Kornimate/medical-research-clean huggingface dataset:
overall survival of large cell neuroendocrine lung cancer patients - a retrospective study

Conditions: Survival Outcomes of Patients With Pulmonary LCNEC

Summary: this is a retrospective study. 132 patients with lcnec and combined lcnec were included to the analysis. patients were treated with radical, palliative or symptomatic intension between 2002-2018 in central and north-eastern centres in poland. the group of patients consists of 47 women (36%) and 85 men (64%). ratio of women to men is 1:1,81. the observation period ranged from 0 to 192 months.

this is a retrospective study. 132 patients with lcnec and combined lcnec were included to the analysis. patients were treated with radical, palliative or symptomatic intension between 2002-2018 in central and north-eastern centres in poland. the group of patients consists of 47 women (36%) and 85 men (64%). ratio of women to men is 1:1,81. the observation period ranged from 0 to 192 months. for all patients included to the analysis, the clinical stage was estimated according to tnm classification of malignant tumours - uicc from 2017. the degree of pathomorphic stage (ptnm) was assessed in 60 patients treated with intention to treat (itt), which is 45% of the total population. the degree of clinical stage (ctnm) was assessed in 72 patients based on the imaging examinations (including pet, ct, mri, bone scintigraphy, etc.) and fine needle aspiration biopsy (fna) (including ebus, with pathological confirmation of lcnec, which is 55% of the total population. the clinical stage (ctnm) was used in case of patients disqualified from radical surgery due to: advanced disease, contraindications to surgery, no patient's consent for treatment.

Eligibility criteria:
inclusion criteria: * adults ≥18 years old, male or female, with pathologically confirmed primary neuroendocrine lung cancer based on histopathological examination: 1. lcnec 2. combined type lcnec * patients with lcnec, combined lcnec without prior treatment independently from the clinical stage according to the 8th edition of tnm 2017 * patients with generalized, unresectable of lcnec, combined lcnec before, during and after palliative treatment * patients with generalized, unresectable lcnec, combined lcnec treated only symptomatically * patients with locally advanced, unresectable lcnec,combined lcnec before, during and after radical treatment * patients with locally advanced, resectable lcnec, combined lcnec before, during and after treatment exclusion criteria: * na

Keywords: lcnec-large cell neuroendocrine carcinoma lung cancer
deep transcranial magnetic stimulation for the treatment of treatment resistance schizophrenia

Conditions: Deep Transcranial Magnetic Stimulation for the Treatment of Treatment Resistance Schizophrenia

Summary: based on the hypothesis that low-frequency deep transcranial magnetic stimulation(dtms) on anterior cingulate cortex （acc） could down-regulate the glutamate level of acc and regulate the acc-related functional network in patients with treatment resistance schizophrenia,this research plan to utilise multimodal functional magnetic imaging method(including structural mri,resting-state functional magnetic resonance imaging and 1h-mrs) to investigate therapeutic efficacy of low-frequency deep transcranial magnetic stimulation on sz patients symptoms,as well as to elucidate the correlation between treatment effects and glutamate level of acc

this study includes 20 treatment resistance schizophrenia patients and 20 healthy controls.this study will investigate 1)abnormalities of the glutamate level of acc in patients with schizophrenia compared to healthy controls by using 1h-mrs technique. 2)potential modulation effects of deep transcranial magnetic stimulation(dtms) on anterior cingulate cortex function of patients with schizophrenia. 3)the therapeutic efficacy of dtms on cognitive impairments and other psychotic symptoms of patients with schizophrenia by adopting cognitive function and psychotic symptoms evaluation,as well as to explore the optimal dtms treatment pattern on cognitive function.

Eligibility criteria:
inclusion criteria: * patients with schizophrenia who meet the dsm-5 diagnostic criteria * aged from 18 to 60 * after 4 weeks of treatment with a sufficient dose of an antipsychotic (equivalent dose of 400 \~ 600 mg/ day chlorpromazine (cpz)), no clinical improvement was achieved (at least two items in panss scale p1,p2,p3,n1,n4,n6,g5 and g9 ≥4 points, or cgi-s ≥4 points) * right-handedness, normal hearing, visual acuity or corrected visual acuity * written informed consent of the patient and his/her family exclusion criteria: * patients who are currently taking clozapine or who have failed to respond to a full course of treatment with clozapine * current or past neurological illness,severe physical illness,substance abuse or addiction,alcohol dependence,mental retardation,pregnancy or lactation,extreme agitation, stupor, negative suicide,or those who can not cooperate * a history of mect within 6 months,or those with contraindications to mri,rtms * medically unstable for at least 1 month (panss score fluctuation\>10%)

Keywords: treatment resistance schizophrenia deep transcranial magnetic stimulation anterior cingulate cortex glutamate h7 coil
glucosafe 2 - a new tool for nutritional management and insulin-therapy in the intensive care unit (icu)

Conditions: Critical Illness; Energy Supply; Deficiency, Severe; Protein Deficiency; Hypoglycemia; Hyperglycemia

Summary: the survival and the outcomes of critically ill patients are strongly influenced by insulin-therapy and nutritional support. the glucosafe 2 pilot study, aims to test the performance and the security of the new glucosafe 2 software, developed by the model-based medical decision support of aalborg university (denmark) and adapted to the clinical needs in the intensive care unit (icu) of the geneva university hospital (hug). this new device is based on a mathematical model of the glucose-insulin metabolism and attempts to give advices for better glycaemia control and nutritional therapy. the glucosafe 2 study hypothesizes that the use of the glucosafe 2 software will allow better glycaemia ("time-in-target") control and better achievement of nutritional energy and protein targets in comparison to the local protocols.


Eligibility criteria:
inclusion criteria: all patients ≥ 18 years admitted to the icu with * an expected length of stay ≥ 72h * at least 1 blood glucose (bg) measurement ≥10 mmol/l or 2 bg measurement ≥ 8.5 mmol/l * informed consent signed by the subject/ legal representative, except for patients in the historical control group exclusion criteria: * lack of legal consent or consent withdrawn, except for patients in the historical control group * pregnant or breast feeding * diabetic ketoacidosis or hyperosmolar state * oral feeding * fulminant hepatic failure * medically contraindicated to receive rapidly acting insulin by intravenous (iv) infusion or iv injection

Keywords: nutrition management glycaemia control icu software critical illness insulin-therapy critically ill patients blood glucose control
self-administered hyperinsufflation chest on the risk of low respiratory infection in patients with multiple sclerosis with sputum capacity deficit

Conditions: Multiple Sclerosis

Summary: in patients with neuromuscular disease, chest mobilization by hyperinsufflation slows respiratory decline by almost 80% compared to controls, and prevents complications like pneumonia, atelectasis and respiratory distress. this insufflation technique improves the airway clearance and reduces the need for invasive ventilation. it also improves cv and deptoux in patients with neuromuscular pathology

during multiple sclerosis (ms), although expiratory involvement and reduced sputum capacity are predominant, automated techniques of hyperinsufflation and in-exsufflation remain underused and undervalued. a single retrospective study suggests a decrease in the decline in respiratory function with regular manual hyperinsufflation. evidence of a benefit of chest mobilization by hyperinsufflation by a controlled trial is therefore necessary before recommending its use in ms.

Eligibility criteria:
inclusion criteria: * confirmed ms diagnosis (mcdonald criteria) * edss ≥ 7 * age greater than or equal to 18 years. * expiratory flow during a coughing effort (deptoux) ˂4.5l / s. exclusion criteria: * ent and / or thoracic surgery less than 6 months old * progressive or past pneumothorax / pneumomediastinum * severe swallowing disorders. * inability to use the device under study
applicability of techniques of lung expansion

Conditions: Stroke

Summary: the survival of patients with lesions in the central nervous system is usually accompanied by physical and mental sequelae. these impairments favor the prolonged restriction to the bed, which may contribute with changes in respiratory function. in this context, lung re-expansion techniques are used to prevent or treat the various respiratory complications.

the survival of patients with lesions in the central nervous system is usually accompanied by physical and mental permanents sequelae. this impairment of cognitive status associated with motor injury favors prolonged restriction of these patients to the bed, which may contribute to the emergence of other health damages. in the clinical practice, lung expansion techniques has been used as a prophylaxis and treatment of respiratory conditions that involve volumetric reductions. however, the deficit of awareness and cooperation difficult the use of several therapeutic resources. there are few interventions that could be proposed due to no need the collaboration to be performed, such as breath stacking technique (bs) and expiratory positive airway pressure (epap). the bs is characterized by execution of inspiratory cycles through a one way valve, which allows stacked volume of gas during each inspiration, until it reaches values approximate to maximum inspiratory capacity. while in the epap, alveolar pressure is elevated to breath against a expiratory flow resistance generated by a spring load valve. the effects on lung volume promoted bs and epap can be safely measured using an electrical impedance tomography (eit). this recent imaging modality offers information about lung air volumes distribution and have a strong linear correlation with regional ventilation within the thorax. the effects on lung volume promoted bs and epap can be safely measured using an eit monitor. this recent imaging modality offers information about lung air volumes distribution and have a strong linear correlation with regional ventilation within the thorax. until this moment, there is not description about the effect of lung expansion techniques on regional lung parameters.

Eligibility criteria:
inclusion criteria: 1. patients undergoing neurosurgery restricted to bed for more than 14 days; 2. aged between 18 and 65 years; 3. glasgow coma scale \< 10 points; 4. breathing spontaneously through the tracheostomy tube; 5. no respiratory infection; 6. chest circumference between 88 and 98 centimeters; exclusion criteria: 1. presence of chronic lung diseases; 2. chest deformity; 3. rib fracture; 4. asymmetrical chest expansion; 5. abdomen distension; 6. spasticity in any hemisphere with ashworth scale score more than 2 points for upper limbs; 7. uncoordinated movements of the limbs; 8. cardiorespiratory instability (heart rate \ 120 bpm; respiratory rate \> 35 ipm; mean arterial pressure \ 120 mmhg; oxygen saturation \< 90%).

Keywords: noncooperative patients
janagliflozin treat type 2 diabetes mellitus (t2dm) inadequately controlled with metformin

Conditions: Diabetes Mellitus, Type 2

Summary: the purpose of this study is to evaluate the efficacy and safety of janagliflozin compared to placebo, both in combination with metformin, in chinese patients with type 2 diabetes mellitus (t2dm) inadequately controlled with metformin alone.

a multicentre, randomized, double-blind, placebo-controlled, parallel-group study (a 24-week core period followed by a 28-week extension period), to evaluate the efficacy and safety of janagliflozin (25 mg and 50 mg) compared to placebo, all in combination with metformin, in patients diagnosed with t2dm who are not achieving an adequate response from metformin monotherapy. approximately 390 patients with inadequate glycemic control with metformin monotherapy will receive once-daily double-blind treatment with janagliflozin 25 mg or 50 mg , both in combination with metformin , for 52 weeks, or receive 24 weeks of double-blind treatment with placebo in combination with metformin followed by 28 weeks of single-blind treatment with janagliflozin 25 mg or 50 mg, both in combination with metformin. during the treatment, if a patient's glycemic level remains high despite treatment with study drug and reinforcement with diet and exercise, the patient will receive treatment with linagliptin (rescue therapy) consistent with local prescribing information.

Eligibility criteria:
inclusion criteria: * t2dm patients with inadequate glycemic control (hba1c level≥7.0% and ≤10.5% at baseline) on metformin monotherapy. * body mass index: 18.0\~35.0 kg/m2 (both inclusive) exclusion criteria: * history of type 1 diabetes mellitus (t1dm), diabetes caused by pancreatic injury, or secondary diabetes (e.g., diabetes caused by cushing's syndrome or acromegaly) * more than 10% change in body weight within the 3 months before screening * any laboratory test indicators meet the following standards: * fasting plasma glucose ≥ 15 mmol/l * aspartate aminotransferase, alanine aminotransferase levels \> 3 times the upper limit of normal (uln); total bilirubin \> 1.5 times uln * hemoglobin \< 100 g/l * egfr \< 60 ml/min/1.73m2 * fasting triglycerides \> 5.64 mmol/l (500 mg/dl)
liraglutide effect in atrial fibrillation

Conditions: Atrial Fibrillation

Summary: the goal (or purpose) of this study is to evaluate (study) a new way to stabilize (steady) the activity between the fat deposits surrounding the heart and the left atrium. to reduce the amount of eat, this study will use a medication called liraglutide. this medication is known to work on fat deposits and produce weight loss. the investigator is conducting this study to find out if liraglutide will reduce the fat deposits surrounding the participant's heart, and stabilize (and perhaps reduce or eliminate) atrial fibrillation activity.


Eligibility criteria:
inclusion criteria: * male and female, age 18 or older * persistent af defined as continuous af sustained beyond 7 days (or af with the decision to cardiovert before 7 days of enrollment or paroxysmal af defined as recurrent af (≥2 episodes) that terminates spontaneously within 7 days * bmi ≥27 kg/m2 * patient wishes to undergo a catheter ablation procedure for the treatment of atrial fibrillation * receiving follow-up care at the university of miami exclusion criteria: * inability to sign an informed consent * patients with longstanding persistent atrial fibrillation of more than 3 years * prior ablation for atrial fibrillation * patients not appropriate candidates for catheter ablation such as those with af due to acute or chronic precipitating medical conditions, for example, hypothyroidism and hyperthyroidism, significant pulmonary disease, pulmonary embolism, left atrial thrombus, class iv heart failure) * patients with a life expectancy \<1 year * patients with a serious medical condition (for example, recent cancer with chemotherapy or radiation therapy within 4 weeks before entering the study) who have not recovered from adverse events due to agents administered more than 4 weeks earlier. * known contraindications to liraglutide, such as the previous history of pancreatitis or medullary thyroid carcinoma * personal or family history of multiple endocrine neoplasias * known serious hypersensitivity reaction to liraglutide * patients using, glitazones, sodium-glucose transporters 2 inhibitors (sglt2i), other glp-1 analogs, or dpp4 inhibitors * type 1 diabetes, defined by american diabetes association criteria, history of diabetic ketoacidosis, pancreas or beta-cell transplantation, or diabetes due to pancreatitis or pancreatectomy * poorly controlled type 2 diabetes with hba1c \> 10% * pregnant women * women who are breast-feeding or intend to become pregnant
exploring the mechanism of severe acute pancreatitis based on metagenomics, metabolomics and proteomics

Conditions: Acute Pancreatitis

Summary: the goal of this observational study is to learn about the biomarkers and mechanisms of severe acute pancreatitis in 30 healthy controls, 30 patients of mild acute pancreatitis, 30 patients of moderately severe acute pancreatitis, and 86 patients of severe acute pancreatitis. the main question it aims to answer are: • the relationship between changes in gut microbiota and clinical prognosis (plasma inflammatory cytokines, incidence and duration of infection in various parts, mortality rate), and the screening and validation of biomarkers that can be used for early prediction of disease severity. • analyze the relationship between changes in blood composition and clinical prognosis (plasma inflammatory cytokines, incidence and duration of infection in various parts, mortality rate), screen and verify biomarkers that can be used for early prediction of disease severity. blood and fecal samples from the healthy control group and diagnosed patients will be collected.


Eligibility criteria:
inclusion criteria: patients group: ① age between 18 and 75 years old; ② within 72 hours of ap onset; ③ ap patients who meet the 2012 atlanta ap classification and diagnostic criteria. healthy control group: * age between 18 and 75 years old; ② no history of acute pancreatitis; ③ routine laboratory tests such as blood routine and fecal routine are normal. exclusion criteria: * used antibiotics, probiotics, and acid suppressants 4 weeks before enrollment; * pregnant and lactating women; * hypothyroidism, nephrotic syndrome, cushing's syndrome, aids; * chronic pancreatitis, pancreatic cancer; ⑤ severe history of cardiovascular and cerebrovascular diseases and organ dysfunction, such as malignant tumors, heart failure, coronary heart disease, chronic obstructive pulmonary disease, liver and kidney failure; ⑥ unsigned informed consent form.
timecourse of immobilization experiment

Conditions: Muscular Atrophy

Summary: the effect of unilateral lower limb immobilisation over one week on muscle atrophy

this study aims to assess the effect of one week of unilateral leg immobilization on quadriceps muscle volume and muscle protein synthesis rates. participants wore a leg brace on one leg and ambulated on crutches during the immobilization period. thirteen healthy young males were recruited to undertake this study. it is currently understood that unilateral leg immobilization will result in a reduction in muscle size (berg et al., 1996, wall et al., 2015) and muscle protein synthesis rates after a period of disuse (de boer et al., 2015, glover et al., 2008). recent research in this area has shown that even short term periods of leg immobilization (i.e. \<1 week) will result in reductions in muscle size and muscle protein synthesis rates after the period of disuse (wall et al., 2015). however we currently do not have detailed information on how muscle disuse affects muscle size and muscle protein synthesis over time during short term disuse (e.g. the first week). the stable isotope tracer deuterium oxide (d2o) will be applied to assess cumulative muscle protein synthesis between days 0-2, 2-7 and 0-7 of the immobilization period in both the immobilized and non immobilized legs. this will be in-conjunction with bilateral vastus lateralis muscle biopsies before and after 2 and 7 days of immobilization. furthremore, quadriceps muscle volume was assessed via mri scans that again occured before and after 2 and 7 days of immobilization. to gain a mechanistic insight on the molecular changes during disuse a custom designed 48 well taqman low density microarray genecard was applied to assess the transcriptional response on genes involved in muscle protein synthesis and breakdown.

Eligibility criteria:
inclusion criteria: bmi \>18 and \<28 no prescription medications or current illness - exclusion criteria: bmi \ 28 current prescription medication no history of leg injury
a pilot study to assess effects of self-administered nitrous oxide (sano) on urodynamic study (uds) parameters

Conditions: Lower Urinary Tract Symptoms

Summary: a urodynamic study (uds) is a common procedure done to learn more about the cause of urinary symptoms. for some patients, uds can be associated with anxiety or discomfort. nitrous oxide (or laughing-gas) is a well-known sedative which is frequently used in dental offices and for pediatric procedures to reduce anxiety and pain. this study is being done to see if giving low-dose (25-50%) nitrous oxide at the time of uds affects the measurements taken during the procedure, such as how much volume your bladder can hold, and pressures during urination. if the measurements are the same with and without self-administered nitrous oxide (sano), it could be suggested that nitrous oxide may be a useful way of reducing patient anxiety and pain during uds.

the urodynamic study (uds) procedure will consist of catheter placement and two "runs". before the start of the procedure, a study staff member will assist the participant with putting on a plastic gas mask. sano and oxygen will be given through this mask. the dose will be adjusted based on the participant's comfort level but they will not be able to request more gas than allowed. sano will be administered during catheter placement at the start of the uds. during the two runs, the participant will either receive sano (run 1) then oxygen (run 2), or oxygen (run 1) then sano (run 2). before the day of the uds, participants will be asked questions related to demographics and medical history to determine study eligibility and experience of the treatment. during the uds, participants will be asked to describe their anxiety and pain levels. afterwards, they will be asked to complete a 15-20 minute structured interview with a study staff member to learn more about patient experience during uds.

Eligibility criteria:
inclusion criteria: * scheduled for urodynamic study * aged 21 to 85 years * suitable for inflation of nitrous oxide/oxygen with willingness to undergo two urodynamic study runs during the procedure * access to an email and computer exclusion criteria: * perioral facial hair impeding good mask seal * learning disabilities and/or inability to cognitively complete survey questions * has any of the following medical conditions: 1. inner ear, bariatric or eye surgery within the last 2 weeks, 2. current emphysematous blebs, 3. severe b-12 deficiency, 4. bleomycin chemotherapy within the past year, 5. heart attack within the past year, 6. stroke within the past year, 7. class iii or higher heart failure

Keywords: urodynamic study nitrous oxide neurogenic bladder overactive bladder ambulatory patient experience of care