Kornimate/medical-research-clean huggingface dataset:
consequences of doing what should not be done in primary care

Conditions: Overdose; Adverse Event

Summary: retrospective observational study in a random selection of 5% of digital records active between 2014 and 2017 to quantify the frequency of do not do primary care recommendations, calculating the over-cost related to them and study reviewing a random selection of cases previously identified to determine whether patient suffered adverse events and their over-cost.

basement: overuse subjected patients to unnecessary risk without promoting a sufficient clinical benefit and over-cost. the less is more medicine movement has led to the identification of do not do in different specialties, also in primary care. objective: to analyze the impact of errors (overuse rates based in do not do recommendations) in clinical practice. method: retrospective observational study in a random selection of 5% of digital records active between 2014 and 2017 to quantify the frequency of do not do primary care recommendations, calculating the over-cost related to them. retrospective study reviewing a random selection of cases previously identified to determine whether patient suffered adverse events and their over-cost. setting. primary care in andalucía, aragón, castilla la mancha, comunidad valenciana, madrid, murcia, navarra y país vasco, eight autonomous communities in spain.

Eligibility criteria:
inclusion criteria: * all patients visiting gps exclusion criteria: * none

Keywords: patient safety quality assurance overuse
the effect of manual lymphatic drainage

Conditions: Venous Leg Ulcer; Venous Insufficiency; Lymphatic Disease

Summary: in venous ulcer, venous insufficiency is accompanied by lymphatic insufficiency. manual lymphatic drainage (mld) technique cause to increase contraction rate of lymphatic collector and venous flow. it is known that manual lymphatic drainage accelerates microcirculation, enabling nutrients and oxygen to reach tissues and at the same time removing residual substances from the tissue. we hypothesis that if we inrease to lypmhatic activity with mld, we could stimulate healing of ulcer. the aim of this study to investigate the effect of manual lymphatic drainage on venous ulcer healing.


Eligibility criteria:
inclusion criteria: * with venous ulcer unhealing for at least 6 weeks * without enfection * vascular surgery is not indicated * there is no obstruction to apply mld and compression to lower extremty exclusion criteria: * with diabetic mellutus * with enfection * with abi\<0,7 * patients who have undergone venous vascular surgery * patients undergoing active wound closure treatment
feasibility of the combination of chemotherapy (carbo/caelyx or carbo/doxorubicin) with tocilizumab (mab il-6r) and peg-intron in patients with recurrent ovarian cancer

Conditions: Recurrent Ovarian Cancer

Summary: the purpose of this interventional study is to determine the feasibility to combine standard chemotherapy (carbo/caelyx or doxorubicin) for recurrent ovarian cancer with immunotherapy (tocilizumab and peg-intron). this study combines standard chemotherapy carboplatin-caelyx or doxorubicin with a monoclonal antibody against il-6r (tocilizumab). high il-6 levels correlate with poor prognosis and chemoresistance in ovarian cancer patients. in cases of chemoresistant ovarian cancer, therefore, modulation of the il-6 pathway, by blocking the il-6 receptor, may represent a promising strategy to both abolish drug resistance and amplify host immunity in patients with recurrent ovarian cancer. blockade of the il-6/il-6r pathway may enhance immunogenic cell death and restore local normal dc maturation. in addition, the use of interferon-alpha (peg-intron) allows the full maturation of dc, thereby enhancing the anti-tumor response.


Eligibility criteria:
inclusion criteria: * histologically proven epithelial ovarian cancer * progression of disease or relapse after previous therapy with platinum * measurable disease (recist 1.1) or elevated ca125 \> 2 times the upper normal limit (unl) within 3 months and confirmed * age ≥18 years * who performance status 0-2 * adequate bone marrow function: wbc ≥3.0 x 109/l, neutrophils ≥1.5 x 109/l, platelets ≥100 x 109/l * adequate liver function: bilirubin ≤1.5 x unl range, alat and/or asat * 2.5 x unl (\<5x unl in case of liver metastases), alkaline phosphatase ≤5 x unl * adequate renal function: the calculated creatinine clearance should be * 50 ml/min * survival expectation \> 3 months * patients must be accessible for treatment and follow-up * written informed consent according to the local ethics committee requirements exclusion criteria: * chemotherapy within past 3 months * previous malignancy within 5 years, with exception of a history of a previous basal cell carcinoma of the skin or pre-invasive carcinoma of the cervix * serious other diseases as recent myocardial infarction, clinical signs of cardiac failure or clinically significant arrhythmias * known hypersensitivity reaction to any of the components of the treatment * pregnancy or lactating * medical or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or sign meaningful informed consent * infection with tuberculosis and hepatitis b or c
a rct on the effect of endometrial injury on improving ongoing pregnancy rate in subfertile women undergoing fet cycles

Conditions: Subfertility

Summary: this is a randomised controlled trial on the effect of endometrial injury in the cycle preceding the frozen-thawed embryo transfer (fet) cycles. the study hypothesis is that endometrial injury will increase the ongoing pregnancy rate in fet cycles.

consecutive women attending subfertility clinic at queen mary hospital, university of hong kong who are scheduled for fet treatment will be recruited. women who have normal uterine cavity will be randomized into study and control groups in 1 to 1 ratio according to a computer-generated randomization list. for patients in the study group, in the cycle immediately preceding the scheduled fet treatment, an endometrial biopsy would be arranged on day 21-23 of the menstrual cycles and they will be instructed to use non-hormonal means of contraception during that cycle. for patient in the control group, a similar procedure would be performed on the same timing during the preceding cycles without entering the uterine cavity, ie endometrial biopsy catheter entering the endocervical canal without entering the endometrial cavity. all patients will then proceed to fet treatment in the next cycle as scheduled. the fet would be carried out as per our protocol. in short, patients attend the clinic daily from 18 days before the next expected period for the determination of serum e2 and luteinising hormone (lh) concentrations until the lh surge, which was defined as the day on which the lh level was above 20 iu/l and doubled the average of the lh levels over the past three days. for patients with irregular menstrual cycles or no ovulation demonstrated during natural cycle monitoring, clomiphene citrate (cc, clomid, merrell, staines, u.k.) 50-100 mg will be given daily for five days from days 3-7. the cycle will be monitored by blood tests from day 10 of the cycle as above. fet was performed on the third day after the lh surge. up to two frozen-thawed embryo(s) can be transferred. no luteal phase support is used. on-going pregnancy rates, defined as viable fetuses beyond 10-12 gestational weeks, between the two groups will be compared. we should measure endometrial thickness on lh+1 in natural and clomid-induced cycles.

Eligibility criteria:
inclusion criteria: * undergoing fet treatment cycles * normal uterine cavity as shown on transvaginal scanning or saline sonogram done at baseline * endometrial thickness \>=8mm during the stimulated ivf cycle and fet cycle exclusion criteria: * pregnancy in previous ivf or fet cycles * presence of hydrosalpinx not surgically corrected prior to fet * presence of endometrial polyp or fibroid distorting uterine cavity * ivf cycles carried out for preimplantation genetic diagnosis * arrange for blastocyst transfer * use of donor oocytes

Keywords: frozen thawed embryo transfer endometrial injury ongoing pregnancy rates
a study of the safety, tolerability and effective of voriconazole for the treatment of serious candida infection and candida infection of the throat in pediatric patients

Conditions: Candidiasis

Summary: the purpose of this study is to determine whether voriconazole is safe and effective for the treatment of serious candida infection and candida infection of the esophagus in children and adolescents.


Eligibility criteria:
inclusion criteria: * male or female 2 to \<18 years of age; subjects 2 to \<12 years of age will be permitted to enroll in this study only after a pfizer sponsored pharmacokinetic study confirms the proposed dosage corresponding to this age group is appropriate. * patients with confirmed candida infection of the blood, body tissues, or the esophagus. * patient's doctor feels voriconazole is an appropriate choice of therapy. exclusion criteria: * a known allergy to voriconazole or to azole to antifungal drugs. * females who are pregnant, lactating (breast feeding) or planning a pregnancy during the course of the study, or who are of childbearing potential and not using highly effective method of birth control. * a patient who is receiving treatment with a drug know to interfere with the heart's electrical system (qtc prolongation). * a patient who is receiving treatment with a drug that is not permitted to be used with voriconazole. * for primary therapy: a patient who has received more than 48 hours of antifungal therapy for the current episode of candida infection. * a patient with significant underlying liver disease at the time of enrollment in the study. * a patient with significant renal disease (crcl \< 50 ml/min) at the time of enrollment in the study. * a patient with a high likelihood of death within 72 hours of study enrollment due to factors unrelated to candida infection.

Keywords: invasive candidiasis candidemia esophageal candidiasis
a safety and tolerability clinical trial of pst-611 in dry age-related macular degeneration

Conditions: Dry Age Related Macular Degeneration

Summary: the goal of this interventional study is to evaluate the safety and tolerability of single ascending doses of pst-611 in men and women over the age of 50 with dry age-related macular degeneration (amd). the main question it aims to answer is: is pst-611-ct1 safe for participants? participants will: * receive a single dose of pst-611 * will be followed up for a total of 16 weeks following pst-611 administration

the maximum study duration per patient is 28 weeks (including an up to 12 week screening period + 16 weeks of follow-up after treatment). the study is a single ascending dose study that investigates two pst-611 dose levels (low and high doses) in 2 successive dose groups. the study will enroll up to 12 participants.

Eligibility criteria:
inclusion criteria: subjects must give written informed consent, be able to make the required trial visits and follow instructions. female and male subjects must be 50 years of age or older. female subjects of childbearing potential must not be pregnant or breast-feeding and must have a negative urine pregnancy test at baseline and throughout the study. they must agree to practice at least one effective method of birth control following administration of study medication. in the study eye, at least one of the following must be present at oct and attributed to amd, as evaluated by the investigator: incomplete rpe and outer retinal atrophy (irora), or complete rpe and outer retinal atrophy (crora). best-corrected visual acuity (bcva), must be 23 etdrs letters (approximate snellen equivalent 20/320) or better in the study eye. subject's fellow eye bcva must be 34 letters (approximate snellen equivalent 20/200) or better. exclusion criteria: both eyes: any active intraocular or periocular infection or inflammation (eg, infectious blepharitis, infectious conjunctivitis, keratitis, scleritis, endophthalmitis), or history of intraocular or periocular infection or inflammation in the 12 weeks (84 days) prior to the pst-611 administration. study eye: any intraocular surgery (including cataract surgery) or intravitreal (ivt) or periocular corticosteroid injection within 12 weeks (84 days) prior to the pst-611 administration. study eye: any anti-vegf ivt treatment within 4 weeks (28 days) prior to pst-611 dosing or subjects who have required and received regular monthly injections of anti-vegf drugs in the months preceding the trial and would thus have a higher likelihood of requiring and anti-vegf treatment within 28 days of the pst-611 administration. study eye: media opacity that interferes with fundus imaging or is likely to require surgery during the trial period. study eye: subject with history of glaucoma filtering surgery (e.g. trabeculectomy or aqueous shunt implant) or who underwent eye surgery within 12 weeks (84 days) of the pst-611 administration. study eye: subject who has uncontrolled intraocular pressure of ≥ 25 mmhg in the se at the screening and baseline visits.

Keywords: dry age related macular degeneration pst-611
investigate the renal movement by single lung ventilation in patients administered rirs for kidney stones.

Conditions: Perioperative/Postoperative Complications; Kidney Stone

Summary: in patients undergoing rirs for kidney stone, we aim to show the effect of single lung ventilation with a double lumen tube on operative (operation scope duration, perforation, hemorrhage, etc. complications) and postoperative parameters (stone-free rates, complications like postoperative hemorrhage and fever, hospital stay, etc.) and to show changes in renal stone position during simultaneous normal ventilation and single lung ventilation.

in recent years open surgical treatment has changed to minimal invasive treatments for kidney stone treatment. additionally, the treatment choices vary depending on the localization of the stone and its dimensions. in the european urology association (eua) guidelines, it states the rirs method can be used to treat stones up to 2 cm in the kidney. due to rirs the operation and scopy durations and hospital stay have clearly reduced compared to the standard treatment of percutaneous nephrolithotomy. however, the high hydrostatic pressure applied to the renal pelvis during rirs may cause unwanted results in the postoperative period such as hydronephrosis and loss of renal parenchyma. during the operation, the stone may move during deep inspirium and expirium sequences linked to deep ventilation which may lengthen the operation and scope durations and brings risks such as perforation during laser lithotripsy application. in this study we aimed to apply single lung ventilation during the operation (one of the indications for single lung ventilation is to increase surgical view and ease manipulation) to minimize renal movement on that side and reduce peroperative and postoperative complications.

Eligibility criteria:
inclusion criteria: 1. older than 18 years 2. asa (american society of anesthesiologists) 1-3 3. patients with 2-3 cm stones in kidneys exclusion criteria: 1. patients with staghorn stones in kidneys 2. patients with urinary system anomalies removal criteria : 1. difficult airway 2. patients with carinal, bronchial lesions 3. patients with bad general situation 4. patients younger than 18 years 5. satiated patients

Keywords: rirs kidney stone single lung ventilation simultaneous normal ventilation
novel prognostic markers in renal cancer

Conditions: Renal Cell Carcinoma

Summary: the purpose of this project is to analyze tumour tissue from a group of subjects with renal cell carcinoma, who have been treated at the royal marsden hospital.

renal cancers have different clinical outcomes. the principal research objective is to study tumour tissue from renal cancer patients and try and understand why some cancers progress more rapidly than others. further, another key aim of this study is to try and understand why some patients respond to treatment and others do not.

Eligibility criteria:
inclusion criteria: * the presence of histologically proven renal cell cancer * the availability of paraffin embedded tissue * informed consent needed for tissue taken after january 2006 (date of enforcement of human tissue act) exclusion criteria: * absence of histological tissue * absence of consent to study tissue after january 2006

Keywords: biomarkers prognosis response to treatment renal cancer
a research study to see how semaglutide helps people with excess weight and type 2 diabetes lose weight

Conditions: Obesity; Diabetes Mellitus, Type 2

Summary: this study will look at how much weight participants will lose and how much blood sugar control they achieve from the start to the end of the study. the weight loss in participants taking the investigational high dose of semaglutide will be compared to the weight loss in people taking "dummy" medicine and a lower dose of semaglutide. in addition to taking the medicine, participants will have talks with study staff about healthy food choices and how to be more physically active. participants will either get semaglutide or "dummy" medicine. which treatment participants get is decided by chance. participants are more likely (4 out of 5) to get semaglutide than the "dummy" medicine. the study medicine will be injected briefly, under skin, with a thin needle, typically in the stomach, thighs, or upper arms. after receiving first dose, the dose of semaglutide will be gradually increased until reaching the target dose. the study will last for about 1.5 years.


Eligibility criteria:
inclusion criteria: * male or female. * age above or equal to 18 years at the time of signing informed consent. * bmi greater than or equal to 30.0 kilograms per square meter (kg/m\^2). * diagnosed with type 2 diabetes (t2d) greater than or equal to 180 days prior to the day of screening. * history of at least one self-reported unsuccessful dietary effort to lose body weight. * hba1c 7.0-10.0 percent (53-86 millimoles per mole \[mmol/mol\]) (both inclusive) as measured by central laboratory at screening. exclusion criteria: * a self-reported change in body weight greater than 5 kilograms (kg) (11 pounds \[lbs\]) within 90 days before screening irrespective of medical records. * personal or first-degree relative(s) history of multiple endocrine neoplasia type 2 or medullary thyroid carcinoma. * renal impairment with estimated glomerular filtration rate (egfr) less than 30 milliliters per minute per 1.73 square meter (30 ml/min/1.73 m\^2) (less than 45 ml/min/1.73 m\^2 in participants treated with sodium-glucose cotransporter-2 \[sglt2i\]) according to chronic kidney disease epidemiology collaboration (ckd-epi) creatinine equation as defined by kidney disease: improving global outcomes (kdigo) 2012 by the central laboratory at screening. * uncontrolled and potentially unstable diabetic retinopathy or maculopathy. verified by a fundus examination performed within 90 days before screening or in the period between screening and randomization. pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
influence of an acidic beverage on the imatinib exposure after major gastrectomy

Conditions: Gastrointestinal Stromal Tumor; Major Gastrectomy

Summary: the most common sites for gist to occur are the stomach (60-70%) and proximal small intestines (20-25%). therefore patients with gist often have altered gi-tract due to tumor resection or palliative surgery which might affect imatinib exposure. indeed, yoo et al. showed that steady state imatinib trough levels in patients with advanced gists after major gastrectomy are lower compared to patients with a previous wedge resection or without gastric surgery. patients that underwent major gastrectomy had an average imatinib plasma trough levels below 1000 µg/l. this while imatinib trough levels above 1000 µg/l are correlated to more beneficial treatment out-comes (longer progression free survival). since imatinib easily and rapidly dissolves at ph 5.5 or less, a lack of gastric acid secretion might be causing the decreased exposure in the patients that underwent major gastrectomy. therefore the investigators would like to study if the exposure to imatinib in patients after major gastrectomy can be improved by creating a more acidic environment for absorption through combining imatinib intake with coca-cola.


Eligibility criteria:
inclusion criteria: * male or female patients ≥ 18 years of age * patients with gist, who previously underwent major gastrectomy * eastern cooperative oncology group (ecog) performance status (ps) of 0-1 * already selected to receive imatinib therapy in a dose of 400-800mg imatinib daily, as judged by the treating physician and with respect for and in agreement with the registration guidelines * subject is able and willing to sign the informed consent form prior to screening exclusion criteria: * concomitant administration of any anti-cancer therapies (e.g. chemo-therapy, other targeted therapy, experimental drug, etc) other than imatinib * concomitant use of medication which strongly inhibits or induces cyp3a4 * refractory nausea and vomiting, malabsorption with other causes than gastrectomy or external biliary shunt that would preclude adequate absorption. * unwillingness to use coca-cola * unwillingness or inability to swallow whole tablets * inability to comply with the requirements of the protocol * inability to understand the nature and extent of the study and the procedures required * participation in a drug study within 60 days prior to the first day of this study

Keywords: imatinib gastrectomy gastrointestinal stromal tumor pharmacokinetics
endobronchial ultrasound guided transbronchial lung biopsy with or without guide sheath in lung tumors and the analysis of echoic patterns of lung tumors and mediastinal lymph nodes, and the association between diagnostic yield of transbronchial lung biopsy and ebus echoic features.

Conditions: Lung Neoplasms

Summary: 1. endobronchial ultrasonography (ebus) is useful in localizing peripheral lung lesions. the ebus, further combined with the guide sheath (gs) technique, has been reported to increase the yield of transbronchial biopsy. however, there are no reports comparing the gs technique and the traditional ebus technique in diagnosing the peripheral lung tumor. 2. previous reports have revealed that several characteristic echoic patterns correlate well with the histopathological findings of benign and malignant lesions. therefore, ebus may also be useful in the differential diagnosis of malignant lesions of the lung.


Eligibility criteria:
inclusion criteria: * patient with radiologically confirmed peripheral lung mass exclusion criteria: * patient clinically not indicated for bronchoscopy exam within the abovementioned cohort

Keywords: lung neoplasm bronchoscopy ultrasonography histology