Kornimate/medical-research-clean huggingface dataset:
carotid artery stent implantation in the treatment of vulnerable plaque

Conditions: Carotid Artery Plaque; Carotid Stenosis; Stent Embolisation

Summary: to investigate the efficacy and safety of carotid stenting for vulnerable carotid plaques. all patients with carotid artery stenosis underwent carotid arterial contrast-enhanced ultrasonography before operation. according to the examination results, they were divided into two groups: vulnerable plaque group and stable plaque group. the incidence of perioperative stroke events in the two groups was compared. the incidence of stroke events in the two groups within 1 year was compared.

1. to enroll 100 cases of patients suffering from carotid artery stenosis。the investigators perform contrast enhanced ultrasound on patients for identifying the vulnerable plagues 2. the investigators divide patients into the stable group and the vulnerable group based on the results of ceus inspection. 3. all patients undergo carotid stent. to analysis the incidence of postoperative complications such as stroke and mortality within 30 days and to compare the differences between the two groups.

Eligibility criteria:
inclusion criteria: * the patients with ischemic symptom whose carotid stenosis were more than 50% * the patients without ischemic symptom whose carotid stenosis were more than 70% exclusion criteria: * • confirmed with severe intracranial vascular lesions * suffering from the large area cerebral infarction or critical stroke sequela * restenosis after cea or cas * suffering from severe coronary heart disease, respiratory failure,the hypertension difficult to controled * patients with malignant tumor or expected life \< 2 years

Keywords: carotid artery stenosis vulnerable plague carotid stenting
efficacy and safety of pyrotinib in patients with her2 mutation advanced non-small cell lung cancer

Conditions: Non-small Cell Lung Cancer

Summary: various driver gene mutations have been identified in lung cancer. among them, human epidermal growth factor 2 (her2) was identified in about approximately 2% of non-small cell lung cancers.pyrotinib is an oral tyrosine kinase inhibitor targeting both her-1 and her-2 receptors. this study is designed to evaluate the efficacy and safety of pyrotinib in patients with her2 positive advanced non-small cell lung cancer.

this study is designed to evaluate the efficacy and safety of pyrotinib in patients with her2 positive advanced pre-treated non-small cell lung cancer. to observe objective response rate (orr) of pyrotinib in her2 positive nsclc. to observe progression free survival （pfs）. to assess the overall survival (os). to assess side effects. to evaluate quality of life. to explore the relationship between biomarkers and the toxicity/efficacy of pyrotinib.

Eligibility criteria:
inclusion criteria: * aged ≥18 and ≤80 years. * ecog performance status of 0 to 1. * life expectancy of more than 12 weeks. * at least one measurable lesion exists.(recist 1.1) * histologically or cytologic confirmed her2 positive advanced non-small cell lung cancer who failed prior therapies. * required laboratory values including following parameters: anc: ≥ 1.5 x 10\^9/l, platelet count: ≥ 80 x 10\^9/l, hemoglobin: ≥ 90 g/l, total bilirubin: ≤ 1.5 x upper limit of normal, uln, alt and ast: ≤ 1.5 x uln, bun and creatine clearance rate: ≥ 50 ml/min lvef: ≥ 50% qtcf: \< 470 ms * signed informed consent. exclusion criteria: * subjects with third space fluid that can not be controled by drainage or other methods. * subjects that are unable to swallow tablets, or dysfunction of gastrointestinal absorption. * less than 4 weeks from the last radiotherapy,chemotherapy,target therapy * subjects with uncontrolled hypokalemia and hypomagnesemia before study entry. * subjects who can not interrupt the using of the drugs that may cause qt prolongation during study. * receiving any other antitumor therapy. * known history of hypersensitivity to pyrotinib or any of it components. ongoing infection (determined by investigator). * history of immunodeficiency, including hiv-positive, suffering from other acquired, congenital immunodeficiency disease, or history of organ transplantation. * subjects had any heart disease, including: (1) angina; (2) requiring medication or clinically significant arrhythmia; (3) myocardial infarction; (4) heart failure; (5) any heart diseases judged by investigator as unsuitable to participate in the trial. * female patients who are pregnancy, lactation or women who are of childbearing potential tested positive in baseline pregnancy test. * known history of neurological or psychiatric disease, including epilepsy or dementia.

Keywords: pyrotinib her2 non-small cell lung cancer phase ii
the effectiveness of a preoperative blood pressure screening program to identify undiagnosed hypertension in ambulatory surgery patients

Conditions: Hypertension; Perioperative Hypertension

Summary: elevated blood pressure is the largest contributing risk factor to all-cause and cardiovascular mortality. according to the u.s. preventive services task force, hypertension affects nearly 30% of the adult population. many patients remain undiagnosed, despite the consensus that screening and timely diagnosis is paramount. in this study, 108 ambulatory surgery patients with elevated blood pressure (160/90) that are not yet formally diagnosed with hypertension will be enrolled and alerted of their high blood pressure by a co-investigator md. they will request permission to follow-up with the patient and the patient's primary care provider 6 months after the initial phone call to check in on the status of their diagnosis and any action taken (lifestyle changes, medication) to alleviate their high blood pressure. patients will receive a follow-up letter/email at 6 and 3 months to remind them of their potential diagnosis.


Eligibility criteria:
inclusion criteria: * patients undergoing elective ambulatory surgery * patients with a pre-operative elevated bp defined as greater than 160/90 * patients above the age of 18 * english speaking exclusion criteria: * patients with a pre-existing diagnosis of htn * patients who are taking a hypertensive medication * patients who had a pre-operative surgical screening assessment
fatty acid oxidation defects and insulin sensitivity

Conditions: Very Long-chain Acyl-CoA Dehydrogenase Deficiency; Trifunctional Protein Deficiency; Long-chain 3-hydroxyacyl-CoA Dehydrogenase Deficiency; Medium-chain Acyl-CoA Dehydrogenase Deficiency; Normal Volunteers; Carnitine Palmitoyltransferase II Deficiency, Myopathic

Summary: the purpose of this study is to learn more about what causes insulin resistance. it has been suggested that proper breakdown of fat into energy (oxidation) in the body is important to allow insulin to keep blood sugar in the normal range. the investigators want to know if having one of the fatty acid oxidation disorders could have an influence on insulin action. fatty acid oxidation disorders are genetic disorders that inhibit one of the enzymes that converts fat into energy. the investigators will study both normal healthy people and people with a long-chain fatty acid oxidation disorder.

the overall goal of this proposal is to investigate the effects of disordered mitochondrial fatty acid oxidation on insulin resistance in humans. mitochondrial dysfunction has been implicated in the development of insulin resistance and type 2 diabetes during excess dietary fat intake and from increased release of endogenous free fatty acids , such as occurs in obesity. controversy exists, however, as to whether this insulin resistance results from intrinsic defects in mitochondrial energy utilization or from abnormalities resulting from excess free fatty acid flux, as well as the role that subsequent accumulation of cellular metabolic intermediates play in impaired insulin signaling. to address these controversies, the investigators will study a unique population of patients with inherited defects in each of the three mitochondrial enzymes in the fatty acid oxidation pathway: 1) very long-chain acyl-coa dehydrogenase (vlcad); 2) trifunctional protein (tfp, which includes long-chain 3-hydroxyacyl-coa dehydrogenase (lchad)); and 3) medium-chain acyl-coa dehydrogenase (mcad). these proteins are required for the oxidation of sequentially shorter fatty acids . the investigators will test the hypothesis that intrinsic defects in mitochondrial function involving oxidation of long-chain, but not medium-chain, fatty acids are sufficient to prevent intralipid-induced insulin resistance.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of vlcad, lchad, tfp or mcad deficiency or same gender, age and bmi as a subject with a fatty acid oxidation disorder * ability to travel to oregon health \& science university, portland, oregon * ability and willingness to complete the protocol exclusion criteria: * hemoglobin \ 1.2 prothrombin time (ptt) \>36 sec, platelets \<150k/mm3 * pregnant or lactating females * endocrine disorder such as diabetes or untreated thyroid disease * cardiovascular disease or elevated plasma lipids * regularly taking meds that strongly affect bleeding, bruising or platelets
comparison of postoperative anti-nausea and vomiting effect between glycopyrronium and ondansetron

Conditions: Postoperative Nausea and Vomiting

Summary: to compare the anti-nausea and vomiting effect between glycopyrronium and ondansetron for patients receiving elective surgery under general anesthesia. based on this study the investigators intend to explore the feasibility of using glycopyrronium to prevent postoperative nausea and vomiting.


Eligibility criteria:
inclusion criteria: * american society of anesthesiologists classification i-iii * receive general anesthesia * voluntarily receive postoperative intravenous controlled analgesia exclusion criteria: * puerpera or lactation women * allergy or existing contraindication to glycopyrronium and ondansetron * participate in other clinical drug trials within three months * can not follow with the study procedure
screening of nutritional status in cardiac surgery

Conditions: Cardiovascular Diseases

Summary: screening of nutritional status is unsolved problem in cardiac surgery. applicability of such criteria as body mass index and albumin and screening scales (mna, nrs-2002, sga, snaq) in cardiac surgery is controversial and insufficiently studied. furthermore, there is some known predictors of poor outcome, which closely related to nutritional status (c-reactive protein, total lymphocyte count). the aim of this study is assessment of several nutritional screening scales, objective nutritional criteria and predictors for the purpose of detection of most informative one or its combination.


Eligibility criteria:
inclusion criteria: * adult patients with cardiovascular disease operated on under cardiopulmonary bypass exclusion criteria: * age under 18 years * emergency * participation in other trial.
laser therapy in managing vaginal prolapse

Conditions: Cystocele; Vaginal Vault Prolapse; Rectocele; Enterocele

Summary: efficacy of laser therapy in postmenopausal women with symptomatic prolapse stage \>1. assessment tools will include prolapse stage quantification system (pop-q) and validated condition related questionnaires.

postmenopausal women with symptomatic cystocele and/or rectocele stage 2 or 3 will be 1:1 randomly allocated to er:yag laser or watchful waiting group. participants in the er:yag laser group will receive laser therapies at monthly intervals, while participants in the watchful waiting group will receive no treatment. all outcomes in both groups will be evaluated at baseline, 4-months and 6-months from baseline.

Eligibility criteria:
inclusion criteria: * symptomatic prolapse stage \>1 (cystocele, vaginal vault prolapse, enterocele, rectocele) according to pop-q system * negative pap-smear exclusion criteria: * asymptomatic prolapse * prolapse stage \<=1 * prolapse of uterus * presence of any type of genital infections (i.e herpes, vaginitis etc) * vaginal bleeding * underlying pathologies that could interfere in patients compliance (i.e psychiatric)
multiple screening methods for the detection of chinese colorectal advanced adenomatous polyps and cancer

Conditions: Colorectal Cancer; Colorectal Adenomatous Polyp

Summary: the primary objective is to determine the sensitivity and specificity of two colorectal cancer (crc) screening methods, including stool dna test and blood mrna test, for colorectal cancer in chinese population, with colonoscopy as reference method. lesions will be confirmed as malignant or precancerous by colonoscopy and histopathologic examination. the secondary objective is to compare the performance of these two crc screening methods to a commercially available fit assay, both with respect to cancer and advanced adenoma. lesions will be confirmed as malignant or precancerous by colonoscopy and histopathologic examination.

participants who are at high risk of developing colorectal cancer will be asked to collect two stool samples one for the stool dna test and the other for the commercially available fit assay, and a single blood sample for the blood mrna test. subjects will undergo colonoscopy within 6 months of enrollment. representative histopathology slides from tissue biopsied or excised during colonoscopy and those from subsequent definitive surgery may be retrieved in order to be evaluated by pathologists to confirm the diagnosis and staging.

Eligibility criteria:
inclusion criteria: 1. subjects received screening questionnaire and had been defined as high risk. 2. subjects haven't received any treatment under colonoscopy within 10 years. exclusion criteria: 1. subjects are under the usage of specific drugs which might affect the screening test. 2. subjects had the contraindication for colonoscopy.

Keywords: colorectal cancer screening stool dna test blood mrna test
effect of nephral 400 st dialysis membrane on coagulation in hemodialysis

Conditions: Extracorporeal Clotting During Hemodialysis

Summary: the purpose of this study is to investigate whether the dialysis filter an69st (nephral 400 st dialysis membrane) induces less clotting during hemodialysis than a conventional polysulphone filter. our hypothesis is that the two filters induce the same degree of clotting.

six consecutive hemodialysis (hd) sessions are evaluated per patient, altogether 10 - 12 stable hd patients (or at least 48 hd sessions altogether). during these six sessions, an69st and fx8 are used on alternate days. dalteparin is given intravenously as a single bolus dose at start of hd (50% of the conventional dose). clinical clotting is evaluated visually each hour of hd after blood draining of the venous air trap: 1=no clot, 2=a fibrinous ring, 3=a clot \ 1 cm and 5=coagulated system (stop in hd). blood specimens are taken at start and after each hour of hd. markers of coagulation (prothrombin 1+2) and of platelets (beta-thromboglobulin) are evaluated as well as anti fxa-activity. the two filters are going to be compared statistically with respect to the degree of clinical clotting and of intravascular coagulation and platelets activation.

Eligibility criteria:
inclusion criteria: * patient aged 18 years or more having been in chronic hd for at least 1 month * dialysis time at least 4 hours 3 times per week * blood flow at least 200 ml/min * fragmin dose unchanged the last week before study start * fragmin given intravenously as one single dose at hd start * haemoglobin \>= 11.0 g/dl and stable +/- 20% the last week before study start * erythropoietin and iron dose unchanged the last week before study start * written and orally informed consent given by the patient exclusion criteria: * treatment with acetylsalicylic acid (asa) * use of warfarin or another oral anticoagulant * clinical signs of infection * disseminated malignant disease

Keywords: clotting hemodialysis anticoagulation bleeding risk
the effect of mannitol volume with changes in osmolarity in traumatic brain injury

Conditions: Anesthesia; Traumatic Brain Injury

Summary: this observational study is designed to research the effect of mannitol volume administration with changes in osmolarity in patients with traumatic brain injury to guide the safe use of mannitol in these patients.

this study used an analytic observational design with a prospective cohort approach to evaluate the relationship between mannitol administration volume and changes in osmolarity in tbi patients at dr. kariadi central general hospital, semarang, indonesia. the study included 32 non-operative tbi patients admitted to the emergency department (ed) and inpatient wards from november 2023 to january 2024. samples were selected using a consecutive sampling method based on the inclusion criteria. the independent variable in this study was the volume of mannitol administered (3x125 cc, 2x250 cc, 3x250 cc; each 250 cc contains 50g mannitol) given as an iv drip for 15-20 minutes, while the dependent variable was blood osmolarity (mosm/l).

Eligibility criteria:
inclusion criteria: * patients aged 18-40 years * glasgow coma scale (gcs) score indicating mild (14-13) or moderate (12-10) exclusion criteria: * renal impairment * multiple trauma with bleeding shock * diabetes mellitus

Keywords: brain injury intracranial pressure mannitol neurocritical care osmolarity trauma
the accuracy of modified ttmb in the spatial distribution of prostate cancer

Conditions: Prostate Cancer

Summary: investigators plan to use modified ttmb technology to puncture prostate of participants suspected prostate cancer, especially those with the first negative biopsy , but having a rising psa.then, investigators will simulate the spatial distribution of prostate cancer in patients with positive biopsy before radical prostatectomy by way of the tps software system . and after the radical prostatectomy ,investigators will simulate the spatial distribution with the help of large tissue slice technique to compare with preoperative simulation ,which to verify the two simulations are consistent.

investigators mainly plan to determine the accuracy of the modified ttmb technology in combination with the tps system on the location of the tumor space distribution by comparing the two simulation, which is significant for the accurate focal thearpy.

Eligibility criteria:
inclusion criteria: 1.male patients; 2.18 yrs and older, and 90 yrs and younger; 3.rectal examination reveal prostate nodules; 4.b ultrasound, ct or mri find abnormal images; 5.psa\>4ng/ml, abnormal f/t ratio and psad exclusion criteria: 1. abnormal coagulation function; 2. severe urinary tract infection; 3. serious cardiovascular and cerebrovascular disease

Keywords: tps system trans-perineal template-guided mapping biopsy prostate cancer spatial distribution large tissue slice
simulation training of endoscopy staff to improve patient experience in colonoscopy

Conditions: Colorectal Cancer

Summary: some patients experience a degree of pain and discomfort during endoscopic examination of the large bowel. sedatives and analgesics may be administered in low doses. excessive dosage or intense pain may lead to hypotension and impaired level of consciousness. the purpose of the present study was to determine if simulation training of endoscopy staff in preventing pain and handling acute complications through effective teamwork could improve the quality of colonoscopy from the patients' perspective.

the study was carried out in a surgical department, where colonoscopies were performed on an out-patient basis under minimal sedation. the intervention consisted of a simulation based course for endoscopy staff. all endoscopy nurses and doctors participated (n=43). the course consisted of three short lectures followed by simulation training. the lectures dealt with technical aspects of colonoscopy, usage of medication and management of unexpected emergency events during the procedure, and finally with interprofessional teamwork and team communication. the lectures were followed by in situ simulation in an endoscopy room. for 2 months before and after the course a questionnaire based survey was carried out. the respondents were consecutive patients who had undergone colonoscopy under minimal sedation or no sedation (according to their own preference ). the questionnaire was filled out when the patient was fully recovered after sedation and ready to go home. the relevant nursing staff and doctor for the procedure also filled out their part of the questionnaire. patients were invited to participate and gave written consent after oral and written information according to the helsinki declaration .

Eligibility criteria:
inclusion criteria: * all patients for colonoscopy under minimal sedation who are able to understand imformation exclusion criteria: * unable to understand information

Keywords: simulation training minimal sedation colonoscopy patient satisfaction teamwork team training patient safety
post-operative delirium in elderly surgical patients

Conditions: Hip Fractures; Delirium

Summary: this research is being done to see what effects sedative drugs during surgery have on peoples' thinking processes after they wake up.

we give sedative drugs to patients having spinal anesthesia so they are "asleep" (sedated) while we are fixing their broken hips. the spinal anesthesia provides pain relief at the site of surgery, while the sedative drugs keep people "asleep" during the procedure. we want to find out whether the amount of sedation we give might (1) make patients be confused when they wake up or (2) have anything to do with how well patients can do their ordinary daily routines a few months after their surgery.

Eligibility criteria:
inclusion criteria: * is 65 years of age or older at admission; * has surgical treatment of a traumatic hip fracture; * has participating surgeon; * has mini-mental status exam score of 15 or higher; * able to read/write/speak/hear/understand english; * gives informed consent; * receives spinal anesthesia exclusion criteria: * receives general anesthesia; * does not write/write/speak/hear/understand english; * has severe chronic obstructive pulmonary disease (copd); * has severe congestive heart failure (chf); * has mini-mental status exam score less than 15; * declines to give informed consent; * age less than 65 years at admission; * attending surgeon does not participate in study

Keywords: hip fractures femoral neck fractures trochanteric fractures intertrochanteric fractures subtrochanteric fractures delirium confusion
physiological effects of aprvplus and tcav in ards

Conditions: ARDS (Acute Respiratory Distress Syndrome)

Summary: in previous studies, airway pressure release ventilation (aprv) has been proven to be an important respiratory support method for ards patients, and various aprv ventilation strategies have been proposed. this study aims to compare the physiological effects of two types of aprv ventilation strategy, early pathophysiology-driven aprv (aprvplus) and time-controlled adaptive ventilation (tcav), through randomized crossover trials, providing evidence for clinical application and further research on aprv.


Eligibility criteria:
inclusion criteria: * intubated and mechanically ventilated patients * meet the 2023 global new definition of ards exclusion criteria: * pregnancy * the expected duration of mechanical ventilation was less than 48 hours * intracranial hypertension (suspected or confirmed) * neuromuscular disorders that are known to prolong the need for mechanical ventilation * known or suspected chronic obstructive pulmonary disease(copd) * terminal stage of disease * pneumothorax (drained or not)at enrollment * treatment with extracorporeal support (ecmo) at enrollment * there was a lack of commitment to life support