Kornimate/medical-research-clean huggingface dataset:
a simple intervention to increase persistence on prep in msm to improve decision making

Conditions: HIV Infections

Summary: oral hiv pre-exposure prophylaxis (prep) is a highly effective hiv prevention modality that requires individuals to take a daily tablet to prevent themselves acquiring hiv. in south africa while this is freely available in the public sector, persistence (that is continuation after initiation) is low amongst vulnerable populations, including men who have sex with men (msm). this study is a feasibility and acceptability study of a behavioral economics informed intervention to improve persistence amongst msm newly initiating prep in south africa. the goal of this study is to show that this approach is possible in a routine setting and gather the necessary data for a fully powered effectiveness trial. study participants will complete a baseline questionnaire and then be randomized to either receive standard of care (control) or to receive the intervention. the intervention package consists of evidence informed reminders, commitment pledges and planning prompts. the intervention package aims to address present bias, optimism bias and salience. the intervention is delivered and the enrollment visit and then through mobile phone reminders / text messages. there is no further in person interaction after the initial interaction. participants may be contacted for a telephonic enplane questionnaire. outcome data is obtained from passive followup through routine medical record review with the primary end point being persistence at 3 months.


Eligibility criteria:
inclusion criteria: * not currently on pre exposure prophylaxis (prep); no prep within the last 12 months * initiating prep on the date of enrolment * access to a mobile phone * willing and able to provide written informed consent in english exclusion criteria: * prep status unknown * previous prep experience within the last year (12 months from enrolment)

Keywords: pre-exposure prophylaxis (prep) persistence vulnerable populations men having sex with men (msm) south africa
visual field infiltration of tranexamic acid reduced the blood loss in total knee arthroplasty

Conditions: Total Knee Arthroplasty

Summary: background and study aims osteoarthritis (oa) is the most common type of arthritis, which most often affects the knee. it occurs when the protective cartilage on the end of bones wears away. the bones then rub against one another, which can cause stiffness, pain and a reduction in a person's range of movement. a knee joint replacement is a common procedure where the weight bearing surfaces of the knee joint are replaced with metal and plastic components to relieve the pain and disability brought on by oa. tranexamic acid（txa） is a traditional method to reduce blood loss, pain score and complications. it is not known however, what is the best method of txa for the patients with tka. the aim of this study is to find out whethervisual field infiltration of tranexamic acid reduced the blood loss in patients who have had knee replacement surgery.

who can participate? adults who have oa and need a total knee replacement. what does the study involve? participants are randomly allocated to one of three groups. for the interventions field, could you please provide a brief methodology for each of your treatment arms, and the total duration of treatment and follow-up? group a: visual field infiltration of tranexamic acid during the operation of total knee replacement. group b: no visual field infiltration of tranexamic acid during the operation of total knee replacement. the blood loss, vas pain scores, length of their hospital stay, swelling and bleeding, and range of motion of the affected knee are assessed in the days following surgery. what are the possible benefits and risks of participating? participants who are allocated to receive treatment with visual field infiltration of tranexamic acid may benefit from a reduction in blood loss, pain, swelling and blood loss after surgery, shortening their hospital stay. there is a small risk of discomfort, frostbite or deep vein thrombosis (a blood clot in a major vein in the leg) when using visual field infiltration of tranexamic acid.

Eligibility criteria:
inclusion criteria: adults who have oa and need a total knee replacement. exclusion criteria: 1. patients had abnormal blood coagulation. 2. patients were diagnosed as rheumatoid arthritis, traumatic osteoarthritis, ankylosing, spondylitis, hemophilic arthritis, peripheral vascular disease. 3. cold urticaria. 4. preoperative anticoagulation, patients had preoperative deep vein thrombosis (dvt). 5. preoperative history of anemia.
effectiveness of a biosimilar epoetin alfa in stable 'end stage renal failure'

Conditions: End Stage Renal Failure; Anaemia

Summary: this is a prospective, observational, non-inferior study in esrf patients stable on eprex who are switched to a biosimilar epoetin alfa. study plans to recrut 44 patients. following recruitment, a baseline data collection of full routine laboratory test before switch to binocrit.primary endpoint is mean change in haemoglobin levels at 12 weeks and secondary endpoint is mean change in haemoglobin levels at 6 weeks safety endpoint will be adverse drug reactions and serious adverse effects analysis: changes from baseline at week 6 and week 12 will be evaluated using paired t-test or wilcoxon signed ranks test as appropriate. changes in continuous variables over time were evaluated using repeated-measures analysis of variance. patients with iron-deficiency (ferritin \<100 ng/ml or transferrin saturation \<20%) will be analysed separately

anaemia in ckd is associated with reduced quality of life and increased cardiovascular disease, hospitalizations, cognitive impairment, and mortality. correcting anaemia is considered an important part of slowing or even stopping the progression of ckd. recombinant human erythropoietins (epo) such as epoetin alfa are erythropoiesis-stimulating agents (esas) that are important treatment options. the esa that is currently used in the hospital is eprex®, a recombinant human epo epoetin alfa which will soon be replaced by binocrit®, a biosimilar esa approved by the european medicines agency (ema). we want to see whether maintenance of haemoglobin in stable esrf patients would be affected by this switch in real life practice in the malaysian population. this is a prospective, observational, non-inferiority study in esrf patients stable on eprex who are switched to a bio similar epoetin alfa . study population will be 44 end stage renal failure patients from penang and seberang jaya hospital.following recruitment, a baseline data collection of full routine laboratory test before switch to a bio similar epoetin alfa .primary endpoint is mean change in haemoglobin levels at 6 weeks and secondary endpoint is mean change in haemoglobin levels at 12 weeks safety endpoint will be adverse drug reactions and serious adverse effects analysis: changes from baseline at week 6 and week 12 will be evaluated using paired t-test or wilcoxon signed ranks test as appropriate. changes in continuous variables over time were evaluated using repeated-measures analysis of variance. patients with iron-deficiency (ferritin \<100 ng/ml or transferrin saturation \<20%) will be analysed separately

Eligibility criteria:
inclusion criteria: 1. end stage renal failure (esrf) patients on 3x per week hd for at least 6 months who are planned for conversion to binocrit 2. stable dose of eprex and iron for at least 3 months 3. no active bleeding exclusion criteria: 1. allergy to erythropoietin 2. bone marrow disorder 3. acute/chronic bleeding 4. acute illness requiring hospitalization within the last 3 months
end-of-life management protocol offered within emergency room: a multicentre study (empower)

Conditions: Palliative Care; Emergency Department; Cost Effectiveness

Summary: end-of-life (eol) care has garnered increasing recognition and acceptance in the field of emergency medicine. some emergency departments (eds) in singapore have instituted or plan to institute eol care as part of the workflow. however, the eol protocols are not standardised across all these eds. the adherence to and quality of eol care have not been formally measured in all institutions. hence, gaps to improve the quality of care have yet to be determined. the aims are to systematically measure the current quality of eol care in three singapore hospital eds and identify the quality gaps; formulate interventions to address these gaps and implement the improved eol care; and measure the improvement post-implementation. the investigators hypothesise that the current quality of eol care in three eds is suboptimal and the interventions planned will improve the quality of care provided. the study team plans to conduct an interrupted time series study to detect whether the interventions have an effect significantly greater than any underlying trend over time. the quality of care indicators to be measured are timely identification of patients who require eol care, adequacy of symptom control based on compliance to prescriptions, opportunities to discuss and develop an individualised care plan, perceived quality of care by healthcare providers and next-of-kin, and cost effectiveness. planned interventions include refining the protocol with collaboration of content experts in palliative care, education and training of healthcare providers, and addressing specific gaps identified to improve cost effectiveness. the results of this study will form the standardisation and foundation for establishing the national benchmark for quality of eol care in singapore eds.


Eligibility criteria:
inclusion criteria: * actively dying patient or high likelihood of mortality within 48 hours * family accepts that the goals of care are provision of comfort, symptom relief and respect of dignity * patient is not a candidate for cardiopulmonary resuscitation, endotracheal intubation or transfer to the intensive care unit * family members want to stay by patient's bedside * any of the life-limiting conditions such as chronic frailty with poor functional state and limited reversibility (karnofski performance scale \<40%), chronic severe illness with poor prognosis, or other deteriorating conditions and at risk of dying with complications that are not reversible, as subject to the treating clinician's judgment exclusion criteria: * vulnerable population e.g. prisoners, pregnant women * patients, relatives or staff who refused to participate * patients who have been recruited, or had declined participation, in the previous ed attendance(s)
efficacy and safety of meloxicam suspension versus diclofenac suspension or nimesulide suspension in patients with a diagnosis of acute, non-bacterial pharyngitis, pharyngotonsillitis or laryngitis

Conditions: Pharyngitis

Summary: the objective of this study was to assess the clinical efficacy and safety of meloxicam suspension 0.25 mg/kg/day once a day, versus diclofenac suspension 1 mg/kg/day twice a day or nimesulide suspension 4 mg/kg/day twice a day, after five days of treatment in patients with a diagnosis of acute, non-bacterial pharyngitis, pharyngotonsillitis or laryngitis


Eligibility criteria:
inclusion criteria: * patients of both genders between 2 and 8 years old * outpatients, with onset of symptoms not more than 72 hours prior to presentation, patients with acute non-bacterial pharyngitis or pharyngotonsillitis diagnosed according to the following criteria: * spontaneous pharyngeal pain, pharyngeal pain upon swallowing, pharyngeal and/or tonsillar hyperemia, absence of purulent plaques, pharyngeal smear negative for ß-hemolytic streptococcus or strepto test® and treatment with an non-steroidal anti-inflammatory drugs (nsaid) required or recommended exclusion criteria: * known or suspected hypersensitivity to study medications or nsaid's * pharyngeal smear positive for ß-hemolytic streptococcus * treatment with antimicrobials prior to enrolment in the study * chronic infection, infectious mononucleosis, peptic ulcer disease that has been active in the previous 6 months * asthma * nasal polyps * angioneurotic edema or urticaria after the administration of aspirin or nsaid's * concomitant treatment with anticoagulants (including heparin), lithium or methotrexate * concomitant administration of other nsaid's (including high dose aspirin) or analgesics, except authorized rescue drugs * administration of any nsaid during the three previous days or of analgesics within six hours prior to the administration of the first study drug dose * treatment with corticosteroids at the time of enrollment or within the two previous months * known liver, renal or hematological disease * participation in another clinical trial during the study period or during the previous month * previous enrollment in this study * inability to comply with the protocol * suspected acute bacterial pharyngitis or pharyngotonsillitis (under the following clinical criteria): * clinical presentation characterized by a rapid onset, very high fever (\>38.5°c), severe pharyngeal pain, cervical adenopathy, intense headache, purulent pharyngeal plaques, evidence of peritonsillar abscess or phlegmon
evaluation of the lung recruitment and end-expiratory lung collapse in acute respiratory distress syndrome (ards)

Conditions: ARDS: Acute Respiratory Distress Syndrome

Summary: in this study gas-exchange and respiratory mechanics variations to peep change will be correlated to ct lung morphological modifications assessed at different airway pressures (5, 15, 30 and 45 cmh2o).


Eligibility criteria:
inclusion criteria: * clinical diagnosis of acute lung injury/ acute respiratory distress syndrome * mechanical ventilation exclusion criteria: * clinical diagnosis of chronic obstructive pulmonary disease * clinical diagnosis of pneumothorax * haemodynamic instability
gabapentin and tizanidine for insomnia in chronic pain

Conditions: Insomnia Due to Medical Condition; Chronic Pain

Summary: this is a double-blind, placebo-controlled, randomized, crossover trial aimed at assessing the effect of gabapentin and tizanidine, two pain medications, on insomnia in chronic pain patients.

chronic pain and insomnia are highly prevalent conditions affecting 10-25% and 6-10% of the general population, respectively. importantly, these two conditions frequently co-occur, with 50-80% of chronic pain patients reporting sleep disturbances. identifying medication that alleviates pain and insomnia simultaneously may help reduce risks associated with polypharmacy, including drug-drug interactions. in this double-blind, placebo-controlled, randomized, crossover trial, gabapentin and tizanidine, two drugs which are respectively commonly used to treat neuropathic and musculoskeletal pain, will be compared to each other and to placebo in their ability to alleviate insomnia in chronic pain patients. in each week, patients will receive 3-night (friday-sunday) trials each of placebo, gabapentin or tizanidine in a randomized, double-blind order and will monitor their insomnia using the athens insomnia scale (ais) questionnaire (adapted to fit the time frame of this trial). the primary outcome consists of the difference in mean ais scores between the 3 treatments at the primary time point, which is monday of each week (after 3 nights of drug intake). patients will also monitor their sleepiness, pain relief and overall improvement as secondary variants using the stanford sleepiness scale (sss), visual analog scale (vas), and patient's global impression of change (pgic) questionnaires respectively. scores on the monday preceding the first treatment will serve as baseline and the period between treatments (i.e. monday-thursday nights) will serve as a 4-day washout period between treatments. our hypothesis is that gabapentin and tizanidine will both be more effective than placebo in alleviating insomnia in chronic pain patients but will not be different from one another.

Eligibility criteria:
inclusion criteria: * bmi ≤ 35 * any ethnicity * must be able to communicate in english * must have access to email and be able to respond to redcap questionnaires in english * has a chronic pain condition (≥ 3 months of pain) * reports sleep disturbance and scores ≥ 6 on ais questionnaire * ability to provide informed consent exclusion criteria: * pregnancy * breastfeeding * has diagnosis of chronic kidney disease * has known qt prolongation \>500 msec on prior ekg * inability to complete daily questionnaires * allergy to, or intolerance of, any of tizanidine or gabapentin * shift workers * anticipated travel across multiple time zones (jetlag) during the duration of the trial * circadian misalignment * prior syncope experience and/or fear of blood/needles (if a blood draw is required)

Keywords: insomnia chronic pain gabapentin tizanidine placebo
impact of the covid-19 pandemic on the organization of healthcare in france

Conditions: COVID-19

Summary: the 2020 covid-19 pandemic, which began spreading on january 24, 2020 in france, has required a profound and rapid reorganization of the health system, based in particular on internal hospital reorganizations of front-line establishments, deprogramming of non-urgent activities, and transfers of non-covid19 patients to 2nd line facilities. beyond the immediate impact on the management of patients infected with covid-19, this reorganization may have reduced the capacity of management for patients requiring urgent or semi-urgent intervention, or may have postponed some necessary care. the isolation of patients at home may also have resulted in lower compliance to therapy and medical treatments and may have contributed to decompensation. at the end of this crisis, the different organizational responses in france should be evaluated to identify the consequences and the areas for improvement in order to be prepared for future exceptional health situations. this investigation on healthcare systems confronted to an exceptional health situation thus seeks to determine if the profound reorganizations implemented during this health crisis have indirect effects on the performance of care, in particular if there is a destabilization of the care systems (emergency, semi-emergency and chronic), a loss of chance for the patients and if innovative care paths have emerged.


Eligibility criteria:
inclusion criteria: * patients with one of these three types of chronic diseases (prevention quality indicators of the agency for healthcare research and quality): heart failure, diabetes, chronic obstructive pulmonary disease. * all french adult patients suffering from the studied chronic diseases, covered by the health insurance and living in metropolitan france are included. exclusion criteria: * patients under 18 years of age or with incomplete or inconsistent data on the "système national des données de santé", or with a symptomatic covid-19 diagnosis.
prospective clinical follow-up after the percutaneous closure of a patent foramen ovale

Conditions: Stroke; Foramen Ovale, Patent

Summary: following a cryptogenic stroke, many patients are nowadays treated with the percutaneous closure of a patent foramen ovale (pfo), assuming that the aetiology of the stroke is secondary to a paradoxical embolism. after the pfo closure procedure a dual antiplatelet regimen is often prescribed for 3-6 months and several cardiologic and neurologic follow-up exams are scheduled in the first 12 months of follow-up. usually a transthoracic +/- transoesophageal echocardiography (tte +/- tee) are performed at 6 months, however this kind of control is not systematically performed. in order to improve the clinical outcomes in this young patients' population, the investigators prospectively perform a complete cardiologic and neurologic follow-up program to all patients undergoing a successful percutaneous closure of a pfo. the aim of these controls is to confirm the good position of the pfo-device, to confirm the absence of any residual right to left shunt or any significant atrial arrhythmias furthermore this prospective follow-up will analyze the possible mechanisms leading to a cerebral stroke recurrence (e.g. size of the pfo, presence of an atrial septal aneurysm, presence of a residual shunt, size of the utilized closure device, ....).

at follow-up the following exams will be performed: * at hospital discharge: chest x-ray +/- tte + 7-days event loop record (elr) * at 6 months: clinical cardiologic and neurologic examination + tte + tee + 7-days elr + trans-cranial doppler (tcd) with micro bubbles detection. * at 1 year: clinical cardiologic and neurologic examination + tte +/- tee + 7-days elr + trans-cranial doppler (tcd) with micro bubbles detection +/- cerebral mri

Eligibility criteria:
inclusion criteria: * 18 years old patients * signed informed consent * all consecutive patients undergoing a successful percutaneous closure of a pfo secondary to a cryptogenic stroke exclusion criteria: * all patients with an alternative aetiology of the initial stroke * all patients in whom the percutaneous closure of the pfo is contraindicated * all patients with a known allergy to aspirin and or clopidogrel

Keywords: cryptogenic stroke percutaneous closure of pfo follow-up exams
comparison of the clinical effects between different physical therapy tools in patellofemoral pain patients

Conditions: Patellofemoral Pain Syndrome

Summary: objectives:the purpose of this study was to investigate the different effects among the quadriceps strength training, taping, and stretching exercise of iliotibial band in patients with patellofemoral pain syndrome by randomized control trial study. method:an observer blind, prospective, factorial design randomized controlled trail. 90 young adults with patellofemoral pain syndrome were randomly allocated into one of three treatment groups: (1) quadriceps strength training, (2) taping, and (3) stretch. each group received treatment for 8 weeks. hypothesis:patients in quadriceps strength training group may get most outcomes in three groups

introduction:patellofemoral pain syndrome ( pfps ) is a common knee disorder. factors that cause patellofemoral pain include: over use, soft tissue imbalance, and malalignment of lower extremity. patients with patellofemoral pain, caused by soft tissue imbalance was thought to be favorite to receive physical therapies. clinically, physical therapies for patients with pfps are including: quadriceps strength training, taping, and stretching exercise. the aforementioned treatment tools showed different effect mechanism. however, there were few clinical studies to compare the clinical effects among the aforementioned three treatment tools. the purpose of this study was to investigate the different effects among the quadriceps strength training, taping, and stretching exercise of iliotibial band in patients with patellofemoral pain syndrome by randomized control trial study. methods:an observer blind, prospective, factorial design randomized controlled trail. 90 young adults with patellofemoral pain syndrome were randomly allocated into one of three treatment groups: (1) quadriceps strength training, (2) taping, and (3) stretch. each group received treatment for 8 weeks. outcome measures were including visual analog scales for worst pain, active-active joint reposition error test, the chinese version of the western ontario and mcmaster universities osteoarthritis index, and one repetition maximum recorded at baseline and after the interventions for 8 weeks.

Eligibility criteria:
inclusion criteria: * anterior or retropatellar knee pain present during at least two of the following: ascending/descending stairs, hopping, running, squatting, kneeling, and prolong sitting * insidious onset of symptom unrelated to a traumatic incident * pain on palpation of peripatella * vas\>3 * age \<50 years old * symptoms sustained for more than 1 month exclusion criteria: * over activity: athlete, infatry * patients with meniscal lesion, ligamentous instability, patellar tendon pathology, radiation pain from spine, referred pain * neurological disease involved