Kornimate/medical-research-clean huggingface dataset:
loxapine and weaning from ventilator

Conditions: Respiratory Insufficiency; Psychomotor Agitation

Summary: patients may be very agitated during the weaning period from mechanical ventilation. administration of loxapine, a neuroleptic that does not notably affect ventilatory drive, may help in obtaining an adequate level of cooperation and, therefore, in reducing the duration of mechanical ventilation.

mechanical ventilation is a life-saving procedure in critically ill patients. this procedure is however not devoid of risks and every effort should be made to shorten its duration. this is best accomplished by the implementation of weaning protocols. sedation (by opiates and benzodiazepines) is often required in such patients for their comfort and adaptation to the respirator. withdrawal of sedation in order to allow patients to resume spontaneous breathing may be associated with agitation and confusion that may hinder weaning. in such cases, reinstitution of heavy sedation will prolong ventilator-dependency. it may therefore be interesting to administer a neuroleptic (loxapine) with good anxiolytic properties but that does not notably interfere with spontaneous breathing ability. patients will be included when they fail a spontaneous ventilation trial (see inclusion criteria) because of marked agitation. usual simple clinical (respiratory frequency, p01 measured on the respirator, arterial pressure, cardiac rate) and biological criteria (arterial blood gas determination) and a measurement of sedation/agitation with validated scales (richmond agitation sedation scale, ramsay score) will be gathered when a patient is deemed ready for a trial of spontaneous ventilation for weaning. in cases of marked agitation according to validated scales, patients will be given a conventional dose (150 mg) of loxapine by the nasogastric tube and the efficacy of this treatment will be evaluated on the same parameters as above. demonstration of the facilitation of weaning by this simple strategy would be useful in order to reduce risks associated with mechanical ventilation.

Eligibility criteria:
inclusion criteria: * patients who are eligible for weaning from the respirator (fio2 less than 50%; positive end expiratory pressure \[peep\] level less than 6 cmh2o) * patients whose agitation (according to accepted scores) during a weaning trial precludes extubation exclusion criteria: * history of convulsions or epilepsy

Keywords: mechanical ventilation agitation difficult weaning
repetitive transcranial magnetic stimulation in patients with hemiplegic stroke

Conditions: Stroke

Summary: stroke is one of the major causes of death in the world. many stroke survivors may suffer from long-term sequelae of stroke such as hemiplegia. the effects of rehabilitation therapy are limited. the development of new treatment strategies is essential. repetitive transcranial magnetic stimulation (rtms) is a non-invasive method to stimulate the focal area of the brain for restoring brain function. the aim of this study is to investigate the therapeutic effect of rtms on the motor recovery in patients with hemiplegic stroke.


Eligibility criteria:
inclusion criteria: * stroke patients with motor weakness * medical research council (mrc) grade 0-4 * more than 2 weeks after stroke onset * age 18 years and older * able to provide consent for the protocol exclusion criteria: * history of previous symptomatic stroke * pregnant women * persons with surgically or traumatically implanted foreign bodies such as a pacemaker, an implanted medication pump, a metal plate in the skull, or metal inside the skull or eyes (other than dental appliances or fillings), intracardiac lines that may pose a physical hazard during magnetic stimulation will also be excluded * patients with history of seizure disorder or epilepsy * subjects without the capacity to give informed consent
investigation of chronic inflammatory processes in male individuals with hypohidrotic ectodermal dysplasia

Conditions: X-linked Hypohidrotic Ectodermal Dysplasia

Summary: x-linked hypohidrotic ectodermal dysplasia (xlhed) is a complex genetic disorder characterized by lack of sweat, sebaceous, submucous, meibomian and mammary glands, sparse hair and eyebrows, and oligodontia. insufficient function of the respective glands may lead to chronic inflammatory processes in airways and eyes of the affected individuals. the investigators will quantify sweat glands of xlhed patients, assess chronic conjunctivitis and blepharitis in conjunction with quantitative and/or qualitative alterations of lacrimal fluid in these subjects, evaluate lung function and assess chronic inflammatory processes in the airways by no measurements. the data should provide a basis for genotype-phenotype correlations.


Eligibility criteria:
inclusion criteria: * for patients: x-linked hypohidrotic ectodermal dysplasia caused by mutations in the gene eda * written informed consent exclusion criteria: * acute respiratory disease * acute allergic problem, e.g. allergic coryza * implantable electronic devices, e.g. pacemaker
apatinib mesylate versus standard second-line tki in the treatment of advanced gist

Conditions: Gastrointestinal Stromal Tumors

Summary: the goal of this mesylate apatinib versus standard second-line tki in the treatment of advanced gastrointestinal stromal tumors: a randomized, open, controlled, single-center clinical study is to explore the efficacy and safety of apatinib compared with second-line treatment in advanced gist patients with first-line tki failure. the main questions it aims to answer are: * to explore the efficacy and safety of apatinib compared with standard second-line treatment for gist with advanced first-line tki failure. * to explore the expression level and mvd value of vegfr2 in gist, and to explore the relationship between the expression level and the location, size, mitotic image and recurrence risk grading of gist. patients with advanced gist were randomly included in the trial group and the control group at a ratio of 1:1.

the objectives of this study were as follows: 1. to explore the efficacy and safety of apatinib compared with standard second-line treatment of advanced gist with first-line tki failure, and to provide high-level clinical evidence for the treatment of late-stage plasmatoma; 2. explore the expression level and mvd value of vegfr2 in gist, and explore the relationship between the expression level and the location, size, mitotic image and recurrence risk grading of gist.

Eligibility criteria:
inclusion criteria: 1. patients were enrolled voluntarily and signed a written informed consent with good compliance and follow-up; 2. age ≥18 years (calculated on the date of signing the informed consent) for both men and women; 3. previous first-line tki (imatinib/avatinib) therapy and eventual treatment failure (disease progression or toxicity intolerance during treatment); 4. subjects who provide pre-c-kit /pdgfra test reporting can provide 10ml blood sample and fresh or archived tumor tissue for genetic testing. 5. ecog score: 0 \~ 1; 6. predicted survival ≥12 weeks. exclusion criteria: 1. previous molecular targeted therapy other than imatinib/avatinib for the treatment of gastrointestinal stromal tumor; 2. toxicity of previous imatinib/avatinib treatment or other treatments has not recovered or reached ncictcae5.0≤ level 1; 3. patients with clinical symptoms of ascites or pleural effusion who need puncture drainage or who have received thoracic and ascites drainage within 1 month before signing informed consent, except those who only show a small amount of ascites or pleural effusion without clinical symptoms; 4. a second primary malignancy within the last 5 years, except for basal cell carcinoma, squamous cell carcinoma of the skin, or carcinoma in situ of the cervix that has been adequately treated; 5. gastrointestinal stromal tumor with central nervous system metastasis; 6. inability to swallow, chronic diarrhea and intestinal obstruction, with multiple factors affecting drug administration and absorption.

Keywords: gastrointestinal stromal tumors apatinib mesylate tyrosine kinase inhibitors
study of benznidazole transfer into breastmilk in lactating women with chagas disease

Conditions: Chagas Disease; Lactation

Summary: the investigators propose to study the transfer of benznidazole into breastmilk from the blood of lactating women who receive the drug for the treatment of chagas disease. breastmilk and blood samples will be obtained from these patients at given times after they take the clinically indicated medication, and the concentrations in both matrices will be compared to estimate degree of transfer, which in turn will be used to evaluate potential degree of exposure of infants breastfed by these women. this study will help clarify safety of continuing breastfeeding while receiving treatment with benznidazole for chagas disease.


Eligibility criteria:
inclusion criteria: * lactating women with chagas disease, not treated before * use of contraception exclusion criteria: * history of allergy to benznidazole or its excipients * pregnancy * significant heart involvement (due to chagas disease) * significant systemic diseases that could affect the interpretation of the results in the opinion of the principal investigator

Keywords: chagas disease lactation breastmilk postpartum period infants pediatric clinical pharmacology developmental clinical pharmacology parasitology trypanosoma cruzi
preoperative oestrogen in postmenopausal women with pelvic organ prolapse

Conditions: Pelvic Organ Prolapse

Summary: introduction with increasing age the incidence of pelvic organ prolapse (pop) rises and will increase substantially in the future according to forecasting studies. it is possible that oestrogens, alone or in combination with other forms of therapy, may assist in the management of pop by increasing collagen synthesis and thereby improving the strength of the weakened vaginal epithelium. yet, studies investigating the effect of topical oestrogen and its impact on pop associated symptoms, both self-reported improvement and observations of objective improvement, are lacking. objective to evaluate the subjective efficacy concerning prolapse associated complaints measured by the german pelvic floor questionnaire (domain pop: pop-score) after preoperative use of local oestrogen compared to preoperative placebo treatment in postmenopausal women with symptomatic pelvic organ prolapse. further variables of interest are pop-score after 3 months, differences regarding the objective prolapse quantification system (pop-q), surgical outcome and tissue operability assessed by the surgeon. methods in this prospective, randomized, double-blind, placebo-controlled, multicenter study the investigators aim to include 120 postmenopausal women with symptomatic pelvic organ prolapse and indicated operative procedure. an analysis of covariance will be computed with the depending variable pop-score after 6 weeks and the independent variables group (verum versus placebo) and pop-score at baseline.


Eligibility criteria:
inclusion criteria: * postmenopausal women * able to read, understand and sign informed consent * able to apply a vaginal cream * symptomatic pelvic organ prolapse with planned and indicated prolapse surgical repair exclusion criteria: * suspicion or history of breast cancer or other oestrogen responsive malignancies (endometrial cancer) * unexplained abnormal vaginal bleeding * history of deep vein thrombosis * inherited or acquired blood clotting disorders (eg, apc resistance, antithrombin iii deficiency) * transient ischaemic attack, myo- cardial infarction or ischaemic heart disease * hypersensitivity to oestrogen * unable to read and sign informed consent

Keywords: local oestrogen
trunk restraint in multiple sclerosis

Conditions: Multiple Sclerosis; Healthy Control

Summary: this study examined the effect of trunk restraint on upper extremity functionality in patients with multiple sclerosis (ms).the study included 66 ms patients over the age of 18 and 30 healthy individuals. participants' upper extremity functions were assessed. their trunks were then restrained and their upper extremity functions were assessed again. the patients' level of disability (edss), trunk control (trunk impairment scale - tis), upper extremity functionality (nine hole peg test- 9hpt), were evaluated.


Eligibility criteria:
inclusion criteria: * being over 18 years old * being diagnosed with ms * volunteering exclusion criteria: * having any additional disease or disorder of the upper extremity or trunk (such as disc herniation, fracture) * having any additional neurological disease
acute abdominal pain: evaluation of lactate value as predictive factor of surgical issue

Conditions: Abdomen, Acute; Renal Colic

Summary: abdominal pain is one of the most common reasons for consultation in emergency departments (ed) worldwide. the challenge for physicians is to not misdiagnose a surgical emergency. the actual gold standard for diagnosis is computed tomography (ct). however with this procedure there is high radiation exposure and a risk factor of radiation-induced cancers, therefore alternative diagnostic techniques should be considered. the aim of this study is to evaluate the performance of measuring venous lactate in patients presenting with acute abdominal pain in ed. in this single-center, prospective, non-interventional study, the diagnostic accuracy of venous lactate in order to detect surgical emergencies is evaluated. the hypothesis made here is that venous lactatemia is a positive predictive factor of surgical emergencies in patients with acute abdominal pain.

abdominal pain is one of the most common reasons for consultation worldwide in emergency departments (ed). the challenge for physicians is to not misdiagnose a surgical emergency. the actual gold standard for diagnosis is computed tomography (ct). however with this procedure there is high radiation exposure and a risk factor of radiation-induced cancers, therefore alternative diagnostic techniques should be considered. the aim of this study is to evaluate the diagnostic performance of measuring venous lactate in patients with acute abdominal pain in ed. a single-center, prospective, non-interventional study, will be conducted between june 2016 and january 2017 in the university emergency department of nice, france. inclusion criteria are patients aged 18 and over, suffering from abdominal pain for seven days or less and requiring a blood test to help with diagnosis. the primary outcome is to determine if the value of venous lactate is a predictive factor of emergency surgery in patients with acute abdominal pain. the secondary outcome is to determine if the "strong ion gap", first defined in "the stewart approach", is a predictive factor of emergency surgery in patients with acute abdominal pain. a blood test will be performed when patients are admitted to the ed. seven days after being admitted to the ed, patients' outcome will be assessed by consulting patients' medical records or by phone call.

Eligibility criteria:
inclusion criteria: * patients over 18 years old * patient presenting acute abdominal pain since 7 days or less * need of blood sample confirmed by physician * affiliation to french social security system * informed consent exclusion criteria: * post traumatic abdominal pain / occurrence of abdominal trauma in the 7 days before ed visit * patients with cirrhosis classified as child-pugh c

Keywords: lactate acute abdominal pain acute abdomen strong ion gap renal colic emergency department emergency surgery stewart
effectiveness of exercise in the treatment of depression

Conditions: Depression; Primary Care; Exercise

Summary: the main objective is to test the non-inferiority of supervised exercise versus antidepressant treatment in reducing depressive symptoms in patients with clinical criteria for depression (according to icd 10) over a period of 6 months follow-up.

this is a randomized clinical trial in primary care in which a total of 312 patients over 65 years with clinically significant depression will be randomly assigned to an exercise program supervised or receive treatment with antidepressant drugs commonly used in clinical practice. at baseline physical fitness of the participants will be checked, and assessments will be made after 15 days and 1, 3 and 6 months. the supervised exercise program will consist of 2 sessions per week in groups of 10-12 patients over a 6 month period in which a sports instructor will train patients to perform at least 30 minutes of regular, moderate-intensity activity with a frequency almost daily, including aerobic exercise and strength training, flexibility and balance. in both groups will be evaluated periodically, among other variables, the state of depressive symptoms, level of physical activity, self-rated health, occurrence of adverse effects and adherence to exercise program or antidepressant treatment. the main outcome measure is the reduction of the baseline score on the scales of depressive symptoms (montgomery-asberg depression rating scale and geriatric depression scale).

Eligibility criteria:
inclusion criteria: * people with depression exclusion criteria: * contraindication to exercise
traditional thai massage and brain electrical activity

Conditions: Scapulocostal Syndrome

Summary: the purpose of this study is to evaluate the immediate effect of traditional thai massage on brain electrical activity in the patients with scapulocostal syndrome


Eligibility criteria:
inclusion criteria: 1. age between 18 - 50 years old 2. the participants have experienced spontaneous scapular pain (vas ≥ 3) for longer than 12 weeks (chronic) and that at least one trigger point will be present in the scapular region (serratus posterior superior, rhomboid groups, levator scapulae and trapezius muscles). trigger points will be diagnosed as the presence of focal tenderness in a taut band and with pain recognition. 3. the participants will be able to follow instructions. 4. good communication and cooperation. exclusion criteria: 1. a history of the following diseases or disorders: * rotator cuff disease * cervical radiculopathy * degenerative shoulder joint disease * shoulder stiffness 2. contraindications of traditional thai massage * contagious skin disease * injury or inflammation of muscle * bone fracture and/or joint dislocation * open wound * uncontrolled hypertension * drug and/or alcohol intoxication
efficacy study of rapamycin- vs. zotarolimus-eluting stents to reduce coronary restenosis

Conditions: Coronary Heart Disease

Summary: the purpose of this trial is to evaluate the efficacy of rapamycin- and zotarolimus-eluting stents for the reduction of coronary restenosis

this prospective, randomized trial will compare the efficacy and safety of a rapamycin plus probucol-eluting stent with a polymer based zotarolimus-eluting stent. patients with symptomatic coronary artery disease without cardiogenic shock who will undergo coronary angiography and willing to participate in the trial will receive a loading dose of 600mg clopidogrel at least 2 hours before the procedure. they will be randomized to receive one of the above mentioned stents.

Eligibility criteria:
inclusion criteria: * patients older than age 18 with ischemic symptoms or evidence of myocardial ischemia in the presence of ≥ 50% de novo stenosis located in native coronary vessels * written, informed consent by the patient or her/his legally-authorized representative for participation in the study * in women with childbearing potential a negative pregnancy test is mandatory. exclusion criteria: * target lesion located in the left main trunk. * target lesion located in the bypass graft. * in-stent restenosis. * cardiogenic shock. * malignancies or other comorbid conditions (for example severe liver, renal and pancreatic disease) with life expectancy less than 12 months or that may result in protocol non-compliance. * known allergy to the study medications: clopidogrel, rapamycin, probucol, zotarolimus, stainless steel or cobalt chrome. * inability to take clopidogrel for at least 6 months. * pregnancy (present, suspected or planned) or positive pregnancy test. * previous enrollment in this trial. * patient's inability to fully cooperate with the study protocol.
intra-arterial neuroprotective strategy for ischemic stroke patients with endovascular therapy (insist-et)

Conditions: Stroke, Ischemic; Intravascular Thrombosis; Mechanical Thrombectomy

Summary: to explore the safety and feasibility of intra-arterial neuroprotective strategy in acute ischemic stroke patients who received recanalization operation.


Eligibility criteria:
inclusion criteria: 1. age ≥18 years; 2. acute ischemic stroke patients who is eligible for endovascular treatment; 3. signed informed consent. exclusion criteria: 1. modified rankin score \>2 caused by a history of prior stroke; 2. coagulation disorders, systematic hemorrhagic tendency, thrombocytopenia (\<80000/mm3); 3. severe hepatic or renal dysfunction, increase in alt or ast (more than 2 times of upper limit of normal value), increase in serum creatinine (more than 1.5 times of upper limit of normal value) or requiring dialysis; 4. severe hypertension (systolic blood pressure over 200mmhg or diastolic blood pressure over 110 mmhg); 5. unsuitable for this clinical studies assessed by researcher.
a prospective assessment of loss of grip strength by baseline bmi in breast cancer patients receiving adjuvant aromatase inhibitors and tamoxifen

Conditions: Breast Cancer; Arthralgia

Summary: the logribmet study is a prospective study that evaluate grip strength changes in both hands of postmenopausal women with breast cancer receiving treatment with tamoxifen or an aromatase inhibitor. patients included in the study will undergo a grip strength measurement and receive a rheumatological questionnaire prior to the start of treatment, then at 3 and 6 months and at year 1 into therapy. furthermore, bmi will be measured to assess if bmi is a predictor for the decrease in grip strength. igf-i, gh and igfbp-3 serum levels will also be measured at all time points.


Eligibility criteria:
inclusion criteria: 1. patients with early breast cancer who are scheduled to receive endocrine therapy with tamoxifen or any of the third-generation aromatase inhibitors, anastrozole, letrozole or exemestane. 2. no major rheumatological disorders such as severe rheumatoid arthritis. 3. patients must have provided informed consent for participation in this study. exclusion criteria: 1. concomitant endocrine therapy for breast cancer. 2. concomitant intake of sex hormone containing drugs such as hormone replacement therapy.

Keywords: breast cancer postmenopausal aromatase inhibitors tamoxifen arthralgia igf-i bmi grip strength