Kornimate/medical-research-clean huggingface dataset:
assessments of diaphragm-pleural mechanics during the weaning from prolonged mechanical ventilation

Conditions: Ventilator Weaning; Respiratory Failure

Summary: weaning failure from mechanical ventilator is commonly seen in respiratory failure and increases duration of ventilator use, icu stay, ventilator associated pneumonia and even mortality. the diaphragm serves as one of the most important respiratory mechanism and its function differs the weaning success rate. since 1980s, ultrasonography assessment in diaphragm movement were developed and further discussion upon whether it serves as a predicting factor for extubation failure. the measurement includes difference of diaphragm thickness, diaphragm excursion or the movement of liver and spleen. multiple studies targeted intubated patients with different measurement methods and all resulted with good weaning prediction value.6 of all the studies, only one study targeted tracheostomy tube patients. they reported diaphragm thickness fraction \>36% as cutoff value is associated with successful spontaneous breathing trial (sbt), with a sensitivity of 0.82, specificity of 0.88. however, little comparison with traditional weaning parameters was mentioned in the study. we designed this prospective observational study to evaluate whether diaphragm movement under ultrasound serves as a predicting index of ventilator discontinuation in patients with tracheostomy. the diaphragm movement will also correlate with other parameters such as rsbi, pi max, pe max, tv spont., weansnow score(ws), vo2, apache ii. esophageal pressure is also provided as an option for our study population for more information such as pleural pressure, transdiaphragm pressure, etc. the ultrasonography measurement of diaphragm movement will be performed within 6 hours before discontinuation of ventilator. the patient remains in semi-recumbent position with the convex probe selected for its good penetration. the probe is placed at a craniocaudal axis, 90 degrees to the skin at the lower intercostal spaces to right anterior axillary line (aal) and left posterior axillary line (pal), which allows a perpendicular ultrasound beam direction to the diaphragm movement. liver (border or vascular structure), splenic (border or vascular structure) will be selected as target point and the marked distance of movement during quiet respiration cycle will be measured 10 times with a largest value calculated. other echo measurements will also be attempted. the study aims to investigate if the measurement of the diaphragm movement serves as a reliable predicting factor for weaning failure in respiratory care center patients.


Eligibility criteria:
inclusion criteria: * prolonged mechanical ventilation with tracheostomy tube * oxygen with a fraction of ≤ 0.4 * positive end expiratory pressure at ≤ 5 cm h2o * pressure support at ≤ 8 cmh2o exclusion criteria: * no spontaneous breathing * unstable hemodynamic status, * history of peritonitis, intraabdominal operation, empyema, or pleurodesis.

Keywords: prolonged mechanical ventilation esophageal pressure pleural pressure
in patients with carpal tunnel syndrome, median nerve conduction is evaluated after moving the wrist bones

Conditions: Carpal Tunnel Syndrome

Summary: the goal of this clinical trial is to analyze the immediate effect of manual mobilization techniques of the carpal bones on the median nerve, in patients with carpal tunnel syndrome. the main question it aims to answer is whether there is an immediate positive effect on the electrophysiological variables of the median nerve in patients with carpal tunnel syndrome after performing this technique. participants will undergo a carpal bone mobilization technique. there will be a comparison group that will not undergo the technique. the researchers will compare the control and intervention groups to see if the technique has an immediate positive effect.


Eligibility criteria:
inclusion criteria: * being over 18 years * present carpal tunnel syndrome diagnosed by electroneurogram * have understanding and communication skills * give consent to participate in the study. exclusion criteria: * having received previous surgery on the hand or wrist * present limitation of movement of the carpal bones. * not signing the informed consent.
removal of beta blocker drugs by hemodialysis

Conditions: Chronic Kidney Diseases

Summary: eight maintenance hemodialysis patients are given one of four beta blocker drugs (atenolol, bisoprolol, carvedilol, metoprolol) three hours prior to a hemodialysis session. blood samples and spent dialysate are collected during dialysis. on separate dialysis sessions, patients received the other study drugs until they have taken each of the four study drugs. dialytic clearance is calculated.


Eligibility criteria:
inclusion criteria: * at least 18 years of age, receiving hemodialysis three times per week for at least 90 days. exclusion criteria: * gastrointestinal or liver disease, body mass index greater than 40 kg/m2, contraindications for receiving a beta blocker (treatment with contraindicated medications, prior adverse reaction, severe reactive airway disease, hemodynamic instability during dialysis).

Keywords: hemodialysis dialytic clearance pharmacokinetics
doce study interaction between direct oral anticoagulants and drug-metabolizing enzyme inducers

Conditions: Atrial Fibrillation; Thromboembolism, Venous

Summary: aim of the study is to investigate whether the influence of drugs inducing of cyp 3a4 isoenzyme of cyp450 and p-gp transporter significantly affect plasma levels of doacs in patients with nvaf and venous thromboembolism

aim of the study is to investigate whether the influence of drugs inducing of cyp 3a4 isoenzyme of cyp450 and p-gp transporter significantly affect plasma levels of doacs in patients with nvaf and venous thromboembolism. also the difference between doacs inducing both cyp3a4 and p-gp transporter (rivaroxaban and apixaban) and doacs inducing the p-pg transporter only will be investigated. thriomboembolic and bleeding events during the study duration will be registered and correlated to the measured doac plasma levels.

Eligibility criteria:
inclusion criteria: * patients with a diagnosis of nonvalvular atrial fibrillation or a diagnosis of venous thromboembolism who are taking direct oral anticoagulants according to current guidelines and concomitant enzyme inducers antiepileptic drugs; patients available for a 12 months follow up; patients who can sign informed consent exclusion criteria: * patients who stop antiepileptic drugs; age \<18 yo patients not willing to perform blood draw or not available for a 12 months follow up; patients who cannot sign informed consent
a study of once-daily oral orforglipron (ly3502970) in japanese adult participants with obesity disease

Conditions: Obesity

Summary: the main purpose of this study is to investigate the efficacy and safety of oral orforglipron in participants with obesity disease with obesity-related health problems.


Eligibility criteria:
inclusion criteria: * participants with a bmi ≥27 kg/m² and \<35 kg/m² and at least 2 obesity-related health problems (treated or untreated), or a bmi ≥35 kg/m² and at least 1 obesity-related health problem (treated or untreated). at least one obesity-related health problem should be hypertension, dyslipidemia or t2d (approximately 25% of participants). * have a history of at least one self-reported unsuccessful dietary effort to lose body weight. * males and females may participate in this trial. female participants must not be pregnant, intending to be pregnant, breastfeeding, or intending to breastfeed. * contraceptive use by participants should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. * no male contraception is required except in compliance with specific local government study requirements. exclusion criteria: * for participants with type 2 diabetes (t2d): * have type 1 diabetes (t1d), history of ketoacidosis or hyperosmolar state/coma, or any other types of diabetes except t2d. * have had 1 or more episode of severe hypoglycemia and/or 1 or more episode of hypoglycemia unawareness within the 180 days prior to screening. * have renal impairment measured as estimated glomerular filtration rate (egfr) \<15 ml/min/1.73 m², calculated by japanese society of nephrology coefficient-modified chronic kidney disease-epidemiology equation during screening. * have a known clinically significant gastric emptying abnormality. * for participants without type 2 diabetes (t2d): have any type of diabetes with hemoglobin a1c (hba1c) ≥6.5 %. * have a self-reported change in body weight \>5 kg (11 pounds) within 90 days prior to screening. * have chronic kidney disease. * have lupus or rheumatoid arthritis. * have the following cardiovascular conditions within 90 days prior to screening. * have acute or chronic hepatitis.

Keywords: overweight metabolism and nutrition disorder
comparison of anticoagulation prolongation vs. no anticoagulation in stemi patients after primary pci

Conditions: STEMI - ST Elevation Myocardial Infarction

Summary: the right study is a large randomized study dedicated to post-ppci anticoagulation in stemi patients. the investigators propose to evaluate the clinical efficacy and safety of anticoagulation prolonged for at least 48 hours after the procedure vs. no prolongation of anticoagulation after procedure in patients with stemi treated with bivalirudin during ppci (primary hypothesis). when allocated to anticoagulation prolongation by randomization, the subject will be assigned to ufh, enoxaparin or bivalirudin (same regimen allocated by centre) for at least 48 hours after ppci. the results from this study are expected to provide guidance on the risk/benefit of post-procedural anticoagulation in patients with stemi.

a minor change of time of randomization after prolongation of bivalirudin infusion at pci dose up to 4 hours on protocol at september 19,2018. reasons: a minor change concerning the timing of randomization considering the current local practice in some centers that use the 4 hour infusion of bivalirudin just after pci. it remains in agreement with the current international guidelines and with the drug label in china. there is no change in drugs used and doses of these drugs once the randomization occurs.

Eligibility criteria:
inclusion criteria: * age ≥18 years old * stemi with ppci of culprit lesion * bivalirudin therapy during ppci * signed informed consent form exclusion criteria: * patients with a formal indication for anticoagulation after ppci (e.g. atrial fibrillation, left-ventricular thrombus, intra-aortic balloon pump, pulmonary embolism, mechanical heart valve) * patients with any indication for chronic anticoagulation * patient with previous lytic treatment * patient with previous coronary artery bypass graft surgery * cardiogenic shock, malignant ventricular arrhythmia, or mechanical complications * any anticoagulation other than bivalirudin started after the procedure before randomization * estimated body weight of \>120 kg or \<45kg * bp ≥180/110mmhg at randomization * any bleeding diathesis or severe hematologic disease or history of intracerebral mass, aneurysm, arteriovenous malformation, recent (\<6months) ischemic stroke or tia, recent (\<6months) intracranial hemorrhage or, gastrointestinal or genitourinary bleeding within the past 2 weeks * history of heparin-induced thrombocytopenia * suspected acute aortic dissection (aad) * major surgery within 1 month * a planned elective surgical procedure that would necessitate an interruption in treatment with p2y12 inhibitors in the next 6 months after enrollment * known plt≤100×109 or hgb≤10g/l * known transaminase \>3-fold uln, or ccr\<30ml/min * known allergy to any study drug * pregnancy or lactation * noncardiac coexisting conditions that could limit life expectancy to less than 1 year * current participation in an investigational drug or device trial

Keywords: anticoagulantion post-procedure stemi
evaluation of coagulopathy in critically ill covid-19 patients.

Conditions: Coagulation Disorder

Summary: novel coronavirus disease 19 (covid-19) is caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2), this pneumonia was first emerged in december 2019 in wuhan, china and rapidly spread around the world . coagulopathy is one of the most significant prognostic factors in patients with covid-19 and is associated with increased mortality and admission to critical care. most observed coagulopathy in patients hospitalized with covid-19 (covid-19-associated coagulopathy) is characterized by increased d-dimer and fibrinogen levels. 71% of patients who did not survive hospitalization reported to have developed disseminated intravascular coagulation


Eligibility criteria:
inclusion criteria: * covid 19 critically ill patients exclusion criteria: * any critical illness not related to covid 19
rad001 and temozolomide in patients with advanced pancreatic neuroendocrine tumors

Conditions: Pancreatic Neuroendocrine Tumor

Summary: this research study will test the safety of rad001 in combination with temozolomide.

* participants will take rad001 by mouth daily. they will also take temozolomide by mouth daily for one week, followed by a one-week break period. this one-week on/one week off schedule for temozolomide will continue for the duration of the treatment. * after the first month of treatment, there will be a 7-day observation period during which no study medication will be taken to observe for any side effects. * during all treatment cycles (1 cycle is 28 days in length) participants will have a physical exam and will be asked questions about their general health and specific questions about any problems they may be experiencing. initially, participants will come in every other week. at each of these visits, blood work will be taken to monitor the participants health. * after every 2 months of treatment, participants will have a ct scan or mri done to see how the medication is working.

Eligibility criteria:
inclusion criteria: * locally unresectable or metastatic pancreatic neuroendocrine tumor * radiologic, operative, or pathology reports should document a pancreatic location of tumor * patients must have confirmed low-grade or intermediate-grade neuroendocrine carcinoma * patients must have at least one measurable site of disease according to recist criteria that has not been preciously irradiated * 18 years of age or older * minimum of two weeks since any major surgery, completion of radiation, or completion of all prior systemic anticancer therapy * prior treatment with chemotherapy is allowed, with the exception of prior treatment with temozolomide or dacarbazine * no prior therapy with rad001 or any other mtor inhibitor * ecog performance status 0,1 or 2 * life expectancy 12 weeks or more * adequate bone marrow, liver and renal function as outlined in the protocol * negative serum pregnancy test * fasting serum cholesterol as outlined in protocol exclusion criteria: * prior treatment with any investigational drug within the preceding 4 weeks * chronic treatment with systemic steroids or another immunosuppressive agent * patients should not receive immunization with attenuated live vaccines during study period or within 1 week of study entry * uncontrolled brain or leptomeningeal metastases, including patients who continue to require glucocorticoids for brain or leptomeningeal metastases * other malignancies within the past 3 years except for adequately treated carcinoma of the cervix or basal or squamous cell carcinoma of the skin * patients who have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study * women who are pregnant or breast feeding * patients who have received prior treatment with an mtor inhibitor or temozolomide * patients with known hypersensitivity to rad001 or other rapamycins or to its excipients * history of noncompliance to medical regimens

Keywords: rad001 temozolomide
smart blood: single-unit versus multiple-unit packed red blood cell transfusion in non-acute postpartum anemia

Conditions: Postpartum Anemia Nos

Summary: there is a paucity of data on management of non-acute postpartum anemia. although blood transfusions were historically initiated with 2 units, the most recent recommendation from the american association of blood banks is to begin with 1 unit. as no randomized controlled trials have been performed in obstetrics, the investigators propose a randomized, controlled trial in non-acute postpartum anemia comparing single- versus multiple-unit transfusion by total numbers of units transfused and maternal morbidity.

postpartum hemorrhage (pph), which accounts for 30% of all direct maternal deaths, is the single most important cause of maternal morbidity and mortality across the globe and is a focus of attention of national organizations such as the council for patient safety in women's health in recent years. yet, there remains a paucity of data on the appropriate management of non-acute postpartum anemia. it is common practice in obstetrics to offer a transfusion of packed red blood cells (prbcs) to women with a hemoglobin (hb) value less than 7 g/dl (hematocrit less than 20%) and to symptomatic women with even higher hemoglobin levels. although transfusions were historically initiated with 2 units of prbcs, the most recent recommendation from the american association of blood banks (aabb) for a stable patient is to begin with 1 unit and reassess. however, while surgical data has successfully demonstrated that liberal blood transfusion increases morbidity and mortality in comparison to restricted transfusion, no randomized controlled trials have been performed in obstetrics to demonstrate superiority of a single-unit transfusion protocol. the investigators propose a randomized, controlled trial in non-acute postpartum anemia comparing single-unit versus multiple-unit transfusion by total numbers of units transfused and maternal morbidity at the university of pennsylvania with the hypothesis that single-unit transfusions can reduce the number of units transfused without increasing maternal morbidity.

Eligibility criteria:
inclusion criteria: * women over 18 * willing and stable to give consent * \> 6 hours postpartum from any mode of delivery * determined by their physician to require blood transfusion either by: * hb \<7g/dl or * \>7g/dl with any sign or symptom of anemia such as fatigue, dizziness, tachycardia, or hypotension * agreed to accept blood transfusion * no contraindications to blood transfusion exclusion criteria: * hemoglobinopathies * patients with an ejection fraction \<35% * hb \<5 g/dl * hr \> 130 bpm, bp \< 80/40
efficacy and safety of aspirin therapy with cabg

Conditions: Coronary Heart Disease

Summary: evaluate the safety of preoperative aspirin therapy when performing bypass surgery in conditions of artificial blood circulation

the hypothesis of the study was that aspirin therapy started 24 hours before cabg is safe. the effectiveness of this hypothesis will be assessed by the presence of a 30-day period after cabg myocardial infarction, ischemic stroke, repeat revascularizations

Eligibility criteria:
inclusion criteria: * patients 18 years of age or older * patient able to give informed consent exclusion criteria: * missing consent * urgent or emergent surgery * off-pump cabg * рatient has clear indication for anticoagulation (eg. mechanical heart valve, atrial fibrillation) or adp receptor antagonist (eg. drug-eluting stent) * history of bleeding diathesis, significant gi bleed, ich, or liver failure * allergy to or intolerance of aspirin

Keywords: coronary artery bypass grafting
investigating the postprandial glucose metabolism after treatment with faster-acting insulin aspart in subjects with type 1 diabetes

Conditions: Diabetes; Diabetes Mellitus, Type 1

Summary: this trial is conducted in europe. the aim of the trial is to investigate the postprandial glucose metabolism after treatment with faster-acting insulin aspart in subjects with type 1 diabetes.


Eligibility criteria:
inclusion criteria: * male or female aged 18-64 years (both inclusive) at the time of signing informed consent * subjects diagnosed (clinically) with type 1 diabetes mellitus at least 365 days prior to the day of screening * body mass index 18.5-28.0 kg/m\^2 (both inclusive) exclusion criteria: * smoker (defined as a subject who is smoking at least five cigarettes or the equivalent per day) who is not able or willing to refrain from smoking or use of nicotine gum or transdermal nicotine patches during the inpatient period * subject who has donated any blood or plasma in the past month or more than 500 ml within 3 months prior to screening
discern: advanced pd therapy candidacy and evaluation system

Conditions: Parkinson Disease

Summary: to collect data to develop models that identify when patients with advanced parkinson's disease (pd) are not responding well to their current therapy and may be ready to consider advanced therapy and when patients receiving advanced therapy are not responding well and need a therapy adjustment.


Eligibility criteria:
inclusion criteria: * able to provide informed consent * diagnosed with parkinson's disease * current levodopa use * hoehn and yahr scale ii-iii * ambulatory and capable of using the discern smartphone system * able to understand and follow instructions regarding using the device * half of participants (10 per site) identified as candidates for deep brain stimulation or drug pump by their treating neurologist, but before their surgeries take place. * the remainder (10 per site) will be individuals with advanced pd as defined by having a updrs motor complications scores ≥ 4. exclusion criteria: * any subject that does not meet the inclusion criteria will be excluded from this study. subjects not capable of following the required clinical instruction for this study will be excluded. potential subjects will be screened to ensure no cognitive impairments exist that would prohibit them from properly using the system. exclusion criteria includes cognitive impairment as evidenced by a score less than 24 on the montreal cognitive assessment (moca) unless the subject has a caregiver able and willing to facilitate use of the discern system based on the judgement of the treating neurologist.

Keywords: dyskinesia parkinson's disease deep brain stimulation wearable