Kornimate/medical-research-clean huggingface dataset:
transcutaneous peripheral neuromodulation for neurogenic bladder

Conditions: Urinary Bladder, Neurogenic

Summary: neurogenic bladder patients may have symptoms of urinary frequency, urgency, urgency incontinence and voiding symptoms due to bladder dysfunction arising from their underlying neurologic condition. current treatment options are effective for some patients, however many patients are not optimally managed due to modest efficacy or significant side effects. second line therapies include intravesical onabotulinum toxin, however it is associated with a risk of urinary retention, and patients with neurologic disorders often are unable to perform self catheterize due to physical limitations. sacral neuromodulation is associated with an undesirably high cost and potential complications in this population. the use of transcutaneous tibial nerve stimulation is an alternative form of neuromodulation, and it may have some potential benefits over percutaneous tibial nerve stimulation. while some preliminary studies have suggested it may be effective, there are no high quality randomized trials. this proposal is a 3 month, randomized, sham-controlled, clinical trial to evaluate the short term clinical efficacy of at home transcutaneous tibial nerve stimulation. valid and reliable patient reported outcome measures, and objective measures of incontinence have been included as outcomes.


Eligibility criteria:
inclusion criteria: 1. \>18 years of age, with a clinical condition associated with neurogenic bladder dysfunction (multiple sclerosis, parkinson's disease, stroke, dementia, cerebral palsy, spinal cord injury)(27). 2. failure of behavioral measures and/or pharmacologic therapy to adequately control neurogenic bladder symptoms. exclusion criteria: 1. current or previous percutaneous/transcutaneous tibial nerve stimulation or sacral neuromodulation therapy 2. stress predominant urinary incontinence 3. newly added bladder medication or dose change with the last 2 months (tamsulosin, silodosin, alfuzosin, terazosin, baclofen, diazepam, amitriptyline, imipramine, ddavp, tolterodine, oxybutynin, fesoterodine, darifenacin, solifenacin, trospium, mirabegron) 4. intravesical botulinum toxin use within the last 1 year 5. implanted pacemaker or defibrillator 6. history of epilepsy 7. unable or unwilling to commit to study treatment schedule 8. pregnant, or possible pregnancy planned for the duration of the study period 9. active skin disease of the lower legs (dermatitis, cellulitis, eczema, trauma) 10. documented allergy to patch electrodes or their adhesive 11. metallic implant within the lower limb
individualized peep in thoracic surgery

Conditions: Thoracic Surgery; One-lung Ventilation; Respiratory Mechanics; Artificial Respiration

Summary: intraoperative protective ventilation with low tidal volumes (tv), positive end-expiratory pressure (peep) and possibly lung recruitment maneuvers (rms) reduces postoperative pulmonary complications. in thoracic surgery, in one-lung ventilation (olv), the evidence is lacking. however, in this context protective ventilation with peep titration is related to better intraoperative oxygenation and respiratory mechanics. it is not clear whether this strategy is associated also with better postoperative oxygenation and less postoperative pulmonary complications.

in this randomized controlled trial the investigators will enroll 42 patients scheduled for elective thoracic surgery (minithoracotomic or video-assisted thoracoscopic segmentectomies and lobectomies). patients will be randomized in two groups: best peep and standard peep. in olv the investigator will set a tv = 5ml/kg ibw in volume control ventilation (vcv) and an adequate respiratory rate (rr) to keep paco2 \< 60 mmhg. with the patient in lateral decubitus and open chest, a cycling step rm (in pressure control ventilation, rr =10/min, i:e=1:1, up to paw = 40 cmh20 with a peep = 20 cmh2o, lasting 2.5 minutes) and a peep decremental titration trial (in vcv, from 16 to 4 cmh2o) will be performed to all patients. then, after another rm, in standard peep group a peep of 5 cmh2o will be set, and in best peep group an individualized peep (the one corresponding to the lower driving pressure, +2 cmh2o) will be applied till the end of surgery. a blood gas analysis will be performed before surgery, with the patient in supine position breathing room air (t1). the respiratory mechanics (ppeak, pplateau, peep, driving pressure) and blood gas (pao2, paco2, ph, hco3, lactates) parameters will be then collected at the following time points: t2 - 5 minutes after induction, patient supine, two lung ventilation; t3 - lateral decubitus, chest open, olv, before rm; t4 - 10 minutes after second rm; t5, 6, 7 - every hour after t4; t8 - at the end of olv, before lung re-expansion; t9 - patient supine, two lung ventilation, before neuromuscular block reversal. postoperatively all patients will spend at least one hour in a recovery room, in oxygen-therapy through a venturi mask with fio2 = 60%. a blood gas analysis and data about pain (nrs scale 0-10) and sedation (ramsey score) will be collected at 1 hour postoperatively (t10). the primary outcome of the study is intra- and postoperative oxygenation and secondary outcomes are intraoperative respiratory mechanics parameters.

Eligibility criteria:
inclusion criteria: * patient's consent to the trial * candidate to elective lung lobectomy or segmentectomy (minimally invasive thoracotomy or video-assisted thoracoscopy) * asa class 1-3 * bmi \< 30 kg/m2 exclusion criteria: * pregnancy * previous pneumothorax, * emphysematous bullae * severe copd * mets \< 4 due to cardiac disease

Keywords: individualized peep one-lung ventilation oxygenation
simplified model of linkage and retention to care, using a mobile unit and a same-day test and treat approach among excluded population. (simplified)

Conditions: HIV Infections

Summary: implementation of a model for access and retention of hiv care for vulnerable and excluded population using a mobile screening unit and a strategy of diagnosis and initiation of treatment with bictegravir (bic) 50 mg/ emtricitabine (ftc) 200 mg / tenofovir alafenamide (taf) 25 mg.

the use of a mobile unit to reach vulnerable hiv-infected people with poor access to the health care system and starting/restarting on the same day ("simplified same day test and treat strategy") is feasible, effective and safe and will allow these people to have a rapid access to art and long-term follow-up and health care for hiv. at the screening visit the patient will sign the informed consent form, revise the clinical history and ensure compliance with criteria. a history of drug abuse, complete physical examination, pregnancy test, rapid hepatitis c test, questionnaires and social situation will be collected from the patient. at the basal visit the patients enrolled in the study will collect lab test (blood count, biochemistry, coagulation, serology, inmunology and virology), vital signs and directed physical examination, concomitant medication and adverse events. after the basal visit the patient will be followed up on visits week 4, 12, 24, 48 and last visit 50 as follow up safety visit.

Eligibility criteria:
inclusion criteria: * vulnerable person ≥18 years * understand and sign the informed consent form * confirmed hiv infection * not receiving art or on art with a pvl \> copies/ml exclusion criteria: * unable to provide contact details * history of allergy to any of the following drugs: bictegravir, tenofovir alafenamide or emtricitabine * taking antiretroviral treatment for less than 1 month * pregnancy or breastfeeding at the time of screening or gestational desires during the study period. * suspected or diagnosed of active opportinistic disease * history of severe liver disease (child- pugh c) or history of descompensated liver disease (defined as the presence of ascites, encephalopathy, coagulopathy, hypoalbuminaemia, oesophageal or gastric varices or persistent jaundice) * history of kidney disease ckp-epi\< 30ml/min * have any condition that, as per investigator criteria, makes the patient not candidate to be included (active disease, social situation, intoxication...)
hyperinsulinemia in prediabetes mediated by interleukin-1β

Conditions: Hyperinsulinemia; PreDiabetes

Summary: the goal of this clinical study is to test whether postprandial insulin secretion in subjects with prediabetes is mediated by interleukin-1β and may be influenced by administration of the medicinal product anakinra (kineret®). the main question it aims to answer is whether there is a difference in insulin secretion following a standardized mixed-meal test under anakinra compared to placebo.


Eligibility criteria:
inclusion criteria: * subjects with prediabetes defined by hba1c 5.7-6.4 % or fasting plasma glucose 6.1-6.9 mmol/l or plasma glucose 2 h following 75g glucose ingestion of 7.8-11.0 mmol/l. * bmi ≥ 28 kg/m2 * age ≥ 18 years * c-reactive protein ≥ 2 mg/dl * for subjects with reproductive potential, willingness to use contraceptive measures adequate to prevent the subject from becoming pregnant during the study exclusion criteria: * upper gastrointestinal surgery * diagnosis of any type of diabetes mellitus * signs of current infection * use of any glucose lowering medication within the last three months * use of investigational drug up to one week prior to start of treatment phase. * anti-inflammatory medication, including systemic glucocorticoid therapy. * neutropenia (leukocyte count \< 1.5 × 109/l or absolute neutrophil count (anc) \< 0.5 × 109/l) * anemia (hemoglobin \< 11 g/dl for males, \< 10 g/dl for females) * clinically significant kidney or liver disease (creatinine \> 1.5 mg/dl, aspartate aminotransferase (ast)/ alanine aminotransferase (alt) \> 2 × uln, alkaline phosphatase \> 2 × uln, or total bilirubin \[tbili\] \> 1.5 × uln) * uncontrolled disease * currently pregnant or breastfeeding * no subjects meeting the criteria for vulnerability. participation in another study with investigational drug within the 30 days preceding and during the present study

Keywords: anakinra (kineret®)
the pk/pd, efficacy, safety and tolerability study of shr3824 in type 2 diabetes mellitus patients

Conditions: Type 2 Diabetes Mellitus

Summary: the purpose of this study is to obtain information on pk/pd, efficacy and safety of shr3824 over 12 weeks in chinese patients with type 2 diabetes. this will be done by comparing the effect of shr3824 to placebo when given in oral doses.


Eligibility criteria:
inclusion criteria: * patients must have a diagnosis of type 2 diabetes mellitus; * hemoglobin a1c levels \>=7.5% and \<=10.5%; * body mass index (bmi) 25 to 45 kg/m2; * patient either has not been previously treated with antihyperglycemic medication or has not been treated with antihyperglycemic in the last 10 weeks. exclusion criteria: * type i diabetes mellitus, diabetes mellitus resulting from pancreatic disorder, or secondary diabetes mellitus (acromegaly, cushing's syndrome, etc.); * past or current history of severe diabetic complications (proliferative diabetic retinopathy, stage iii or later stage overt nephropathy, diabetic ketoacidosis, or serious diabetic neuropathy); * systolic blood pressure of ≥160 mmhg or diastolic blood pressure of ≥100 mmhg on the start or end day of the run-in period; * history of myocardial infarction, unstable angina, or cerebrovascular disorder within 6 months before the start of the run-in period; * past or current history of malignant tumor; * past or current history of drug hypersensitivity such as shock and anaphylactoid symptoms; * pregnant women, lactating mothers, or women of childbearing potential; * any condition that subjects are assessed to be ineligible by the investigator (sub investigator).
acridine carboxamide in treating patients with advanced non-small cell lung cancer

Conditions: Lung Cancer

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. purpose: phase ii trial to study the effectiveness of acridine carboxamide in treating patients who have advanced non-small cell lung cancer that cannot be treated with surgery.

objectives: i. determine the effect of acridine carboxamide on objective response, response rate, and duration of response in patients with unresectable, locally advanced, progressive or metastatic non-small cell lung cancer. ii. determine the toxicities and pharmacokinetics of this regimen in these patients. outline: this is a multicenter study. patients receive acridine carboxamide iv over 24 hours for 5 days. treatment repeats every 3 weeks for a maximum of 6 courses in the absence of disease progression or unacceptable toxicity. patients are followed every 6 weeks until disease progression or commencement of another treatment. projected accrual: a total of 14-25 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: histologically proven unresectable, locally advanced, progressive or metastatic non-small cell lung cancer not amenable to curative surgery or radiotherapy no prior first line chemotherapy for metastatic or advanced disease at least 1 bidimensionally measurable target lesion by ct scan no symptomatic brain metastases patient characteristics: age: 18 and over performance status: ecog 0-2 life expectancy: at least 3 months hematopoietic: wbc greater than 3,000/mm3 platelet count greater than 100,000/mm3 hepatic: bilirubin less than 1.5 times upper limit of normal (uln) sgot, sgpt, and alkaline phosphatase no greater than 2 times uln (5 times uln if liver metastases present) renal: creatinine no greater than 1.7 mg/dl cardiovascular: no ischemic heart disease within the past 6 months normal 12 lead ecg other: not pregnant or nursing negative pregnancy test fertile patients must use effective contraception no other prior or concurrent malignancy except cone biopsied carcinoma of the cervix or adequately treated basal or squamous cell skin cancer no unstable systemic disease or active uncontrolled infection no psychological, familial, sociological, or geographical condition that could preclude compliance prior concurrent therapy: biologic therapy: not specified chemotherapy: see disease characteristics no prior chemotherapy endocrine therapy: not specified radiotherapy: at least 4 weeks since prior radiotherapy surgery: at least 2 weeks since prior major surgery other: no other concurrent anticancer agents no other concurrent investigational therapy

Keywords: recurrent non-small cell lung cancer stage iiia non-small cell lung cancer stage iiib non-small cell lung cancer stage iv non-small cell lung cancer
transarterial chemoembolization (tace) plus bevacizumab for liver metastases

Conditions: Cancer; Metastatic Cancer; Liver Metastases

Summary: trans arterial chemoembolization (tace) has emerged as a treatment option for chemotherapy-refractory diseases in liver metastases. by delivering chemotherapy agents directly to the tumor site, tace can maximize local drug concentrations and reduce systemic adverse reactions. bevacizumab is a monoclonal antibody that functions as an angiogenesis inhibitor. it works by slowing the growth of new blood vessels by inhibiting vascular endothelial growth factor a (vegf-a). the application of bevacizumab during tace has not been reported. in this study, we will evaluate the the overall survival (os)、efficacy, and safety of the application of bevacizumab during tace in patients with liver metastases by designing an open, single-arm phase ii clinical study.


Eligibility criteria:
inclusion criteria: * confirmation of metastatic liver cancer via histological examination or a characteristic imaging profile on dynamic computed tomography (ct) scan or magnetic resonance imaging (mri) without indications for surgical resection * eastern cooperative oncology group performance status (ecogps) of 0 or 1 * liver function categorized as child-pugh class a or b * stable non-hepatic metastases, such as skeletal, pulmonary, or lymph node metastases * hepatic tumor burden below 70% * expected survival duration exceeding six months * laboratory findings meeting specific criteria, including platelet count \>50×109 /l, hemoglobin \>8.0 g/dl, anc count ≥1.5 × 109/l, bilirubin \<51 mmol/l, alanine and aspartate aminotransferase \<3 times the upper limit of the normal range, and serum creatinine \<1.5 times the upper limit of the normal range. exclusion criteria: * active infection * presence of severe comorbidities, such as hepatic encephalopathy, refractory ascites, and esophageal variceal bleeding * prior liver resection * previous tace therapy received at other healthcare facilities * poor performance status (ecogps \> 1)
metabolic adaptations to chronic and acute exercise in overweight adults (atx-study)

Conditions: Healthy

Summary: the primary purpose of this study is to examine the effects of chronic exercise training and an acute session of exercise on key risk factors associated with metabolic syndrome (e.g., glucose tolerance, blood lipid profile, and blood pressure) and alterations in subcutaneous adipose tissue structure and metabolic function in overweight adults.

subjects will be asked to complete the substrate metabolism laboratory general screening questionnaire and american heart association health/fitness questionnaire to determine if they are eligible to complete the preliminary testing procedures. if eligible, subjects will be asked to visit the substrate metabolism laboratory to participate in the preliminary testing procedures (listed below) before participating in the experimental trial. preliminary testing procedures: * blood pressure, height and weight measurements * body composition assessment (\~20 min) * exercise fitness test (\~10 min) * resting metabolic rate (rmr) measurement (\~30 min) * 3 hour oral glucose tolerance test (ogtt) experimental trial: the evening before the experimental trial, subjects will eat a standardized dinner meal and snack. the meal and snack must be eaten at specific times as indicated by the research staff. after eating the snack, subjects will need to fast (no food or beverages - besides water) overnight. participants who exercise regularly will be instructed to exercise exactly 3 days before the experimental trial, and then abstain from their exercise training program until after the study is complete. in the morning, subjects will return to the substrate metabolism laboratory. the research team will collect a blood sample from the subject's hand or forearm and a small sample of fat tissue in the subject's abdomen with a needle. next, subjects will exercise on a treadmill at a moderate intensity for about 1 hour. immediately after exercising the research team will collect a second blood sample. subjects will remain in the laboratory for 1 hour after exercising, and then the research team will collect another blood and fat tissue sample. upon completion of the experimental trial, subjects will be provided a snack before leaving the laboratory.

Eligibility criteria:
inclusion criteria: * age: 18-40 * body mass index: 25-35 kg/m2 * regular exercisers: (≥4 days/wk of aerobic exercise; 30-60min/session at moderate and vigorous intensities) * non-exercisers: no regularly planned exercise/physical activity * women must have regularly occurring menses and must be premenopausal exclusion criteria: * blood pressure \> 140/90 mm hg * pregnant or lactating * evidence/history of cardiovascular or metabolic disease * medications known to affect lipid or glucose metabolism
efficacy of 200 iu onabotulinumtoxina in idiopathic overactive bladder resistant to anticholinergic treatment

Conditions: Idiopathic Overactive Bladder Resistant to Anticholinergic Treatment

Summary: this study aimed to assess the efficacy and safety of onabotulinumtoxina (botulinum toxin type a) in patients with idiopathic overactive bladder (oab) and urinary incontinence who had previously failed to respond to anticholinergic treatment. additionally, we examined the impact of significant reductions in bladder wall thickness on therapeutic outcomes.

the efficacy of onabotulinumtoxina was investigated in patients who attended urology outpatient clinics between january 2016 and june 2022 for overactive bladder unresponsive to anticholinergic therapy. baseline symptoms and quality of life data were compared to those at month 6 after the treatment. the voiding diary (for 3 days) of each patient was reviewed to assess and record patients' symptoms. baseline ultrasound (us)-measured post-void residual urine (pvr) and bladder wall thickness (bwt) values were recorded. patients with a history of neurological disorders, anticholinergic-naive patients, patients diagnosed with bladder cancer, and those with bladder outlet obstruction were excluded from the study.

Eligibility criteria:
inclusion criteria: * overactive bladder urge incontinence exclusion criteria: * neurological and/or neurosurgical disorders, anticholinergic-naive patients, bladder cancer, bladder stone, interstitial cystitis, prostate cancer chronic prostatitis bladder outlet obstruction
polypharmacy and associated risk factors and clinical outcomes for surgical patients discharged from hospital

Conditions: Polypharmacy; General Surgery

Summary: the world health organisation patient safety challenge: medication without harm has brought our attention to the importance of medication-related harm as a global public health issue. one of the major contributing factors is polypharmacy, the usage of multiple medicines at the same time. people are getting older and living longer with chronic diseases; they need more medications, which frequently leads to polypharmacy. subsequently, they are at more risk of medication-related harm. the planned project is an epidemiological study on polypharmacy, medication appropriateness, risk factors, and clinical outcomes post-discharge from a hospital for surgical patients. the study group hypothesise that pre-and post-operative polypharmacy and potentially inappropriate prescribing is common, especially among older patients, patients with a high comorbidity and frailty burden, and patients undergoing more complicated surgery. our hypothesis is additionally that preoperative polypharmacy and potentially inappropriate prescribing is associated with a higher short- and long-term mortality, a longer primary hospitalization length of stay, and a higher risk of readmission.

this is an observational, retrospective, single centered study, using clinical data from the patient's medical record from the hospital, the national prescription database of the directorate of health, and the and icd-10 codes from primary care records. for this analysis, medicines will be classified into drug classes based on the first five characters of their who anatomical therapeutic chemical (atc) code. the prevalence (pre) and incidence (post) of polypharmacy (≥5 or more regular medicines) and hyper-polypharmacy (≥10 regular medicines) will be calculated. potentially inappropriate prescribing will be assessed in individuals ≥65 years applying beers 2019, start and stopp 2014, explicit prescribing criteria. the analysis will be restricted to older individuals, as beers criteria have not been validated in younger age groups. the anticholinergic burden will be assessed for all individuals ≥18 years will be assessed by applying the anticholinergic burden scale this stratification is important in order to deliver targeted interventions in resource-limited healthcare settings

Eligibility criteria:
inclusion criteria: * participants: surgery patients ≥18 years in admitted to landspitali university hospital over the period 2010-2018. exclusion criteria: * under 18 years of age

Keywords: polypharmacy potentially inappropriate medication list drug-related side effects and adverse reaction readmission patient discharge prediction tool start and stop inappropriate prescribing general surgery beers criteria stopp start criteria