Kornimate/medical-research-clean huggingface dataset:
ct-based hvpg assessment for predicting the prognosis of hcc with tace (chance-chess 2302)

Conditions: Hepatocellular Carcinoma; Portal Hypertension

Summary: this study aims to evaluate the impact of non-invasive ct-based hepatic venous pressure gradient (hvpg) assessment on prognosis of hepatocellular carcinoma (hcc) patients treated with transarterial chemoembolization (tace).

hepatocellular carcinoma (hcc) is the sixth most common cancer worldwide and the second leading cause of cancer-related deaths globally. transarterial chemoembolization (tace) is recommended as standard therapy for intermediate-stage hcc according to the current guidelines and is also the most widely used in advanced hcc in real-world practice. portal hypertension increases the risk of hepatic decompensation, which impairs survival in patients with hcc. clinically significant portal hypertension is defined as \>10 mmhg increase in the hepatic vein pressure gradient (hvpg), and the current gold standard for its assessment is direct measurement, through a transjugular approach. however, due to its invasive character and high effort, hvpg measurement is not a standard tool in the initial diagnostic evaluation of patients with hcc. this study aims to evaluate the impact of non-invasive ct-based hepatic venous pressure gradient (hvpg) assessment on prognosis of hepatocellular carcinoma (hcc) patients treated with transarterial chemoembolization (tace).

Eligibility criteria:
inclusion criteria: 1. has a diagnosis of hcc confirmed by radiology, histology, or cytology; 2. received at least 1 tace treatment； 3. contrast-enhanced computed tomography (cect) examination within 1 month before the first tace treatment; exclusion criteria: 1. cholangiocarcinoma, fibrolamellar, sarcomatoid hepatocellular carcinoma, and mixed hepatocellular/cholangiocarcinoma subtypes(confirmed by histology, or pathology) are not eligible; 2. eastern cooperative oncology group - performance status (ecog-ps) \> 2; 3. history of liver or spleen resection; 4. loss to follow-up; 5. cect image data was incomplete, unclear, or artifact occurred.

Keywords: hepatocellular carcinoma transarterial chemoembolization portal hypertension non-invasive imaging assessment deep learning
vertical femoral neck fractures in young adult patients

Conditions: Femoral Neck Fractures

Summary: does the current techniques of internal fixation of vertical neck fracture in young adult patients give a satisfactory radiological and functional outcome at one year follow up?

* displaced femoral neck fractures in young adults are most likely to result from high energy trauma that causes a vertically-oriented shearing injury through the femoral neck. * the most descriptive classification used for femoral neck fractures in young patients is the pauwels classification. as the degree of the femoral neck fracture line relative to the horizontal plane increases, the types differ (30 degrees type i, between 30 degrees and 50 degrees type ii, 50 degrees type iii), and the instability of the fracture. * greater fracture verticality contributes to greater difficulty in obtaining adequate stability to resist vertical shear forces around the hip, thereby resulting in ascending greater risk of complications such as nonunion and osteonecrosis despite a number of potential fixation strategies. * the primary goals of surgery include preservation of the femoral head, avoidance of osteonecrosis, and achievement of a stable union. * fixation options include cannulated screws, sliding hip screw with or without an additional derotation screw,. among orthopedic trauma surgeons there is no consensus that a single fixation option is superior for treating these injuries.

Eligibility criteria:
inclusion criteria: * age of the patients from 20 to 50 years * pauwel type iii fractures * recent fracture within one week exclusion criteria: * • open fractures * pathological or osteoporotic fractures. * patient with comorbidities: d.m, renal patient, neurological deficits. * patient associated with femoral head fractures or head impaction.
prevention of arrhythmia device infection trial (padit)

Conditions: Arrhythmia

Summary: the goal of the pilot study is to compare whether a centre-wide policy of incremental antibiotic therapy will reduce pacemaker infection compared to a policy of conventional antibiotic prophylaxis in high-risk patients undergoing arrhythmia device procedures. this pilot study will provide feasibility information for a larger cluster randomized crossover design (crcd).

multi-center, cluster crossover, unblinded, pilot study. centers will be randomized to conventional vs. incremental antibiotic therapy for 2 months or until eligible 20 patients are treated, whichever comes first. at 2 months, centers will have a crossover period of 4 weeks where the alternate strategy is implemented, followed by the final 2-month/20 patient enrolment period. during each treatment period the randomized antibiotic strategy will be used on all center patients undergoing a device implant procedure. prior to the planned surgery or at the first follow up visit, patients who meet the study eligibility criteria will be approached to obtain consent for data collection purposes. follow up will be according to usual clinical care at the center.

Eligibility criteria:
inclusion criteria: * \> 18 years * received one of the following procedures: 1. a second or subsequent procedure on the arrhythmia device pocket: i. icd, pacemaker, crt-p, crt-d generator and/or lead replacement. ii. pocket or lead revision iii. system upgrade (insertion or attempted insertion of leads) 2. new cardiac resynchronization therapy device implant (pacemaker or icd) exclusion criteria: * life expectancy \< 12 months in the opinion of the local investigator. * allergy or unable to tolerate cefazolin or clindamycin or vancomycin. * allergy or unable to tolerate intracavitary bacitracin identified per-operatively. * pre-operative identification that the patient has infection.

Keywords: arrhythmia device procedure high risk patients antibiotics infection cluster
a phase 2b study of spi-1005 to prevent acute noise induced hearing loss

Conditions: Noise Induced Hearing Loss

Summary: spi-1005 is a novel oral drug that contains a glutathione peroxidase mimetic (ebselen) that will be tested in subjects with a history of nihl at risk for additional nihl. the goal of this multi-center phase 2b study is to determine whether spi-1005 is effective in reducing an acute nihl in this affected population. in this phase 2b study subjects with prior nihl will be enrolled and exposed to a calibrated sound challenge (csc) that induces a slight acute nihl.

randomized, double-blind, placebo-controlled, safety and efficacy study of oral spi-1005 in adults with noise induced hearing loss (nihl). all recruited subjects will have their severity of nihl determined before the start of spi-1005 treatment using various hearing tests. subjects will be enrolled and randomized to either placebo or spi-1005. subjects will be dosed with either placebo or spi-1005 for 7 days, beginning 1 day before an acute nihl. subjects will have hearing tests performed before and immediately after a calibrated sound challenge (csc). follow-up hearing tests will be performed post-csc.

Eligibility criteria:
inclusion criteria: * adult male or female patients, 18-50 years of age * history of either recreational and/or occupational exposure to noise * voluntarily consent to participate in the study * females of childbearing potential should be using and committed to continue using one of the following acceptable birth control methods: sexual abstinence (inactivity) for 14 days prior to screening through study completion; or intra-uterine device in place for at least 3 months prior to study through study completion; or barrier method (condom or diaphragm) with spermicide for at least 14 days prior to screening through study completion; or stable hormonal contraceptive for at least 3 months prior to study through study completion; or surgical sterilization (vasectomy) of partner at least 6 months prior to study. * females of non-childbearing potential should be surgically sterile (bilateral tubal ligation with surgery at least 6 months prior to study, hysterectomy, or bilateral oophorectomy at least 2 months prior to study) or be at least 3 years since last menses. exclusion criteria: * current use or within 60 days prior to study of excluded ototoxic medications * history of autoimmune inner ear disease * history of middle ear or inner ear surgery * current conductive hearing loss or middle ear effusion * significant cardiovascular, pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, or psychiatric disease * history of hypersensitivity or idiosyncratic reaction to compounds related to ebselen * current use or within 30 days prior to study of drugs or substances known to be strong inhibitors or inducers of cytochrome p450 enzymes * participation in another investigational drug or device study within 90 days prior to study enrollment * female patients who are pregnant or breastfeeding

Keywords: acute noise induced hearing loss prevent acute noise induced hearing loss
a single dose comfort comparison of travatan z in one eye versus xalatan in the opposite eye in patients with primary open-angle glaucoma or ocular hypertension

Conditions: Open-Angle Glaucoma; Ocular Hypertension

Summary: the purpose of this study is to compare the comfort of travatan z in one eye and xalatan in the opposite eye in patients with primary open-angle glaucoma or ocular hypertension.


Eligibility criteria:
inclusion criteria: * 18 years of age or older. * clinical diagnosis of ocular hypertension, primary open-angle, pigment dispersion, or exfoliation glaucoma in both eyes. * best corrected visual acuity of 20/200 snellen or better in each eye. * intraocular pressure within protocol-specified range. * other protocol-defined inclusion criteria may apply. exclusion criteria: * any abnormality preventing reliable applanation tonometry in the study eye(s). * any eye conditions or procedures as specified in protocol. * progressive retinal or optic nerve disease from any cause. * use of contact lenses in the study eye(s). * other protocol-defined exclusion criteria may apply.

Keywords: comfort
clinical efficacy evaluation of electroacupuncture as adjuvant therapy for female patients with overactive bladder

Conditions: Overactive Bladder

Summary: overactive bladder (oab) is often accompanied by frequent urination and nocturia, and does not necessarily manifest as urge incontinence. urgency to urinate and frequent urination can lead to psychological burdens, affect interpersonal relationships and reduce women's quality of life. treatment of oab includes lifestyle changes, behavioral therapy, drug therapy, neuromodulation, botulinum toxin therapy, and surgical intervention. at present, anticholinergic drugs are usually the first-line treatment for oab, but the side effects of dry mouth often lead to poor patient compliance. transcutaneous tibial nerve stimulation (ptns) is a minimally invasive neuromodulation technique. past studies have confirmed that ptns has clinical efficacy in treating symptoms related to overactive bladder, while tcm's electroacupuncture is similar to ptns. the main purpose of this study was to evaluate the specific acupoints in accordance with traditional chinese medicine theory in women with oab under conventional western medicine treatment to evaluate the improvement of women's related urinary tract symptoms, quality of life and autonomic nervous system function.

overactive bladder (oab) is often accompanied by frequent urination and nocturia, and does not necessarily manifest as urge incontinence. urgency to urinate and frequent urination can lead to psychological burdens, affect interpersonal relationships and reduce women's quality of life. treatment of oab includes lifestyle changes, behavioral therapy, drug therapy, neuromodulation, botulinum toxin therapy, and surgical intervention. at present, anticholinergic drugs are usually the first-line treatment for oab, but the side effects of dry mouth often lead to poor patient compliance. transcutaneous tibial nerve stimulation (ptns) is a minimally invasive neuromodulation technique. past studies have confirmed that ptns has clinical efficacy in treating symptoms related to overactive bladder, while tcm's electroacupuncture is similar to ptns. the main purpose of this study was to evaluate the specific acupoints in accordance with traditional chinese medicine theory in women with oab under conventional western medicine treatment to evaluate the improvement of women's related urinary tract symptoms, quality of life and autonomic nervous system function.

Eligibility criteria:
inclusion criteria: * female patient aged 20-80 with overactive bladder. exclusion criteria: * patient has history of cancer, stroke, or hyperthyroidism.. * patient isn't willing to accept acupuncture or moxibustion treatment. * patient who is pregnant or plan to pregnant. * patient with urinary tract infection. * patient who had injection of botulinum toxin (botox®), ptns or smn treatment before. * patient recieved acupuncture treatment before.

Keywords: urge incontinence overactive bladder quality of life tcm constitution, electroacupuncture
efficacy study of surgical technique in intramedullary tibia nailing, using trigen meta tibia nails

Conditions: Tibial Fractures

Summary: multicentre prospective randomized clinical trial, to evaluate patients after surgery for extra-articular tibial fractures treated with smith\& nephew's trigen meta intramedullary nailing system; comparing two surgical techniques: group a=standard technique(90º of knee flexion) and group b=with the semi-extended surgical technique. (2\*100 patients) research objectives: the primary research objectives are to evaluate: i) anterior knee pain and ii) the nail position and overall fracture alignment outcome measures: 1. nail positioning by means of intra-operative fluoroscopy and post operative x-rays. 2. anterior knee pain by means of vas-scores, a kneeling test and subjective outcomes by means of patient questionnaires 3. knee-related adverse events 4. overall fracture alignment

after surgery with standard intramedullary nailing technique in tibia fractures, 40-80% of the patients still complain of anterior knee pain postoperative. the expected advantages of the semi-extended nailing technique is less anterior knee pain and less malunion of the fracture. using the semi-extended nailing technique also might give the advantage of better position of the nail by a more concentric reaming of the tibia, due to less tension on the patella tendon during reaming process.

Eligibility criteria:
inclusion criteria: * patient has sustained a closed (tscherne classification) or open tibial fracture (gustillo-anderson classification) that is amendable for operative fixation with an intramedullary nail. * patient has an isolated tibia and fibula fracture * skeletally mature * patients aged between/including 18 to 70 years * patient has given formal consent to be involved in the trial and has completed the study consent form * patient is likely to comply with study follow-up requirements exclusion criteria: * pathologic fractures * other fractures involving the same lower extremity * soft tissue injuries/problems that would prevent the surgeon from using both of the surgical techniques to insert an intramedullary nail * patient having pre-existing knee joint disease causing anterior knee pain * patient likely to have problems with follow-up * patient unwilling to give informed consent to be included in the trial

Keywords: intramedullary tibia nailing anterior knee pain nail positioning
benchmarking integrated care for people living with huntington's disease in england

Conditions: Huntington Disease

Summary: the survey and full study information can be accessed here: https://southampton.qualtrics.com/jfe/form/sv_8ieeddjzy4xaii6 the goal of this anonymous survey is to benchmark integrated care from the perspective of service users in adults living with huntington's disease, including informal caregivers. the main question it aims to answer is: is standard of care for people living with hd in england person-centred integrated care from the perspective of service users? participants will complete a one-time anonymous survey either online or on paper, according to their preference, that takes an average of 20-30 minutes. participants can take breaks as needed, picking up the survey from where it was paused.

huntington's disease (hd) is a rare brain disease that affects people's coordination, thinking and behaviour. it is a hereditary condition, affecting families across generations. because its complex, it requires different sectors working together. different surveys can be found in long term neurological conditions indicating care fragmentation and unmet severe needs, but evidence in hd is sparse. two surveys were identified covering people's needs in the uk, dated from 2006 and 2010. when looking for models or approaches tested to improve outcomes for people living with hd, no studies were found. this is an underserved population with complex needs and care gaps that remain unaddressed. little is known about to what extent people living with hd are experiencing care coordination between services and sectors in england. integrate-hd aims to find out what good, joined-up care looks like. the study will explore the views and experiences of people living with hd, to identify the changes needed to improve people's care and quality of life. integrate-hd is a national survey to benchmark integrated care from the perspective of people living with hd, including informal caregivers. the study objectives are to: 1. characterise and classify systems/organisations in england involved in hd care in relation to person-centred integrated care from the perspective of users. 2. identify areas considered integrated by service users. 3. identify areas considered fragmented by service users. 4. map care resources used by people living with hd in england. 5. identify unmet care needs that need improvement.

Eligibility criteria:
inclusion criteria: adults with capacity living in england and fluent in english that are: * a person at risk of hd (where at least one parent is diagnosed with hd, therefore their offspring has 50% chance of developing the disease); * a person diagnosed with hd symptomatic or asymptomatic (after undergoing gene testing and having a positive result); * an informal caregiver supporting someone living with hd; * a former informal caregiver with experience of supporting someone living with hd in the last 3 years. exclusion criteria: * below 18 years old; * not fluent in english; * a person without capacity.

Keywords: integrated care huntington's disease caregiver person-centred care benchmarking survey
double blind rct of bicifadine sr in outpatients with chronic neuropathic pain associated with diabetes

Conditions: Diabetic Peripheral Neuropathy

Summary: to compare the efficacy of two dosages (600mg/day and 1200mg/day) of bicifadine sr with placebo for 14 weeks in reduction of chronic neuropathic patin (measured by a daily rating of pain intensity) associated with diabetic periperal neuropathy in adult outpatients. to compare the tolerability of two dosages of bicifadine sr with placebo in adult outpaitens treated for chronic neuropathic pain for 14 weeks associated with diabetic peripheral neuropathy.


Eligibility criteria:
inclusion criteria: * male or female, 18 years or older * diagnosis of type-1 or type 2 non-insulin dependent diabetes mellitus * chronic bilateral pain due to diabetic neuropathy * pain for at least six months * primary pain is located in the feet * others-contact site for information exclusion criteria: * symptoms of other painful conditions * presence of amputations other than toes * clinically significant psychiatric or other neurological disorder * use of certain medications * clinically important other diseases * pregnancy * history of alcohol or narcotic abuse within two years * others-contact site for information
iron repletion in chronic cough and iron deficiency

Conditions: Cough; Laryngeal Disease; Bronchial Disease; Iron Deficiency

Summary: chronic cough is more frequent and severe in women than in men. women often have decreased iron stores, due to menses and pregnancies. aim of the study: to investigate if iron deficiency has a role in chronic cough by favouring airway hypersensitivity to inhaled irritants.

women with chronic cough and iron deficiency, cough unresponsive to empiric treatment (suggested by cough guidelines) with antih1-histaminic drug plus proton pump inhibitor. cough vas (score from 1,best, to 5, worst). histamine inhalation challenge, performed to assess bronchial, laryngeal, and cough thresholds, performed by delivering doubling concentrations, from 0.5 mg/ml up to 32 mg/ml, by a nebulizer. after each dose fev1, as bronchial index, maximum mid-inspiratory flow (mif50) as laryngeal index, and coughs number are assessed. bronchial threshold is the concentration causing 20% decrease in fev1, laryngeal threshold that causing 25% decrease in mif50, cough threshold that causing 5 coughs. histamine hyperresponsiveness of the bronchi (bhr), larynx (lhr) and cough (coughhr) are defined for thresholds equal or below 8 mg/ml. histamine thresholds and cough vas obtained in baseline, after cough empiric treatment with antih1-histaminic and proton pump inhibitor, and after iron supplementation.

Eligibility criteria:
inclusion criteria: * unexplained cough : no detectable trigger for chronic cough identified, such as persistent rhinitis, chronic sinusitis, gastroesophageal reflux disease and asthma. * no benefit by prior treatment with antih1-histaminic drug and proton pump inhibitor. * iron deficiency. * normal lung function tests and chest radiography no relevant systemic disease. * no acute respiratory infection in the last eight weeks. * no pharmacological treatment in the last two weeks. exclusion criteria:

Keywords: cough laryngismus bronchial spasm deficiency diseases