Kornimate/medical-research-clean huggingface dataset:
electro-acupuncture (ea) and chronic pelvic pain (cpp)

Conditions: Chronic Pain

Summary: chronic pelvic pain (cpp) is a debilitating condition that affects over 1 million women in the united kingdom. the annual healthcare costs are estimated at over £150 million. proven interventions which include the use of analgesics or hormonal treatments are unsatisfactory in many cases. the investigators believe that the meridian balance method (bm) electro-acupuncture (ea) treatment (which includes a traditional chinese medicine health consultation \[tcm hc\]) may be helpful in the management of cpp. studies on the mechanisms of ea have demonstrated an analgesic effect. a recent individual patient data meta-analysis on the use of acupuncture for four chronic pain conditions found a small statistically significant effect size when compared to sham acupuncture. the effect size was larger and statistically significant when compared to usual care controls. this meta-analysis, and other large studies, suggests that, in addition to this analgesic effect, the interaction between the patient and the healthcare provider also plays a role in its effect on painful symptoms. our hypothesis is that the meridian bmea treatment alleviates pain, and improves physical and emotional functioning, in women with cpp. the investigators plan to undertake a single centre pilot study to assess the feasibility of performing a future three-armed randomised controlled, parallel group design trial to determine the efficacy of the meridian balance method electro-acupuncture (bmea) treatment in the management of women with cpp. the primary objective is to determine whether it is possible to achieve acceptable recruitment and retention rates within defined inclusion/exclusion criteria. the secondary objectives are to determine the effectiveness and acceptability to patients of the proposed methods of recruitment, randomisation, interventions and assessment tools. the investigators aim to recruit 30 women with cpp in nhs lothian over a 12-month period and randomise them to bmea treatment, tcm hc or standard care (sc). response to the intervention will be monitored by validated pain, physical and emotional functioning questionnaires at weeks 0 (baseline), 4 (end of study) 8 and 12. focus group discussion to gain feedback on study experience will be conducted at the completion of the study.


Eligibility criteria:
inclusion criteria: * chronic pelvic pain longer than 6 months duration * average numerical pain score of at least 4 out of 10 in the previous week * able and willing to comply with intervention * women aged 18 and above exclusion criteria: * pregnancy * malignancy * severe bleeding disorders (e.g. type 2, 3 von willebrand disease) * severe needle phobia * taking anti-coagulants * a history of seizure * a pace-maker in situ * moderate to severe psychiatric illness (currently under the care of a psychiatrist) * had received electro-acupuncture and meridian balanced method within the last 6 months

Keywords: electro-acupuncture chronic pelvic pain patient practitioner interactions tcm health consultation meridian balanced method acupuncture
faith - factor xa inhibitor-related intracranial haemorrhage

Conditions: InTracranial Haemorrhage

Summary: faith study is a multicentre retrospective analysis study that aims to understand the burden of ich related to fxa inhibitors and the current treatment approaches in country/countries where specific reversal agents are not available yet. the results of this analysis will improve our understanding of fxa inhibitor-related ich, its socioeconomic impact and factors associated with negative outcomes in real-world settings. the insights gained can inform clinical decision making and potentially lead to strategies to optimise the use of fxa inhibitors, increase the availability of specific reversal agents and improve patient safety and outcomes.

faith is a retrospective, non-interventional, multicentre cohort study that will retrieve the data from medical records of adult patients who were hospitalised with confirmed diagnosis of ich while being treated with fxa inhibitors. the primary objectives of the study is to describe the characteristics and hospital outcomes of hospitalised patients with fxa inhibitors-related ich in real-world settings. data of consecutive patients admitted on or after 1 january 2021 and by 30 june 2023 will be retrieved. the index date is defined as the date of hospital admission.the identification of ich will be based on the ct/mri scan records and according to the icd-10-cm diagnosis code. to establish the causal relation between fxa and ich, the study will include only patients who were determined in the medical records to have taken oral fxa inhibitors.the historical data will be followed up from the index date (the date of hospital admission) until the earliest date of death, lost to follow-up or up to 6 months.the 6-month follow-up period will allow for the assessment of the disability rate and the need for supportive care among survivors.

Eligibility criteria:
inclusion criteria: * men and women ≥ 18 years of age at the time of hospital admission. * patients presented with a spontaneous or traumatic haemorrhage into any intracranial compartment. the diagnosis of ich will be based on computed tomography (ct) or magnetic resonance imaging (mri) scan and according to the icd-10-cm diagnosis code. * patients who were determined in the medical records to have taken a dose of oral fxa inhibitors within 24 hrs before hospital presentation that warranted reversal of anticoagulant activities. exclusion criteria: * patients who were treated with andexanet alfa. * patients who were enrolled in any clinical trials during the study period.

Keywords: factor xa inhibitor-related intracranial haemorrhage fxa ich faith
a study of shr-1316 and fluzoparib（shr-3162） in small cell lung cancer patients

Conditions: Small Cell Lung Cancer

Summary: the purpose of this study is to evaluate the safety and efficacy of shr-1316 in combination with fluzoparib（shr-3162） in small cell lung cancer patients


Eligibility criteria:
inclusion criteria: * patients must be at least 18 years of age. * histologically or cytologically confirmed sclc. * failed at least one prior line of platinum-based chemotherapy. * patients must have measurable disease as defined by recist v1.1. * ecog 0-1. * adequate hematologic and organ function * signed inform consent form exclusion criteria: * active or untreated central nervous system (cns) metastases * spinal cord compression not definitively treated with surgery and/or radiation . * leptomeningeal disease * uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures * malignancies other than sclc within 5 years prior to randomization * history of autoimmune disease * positive test result for human immunodeficiency virus (hiv) * active hepatitis b or hepatitis c * severe infections * subjects with a condition requiring systemic treatment with either corticosteroids (\>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of first administration of study treatment. * significant cardiovascular disease * prior allogeneic bone marrow transplantation or solid organ transplant * treatment with systemic immunosuppressive medications prior to randomization * pregnant or lactating women * history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
wiser choices in osteoporosis choice ii: a decision aid for patients and clinicians

Conditions: Osteoporosis; Osteopenia; Fragility Fractures

Summary: emphasis in treating osteoporosis has been on t-scores rather than overall fracture risk. fracture risk assessment tool (frax) supports a risk sensitive approach to osteoporosis treatment by providing an absolute fracture risk. frax combined with a decision aid may promote a shared decision making approach with patients, allowing the clinician and patient to weigh potential fracture risk (without treatment), versus risk reduction with medication (including side effects and costs). osteoporosis choice ii will test the effectiveness of: * frax * frax + decision aid * usual care (no decision aid and no frax given to clinician)


Eligibility criteria:
inclusion criteria: * peri and postmenopausal caucasian, black, hispanic and asian women, aged 50-90 * bone mineral density (bmd) t-score \< 1.0 * have appointment with clinician to discuss test results and treatment options * patients with frax \<20% risk who have taken a bisphosphonate for \< 5 years. exclusion criteria: * unable to speak or read english

Keywords: decision aid shared decision making shared medical decision making
controlled trial: 5-day course of rifampin versus doxycycline for the treatment of mild to moderate scrub typhus

Conditions: Scrub Typhus

Summary: new antibiotics are required to have not only the antibacterial activity against doxycyline-resistant o. tsutsugamushi but also lower risk for resistance or any cross-resistance to others. in this prospective, open-label, randomized trial, we enroll patients with mild-to-moderate scrub typhus. we compared the efficacy and safety of a 5-day rifampin therapy with those of a 5-day doxycycline therapy at chosun university hospital, or one of its two community-based affiliated hospitals which are all located in southwestern korea between 2006 and 2009.


Eligibility criteria:
inclusion criteria: inclusion criteria were: * adults aged 18 years or older * a fever of higher than 37.5°c * the concurrent presence of eschar or a maculopapular skin rash; and the clear presence of more than two symptoms such as headache, malaise, myalgia, coughing, nausea and abdominal discomfort. * patients were hospitalized at chosun university hospital in kwangju, korea or one of its two community-based affiliated hospitals which are all located in southwestern korea between 2006 and 2009. exclusion criteria: the exclusion criteria were: * an inability to take oral medications * pregnancy * hypersensitivity to the trial drugs * previous drug therapy with potential antirickettsial activity (e.g., rifampicin, chloramphenicol, macrolides, fluoroquinolones or tetracyclines) within 48 h prior to admission * severe scrub typhus (shock requiring vasopressor therapy for more than one hour * a stuporous or comatose level of consciousness * respiratory failure requiring mechanical ventilation or renal failure requiring immediate dialysis) (4, 10). * for the differential diagnosis of scrub typhus from other diseases with similar symptoms (e.g., murine typhus, leptospirosis, hemorrhagic fever with renal syndrome and systemic lupus erythematosus), patients underwent diagnostic tests. we thus excluded patients with concurrent infections who had the risk of causing different outcomes.

Keywords: doxycycline, rifampin scrub typhus.
adult dengue platelet study

Conditions: Dengue Fever

Summary: retrospective data in children with dengue hemorrhagic fever (dhf) and dengue shock syndrome (dss), and in adults with dengue fever (df), suggested a lack of benefit from prophylactic platelet transfusion for severe thrombocytopenia in dengue patients without bleeding. however, in taiwan and singapore, platelet transfusion was given to 13-50% of hospitalised dengue patients. this is a prospective randomised study to examine the safety and efficacy of prophylactic platelet transfusion in adults with dengue and severe thrombocytopenia without bleeding. the hypotheses are: 1. prophylactic platelet transfusion is safe in hospitalised dengue patients with severe thrombocytopenia. 2. prophylactic platelet transfusion is effective in preventing bleeding in hospitalised dengue patients with severe thrombocytopenia.

patients fulfilling inclusion and exclusion criteria, and giving informed consent, will be randomised to a treatment arm of 4 units of platelets for every day they have a platelet count \<20x10\^3/ul, or a control arm with supportive care. patients will be followed up daily till hospital discharge, and again at day 21. it is assumed that the incidence of bleeding from randomization to day 7 or discharge, whichever earlier, is 10% for the control (no transfusion) group and 5% for the intervention (transfusion) group. with 1:1 allocation ratio, to attain 80% power and one-sided 5% type i error rate, the required number of subjects in each arm is 382 by a chi-square test with yates' continuity correction. if a drop-out rate of 5% is allowed, the required number increases to approximately 400 per arm.

Eligibility criteria:
inclusion criteria: 1. age ≥ 21years 2. probable or confirmed dengue a) confirmed dengue: laboratory confirmation of acute dengue by either i) positive polymerase chain reaction (pcr) for viral ribonucleic acid (rna), or ii)positive ns1 antigen test with a compatible clinical syndrome b) probable dengue: positive acute dengue serology and clinical presentation fulfilling either who 1997 or 2009 criteria for probable dengue. i) 1997 criteria: acute febrile illness and two or more of the following: * headache, * retro-orbital pain, * myalgia, * arthralgia, * rash, * hemorrhagic manifestations, * leucopoenia ii) 2009 criteria: fever and two of the following: * nausea/vomiting, * rash, * aches/pains, * positive tourniquet test, * leucopoenia, * one or more warning sign * abdominal pain/tenderness, * persistent vomiting, * clinical fluid accumulation, * mucosal bleed, * lethargy/restlessness, * liver enlargement \>2cm, * increase in haematocrit concurrent with rapid decrease in platelet count 3. platelets ≤ 20x103/μl

Keywords: dengue platelet transfusion bleeding prevention
gdft based on ppv compared with standard fluid therapy in patients undergoing complex spine surgery: rct

Conditions: Spine Disease

Summary: the investigators will do the goal directed fluid therapy by protocolized fluid management in the experimental group, using ppv to guide the fluid administration, compare with standard fluid management in patients undergoing complex spine surgery.


Eligibility criteria:
inclusion criteria: * asa 1-3 * elective surgery * thoracic/lumbar spine surgery \>= 3 levels and duration \>= 3 hours exclusion criteria: * cr \>2 mg/dl or egfr \< 60 ml/min * coronary artery disease, congestive heart failure or cardiac arrhythmia * bmi \>30 kg/m2 * hemodynamic unstable, preoperatively * uncontrolled hypertension * respiratory system compliance \< 30 ml/cmh2o
drug monitoring of sorafenib in patients with advanced hepatocellular carcinoma

Conditions: Hepatocellular Cancer

Summary: sorafenib improves overall survival and progression free survival in advanced hepatocellular carcinoma. wide interindividual pharmacokinetic variability was observed. data from early phase trials in solid tumours showed trough sorafenib levels were associated with incidence of skin rash and hypertension. rash, hypertension and higher trough levels were moderately predictive of progression free survival.the trough level of sorafenib may be predictive of survival and response in patients treated with sorafenib for advanced hepatocellular carcinoma.


Eligibility criteria:
inclusion criteria: * ecog ≤ 2 * histologically or cytologically diagnosed hepatocellular carcinoma, or diagnosis on at least one cross-sectional imaging with the characteristic appearance of hcc (i.e. liver lesion with arterial enhancement and portal venous washout) * decision to treat with single agent sorafenib at 400mg bid (dose reductions or interruptions are permitted if side effects occur during treatment) * no prior systemic chemotherapy or targeted therapy * child-pugh liver function class a or b * at least one untreated target lesion that can be measured in one dimension according to recist * adequate organ functions exclusion criteria: * prior systemic chemotherapy or molecularly targeted therapy * concurrent active malignancy * concomitant strong cyp3a4 induced or inhibitor at a therapeutic dose (see section 6.4.1) * medical or psychiatric conditions that compromise the patient's ability to give informed consent * hypertension that cannot be controlled by medications (\> 150/100 mmhg despite optimal medical therapy) * history of, or known brain metastases (skull metastases allowed), carcinomatous meningitis, or leptomenigeal disease * major surgery (e.g. open abdominal therapy, pelvic, thoracic, orthopaedic or neurosurgery) within 4 weeks of the date of first dose * local-regional treatment (i.e. percutaneous and trans-arterial procedures) within 4 weeks. restaging ct or mri scan must be repeated at least 4 weeks after local-regional treatment and within 3 weeks before the date of first dose * for patients treated with yttrium (90y) radiotherapy, a washout period of 2 months is required. * evidence of severe or uncontrolled systemic disease or any concurrent condition which in the investigator's opinion makes it undesirable for the patient to participate in the study or which would jeopardize compliance with the protocol * pregnancy or breast feeding

Keywords: patients with advanced hepatocellular cancer
treatment patterns and clinical outcomes among patients with hr+/her2- mbc receiving palbociclib combination therapy in the us community oncology setting.

Conditions: Breast Cancer

Summary: by leveraging a community-based, cancer-specific electronic healthcare record for this study, we aim to understand treatment patterns and clinical outcomes among patients with hr+/her2- mbc who received care within the context of a large community oncology network in the united states.


Eligibility criteria:
inclusion criteria: 1. documented diagnosis of hr+/her2- mbc 2. initiated palbociclib + fulvestrant as first-line therapy in the metastatic setting and had at least 2 visits following the index date 3. received care at a us oncology site(s) utilizing the full ehr at time of treatment and data are available for research purposes exclusion criteria: 1. enrollment in an interventional clinical trial during the study period 2. evidence of prior treatment with cdk4/6 inhibitors in the metastatic setting 3. receipt of treatment indicated for another primary cancer during the study period or history of another primary cancer documented within the us oncology ehr.
the effects and cost-effectiveness of an integrated multidisciplinary approach for psychogeriatric patients

Conditions: Delirium, Dementia, Amnestic, Cognitive Disorders; Memory Disorders

Summary: the purpose of this study is to determine the effects and cost-effectiveness of a diagnostic observation center for psychogeriatric patients (doc-pg). our main hypothesis is that doc-pg has added value compared with usual care regarding health related quality of life (hrqol).

an integrated multidisciplinary approach to diagnosing and managing dementia is generally recommended, though rarely investigated. in recent years, multidisciplinary memory clinics (mcs) for patients with dementia have been established in many places over the world. these services have recently also been criticised for being principally hospital-based, for their apparently limited focus that entails only medical diagnostics and pharmacotherapy and for thus diverting resources from community mental health teams(cmhts) .on the other hand, cmhts are mainly concerned with the provision and organisation of integrated care, and unlike mcs, cmhts generally have limited access to hospital-based diagnostics such as brain-imaging. in april 2002, an outpatient diagnostic facility, the diagnostic observation centre for psychogeriatric patients (doc-pg) was established in maastricht, the netherlands. doc-pg combines the hospital-based approach of the mc with the care-oriented approach of the regional cmht and aims to provide the general practitioner (gp) with elaborate diagnostic and therapeutic advice for patients with cognitive disorders. comparison: doc-pg is compared with usual care i.e. the gp took care of the diagnosis, or he or she referred the patient to one of the separate regional services, e.g. the maastricht memory clinic (mmc), geriatric medicine, or the department of mental health for the elderly of the mental health community service (cmht).

Eligibility criteria:
inclusion criteria: * aged 55 years or over * suspected of having dementia or combined somatic/psychiatric disorder * no referral to other local/regional services in the last two years * availability of a proxy (visiting the patient at least once a week) exclusion criteria: * acute disorders that need a prompt therapeutic intervention * living in a nursing home or receiving care that is comparable to that of a nursing home

Keywords: health services for the aged geriatric psychiatry
tract study: evaluation of the value of routine thoraco-abdominal ct in blunt trauma patients

Conditions: Abdominal Injuries; Thoracic Injuries

Summary: the aim of this study is to establish the additional effectiveness and costs of routine thoraco-abdominal computed tomography (ct) in blunt trauma patients versus conventional radiological imaging and to determine which clinical parameters predict a high additional value of routine thoraco-abdominal ct.

the technological advances in computed tomography (ct), with faster image acquisition resulting in higher resolution, result in making ct a more widely and intensively used imaging modality in trauma patient care. thoraco-abdominal ct in addition appears to have additional diagnostic value compared to conventional radiography, especially in severely injured trauma patients. nowadays, both clinical data and conventional radiology are used to determine which patient should undergo body ct scanning. currently there are no widely accepted guidelines for the use of a "standard" trauma ct (tract). although many retrospective and several prospective cohort studies have been published on this topic, the data are not sufficient to sustain evidence-based practice in decision-making. the aim of this study is, to establish the additional effectiveness and costs of routine thoraco-abdominal ct in blunt trauma patients versus conventional radiological imaging and to determine which clinical parameters predict a high additional value of routine thoraco-abdominal ct. consecutive trauma patients, who are at least 16 years old and are suffering from severe injuries, undergo a standard trauma ct of the cervical spine, the thorax and abdomen after clinical evaluation and conventional radiological workup. clinical, conventional and computed tomographic radiological assessment, costs, therapeutic consequences and 6 months patient follow up are recorded and will be statistically analyzed.

Eligibility criteria:
inclusion criteria: * patients with life threatening vital problems: respiratory, circulatory (pulse \> 120/min, blood pressure \ 4 sec, exterior blood loss \> 500 ml) or neurologically (glasgow coma score \< 14, abnormal pupils) compromised patients. * patients with a revised trauma score under 12 * patients with signs of fractures from at least two long bones * patients with clinical signs of flail chest/multiple rib fractures * patients with a clinically evident pelvic rim fracture * patients with signs of unstable vertebral fractures or signs of neural cord compression * patients involved in a high-energy injury mechanism * fall from height (\> 3 m) * as declared by prehospital emergency medical services exclusion criteria: * patients suffering from a shock class iiib/iv * patients who need immediate neurosurgical intervention * pregnant patients * patients referred from other hospitals * patients who die at the emergency department

Keywords: computed tomography wounds and injuries,non penetrating algorithms blunt trauma of the thorax and abdomen