Kornimate/medical-research-clean huggingface dataset:
dissemination of colorectal cancer screening to primary care physicians

Conditions: Colorectal Cancer

Summary: the aim is to assess the efficacy of an intervention, academic detailing, a brief, frequently repeated educational program, on increasing recommendations for colorectal cancer screening among primary care providers by comparison to a service-as-usual control. the study is a stratified randomized clinical trial of primary care physicians, stratified by distinct urban communities in the new york metropolitan area. the primary outcome is colorectal cancer screening recommendations measured via medical audit at 12-month followup after randomization.

the purpose of the present study is to adapt and extend the use of academic detailing to the dissemination of colorectal cancer (crc) screening findings and guidelines to primary care physicians practicing in selected geographic areas in new york city. since improving implementation of cancer screening guidelines also involves compliance by patients in completing the recommended tests or examinations, we will also seek to assess knowledge, attitude and screening behaviors of patients visiting primary care practitioners in our sample. our long-term goal is to reduce colorectal cancer mortality among ethnic and racial minorities, by influencing the screening behaviors of their primary care physicians. the specific aims of the study are as follows: * aim 1. to test the hypothesis that an intervention, multi-component academic detailing, will increase the rate of physician crc screening at 3and 6month postrandomization, compared to the rate observed in a serviceasusual control. * aim 2. to develop models predicting which physician offices are most and least likely to adopt the intervention, and to generate hypotheses about tailoring the dissemination of crc screening guidelines to different physician subgroups. * aim 3. to conduct cost-effectiveness analysis comparing the incremental societal costs and effects (in lives saved, life-years saved, and quality-of-life-years saved) of the crc intervention implemented in physicians' offices.

Eligibility criteria:
inclusion criteria: * devote at least 50% of their practice to primary care * work in the study communities * are non-hospital based community practitioners * have no immediate plans to retire or to leave their practice. exclusion criteria: * specialty physicians * intend to retire or otherwise leave practice over course of the study * other conditions that would preclude meaningful participation * not working in study communities

Keywords: colorectal cancer screening primary care physicians health disparities stratified randomized clinical trial
weekly topotecan with docetaxel in recurrent small cell lung cancer

Conditions: Mediastinal Neoplasms

Summary: the purposes of this study are: * to determine the overall response rate of patients treated with at least 2 cycles of this regimen. * to determine the feasibility and toxicity of the combination of topotecan and docetaxel.

the main objective of this study was to determine the overall response rate of patients treated with at least 2 cycles of topotecan and docetaxel. the secondary objectives were to determine the feasibility and toxicities of this combination. the final secondary objective is overall survival for patients that received 2 or more cycles. methods: eligible pts with recurrent small cell lung cancer had to be at least 3 months from initial treatment. pts received docetaxel 30 mg/m2 iv followed by topotecan 3 mg/m2 iv days 1 and 8 of a 21 day cycle. disease assessment was done every 2 cycles. toxicity was measured each cycle.

Eligibility criteria:
inclusion criteria: * recurred greater than 90 days after initial treatment * at least 1 measurable lesion * only 1 prior chemotherapy * must be over 18 years of age * ecog performance status of 0 - 2 * adequate hematologic, renal, and hepatic function exclusion criteria: * no prior use of topotecan, docetaxel, or irinotecan * no symptomatic brain metastases * history of cardiac arrhythmias, congestive heart failure, stroke, or embolic events * no prior investigational agents within 1 month prior * lung cancer of mixed histology * known uncontrolled seizure disorders

Keywords: small cell lung cancer recurrent
acupuncture in traumatic brain injury

Conditions: Chronic Post-traumatic Headache; Mild Traumatic Brain Injury

Summary: the purpose of the study is to determine the effect of a low vs. high dose of acupuncture treatment in individuals with chronic post-traumatic headache (cpth). a total of 36 people with mild traumatic brain injury (mtbi) suffering from cpth will be enrolled in this study to receive acupuncture treatment for 5 weeks. participants will be randomized into two groups: 1) low acupuncture group (5 treatments) and 2) high acupuncture group (10 treatments). it is hypothesized that both treatment groups will have decreased headaches, but that 10 treatments will greater alleviate headaches when compared to 5 treatments.


Eligibility criteria:
inclusion criteria: * ability to provide and provision of signed and dated informed consent form * age 18-65 * diagnosis of mild traumatic brain injury (mtbi) (as defined by the international classification of headache disorders 3rd edition (ichd-3); a. either no loss of consciousness, or loss of consciousness of \<30 minutes duration, b. glascow coma scale (gcs) ≥ 13, and c. symptoms and/or signs diagnostic of concussion) * diagnosis of mtbi ≥3 months and ≤12 months at the time of study enrollment * suffering from chronic post-traumatic headache (cpth) of any etiology (e.g. tension or migraine), with chronic defined as developed within 7 days after injury and lasting ≥3 months from the time of injury * stable medication regimen for ≥1 months and agree to adhere to his or her current medication treatment regimen through study participation exclusion criteria: * non-english speaking * history of acupuncture since diagnosis of mtbi * history of pre-existing primary headache, defined as more than 12 days of tension-type headache annually and/or more than one migraine attacks per month in the last year * history of any other serious neurological, psychiatric, chronic pain disorders, or seizures * history of bleeding diathesis, other bleeding disorders, or syncope with needle puncture * history of cardiac arrhythmia or current pacemaker, neurostimulator, or other implanted stimulation device * recent or active substance use disorder * women who are currently pregnant, lactating, or planning to become pregnant during the study * any other medical conditions that could affect their ability to participate in acupuncture treatments for the study duration (as determined by study investigators) * active participation or past participation ≤3 months in any other interventional study. * unwilling to participate in all study related activities

Keywords: acupuncture
continuous regional arterial infusion of low molecular weight heparin in patients with severe acute pancreatitis

Conditions: Acute Pancreatitis

Summary: our animal studies found that continuous regional arterial infusion (crai in the celiac trunk) of low molecular weight heparin (lmwh) could alleviate inflammation, improve global hemodynamics and restore organ function in a porcine model of severe acute pancreatitis (sap,unpublished). in this study, the investigators aim to evaluate the effects of crai of lmwh in the treatment of sap patients. the investigators suppose crai could help improve the outcomes of these patients.


Eligibility criteria:
inclusion criteria: * symptoms and signs of severe acute pancreatitis according to atlanta criteria * within 3 days from the onset of the disease * available for interventional treatment(not sensible to radiocontrast agent) exclusion criteria: * pregnant pancreatitis * receiving surgery or aspiration before;need of early surgery * patients with coagulation disorders

Keywords: severe acute pancreatitis; continuous regional arterial infusion; low molecular weight heparin
clinical study of albumin-bound paclitaxel plus nedaplatin in cervical cancer

Conditions: Uterine Cervical Cancer

Summary: using albumin-bound paclitaxel and nedaplatin in the advanced or recurrent metastasis cervical cancer, to evaluate the efficacy and toxic reaction.

albumin-bound paclitaxel is a novel, solvent-free, albumin-bound nanoparticle form of paclitaxel designed to avoid problems associated with solvents used in taxol. and albumin-bound paclitaxel was characterized with high tolerated doses with greater efficacy, and with greater concentration in tumor tissue compared with normal tissues. this is a single center, non-randomized, open-label phase ii clinical study to investigate the efficacy and tolerability of albumin-bound paclitaxel plus nedaplatin in patients with advanced, recurrent metastatic cervical cancer. about 30 patients will receive 175-200 mg/m2 albumin-bound paclitaxel, d 1 combined with 80- 100 mg/m2 nedaplatin, d 2, every 3 weeks. at least 2 cycles will be completed for each patient, for whom responded to the treatment, 4-6 cycles will be completed.

Eligibility criteria:
inclusion criteria: * cervical cancer, advanced or recurrent metastasis * measurable and assessible tumor lesions * used ordinary paclitaxel or platinum drugs, more than 28 days * aged 18-70 * kps score\> 60 points, expected to survive more than 3 months * normal bone marrow function * the function of liver and kidney had no obvious damage * normal function of vital organs * no brain metastases * patients or their agents to sign informed consent * compliance, and can be followed up regularly exclusion criteria: * brain metastases * serious complications * acute inflammatory response * combined with other tumor * pregnancy or breast-feeding women * vertebral metastasis with nerve compression symptoms * large volume of pleural effusion, pericardial effusion * other malignancy within five years * drug allergy * other chemotherapy contraindications * the possibility of pregnancy, and not willing to contraception * no measurement of lesion * mental illness which is difficult to control

Keywords: advanced uterine cervical cancer
correlation between cpap compliance and food intake timing

Conditions: Obstructive Sleep Apnea

Summary: despite widespread agreement that continuous positive airway pressure is effective therapy for obstructive sleep apnea, it is estimated that 50% of patients recommended for therapy are noncompliant 1 year later. nasal continuous positive airway pressure (cpap) is the most definitive medical therapy for obstructive sleep apnea (osa). many patients have difficulty tolerating nasal cpap due to nasal airway problems, mouth leak, and general discomfort from the mask and headgear. interventions to improve compliance in such patients have not been studied. the investigators plan to further evaluate the usage of cpap and identify if the timing of last meal before bedtime affects the compliance and tolerance of cpap.

osa is a chronic disorder characterized by frequent reduction and/or cessation of inspiratory airflow during sleep, with resulting hypoxemia and hypercapnia that are terminated by arousals. this pattern of repetitive arousals and nocturnal hypoxemia leads to disruption of sleep architecture and daytime hyper-somnolence as well as a multitude of neurobehavioral and cardiopulmonary derangements. all patients diagnosed with osa should be instructed to undergo behavioral changes such as weight loss, avoidance of alcohol and sedatives, sleeping on the side and improvement in sleep hygiene, such as keeping a regular sleep schedule and getting an adequate amount of sleep. continuous positive airways pressure (cpap) is currently considered to be the cornerstone of therapy for sleep apnea (osa). however compliance with this treatment is frequently poor, which may lead to ongoing symptoms of sleep disruption, daytime sleepiness and poor waking cognitive function. mechanical and psychological/educational interventions have been proposed to try to increase the hours of use of cpap therapy. in older male patients with osa, compliance with cpap therapy is associated with attendance at a patient cpap education and support group. resolution of symptoms with therapy also appears to be associated with enhanced compliance. some studies suggest that there is no direct causal relationship between osa and gastro esophageal reflux disease (gerd). the investigators hypothesize that the compliance and tolerance to cpap is affected with the timing of last meal before bedtime and this may also affect the symptoms of gerd.

Eligibility criteria:
inclusion criteria: * patients diagnosed with obstructive sleep apnea. * patients on cpap therapy * patients older than 21 years exclusion criteria: -patients not on cpap therapy

Keywords: osa
sbrt for oligometastatic lymph node recurrence in prostate cancer: a single institution experience

Conditions: Prostate Cancer Recurrent; Prostate Cancer; Lymph Node Metastases

Summary: single-institution retrospective analysis for predictive factors of prostate cancer patients presenting with isolated or limited lymph node (ln) recurrence (1-3 lesions) on f-ccholine pet-ct (cholpet) treated with sbrt between january 2010 and july 2015.

single-institution retrospective analysis of consecutive prostate cancer patients after definitive primary treatment, without local recurrence, presenting with isolated or limited lymph node (ln) recurrence (1-3 lesions) on f-ccholine pet-ct (cholpet) treated with sbrt between january 2010 and july 2015. endpoints of interest are biochemical response rate (defined as a reduction by at least 10% of the initial psa value), time to biochemical recurrence (tbr) (defined as the time interval from sbrt until second psa rise), and time interval between sbrt and adt start. univariate analysis is used to identify prognostic factors.

Eligibility criteria:
inclusion criteria: * histologically proven diagnosis of prostate cancer * radical prostatectomy (± salvage radiotherapy) * psa relapse (defined by two consecutive rising psa values \>0.2 ug/l) * one to three lymphnodes positive on choline-pet * no recurrence in prostatic bed on choline-pet * who performance status of 0-1 * no previous chemotherapy or adt for prostate cancer. exclusion criteria: * primary treatment for prostate cancer by rt or brachytherapy * bone (m1b) metastases * visceral (m1c) metastases * any symptomatic nodal lesion
a clinical study of the effectiveness and safety of a disposable intra-vaginal device for stress urinary incontinence (sui)

Conditions: Stress Urinary Incontinence (SUI)

Summary: this study will evaluate the effectiveness of the pessary device by assessing reduction in urine leakage in approximately 80 women with sui. efficacy will be assessed by pad weight gain, frequency of stress urinary incontinence events, and a quality of life questionnaire.


Eligibility criteria:
inclusion criteria: * be female 18 years or older; * provide written informed consent prior to study participation and receive a signed copy; * be in generally good health as determined by the investigator; * have a ≥ 3 month history of experiencing sui (self reported); * be willing to use the pessary investigational device to control stress urinary incontinence; * be willing to comply with study requirements and instructions; exclusion criteria: * pregnant, lactating or planning to become pregnant during the study; * within 3 months post partum; * intrauterine device (iud) placement of less than 6 months; * has self-reported difficulty emptying her bladder; * a history of toxic shock syndrome (tss) or symptoms consistent with tss; * experience difficulty inserting or wearing an intra-vaginal device, including a tampon; * vaginal surgery, perineal surgery, uterine surgery, or abortion (spontaneous or induced) within the past 3 months; * has any screening laboratory value outside the laboratory reference range considered clinically significant by the investigator which could impact the safety of the subject or the outcome of the study; * for any reason, the investigator decides that the subject should not participate in the study.

Keywords: single use disposable pessary stress urinary incontinence sui
antibiotic stewardship in infectious disease departement

Conditions: Infectious Disease

Summary: consensual antibiotic protocols have been developed and validated locally by infectious disease specialists, internists and emergency physicians, in order to encourage their compliance. a preliminary study was conducted from june 2015 to february 2016, including 622 patients admitted to the emergency department for infectious syndrome such as / * pneumoniae * urinary tract infection * cellulitis * meningitis * malaria * febrile neutropenia * febrile acute diarrhea * fever back to the tropics * angina * sexually transmitted infection this prospective study will observe and analyze the adherence of prescribers to these protocols. with description of patients who benefited or not the antibiotic protocol, according to a syndromic approach and analysis of the causes of non-adherence to the protocols. in order to limit the length of stay and reduce the cost of hospitalization..

consensual antibiotic protocols have been developed and validated locally by infectious disease specialists, internists and emergency physicians, in order to encourage their compliance. a preliminary study was conducted from june 2015 (setting up protocols) to february 2016, including 622 patients admitted to the emergency department for infectious syndrome such as / * pneumoniae * urinary tract infection * cellulitis * meningitis * malaria * febrile neutropenia * febrile acute diarrhea * fever back to the tropics * angina * sexually transmitted infection this prospective study will observe and analyze the adherence of prescribers to these protocols. with description of patients who benefited or not the antibiotic protocol, according to a syndromic approach and analysis of the causes of non-adherence to the protocols. in order to limit the length of stay and reduce the cost of hospitalization..

Eligibility criteria:
inclusion criteria: * patient admitted to emergency for infectious syndrome * patient \> 18 years old. * patient who accept to have his medical records reviewed for research. exclusion criteria: * patient \< 18 years old.
multi-center study on surgical or non-surgical treatment for children type 1 humeral condyle fracture

Conditions: Treatment for Type I Humeral Condyle Fracture

Summary: the study evaluates the effectiveness of surgical or non-surgical treatment for children type 1 humeral condyle fracture.half of the participants receive surgical treatment and the other half receive non-surgical treatment


Eligibility criteria:
inclusion criteria: children type 1 humeral condyle fracture，fracture displacement less than 2mm exclusion criteria: other type humeral condyle fracture
non-inferiority of reduced-dose rituximab in rheumatoid arthritis in low disease activity and remission

Conditions: Rheumatoid Arthritis; Remission

Summary: to investigate whether a reduced-dose dosing regimen (1x500mg semiannually) of rituximab (rtx) (mabthera®) is non-inferior in patients with rheumatoid arthritis (ra) whose disease is in persistent low disease activity (lda) or clinical remission (rem) (plda/prem) as compared to the standard dosing regimen of 1x1000mg semi-annual infusions.

randomized, controlled, single-centre study with 1x500mg or 1x1000 semi-annual infusions of rtx (mabthera) as intervention and a follow-up period of 2 years. patients as well as assessors will be blinded to the type of treatment. patients in the 1x500mg group who experience a flare as defined by the disease activity score 28-esr (das28) will receive 1x1000mg rtx (mabthera) at their upcoming scheduled infusion appointment. patients in the 1x1000mg group whose disease activity reaches das28 \>3.2 during the duration of the study will be re-evaluated for a change in biological therapy and will discontinue the study.

Eligibility criteria:
inclusion criteria: * diagnosis of ra according to the 2010 american college of rheumatology (acr) / european league against rheumatism (eular) classification criteria * current treatment with rtx (at time of inclusion have already received at least 2 cycles of 1000mg rtx) at the day-clinic of the division of rheumatology of the medical university of vienna * persistent low disease activity or clinical remission as defined below * persistent clinical remission (prem) will be defined as a simplified disease activity index (cdai) (12) ≤2.8 measured at two time-points 6 months apart. the cdai is calculated as follows: tender joint count (tjc) + swollen joint count (sjc) + patient's assessment of general health on a 100 mm visual analogue scale (gh) + evaluator's assessment of general health on a 100 mm visual analogue scale (egh) * persistent low disease activity (plda) will be defined as a cdai ≤10 measured at two timepoints 6 months apart patients who achieve rem at only either one of the two successive time-points will be considered as having plda with regard to the current trial exclusion criteria: * patients ≤ 18 yrs * patients receiving rtx for a disease other than ra * patients who fail to meet criteria for rem or lda at either one of the two successive timepoints (i.e. having a disease activity \>10 as measured by the clinical disease activity index, (cdai))
effect of topical sinonasal antibiotics

Conditions: Chronic Rhinosinusitis (Diagnosis); Antibiotic Side Effect

Summary: in this study, patients who have had previous endoscopic sinus surgery and present with an acute exacerbation of chronic rhinosinusitis will be offered endoscopic-guided, culture-directed antibiotic therapy. they will then be randomized to receive oral or intranasal topical antibiotics. both of these are considered standard of care, but there is some limited data suggesting superiority of topical antibiotics especially if guided by culture and in patients who have undergone previous surgery. however, a study that directly compares the two has not been published. modified lund-kennedy endoscopic finding scores and subjective snot-22 questionnaires will be collected before and at 3-4 weeks after treatment. medication-related sided effects will be noted and analyzed. after 6-8 month follow-up, we will analyze the rate of recurrence of exacerbations, need for further antibiotics, need for revision surgery, and snot-22 scores based on oral versus topical antibiotic treatment. our objective is to evaluate both short and long-term response to both oral and topical administration of antibiotics in this patient population in order to determine if either route of administration is superior to the other.


Eligibility criteria:
inclusion criteria: * patients who have documented crs refractory to initial medical management and have undergone sinus surgery (opening of at least one sinus ostium, exclusive of sole balloon dilation), and those with an acute exacerbation of crs with sinus mucopurulence on exam. exclusion criteria: * patients less than 18 years of age, and those that have taken an antibiotic regimen in the previous 2 weeks before culture.

Keywords: chronic rhinosinusitis topical sinonasal antibiotics randomized controlled trial