Kornimate/medical-research-clean huggingface dataset:
effect of venlafaxine versus dosulepin in pain predominant somatic symptom disorder

Conditions: Somatic Symptom Disorder (DSM-V)

Summary: somatic symptom disorder (ssd) is marked by persistent physical complaints, often involving pain, alongside excessive thoughts or behaviors related to health, which substantially disrupt daily functioning. the underlying mechanisms of ssd are multifaceted. the serotonin hypothesis links low serotonin levels to the development of somatic symptoms, while the cortisol hypothesis highlights dysregulation of the hypothalamic-pituitary-adrenal (hpa) axis, with chronic stress often associated with hypocortisolism. furthermore, the neuroinflammatory hypothesis suggests that cytokine-driven inflammation and activation of glial cells may intensify pain and somatic symptoms, exacerbating patient outcomes. challenges such as limited acceptance of the diagnosis, resistance to treatment among patients and caregivers, and societal stigma further hinder effective management. currently, treatment options lack definitive efficacy, with pharmacological interventions primarily targeting serotonin pathways. there is limited exploration of therapies addressing mechanisms like cortisol dysregulation and neuroinflammation. commonly used medications include tricyclic antidepressants (tcas), serotonin-norepinephrine reuptake inhibitors (snris), and selective serotonin reuptake inhibitors (ssris), with prescribing decisions often based on physician discretion and patient tolerance rather than clear evidence favoring one class over another. the proposed study aims to compare the efficacy and safety of dosulepin (a tca) and venlafaxine (an snri) in managing ssd patients with predominant pain. by evaluating their impact on symptom severity, quality of life, and biomarkers such as serum cortisol and tnf-alpha levels, this research seeks to enhance understanding of ssd treatment. the findings aim to address gaps in ssd pharmacotherapy and contribute to improved patient care strategies.


Eligibility criteria:
inclusion criteria: * patients with a primary diagnosis of somatic symptom disorder with pain predominance (dsm-5). * patients of either sex within the age group of 18-65 years. * patients with phq-15 score of ≥ 5. * all included patients will be treatment-naïve or have not received any treatment in the last 4 weeks. * patients who have given written informed consent. exclusion criteria: * a diagnosed psychological condition that might require other treatment (e.g., psychosis, suicidality) * patient undergoing current psychotherapy. * patients with cognitive impairment. * history of allergy to either of the study drugs (dosulepin or venlafaxine). * patients with comorbidities like any malignancies, hepatic, renal, cardiovascular, neurological or endocrinal, or respiratory dysfunction. * substance abuse history of psychoactive agents. * pregnant and lactating mothers.

Keywords: somatic symptom disorder dosulepin venlafaxine somatic syndrome disorder with pain predominance cortisol tnf alpha
comparison of two anatomic landmarks with ultrasonography in spinal anesthesia

Conditions: Arthropathy of Knee

Summary: the most used anatomical landmark for application of spinal anesthesia is tuffier's line. other alternative landmark is tenth rib. however there is no trial that compare these landmarks based on using ultrasonography.

the investigators aim to compare two landmarks (tuffier's line and tenth rib line) for accuracy by using ultrasonography. 40 patients will be included in each groups. all of them will be assessed by ultrasonography during application of spinal anesthesia. and the investigators will examine the percentage of successful estimation of correct vertebral space.

Eligibility criteria:
inclusion criteria: * knee arthroscopic surgery exclusion criteria: * bmi\>30 * anatomical anomaly of vertebrae

Keywords: spinal anesthesia ultrasonography anatomical landmark
tislelizumab plus tki as adjuvant therapy versus active surveillance in patients with hcc

Conditions: Liver Neoplasms

Summary: background: ablation is important radical treatment in hepatocellular carcinoma (hcc). however, the 5-year recurrence rate of hcc after ablation is up to 80%. early and late recurrences are more likely related to tumor size, tumor multiplicity, vascular invasion, higher serum afp level and disease etiology, etc. some studies suggested that adjuvant immunotherapy might be associated with decreased recurrence and prolonged rfs. adjuvant atezolizumab + bevacizumab (imbrave 050) showed rfs improvement following curative resection or ablation. currently, there is limited study on immunotherapy combined with tki as postoperative adjuvant therapy for hcc. this is an open-label, prospective cohort study to compare the efficacy and safety of tislelizumab plus tyrosine kinase inhibitor (tki) as adjuvant therapy versus active surveillance in hcc patients with high risk of recurrence after curative ablation.


Eligibility criteria:
inclusion criteria: * eligible patients are ≥18 years, diagnosed with hcc confirmed by histopathology or cytology, with no prior targeted or immune checkpoint therapy for hcc, and have undergone curative ablation with no residual lesions according to imaging or pathological assessment. patients are at high risk of recurrence meeting one of the following criteria: solitary tumor \>2cm but ≤5cm, or multiple tumors ≤4tumors and all≤5cm； poor tumor differentiation； macrovascular invasion of the portal vein(vp1/vp2) ； the absence or infiltration of a tumor capsule ； afp≥32ng/ml； hbv dna ≥105iu/ml； history of recurrence after curative treatment； family history of tumors. exclusion criteria: concurrent with other primary malignant tumors; severe coagulation dysfunction or severe thrombocytopenic purpura; there is serious infection or organ failure; have previously received targeted drugs or other pd-1 antibody therapy;

Keywords: hcc liver cancer
the response of intraocular pressure to systemic hypercapnia and hyperoxia

Conditions: Intraocular Pressure

Summary: the purpose of this study is to determine how intraocular pressure responds to changes in the levels of carbon dioxide or oxygen that a healthy individual inspires.

in response to changes in the composition of inhaled gases, blood vessels will dilate or constrict. as a result, hypercapnia or hyperoxia may affect the production and drainage of aqueous humour in the anterior chamber of the eye. the balance between the production and drainage of the aqueous humour determines the intraocular pressure. as this system is hydrodynamic, it is expected that any increase or decrease in the production of aqueous humour due to dilation or constriction of the capillaries within the ciliary body will be compensated by increased or decreased drainage at the trabecular meshwork. therefore intraocular pressure is not expected to show a response to hypercapnia or hyperoxia, but this supposition needs to be tested in a stably controlled manner of inducing inhaled gas provocations. this study will measure the intraocular pressure at varying levels of hypercapnia and hyperoxia using a sequential rebreathing circuit and automated gas blender. this will allow the precise targeting and stable control of end-tidal partial pressure values of carbon dioxide and oxygen. in this study, intraocular pressure will be measured at seven different inhaled gas stages. the seven stages are as follows: 1. baseline, measured in eye a (petco2=38mmhg and peto2=100mmhg) 2. 10% hypercapnic increase, measured in eye a (petco2=42mmhg and peto2=100mmhg) 3. 20% hypercapnic increase, measured in eye a (petco2=46mmhg and peto2=100mmhg) 4. baseline, measured in both eyes (petco2=38mmhg and peto2=100mmhg) 5. 250% hyperoxic increase, measured in eye b (petco2=38mmhg and peto2=250mmhg) 6. 500% hyperoxic increase, measured in eye b (petco2=38mmhg and peto2=500mmhg) 7. baseline, measured in eye b (petco2=38mmhg and peto2=100mmhg)

Eligibility criteria:
inclusion criteria: * age range 18-30 years old * visual acuity of 20/20 or better exclusion criteria: * refractive error \>±6.00 ds and/or ± 2.00 dc * history or presence of ocular disease * family history of diabetes or glaucoma * history of intraocular or refractive surgery * nursing or pregnant women * history of clinically diagnosed endocrine disease * history of vascular disease, cardiovascular disease, or any treated respiratory disorders (seasonal asthma excluded from this so long as subject not taking rx at the time) * history of systemic hypertension * habitual smoking * use of medications that affect blood flow

Keywords: intraocular pressure hypercapnia hyperoxia rebreathing circuit
examining the efficacy of personalized lifestyle intervention in individuals with rheumatoid arthritis

Conditions: Inflammatory Arthritis

Summary: it is aimed to examine the effects of person-centered lifestyle intervention on occupational performance, general health status, and quality of life in individuals with rheumatoid arthritis.

rheumatoid arthritis (ra) is defined as a chronic, inflammatory autoimmune disease that can damage both joints and non-articular organs, including the heart, kidneys, lungs, digestive system, eyes, skin, and nervous system. management of ra requires a multidisciplinary approach, as common risk factors for ra include both modifiable lifestyle-related variables and non-modifiable traits such as genetics and gender. although there is no definitive cure, it is necessary to optimize physical, emotional, and social health in order to minimize the impact of the disease. at this point, self-management interventions come to the fore. since many areas of life are affected in individuals with ra, it is seen that there is a need for combined treatments that address the individual holistically, as suggested by eular. lifestyle intervention is a combined approach that encourages individuals to change their lifestyles by increasing participation in meaningful readings. there is strong evidence in the literature that lifestyle intervention is an effective approach to managing the symptoms of many chronic diseases. the number of studies involving lifestyle interventions in individuals with ra, whose importance is emphasized in the literature, is limited. therefore, our study was planned to examine the effects of person-centered lifestyle intervention on occupational performance, general health status, and quality of life in individuals with ra. hypotheses:

Eligibility criteria:
inclusion criteria: * being diagnosed with ra between the ages of 18-65 and meeting the acr/eular diagnostic criteria * patients with low to moderate disease activity (das28 ≤5.1) * no pharmacological treatment changes for ra in the last 3 months * have not had any surgery in the last 6 months * understand and cooperate with testing guidelines * to be literate exclusion criteria: * having any musculoskeletal disease, neurological disease, and/or visual and auditory impairment other than ra * pregnancy
predictive factors of unpredicted movement in motor evoked potential

Conditions: Involuntary Movements; Brain Surgery

Summary: the purpose of this study was to identify the predictive factors of unpredicted movement in motor evoked potential (mep) during intraoperative neurophysiologic monitoring in adult patients undergoing brain surgery.

despite advances in neuroendovascular techniques, several complications can occur by brain urgery. therefore, for neurosurgeons and anesthesiologists, it is a major concern to describe and monitor surgical lesion for maintaining structural and functional integrity as well as achieving maximal cytoreduction in lesion, and modifying the management of patients on the process of surgery. for example, microvascular doppler sonography, indocyanine green aniography, intraoperative digital subtraction angiography, and intraoperative neurophysiologic monitoring (ionm) are used for this purpose. the incidence of unpredictable and unacceptable movement is relative low. however, the results are so horrendous that they can cause injuries in site of rigid pin fixation of the head, cervical spine injuries, excessive surgical field movement, and deterioration of surgical outcome. however, risk factors associated with unpredictable and unacceptable movement remain unclear. therefore, the aim of this retrospective study was to evaluate risk factors associated with unpredictable and unacceptable movement in the patients who underwent brain surgery with mep monitoring under general anesthesia while using neuromuscular blocking agent. the investigators recorded demographic data including age in years, sex, height in meters, weight in kilograms, body mass index (bmi in kg/m\^2), asa physical status class, diagnosed disease, performed surgical procedure, duration of anesthesia in minutes, duration of surgery in minutes, underlying disease (e.g. hypertension, diabetes, neurologic disease, respiratory disease), medications. laboratory data was also collected including arterial blood gas analysis, hematocrit, hemoglobin, sodium, potassium, ionized calcium, ionized magnesium, and lactate. unpredictable and unacceptable movement was defined as either the dangerous gross movement requiring the increase the continuous infusion rate of rocuronium in view of the surgeon, anesthesiologist, and neurophysiologic specialist or the shake of the surgical field requiring the increase the continuous infusion rate of rocuronium.

Eligibility criteria:
inclusion criteria: * from june 2003 to august 2017, patients who underwent motor-evoked potential monitoring during brain surgery under partial neuromuscular relaxation at the seoul national university bundang hospital. exclusion criteria: * age : 18 or younger and 75 or older * anesthesiologists physical status classes iii or more * body mass index(bmi) \ 25 kg/m\^2 * patients who received medications that affect muscle relaxation recovery other than anticonvulsants * ot/pt \> 40 iu/l, cr \> 1.4 mg/dl * moderate to severe respiratory or heart disease

Keywords: predicted factor motor evoked potentials
effectiveness of different non-pharmacological methods in pain management during vaccination.

Conditions: Pain

Summary: aim: this study was conducted to determine and compare the effectiveness of different non-pharmacological methods in pain management during vaccination. methods: this randomized experimental study with placebo and control groups was conducted with 175 infants assigned to the shotblocker® (n = 35), shotblocker®-placebo (n = 35), sucrose (n = 35), sucrose-placebo (n = 35) and control (n = 35) groups. the pain levels of the infants were determined by blind assessors (nurses, parents, and observer) using the neonatal infant pain scale (nips) before and during vaccination.


Eligibility criteria:
inclusion criteria: * born at full term * no infection, redness, deteriorated skin integrity, or nerve damage in the area of application * had not undergone any clinical injection. exclusion criteria: * infants who have applied analgesics before the vaccination

Keywords: pain infants
comparison of dexmedetomidine and midazolam for intra-op sedation in tiva in children undergoing inguinal hernia repair

Conditions: Inguinal Hernia

Summary: to compare dexmedetomidine and midazolam for intra-op sedation in tiva in children undergoing inguinal hernia repair. the results of the study if found significant will guide the anesthetist in appropriate choice and dose of sedative drug with highest efficacy and minimum side effects to avoid post operative adverse effects associated with anesthesia


Eligibility criteria:
inclusion criteria: * male and female paediatric patients in age range neonates to 15 years * planned for elective inguinal hernia repair * patients with uncomplicated hernia with asa class i or ii exclusion criteria: * patients undergoing emergency inguinal repair * patients with asa class iii,iv,v or vi * patients present with complicated hernia * patients with bmi above 40kg/m2 * patients with any allergy to anesthesia * patients with coagulopathy * patients with narcotic/opioid addiction
chinese chronic renal insufficiency study: based on smartphone platform

Conditions: Chronic Kidney Diseases

Summary: this is a multi-center prospective cohort study. the purpose of this study is to investigate the relationship between bone metabolic markers and other non-traditional risk factors with kidney function progression, cardiovascular and cerebrovascular diseases, and bone loss in patients with ckd g3-5nd. in the meantime, this study is to explore a new mode of management and complication monitoring through mobile communication in chronic kidney disease patients.

abnormal mineral bone metabolism of chronic kidney disease (ckd-mbd) is the most common complication of ckd. it involves kidney, bone metabolism, parathyroid gland, cardiovascular and cerebrovascular organs. it is an independent risk factor for progression of ckd to end-stage renal disease (esrd), vascular and cardiac valve calcification, and cardiovascular and cerebrovascular events. however, less data concerning the relationship between bone metabolic index, such as high blood phosphorus and cardiovascular diseases, bone mass reduction and fracture is available in chinese adult patients. this study is a multi-center prospective cohort study to explore the relationship between bone metabolic markers and other non-traditional risk factors with renal function progression, cardiovascular and cerebrovascular diseases, and bone loss in patients with ckd g3-5nd. based on the sample size estimation, 3360 subjects should be enrolled in this study. the primary outcome is progression to esrd (start dialysis or kidney transplantation) or doubling of serum creatinine, as well as cardiovascular events and all-cause mortality. at present, the follow-up and the management of complications of ckd patients are not enough. the popularity of mobile communication in china provide the possibility to strengthen the follow-up and complications management in ckd patients and save human resources. this study is to explore a new mode of collecting datas through mobile communication in chronic kidney disease patients.

Eligibility criteria:
inclusion criteria: * at least two measurements of serum cr (with a minimum interval of 3 months), , 10≤egfr≤60ml/min/1.73m\^2 exclusion criteria: * unable or unwilling to provide informed consent * patients attending oncology, psychiatry, human immunodeficiency virus/acquired immunodeficiency syndrome (hiv/aids), viral hepatitis (hbv or hcv) services * acute mycardial infarction within the last six months * nyha class iii or iv heart failure at baseline * ongoing chemotherapy or immunosuppressive therapy (in the preceding 6 months to treat renal or immune disease) * current renal replacement therapy * current pregnancy or breastfeeding women * any organ transplantation * currently participation in an interventional clinical trial

Keywords: chronic kidney diseae mineral bone disease cardiovascular events mobile communication
effect study of a theory-based internet intervention on safe-sex practices

Conditions: Sexual Risk Behavior for HIV-Infection

Summary: the purpose of this study is to examine the efficacy of a theory based, online tailored intervention on stimulating safe-sex practices among men who have sex with men (msm). our hypothesis was that a tailored internet intervention would be more effective in stimulating safe-sex practices of gay men than a non-tailored internet intervention when compared to a waiting-list control group.

relationships are a high-risk setting for hiv-infection. this trial aimed at testing the efficacy of an online theory-based tailored intervention for preparing single msm to practice safe sex with future steady partners-labeling it the 'cognitive vaccine approach'. the target was the promotion of negotiated safety (ns): steady partners testing for hiv and reaching agreements to either be monogamous or to only have safe sex outside the relationship in order to have safe unprotected anal intercourse with each other. the intervention content was based on the information, motivation, behavioral-skills model and the intervention was tailored according to knowledge, motivation, and skill-related deficiencies of each participant. condom use was promoted as the default alternative for ns. using an online randomized controlled trial we examined the effects of a tailored versus non-tailored version of the intervention. the cognitive effect (i.e. response efficacy, intentions, and perceived behavioral control (pbc) was measured directly after the intervention and, after 6-months, the behavioral effect (i.e. ns and condom use) via e-mail follow-up.

Eligibility criteria:
inclusion criteria: * men who have sex with men of all ages, hiv-negative or of unknown serostatus, single, and open to a steady relationship with a man in the future

Keywords: hiv-prevention internet prevention intervention online randomized controlled trial effect evaluation msm steady relationships
docetaxel and carboplatin as first-line chemotherapy in early stage as well as advanced or metastatic ovarian cancer

Conditions: Ovarian Neoplasms

Summary: primary objective: to assess response rate. to record the clinical improvement in relation to stage and histopathological grading. secondary objective: to determine progression free survival. to find out overall survival. to evaluate the safety of the study regimen.


Eligibility criteria:
inclusion criteria: * performance status karnofsky index ≥ 60%. * early stage as well as advanced/metastatic ovarian cancer proven by abdominal ultrasonography, chest x-ray, computerized axial tomography scan. * histologically: epithelial/germ cell * haematology: absolute neutrophil count: ≥2x10\^9/l; platelet: ≥150x10\^9/l; haemoglobin: ≥ 10g/dl * liver function: total bilirubin: ≤1x unl (upper normal limit); aspartate transaminase \& alanine aminotransferase: ≤2.5 x unl; alkaline phosphatase: ≤2.5 unl * renal function: creatinine: ≤130 µmol/l; if creatinine \> 130 µmol/l, the 24 hour creatinine clearance should be \> 60 ml/min. exclusion criteria: * symptomatic peripheral neuropathy \> grade 1 by national cancer institute - common toxicity criteria scale * uncontrolled diabetes mellitus and uncontrolled hypertension * pregnant, or lactating patients(patients of childbearing potential must be using adequate contraception). * active infection or other serious underlying medical condition not compatible with program entry eg. congestive heart failure, previous myocardial infarction within 6 months prior to treatment. the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.