Kornimate/medical-research-clean huggingface dataset:
level of expression and prognostic value of cxcl4, cxcl4l1 and cxcr3 in renal cell carcinoma

Conditions: Carcinoma; Carcinoma Renal Cell; Kidney Neoplasms; Kidney Diseases; Chemokines

Summary: despite novel treatment options, renal cell carcinoma (rcc) has been characterized by a constant increase in its mortality and consequently requires an important involvement in translational research. the aim of this study is to evaluate the interest of cxcl4, cxcl4l1 and cxcr3 as biomarkers in localized, locally advanced or metastatic rcc. indeed these chemokines have shown anti-angiogenic and anti-tumor properties in experimental models and may be particularly interesting for prognostic and predictive purposes.

based on a physiopathological rationale, the use of rcc-directed antiangiogenic therapies into clinical practice leads to conclusive results and makes rcc a particularly well-suited tumor type to study factors involved in the angiogenic process. furthermore the intensive use of targeted therapies in clinical practice raised new questions about their management. therefore the identification of new molecular biomarkers is important: * to improve the precision of prognostic models currently based on clinical, biological or histopathological variables * to identify high risk patients that could benefit from an adjuvant treatment or a closer postoperative follow-up * to predict the response to antiangiogenic therapies and therefore identify the drug which is likely to be the most effective within an ever increasing pharmacopeia * to follow the therapy as precisely as possible, predict or attest the disease progression justifying a therapeutic modification low cxcl4, cxcl4l1 and cxcr3 tumor expression levels are associated with bad prognosis factors in rcc. consequently their interest in rcc is worth being evaluated, in two subgroups : localized / locally advanced renal cell carcinoma and metastatic renal cell carcinoma.

Eligibility criteria:
inclusion criteria: * patients diagnosed with localized, locally advanced or metastatic renal cell carcinoma : * having a radical or partial nephrectomy * or treated by rcc-directed targeted therapy * patients who have signed and dated an informed consent form with the investigator exclusion criteria: * under 18 years old

Keywords: renal cell carcinoma nephrectomy antiangiogenics chemokines prognostic value carcinoma carcinoma, renal cell kidney neoplasms kidney diseases neoplasms, glandular and epithelial neoplasms by histologic type neoplasms adenocarcinoma urologic neoplasms urogenital neoplasms neoplasms by site urologic diseases adjuvants, immunologic physiological effects of drugs pharmacologic actions biomarkers targeted therapies surgery
assessment of hemodynamic response in surgery of circumcision in children

Conditions: Children Who Need Circumcision

Summary: the surgery stress relives systemic inflammatory response by hormones and adrenergic receptors. when the pro-inflammatory mediator is higher than anti-inflammatory response, the physiologic status is impaired and the patient is more susceptible an infection and cardiovascular collapse. the anesthesia can abolish or minimize the surgery stress, improved more safety to the patient. this study is a double blind controlled trial with 40 patients divided in two groups (emla and dorsal penile nerve block - dpnb) submitted a standard inhalator anesthesia and postectomy surgery by plastbell®. the investigators will be observe heart rate, respiratory rate, arterial pressure, involuntary movements during the surgery and pain in the pos-operatory. with this study, the investigators can define what tactic (emla or dpnb) associated a general anesthesia is more effective to relive the pain when children are submitted a postectomy by plastbell®.


Eligibility criteria:
inclusion criteria: asa status physical 1 children between 3 and 13 years old exclusion criteria: * parents don't accept the study classic circumcision

Keywords: dpnb, pain, hemodynamics effects, circumcision
a retrospective cohort study on primary cutaneous amyloidosis

Conditions: Primary Cutaneous Amyloidosis

Summary: the aim of this clinical trial is to find out whether the combination of tocilizumab tablets and acitretin capsules is more effective than acitretin capsules alone in treating primary cutaneous amyloidosis. it will also investigate the safety of the combination of tocilizumab tablets and acitretin capsules. the main questions it aims to answer are: 1. does the combination of tocilizumab tablets and acitretin capsules relieve the pruritus symptoms of the participants faster and reduce the pruritus score more than acitretin capsules alone? 2. what medical problems will the participants encounter when taking tocilizumab tablets combined with acitretin capsules? the researchers compared the combination of tocilizumab tablets and acitretin capsules with acitretin capsules alone to see if the combination could better treat primary cutaneous amyloidosis without causing serious adverse reactions. participants will: 1. take the combination of tocilizumab tablets and acitretin capsules or acitretin capsules alone every day for 16 weeks. 2. visit the clinic once every 4 weeks for checkups and tests. 3. observe participants at 4 weeks, 12 weeks and 24 weeks after discontinuation of medication to determine the recurrence status. 4. collect the visual analogue scale (vas) scores for pruritus, symptom severity (scorad) scores , rash area and severity, treatment response (easi) scores, dermatological quality of life index (dlqi), and insomnia severity index (isi) of participants before and after treatment.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years old, without infectious diseases such as "hepatitis b" and "tuberculosis" and major underlying diseases (gender not limited); * "outpatient diagnosis" includes "primary cutaneous amyloidosis", "macular amyloidosis" or "lichen amyloidosis"; * visited the outpatient department for pca treatment for 4 times or more; * the medication record shows "avastin capsules" and/or "tofacitinib citrate"; * the medical record fully records baseline characteristics, medication dosage, efficacy assessment and adverse events. exclusion criteria: * nodular amyloidosis or combined with other types of amyloidosis (such as systemic amyloidosis); * during the study period, other immunosuppressants (such as glucocorticoids, methotrexate) or biologics were used; * incomplete medical records such as demographic data, laboratory parameters, prescription administration and patient prognosis, as well as irregular treatment, etc.
care: cancer risk perception and women of color

Conditions: Breast Carcinoma

Summary: this study examines patient understanding of current and lifetime risk for breast cancer in women of color from diverse racial and ethnic backgrounds.

primary objectives: i. examine the association between bc risk factors and bc risk perceptions among younger black and hispanic women and explore differences in associations by race and ethnicity (black hispanic, black, hispanic). ii. explore how younger black and hispanic women conceptualize and formulate their risk for bc and to explore the relationship between risk perceptions and risk-reduction strategies. outline: this is an observational study. patients complete a survey and may participate in an interview on study.

Eligibility criteria:
inclusion criteria: * self-identify as female * between the ages of 18 and 50 * no medical history of breast cancer exclusion criteria: * unable to understand or comprehend english or spanish
an assessment on current outcomes of peritoneal dialysis in korea

Conditions: Kidney Failure, Chronic

Summary: in this study, the recent trends in outcomes according to the dialysis modality in korea since 2009, the effect of the use of peritoneal dialysis solutions containing icodextrin or high-glucose on various outcomes, the usefulness of 'pd first strategy', and the economic burden according to the dialysis modality will be investigated retrospectively using the korean health insurance review and assessment service (hira) database.

this study is designed as an observational and retrospective cohort study, thus there will be no intervention or specified prescription. for the comparison of outcomes according to dialysis modality, we will adopt an intention-to-treat analysis, and consider the dialysis modality at day 90 to be the initial dialysis modality. however, the investigators will also regard the dialysis modality at day 30 as the initial dialysis modality in order to evaluate and compare earlier mortality.

Eligibility criteria:
inclusion criteria: * patients who started dialysis during the study period and remained on the dialysis therapy for at least 90 days exclusion criteria: * patients who were younger than 18 years of age * patients who survived for less than 90 days from the date of dialysis initiation

Keywords: hemodialysis peritoneal dialysis
safety and efficacy of early treatment with deferiprone in infants and young children

Conditions: Beta Thalassemia Major Anemia; Iron Overload

Summary: this study is looking at the effects of giving early treatment of deferiprone to young children with beta thalassemia who have started receiving regular blood transfusions but have not yet reached the criteria for starting on iron chelation therapy. half the patients in the study will receive deferiprone, and the other half will receive placebo, for up to 12 months.

this study will give deferiprone to infants and young children with thalassemia who have started receiving regular blood transfusions but whose iron load is not yet at the level where chelation treatment would normally begin. the purpose is to see if doing this will postpone the build-up of iron without causing serious side effects. half the children in the study will be given deferiprone at a dose that is lower than what is normally prescribed, and the other half will be given placebo. all patients will receive the assigned product three times a day for up to 12 months. tests for signs of iron overload will be done monthly, and a patient whose iron load reaches the level where chelation therapy would normally begin will be immediately taken out of the study and started on standard chelation therapy.

Eligibility criteria:
inclusion criteria: 1. male or female aged ≥ 6 months to \< 10 years 2. confirmed diagnosis of beta-thalassemia, as determined by high performance liquid chromatography (hplc) or dna testing 3. started on a red blood cell (rbc) transfusion regimen, with a minimum of 2 transfusions already completed 4. screening level of serum ferritin (sf) greater than \>200 μg/l but not more than 600 μg/l. since sf level may be impacted by the presence of infection, it must additionally be verified that the child has had no signs of infection in the previous 7 days, including the day of screening, and that the level of c-reactive protein (crp) is no greater than 20% higher than the normal range for the patient's age. if there are signs of infection and/or the crp level is above this threshold, the sf level must be checked again a minimum of one week later. exclusion criteria: 1. prior use of iron chelation 2. diagnosis of hepatitis b or c, or hiv infection 3. evidence of abnormal liver or kidney function at screening: serum alanine transaminase (alt) level \> 5 times upper limit of normal or creatinine levels \>2 times upper limit of normal 4. disorders associated with neutropenia (absolute neutrophil count \< 1.5 x 10\^9/l) prior to the initiation of study medication 5. a serious, unstable illness, as judged by the investigator, during the previous 3 months before screening/baseline visit including but not limited to hepatic, renal, gastro-enterologic, respiratory, cardiovascular, endocrinologic, neurologic or immunologic disease. 6. presence of any medical condition which in the opinion of the investigator would cause participation in the study to be unwise.

Keywords: thalassemia iron overload chelation deferiprone ferriprox
trendelenburg study

Conditions: Comparison of Non-invasive Monitors of Cardiac Function

Summary: 1) observe the hemodynamic and cardiovascular changes associated with the change from the supine to the steep trendelenburg position, 2) observe the hemodynamic and cardiovascular changes during intra-abdominal insufflation used during laparoscopic surgical procedures.

this is a single site, prospective, non-blinded, non-randomized, non-interventional study designed to evaluate the hemodynamic and cardiovascular effects of the steep trendelenburg position on non-invasive or minimally invasive monitors used in the operating room during surgical procedures requiring this patient position. specific aims: 1) observe the hemodynamic and cardiovascular changes associated with the change from the supine to the steep trendelenburg position. 2) observe the hemodynamic and cardiovascular changes during intra-abdominal insufflation used during laparoscopic surgical procedures. hypothesis: hemodynamic and cardiovascular changes during alterations in position from supine to steep trendelenburg and intra-abdominal insufflation measured by non-invasive and minimally invasive monitors will correlate with transthoracic echocardiographic measurements.

Eligibility criteria:
inclusion criteria: * scheduled for elective surgery requiring steep trendelenburg positioning. exclusion criteria: * bmi \>30. \<18 years. pregnancy. prisoners.

Keywords: nexfin flotrac esophageal cardiac output
general plus spinal anesthesia and general anesthesia alone on right ventricular function

Conditions: Right Ventricular Dysfunction

Summary: the investigator hypothesize that high spinal anesthesia (hsa) by its effect on attenuation of stress response, decrease in pulmonary vascular resistance, myocardial protection and positive myocardial oxygen balance will cause improvement in right ventricular function. so far there is no study that has evaluated the effect of hsa anesthesia on the right ventricular function, hence the investigator planned this study to compare the effect of hsa on the right ventricular function in patients with mitral valve disease with moderate to severe pulmonary hypertension planned for mitral valve replacement surgery.

all study patients will undergo routine tte and tee examination protocol followed at the investigator institution. all the other routine monitoring such as end tidal carbon dioxide, urine output, abg, act, bis, electrolytes, blood sugar, hemoglobin and ventilatory parameters etc for open heart surgery will be done as per institutional practice. in the study group, the patients will receive spinal anesthesia after placement of invasive lines and prior to induction of ga.in both the study group ga will be induced with midazolam 1-2 mg, fentanyl 2μ/kg and propofol titrated to achieve loss of consciousness. inj. vecuronium bromide 0.1mg/kg will be used as muscle relaxant to facilitate tracheal intubation and lignocaine spray (lox 10% spray, neon laboratories ltd, thane, india) will be used over vocal cords prior to intubation to blunt the sympathetic stimulation. subsequently anesthesia will be maintained in both the groups, with isoflurane inhalation to maintain bis values between 40 to 60. in control group, fentanyl infusion 1μ/kg/hr will be started for analgesia, a similar looking infusion without fentanyl will be started in the spinal group.all patients will be shifted to icu with inotropic and vasopressor support as per the hemodynamic condition.

Eligibility criteria:
inclusion criteria: * 50 consecutive patients of 18 to 60 years age, * nyha class ii or iii, * with mitral valvular disease with moderate to severe pah (mean pulmonary artery pressure \> 40 mmhg) undergoing mvr exclusion criteria: * emergency or redo surgery, patients with associated cad or other valvular heart disease, * copd, * bronchial asthma, * obesity (bmi more than 30), anticipated difficult airway, * opioid drug abuse or addiction and those with contraindication for spinal anaesthesia including local site infection, * spinal deformity, deranged coagulogram defined by platelet count \ 1.
determination of fraction size equivalent dose (fed) levels for intracranial conformal avoidance radiotherapy

Conditions: Glioma; Brain Neoplasms

Summary: the primary objective is to evaluate and quantify the reproducibility of functional magnetic resonance imaging (fmri) maps of the eloquent brain areas corresponding to specific neurological functions based on activation maps obtained with different thresholds in patients with benign and biopsy proven low-grade brain neoplasms. another objective is to access the impairment in neurological function in image guided intracranial radiotherapy using neurocognitive assessment tools and to derive dose response curves relating the impairment in a particular neurological function to the fed received by the area of eloquent brain corresponding to it.


Eligibility criteria:
inclusion criteria: * indication for brain radiotherapy. * ability to undergo mri scans and time to participate in neurocognitive testing.

Keywords: low grade gliomas and benign cns lesions
effects of the beta-blocker nebivolol (bystolic) on subjects with high normal blood pressure and/or a family history of hypertension

Conditions: Pre-hypertension; Hypertension

Summary: the investigators aim to evaluate subjects at high risk of future development of hypertension, those with a family history of hypertension and/or that already have high normal(sbp 120-139 mmhg or dbp 80-89 mmhg) blood pressure. the investigators plan to investigate whether these subjects have the same markers (such as microscopic protein in the urine or c-reactive protein in the blood) in the blood and urine that people with high blood pressure have, and whether they are improved before and after taking the beta-blocker nebivolol.


Eligibility criteria:
inclusion criteria: * • prehypertensive male and female subjects with sbp =120-139 or dbp =80-89 with at least one known family member (must be diagnosed prior to the age of 60) with essential hypertension (confirmation may be sought). * all ethnicities * non-smokers and non-drug abusers, no current smoking or illicit drug use in the prior 3 months. * aged 18-40 years * no known serious medical conditions requiring close monitoring from physicians- such as liver impairment, chronic kidney disease, or diabetes mellitus * subjects will need to remain in the san diego area for the duration of the study (10 weeks) and be accessible by telephone or email. * female subjects must be willing to use a birth control method, such as abstinence, birth control pills, diaphragm, condom, or intrauterine device to prevent pregnancy during the study. exclusion criteria: * subjects with sbp \>140 or sbp\ 90 and dbp\<80 * we will exclude subjects whose family members have known secondary etiologies for hypertension such as hyperaldosteronism or cushing's disease. * subjects cannot have a chronic medical condition that is actively treated by a physician, such as liver impairment, diabetes, or kidney disease * history of bronchial asthma or chronic obstructive pulmonary disease * subjects cannot be on any anti-hypertensive medications for any reason. * subjects may not have previous intolerance, hypersensitivity, or allergy to any beta blocker therapy or may have contraindications to beta blocker therapy such as asthma, bradycardia, etc. * subjects may not be taking medications which may affect the metabolism of nebivolol, such as those that inhibit cyp2d6 (such as fluoxetine or cimetidine) * nursing women, pregnant women, or those that plan to become pregnant in the study period will also be excluded. (pregnancy tests will be performed on all female subjects at the start of the study) * subjects with pulse rate consistently \<60 beats per minute or evidence of arrythmias including atrioventricular block. * those that have smoked or used illicit drugs within the past 3 months * female subjects that are not willing to use a birth control method, such as abstinence, birth control pills, diaphragm, condom, or intrauterine device to prevent pregnancy during the study.

Keywords: genetic risk of hypertension
patient-reported outcome after sling insertion using the incontinence outcome questionnaire (ioq)

Conditions: Stress Urinary Incontinence

Summary: midurethral tapes are by now standard procedure in the surgical treatment of women with stress urinary incontinence. while the retropubic tvt is well documented with long-term results up to 11 years and continence rates of 90 %, the published data for the transoburator tapes (to) cover follow-up of 3 years only. so far, all tapes establish continence effectively. recently, the detailed 27-item incontinence outcome questionnaire (ioq) was constructed to assess patient-reported outcome and quality of life after insertion of a midurethral tape and validated for the german language. the aim of this study was to evaluate patient-reported mid- and long-term outcome after insertion of tension-free vaginal tape (tvt), transobturator sling, outside-in (tot) and tension-free transobturator tape, inside-out (tvt-o).


Eligibility criteria:
inclusion criteria: * incontinence sling * time frame 1/1999 - 12/2007

Keywords: stress urinary incontinence retropubic sling transobturator sling tension-free vaginal tape transobturator tape tvt tvt-o tot remeex ivs
medical optimization of management of type 2 diabetes complicating pregnancy (mompod)

Conditions: Diabetes; Pregnancy

Summary: purpose: the objective of this proposal is to study the safety and efficacy of metformin added to insulin for treatment of type 2 diabetes mellitus (t2dm) among pregnant women. participants: 950 pregnant women with type 2 diabetes complicating pregnancy from 10 u.s. clinical centers procedures (methods): pregnant women with t2dm between 10 weeks and 22 weeks 6 days and a singleton fetus will be randomized to double-blinded insulin/placebo versus insulin/metformin. primary outcome is composite adverse neonatal outcome (clinically relevant hypoglycemia, birth trauma, hyperbilirubinemia, stillbirth/neonatal death). study visits monthly at clinical visits; blood draw at 24-30 weeks, newborn anthropometric measurements at less than 72 hours of life. maternal and infant outcomes will be chart abstracted.


Eligibility criteria:
inclusion criteria: * maternal age 18-45 years * singleton pregnancy with no known fetal anomalies * gestational age between 10weeks 0 days and 22 weeks 6 days by menstrual dating confirmed by ultrasound, or ultrasound alone * clinical diagnosis of preexisting t2dm requiring medical treatment (oral agent or insulin) * clinical diagnosis of diabetes diagnosed between 10 weeks and \< 20 weeks 6 days gestation * willing to start insulin therapy and discontinue oral hypoglycemic pills other than study pills * able to swallow pills exclusion criteria: * clinical diagnosis of pre-existing renal disease, defined as creatinine \> 1.5 mg/dl * clinical history of lactic acidosis * known allergy to metformin * participation in another study that could affect primary outcome * delivery planned at non-mompod study locations * unwillingness to use insulin treatment or follow prenatal care doctor's instructions for insulin and blood glucose monitoring

Keywords: metformin glucophage riomet glumetza fortamet glucophage xr