Kornimate/medical-research-clean huggingface dataset:
variable effects of anti-diabetics on stress hyperglycemia ratio

Conditions: Type 2 Diabetes

Summary: a blood glucose level of equal to or greater than 180 mg/dl that occurred during stress in a patient without diabetes mellitus (dm) is termed stress hyperglycemia (sh). the stress hyperglycemia ratio (shr) is defined as the fasting blood glucose divided by the blood glucose level that is calculated from the glycosylated hemoglobin (hba1c) value on admission. a significantly higher shr is associated with worse prognostic biomarkers in diabetic patients with complications

stress hyperglycemia (sh) is an increase in circulating glucose levels in biological fluids as a physiological response to stress in diabetic patients who are known or newly diagnosed, or a pathological condition associated with in-hospital-related hyperglycemia. interventions. through their pleiotropic effects, some oral hypoglycemic agents improved stress hyperglycemia. when compared to non-sglt-i (sodium glucose transporter-inhibitor) users, diabetic patients who used (sglt-i) and had an acute myocardial infarction had less prevalent stress hyperglycemia, a smaller infarct size, and evidence of a low inflammatory response. the rationale this study is to evaluate the shr in t2d patients who do not have serious illnesses and are managed with oral hypoglycemic agents

Eligibility criteria:
inclusion criteria: * age ≥35 years * diagnosis of type 2 diabetes * absence of serious illnesses * no evidence of trauma exclusion criteria: * overt complications of diabetes * any participant used antibiotics for infectious diseases * any participant used non-steroidal antiinflammatory drugs * current or past history of mental diseases * current hematological diseases * pregnancy * nursing mothers

Keywords: stress hyperglycemia ratio sitagliptin empagliflozin
nateglinide: a double blind add-on study with pioglitazone for type 2 diabetic patients

Conditions: Type 2 Diabetes Mellitus; Diabetes Mellitus, Type II

Summary: the purpose of this study is to investigate the superiority of nateglinide over placebo for inadequately controlled type 2 diabetic patients with pioglitazone treatment.


Eligibility criteria:
inclusion criteria: * type 2 diabetes mellitus under the treatment with pioglitazone exclusion criteria: * patients who cannot follow the diet therapy and/or exercise therapy * type 1 diabetes mellitus

Keywords: nateglinide pioglitazone combination drug therapy treatment
clinical trial of creatine in amyotrophic lateral sclerosis [als]

Conditions: Amyotrophic Lateral Sclerosis

Summary: the purpose of this study is to evaluate the safety and effectiveness of creatine treatment in amyotrophic lateral sclerosis (als). there is currently no known effective treatment for als. it is known that nerve cells die in the brains and spinal cords of patients with als but the cause of the cell death is unknown. it has been shown that there is overactive nerve activity due to increased levels of a chemical called glutamate and that there is abnormal cellular metabolism along with increased production of substance called "free radicals." improving cellular metabolism and readjusting the activity of glutamate in the brain may be beneficial to als patients. creatine is a naturally occurring compound, which improves energy metabolism in cells. creatine has been given to patients with energy metabolism defects in their muscles, and to athletes. creatine improves survival in a mouse model of als. three human subjects with als have received creatine for up to six months without any side effects. overall, creatine has been well tolerated and safe.

half of the subjects in this study will be selected by chance to receive creatine treatment for 6 months and the other half to receive placebo. neither the subject nor the investigator will know which drug the subject is receiving, although this information will be available in case of emergency. it is anticipated that all subjects will have the choice to receive creatine after the 6 months study in an open-label study for an additional 12 months. a total of 114 patients will participate at 15 centers. approximately 8 subjects will be enrolled at the washington university. the effectiveness of creatine will be determined first by assessing any changes in strength in the arms and second by changes in grip strength, functional activities, electromyography changes or changes of the level of soh 2'dg in the urine.

Eligibility criteria:
inclusion criteria: * a clinical diagnosis of definite, probably or laboratory supported probably als, either sporadic or familial als according to a modified el escorial criteria * willing and able to give informed consent * fvc greater than or equal to 50% predicted * evidence of abnormality in upper and/or lower extremity motor function (clinical evidence of muscle atrophy and weakness in an upper and/or lower extremity). the patient should have at least 4 or 8 testable upper extremity muscle groups. * subjects may take riluzole. riluzole must have been at stable doses for at least thirty days prior to baseline visit. * if woman of childbearing age, must be non-lactating and surgically sterile or using an effective method of birth control (double barrier or oral contraceptive) and have a negative pregnancy test * disease duration less than five years
a clinical study of association between postoperative dyslipidemia and organ rejection in transplant patients

Conditions: Heart Transplant Failure and Rejection

Summary: abnormal lipid metabolism is a common complication after organ transplantation, with pathological changes in lipid parameters occurring in approximately 60-80% of cardiac transplant recipients receiving triple immunotherapy with cyclosporine, imid azathioprine, and methylprednisolone. with the significant increase in long-term survival and increasing age of transplant patients, atherosclerotic cardiovascular diseases, such as those caused by dyslipidemia, have become a major cause of transplant organ failure and recipient death. however, the causes of dyslipidemia after organ transplantation, as well as the effects and mechanisms of dyslipidemia on transplant rejection, are unknown. previous studies have found that 1. increased lipid levels occur in recipients after heart transplantation; 2. during rejection, hepatic pcsk9 expression is increased in recipients; 3. a high-fat environment increases the immunoreactivity of human peripheral blood lymphocytes. it is suggested that pcsk9-lipid disorder-immune cell interactions may be associated with the development of transplant rejection. in this project, we propose to (1) establish a long-term follow-up system for postoperative cardiac transplantation patients in our department to track the characteristics of lipid changes in transplantation patients, to clarify the link between dyslipidemia and rejection, and to provide a strong evidence-based medical basis for the management of lipids during the perioperative period and in the postoperative period; (2) expand the dimensions of lipid-related assays under the support of the above system, and to incorporate transcriptomic, proteomic, and metabolomic research methods to elucidate transplantation rejection in a multidimensional manner. (ii) expanding the dimensions of lipid-related assays to include transcriptomic, proteomic, and metabolomic studies to elucidate the relationship between pcsk9 and dyslipidemia in transplant patients; (iii) adopting single-cell sequencing technology to deeply reveal the potential mechanism by which changes in lipids affect t-cell-mediated rejection of cardiac transplants. the mechanism of t-cell-mediated cardiac transplantation rejection is revealed by single-cell sequencing.


Eligibility criteria:
inclusion criteria: * after heart transplantation * age ≥ 18 * disease duration: symptomatic heart failure ≥ 6 months prior to screening date * the patient's informed consent exclusion criteria: * refusal of the patient to provide consent * suspected poor capability to follow instructions and cooperate * another life-threatening disease with poor prognosis (survival less than 2 years) * participation in any other clinical study within less than 30 days prior to screening date

Keywords: heart transplantation macrophages fatty acid pcsk9 lipid metabolism
cangrelor in st-elevation myocardial infarction to decrease infarct size

Conditions: STEMI - ST Elevation Myocardial Infarction

Summary: this study evaluates differences in the extent of myocardial necrosis noted by cardiac mri in patients with st-elevation myocardial infarction randomized to receive cangrelor during their percutaneous coronary intervention and compares them to patients randomized to not receive cangrelor.

cangrelor is a direct-acting and reversible intravenously administered platelet inhibitor approved as an adjunct to percutaneous intervention (pci) for reducing the risk of periprocedural myocardial infarction, repeat coronary revascularization, and stent thrombosis. as it has a quick onset of action (2 minutes) compared to traditional oral platelet inhibitors, cangrelor is emerging as an important new option for use in patients undergoing percutaneous intervention who have not been treated with oral platelet inhibitors. furthermore, multiple studies have demonstrated that patients with st-elevation myocardial infarction (stemi) who undergo emergent pci do not have optimal platelet inhibition even after administration of a loading dose of traditional oral platelet inhibitors. however, the clinical significance of complete platelet inhibition around the time of pci is not fully understood. the primary objective is to characterize the utility of immediate platelet inhibition with intravenous cangrelor in patients presenting with an acute stemi by assessing the extent of infarct size (either enzymatically or by imaging). if the findings are favorable, this may suggest that immediate platelet inhibition is an important part of care in this patient population.

Eligibility criteria:
inclusion criteria: * patients with an acute stemi with the university of kentucky as the institution of presentation with plans for pci * english-speaking exclusion criteria: * pregnant patients * prisoners * patients who are unable to provide his/her own consent * patients with a prior history of myocardial infarction * patients who have received thrombolytics * patients on systemic anticoagulation * patients who are hemodynamically unstable with evidence of shock * patients who are mechanically intubated * patients with devices not mri compatible * patients with chronic kidney disease, glomerular filtration rate less than 30 * patients who are already on dual antiplatelet therapy
awake endotracheal intubation in cervical injury

Conditions: Trauma; Patient Satisfaction; Airway Morbidity

Summary: the researcher will compare awake endotracheal intubation with glidescope video assisted laryngoscope vs fiberoptic bronchoscope in patients with traumatic cervical injury;

one hundred patients undergoing post traumatic cervical spine fixation under general anesthesia will be randomly allocated to two groups in a prospective study. between december 2022 and may 2023. all patients will be premedicated before the procedure and after giving 500 ml of lactated ringer solution with glycopyrrolate 0.2 mg iv and dexmedetomidine 1 mic/kg iv over 10 minutes then 0.4 mic/kg/h continuous iv infusion. all patients will receive standard clinical care monitoring including three lead ecg, noninvasive arterial blood pressure measurement and pulse oximeter. patient will be administered oxygen 6 l/min through nasal prong. patients will be allocated into two equal groups (50 patients per group) for awake intubation with either fob (f group) or gvl (g group) according to computer generated randomization technique. each patient will receive nebulization with 5 ml of lidocaine 1% for 5 min followed by topicalization of soft palate and fauces with 5 puffs of lidocaine spray (10 mg/spray) immediately before the technique of endotracheal intubation (id 6.5 mm for female and 7 mm in male, armored tube. before airway manipulation each patient will receive a bolus dose of fentanil 1 mic/kg. during the procedure philadelphia cervical collar will be removed and mils of cervical spine will be carried out by trained assistant (senior registrar anesthetist, 5 years' experience). after successful intubation (by consultant anesthesia who had more than 100 times successful intubation with either fob or gvl) and neurological assessment (by spinal surgeon), general anesthesia will be induced with propofol 1.5 mg/kg, cisatracurium 0.1 mg/kg and remifentanil 0.5 lg/kg. hypotension (decreased in mapp 20% of base line) will be treated with ephedrine bolus 5-10 mg and 250 ml of lactated ringer solution. only three attempts will be permitted per each patient and if failed plan b was to carry out endotracheal intubation under inhalational induction with fob without neuromuscular blockade and to exclude patients from the study. attempt will be held if o2 saturation decreased below 90%.

Eligibility criteria:
inclusion criteria: * asa i-ii patients * ages 26-44 * undergoing a selective cervical spine fixation. exclusion criteria: * body mass index (bmi) more than 35 kg/m2. * obstructive airway disease * cardiovascular disease * apparent airway difficulty * patient refusal .
bewell360-cg care model: health and wellness coaching to support caregivers of patients living with advanced lung cancers

Conditions: Advanced Lung Carcinoma; Stage III Lung Cancer AJCC V8; Stage IV Lung Cancer AJCC V8

Summary: this clinical trial aims to develop a new care delivery model, called bewell360-care giver (cg), to support caregivers of patients living with lung cancer that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced). the bewell360-cg care model may enhance the wellbeing and quality of life of patients living with advanced lung cancer, and improve the current care standards for cancer patients and their caregivers.

primary objectives: i. to pilot a novel, scalable, user-friendly health and wellness coaching (hwc) care model- the bewell360-cg - that is embedded and integrated as part of a palliative approach to care for cgs of patients with advanced lung cancer. ii. to train palliative care (pc) staff to identify major themes and practical issues (barriers and facilitators) impacting cgs qol and well-being, within and outside healthcare settings. (aim 1) iii. to evaluate the impact of bewell360 on the cgs experience of their wellbeing and qol. (aim 2) iv. to evaluate the impact of bewell360 on the quality of care of patients living with advanced lung cancer and receiving pc. (aim 2) v. to create foundational knowledge about the feasibility and proof of concept of bewell360-cg within pc for further future implementation and dissemination (translation) into practice. (aim 3) outline: caregivers (cgs) are assigned to 1 of 2 arms. arm 1: cgs receive the standard of care services assigned by the care team for their patient. participants also receive additional educational and supportive material for health and wellness. arm 2: cgs receive the standard of care services assigned by the care team for their patient and participate in the bewell360-cg coaching sessions on study.

Eligibility criteria:
inclusion criteria: * cgs of patients with advanced lung cancer receiving care at mayo clinic florida (mcf) in the palliative care (pc) or oncology clinics * patient with a predicted life expectancy \>=6 months * adult cgs' of any gender, race and ethnicity * english speaking * willing to provide informed consent and complete hwc sessions, study interviews, and surveys. we will identify the respective patients through the patient appointment schedule list and use the patient electronic medical record (emr) to confirm the point of contact of cgs. * palliative care staff participating in the research study exclusion criteria: * patients or cgs who are unable to complete surveys, coaching sessions and participate in interviews. palliative care clinicians will determine inability to participate based on burden to patient and clinical diagnosis.
safety and efficacy of furosemide 40mg + amiloride hydrochloride 10mg to reduct edema

Conditions: Congestive Heart Failure

Summary: the study consists in two treatment groups, one group will receive diurisa® (furosemide 40 mg + amiloride chloride 10 mg) and the other one will receive furosemide 40 mg (lasix®)

general purpose 1. to comparatively evaluate the tolerability and efficacy of a fixed combination of furosemide (40 mg) and amiloride (10 mg) compared with furosemide alone, in the treatment of patients with hf functional class ii (nyha) specific purposes 1. to evaluate the effect on kalemia of the fixed combination of furosemide and amiloride compared with furosemide alone in the treatment of patients with hf functional class ii (nyha) 2. to evaluate the efficacy of the fixed combination of furosemide and amiloride in reducing edema of the llll, as compared with furosemide alone, in the treatment of patients with hf functional class ii (nyha).

Eligibility criteria:
inclusion criteria: 1. being over 18 years old 2. must be able to follow instructions and attend study visits. 3. diagnosis of chf functional class ii (nyha) without prior use of diuretics 4. women of childbearing potential who are using a reliable contraceptive method, as assessed by the principal investigator exclusion criteria: 1. any clinically significant, serious or severe medical condition (e.g., thyroid, renal or liver disorder, chronic obstructive pulmonary disease, etc.) 2. history of acute myocardial infarction (within 6 months) or decompensated coronary artery disease 3. pulmonary hypertension - pasp \> 45 mmhg 4. fasting blood glucose above 150 mg/dl 5. psychiatric or neurological disorders 6. a condition that, according to principal investigator's opinion, may interfere with the optimal study participation or which may put the patient at special risk. 7. participation in any other investigational study within 12 months before signing the icf. 8. known medical history of allergy, hypersensitivity or intolerance to any of the components of the drugs to be used in this study. 9. any medical treatment that is unrelated to the study and scheduled to the clinical trial period, except for non-serious well-controlled comorbidities which are already being followed up medically. 10. another drug scheduled to be initiated after study entry. 11. obesity - bmi \> 30 kg/m2 12. pregnancy and lactation

Keywords: chf functional class ii patients with chf patients with chf functional class ii (nyha) of any etiology
a clinical study evaluating the efficacy and safety of retinoic acid in patients with 15q11-q13 duplication syndrome

Conditions: Autism; Treatment Adherence; Retinoic Acid; Dup15Q Syndrome

Summary: autism spectrum disorders (asd), with its core symptoms of communication and repetitive behaviors, is a serious neurodevelopmental disorder common in childhood and affects about 1% of children. so far, autism remains a clinical dilemma with no effective therapy. the most common chromsomal ability among asd patients is 15q11-13q duplication syndrome(dup15q syndrome).clinical phenotypes of dup15q syndrome include autism, mental retardation, epilepsy (usually refractory epilepsy, often manifested as infantile spasm), congenital heart disease, mild facial abnormalities, etc. ube3a is one of the most important genes in the 15q11-q13 region.biochemistry and molecular biology of the chinese academy of sciences hu ronggui group found a new kind of autism in mechanisms and potential therapeutic targets - describe the ubiquitin ligase ube3a protein and retinoic acid.previous studies have shown that the basis of the relevant treatment measures can effectively relieve the mouse model of autism characteristics. therefore, retinoic acid supplementation in the treatment of dup15q syndrome is a potential therapeutic target.


Eligibility criteria:
inclusion criteria: 1. between 6 and 18 years old 2. clinical diagnosis + scale diagnosis of autism (1) clinical diagnosis: clinical diagnosis was made by 2 experienced doctors according to the medical history provided by the caregivers and the diagnostic criteria of asd in dsm-v; (2) scale diagnosis: the diagnostic assessment was conducted by highly qualified practitioners taking the ados-2 score, restricted behabior (rrb) and social affect (sa) scores. the scores were converted to standardized severity scores (css) for three diagnoses of non-spectrum disorders, autism and autism spectrum disorders. 3. genetics: 15q11-13 duplicates diagnosed by snp-array or a-cgh microarray, including ube3a gene exclusion criteria: 1. a history of acute or chronic infection within the last 3 months 2. there are still active seizures within the past 1 year 3. have taken vitamin and/or mineral supplements within the last 6 months 4. a history of chronic diseases, including abnormal liver function, abnormal kidney function, and abnormal thyroid function;
a prospective study of cabazitaxel in patients with non seminomatous germ-cell tumors

Conditions: Non-seminomatous Germ-cell Tumors

Summary: cabazitaxel is a new generation taxane with a high capacity for blood-brain barrier crossing and limited peripheral neuro-toxicity, two major potential advantages in patients with advanced nsgcts. cabazitaxel has a broader in vitro spectrum of activity than docetaxel. taxanes have demonstrated activity in pre-treated gcts and are now part of standard treatment, but cabazitaxel has not yet been tested in patients with nsgct.


Eligibility criteria:
inclusion criteria: * male patients aged 15 years or older * evidence of advanced nsgct documented either by pathology or by elevated tumor markers (afp or hcg) and a compatible clinical presentation * primary site located in either the testis, the retroperitoneum or the mediastinum * progressive disease after at least 2 lines of chemotherapy for advanced nsgct (ie, non-stage i) * in case of brain metastases, confirm that patients should be stable / controlled with corticosteroid/anti seizures agents * no other progressive carcinoma within previous the 5 years, except for basal-cell carcinoma of the skin * life expectancy \>/= 3 months * adequate hematologic function : * hemoglobin \>/= 10.0 g/dl * absolute neutrophil count \>/= 1.5 x 10 \^ 9/l, * platelet count \>/= 100 x 10 \^ 9/l, * adequate organ function * serum creatinine \ 60 ml/min * ast/sgot and alt/sgpt \</= 1.5 x uln * bilirubin \</= 1.5 x uln * information delivered to patient and informed consent form signed by the patient or his legal representative * patient affiliated to a social security system or beneficiary of the same exclusion criteria: * patients receiving anti cancer therapy within 4 weeks prior to enrolment * previous radiotherapy within 4 weeks prior to enrolment * serious uncontrolled concurrent medical illness * history of severe hypersensitivity reaction (\>/= grade 3) to polysorbate 80 containing drugs or to other taxanes * concurrent or planned treatment with strong inhibitors or strong inducers of cytochrome p450 3a4/5 (see appendix a). a one week wash-out period is necessary for patients who are already on these treatments. * patient with reproductive potential not implementing accepted and effective method of contraception for up to 6 months after the last dose of cabazitaxel. * active grade \>/= 3 peripheral neuropathy * patients who have had a major surgery within 4 last weeks prior enrolment * uncontrolled cardiac arrhythmias, angina pectoris, and/or hypertension. history of congestive heart failure (nyha iii or iv) or myocardial infarction within last 6 months is also not allowed