mm\^3 * granulocyte count ≥ 2,000/mm\^3 * platelet count ≥ 100,000/mm\^3 * hemoglobin ≥ 9.0 g/dl hepatic * ast and alt ≤ 2.5 times upper limit of normal * bilirubin ≤ 1.5 mg/dl renal * creatinine clearance ≥ 50 ml/min pulmonary * pao_2 ≥ 70 mm hg on room air other * able to swallow oral medication prior concurrent therapy: biologic therapy * not specified chemotherapy * no prior chemotherapy for gastric cancer endocrine therapy * not specified radiotherapy * no prior radiotherapy for gastric cancer surgery * no prior surgery for gastric cancer other * no other prior therapy for gastric cancer

Keywords: stage iv gastric cancer adenocarcinoma of the stomach
xience registry in complex lesion of acute coronary syndrome patients with ticagrelor (rich)

Conditions: Coronary Artery Disease; Percutaneous Coronary Intervention; Acute Coronary Syndrome

Summary: the goal of this multicenter prospective clinical cohort study is to investigate the impact of early use of low-dose ticagrelor-based dual antiplatelet agent therapy (tdapt) (ticagrelor 120mg daily; l-tdapt) as compared to standard-dose tdapt (ticagrelor 180mg daily; s-tdapt) in outcomes of percutaneous coronary intervention (pci). the main question it aims to answer are: given the low ischemic risk and high bleeding tendency in asians, the low dose tdapt may provide better net clinical benefits of ischemic and bleeding events than the standard dose tdapt.

participants were administrated with 300mg of aspirin and 180mg of ticagrelor orally before they underwent index pci, and were prescribed with s-tdapt from the next day after index pci at least for 1 week. the start of l-tdapt was decided by each attending physician's preference. successful pci was defined as a residual stenosis \<30% with thrombolysis in myocardial infarction grade 3 flow after pci and the absence of death by mi and reintervention for the index coronary lesions during the admission period. standard definitions of cardiovascular events were used for all clinical events. myocardial infarction (mi) was defined using the 4th universal definition of mi as previously described. repeat revascularization (rr) was defined as a new pci for the target vessels or de-novo coronary lesions. all-cause death was defined as a death from any cause. cardiovascular death was defined as death from mi, stent thrombosis and ischemic stroke. a major adverse cardiac and cerebrovascular event (mace) was defined as a composite of cardiovascular death, non-fetal mi, rr, stent thrombosis and ischemic stroke. a bleeding event was defined as the bleeding event equivalent to bleeding academic research consortium (barc) classification 2 or higher. a net clinical event (nce) was defined as a composite of maces and bleeding events. patients were scheduled to follow up to 2 years after index pci. clinical follow-up started when a patient discharged from the hospitalization for the index pci and ended when the patient experienced the any clinical event or reached the end of follow-up. the follow-up visits were scheduled at 1, 3 and 6 months, 1 year and 2 years after discharge.

Eligibility criteria:
inclusion criteria: * 19 years of age or older * acute coronary syndrome (acs) undergoing pci * pci for complex coronary lesions using everolimus-eluting stents (xience®, abbot corp, chicago, illinois, us) * prescribed with s-tdapt for more than 3 months exclusion criteria: * cardiogenic shock * pci using drug-eluting stents (des) other than the everolimus-eluting stents * those who had conditions requiring a long-term oral anticoagulant therapy * those with life expectancy \<1 year

Keywords: low-dose ticagrelor-based dual antiplatelet agent therapy percutaneous coronary intervention acute coronary syndrome complex coronary lesion net clinical outcome everolimus-eluting stent
mitochondrial apoptotic pathway induced by myocardial ischemia-reperfusion injury in human

Conditions: Ischemia-reperfusion(I/R); Cardiopulmonarybypass; the Mitochondrial Pathway; Ischemic Postconditioning

Summary: background: the cardiomyocytes apoptosis induced by ischemia-reperfusion(i/r) is one of the most important factors in the myocardial i/r injury(miri) undergoing cardiac valve replacement with cardiopulmonary bypass(cvrcpb),and ischemic postconditioning (i-postc) can inhibit apoptosis of myocardial cells. consequently, this study investigated the key genes and apoptosis signaling pathways of myocardium in patients undergoing cvrcpb. methods: a total of 36 new york heart association class ii or iii patients with rheumatic heart disease (rhd) of both sexes, aged 21-59 years, who were scheduled for first cardiac valve replacement with cpb in the investigators' hospital from february 2014 to may 2015, were randomly divided into the following three groups (n=12 each): negative control group (neg group); i/r group (pos group); and i-postc group (treat group). in the treat group, the procedure involved 5 min before opening the ascending aorta, aortic unclamping for 30 s, and cross-clamping for 30 s for three cycles, after which the ascending aorta was completely opened. the neg and treat groups were not treated. thirty-six patients were assessed for arrhythmia and recovery of myocardial contractile function after reperfusion by electrocardiograms and degree of dependence on vasoactive drugs. the myocardial tissues of the right atrial appendage were obtained at 3 min before cpb was established in the neg group, and at 45 min after opening the aorta in the pos and treat groups. in all three groups, the myocardial tissues of the right atrial appendage were obtained and preserved at -80°c for further experiments. the right atrial appendage of three patients randomly selected in each group was fixed with rna later (qiagen, hilden, germany) in a centrifuge tube overnight at 4°c, and then preserved at -20°c for rna extraction. human 12×135k gene array profiling of mrna expressions was undertaken in human cardiac muscle cells. differentially expressed mrnas verified by quantitative real-time rt-pcr were subjected to pathway analysis. the mrna expressions of aif, apaf1, cycs, bax, caspase-3, caspase-9, caspase-6, caspase-7, bcl2, bag1, and pi3k were assessed by real-time rt-pcr and western blot analysis. the levels of myocardial apoptosis induced by i/r were investigated by tunel assays. the changes in miri induced by myocardial apoptosis were investigated by pathologic examination of the myocardium.


Eligibility criteria:
inclusion criteria: * new york heart association class ii or iii * aged 21-59 years * scheduled for first cardiac valve replacement with cpb exclusion criteria: * the patient with a history of heart operation or diabetes, * with a history of liver and/or kidney dysfunction, * with a history of coronary heart disease and the left ventricular ejection fraction(lvef)\<0.4, receiving drugs with pretreatment effectssuchas hormones, atp-sensitive potassium (katp) channel openers，insulin，et al. within preoperative one week,
influx system for nasal breathing improvement

Conditions: Nasal Airway Obstruction

Summary: pilot study of the aerin medical wand used for improvement in nasal breathing

this is a non-significant risk, prospective, non-randomized pilot study to evaluate the incidence of serious adverse events directly attributable to the aerin medical wand, when used to deliver radiofrequency (rf) energy to tissues of the nasal airway for the treatment of nasal obstruction.

Eligibility criteria:
inclusion criteria: * patients with history of chronic nasal obstruction and poor nasal breathing exclusion criteria: * patients with prior nasal history, nasal pathology, or injury, and/or other conditions that may interfere with participation in the study

Keywords: nasal obstruction
validation of a portable sleep device in patients with co-existing medical illnesses

Conditions: OSA

Summary: the standard sleep study for diagnosing obstructive sleep apnea (osa) in patients with co-existing illness is by conducting an attended polysomnography (psg) with more than 7 channels for recording physiological parameters in the sleep center, as recommended by international guidelines. however the guidelines are more than 10 year old without update. with the growing and aging of the population, there is a need to explore if portable monitoring devices could be used in this group of population, so this group of patients can be managed in a timely manner. portable monitoring devices have been used widely in patients without significant co-existing illness. these devices record at least 4 physiological parameters for diagnosing osa and can be performed in an unattended setting e.g. at home because of the simplicity. this can shorten the waiting time for making a diagnosis using psg. eighty patients suspected of osa, with stable co-existing illnesses, will be recruited for the study. informed consent will be signed before participation. they will be offered a standard attended psg in the sleep center. a portable monitoring device "nox t3" will be hooked up to the patients concurrently during the psg.


Eligibility criteria:
inclusion criteria: * adult patients suspect of osa (with or without symptoms) of age between 18 to 80 years old, with or without significant comorbidities. * patients consent of concurrent use of both type i and or type iii devices at the same time in hospital setting. exclusion criteria: * pregnant patients. * patients refuse to have both type i and type iii devices used concurrently. * patients with any co-existing medical illnesses which are unstable. "unstable" is defined as: * any recent hospital admission within 1 month before the schedule of sleep study * any recent change of medication within 1 month before the schedule of sleep study * any change in patient conditions requiring medical attention within 1 month before the schedule of sleep study.
the effects of gum chewing on bowel function recovery following cesarean section

Conditions: Paralytic Ileus

Summary: following all abdominal surgery, paralytic ileus commonly develops. surgeons have traditionally withheld postoperative oral intake until the return of bowel function to prevent related complications. gum chewing can stimulates bowel movement and promotes the return of bowel function through the cephalic-vagal reflex and increased intestinal enzymes secretion. the objectives of this study are to examine effects of adding gum chewing to the conventional postoperative feeding regimen on the return of bowel function, its related complications, and patients' satisfaction.


Eligibility criteria:
inclusion criteria: * pregnant women undergoing cesarean delivery exclusion criteria: * perioperative hyperalimentation * recent chemotherapy * concurrent bowel surgery * previous bowel surgery * concurrent bowel obstruction * history of inflammatory bowel diseases * previous abdominal/pelvic radiation * postoperative placement of endotracheal tube/nasogastric tube * postoperative admission to intensive care unit
emg activation of gluteal musculature during exercises with and without resistance

Conditions: Low Back Pain

Summary: the gluteus medius (gmed) and gluteus maximus (gmax) muscles are important components in the treatment of many lower limb injuries. recent studies have evaluated a myriad of exercises which activate the gmed and gmax, but limited research remains on exercises involving resistance and the role of the tfl. the purpose of this study is to evaluate gmed, gmax, and tfl percent maximal voluntary isometric contraction (%mvic) and perceived exertion in healthy and low back pain patients while performing exercises with and without resistance. methods: a convenience sample of healthy subjects and patients diagnosed with non-radicular low back pain will be recruited. exclusionary criteria will include: current low back or lower extremity injury (healthy group), pregnancy, history of hip surgery, and radicular symptoms. surface electromyography will be used to quantify the activity level of the gluteal muscles and tfl while performing a series of 8 exercises with and without thera-band® resistance tubing and stability trainer. the maximal voluntary isometric contraction (mvic) will be established for each muscle group and the order of exercises performed will be randomized to minimize the effect of fatigue. following the completion of each exercise, the patient will rate their perceived exertion level on the thera-band® resistance intensity scale for exercise (rise). the emg signals will be smoothed and rectified and analyzed using a root-mean-square algorithm. clinical relevance: the results of this study will allow clinicians to better prescribe exercises, proven to activate the gluteal muscles and limit the tfl involvement, in the treatment of low back pain.


Eligibility criteria:
inclusion criteria: * healthy, physically active subjects * patients diagnosed with non-radicular low back pain * 18-65 exclusion criteria: * current low back or lower extremity injury (healthy group) * pregnancy * history of hip surgery * radicular symptoms

Keywords: gluteus maximus gluteus medius tfl emg perceived exertion thera-band
point-of-care ultrasound-driven vs standard diagnostic pathway in emergency department patients with dyspnea

Conditions: Dyspnea

Summary: the pocus pathway-trial is a multi-center, randomized, investigator-initiated, open labelled, pragmatic, controlled trial of a point-of-care ultrasound-driven diagnostic pathway vs standard diagnostic pathway in dyspneic emergency department patients. the primary outcome will be 24-hour hospital stay and 642 patients will be included. key secondary outcomes include overall hospital length of stay, image resources, and 72-hour revisits.


Eligibility criteria:
inclusion criteria: 1. emergency department contact 2. age ≥ 18 years 3. chief complaint is dyspnea 4. including physician present exclusion criteria: 1. fulfilling of criteria for coded rapid-response teams (i.e., trauma, surgical or medical emergencies). 2. prior focused lung or focused cardiac ultrasound in the current emergency department stay 3. prior enrollment in the trial 4. unable to consent 5. non danish-speaking

Keywords: point-of-care ultrasound emergency medicine diagnostic pathways
pilot investigation to evaluate flowox2.0™ for experimental treatment of spasticity

Conditions: Multiple Sclerosis; Spasticity, Muscle; Pain

Summary: this is a descriptive, prospective, non-controlled clinical investigation to be conducted on approximately 10 enrolled subjects at one site at haukeland university hospital in bergen, norway. the target subjects are male or female, 18-70 years, diagnosed with ms according to revised mcdonald criteria (9) with spasticity and pain associated with the spasticity. spasticity is evaluated based on self-reported spasticity using the numerical rating scale (nrs) which describes the average score of spasticity over the last 24 hours at \>4 (where the scale scores spasticity from 0-10, where 0 is no spasticity, and 10 is worst possible spasticity), - combined with pain in the lower extremities last 24 hours. the pilot investigation is done to evaluate if flowox2.0™ can be used to treat spasticity with concomitant pain in patients with multiple sclerosis, using intermittent negative pressure affecting arteriovenous reflex.


Eligibility criteria:
inclusion criteria: 1. diagnose ms according to revised mcdonald criteria 2. give written informed consent. 3. have an age between 18-70 years. 4. have stable disease without attack or progression of loss of function in the last three months. 5. have self-reported spasticity, scored using the numeric rating scale (nrs) which describes the average score of spasticity over the last 24 hours, at ≥ 4 (where the scale scores spasticity from 0-10, where 0 is no spasticity, and 10 is worst possible spasticity), - combined with pain in the lower extremities last 24 hours 6. have tried standard treatment for spasticity and pain without achieving a satisfactory effect. 7. stable and unchanged treatment of spasticity and pain the last month 8. stable and unchanged disease-modulating treatment for ms last 6 months. 9. function level measured by the expanded disability status scale (edss) 2.0-6.5 10. can self-manage study equipment. exclusion criteria: 1. have spasticity due to a disease other than ms. 2. pregnancy or plan a pregnancy within the upcoming study period of 6 months. 3. have an ongoing infection. 4. have received botulinum toxin injection for spasticity within the last 4 months. 5. have symptoms or illness that make it difficult to participate in the study. 6. having planned surgery or other treatment within the coming study period of 6 months makes it difficult to participate in the study. 7. have functional scores outside inclusion criteria measured by edss 2.0-6.5 8. have had disease activity beyond requirements for stable disease as described in inclusion criteria 9. have changed drug treatment beyond requirements for stable treatment as described in inclusion criteria.

Keywords: blood flow flowox™ stiffness
colchicine effect on perivascular inflammation index on coronary cta

Conditions: Atherosclerosis; Inflammatory Response; Coronary Disease

Summary: inflammation is an important pillar of atherogenesis in coronary disease. studies have documented the prognostic power of measuring coronary perivascular adipose tissue attenuation (pvat) and its good correlation as an early inflammatory biomarker in the atherogenesis process, in addition to being a predictor for cardiovascular events in the future. colchicine, a medication with well-documented anti-inflammatory action and with an impact on reducing cardiovascular outcomes, may have an action in reducing fai (fat attenuation index). this study aims to evaluate the effect of colchicine in reducing coronary perivascular inflammation.

a single-center, prospective, single-blind randomized study to evaluate the efficacy of colchicine versus placebo in patients with documented fai ≥ -70.1 hu of the proximal segment of the right coronary artery and/ou left anterior descending coronary artery and non-calcified or mixed plaques on coronary angiography performed electively after 12-month follow-up.

Eligibility criteria:
inclusion criteria: * individuals of both sexes over 18 years of age; * patients undergoing coronary ct angiography from may/2021 * ct angiography showing non-calcified or mixed coronary plaques and high fai value (\> -70.1 hu) in the proximal segment of the right and/or anterior descending coronary artery with * willing and able (in the opinion of the investigators) to fulfill all study requirements exclusion criteria: * past history of acute myocardial infarction * history of percutaneous or surgical myocardial revascularization * history of previous cardiac surgery or congenital heart disease * current use of colchicine * autoimmune disease requiring immunosuppressive therapy or current use of systemic corticosteroid therapy * active neoplasm with indication of surgery, chemotherapy or radiation in the last 12 months (patients with a history of neoplasm and who underwent curative surgery without need for treatment in the last 12 months will be allowed) * inflammatory bowel disease or chronic diarrhea * clinically significant non-transient hematologic abnormalities * renal dysfunction (gfr \ 2.5 mg/dl or \< 220 µmol/l) * severe liver disease (aspartate aminotransferase \[ast\] or alanine aminotransferase \[alt\] \> 3x uln in the last 6 months) * drug addiction or alcoholism * history of clinically significant sensitivity to colchicine * inability to sign the informed consent form * participation in another study

Keywords: perivascular adipose tissue attenuation fat attenuation index colchicine coronary disease inflammation