Kornimate/medical-research-clean huggingface dataset:
silent myocardial ischemia in patients undergoing non-oncological abdominal surgeries

Conditions: Silent Myocardial Ischemia; Acute Myocardial Infarction

Summary: perioperative mortality in non-cardiac surgical procedures is 1-2 % with half of these cases attributed to cardiovascular events. silent myocardial ischemia, which typically occurs within 72 hours to 30 days after surgery is the most common. the only diagnostic criterion is troponin t, which should ideally be measured before the operation. in addition to troponin, blood samples can be taken for n terminal-pro bnp. genetic factors can also contribute to the development of myocardial infarction. methylenetetrahydrofolate reductase (mthfr) is an important enzyme in homocysteine metabolism. the two most investigated variants of the mthfr gene are c677t and a1298c single nucleotide polymorphisms (snps). as new biomarkers of cardiovascular diseases, non-coding rnas, especially micrornas (mirnas) and circulating extracellular vesicles (evs) are of interest. on the other hand, evs were shown to reduce myocardial autophagy, leading to death during mi or ischemic-reperfusion injury. methods: the investigators will enroll approximately 200 patients aged 18 and older. the first study of silent myocardial ischemia, will include patients without cardiovascular disease undergoing urgent or elective surgery for benign abdominal diseases. the second group will include patients with stemi undergoing primary coronary angiography. patients will also complete a questionnaire on folate intake. subsequently, the investigators will collect blood for standard laboratory tests as well as troponin t, n terminal-pro bnp, homocysteine, and folic acid. blood will be also collected for biomarker analysis. on the third day of hospitalization, blood will be collected again for troponin t, nt-probnp and biomarkers. after that, the investigators will follow up the patients for another year every three months for the possible occurrence of major adverse cardiovascular events (mace). peripheral blood and blood from the coronary sinus will be collected in patients from the second study group for biomarker research. expected results and significance for science and medicine: the investigators anticipate that the study will improve the understanding of clinical, biochemical, and biological markers of silent ischemia and cardiovascular complications following non-oncological abdominal surgeries. knowledge of these factors would enable early identification of patients at higher risk of such complications, leading to more targeted preoperative preparation for non-oncological abdominal surgeries.


Eligibility criteria:
inclusion criteria: * patients with non-oncological abdominal disease and without cardiovascular disease * patients with stemi exclusion criteria: * patients with active cancer * pregnant women * psychiatric patients * patient with dementia * patients who do not understand basic instructions * alcohol and illegal drug addicts

Keywords: acute coronary syndrome silent myocardial ischemia troponin t nt-pro bnp genetic polymorphisms mirna extracellular vesicles
low dose irradiation for small bowel transplant

Conditions: Irreversible Intestinal Failure; Allograft Rejection

Summary: the specific aims of this study is to improve short and long-term patient and graft survival, to reduce the incidence and severity of allograft rejection, to reduce the incidence of infection and to reduce and/or eventually eliminate the need for long-term immunosuppression.

the rationale behind this study involves the need to better manage rejection in the intestinal allograft recipient. although tacrolimus based immunosuppression has made intestinal transplantation feasible, the requisite need for chronic high dose immunosuppression in order to control rejection has inhibited the wide spread clinical use and practicality of intestinal/multivisceral transplantation. the measures needed to prevent graft loss have frequently resulted in lethal infections, the leading cause of death. this trial is significant for determining if this new strategy of allograft immune-modulation with low dose ex-vivo irradiation and simultaneous done bone marrow cell infusion will favorably affect short and long term outcomes by reducing the risk of allograft rejection. this trial is offered to all patients with irreversible intestinal failure who must undergo intestinal, combined liver-intestinal, and multivisceral transplantation at the university of pittsburgh medical center. patients are recruited through the referral system and no cold calling is carried out. patient confidentiality is maintained by the use of codes to identify the study participants. all data is stored in a locked filing cabinets as a means to protect participants against a breach of confidentiality. this trial involves ex-vivo low dose irradiation of the intestinal allograft with or without adjunct donor bone marrow cell infusion. an intravenous bone marrow cell infusion is prepared form the thoracolumbar vertebral bodies harvested from cadaveric donors. control subjects will be those who refuse to be enrolled in the study or those for whom donor bone marrow is not available. all patients will be treated perioperatively with thymoglobulin, a rabbit polyclonal anti-lymphocyte globulin at a dose of 5-10 mg/kg. tacrolimus will be given in a standard fashion and from the outset as a single monotherapeutic agent to prevent early allograft rejection and promote graft acceptance. all patients will be monitored for rejection, graft function, opportunistic infections and gvhd. surveillance endoscopy with guided mucosal biopsies will be obtained according to the standard protocol. attention will be paid for any clinicopathologic changes suggestive of acute or chronic irradiation injuries. the study closed for enrollment as of 9/30/03.

Eligibility criteria:
inclusion criteria: * all patients between 17 and 70 who are diagnosed with intestinal failure awaiting intestinal/multivisceral transplant exclusion criteria: * active systemic/abdominal infections * incurable malignancy * acquired immune deficiency syndrome * severe cardiopulmonary insufficiency * current alcoholism * pregnant female

Keywords: intestinal transplant bone marrow irradiation of allograft
real-world data regarding treatment of ulcerative colitis patients with golimumab

Conditions: Ulcerative Colitis; Flare Up, Symptom

Summary: tnf inhibitors have improved treatment options for patients with inflammatory bowel disease (ibd) and three tnf inhibitors, infliximab, adalimumab and golimumab are available for treatment of ulcerative colitis in switzerland. however, these drugs have been tested under ideal conditions in randomized controlled trials. real-world data are needed to complement this information. it is the aim of our study to test, whether patients with ulcerative colitis can be effectively treated with golimumab in a real world setting in switzerland. the investigators will use data from the swiss ibd cohort study (sibdc) in switzerland. they will identify all sibdc patients with uc treated with golimumab and perform a retrospective chart review. the investigators will acquire patient reported outcomes and objective measures for inflammation at baseline, at 6-10 weeks and at 6 and 12 months after golimumab treatment. primary endpoint will be clinical response (i.e. meaningful improvement) at 6-10 weeks. secondary endpoints will be clinical response at 6 and 12 months and clinical remission (i.e. free of symptoms of disease).

ulcerative colitis patients from the swiss ibd cohort study treated with golimumab will be identified. the investigators will perform a retrospective chart review and assess patient reported outcomes and objective measures of inflammation to assess response and remission. as clinical response in uc the investigators will define a composite end point of: marked improvement in partial mayo score and improvement in one or more of the following parameters (acquired during chart review): * endoscopy data * ultrasonography * calprotectin (cut off 100microg/g) * crp * anemia resolution marked improvement is defined as: clinical response based on partial mayo score (including physician global assessment): decrease in partial mayo score ≥ 2 points and ≥ 30% from baseline and a decrease in rectal bleeding subscore ≥ 1 point or absolute rectal bleeding score ≤ 1. improvement in lab work is defined as a reduction of the difference between baseline values and the next limit of normal by ≥ 30%. improvement in endoscopy/ ultrasonography is defined as a reduction of colitis in the same technique compared to baseline substantiated by images (endoscopy) or measurements of diameter of the bowel wall. as clinical remission in uc the investigators define normalization (i.e. absence of pathology) of patient reported outcomes (frequency of stool, blood in stool) and no evidence of residual disease activity in all of the following parameters: * endoscopy data * ultrasonography * calprotectin (cut off 100microg/g) * crp and anemia

Eligibility criteria:
inclusion criteria: * patient of the swiss ibd cohort study * diagnosis ulcerative colitis * past treatment with golimumab (at least one dose) exclusion criteria: * none

Keywords: golimumab tnf-inhibitors clinical response clinical remission ulcerative colitis
tace+rfa versus re-resection for recurrent small hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma; Surgery; Ablation

Summary: hepatocellular carcinoma (hcc) is the fifth most common cancer in the world. partial hepatectomy is still considered as the conventional therapy for hcc. intrahepatic recurrence of hcc after partial hepatectomy is common and was reported to be more than 77% within 5 years after surgery. repeat hepatectomy is an effective treatment for intrahepatic hcc recurrence, with a 5-year survival rate of 19.4-56%. this is comparable to the survival after initial hepatectomy for hcc. unfortunately, repeat hepatectomy could be carried out only in a small proportion of patients with hcc recurrence (10.4-31%), either because of the poor functional liver reserve or because of widespread intrahepatic recurrence. in the past two decades, percutaneous radiofrequency ablation (prfa) has emerged as a new treatment modality and has attracted great interest because of its effectiveness and safety for small hcc (≤ 5.0 cm). studies using prfa to treat recurrent hcc after partial hepatectomy reported a 3-year survival rate of 62-68%, which is comparable to those achieved by surgery. prfa is particularly suitable to treat recurrent hcc after partial hepatectomy because these tumors are usually detected when they are small and prfa causes the least deterioration of liver function in the patients. our previous retrospective study demonstrated that rfa was comparable to re-resection for recurrent hcc, and our recent rct showed that rfa combined with tace is superior to rfa for hcc ≤7.0cm. so our hypothesis is that rfa combined with tace is superior to re-resection for recurrent small hcc. the aim of this retrospective study is to compare the outcome of reresection with tace+rfa for small recurrent hcc after partial hepatectomy.


Eligibility criteria:
inclusion criteria: 1. age 18 - 75 years; 2. recurrence of hcc 12 months after initial hepatectomy; 3. no other treatment received except for the initial hepatectomy; 4. single tumor≤5cm in diameter; or 2-3 lesions each ≤ 3.0 cm 5. lesions visible on ultrasound and with an acceptable and safe path between the lesion and the skin as shown on ultrasound; 6. no severe coagulation disorders (prothrombin activity \< 40% or a platelet count of \< 40,000 / mm3; 7. eastern co-operative oncology group performance(ecog) status 0 -1 exclusion criteria: 1. the presence of vascular invasion or extrahepatic spread on imaging; 2. a child-pugh class c liver cirrhosis or evidence of hepatic decompensation including ascites, severe coagulation disorders (prothrombin activity \< 40% or a platelet count of \< 40,000 / mm3), esophageal or gastric variceal bleeding or hepatic encephalopathy; 3. an american society of anesthesiologists (asa) score ≥ 3 -

Keywords: hepatocellular carcinoma repeat hepatectomy radiofrequency ablation transcatheter arterial chemoembolization
post-extubation assessment of laryngeal symptoms and severity

Conditions: Intubation, Intratracheal; Critical Illness; Mechanical Ventilation Complication; Complication of Ventilation Therapy

Summary: the goal of this study is to learn more about voice and airway problems that patients experience during and after the time patients have an oral endotracheal tube in patients' airway to help patients breathe while receiving mechanical ventilation in an intensive care unit (icu).


Eligibility criteria:
inclusion criteria: * ≥18 years old * required mechanical ventilation via an oral endotracheal tube * anticipated intubation ≥8 hours exclusion criteria: * pre-existing dysphonia, dysphagia * pre-existing central nervous system, neuromuscular, or connective tissue disease * prior tracheotomy and/or tracheotomy placed prior to enrollment * history of major thoracic surgery (e.g., sternotomy, thoracotomy) prior to the current admission * head and/or neck disease * head and/or neck surgery other than tonsillectomy * known or suspected anatomical abnormalities or pre-intubation trauma of the oral cavity, pharynx, larynx, or esophagus * unlikely to be extubated (i.e., expected death)

Keywords: larynx injury voice trachea
investigation of klyx in patients with constipation

Conditions: Constipation

Summary: this is a randomised, assessor-blind, multi-centre pilot study to investigate the comparative safety and efficacy of klyx and glycerine enema in the symptomatic treatment of constipation in chinese patients.


Eligibility criteria:
inclusion criteria: * have signed the informed consent form and have been verbally explained the details of the trial and treatment procedures * ethnically chinese * males or females aged between 18 and 65 years inclusive * a history of constipation symptoms for at least 6 months fulfilling, with occurrence of two or more of the following symptoms during the 3 months before screening (the 3 months need not be consecutive): i. very hard (pellet-like) and/or hard stools (type 1 or 2 of the bristol stool scale) for at least 25% of the time; or ii. sensation of incomplete evacuation at least 25% of the time; or iii. straining during defecation at least 25% of the time; or iv. sensation of anorectal obstruction or blockage often during defecation at least 25% of the time; or v. manual manoeuvres needed often to facilitate defecations (e.g. digital evacuation, support of the pelvic floor) at least 25% of the time; or vi. fewer than 3 defecations per week. * patient has had no bowel movement (i.e. still constipated) two days prior randomisation. exclusion criteria: * any disorder or laboratory result at screening that in the judgement of the investigator that will place the subject at excessive risk if participating in a controlled study * clinically suspected to have colorectal cancer * significant gastroparesis or gastric outlet obstruction * hypersensitivity to sodium docusate and/or sorbitol * hypersensitivity to glycerine * pregnant or lactating women, women who intend to conceive, or women who are sexually active and capable of pregnancy who are not using a method of birth control (e.g. prescription hormonal contraceptives, intrauterine device, double-barrier method, male partner sterilization) * diabetic patients currently on insulin therapy * having participated in other clinical trial(s) within the 3 (three) months prior screening * unable to withdraw medications that may affect gastrointestinal motility such as prokinetics, erythromycin analogues, laxatives, etc. * unable to meet or perform study requirements: known or suspected inability to comply with the study protocol
exploring brain damages after covid-19 infection

Conditions: SARS-CoV 2

Summary: although direct evidence is currently lacking, the high identity between sars-cov-1 and sars-cov-2 suggests, that the latter viral strain could also infect the central nervous system (cns). indeed, some cases of sars-cov2 encephalitis begin to be described and cns damages are increasingly highlighted in the literature, but still not objectified by imaging and do not allow to explain the entire clinical patterns. we hypothesise that these cns damages are not always objectified by magnetic resonance imaging (mri) but could be indirectly observed by a physiological dysfunction of neural conduction in the brainstem. we will explore brainstem disruption through an electrophysiological approach.

clinical and preclinical data from studies with other coronaviruses suggest an evident neurotropism, which may result in more complex clinical scenarios. can the sars-cov-2 enter the central nervous system (cns) and infect neural cells ? and if yes, how the cns damage contributes to pathophysiology of the covid-19, to its signs, symptoms and progression as well as to its sequelae. it has been demonstrated that coronaviruses such as sars-cov and mers-cov do not limit their presence to the respiratory tract and frequently invade the cns. the intranasal administration of sars-cov-1 or mers-cov resulted in the rapid invasion of viral particles into the brain of mice, possibly through the olfactory bulb via trans-synaptic route. the brainstem, which hosts the respiratory neuronal circuit in the medulla, was severely infected with both types of viruses, which may contribute to degradation and failure of respiratory centres.

Eligibility criteria:
inclusion criteria : * age ≥ 18 years. * hospitalized patient suffering from a positive covid 19 diagnosed by reverse transcription polymerase chain reaction (rt-pcr) or chest computed tomography scan (ctscan) with specific lesions exclusion criteria : * history of neurological damage interfering with auditory evoked potentials (pea) and electromyography (emg) reflexes of the brainstem (stroke of the brainstem, acoustic neuroma, amyotrophic lateral sclerosis, facial diplegia, damage to nerves v or vii, etc.) * impaired alertness * sedative treatments or treatments that disturb nerve conduction. * pregnancy or breastfeeding * individuals under legal protection or unable to express personally their consent

Keywords: covid-19 brainstem electrophysiology
evaluation of an karajishi contour investigational blood glucose monitoring system

Conditions: Diabetes

Summary: the purpose of this study is to determine if subjects who have diabetes can operate the investigational blood glucose monitoring system (bgms) without training and obtain valid glucose results.


Eligibility criteria:
inclusion criteria: * males and females, 18 years of age and older * people with type 1 or type 2 diabetes * able to speak, read, and understand english * willing to complete all study procedures exclusion criteria: * hemophilia or any other bleeding disorder * pregnancy * physical, visual, or neurological impairments that would make the person unable to perform testing with the bgm * previously participated in a bg monitor study using the karajishi bgms (or used a bayer contour meter) * working for a medical laboratory, hospital, or other clinical setting that involves training on and clinical use of blood glucose monitors * working for a competitive medical device company, or having an immediate family member who works for such a company * a condition which, in the opinion of the investigator or designee, would put the person or study conduct at risk
the optimal long term treatment strategy of anti-resorptive medications

Conditions: Osteoporosis; Bone Mineral Density

Summary: this study is to investigate whether the alternating use of prolia (denosumab) and aclasta (zoledronic acid) can continue to increase bone density.

this study intends to use a randomized trial to test whether the long-term treatment of denosumab and zoledronic acid can achieve sustained bone density progress and avoid the risk of rapid bone loss after the withdrawal of denosumab.

Eligibility criteria:
inclusion criteria: 1. postmenopausal women or men over 50 years old with osteoporosis or osteopenia leading to fractures. 2. denosumab treatment for at least two years and less than three years (up to maximum of five doses). exclusion criteria: 1. secondary osteoporosis. 2. metabolic bone diseases. 3. malignancy. 4. continuous steroid treatment, hormone therapy or other medical treatment affecting bone metabolism. 5. patients had ever used antiosteoporosis medications other than dmab 6. estimated glomerular filtration rate \< 35 ml/min. 7. allergy to zoledronate. 8. any other contraindications to zoledronate use. 9. history of diagnosed hypocalcemia. 10. age greater than 80 years.

Keywords: osteoporosis denosumab zoledronic acid
effects of an anti-trpm8 in the atopic dermatitis pruritus

Conditions: Atopic Dermatitis

Summary: the aim of the study is to analyse the effect of the menthoxypropanediol, a derivative of menthol, on the pruritus of atopic dermatitis (ex vivo study).

ad is a fairly common pathology whose prevalence in western europe and the united states is estimated at 10 to 15% in children and 4 to 7% in adults. this frequency has been steadily increasing for several decades. however, while the prevalence is increasing rapidly in emerging countries, a plateau has been observed for a few years in the industrialized countries with a maximum of 20% reached in northern europe. the predominant symptom of ad is pruritus. it has a strong impact on the lives of patients both physically, psychologically and socially, which causes stress and sleep disorders. because of this pruritus, sleep disturbances but also the displaying character of the disease, the quality of life of patients and their families is very often altered. the pathophysiology of this chronic pathology and associated pruritus is complex and incompletely understood and current treatments are unfortunately only symptomatic. many receptors (trpa1, trpv1, par2 ...), molecules (neuromediators, neuropeptides, histamine ...) and secreted cytokines (il-2, -4, -13 and -31, tslp) are involved in the induction and mediation of chronic pruritus. their role in pruritus associated with ad begins to be understood. among them, the trpm 8 has a particular interest. indeed, this receptor belongs to the superfamily of the "potential transient receptor (trp)" whose members are known to play a major role in sensory perceptions, including the perception of pruritus. trpm8 is a thermoreceptor, activated by cold (t \<28 ° c) or compounds such as menthol or derivatives, or eucalyptus and the beneficial action of menthol in the soothing of pruritus makes the trpm8 receptor an attractive therapeutic target for treatment of pruritus in ad. its role has never been studied in this context. this project aims to study the role of trpm8 in the pathophysiology of pruritus in ad in an in vitro model. biopsies of atopic dermatitis patients (2/patient in pruritic skin lesion) will be put in culture and submit to topical application of menthoxypropanediol. the effect of this molecule on receptors involved in pruritus pathway will be assay (immunohistochemistry, qpcr).

Eligibility criteria:
inclusion criteria: * patients over 18 years of age with atopic dermatitis. * and presenting active itchy lesions, * patients with no systemic and / or topical treatment for ad or pruritus. * patients who gave their written consent exclusion criteria: * patients with a physical or psychological disability to sign the consent. * patients not supported by social security.

Keywords: atopic dermatitis trpm8 menthol