Kornimate/medical-research-clean huggingface dataset:
incretin physiology associated with steroid hormone treatment

Conditions: Type 2 Diabetes Mellitus; Steroids

Summary: the purpose of this study is to evaluate whether the reduced incretin effect and the paradoxical glucagon responses during oral glucose ingestion and isoglycaemic iv glucose infusion observed in patients with type 2 diabetes are causes (non-inducible in lean healthy subjects without family history of diabetes) or consequences (inducible) of the diabetic state.

the incretin effect is severely reduced in patients with type 2 diabetes. this pathophysiological trait is accompanied by an almost abolished insulinotropic effect of the incretin hormone glucose-dependent insulinotropic polypeptide (gip) and a reduced insulinotropic potency of the other incretin hormone glucagon-like peptide-1 (glp-1). furthermore, recent studies suggest that hypersecretion of glucagon during oral glucose ingestion, as opposed to a normal suppression of glucagon during isoglycaemic intravenous (iv) administered glucose, further attenuates the incretin effect in patients with type 2 diabetes. however, it remains unclear whether the severely reduced incretin effect and its accompanying pathophysiological traits characterizing patients with type 2 diabetes can be induced temporarily in healthy subjects by a short period of glucose homeostatic dysregulation. in this study the incretin effect will be measured using 50-g oral glucose tolerance test and isoglycaemic iv glucose infusion and meal test in 10 healthy caucasian subjects without family history of diabetes before and after dysregulation of glucose homeostasis using high calorie diet, physical inactivity and administration of adrenocortical steroids

Eligibility criteria:
inclusion criteria: * caucasians without type 2 or type 1 diabetes * normal ogtt (75 g of glucose) according to who criteria * normal hemoglobin * normal blood pressure exclusion criteria: * liver disease * kidney disease * relatives (parents/siblings) with type 2 diabetes * pregnancy * contra-indications to treatment with adrenocortical steroids

Keywords: incretin effect steroids glucagon-like peptide 1 gastric inhibitory peptide glucose-dependent insulinotropic polypeptide insulin c-peptide glucagon
the physiological impact of cto pci on coronary pressure measurements and correlation in donor vessel

Conditions: Acute Coronary Syndrome; Coronary Artery Disease

Summary: this study will be recording pressure wire readings from both blocked and narrowed arteries, to better guide treatment options; medications, stents or potentially bypass surgery, for patients with chronic total occlusion (cto).

the patients in this study are planned to have a percutaneous coronary intervention (pci) with recanalization of chronic total occlusion (cto) on clinical grounds alone. this study will be recording pressure wire readings from both blocked and narrowed arteries, to better guide treatment option. to date there is no data available on instantaneous wave free ratio (ifr) measurement (a pressure derived assessment of flow limitation) in patients with blocked arteries.

Eligibility criteria:
inclusion criteria: 1. age \>18 years of age 2. stable angina / ischaemic symptoms 3. evidence of viability and / or ischaemia in the chronic total occlusion (cto) territory 4. participant is willing and able to give informed consent for participation in the study 5. presence of a chronic total occlusion (cto) in rca: * duration of the occlusion \> 3 months; * thrombolysis in myocardial infarction (timi) (50) coronary flow grade 0; * spontaneously visible collaterals, rentrop classification grade 1 or 2 or 3 from contralateral donor artery 6. presence of minor to intermediate coronary stenosis (1-70 %) in the contralateral donor artery 7. eligible for pci to a chronic total occlusion (cto) exclusion criteria: 1. previous cabg with patent grafts to the interrogated donor artery 2. left main stenosis of \> 40 % 3. presence of severe flow limiting stenosis in the contralateral donor artery (typically \> 70 % stenosis) 4. haemodynamic instability at the time of intervention (heart rate \<40 beats per minute, systolic blood pressure \<90mmhg), balloon pump) 5. significant contraindication to adenosine administration (e.g. heart block, severe asthma) 6. contraindications to pci 7. severe hepatic or lung disease (chronic pulmonary obstructive disease) 8. pregnancy 9. acs within 48 hours of procedure 10. severe valvular heart disease 11. severe cardiomyopathy / infiltrative heart disease 12. egfr \< 40

Keywords: percutaneous coronary intervention (pci) chronic total occlusion (cto) cardiac mri instantaneous wave-free ratio (ifr)
management of highly active anti-retroviral therapy-related hyperlipidemia among hiv-infected patients in taiwan

Conditions: HIV

Summary: 1. written informed consent must be obtained before any study specific procedures are undertaken. 2. the process of the experiment (brief describe) the patients must come back for follow during 4 to 12 weeks after starting the new therapy. the investigators will follow the patients' lipid profile and any side effects and stop the observation till 36 months after starting the new therapy. the serum level of hiv-vl, cd4, got, gpt, triglyceride, cholesterol, hdl-cholesterol, and ldl-cholesterol will be checked every 3 months. the patients' chart and all data will be delinked to protect the patients' right and privacy.


Eligibility criteria:
inclusion criteria: * hiv-infected patients who receive haart therapy but have metabolic side effects. * age over 20 years old exclusion criteria: * abnormal liver function: got or gpt 5 times over normal upper limit
atopy network - comprehensive allergy centers: medical care of patients with moderate to severe allergic diseases

Conditions: Atopic Disorders

Summary: the atopy registry aims to assess data about atopic disorders and their medical care in a standardized form. with this, the comparative efficacy, tolerability and safety of systemic therapies for atopic disorders should be investigated. an optional additional module "bioanalytic" shall provide insights into further connections regarding immunology, genetics and microbiome.

the prevalence of atopic disorders increased in the western countries within the past decades. atopic disorders are among others: food allergy, atopic dermatitis, allergic rhinitis, bronchial asthma, chronic spontaneous urticaria, eosinophilic esophagitis and chronic rhinosinusitis with nasal polyposis. seriously affected patients often have coexisting atopic disorders. in fact, 60-75% of the patients with a severe atopic dermatitis also suffer from an allergic rhinoconjunctivitis and 40-50% from bronchial asthma. this leads to a decreased quality of life (lg) especially in seriously affected patients. the treatment of atopic disorders is not standardized yet. the atopy registry should promote the creation of a germany-wide registry for different atopic disorders.furthermore, the registry should characterize the medical care of patients with atopic disorders (patient satisfaction, therapy order, treatment success). this study serves as a longterm observation und is designed to compare different systemic therapies, since head-to-head studies regarding the efficacy are still missing. the analysis of biomaterial is involved to state possible correlations between endotype and phenotype.

Eligibility criteria:
inclusion criteria: * patients are at least 6 years old * patients with a proven moderate to severe atopic disorder who are planned to receive a biologic systemic therapy * at least one additional proven atopic disorder exclusion criteria: * \<2 atopic disorders * poor compliance * pregnancy or breastfeeding
ondansetron versus dexamethasone/ondansetron to treat acute nausea in the emergency department

Conditions: Nausea; Abdominal Pain

Summary: nausea is a common complaint in patients who present to the emergency department (ed). although the number of conditions that can present with nausea are numerous, the mainstay of treatment has become intravenous ondansetron (zofran), not only due to its rapid onset but also its availability. one of the major drawbacks to using this form is that it often needs to be redosed. this study aims to compare intravenous (iv) ondansetron alone versus iv ondansetron given with iv dexamethasone (decadron) as another viable option when treating patients with nausea in the emergency department. previous studies in patients undergoing surgical procedures have shown that when iv dexamethasone is given with iv ondansetron to post-operative patients they have less nausea and vomiting than ondansetron alone, and were even found to show decreased post-operative pain associated with nausea. it has also been shown to decrease the need to re-dose antiemetic medication. although this combination has not been tested in the emergency department it is believed by these investigators that the additional use of dexamethasone may decrease the need to use repeated doses of ondansetron. the investigators believe this may change the way physicians currently approach the nauseated patient in regards to treatment. that rather than possibly giving multiple doses of one medication over and over to reduce a patient's nausea, physicians can give two medications together at one time. the investigators hope to demonstrate that by giving intravenous dexamethasone and ondansetron together, it may be possible to reduce the number of patients who need additional doses of nausea medication.

nausea is a common complaint in patients who present to the emergency department (ed). although the number of conditions that can present with nausea are numerous, the mainstay of treatment has become intravenous ondansetron (zofran), not only due to its rapid onset but also its availability. one of the major drawbacks to using this form is that it often needs to be redosed. this study aims to compare intravenous (iv) ondansetron alone versus iv ondansetron given with iv dexamethasone (decadron) as another viable option when treating patients with nausea in the emergency department.

Eligibility criteria:
inclusion criteria: * chief complaint of nausea or abdominal pain with nausea * inability to tolerate oral nausea medication * patients with a negative pregnancy test exclusion criteria: * patients younger than 18 years of age * patient's chief complaint includes headache, chest pain, or dizziness * patients with whom there are contraindications to using the studied medicine (allergies, known adrenal disease) * blood sugar greater than 300 * non-english speaking subjects

Keywords: ondansetron dexamethasone
national multicenter registry for pediatric end-stage heart failure in china

Conditions: Heart Failure; Children

Summary: to establish a multicenter pediatric end-stage heart failure (eshf) specialized disease data platform and promote its adoption across major children's medical centers nationwide. based on this platform, conduct a national multicenter cohort study on specialized treatments for pediatric eshf (including pharmacotherapy, ventricular assist devices, heart transplantation, etc.). this initiative will provide a foundational platform for advancing national clinical research on pediatric end-stage heart failure.


Eligibility criteria:
inclusion criteria: patients who meet any of the following criteria despite receiving optimal guideline-directed medical therapy (gdmt): severe and persistent heart failure symptoms \[new york heart association (nyha) class iii (advanced) or iv\]; significant cardiac dysfunction, defined as: left ventricular ejection fraction ≤30% isolated right ventricular failure non-operable severe valvular or congenital abnormalities persistently elevated b-type natriuretic peptide (bnp) or n-terminal pro-bnp (nt-probnp) levels severe diastolic dysfunction or left ventricular structural abnormalities (based on esc definitions for heart failure with preserved ejection fraction \[hfpef\] and heart failure with mildly reduced ejection fraction \[hfmref\]); requirement of: high-dose intravenous diuretics (or combination diuretic therapy) for pulmonary/systemic congestion, or inotropic/vasoactive agents for low cardiac output, or management of malignant arrhythmias resulting in \>1 unplanned hospital visits or admissions within the past 12 months; severely impaired mobility due to cardiac causes with either: inability to ambulate, or 6-minute walk distance \<300 m, or peak oxygen consumption (pvo₂) \<12-14 ml/kg/min. - exclusion criteria: concurrent life-limiting systemic disorders structural cardiac lesions with indication for surgical/interventional correction -

Keywords: end-stage heart failure pediatric
serum potassium as a predictor of clinical outcomes in an older patient cohort with chronic postsurgical pain

Conditions: Potassium, Decreased Level; Postsurgical Pain, Chronic

Summary: perioperative serum potassium in patients over 65 impacts recovery, quality of life and physical functioning. while perioperative serum potassium is an important preoperative risk factor for poor surgical outcomes in older adults, the relationship between perioperative serum potassium and postsurgical pain in this population has not been investigated. the investigators hypothesized that preoperative serum potassium would be associated with greater odds of postsurgical chronic pain.

this study is a secondary interim analysis of 'perioperative database of chinese elderly patients,' an ongoing prospective observational cohort study that began in 2020 at the muti-center in china with the primary aim of complications in older adults before and after surgery. the investigators described the demographics, comorbidities, and assessment scores as n (percentage) or mean (sd), as appropriate. unadjusted bivariate analyses included t-test or χ2 test to compare differences between minimal pain and intrusive pain at 3 months after surgery based on demographics, preoperative status, baseline pain status and perioperative serum potassium. the investigators then created a logistic regression model with the outcome of persistent pain at 3 months after surgery and serum potassiumas the main predictor, adjusting for baseline pain, surgery type and surgery part and frailty status based on the hypothesis and association. the investigators also tested for the interaction between baseline pain and serum potassiumas.

Eligibility criteria:
inclusion criteria: * geriatric surgical patients ≥65 years old * diagnosis of chronic postsurgical pain (cpsp) cpsp was made based on the guidelines of the international society for pain (cpsp: icd-11) as follows: chronic postsurgical pain is chronic pain developing or increasing in intensity after a surgical procedure and persisting beyond the healing process, i.e. at least 3 months after surgery. the pain is either localised to the surgical field, projected to the innervation territory of a nerve situated in this area, or referred to a dermatome (after surgery/injury to deep somatic or visceral tissues). other causes of pain including infection, malignancy etc. need to be excluded as well as pain continuing from a pre-existing pain problem. dependent on type of surgery, chronic postsurgical pain often may be neuropathic pain. exclusion criteria: * patients in the central nervous system group were excluded from cardiac and neurosurgery, patients in the heart injury group were excluded from cardiac surgery. * patients who did not agree to participate in the study were excluded in all groups.

Keywords: elderly chronic postsurgical pain risk factors serum potassium
metronomic versus conventional chemotherapy in as maintenance treatment in mcrc

Conditions: Colorectal Cancer

Summary: the optimum regimen of maintenance treatment after first-line chemotherapy in patients with metastatic colorectal cancer (mcrc) is unknown. this study was designed to determine the efficacy and safety of maintenance treatment with capecitabine metronomic chemotherapy versus conventional chemotherapy.

in this prospective, open-label, randomised controlled trial, the investigators will recruit 250 mcrc patients who have finished 18 to 24 weeks first-line chemotherapy and disease evaluation is sd, pr or cr. then, the patients will be randomised into two group. the experimental group, capecitabine metronomic chemotherapy versus capecitabine conventional chemotherapy as control group. these treatment regimens will be continued until progression, death, or an unacceptable adverse event. the primary endpoint is progression-free survival (pfs). secondary endpoints are overall survival (os), quality of life (qol) and toxic effects.

Eligibility criteria:
inclusion criteria: * histological proof of colorectal cancer (in case of a single metastasis, histological or cytological proof of this lesion should be obtained); * distant metastases (patients with only local recurrence are not eligible); * unidimensionally measurable disease (\> 1 cm on spiral ct scan or \> 2 cm on chest x-ray; liver ultrasound is not allowed). serum cea may not be used as a parameter for disease evaluation; * in case of previous radiotherapy, at least one measurable lesion should be located outside the irradiated field. exclusion criteria: * prior adjuvant treatment for stage ii/iii colorectal cancer ending within 6 months before the start of induction treatment; * any prior adjuvant treatment after resection of distant metastases; * previous systemic treatment for advanced disease.
examining the role of tolerance on dose-dependent effects of acute thc on oculomotor and cognitive performance

Conditions: Cannabis Use; Impaired Driving; Cognitive Impairment

Summary: the purpose of this research is to determine the extent to which oculomotor function accurately detects thc-impairment, if cannabis use experience impacts this detection threshold, and to examine how the oculomotor index corresponds to a measure of sustained attention. a double-blind, placebo-controlled, within-subjects crossover design will be used to examine the dose-effects of thc (0, 5mg, 30mg) on oculomotor performance tasks and a sustained attention task in frequent and infrequent cannabis users. results from the study will advance the investigators' understanding of the effect of thc and cannabis use frequency on oculomotor function and sustained attention, and will directly inform the validity of the investigators' oculomotor platform for identifying acute thc- induced impairment in frequent and infrequent users.


Eligibility criteria:
inclusion criteria: * inclusion criteria: healthy non-treatment seeking adults (age 18 to 60, n = 40) who report * (a) infrequent cannabis use defined as at least one reported use in the past year with a negative thc urine toxicology at baseline, or * (b) report frequent cannabis use defined as \> 5 days per week for \> 1 year with a positive thc urine toxicology at baseline. these criteria were selected to target individuals with low and high-frequency cannabis use in order to examine the direct effect of tolerance on study outcome measures. exclusion criteria: * (1) meet dsm-v criteria for substance use disorders other than tobacco, cannabis, or caffeine, * (2) are currently receiving or interested in immediately receiving behavioral treatment or medication for cannabis cessation, * (3) current use of any medications that could affect study outcomes, * (4) test positive for drugs of abuse (other than cannabis) and/or breath alcohol test at study admission, * (5) have a current physical or mental illness judged by the study team to negatively impact participant safety or scientific integrity, * (6) are currently pregnant, planning to become pregnant in the next three months or are currently breastfeeding, * (7) have a history of clinically significant cardiac arrhythmias or vasospastic disease (e.g. prinzmetal's angina), or (8) are currently enrolled in another clinical trial or have received any drug as part of a research study within 30 days of study participation.

Keywords: cannabis thc impairment
e-bike versus classic bike intervention trial

Conditions: Physical Activity; Obesity

Summary: the effects of active commuting with an e-bike, as compared with a "classic" bike, on cardiorespiratory fitness and vascular health are largely unknown. to assess whether active commuting with an e-bike or a classic bike increases peak oxygen consumption (vo2peak) in untrained and overweight individuals.

riding an electrically assisted bicycle (e-bike) is thought to be suitable to increase physical activity in daily life, to promote health, and to increase cardiorespiratory fitness in normal-weight individuals. the positive effect of commuting to work by a normal bike on cardiorespiratory fitness has been shown to be an important predictor of cardiovascular mortality in previous studies. we thought to improve maximal oxygen uptake by commuting to work by e-bike vs. classic bike. besides cardiorespiratory fitness we assessed arterial stiffness as brachial-ankle pulse wave velocity as an independent predictor of cardiovascular events and all-cause mortality.

Eligibility criteria:
inclusion criteria: body mass index 25-35 kg/m2, and willingness to commute to work by e-bike or by normal bike at least 3 times per week with a one-way distance of ≥ 6 km. exclusion criteria: cycling as a leisure-time activity, active commuting to work or exercise training more than once per week within 4 weeks before the start of the study, uncontrolled cardiovascular diseases limiting cardiorespiratory fitness, stage ii arterial hypertension (systolic blood pressure \> 160 mmhg, diastolic blood pressure \> 95 mmhg), renal diseases, uncontrolled diabetes mellitus (hba1c \> 6.5%), or active malignancy or chemotherapy during the past 6 months.
comparison of two ventilation methods for micro-laryngeal surgery

Conditions: Laryngeal Disease

Summary: single-center, randomized study, comparing two methods of oxygenation on 80 patients

this study is a single-center, randomized study, comparing two methods of oxygenation during micro-laryngeal surgery performed under general anesthesia and myorelaxation: high-flow nasal oxygen therapy (hfno) or flow controlled ventilation (fcv) using a laryngeal tri-tube. the study population will be composed of 80 patients, aged over 18 and under 80.

Eligibility criteria:
inclusion criteria: * patient over the age of 18 and under the age of 80 * patient to benefit from micro-laryngeal ent surgery under general anesthesia and myorelaxation with an estimated duration which does not exceed 30 minutes * having signed a consent form * being affiliated with a health insurance plan. exclusion criteria: * pregnant or lactating patient * patient with a weight \<40 kg * obese patient (bmi\> 30) * patient with foreseeable intubation difficulty * patient maintained under general anesthesia postoperatively * surgery requiring time by surgical laser * surgery involving the use of an active electrosurgical electrode in the immediate area of the electrosurgical device or electrode * predictable surgery longer than 30 minutes * being deprived of liberty or under guardianship.