Kornimate/medical-research-clean huggingface dataset:
atrial fibrillation incidence, risk factors and genetics

Conditions: Atrial Fibrillation; Cardiovascular Diseases; Heart Diseases; Hypertension; Cerebrovascular Accident; Arrhythmia

Summary: to assess the risk of incident atrial fibrillation after stopping anti-hypertensive medication including beta-blockers and ace inhibitors. also, to assess the role of genetics in subsequent risk of stroke among patients with atrial fibrillation.

background: prevention and treatment of atrial fibrillation (af) is a significant public health issue. atrial fibrillation affects 9 percent of persons aged 80 to 89. it is associated with elevated risk of stroke and death. the condition is likely to increase as survival rates from myocardial infarction continue to improve, prevalence of congestive heart failure grows, and treatment approaches evolve. the study will assess the safety of commonly used medications in relation to the risk of incident atrial fibrillation, and will assess the association of several genetic polymorphisms with stroke risk after af onset. several lines of evidence suggest that both beta-blockers and ace inhibitors may prevent or inhibit the atrial electrical remodeling that allows af to become established and maintained. withdrawal of these medications may be associated with increased risk of af in individuals at risk. genetic polymorphisms that promote thrombosis are associated with an increased risk of venous thrombosis, and in some studies, with arterial thrombosis including stroke or myocardial infarction. although several recently published trials indicate that warfarin or aspirin treatment of patients with af decreases the risk of stroke, little is known about the risk of stroke as a complication of af in relation to genetic variants that affect clotting. design narrative: the main tasks of the case-control study are: 1) identification of cases with incident af and controls; 2) review of outpatient and inpatient medical records to assess eligibility and collect information on risk factors and medical history; 3) classification of medication use over time; 4) for af patients, telephone interview and collection of blood samples; 5) blood specimen processing, dna extraction, and genotyping; and 6) data analysis of the associations of medication use and genotype with af onset and stroke complications.

Eligibility criteria:
no eligibility criteria
imaging and biomarkers of hypoxia in solid tumors

Conditions: Neoplasms

Summary: hypoxia, meaning a lack of oxygen, has been associated strongly with a wide range of human cancers. hypoxia occurs when tumor growth exceeds the ability of blood vessels to supply the tumor with oxygenated blood. it is currently understood that hypoxic tumors are more aggressive. current methods for measuring hypoxia include invasive procedures such as tissue biopsy, or insertion of an electrode into the tumor. ef5-pet may be a non-invasive way to measure tumor hypoxia.

to establish pet imaging with the tracer ef5 as an accurate and reliable method for measuring the oxygen content of a tumor and to establish the measurement of secreted markers in blood as an accurate and reliable method for measuring the oxygen content of a tumor.

Eligibility criteria:
inclusion criteria * any solid tumor malignancies of any stage meeting all of the following criteria: minimum tumor dimension is at least 1 cm (to ensure it is above the detection threshold of pet imaging). examples include but are not limited to: locally advanced squamous cell carcinoma of the head and neck to be treated by either initial surgery or primary chemoradiotherapy; inoperable non-small cell lung cancer or pancreatic carcinoma to be treated with stereotactic radiotherapy, which may be biopsied again at the time of percutaneous needle delivery of implanted fiducial markers. * patients with newly diagnosed malignancies should not have initiated treatment for their disease before participating in this study. patients with recurrent or second malignancies may have had prior therapy as appropriate for their disease, but should have completed all prior treatment at least 30 days before participation in this study and should not have initiated new treatment for the current problem. * greater than or equal to eighteen years of age. * sufficiently healthy to tolerate all study procedures. * organ and marrow function sufficient to undergo planned therapy. * ability to understand and the willingness to sign a written informed consent document. exclusion criteria • pregnant or nursing
median sternotomy in penetrating cardiac trauma

Conditions: Trauma Chest

Summary: the investigators aim to assess role of median sternotomy in penetrating cardiac trauma regarding morbidity and mortality of the patients.

cardiac trauma is a leading cause of death in the usa and occurs mostly due to motor vehicle accidents. cardiac trauma may be blunt or as a penetrating chest injuries, and both can lead to aortic injuries. the right ventricle followed by the left ventricle was the most common site of injury. timely diagnosis and early management are the key to improve mortality. mortality related to cardiac trauma remains high despite improvement in diagnosis and management. assessment of suspected cardiac injuries in a trauma setting is a challenging and time-critical matter, with clinical and imaging findings having complementary roles in the formation of an accurate diagnosis. cardiac computed tomography and cardiac ultrasound are the two most important diagnostic modalities. pericardial tamponade and haemothorax were common intra-operative findings. patients having penetrating cardiac injury presenting with detectable signs of life on arrival to the hospital can be rescued by early surgical intervention. penetrating cardiac injuries are high-risk, high-mortality injuries considering the outcomes. therefore, it is important to choose the appropriate incision. in general clinical settings, thoracotomy and median sternotomy are choices of incisions to explore the injury. it is really important to transfer these patients to the nearest facility in time, make sure they get immediate diagnosis and proper resuscitation until they are ready to be taken into the operating room for exploration.

Eligibility criteria:
inclusion criteria: * a. inclusion criteria: penetrating traumatic cardiac patients. b.age:patients aged from15 to 60 years old. exclusion criteria: * patient who arrest immediately when arrived trauma unit. * patients with polytrauma * patients with chronic medical disease as asthma or ischemic herat disease
preliminary study examining heart failure patients responses to depression education

Conditions: Chronic Heart Failure

Summary: purpose of the study: the significant impact of depression on the poor prognosis and functional restrain, recognition and successful treatment of depression in patients with chronic heart failure (chf) may result in improvement of overall outcome of those patients. however, depression comorbid with chf has been overlooked in the real practice. therefore, the investigators are proposing a study to 1) assess the prognostic impact of depression in patients with stable chf who have been managed as outpatients, and 2) assess whether provision of depression education to chf patients will improve the care of depression. patients with chronic heart failure are enrolled into this study with a half of them are randomly assigned to receive a packet of depression education materials and then other half not. participants and investigators both are blinded to the assignment. all the participants are provided a toll free phone number to contact the research team as needed. depressive symptoms and patients knowledge of depression are assessed at baseline prior to randomization and at 1-month and 6-month following the enrollment. responses of the study participants, such as change of depressive symptoms, and requests for psychiatric help are examined between two groups.


Eligibility criteria:
inclusion criteria: inclusion criteria * lvef ≤ 35%. * nyha class ii, iii, or iv heart failure for the previous three months despite a minimum of 6 weeks of treatment. * must be on optimal heart failure therapy according to aha/acc and hfsa heart failure guidelines, including treatment with acei and beta-blocker therapy, or have documented rationale for variation, including intolerance, contraindication, patient preference, or personal physician's judgment. exclusion criteria: * age less than 18. * currently pregnant or intending to become pregnant in the next year. * cardiovascular procedure or hospitalization for any reason planned in the next 6 months. * expectation of receiving a cardiac transplant in the next six months. * unable to provide the study consent. * participation another clinical trial(s) that may interfere with follow-up or data collection for this study, or that may affect cardiovascular mortality.

Keywords: heart failure depression depression care education
effective endurance training in metabolic syndrome

Conditions: Impaired Glucose Tolerance; Overweight; Hypertension; Dyslipidemia

Summary: to see how fast and how much physical training can reduce risk factors related to metabolic syndrome


Eligibility criteria:
inclusion criteria: * insulin resistance, impaired glucose tolerance or type 2-diabetes, including two or more of the following factors: blood pressure ≥ 140/90 mm hg, triglycerides fasting ≥ 1,7 mmol/l, and/or low hdl-cholesterol (≤ 0,9 mmol/l in men, ≤ 1,0 mmol/l in women) * obesity, waist-hip ratio ≥ 0,9 in men, ≥ 0,85 in women or bmi (body mass index) ≥ 30 kg/m2 * microalbuminuria (albumin secretion ≥ 20 mg/l or 20 - 200 g per minute) exclusion criteria: -

Keywords: exercise exercise therapy
detection of immune changes as a result of surgical trauma in human subject

Conditions: Surgical Trauma

Summary: surgical trauma triggers a massive inflammatory response. over time, both the innate and adaptive branches of the immune system are affected by surgical trauma. the purpose of this study to characterize the cellular and molecular mechanisms immune response to surgical trauma. additionally, detailed information about patients' recovery profile will be recorded over a period of 6 weeks, with the eventual goal of linking immune responses to recovery profiles.


Eligibility criteria:
inclusion criteria: * 18 - 90 * planning to undergo hip surgery * fluent in english * willing and able to sign informed consent and hipaa authorization exclusion criteria: * any systemic disease that might compromise the immune system * diagnosis of cancer within the last 5 years * psychiatric, immunological, and neurological conditions that would interfere with the collection and interpretation of study data * pregnancy * any other conditions that, in the opinion of the investigators, may compromise a participant's safety or the integrity of the study
urokinase therapy in diabetic foot syndrome

Conditions: Diabetic Foot; Arterial Occlusive Disease; Ischemia

Summary: the purpose of this study is to evaluate whether a treatment with urokinase (500 000 or 1 000 000 iu) can lead to ulcer-healing, lower rate of major amputation, and prolonged survival in patients with diabetic foot syndrome.

patients with diabetic foot ulceration and critical limb ischemia have a high risk of major amputation especially if limbs cannot be revascularized. urokinase is effective in improving the microcirculation in critical limb ischemia by lowering fibrinogen and might improve outcomes. there are however no data on the efficacy and safety of urokinase treatment in terms of survival free of major amputation, ulcer healing and the rate of minor and major bleeding. therefore this trial is conducted to investigate the effect of urokinase treatment on these parameters.

Eligibility criteria:
inclusion criteria: * angiopathic or angioneuropathic diabetic foot lesions * critical limb ischemia * no surgical or interventional treatment option exclusion criteria: * feasibility of vascular surgery or angioplasty * prior treatment of the current ulceration with urokinase * need for dialysis * creatinine \> 180µmol/l * any kind of cerebral event less than three months before inclusion into the study * proliferative retinopathy (not remediated) * uncontrolled hypertension * hemorrhagic diathesis * gastrointestinal bleeding * need for oral anticoagulation * mental disorders * pregnancy * participation in another study

Keywords: urokinase, diabetes, wound healing, major amputation
deep learning-based analysis of colorectal cancer pathology images: an innovative approach for predicting colorectal cancer subtypes

Conditions: Colorectal Liver Metastasis (CRLM); Histopathological Growth Patterns (HGPs); Artificial Intelligence (AI) in Diagnosis; Vision Transformer (ViT); Desmoplastic Classification

Summary: colorectal cancer (crc) is a leading cause of mortality in china, with metastasis significantly contributing to poor outcomes. histopathological growth patterns (hgps) in colorectal liver metastasis (crlm) provide vital prognostic insights, yet the limited number of pathologists highlights the need for auxiliary diagnostic tools. recent advancements in artificial intelligence (ai) have demonstrated potential in enhancing diagnostic precision, prompting the development of specialized ai models like coffee to improve the classification and management of hgps in crlm patients. this study aims to develop and validate a transformer-based deep learning model, coffee, for the classification of colorectal cancer subtypes using whole slide images (wsis) from patients diagnosed with colorectal cancer liver metastasis. the model is pre-trained using self-supervised learning (dino) on wsis from the tcga-coad cohort, utilizing a vision transformer (vit) architecture to extract 384-dimensional feature vectors from 256×256 pixel patches. the coffee model integrates a transformer-based multiple instance learning (transmil) framework, incorporating multi-head self-attention and pyramid position encoding generator (ppeg) modules to aggregate spatial and morphological information. the study includes training, testing, and prospective validation cohorts and evaluates the performance of the model in both binary and multi-class classification settings, as well as its potential to assist pathologists in clinical workflows.


Eligibility criteria:
inclusion criteria: 1. patients diagnosed with colorectal cancer liver metastasis (crlm) undergoing surgical treatment; 2. the maximum diameter of resected metastatic lesions should be ≥ 2 cm; 3. availability of pathology slides along with baseline clinical, biological, and pathological features. exclusion criteria: 1. tissue sections obtained from biopsy specimens; 2. absence of viable tumor tissue in metastatic lesions; 3. lesions previously treated with ablation followed by surgical resection, resulting in inadequate tissue slide quality.
establishment of a trans-round window inner ear continuous drug delivery system for the treatment of severe-to-profound sudden sensorineural hearing loss

Conditions: Hearing Loss, Sudden

Summary: the investigators enrolled patients with total sudden deafness who had failed treatment with systemic combined intra-dural hormone injections. the patients were randomly divided into a pilot group and a control group for a randomized controlled clinical study, with the pilot group receiving a round window niche enlargement via round window inner ear administration and the control group receiving regular intra-drum injection hormone therapy


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years old, ≤ 65 years old 2. the diagnostic criteria for total deafness type of sudden deafness published in 2015 were met, and the patient had sudden, unilateral full-frequency severe or very severe sensorineural deafness with or without deafness, tinnitus, peri-aural numbness, vertigo, and dizziness, and the diagnosis of sudden deafness was supported by physical examination, pure tone audiometry(pta), acoustic impedance, and auditory brainstem response(abr). magnetic resonance(mr) of the internal auditory tract ruled out the occupancy of the internal auditory tract and pontocerebellar region. 3. those with an onset of ≤ 6 weeks who have received a systemic application of glucocorticoid shock therapy, glucocorticoid intra-drum injections, and medication to improve inner ear circulation, but have not responded to treatment (pta improvement \< 15 db). 4. no history of middle or inner ear surgery, no history of radiotherapy or chemotherapy; no general anesthesia - contraindication. 5. patients voluntarily participate in this study and sign an informed consent form exclusion criteria: 1. bilateral sudden deafness, drug-based deafness, autoimmune diseases, specific infections, syndromic deafness malignant tumors. 2. pregnant and lactating women. 3. cannot tolerate general anesthesia surgery, and severe liver and kidney dysfunction. 4. any other conditions that the investigator believes should be excluded from this study.
care pathways of acute heart failure patients: impact on in-hospital mortality.

Conditions: Acute Heart Failure

Summary: the investigators conducted a prospective observational study to describe the different pre-hospital and in-hospital pathways of patients with acute heart failure (ahf) and their association with in-hospital mortality.

prospective observational national multicentric study in 26 centres. between june 2014 and october 2018 the investigators collected data about baseline characteristics, first recourse, in-hospital places of care and places of hospitalizations. lengths of care and lengths of hospitalization. collected data of each patient were reported on a specific assessment tool. the investigators ran a univariate analysis and logistic regression between steps of the care pathway and in-hospital mortality. the main result was validated by an analysis with a propensity score: association between a hospitalization in cardiology and in-hospital mortality.

Eligibility criteria:
inclusion criteria: * all patients presenting to hospital with acute heart failure according to the physician in care exclusion criteria: -
observational cohort of covid-19 patients at raymond-poincare

Conditions: COVID-19

Summary: the sars-cov-2 infection detected in china in december 2019 is responsible for the current covid-19 pandemic affecting nearly 1.2 million people worldwide to date. infection with this virus of the coronavirus family is causing a broad clinical spectrum, the main manifestation of which is an influenza-like condition associated with a pattern of severe hypoxemia pneumonia, and in some cases fatal. little is known about this pathology, so we propose to carry out an observational cohort of patients treated in our hospital for an sars-cov-2 infection. this cohort should make it possible to clinically, biologically and radiologically characterize the sars-cov-2 infections. we will also collect the therapeutic strategies implemented, their possible toxicity and the evolution of the patients.

covid-19 is a virus belonging to the coronavirus family, which includes a large number of viruses that can cause a wide variety of diseases in humans. the sars-cov-2 virus that caused the current covid-19 pandemic, although widely described in the literature, still has many grey areas. the main clinical manifestation is an influenza-like illness associated with respiratory tract infection that can lead to severe hypoxemic pneumonia with fatal outcomes in 2.3% of cases. the clinical spectrum is not yet very well known, as evidenced by the evidence of anosmia, agueusia, or recent skin manifestations, but also strong suspicion of possible neurological damage. similarly, it is not yet very well established, apart from certain co-morbidities, which patients are likely to develop serious forms requiring admission to intensive care, as shown by the proportion of patients \< 60 years of age admitted to intensive care for ards. moreover, the question of how to manage these patients still raises many questions, particularly about the type of molecules to be introduced and at what point in the history of the disease. some of these molecules, such as the lopinavir/ritonavir combinations and the hydroxychloroquine/ azithromycin combination, are not free of complications, particularly cardiac complications requiring close monitoring by ecgs and repeated dosing, the effectiveness of which has not yet been clearly demonstrated. in order to better understand this infection, we propose to set up a cohort of patients treated for cov-2 sars infection on our site. study scheme: longitudinal cohort study of patients with confirmed or strongly suspected cov-2 sars infection.

Eligibility criteria:
inclusion criteria: * patient ≥ 18 years old * sars-cov-2 infection confirmed by pcr or strongly suspected on compatible radio-clinical grounds during an epidemic period. exclusion criteria: * not able to express their opposition * patient under guardianship or curatorship

Keywords: covid-19
post-marketing phase 4 safety & tolerability study of breztri aerospheretm in indian patients with chronic obstructive pulmonary disease

Conditions: Moderate to Severe COPD

Summary: the purpose of this study is to observe the safety and tolerability of breztri aerospheretm as maintenance treatment in indian patients with moderate to severe copd.

study details include: the study duration will be 26 weeks the treatment duration will be 24 weeks

Eligibility criteria:
inclusion criteria: patients with a physician-confirmed diagnosis of copd * with a history of one severe copd exacerbation or two or more moderate copd exacerbations in the preceding 12 months. * post-bronchodilator fev1 should be between ≥30 % to \<80% of the predicted normal. * both male and female patients are allowed in the study * female of non-childbearing potential (i.e., physiologically incapable of becoming pregnant, including any female who is 2 years post-menopausal) * a urine pregnancy test must be negative at screening. * female participant must follow effective contraceptive method as outlined in protocol * patients should be capable of giving signed informed consent exclusion criteria: * significant diseases or conditions other than copd, which, in the opinion of the investigator, may put the subject at risk because of participation in the study or may influence either the results of the study or the subject's ability to participate in the study. * chest x-ray within 6 months before screening must be acceptable to the investigator. subjects who have a chest x-ray that reveals clinically significant abnormalities not believed to be due to the presence of copd should not be included. a chest x-ray must be conducted if the most recent chest x-ray is not available at the time of screening. * patients having moderate to severe exacerbations within 6 weeks before the screening period. * female patients who are pregnant or lactating or planning a family during the study period. * patients with either a history of hypersensitivity to excipients of the study drug or drugs with a similar chemical structure or class to the study drug. * patients participating in any current or future interventional trial during the study will not be enrolled in the current study.