araag2/TREC_Precision-Medicine huggingface dataset:
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Follow-up After Endovascular Repair of Abdominal Aortic Aneurysm

Summary: To collect and analyze clinical follow-up data which can be used to assess the safety, efficacy, and durability of endovascular AAA repair with Zenith and Chuter-Gianturco stent-grafts.

Detailed description: We propose to analyze the data collected for clinical purposes in 453 patients who already underwent endovascular AAA repair at UCSF and SFVA, and others who will undergo this operation in the future. Most of these patients have now passed the 2-year follow-up required by the original protocol, all continue to be followed for clinical purposes, using the same studies, the same data forms and the same schedule as before, because studies of various devices of this type have shown that the potential for late problems requires continuing scrutiny of stent-graft structure and function, as a basis for timely re-intervention.

Eligibility: Inclusion Criteria:
  -  AAA with diameter > 4 cm or AAA with a history of growth > 0.5 cm per year
  -  treatment of AAA with Zenith Stent-Graft
  Exclusion Criteria:
  -  Pregnant
  -  Life expectancy less than two years
  -  Less than 18 years of age
  -  Unwilling to comply with clinical follow-up schedule
  -  Inability or refusal to give informed consent

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: The Induction of IL-6 by NF-kB in PBMC in OSA

Summary: Aim of study:
  1. To compare the level of IL-6 mRNA expression in peripheral blood monocytes between normal subjects and patients with OSAS
  2. To compare the activation of NF-B in peripheral blood monocytes between control subjects and patients with OSAS; Check the correlation between level of L-6 mRNA expression and activation of NF-kB
  3. To determine the effect of CPAP on the activation of NF-kB and IL-6 in peripheral blood monocytes in patients with moderate –severe OSAS

Detailed description: Obstructive sleep apnea syndrome (OSAS) has emerged in recent years as an important risk factor for cardiovascular morbidity. The mechanisms responsible for developments of cardiovascular sequelae in patients with OSA include hypoxia, hypercapnia, exaggerated negative intrathoracic pressure and bursts of sympathetic activity provoking surges in blood pressure and heart rate. Meanwhile, increase of inflammatory mediators, which included C-reactive protein (CRP), oxidative stress, adhesion molecules, vascular endothelial growth factor (VEGF) and proinflammatory cytokines (interleukin (IL) -1, IL-2, IL-6, IL-8, IL-10 and tumor necrotic factor- (TNF-)), also involve in the development of cardiovascular disease in patients with OSAS.
  According to our preliminary study, serum levels of IL-6 and CRP were higher in patients with OSAS than control subjects and levels of both IL-6 and CRP were highly correlated with the lowest pulse oxygen saturation. Hypoxia triggered the production of IL-6 through the induction of NFB, which was demonstrated in ischemic heart disease and pancreatitis. However, this mechanism has not been prooved in OSAS.
  Therefore, we conduct this study to prove our hypothesis (1) The mRNA expression of IL-6 in peripheral blood monocytes was significantly higher in patients with OSAS than control subjects (2) The activation of NF-k B in peripheral blood monocytes was more significant in patients with OSAS than control subjects, and the level of NF- kB activation is associated with the level of IL-6 mRNA expression (3) CPAP therapy could lower both the activation of NF-kB and IL-6 mRNA expression in patients with moderate-severe OSAS.

Eligibility: Inclusion Criteria:
  -  severe obstructive sleep apnea (AHI>=30 /hr) male older than 18 y/o
  Exclusion Criteria:
  -  refuse participate, chronic lung disease active infection neurologic event

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Opioid-potentiated Volative Anaesthetic Vs. Remifentanil And Propofol During Abdominal Aortic Aneurysm Surgery

Summary: Comparing 2 different anaesthetic methods during abdominal aortic aneurysm surgery. The patients will be followed up 30 days postoperative. Number of patients included will be 200. Perioperative details will be analyzed.


Eligibility: Inclusion Criteria:
  -  Patients who are planned for open, elective abdominal aortic aneurysm surgery.
  -  ASA group 1-4.
  Exclusion Criteria:
  -  Patients below 18 years.
  -  Patients who are included in other pharmaceutical studies.
  -  Opioids-, benzodiazepins-, antiepileptic drugs-, alcohol- and α2-agonists abuse.
  -  Pregnant and breastfeeding women.
  -  Patients with familiar history of malignant hyperthermia.
  -  Patients with known hypersensitivity for opioids, propofol or volative anaesthetics.
  -  Patients with considerable arrythmia (atrial fibrillation /atrial flutter is acceptable). Uncontrolled hypertension, serious psychiatric disease.
  -  Patients with unstable angina pectoris or myocardial infarction last month before inclusion.
  -  Acute abdominal aortic surgery. Acute dissection or rupture.
  -  Planned laparoscopic abdominal aortic aneurysm surgery.

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: The Effect of Doxycycline on Matrix Metalloproteinase Expression and Activity in the Abdominal Aneurysm

Summary: The matrix metalloproteinase-9 (MMP-9) is considered to play a central role in abdominal aortic aneurysm (AAA) initiation. Doxycycline has direct MMP-9 inhibiting properties in vitro, and it effectively suppresses AAA development in rodents. Observed inhibition of AAA progression, and contradictory findings in human studies evaluating the effect of doxycycline therapy on aortic wall MMP-9 suggest that the effects of doxycycline extend beyond MMP-9 inhibition, and that the effect may be dose dependent.

Detailed description: In this clinical trial, we evaluated the effect of two weeks of low (50 mg/day), medium (100 mg/day) or high dose (300 mg/day) doxycycline versus no medication in patients undergoing elective AAA repair. The effect of doxycycline treatment on MMP and cysteine proteases, and their respective inhibitors was evaluated in an integrative approach.

Eligibility: Inclusion Criteria:
  -  Elective open aneurysm repair
  Exclusion Criteria:
  -  Severe kidney and liver dysfunction

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Powerlink Bifurcated Stent Graft Long-Term Follow-up Study

Summary: Powerlink Bifurcated Infrarenal long-term follow-up study


Eligibility: Inclusion Criteria:
  -  All surviving patients from the original study cohort who received the Powerlink device
  -  All surviving patients from the original study cohort who were assigned to the open surgical control arm

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Aortic Distensibility

Summary: Can software be developed to automatically aid in the measurement of abdominal aortic aneurysms, and is there a way to predict future rupture or growth of abdominal aortic aneurysms.

Detailed description: Hypothesis: ECG-gated multidetector CT and ECG-gated Dual Source CT can be used to create multiple volumetric datasets of the abdominal aorta over the time period of the cardiac cycle, allowing for direct and regional calculations of abdominal aortic distensibility over the entire volume of the abdominal aorta, providing insight into risk of abdominal aortic aneurysm rupture and early large vessel stiffness.

Eligibility: Inclusion Criteria:
  -  AAA must be at least 3 cm to a maximum 4.9cm cross-sectional diameter.
  -  BMI 31 or less.
  -  Creatinine results <2.0 and within six months prior to scan.
  -  US patients must have only normal creatinine (0.9 to 1.4) for one year before study visit.
  -  Patients who are originally scheduled for US, who are then subsequently rolled in this study, will have only a ultrasound scan as followup after the initial CTA.
  Exclusion Criteria:
  -  Creatinine > 2.0.
  -  Creatinine <0.9 or >1.4 for those who are scheduled for US.
  -  Atrial fibrillation or other arrythmia.
  -  Known AAA greater than 5 cm in size.
  -  Allergy to contrast dye.

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Safety Study for the Treatment of Abdominal Aortic Aneurysms

Summary: The primary study objective, at this time, is to follow out to 5 years post implant the safety of already enrolled subjects who were treated with the UniFit Aorto-uni-iliac (AUI) Endoluminal Stent Graft (the "study device") for the repair of abdominal aortic aneurysms (AAAs).

Detailed description: This is a phase II, single-arm, prospective study of the safety of the study device for the repair of AAAs.
  The investigator will identify eligible patients and explain the study and study device placement procedure to each patient and/or any available family members. Patients who provide written informed consent will be evaluated for study eligibility within the time period identified under Duration of Treatment. Patients who are confirmed to be eligible, based on screening assessment findings, will be enrolled in the study.
  After hospital discharge, patients will attend study center visits at 30 days, 6 months, and 1, 2, 3, 4, and 5 years post-procedure for follow-up evaluations.

Eligibility: Inclusion Criteria:
  -  Patient is 18 years of age or older
  -  Patient has a AAA that meets one of the following criteria:
  1. Aneurysm diameter of greater than 4.5 cm, or less than 4.5 cm with rapid expansion
  2. The aneurysm has a saccular configuration where potential for rupture is increased or has exhibited dissection with potential for rupture at, or compromised flow to, vital structures
  -  The vessels immediately proximal and distal to the lesion are capable of accommodating the study device
  -  The access artery diameter and profile of the artery are capable of study device delivery.
  -  Patient has proximal and distal neck lengths of greater than or equal to 1.0 cm
  -  Patient is willing and able to comply with the follow-up regime.
  -  Patient has provided written informed consent.
  Exclusion Criteria:
  -  Patient has an aortic diameter greater than 36 mm.
  -  Patients with ASA score less than 3 and deemed low risk by the Investigator for open surgical repair.
  -  Patient has an indispensable inferior mesenteric artery.
  -  Patient has a distal landing zone of < 2 cm in length or > 16 mm in diameter
  -  Patient has iliac arteries whose tortuosity prevents passage of the introducer catheter.
  -  If female, patient is pregnant
  -  Patient has a life expectancy less than two years.
  -  Patient has an allergy to any of the study device materials
  -  Patient has coagulopathy or bleeding disorders
  -  Patient for whom contrast medium or anticoagulation drugs are contraindicated
  -  Patient has an uncontained rupture of the aneurysm.
  -  Patient has an active systemic or localized groin infection
  -  Patient has a connective tissue disease.
  -  Patient has a GFR < 30 ml/min/1.73m2
  -  Patient has a circumferential mural thrombus at the implantation site.
  -  Patient is a candidate for a bifurcated endovascular graft.
  -  Patient has an aortic trunk with an angle greater than 90°.

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Atorvastatin in Perioperative Vascular Surgery - Pilot Study

Summary: This study is designed to determine if the use of atorvastatin (Lipitor), a member of the HMG coA reductase inhibitor class of drugs referred to as statins, will reduce cardiovascular outcomes ( mortality - myocardial infarction - stroke ) when given in high doses in comparative standard doses in the perioperative period of major vascular surgery.
  Abdominal aortic aneurysm , Carotid endarterectomy , Revascularization of lower limbs


Eligibility: Inclusion Criteria:
  -  Vascular surgery (abdominal aortic aneurysm , carotid endarterectomy , limbs revascularization)
  Exclusion Criteria:
  -  Pregnant or lactating women
  -  Patient with sensitivity to atorvastatin
  -  Patient has elevations in certain laboratory values (CK, AST, ALT)
  -  Known history of active hepatic disease or known hepatic insufficiency
  -  Patients participating in another clinical trial
  -  Prior statin therapy to include: >10 mg of atorvastatin (Lipitor) or >20 mg of other HMG-CoA Reductase Inhibitors (statins) or use rosuvastatin
  -  Serious infectious disease after surgery
  -  Known history of cancer

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Fast Track Management in Elective Open Infrarenal Aortic Aneurysm Repair

Summary: Fast track programs have been introduced in many surgical fields to minimize postoperative morbidity and mortality. Morbidity after elective open infrarenal aneurysm repair is as high as 30%, mortality ranges up to 10%. In terms of open infrarenal aneurysm repair no randomized controlled trials exist to introduce and evaluate such patient care programs.

Detailed description: Prospective randomization of patients admitted with infrarenal aortic aneurysm who undergo elective open repair in a "traditional" and "fast track" treatment arm. Main differences consist in preoperative bowel washout (none vs. 3L cleaning solution) and analgesia (patient controlled analgesia vs. patient controlled epidural analgesia: PCA vs. PCEA). Study endpoints are morbidity and mortality, need for postoperative mechanical ventilation and length of stay (LOS) on intensive care unit (ICU).

Eligibility: Inclusion Criteria:
  -  infrarenal aortic aneurysm
  -  given written informed consent
  Exclusion Criteria:
  -  contraindication for epidural anesthesia
  -  suprarenal clamping

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Haemate HS in Patients With Severe Bleeding Undergoing Valve Replacement Due to Aortic Stenosis

Summary: Evaluation of efficacy by determination of transfusion requirements and safety by determination of adverse events in administration of Von Willebrand factor concentrate F VIII (Haemate).


Eligibility: Inclusion Criteria:
  -  patients with isolated valvular aortic stenosis or combined aortic-valve defect with prevailing stenosis with severe bleeding during aortic-valve replacement
  -  Caucasian
  -  written informed consent (Classification of bleeding as "normal", "moderate" or "excessive" by the surgeon.Classification as excessive leads to recruitment)
  Exclusion Criteria:
  -  active endocarditis
  -  history suggestive for inherited oe acquired bleeding disorder
  -  concomitant coronary heart disease
  -  agents impairing platelet function up to 14 days before surgery
  -  Pregnancy
  -  inherited platelet function
  -  known intolerance against HAEMATE HS
  -  previous thromboembolic complications
  -  Hepatitis B, C or HIV infection
  -  previous chemotherapy
  -  emergency surgery within the last 7 days
  -  weight < 50 kg and > 100 kg

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: A Phase I Evaluation of the Safety of the TriVascular Stent-Graft System in the Treatment of Abdominal Aortic Aneurysms

Summary: This study was a prospective observational study examined the safety of the TriVascular AAA Stent-Graft System in the elective treatment of patients with abdominal aortic aneurysms. Specifically, the study will evaluate the safety of the TriVascualr AAA Stent-Graft System, evaluate the ability to deliver the Tri-Vascular AAA Stent-Graft System to the desired location within the aorta, and evaluate the ability of the TriVascular AAA Stent-Graft to exclude the abdominal aortic aneurysm.


Eligibility: Inclusion Criteria:
  -  Male or infertile female
  -  Have signed an informed consent form.
  -  Are considered an appropriate candidate for open surgical repair of an abdominal aortic aneurysm.
  -  at least one of the following: Abdominal aortic aneurysm >= 4.5 cm in diameter; aneurysm has increased in size by 0.5cm in last 6 months; maximum diameter of aneurysm exceeds 1.5 times the transverse dimension of an adjacent normal aortic segment; saccular aneurysm larger than 3 cm.
  -  Have patent iliac or femoral arteries that allow endovascular access to the aneurysmal site with a 17F Delivery Catheter.
  Exclusion Criteria:
  -  A dissecting, acutely ruptured, or leaking aneurysm, or an acute vascular injury due to trauma.
  -  A need for emergent surgery.
  -  contraindication to undergoing angiography.
  -  A Thoracic aortic aneurysm that requires treatment.
  -  Presence of thrombus or atheroma in proximal aortic neck covering > 50% of the endoluminal surface.
  -  Presence of diffuse atherosclerotic disease in either common iliac artery that reduces the iliac artery diameter to <7mm.
  -  Congenital abnormalities in which the placement of the stent-graft will cause occlusion of major arterial flow. Such abnormalities should be evaluated(e.g. angiography or CT) prior to treatment.
  -  Unstable angina
  -  Morbid obesity or other clinical conditions that severely inhibit x-ray visualization of the aorta.
  -  Connective tissue disease (e.g., Marfan's or Ehlers-Danlos syndrome.)
  -  Hypercoagulable state.
  -  Contraindication for anticoagulation.
  -  Acute renal failure.
  -  Active systemic infection.
  -  less than 18 years of age.
  -  Life expectancy less than 1 year.
  -  Current, or anticipated participation within 1 year, in another research study involving an investigational device or new drug (with the exception of participation in the Lifeline Registry of Endovascular Therapy).
  -  Other medical, social, or psychological issues that in the opinion of the investigator preclude them from receiving this treatment, and the procedures and evaluations pre- and post-treatment.

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Suprarenal Proximal Cuff Study for Treatment of Abdominal Aortic Aneurysm

Summary: The use of a suprarenal extension device during the index AAA procedure to accommodate the patient's anatomy and to prevent or repair leakage.


Eligibility: Inclusion Criteria:
  -  18 years old
  -  Informed consent understood and signed
  -  Will comply with post-treatment follow-up requirements up to 5 years
  -  Candidate for Powerlink Infrarenal Bifurcated Graft
  Exclusion Criteria:
  -  Life expectancy < 2 years
  -  Participating in another clinical research study
  -  Pregnant or lactating women
  -  Patient has other medical or psychiatric problems, which in the opinion of the Investigator, precludes them from participating in the Study
  -  Creatinine level > 1.7mg/dl
  -  Renal transplant patient
  -  Patient with > 75% renal artery stenosis and not eligible for PTA/stent intervention prior to suprarenal device fixation

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Biomarkers of Aneurysm Wall Strength

Summary: The purpose of this study is to identify possible in vivo biochemical and biological markers related to aortic wall strength.

Detailed description: Rupture of an Abdominal Aortic Aneurysm (AAA) is potentially lethal. prophylactic surgical repair is therefore warranted when the risk of rupture exceeds the risk of complications following surgery. Aneurysm rupture occurs when the forces (stress) acting on the aneurysm wall surpass aneurysm wall strength. Information on both wall stress and strength might therefore improve rupture risk assessment and patient selection for prophylactic repair. Although aneurysm wall stress calculations are possible, no in vivo method exists to determine aneurysm wall strength. This study was designed to identify possible biomarkers of aneurysm wall strength

Eligibility: Inclusion Criteria:
  -  Patient scheduled for transabdominal aortic surgery
  Exclusion Criteria:
  -  Patient characteristics and aneurysm anatomy suitable for endovascular repair
  -  Previous aortic surgery

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Prevention of Incisional Hernia by Mesh Augmentation After Midline Laparotomy for Aortic Aneurysm Treatment

Summary: The research hypothesis for this study is to possibly reduce the incidence of incisional hernia 2 years postoperatively after midline laparotomy for treatment of aortic aneurysm from 25% to 5% by mesh augmentation during closure of the laparotomy. The study is designed as a prospective randomised multi-centre trial, randomising patients in 2 groups concerning the surgical technique of the closure of the abdominal wall.


Eligibility: Inclusion Criteria:
  -  All patients undergoing elective Abdominal Aorta Aneurysm treatment through a midline laparotomy are eligible for the trial.
  -  All patients should sign the informed consent.
  Exclusion Criteria:
  -  Patients below 18 years.
  -  Pregnancy.
  -  Emergency surgery for aortic aneurysm.
  -  Presence of mesh in the abdominal wall on the midline from previous operations ASA score 4 or more.

Relevance to patient case: not relevant
Patient case: 63-year-old female with aortic aneurysm; genetic feature: ACTA2

Clinical trial: Study to Evaluate the Safety and Efficacy of NKTR-102 in Patients With Metastatic or Locally Advanced Breast Cancer

Summary: This is a multicenter, open-label, two-arm, 2-stage, Phase 2 study of NKTR-102 in patients with metastatic or locally advanced breast cancer whose disease has failed prior taxane-based treatment in the metastatic setting.
  Patients will be randomized 1:1 into one of two treatment arms. NKTR 102 will be administered at a dose level of 145 mg/m2 in both arms. In Arm A, NKTR-102 will be given on a q14d schedule. In Arm B, NKTR-102 will be given on a q21d schedule. Approximately 70 patients may be evaluated in this study with approximately 35 patients enrolled in each treatment arm.


Eligibility: Inclusion Criteria:
  1. Inoperable metastatic or locally advanced breast cancer
  2. No more than 2 prior chemotherapy regimens given in a metastatic or locally advanced setting and prior treatment in the metastatic setting must have included a taxane
  Exclusion Criteria:
  1. Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to Day 1 of Cycle 1
  2. Patients who have had any major surgery within 4 weeks prior to Day 1 of Cycle or minor surgery within 2 weeks prior to Day 1 of Cycle 1

Relevance to patient case: not relevant