Kornimate/medical-research-clean huggingface dataset:
perioperative pain control with celecoxib (celebrex) in total knee arthroplasty

Conditions: Osteoarthritis

Summary: we propose that administration perioperative celecoxib is effective to control postoperative vas pain scores, improve rehabilitation results, and decrease narcotics usage in total knee replacement patients.

total knee replacement is an effective method to treat end-stage osteoarthritis. however, post-operative pain is still a bothering problem. pre-emptive analgesia is defined as an antinociceptive treatment which prevents pain before its onset. preoperative analgesia is thought more effective than an equal post-operative dose. surgical trauma induces the synthesis of prostaglandins, which sensitize the peripheral nociceptors.non-steroidal anti-inflammatory drugs (nsaids) inhibit prostaglandin synthesis both in the periphery and the spinal cord, therefore decreasing the post-operative hyperalgesic state. celebrex (celecoxib) is a nonsteroidal anti-inflammatory drug (nsaid) that is used to treat arthritis, pain, menstrual cramps, and colonic polyps. prostaglandins are chemicals that are important contributors to the inflammation of arthritis that causes the pain, fever, swelling and tenderness. celecoxib blocks the enzyme that makes prostaglandins (cyclooxygenase 2), resulting in lower concentrations of prostaglandins. as a consequence, inflammation and its accompanying pain, fever, swelling and tenderness are reduced. celecoxib differs from other nsaids in that it causes less inflammation and ulceration of the stomach and intestine (at least with short-term treatment) and does not interfere with the clotting of blood. the study group received 400mg oral celecoxib about 1 hr prior to total knee replacement surgery, and 200mg every 12 hrs, along with pca morphine, over the first five post-operative days. the control group received placebo, along with pca morphine over the same postoperative period. all patients had spinal anesthesia and hemovac drain tubes inserted for postoperative blood loss evaluation. specific aims and goals: 1. to establish better rehabilitation results and lower vas pain scores after administration perioperative celecoxib in total knee replacement patients. 2. to establish morphine sparing effect after perioperative celecoxib administration. 3. to evaluate the risks after prescribing perioperative celecoxib.

Eligibility criteria:
inclusion criteria: * patients receiving total knee replacement will be recruited in this study. exclusion criteria: * subjects with end-stage renal disease, cerebral vascular accident, peptic ulcer, long-term usage of nsaids.
acetazolamide for respiratory failure in combination with metabolic alkalosis

Conditions: Respiratory Insufficiency; Alkalosis

Summary: respiratory failure is a common consequence of chronic obstructive pulmonary disease (copd). a concurrent metabolic alkalosis may worsen the respiratory failure, as a higher ph in blood (and thus in cerebrospinal fluid) results in a weaker respiratory drive. use of diuretics is the most common cause of metabolic alkalosis. when a patient with an acute exacerbation of a respiratory failure is also alkalotic, there are (at least theoretical) reasons to lower the ph in order to increase the respiratory drive. among other alternatives, the drug acetazolamide can be used for this purpose. in some hospitals there is a tradition for the use of acetazolamide on this indication, but any evidence for the effect of such a treatment is rather weak. thus, the aim of this trial is to evaluate the effect of acetazolamide as an adjuvant treatment for hospitalized patients with acute exacerbation of respiratory failure in combination with metabolic alkalosis.


Eligibility criteria:
inclusion criteria: * arterial po2 8 kpa or lower, and arterial pco2 7 kpa or higher. * base excess 8 mmmol/l or higher. * written informed consent exclusion criteria: * acetazolamide treatment regarded as obviously indicated or obviously contraindicated * already using acetazolamide * moribund patient * unable to give fully informed consent * allergy towards the tablet content or unable to swallow the tablets * pregnant or breast-feeding

Keywords: respiratory insufficiency alkalosis
efficacy and safety of remimazolam besylate versus propofol for sedation in mechanically ventilated icu patients

Conditions: Critical Illness

Summary: the purpose of this study is to evaluate the efficacy and safety of remimazolam compared to propofol for sedation in mechanically ventilated icu patients.

this is a single-center, prospective, randomized, controlled pilot study using remimazolam and propofol for sedation in mechanically ventilated icu patients. subjects are randomized to remimazolam group and propofol group in a 1:1 ratio. remifentanil is administered as the analgesic. efficacy and safety profiles of remimazolam besylate are to be evaluated.

Eligibility criteria:
inclusion criteria: * age ≥ 18 and ≤ 75 years; * intubated and mechanically ventilated ≤96 hours before enrollment； * expected to require continuous invasive ventilation and sedation ≥24 hours; * requirement for light to moderate sedation (a rass score of -3 to 0). exclusion criteria: * body mass index (bmi) \ 30 kg/m2; * acute severe neurological disorder and any other condition interfering with rass assessment; * systolic blood pressure less than 90 mm hg after appropriate intravenous volume replacement and continuous infusions of 2 vasopressors; * heart rate less than 50 beats/min; * second- or third-degree heart block in the absence of a pacemaker; * unstable angina; * acute myocardial infarction; * left ventricular ejection fraction less than 30%; * contraindicate or allergic to study drugs; * moribund state; * acute hepatitis or serious hepatic dysfunction (child-pugh class c); * chronic kidney disease with glomerular filtration rate (gfr) \< 60 ml/min/1.73m2; * alcohol abuse; * myasthenia gravis; * pregnancy or lactation.

Keywords: remimazolam besylate propofol intensive care unit mechanical ventilation
effect of osimertinib in ethnic chinese with egfr and t790m mutated nsclc

Conditions: T790M Positive NSCLC Patients

Summary: to assess the effectiveness and safety of osimertinib treatment in a real world setting.

the current study will not only assess the effectiveness of osimertinib treatment in a real world setting, but will also help us to understand the real-world testing patterns among t790m mutation positive locally advanced or metastatic nsclc patients who have progressed after egfr tki treatment.

Eligibility criteria:
inclusion criteria: * above 18 years of age; * locally advanced (stage iiib) or metastatic (stage iv) nsclc, not amenable to curative surgery or radiotherapy * confirmed t790m mutation * progressed on previous egfr tki treatment. patients may have also received additional lines of treatment * received osimertinib treatment in the participating site between may 1st and oct 31st 2016 exclusion criteria: • enrolment in studies that prohibit any participation in this observational study
trial of jyb1904 in chronic spontaneous urticaria.

Conditions: Chronic Spontaneous Urticaria

Summary: this phase ii trial is meant to evaluate the efficacy, safety and tolerability of jyb1904 injection in patients with chronic spontaneous urticaria.


Eligibility criteria:
inclusion criteria: * male or female adult subjects (≥18 years of age). * diagnosis of chronic spontaneous urticaria(csu) ≥ 3 months prior to screening visit 1 and previously inadequately controlled with a second-generation h1 antihistamine. * itching and hives lasting ≥ 6 weeks prior to screening visit 1. * have a uas7 (range 0 - 42) ≥ 16, an iss7 (range 0 - 21) ≥ 6, and an hss7 (range 0 - 21) ≥ 6 within 7 days prior to randomization. exclusion criteria: * induced urticaria with a defined trigger, including artificial urticaria (cutaneous scratches), cold-contact, heat-contact, solar, pressure, delayed-pressure, water-source, cholinergic, or contact urticaria * any other dermatological condition with chronic itching, such as atopic dermatitis, herpetic pemphigoid, herpetic dermatitis, senile itching, or psoriasis, which in the opinion of the investigator may affect the study assessment and study results * other conditions with symptoms of urticaria or angioedema, including but not limited to urticarial vasculitis, pigmented urticaria, erythema multiforme, mastocytosis, hereditary urticaria, or acquired/drug-induced urticaria. * previous allergic reaction or poor efficacy with omalizumab. * contraindication or hypersensitivity to antihistamines (e.g., fexofenadine, loratadine, desloratadine, cetirizine, levocetirizine, rupatadine, bilastine) or any of the ingredients.
trial of transcatheter arterial chemoembolization for hepatocellular carcinoma

Conditions: Carcinoma, Hepatocellular

Summary: the purpose of this study is to compare the efficacy and safety of cisplatin (cddp) and epirubicin (epi) in the treatment of transcatheter chemoembolization for hepatocellular carcinoma (hcc).


Eligibility criteria:
inclusion criteria: * subject must be histologically or clinically proven hcc, inoperable, no indication of local treatment and has measurable lesions. * subject must to be the first experience of tace. * subject has no extra-hepatic tumor and no obstruction of main portal vein. * subjects must have fully recovered from previous treatment (at least 4 weeks interval is needed from prior chmotherapy or radiation therapy). * ecog performance status 0-2 * child-pugh class a or b * subject must have adequate functions of bonemarrow, renal, circulatory organs and appropriate examination results as below: 1. serum total bilirubin 2.0mg/ml 2. wbc 3000/mm3 3. plt 50000/mm3 4. hb 9.0g/dl 5. creatinine ; upper normal limit (unl) 6. bun 25mg/dl * written informed consent exclusion criteria: * subject has extra hepatic metastasis. * tumor thrombosis exists at main portal vein. * remarkable artery-portal vein shunt or veno-arterial shunt. * uncontrollable ascites or pleural effusion. * history of severe hypersensitivity. * any previous tace or tae for hcc. * any previous chemotherapy using epirubicin or cddp. * complications as below (except chronic hepatitis or liver cirrhosis) 1. severe heart disease 2. myocardial infarction within 6 months 3. renal insufficiency 4. active infections (except virous hepatitis) 5. gastrointestinal bleeding 6. active double cancer 7. hepatic encephalopathy or heavy mental disorder. * pregnancy or lactation women, or women with suspected pregnancy or men with willing to get pregnant. * any subject judged by the investigator to be unfit for any reason to participate in the study.

Keywords: carcinoma, hepatocellular trans arterial chemoembolization epirubicin cisplatin
optimizing treatment for patients with juvenile idiopathic arthritis in sustained remission: the move-jia trial

Conditions: Juvenile Idiopathic Arthritis

Summary: the goal of this clinical trial is to compare three different maintenance and step-down treatment strategies in children and adolescents with juvenile idiopathic arthritis in sustained remission. the main questions it aims to answer are: * is the proportion of study participants with a disease flare different between each of the two drug withdrawal arms and the stable treatment arm during 12 months? * does the proportion of study participants with a disease flare differ between the two drug withdrawal arms during 12 months? * how long time does it take before a disease flare occurs, and how long does it take before disease remission is reestablished for participants in the different treatment arms? participants will be randomized to either a) continued stable treatment with methotrexate and tumor-necrosis alpha inhibitor (tnfi); b) gradual withdrawal of methotrexate while continued stable dose tnfi; or c) gradual withdrawal of tnfi. participants will be examined every 4 month, and with extra visits if they experience increased symptoms or suspect a disease flare. if a flare occurs, the medications received at study inclusion will be restarted.


Eligibility criteria:
inclusion criteria: 1. participant must be 2-\<18 years of age at the time of signing the informed consent. 2. fulfilment of the international league of associations for rheumatology (ilar) classification criteria for non-systemic juvenile idiopathic arthritis (jia). 3. inactive disease for ≥12 months documented at a minimum of 2 consecutive visits and documented inactive disease according to wallace criteria at inclusion, and no active uveitis for ≥24 months. 4. stable treatment with methotrexate and tumor necrosis factor inhibitor (tnfi) for ≥6 months. weight adjustments permitted. 5. capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (icf). 6. male participants: no contraceptive measures necessary. 7. female participants: contraception guidance for women of childbearing potential (wocp). exclusion criteria: 1. chronic widespread pain syndrome 2. major comorbidity including uncontrolled infectious, neurological or mental disease, malignant disease, severe heart failure, severe renal failure, active ulcus ventriculi, and uncontrolled diabetes mellitus. 3. use of oral, intra-articular, intramuscular or intravenous corticosteroids due to jia less than 12 months prior to randomization. 4. participating in an ongoing clinical randomized study.. 5. drug/alcohol abuse which hampers adherence to the study protocol as based on the investigators judgement. 6. language barriers that hamper adherence to the study protocol. 7. pregnancy or breastfeeding. 8. any condition that in the view of the investigator would suggest that the patient is unable to comply with the study protocol and procedures. 9. unwillingness to use safe contraception for sexually active wocp.

Keywords: jia maintenance treatment medication withdrawal withdrawal
the effectiveness of resistance exercise for glycemic control in type 2 diabetes mellitus patients

Conditions: Type 2 Diabetes

Summary: resistance exercise is effective in improving glycemic control in diabetes patients. the effectiveness of a home-based resistance exercise program has not been establish.

exercise play an important role in diabetes control. the american diabetes association (ada) approved of resistive exercise as an effective method in controlling blood sugar of type 2 diabetes patients. few community-based intervention has been establish. so the authors developed the low-cost community based resistance exercise program to promote exercise in of type 2 diabetes patients.

Eligibility criteria:
inclusion criteria: * type 2 diabetes was diagnosed by physician using fasting plasma glucose not less than 126 mg/dl and/or hba1c not less than 7 %. * type 2 diabetes was diagnosed at least 6 months previously. * the subject was ongoing treatment in primary care unit of prince of songkla university. exclusion criteria: * gestational diabetes and type 1 diabetes patients * history of cardiovascular disease within the pass 6 months or any unstable chronic condition including dementia, proliferative diabetic retinopathy, retinal hemorrhage or detachment, dialysis and diabetic foot patients.

Keywords: resistive exercise resistance exercise training program rubber bands glycemic control type 2 diabetes mellitus
cardiopulmonary exercise testing in severe mitral regurgitation

Conditions: Mitral Valve Regurgitation; Pulmonary Hypertension

Summary: the purpose of this study is the evaluation of cardiac and pulmonary response to cardiopulmonary exercise in severe mitral regurgitation and its variation under treatment (surgical mitral valve repair, percutaneous mitral valve repair, optimal medical treatment). the study is conducted as a prospective, observational, single-center study. patients suffering from symptomatic severe mitral regurgitation will be eligible, if they are referred to the university hospital of regensburg, germany, for further diagnostic procedures and heart team discussion. cardiopulmonary exercise testing is performed comprising standardized stress echocardiography as well as ergospirometry. additional detailed assessment will be conducted including standardized questionary, clinical examination, transesophageal echocardiography and measurement of biomarkers.


Eligibility criteria:
inclusion criteria: * symptomatic, severe mitral regurgitation * referral for diagnostic work-up and heart team discussion * declaration of informed consent exclusion criteria: * contra-indication for cardiopulmonary stress examination (unstable angina pectoris, left main disease, abnormal electrolyte concentrations, acute decompensation) * pregnancy * exercise test on treadmill not possible (amputation of lower extremity, severe arthritis of lower extremities) * no acceptable acoustic window at rest

Keywords: stress echocardiography cardiopulmonary exercise testing ergospirometry
contrast-enhanced ct-based deep learning model for preoperative prediction of disease-free survival (dfs) in localized clear cell renal cell carcinoma (ccrcc)

Conditions: Clear Cell Renal Cell Carcinoma; Prognostic Cancer Model; Recurrent Renal Cell Cancer

Summary: this study aims to preoperatively predict dfs of patients with localised ccrcc using a deep learning prognostic model based on enhanced contrast ct images, validate it's predictive ability in multicentre data and compare it's predictive ability with traditional models.


Eligibility criteria:
inclusion criteria: * underwent partial/radical nephrectomies * histologically diagnosed as ccrcc * with complete clinical data and preoperative ct image data exclusion criteria: * with incomplete clinic-pathological data * lack of preoperative contrast-enhanced ct images or the image quality was unsuitable for analysis * who received pre-surgery neoadjuvant or adjuvant therapies * with multiple renal tumors or/and had synchronous metastasis
carb counting vs. simplified qualitative meal-size estimation

Conditions: Type 1 Diabetes Mellitus

Summary: the goal of this study is to compare qualitative meal-size estimation to accurate carb counting in adolescents with type one diabetes using all available aid (automated insulin delivery) systems. we will compare glucose control parameters and patient related outcome measures between the groups. 120 children and adolescents with type 1 diabetes who begin using aid system will be randomly assigned to one of two groups: simplified qualitative meal size estimation or accurate carb counting. the study will last 6 months, with an additional optional follow up points at 12 and 24 months. in the first visit all patients will receive nutrition guidance from the dietitian. in the accurate carb counting group, participants will use precise carb counting to manage their meals. in the simplified qualitative meal-size estimation group, participants will use a simplified meal announcement based on three presets for each meal, small, medium, or large, which will be personalized based on the dietitian's assessment. during the study, the dietitian will evaluate the insulin-to-carb ratio and meal estimation at least once in the first two weeks. follow-up visits will be scheduled at 4-6 weeks, 3, and 6 months after the study's initiation. at each visit participants will upload their data from their aid systems. evaluation of their diabetes control will be made and an assessment regarding the carbohydrates calculation method. digital questionnaires assessing diabetes distress, disordered eating behaviors, dietary regimen, and eating patterns will be provided at the beginning of the study and after 6 months, with an additional optional follow-up points that will be held at 12 and 24 months after the study's initiation.


Eligibility criteria:
inclusion criteria: 1. t1d- diagnosed 2. age 6-18 years 3. treated with insulin (multiple daily injections or pump) and intending to initiate treatment with aid systems exclusion criteria: 1. non-t1d 2. unstable medical conditions (other than diabetes) that may impact weight or diabetes management (as severe psychiatric disorders, various syndromes) 3. use of medications that may impact weight or diabetes management (as use of steroids for an extended period of time. use of glp-1) 4. inability to understand the information, material and questionnaires of the study -

Keywords: automated insulin delivery system carb counting
effect of aquatic therapy on pulmonary functions in patients with muscular dystrophy

Conditions: Muscular Dystrophy

Summary: this study aimed to assess the efficacy of aquatic therapy on pulmonary functions in patients with muscular dystrophy.

muscular dystrophy (md) is a group of muscle diseases that results in increasing weakening and breakdown of skeletal muscles over time. the disorders differ in which muscles are primarily affected, the degree of weakness, how fast they worsen, and when symptoms begin. many people will eventually become unable to walk. some types are also associated with problems in other organs. the muscular dystrophy group contains thirty different genetic disorders that are usually classified into nine main categories or types. the signs and symptoms consistent with muscular dystrophy are: progressive muscular wasting, poor balance, scoliosis (curvature of the spine and the back), progressive inability to walk, waddling gait, calf deformation, limited range of movement,respiratory difficulty, cardiomyopathy and muscle spasms

Eligibility criteria:
inclusion criteria: * their age will ranging from four to forty years. * patients participated in this study will from both sexes. * all patients will able to walk supported or unsupported by the therapist. * all patients will able to follow the instructions during testing and training. * all patients had no fixed contractures or deformities at the lower limb. exclusion criteria: * patients with visual or auditory problems. * patients with structural joints deformities of the lower limbs. * patients with convulsions and fixed contractures. * uncooperative patient.

Keywords: aquatic therapy pulmonary functions muscular dystrophy
prevalence of obstructive sleep apnea syndrome in type 1 diabetic patients treated with insulin pump (at1home)

Conditions: Type 1 Diabetes

Summary: patients with type 1 diabetes have poorer glycemic control that could lead to macrovascular or neuropathic complications; in addition to an optimal treatment, prevention of diabetes complications requires to control associated risk factors, such as hypertension or dyslipidemia. sleep apnea syndrome is a public health problem due to its high prevalence and marked morbidity and mortality, one increasingly interesting aspect is its relationship with metabolic disorders, specifically diabetes.obstructive sleep apnea syndrome seems to be underestimated in this population. in this context, it appears to be important to estimate the prevalence of sleep respiratory diseases in patients with type 1 diabetes.


Eligibility criteria:
inclusion criteria: * male or female aged 18 to 75 years * type 1 diabetic * treated on insulin therapy by external pump * take home monitoring as part of a usual care for insulin therapy by external pump * voluntary to participate in research with written informed consent * patient affiliated to the social security or similar regime exclusion criteria: privited person of liberty by judicial or administrative decision, person covered by legal protection (pregnant or lactating women, patients under guardianship) article l1121-8 * in exclusion period of other studies * patient may, at the discretion of the investigator, not comply with the study procedures

Keywords: obstructive sleep apnea syndrome