araag2/TREC_Precision-Medicine huggingface dataset:
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: The Benefits of Deep Neuromuscular Block and Sugammadex in Laparoscopic Colorectal Surgery

Summary: Pneumoperitoneum, the use of carbon dioxide, presents some disadvantages, including a risk of hypercarbia and respiratory acidosis during surgery in the respiratory system, and of an increased mean arterial pressure and systemic vascular resistance due to sympathetic excitation in the cardiovascular system. 10~15 mmHg intra-abdominal pressure is required in order to achieve a pneumoperitoneum, and increased abdominal pressure following a pneumoperitoneum causes hemodynamic changes leading to a reduced cardiac function by increasing the left ventricular end systolic wall stress and the right and left ventricular filling pressure, while decreasing the stroke volume and cardiac index. The author compared the intra-abdominal pressure necessary to achieve a pneumoperitoneum under deep muscle relaxation and medium muscle relaxation in ten patients undergoing laparoscopic surgery for colorectal cancer as part of preliminary research. The results showed that deep muscle relaxation, compared to medium muscle relaxation, was able to lower the intra-abdominal pressure by an average of 5.6 mmHg (13.2 ± 0.8 vs 7.6 ± 1.1) and the inspiratory pressure by an average of 8. Above all, even after lowering the intra-abdominal pressure with deep muscle relaxation, the surgeon was able to maintain a view almost identical to the one afforded by medium muscle relaxation. However, up until now, no reports have clearly indicated the change in pneumoperitoneum pressure, the patient's hemodynamic change, post-operative recovery, and surgical prognosis depending on the depth of muscle relaxation.Against this background, this study aims to identify the degree to which intra-abdominal pressure in laparoscopic colorectal surgery can be reduced by deep muscle relaxation, and the corresponding advantages this method presents in terms of physiological changes such as hemodynamic and respiratory system changes. In addition, the study intends to examine the difference between deep muscle relaxation and medium muscle relaxation in terms of surgical prognosis, including their effects on post-operative pain and on the patient's recovery of intestinal mobility.


Eligibility: Inclusion Criteria:
  -  Patients aged 19 to 80 scheduled to undergo laparoscopic colorectal or rectal surgery below the ASA class 3
  Exclusion Criteria:
  -  Patients with neuromuscular disease/patients with a personal history or family history of malignant hyperthermia/patients with a serious heart, kidney (GFR < 60) or liver condition (ALT/AST > 100)/ patients who have had colorectal or rectal surgery/obese patients (BMI ≥35)

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Dextromethorphan in Chemotherapy-induced Peripheral Neuropathy Management

Summary: The aim of this study is to assess if dextromethorphan administered during 4 weeks induces a decrease of pain intensity in breast cancer patients suffering from chemotherapy-induced peripheral neuropathy compared to placebo group.

Detailed description: This is a randomized, placebo-controlled, double-blind, parallel-group clinical trial comparing dextromethorphan and placebo for the treatment of chemotherapy-induced peripheral neuropathy, assessed with a (0-10) numerical scale. Cognition, anxiety, depression, sleep and quality of life are also assessed.
  The influence of CYP2D6, CYP3A4 and MDR1 polymorphism on the dextromethorphan analgesic efficacy will be measured.

Eligibility: Inclusion Criteria:
  -  - Age ≥ 18 years
  -  Breast cancer patients suffering from chemotherapy-induced peripheral neuropathy for at least 3 months after the end of their last cancer chemotherapy
  -  Numerical rating scale ≥ 4
  -  Patient in stable clinical situation on the next month (no surgery, radiotherapy, hormone therapy, chemotherapy or other treatment scheduled in the month following the enrollment)
  -  Patients affiliated to the French Social Security
  -  Patients with free and informed consent has been obtained
  Exclusion Criteria:
  -  - Hypersensitivity to the active substance or to any of the excipients
  -  Hypertension
  -  History of stroke
  -  Severe heart failure
  -  Severe hepatic impairment
  -  Shortness of breath
  -  Congenital galactosemia, glucose-galactose malabsorption, lactase deficiency
  -  Association with linezolid
  -  Pre-existence or history of peripheral neuropathy due to a cause different from neurotoxic chemotherapy
  -  Diabetes (type I and II)
  -  Medical and surgical history incompatible with the study
  -  Patient receiving treatment with amantadine, ketamine, memantine, L-Dopa, dopaminergic agonists, anticholinergics, barbiturates, neuroleptics, Monoamine oxidase inhibitor, dantrolene or baclofen, phenytoin, cimetidine, ranitidine, procainamide, quinidine, quinine, amiodarone, fluoxetine, paroxetine, propafenone, thioridazine, ritonavir, nicotine, hydrochlorothiazide, warfarin
  -  Present or past psychotropic substances and alcohol dependence
  -  Childbearing age, no use of effective contraceptive method, pregnancy or lactation
  -  Patient exclusion period, or the total allowable compensation exceeded
  -  Patients undergoing a measure of legal protection (guardianship, supervision ...)

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Efficacy of Neoadjuvant Thermo-Radio-chemotherapy for Locally Advanced Rectal Cancer Before Laparoscopic Total Mesorectal Excision: Prospective Phase II Trial

Summary: The current standard treatment of locally advanced rectal cancer is neoadjuvant concurrent chemo-radiation therapy (CCRT) followed by total mesorectal excision (TME). Recently, laparoscopic surgery is getting substitute open surgery based on the advantages of early recovery, short admission, less pain, less blood loss, and little scar without compromising oncologic outcomes.
  It is reported that hyperthermia is effective in synthetic (S) phase, Low oxgen pressure, acidic, and low perfusion site which are known as radio-resistant. Because of these characteristics, it considered as the most valuable radiosensitizer in cancer treatment, theoretically. Furthermore, mild hyperthermia (41 to 41.5 ºC) can promote tumor reoxygenation.
  Based on those background, the investigators start this prospective study to evaluate the efficacy of laparoscopic TME after CCRT with hyperthermia in locally advanced rectal cancer.


Eligibility: Inclusion Criteria:
  -  20 years or older
  -  pathologically confirmed rectal cancer
  -  Eastern Cooperative Oncology Group performance status 0 to 2
  -  Candidate of laparoscopic TME
  -  Optimal bone marrow function
  -  Locally advanced rectal cancer confirmed by magnetic resonance imaging
  Exclusion Criteria:
  -  Extrapelvic metastasis
  -  Previous pelvic irradiation
  -  Current status of pregnant or breast feeding
  -  Confirmed other malignancy within two years except thyroid cancer

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Cohort Study of the Clinical Course of Macular Diseases in Kagawa

Summary: Macular diseases often cases severe visual impairment. Recent clinical introduction of anti-vascular endothelial growth factor agents may change the clinical course of various macular diseases, including age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), retinal angiomatous proliferation (RAP), central serous chorioretinopathy (CSC), myopic choroidal neovascularization (CNV), retinal vein occlusion (RVO), diabetic macular edema (DME), and so forth. The advance in vitrectomy improve visual outcomes in some maculae diseases, including epiretinal membrane (ERM), macular hole (MH), vitreomacular traction syndrome (VMTS).
  Patients with such macular diseases are registered and are followed up for 5 years with appropriate treatment for each patient. By the analysis of the correlation between initial examinations and final visual acuity, factors associated with good visual prognosis will be elucidated.


Eligibility: Inclusion Criteria:
  -  Patients who visit Department of Ophthalmology, Kagawa University Hospital with macular diseases, such as AMD, PCV, RAP, RVO, DME, ERM, MH, VMTS.
  -  Patients who are agreed with the participation of this study.
  Exclusion Criteria:
  -  None

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Automated Control of End-tidal Volatile Anesthetic Concentration

Summary: The new MIRUS system as well as the established AnaConDa system uses a reflector to conserve volatile anaesthetics (VA). Both systems act with commercially available ICU ventilators. In contrast to AnaConDa the MIRUS includes an automated control of end-tidal VA concentrations. In this study the investigators compared feasibility, costs and recovery times after anaesthesia with isoflurane (ISO), sevoflurane (SEVO) or desflurane (DES) in ventilated and spontaneously breathing patients.

Detailed description: The study was approved by the appropriate Institutional Review Board. After written informed consent 63 ASA I-III patients undergoing elective hip or knee replacement surgery under general anesthesia were included. Patients were randomly organized into 3 groups (20-22 each). Anesthesia was induced with intravenous anaesthetics. After tracheal intubation MIRUS automatically adjusted the end-tidal VA concentration to 1.0 MAC. Patients were ventilated with the Puritan Bennett 840 ICU ventilator. After 1 h of anaesthesia with 1.0 MAC the ventilator mode was switched from SIMV V+ (totally controlled ventilation, "passive patient", with a tidal volume of 8 ml/IBW) to proportional assist ventilation (PAV) with 50% support ("active patient"). At the end of surgery the MIRUS system was stopped (MAC set to 0.0) and recovery times were measured.

Eligibility: Inclusion Criteria:
  -  Signing of the informed consent document (patient or relatives).
  -  Patient age 18 years or older.
  -  ASA I-III
  Exclusion Criteria:
  -  ASA IV patients
  -  Epidural or spinal analgesia
  -  Allergy or known hypersensitivity to any of the study drugs
  -  Patients with known or suspected genetic susceptibility to malignant hyperthermia
  -  Previous participation in this trial
  -  Participation in another clinical trial within 4 weeks prior to selection.
  -  Pregnant women

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Efficacy and Safety of Ultrasound Hyperthermia Combined With Chemotherapy on Oral and Maxillofacial-Head and Neck Cancer

Summary: The purpose of this study is to determine whether Ultrasound Hyperthermia is effective and safe in the treatment of Oral and Maxillofacial-Head and Neck Cancer.

Detailed description: As a non-invasive treatment, Ultrasound Hyperthermia has received increasing interest for the treatment of cancer.Many studies have shown that Therapeutic Ultrasound is safe and effective. Eligible patients were randomly assigned by using permutated blocks designed for each site to receive either Ultrasound Hyperthermia combined with chemotherapy (Arm A) or chemotherapy alone(Arm B).Chemotherapy will be conducted as follows. For Squamous cell carcinoma of head and neck,it will be administrated with Docetaxel(at a dose of 75 mg per square meter of body-surface area and intravenous infused in 1 hr at day 1rt), Cisplatin(at a dose of 75 mg per square meter of body-surface area and intravenous infused in 1 hr at day 1rt) and Fluorouracil(at a dose of 75 mg per square meter of body-surface area and intravenous infused last 5 days) . For other types of cancer,the treatments will be administrated in accord with the guideline.In addition,Ultrasound Hyperthermia will be conducted 5 times(day 1rt,3rd,5th,7th,9th) in Arm A. Patients in arm B will receive chemotherapy only. One cycle comprises a period of 3 weeks (21 days).All patients will receive 2 cycles in both arms. All the patients eligible for the operation will take surgery. After treatment，some patients with advanced unresectable cancer may be down-staged from stage IV, and will regain the opportunity of operation.

Eligibility: Inclusion Criteria:
  -  Joined the study voluntary and signed informed consent form
  -  Age 18-75，both genders.
  -  Had histologically or cytologically confirmed advanced squamous cell carcinoma of the head and neck
  -  At least one lesions can be measured,Conventional measurements ≥2cm, computed tomography(CT) examination ≥1cm .
  -  Eastern Cooperative Oncology Group(ECOG) Performance Scale 0-2.
  -  Life expectancy of more than 6 months.
  -  Use of an effective contraceptive method for women when there is a risk of pregnancy during the study.
  -  Haemoglobin≥90g/L ,White blood cell(WBC) ≥3×10^9/L
  -  Hepatic function:ALAT、ASAT< 2.5 x ULN, TBIL< 1.5 x ULN
  -  Renal function: Creatinine < 1.5 x ULN
  Exclusion Criteria:
  -  Participation in other interventional clinical trials within 1 month
  -  Previous received other drug or operative treatment within 6 month
  -  Pregnant or breast-feeding women
  -  History of serious allergic or allergy
  -  Patients with the history of Serious lung or head disease
  -  Local skin ulceration

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Preoperative Radiochemotherapy With Hyperthermia for Locally Advanced Rectal Cancer

Summary: The current trial is evaluating the impact of deep regional hyperthermia on the pathological complete response rate in locally advanced rectal cancer in the context of preoperative 5FU based radiochemotherapy.


Eligibility: Inclusion criteria:
  -  Histologically confirmed Adenocarcinoma of the rectum (up to 10 cm from the anal verge)
  -  International Union Against Cancer stages II or III
  -  ECOG PS 0/2
  -  Informed consent
  Exclusion Criteria:
  -  Congestive heart failure (NYHA III/IV)
  -  History of myocardial infarction within the last 6 months.
  -  AV Block III
  -  Total hip replacement or major metal pelvic implants
  -  Cardiac pacemaker
  -  Contraindications for radiochemotherapy
  -  Contraindications for surgical tumor resection
  -  Previous pelvic radiotherapy or chemotherapy
  -  Active chronic inflammatory bowel disease
  -  Collagenosis
  -  Congenital diseases with increased radiosensitivity
  -  Pregnancy or breastfeeding
  -  Secondary malignancies other than locally controlled basalioma or in-situ carcinomas Infiltration of the anal canal

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Hyper-Thermia Enhanced Anti-tumor Efficacy of Trabectedin

Summary: This trial compares trabectedin alone to trabectedin in combination with regional hyperthermia in patients with high-risk soft tissue sarcoma. The study is designed to demonstrate a significant benefit for sarcoma-therapy by adding regional hyperthermia.


Eligibility: Inclusion Criteria:
  -  Age > 18 years
  -  Histologically confirmed STS (primary or recurrent), except: Ewing sarcoma, osteosarcoma, skeletal chondrosarcoma (extraskeletal chondrosacomas are included), GIST, dermatofibrosarcoma protuberans, malignant mesothelioma, rhabdomyosarcoma
  -  Patients after failure of first-line chemotherapy (anthracyclines and ifosfamide) with or without RHT
  -  Progressive or recurrent tumor which is unresectable or only resectable with adverse functional outcome
  -  After macroscopic incomplete resection or marginal resection (tumor-free margins < 1 cm)
  -  Prior chemotherapy, including anthracyclines and ifosfamide (with or without RHT) or patients who cannot be given these medicines
  -  Oligometastasis (≤ 5 lesions)
  -  Performance status (ECOG) 0,1 or 2
  -  More than 3 weeks from last treatment
  -  Neutrophil count > 1,5 G/l, hemoglobin > 9 g/dl, platelets > 100 G/l
  -  Albumin > 25 g/l, total bilirubin < 1 x ULN, ALT/AST < 2.5 x ULN, AP < 2.5 x ULN, Cockroft and Gault's calculated creatinine clearance > 30 ml/min, CPK < 2.5 x ULN
  -  Patients with the ability to follow study instructions and likely to attend and complete all required visits
  -  Written informed consent of the subject
  Exclusion Criteria:
  -  Uncontrolled infection (e.g. active viral hepatitis)
  -  Unstable cardiac status
  -  Peripheral neuropathy > grade 2
  -  Known or persistent abuse of medications, drugs or alcohol
  -  Other malignancy during the last 5 years (exclusion of basal cell carcinoma or adequately treated cervical carcinoma in situ)
  -  Prior therapy with Tr or known history of hypersensitivity to drugs with a similar chemical structure
  -  Pregnancy or breast-feeding
  -  Females of childbearing potential, who are not using and not willing to use medically reliable methods of contraception for the entire study duration
  -  Uncontrolled CNS-metastases
  -  Medical or technical impossibility for hyperthermia to heat the major target lesion

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: A Database Study to Estimate the Risk of Multiple Sclerosis Following Vaccination With Arepanrix™ in Manitoba, Canada

Summary: The purpose of this database study is to assess if Arepanrix™ vaccination during the 2009 pandemic was associated with an increased risk of multiple sclerosis (MS) in Manitoba, Canada.

Detailed description: This observational, retrospective, propensity-score matched cohort study using the Manitoba Immunization Monitoring System (MIMS) and the hospital, physician, and prescription claims databases of the Manitoba Health (MH) Database System will assess if Arepanrix™ vaccination during the 2009 pandemic was associated with an increased risk of multiple sclerosis (MS) and other demyelinating conditions not ultimately leading to a multiple sclerosis diagnosis in Manitoba, Canada.
  The data will be collected form the following linked databases:
  -  Manitoba Health (MH) administrative databases
  -  Manitoba Immunization Monitoring System (MIMS)
  -  Manitoba Health Population Registry (MHPR)
  -  Drug Program Information Network (DPIN)
  -  Hospital Abstract Database
  -  The Medical Services database

Eligibility: Inclusion Criteria:
  -  The entire population of Manitoba is considered for inclusion.
  Exclusion Criteria:
  -  Individuals less than or equal to 6 months of age;
  -  Having less than one year of insurance coverage before the enrolment period;
  -  Not registered with MH during the enrolment period;
  -  Physician or hospitalization records indicating a diagnosis of any demyelinating condition between 1971 (earliest year for which information is available) and the index date.

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Effects of Deep Regional Hyperthermia in Patients With Anal Carcinoma Treated by Standard Radiochemotherapy

Summary: Randomized study to investigate the efficacy of deep regional hyperthermia in patients with anal carcinoma treated by standard radiochemotherapy with MMC and 5-FU.

Detailed description: Pat. with anal carcinoma and treated with standard radiochemotherapy with Mitomycin C and 5-FU will in the experimental arm receive deep regional hyperthermia (6x).

Eligibility: Inclusion Criteria:
  -  Histologically proven anal squamous cell carcinoma (SCC) (WHO 2004), including anal canal carcinoma (UICC 2002) and anal margin carcinoma (UICC 2002)
  -  All stages except T1 N0 M0 after local excision (UICC 2002)
  -  Age ≥ 18 years
  -  ECOG Status 0-1
  -  Patients that have understand protocol and signed informed consent form
  -  Sufficient bone marrow function: WBC ≥ 3,0 x 10^9/l, Platelets ≥ 100 x 10^9/l, Hemoglobin ≥ 10 g/dl
  -  Sufficient liver function: Bilirubin < 1,5 mg/dl, SGOT, SGPT, alkaline phosphatase, gGT less than 3 times upper limit of normal
  Exclusion Criteria:
  -  Stage T1 N0 M0 after local excision (UICC 2002)
  -  Uncontrolled, severe cardiac dysfunction (NYHA III/IV)
  -  Pre-existing uncontrolled cardiac disease, signs of cardiac failure, or rhythm disturbances requiring therapy
  -  Myocardial infarction within the past 12 months
  -  Congestive heart failure
  -  Complete bundle branch block
  -  New York Heart Association (NYHA) class III or IV heart disease
  -  Chronic inflammatory disease of the intestine
  -  Active intractable or uncontrolled infection
  -  Chronic diarrhea ( > NCI CTC-Grad 1)
  -  Acute thrombosis
  -  Collagen vascular disease
  -  Cardiac pacemaker
  -  HIV-infection; Patients with hepatitis A or B virus infection, with HPV infection or Patients receiving immune suppressive treatment can be included
  -  Devices that preclude deep regional hyperthermia (Endoprosthesis, stent in vascular system, acute thrombosis)
  -  Any metal implants (with exception of non-clustered marker clips)
  -  Conditions that preclude the application of fractionated pelvic radiotherapy
  -  Conditions that preclude regular follow-up
  -  Pregnant or breast feeding women
  -  Prior pelvic radiotherapy
  -  Prior chemotherapy
  -  Drug addiction
  -  On-treatment participation on other trials
  -  Prior or concurrent malignancy or leucemia (≤ 5 years prior to enrolment in study) except anal cancer or non-melanoma skin cancer or cervical carcinoma FIGO stage 0-1 if the patient is continuously disease-free
  -  The presence of increased radiation sensitivity, for example ataxia teleangiectatica, or similar
  -  Psychological, familial, sociological, or geographical condition that would preclude study compliance

Relevance to patient case: not relevant
Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Effect of an Electronic Cognitive Aid Versus Static Cognitive Aid on the Management of a Simulated Crisis

Summary: Clinical decision support tools with in the electronic medical record can improve clinical care processes. To date, there is little evidence evaluating crisis management with such decision support tools. The investigators aim to create an electronic cognitive aid with embedded decision support to aid clinicians during the management of a crisis. In order to test the effectiveness of this tool, investigators seek to compare the simulated medical management of a crisis (malignant hyperthermia) using a traditional cognitive aid (laminated card) versus a dynamic electronic visual aid with decision support.


Eligibility: Inclusion Criteria:
  -  resident physicians training in Anesthesia
  Exclusion Criteria:
  -  Non resident anesthesia providers

Relevance to patient case: not relevant