Kornimate/medical-research-clean huggingface dataset:
efficacy and prognosis of surgical intervention in patients with carotid artery stenosis

Conditions: Carotid Artery Stenting; Carotid Endarterectomy; Carotid Artery Plaque

Summary: this study is a prospective, single center cohort study. by combining pathological examination of carotid atherosclerotic plaque with preoperative imaging examination, we explore the imaging characteristics of high-risk carotid plaque, and explore the effectiveness and safety of different surgical methods (cas and cea) for high-risk plaque patients with carotid stenosis.

according to the inclusion and exclusion criteria, 100 patients with carotid artery stenosis who underwent surgical reconstruction surgery at our research center were prospectively collected from december 2023 to december 2024. preoperative laboratory examinations such as blood routine, biochemistry, coagulation, and imaging examinations such as carotid artery ultrasound and tccd, carotid artery ultrasound contrast, high-resolution mri, head mri plain scan, carotid artery cta or dsa were completed, based on the comprehensive evaluation of the patient's condition by the supervising physician, the appropriate surgical method (cea or cas) is selected. follow up will be conducted 1/3/6/12 months after surgery to evaluate the incidence of endpoint events (cerebral infarction+all-cause death+postoperative restenosis), moca and mmse cognitive scores, quality of life scores, and severe perioperative complications. at the same time, for patients undergoing cea surgery, pathological examination of the postoperative carotid artery plaque will be conducted to clarify the nature of the plaque, and combined with imaging examination, the characteristics of high-risk carotid artery plaques will be studied

Eligibility criteria:
inclusion criteria: 1. the patient is aged 45-85 years old; 2. symptomatic patients with stenosis degree greater than 50%, or asymptomatic patients with stenosis degree between 70% and 99% (ultrasound, ct or contrast); 3. can complete regular follow-up; 4. the patient is informed and agrees to participate in the study. exclusion criteria: -

Keywords: carotid revascularization carotid artery stenting carotid endarterectomy
trial of iw-3718 for 8 weeks in patients with persistent gastroesophageal reflux disease (gerd) receiving proton pump inhibitors (ppis)

Conditions: Gastroesophageal Reflux Disease (GERD)

Summary: the objective of this study is to evaluate the safety and efficacy of iw-3718 administered to patients with gerd who continue to have persistent symptoms, such as heartburn and regurgitation, while receiving once-daily (qd), standard dose ppis.


Eligibility criteria:
inclusion criteria: each patient must meet all of the following criteria to be eligible for enrollment in this study: * patient is an ambulatory male or female (if female, nonpregnant) and is at least 18 years old at the screening visit. * patient has a diagnosis of gerd and reports experiencing gerd symptoms (heartburn or regurgitation) while taking standard ppi therapy. * patient has evidence of pathological acid reflux. * female patients must not be pregnant and must agree to avoid pregnancy for the duration of the study. * patient must comply with study procedures. exclusion criteria: patients who meet any of the following criteria will not be eligible to participate in the study: * patient has a history of complete lack of gerd symptom response to ppi therapy. * patient has a significant medical or surgical history including conditions that would impact drug absorption or metabolism (such as bowel obstruction, poorly controlled diabetes, gastroparesis, hiatal hernia). * patient reports pain or burning behind the breastbone or in the center of the upper stomach as his or her predominant symptom at the screening visit. * patient has received an investigational drug during the 30 days before the screening visit, or is planning to receive another investigational drug or use an investigational device at any time during the study. note: other inclusion and exclusion criteria apply, per the study protocol.

Keywords: gastroesophageal reflux disease gerd proton pump inhibitor iw-3718
repeat or single quadratus lumborum block for the reduction of opioid prescriptions after surgery in retroperitoneal sarcoma patients ("resqu-sarc" trial)

Conditions: Retroperitoneal Sarcoma

Summary: this phase ii trial studies how well a repeat or single liposomal bupivacaine injection (quadratus lumborum block) works in reducing opioid prescriptions after surgery in patients with retroperitoneal sarcoma. liposomal bupivacaine is a numbing medication. giving a second injection block may decrease dependency on opioid medications for pain relief after surgery and prevent long-term use and addiction.

primary objective: i. to use a pragmatic phase ii randomized controlled trial to compare two standardized bundles of usual care for postoperative pain management to reduce the initial discharge prescription opioid volume. secondary objective: i. to assess which pragmatic arm improves aspects of postoperative recovery including 30-day, 3-month, and 1-year opioid use, patient symptom inventory at those time points, hospital measures including length of stay and inpatient pain scores. outline: patients are randomized to 1 of 2 arms. arm i: patients receive standard of care liposomal bupivacaine injection before and during surgery and standard of care non-opioids and opioids at days 0-3 after surgery in the absence of unacceptable toxicity. arm ii: patients receive standard of care liposomal bupivacaine injection before and during surgery and standard of care non-opioids and opioids at days 0-3 after surgery in the absence of unacceptable toxicity. patients then receive a second liposomal bupivacaine injection on day 4 after surgery. after completion of study treatment, patients are followed up at 1, 3, and 12 months after the surgery.

Eligibility criteria:
inclusion criteria: * patients undergoing elective open sarcoma resection for potentially curative intent who would otherwise be treated with quadratus lumborum (ql) block + intravenous-patient controlled analgesia (iv-pca) converted to oral pain medications (meds) (non-narcotic bundle + opioid pain pill) exclusion criteria: * patients with current or past substance (drug or alcohol) abuse disorder * laparoscopic or minimally invasive surgery * cases in which anticipated discharge is on or before postoperative day 4
a study of the effect of fty720 on pulmonary function in patients with moderate asthma

Conditions: Asthma

Summary: this study will evaluate the effect of fty720 on the lung function of patients with moderate asthma


Eligibility criteria:
inclusion criteria: * forced expiratory volume in 1 second of at least 60% * history of asthma for at least 6 months * current use of short-acting beta agonists, inhaled long-acting beta agonists and inhaled corticosteroids (up to a specified dose) exclusion criteria: * history of lung disease other than asthma * smokers * use of inhaled corticosteroid above specified dose * use of oral beta agonists or corticosteroids or other asthma medications * hypersensitivity to the drug * respiratory tract infections within 1 month of the study other protocol-defined inclusion/exclusion criteria may apply

Keywords: asthma, adrenergic beta agonists, multiple sclerosis, pulmonary function tests, forced expiratory volume
clinical and economic burden of patients with chronic obstructive pulmonary disease in a medicaid population

Conditions: Pulmonary Disease, Chronic Obstructive

Summary: reports suggest that the medicaid population includes a higher percentage of smokers than the general population. a high prevalence of smokers in a population is likely to lead to a higher burden of chronic obstructive pulmonary disease (copd). few studies have evaluated the economic burden of copd in a medicaid population. the objective of this observational, retrospective cohort study is to estimate the economic burden of copd in subjects with a copd diagnosis who are enrolled in medicaid and are receiving maintenance treatment covered by medicaid. specifically, the null hypothesis for the primary outcome measure is that no difference is observed in all-cause costs between subjects with and without copd. the test hypothesis is that there is a difference in all-cause costs between subjects with and without copd. secondary outcomes to be evaluated include all-cause resource use and copd-related costs for the copd cohort. the study uses a medical and pharmacy administrative claims database called marketscan medicaid database that contains the medical, surgical, and prescription drug experience of nearly 7 million medicaid recipients. this analysis will use data from 8 states.


Eligibility criteria:
inclusion criteria: * at least 40 years of age at index date * continuously eligible to receive healthcare services through medicaid in the pre-index and follow-up period * enrolled in fee-for-service plans * without a diagnosis code of exclusionary comorbid conditions - cystic fibrosis, bronchiectasis, respiratory cancer, pulmonary fibrosis, pneumoconiosis, sarcoidosis, pulmonary tuberculosis (including fibrosis due to tuberculosis) exclusion criteria: * age less than 40 at index dates

Keywords: chronic obstructive pulmonary disease costs resource utilization medicaid
diagnosing and targeting mechanisms of diuretic resistance in heart failure

Conditions: Heart Failure

Summary: effective diuresis is the primary goal of most acute decompensated heart failure hospitalizations, but diuretic resistance is common and our ability to detect it is limited. further, there are therapeutically distinct groups of diuretic-resistant patients. these are not easily distinguished using currently available methods, leading to trial-and-error based treatment that promotes lengthy hospitalizations. the aims of this study are: 1. to develop inexpensive and efficient tools to predict diuretic response 2. to understand the prevalence of therapeutically targetable mechanisms of diuretic resistance using endogenous lithium clearance 3. to develop methodology to differentiate diuretic resistance mechanisms using common/inexpensive laboratory tests 4. to provide proof of concept that mechanistically tailored diuretic therapy can improve natriuresis

this study is a minimal-risk observational open-label single center study with randomization between two standard of care interventions. approximately 500 patients admitted to the hospital (yale new haven health system) with a clinical diagnosis of heart failure will be enrolled in the overall study. patients will undergo sampling of their blood and collection of urine at a minimum of 4 timepoints (called "visits"), or a minimum of 5 in the interventional arm. patients with a low urine sodium output (\<100 mmol) on visit 1 will be eligible for 1:1 randomization to either an increased dose of their visit 1 loop diuretic or addition of iv chlorothiazide to their visit 1 loop diuretic.

Eligibility criteria:
for all patients: inclusion criteria: * age ≥ 18 years * clinical diagnosis of adhf with at least one objective sign of volume overload: rales, edema, elevated jvp, preadmission weight gain * current use of bolus iv loop diuretic therapy and projected need by the treating clinician for continued treatment with iv diuretics for at least 3 days with the goal of significant fluid removal (\>1l net fluid loss/day) exclusion criteria: * inability to perform informed consent or comply with the serial urine collection procedures * significant bladder dysfunction or urinary incontinence * hematocrit less than 21% or active bleeding for patients in the interventional arm: inclusion criteria: * cumulative 6-hour sodium output \< 100 mmol following visit 1 iv loop diuretic dose * visit 1 iv loop diuretic dose ≤ 160 mg of furosemide equivalents * serum sodium \> 125 mmol/l * at least 6 hours since last dose of diuretic exclusion criteria: * current use or projected future requirement by the treating physician for thiazide diuretics * use of high dose mineralocorticoid receptor antagonist therapy (\>50mg of spironolactone or \>100mg of eplerenone) or amiloride
dexmedetomidine combined with ropivacaine for postoperative continuous femoral nerve block

Conditions: Elderly; Knee Arthroplasty; Nerve Block; Dexmedetomidine; Postoperative Delirium; Long-term Outcome

Summary: delirium is common in the elderly after orthopedic surgery and is associated with worse outcomes. continuous femoral nerve block is frequently used for postoperative analgesia after total knee arthoplasty. the investigators hypothesize that dexmedetomidine, when combined with ropivacaine for continuous femoral nerve block, can reduce the incidence of delirium and improve the long-term outcome in elderly patients after total knee arthroplasty.

a growing number of elderly patients undergo total knee arthroplasty. delirium is a common complication in these patients after surgery and is associated with worse outcomes, including prolonged hospital stay, poor functional recovery, decreased cognitive function, increased health care costs, and elevated mortality rate. dexmedetomidine has been shown to prolong the duration of nerve block without neurotoxicity and improve postoperative sleep quality. the investigators hypothesize that dexmedetomidine, when combined with ropivacaine for continuous femoral nerve block, can reduce the incidence of delirium and improve the long-term outcome in elderly patients after total knee arthroplasty.

Eligibility criteria:
inclusion criteria: * elderly patients (≥ 65 years but \< 90 years); * scheduled to undergo single total knee arthroplasty; * planned to receive continuous femoral nerve block for postoperative analgesia. exclusion criteria: * refuse to participate in this study; * preoperative history of schizophrenia, epilepsy, parkinsonism, or myasthenia gravis; * inability to communicate in the preoperative period because of coma, profound dementia or language barrier; * preoperative hemorrhagic disease or coagulopathy (platelet count, prothrombin time and/or activated partial thrombin time below the lower limit of normal); * preoperative obstructive sleep apnea (diagnosed as obstructive sleep apnea, or stop-bang score ≥3); * preoperative sick sinus syndrome, severe sinus bradycardia (\< 50 beats per minute), or second-degree or above atrioventricular block without pacemaker; * severe hepatic dysfunction (child-pugh class c); * severe renal dysfunction (requirement of renal replacement therapy before surgery); * asa classification ≥ iv or unlikely to survive for more than 24 hours after surgery.

Keywords: elderly knee arthroplasty nerve block dexmedetomidine postoperative delirium long-term outcome
effect of patient management based on continuous continuous glucose monitoring on major adverse cardiovascular events in patients with type 2 diabetes and moderate to severe coronary artery stenosis

Conditions: Diabetes Mellitus, Type 2; Major Adverse Cardiac Events

Summary: patients with type 2 diabetes and moderate to severe coronary artery stenosis who were treated at zhejiang second hospital and cooperative hospitals were randomly divided into a patient management group based on continuous continuous glucose monitoring (cgm) or a patient management group based on hba1c. both groups controlled cardiovascular risk factors according to the chinese guidelines for the prevention and treatment of type 2 diabetes (2020) and the ada guidelines for the prevention and treatment of diabetes (2023), and conducted hba1c testing every 3 months. in the cgm-based glucose management group, cgm measurements will be performed at baseline and at 6, 12, 18, and 24 months. in the cgm-guided treatment group, the target tir\>70%, tbr\<4%, tar\<25%, and hba1c\<7.0%; in the hba1c-guided treatment group, the target hba1c\<7.0%. the primary endpoint was major adverse cardiovascular events (mace: cv death, nonfatal myocardial infarction, nonfatal stroke).


Eligibility criteria:
inclusion criteria: male or female between 35 and 75 years old type 2 diabetes hba1c: 7.5%-10% moderate to severe coronary artery stenosis (the degree of stenosis of any major coronary artery is ≥50% as assessed by coronary angiography or coronary cta) the blood sugar lowering regimen has been stable in the past 3 months ability to understand the requirements of the study and provide informed consent exclusion criteria: type 1 diabetes or other types of diabetes acute myocardial infarction or stroke within the past three months ketoacidosis, hyperosmolar hyperglycemic state relative or absolute contraindications to contrast agent examinations such as severe renal insufficiency, contrast agent allergy, and hyperthyroidism elective surgery planned within 2 years preparing for pregnancy or becoming pregnant life expectancy less than 2 years skin allergies and other situations where cgm cannot be used currently participating in other clinical studies
effects of ischemic postconditioning on micrornas in double valve replacement

Conditions: Cardiopulmonary Bypass; Ischemic Postconditioning

Summary: 1. cardiopulmonary bypass and cardioplegic arrest could regulate expression of micrornas in patients undergoing double valve replacement (aortic and mitral). 2. the modulation of myocardial micrornas by cardiopulmonary bypass and cardioplegic arrest may be rescued by ischemic postconditioning. 3. downstream effectors would also be affected.


Eligibility criteria:
inclusion criteria: * consecutive eight patients with rheumatic heart valve disease undergoing elective double valve replacement(aortic and mitral)are considered for participation in this study. exclusion criteria: * insulin-dependent diabetes mellitus * pulmonary, renal, or hepatic failure * infective valve disease * valve disease with coronary artery disease * hypertension * emergency and reoperations * received aspirin,corticosteroids, or statin preoperatively * received preoperative inotropic support
studying phosphorus metabolism

Conditions: Phosphorus Metabolism

Summary: phosphorus and phosphate irons play critical roles in bone structure and essential cellular functions. the purpose of this study is to learn more about the factors and hormones that regulate phosphorus in the body by collecting blood and urine samples from patients with disorders of phosphate control. both children and adults will be enrolled in this study. researchers will collect blood and urine samples from participants on multiple occasions (2 to 6 times). some blood specimens will be taken after an overnight fast and participants may be asked to collect all their urine during a 24-hour period. researchers will analyze these blood and urine samples to better understanding how the body handles phosphorus.

phosphorus and phosphate ions play an important role in cellular metabolism as well as bone structure. scientific evidence suggests that, in addition to vitamin d and pth systems, novel factors, such as fibroblast growth factor 23 (fgf-23) and matrix extracellular phosphoglycoprotein (mepe), may play an important role in phosphorus regulation. these factors have been best studied in rare genetic and acquired phosphate wasting disorders such as tumor induced osteomalacia (tio), x linked hypophosphatemia (xlh) and autosomal dominant hypophosphatemic rickets (adhr). patients with other abnormal phosphate regulating states such as hyperparathyroidism and hypoparathyroidism, pseudohypoparathyroidism etc. undergoing phosphorus-altering interventions may provide important insight into the role of these hormones. we are proposing an observational study with collection of blood and urine samples to study both established (e.g. mineral ions, bone markers, pth-vit d system, tmp-gfr) and novel (e.g. fgf-23 and mepe) constituents of the phosphorus metabolism pathway. patients with abnormal phosphorus regulating states will be enrolled and we will study the natural history of their disease and the effects of specific interventions that are likely to change phosphorus balance. the outcome will potentially aid understanding of this new field of mineral regulating hormones and generate both interest and research in phosphorus metabolism. it is hoped that this will also encourage clinical trials in treatment of phosphate wasting disorders.

Eligibility criteria:
inclusion criteria: patients of any age, gender or ethnicity who will help fulfill the objectives laid out in section ii. we propose to study patients primarily enrolled in other clinical center protocol(s). they will continue to receive treatment/ interventions per the original protocols. exclusion criteria: patients with significant cognitive impairment who are unable to give informed consent or patients having other significant mineral disturbances that could confound the parameters being studied will be excluded.

Keywords: fibroblast growth factor 23 fgf-23 hypophosphatemia phosphaturia phosphorus phosphorus metabolism
assessment of the role of tegaserod therapy in the management of gastroesophageal reflux disease (gerd) symptoms in patients with incomplete response to proton pump inhibitors (ppis).

Conditions: Gastroesophageal Reflux Disease (GERD)

Summary: study to assess the effects of tegaserod added to ppi therapy in the resolution of heartburn and regurgitation in patients with incomplete relief from ppis .


Eligibility criteria:
inclusion criteria: * heartburn for at least 3 days in the week prior to screening * regurgitation for at least 3 days in the week prior to screening * stable dose ppi therapy \> 4 weeks * incomplete relief on daily ppi therapy \> 4 weeks exclusion criteria: * evidence of structural abnormality of the gastrointestinal tract or disease/conditions * previous gastrointestinal surgery that may influence esophageal motor function * evidence of cathartic colon or a history of laxative use other protocol-defined inclusion/exclusion criteria may apply.

Keywords: gerd ppi heartburn regurgitation
investigating patient satisfaction with oral anti-cancer treatment

Conditions: Clear Cell Renal Cell Carcinoma

Summary: prospective non-interventional non-controlled multicenter observational study to evaluate aspects of pharmaceutical care in patients with advanced renal cell carcinoma treated with an oral anti-cancer drug. the main objective of this study is to evaluate the patient perspective in the treatment of advanced renal cell carcinoma with an oral anti-cancer drug. the following aspects will be investigated: * intrinsic desire for information about treatment. * patient satisfaction with treatment information. * patient satisfaction with treatment. * medication adherence. * health-related quality of life. * the role of different health care professionals in the treatment of rcc with oral drugs this study should reveal information necessary for the development of pharmacotherapeutic care concepts that meet the needs of cancer patients treated with an oral anti-cancer drug over a long period.


Eligibility criteria:
inclusion criteria: * patients who are 18 years or older, and who can be contacted by phone and/or e-mail are eligible for the study exclusion criteria: * patients who are not able to understand dutch or french will be excluded from the study