Mathilde/NLI4PR huggingface dataset:
Patient case (clinical description): A 32-year-old woman comes to the hospital with vaginal spotting.  Her last menstrual period was 10 weeks ago. She has regular menses lasting for 6 days and repeating every 29 days. Medical history is significant for appendectomy and several complicated UTIs. She has multiple male partners, and she is inconsistent with using barrier contraceptives. Vital signs are normal.  Serum β-hCG level is 1800 mIU/mL, and a repeat level after 2 days shows an abnormal rise to 2100 mIU/mL.  Pelvic ultrasound reveals a thin endometrium with no gestational sac in the uterus.

Patient's own account: I just turned 32 and last morning I woke up with strange blood stains on my underwear. My last periods were more than 2 months ago, which is unusual for me because I used to have regular periods lasting for 6 days every 29 days, more or less. I had several UTIs in the past. I also had appendicitis. I'm currently seeing several men and, to be honest, some of them do struggle to wear a condom. I went to the hospital to check myself up and they told me that my vitals were normal. I also had a blood test on Monday, and my β-hCG level was 1800 mIU/mL, and then on Wednesday, it went up to 2100 mIU/mL. The gynecologist also did an ultrasound and she told me that, hopefully, there was no ovule.

Clinical trial: Endometrial Effects of Sildenafil in Frozen-Thawed Cycles in Women With Thin Endometrium

Eligibility criteria:
Inclusion Criteria:

          -  Women (25 -40 years) undergoing IVF frozen-Thawed cycles and known to have good
             quality embryos.

          -  previous thin endometrium (< 8mm on at least 3 previous cycles) with normal
             Hysteroscopy findings

        Exclusion Criteria:

          -  women less than 25 years old or more than 40 years old.

          -  abnormal hysteroscopic findings.

          -  women with congenital uterine anomalies.

          -  History of previous uterine surgery

          -  Any contraindication to Sildenafil as Previous history of cardiac disease or stroke.
Female
No healthy subjects accepted to join the trial.
Subject must be at least 25 Years old.
Subject must be at most 40 Years

Eligibility (NLI label): Entailment
Patient case (clinical description): A 48-year-old man comes to the office complaining of heartburn and acid reflux.  He has taken over-the-counter antacids but sees no relief.  Other medical history is unremarkable.  The patient does not use tobacco, alcohol, or illicit drugs.  Vital signs are within normal limits.  BMI is 31 kg/m2.  Physical examination is  positive for mild tenderness in upper stomach. Chest x-ray shows an air-fluid opacity behind the heart.  A barium swallow study reveals approximately 1/3 of the stomach herniating through the esophageal hiatus.

Patient's own account: I went to my doctor's office because of a non-stop heartburn and some acid reflux. I took over-the-counter medications, but it keeps going strong! I don't smoke, take drugs or drink alcohol, I'm healthy! The doctor took my vitals, which turned out normal. My BMI is 31, which might be a bit too much for a 48-year-old guy like me. They examined my stomach and found a mild tenderness in the upper part. I also did some X-rays, and they found out that I have an air-fluid opacity behind my heart. I did another X-ray, and it turns out that a part of my stomach went up my chest through a hole in my diaphragm!

Clinical trial: Role of Pain Modulation in GERD Patients Who Failed Standard Dose PPI

Eligibility criteria:
Inclusion Criteria:

          -  Currently being treated with a PPI, but continue to experience GERD symptoms (such as
             heartburn) at least 2 times per week.

        Exclusion Criteria:

          -  Known allergy or intolerance to TCA

          -  History of serious arrhythmia or use of anti-arrhythmics

          -  History of seizures

          -  Subjects with significant co-morbidity, e.g., cardiovascular, respiratory, urogenital,
             renal, gastrointestinal, hepatic, hematological, endocrine, neurologic or psychiatric

          -  With evidence or history of drug abuse within the past 6 months

          -  Erosive esophagitis, esophageal ulceration, peptic stricture, Barrett's esophagus or
             adenocarcinoma of the esophagus on endoscopy

          -  History of esophagogastric surgery

          -  Gastric or duodenal lesions (ulcer, tumor, etc.)

          -  Women who are pregnant or of childbearing age who are not on contraception

          -  Patients who are unwilling or unable to provide informed consent

          -  Insulin dependent diabetes
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 80 Years

Eligibility (NLI label): Entailment
Patient case (clinical description): A 47-year-old man comes to the clinic for the follow up of his neuromuscular disease. He experienced gradual, progressive weakness of the left upper extremity over the last year.  Over the last few months, he has also noticed weakness in the right upper extremity.  BP is 120/75, PR is 80 and temperature is 37 C. Reflexes are brisk in the upper extremities, and the plantar responses are extensor.  Mild gait ataxia is present. The patient is under treatment of Riluzole 50 mg BID with the diagnosis of ALS.

Patient's own account: I've been suffering from a neuromuscular disease for a while now, and I went to my doctor's office. I'm now a 47-year-old man and over the past year I experienced a progressive and gradual weakness of my left upper extremity, and over the past month, I also noticed a weakness over my right upper extremity. My heart rate was 120/75, and my  PR was 80 with 37°C for temperature. My reflexes are not good in my upper extremities, and I have trouble with my balance. I'm also under Exservan 50 mg for my sclerosis.

Clinical trial: Memantine Therapy in Amyotrophic Lateral Sclerosis

Eligibility criteria:
Inclusion Criteria

          1. Age 18-85

          2. Male or Female

          3. Clinically definite ALS by El Escorial criteria

          4. Elevated levels of Tau in CSF

        Exclusion Criteria:

          1. Patients with FVC below 1.5 L or who require respiratory assistance

          2. History of liver disease

          3. Severe renal failure

          4. History of intolerance to Riluzole or Memantine

          5. Any other co morbid condition which would make completion of trial unlikely

          6. If female, pregnant or breast-feeding; or, if of childbearing age, an unwillingness to
             use birth control.

          7. Taking any trial medications. Non-trial medications are not cause for exclusion.

          8. Unwillingness to provide consent
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 85 Years

Eligibility (NLI label): Entailment
Patient case (clinical description): A 60-year-old man comes to the clinic complaining of hand tremor that started few months ago.  It is most bothering when he wants to drink from a glass or pour from a bottle. He does not smoke, but drinks occasionally. He recently started consuming more alcohol as his tremor subsides somewhat when he drinks small amounts of alcohol.  Family history is significant for similar problems in his mother.  Vital signs are normal and the patient has no other medical conditions.  Neurologic examination shows bilateral tremor in the upper extremities. The diagnosis of essential tremor is confirmed.

Patient's own account: I'm only a 60 years old man but I already suffer from shaky hands. It started a few months ago, and it really bothers me when I want to pour myself a glass or even while drinking. I don't smoke, but I drink alcohol from time to time. To be honest, I've been drinking a little more lately since it helps me with the shaking. My mom had the same issue when she was my age. The doctor took my vitals, and they were normal. I don't have any other medical issues. I underwent neurological exams and it showed that I’m shaky from both sides. The doctor diagnosed me with essential tremor.

Clinical trial: Octanol to Treat Essential Tremor

Eligibility criteria:
-  INCLUSION CRITERIA:

             14 patients with a clinical diagnosis of essential tremor will participate in the
             study. Selection criterion is essential tremor with a history of ethanol
             responsiveness. Informed consent will be obtained by any of the co-investigators.

        Patients must be off any medications used to treat essential tremor such as mysoline or
        propranolol for at least 2 weeks. Patients must withhold ethanol and caffeine 24 hours
        prior to starting the treatment periods through the end of treatment periods, including
        alcohol or caffeine containing over the counter medications. Ethanol and caffeine
        consumption is allowed in the washout period.

        EXCLUSION CRITERIA:

        Patients with abnormalities on neurologic exam other than tremor.

        Patients with a history of chronic alcohol dependence.

        Patients with chronic medical conditions such as renal failure, hepatic failure and chronic
        lung disease.

        Patients on other medications that cannot be temporarily discontinued for the length of the
        study.

        Patients, who, for moral or religious reasons, do not wish to take a potentially
        intoxicating drug.

        Patients with abnormalities on their baseline screening laboratory tests.

        Women who are pregnant or lactating.

        Patients under the age of 21.

        Asians and Pacific Islanders.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 21 Years old.


Eligibility (NLI label): Entailment
Patient case (clinical description): A 15-year-old boy with mild intellectual disability is brought to the office by his parents for a routine physical examination.  The boy is going to a school for students with learning disabilities.  The patient was adopted, and his immunizations are up to date.  Review of the patient's medical records is notable for cytogenetic studies that showed a small gap near the tip of the long arm of the X chromosome, which is consistent with fragile X syndrome, an X-linked disorder. The defect is an unstable expansion of trinucleotide repeats (CGG) in the fragile X mental retardation 1 (FMR1) gene, located on the long arm of the X chromosome. He is not using any medications and vital signs are within normal levels. His blood chemistry analysis as bellow:
Blood Chemistry Value      Normal Range     Patient Value
Glucose                    90-120 mg/dl     95 mg/dl
BUN (Blood Urea Nitrogen)  7-24 mg/dl       10 mg/dl
Creatinine                 0.7-1.4 mg/dl    0.8 mg/dl
Calcium                    8.5-10.5 mg/dl   9 mg/dl
Sodium                     134-143 mEq/L    135 mEq/L
Potassium                  3.5-4.5 mEq/L    3.7 mEq/L
Chloride                   95-108 mEq/L     98 mEq/L
CO2                        20-30 mEq/L      25 mEq/L
Blood pH                   7.38-7.42        7. 39

Patient's own account: My husband and I brought our 15-year-old son to the clinic for his routine exam. My son is going to school for special needs students. We adopted him a few years ago. His vaccinations are up to date. He already passed some chromosome testing and they found that he has a fragile X syndrome. The doctor told us that it comes from repeats in the fragile X chromosome. My son is not using any medication and his blood pressure temperature and breathing were normal during the exam. He also did a blood test. The results came back and showed that his blood sugar urea creatinine calcium sodium potassium chloride CO2 and blood pH were all within the normal range.

Clinical trial: Trial of Minocycline to Treat Children With Fragile X Syndrome

Eligibility criteria:
Inclusion Criteria:

          -  Must have fragile X syndrome with molecular documentation

          -  Current pharmacological treatment regimen has been stable for at least 4 weeks

        Exclusion Criteria:

          -  Subjects who plan to initiate or change pharmacologic or non-pharmacologic
             interventions during the course of the study

          -  subjects who are unable to take oral medication

          -  subjects who have been on minocycline previously

          -  subjects who are allergic to minocycline or tetracyclines

          -  subjects who are pregnant

          -  subjects with history of lupus or hepatic dysfunction
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 42 Months old.
Subject must be at most 16 Years

Eligibility (NLI label): Entailment
Patient case (clinical description): A 57-year-old man comes to the emergency department due to constipation.  His last bowel movement was 2 days ago. He complains of spending about 30 minutes once attempting to defecate. He also has lower back pain.  There is no history of trauma. The pain is not relieved with over-the-counter pain medications.  His vital signs are within normal limits.  Examination shows low back pain that is worse with back flexion and raising of the legs; it radiates into his left leg.  Pinprick in the perianal area does not cause rapid contraction of the anal sphincter.  The rest of the neurologic examination is normal. He is suspected of Cauda Equina syndrome and referred to a spinal MRI.

Patient's own account: I'm a 57 year-old-man, and I had to go to the ER because I couldn't go defecate. My last trip to the toilet was 2 days ago, and I tried too many times, during 30 min, to get my poop to get out. I also have terrible lower back pain. The doctor did not notice any trauma. I tried to get the pain away using over-the-counter medications, but it simply did not work! Back in the ER my vitals were normal. My pain was even more intense with back flexion, and when I raised my legs, it radiated into my left leg. The doctor did an anus exam where he had to pinch it and it was not reacting! However the rest of my neurologic exam was normal. The doctor suspects a Cauda Equina syndrome and referred me to a spinal MRI.

Clinical trial: Acute Low Back Pain in the Emergency Department Treated With Osteopathic Manipulative Treatment Versus NSAIDs

Eligibility criteria:
Inclusion Criteria:

          -  All patients 18 years of age or older with the chief complaint of acute low back pain
             defined as symptom duration no longer than four weeks prior to ED presentation and
             having clinical findings of somatic dysfunction (muscle edema, erythema, bogginess,
             hypertonic muscles, asymmetry of tissue, pain with movement, severe/sharp tenderness).

        Exclusion Criteria:

          -  Patients will be excluded if they previously participated in the study, history of
             gastrointestinal bleed, allergies to NSAIDs, NSAID use 4 hours prior to arrival,
             history of or concern for spinal column fracture, current diagnosis of active
             malignancy or metastatic cancer, open skin wounds at the treatment location site,
             patients with neurological deficits related to acute back pain, pregnant women,
             individuals unable to take oral medications, temperature >38C, prisoners, those unable
             to consent, subjects under police custody, nursing home residents, non-English
             speaking patients.
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 18 Years old.


Eligibility (NLI label): Contradiction
Patient case (clinical description): A 20-year-old man comes to the emergency due to bleeding after a tooth extraction.  The bleeding has persisted for approximately 30 minutes despite constant direct pressure.  He is a known case of Hemophilia type A treated with FVIII. Blood pressure is 95/60 mm Hg and pulse is 105/min. His weight is 70 Kg. Family history is positive for Hemophilia type A in his maternal uncle. He also has a lipoma on his left arm which he plans to remove surgically. His FVIII activity is 40%.

Patient's own account: I got my tooth extracted and I could not stop bleeding for 30 min. I'm a 20 yo dude but I have Hemophilia type A treated with FVIII. My blood pressure was 95/60 and my pulse 105/min. I'm 70 kg. My uncle on my mom's side also has type A hemophilia. I also have a fatty swelling on my left arm and I was supposed to remove it. My FVIII activity was 40%.

Clinical trial: Once-A-Day Prophylaxis for Youth and Young Adults With Severe Hemophilia A

Eligibility criteria:
Inclusion Criteria:

          -  Severe hemophilia A (<1% factor VIII)

          -  Age 12 to 24 years inclusive

          -  Male

          -  No current factor VIII inhibitor (an inhibitor will be defined as ≥ 0.6 Bethesda
             Units) within the past year

          -  Able to participate in a home infusion program with adequate peripheral venous access
             as assessed ny the treating investigator

        Exclusion Criteria:

          -  Important co-morbidities (Acquired Immunodeficiency Syndrome or symptomatic HIV
             infection, symptomatic hepatitis B or C infection)

          -  Other concomitant acquired or congenital bleeding disorder (e.g. von Willebrand's
             Disease)

          -  Receiving factor VIII replacement through central venous catheter
Male
No healthy subjects accepted to join the trial.
Subject must be at least 12 Years old.
Subject must be at most 24 Years

Eligibility (NLI label): Entailment
Patient case (clinical description): A 49-year-old man comes to the office because of the bulging in his groin.  Physical examination shows a swelling above the inguinal ligament. When the patient is asked to cough, the size of the bulge increases.  His medical history is significant for mild dyslipidemia, which is under control by lifestyle modifications. He does not smoke, but drinks alcohol occasionally. His vital signs and other physical examinations are unremarkable. He is referred to a surgeon and scheduled to undergo elective laparoscopic hernia repair.

Patient's own account: I'm a 49-year-old man and I went to my doctor the other day because I could not stand that sharp pain in my upper thigh, it was so swollen! The doctor told me that it was swollen right next to my ligament. It's even bigger when I'm coughing. I'm suffering from high cholesterol and I already had to adapt my lifestyle to keep the disease under control. I do not smoke but to be honest I still drink from time to time. The doctor found my vitals normal. She gave me a note to see a surgeon to get my mass removed and get a hernia repair.

Clinical trial: Local or Regional or General Anesthesia for Hernia Repair: a Randomized Controlled Trial

Eligibility criteria:
Inclusion Criteria:

          -  Patients scheduled to undergo elective unilateral inguinal hernia repair at Siriraj
             Hospital will be undertaken.

          -  ASA I-III,

          -  Age greater than 18 years old

        Exclusion Criteria:

          -  Allergy to any medication used this study,

          -  Femoral hernia, recurrent hernia, bilateral hernia,

          -  Bleeding abnormalities,

          -  Severe hepatic, renal or cardiovascular disease,

          -  Chronic use of opioid,

          -  History of using steroidal or nonsteroidal anti-inflammatory drugs in the past 6
             months,

          -  Inability to communicate in Thai or to understand the purpose of the study
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Entailment
Patient case (clinical description): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient's own account: I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Clinical trial: Bone Marrow Aspirate Compared to Platelet Rich Plasma for Treating Knee Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

          -  Male or female age 18-80 years

          -  Knee osteoarthritis

          -  Subjects must present with pain or swelling to target knee for at least 4 months

          -  Kellgren-Lawrence score between 1 and 3 upon x-ray evaluation

          -  Must be willing and able to provide informed consent

          -  Willing and able to return for scheduled follow-up visits

        Exclusion Criteria:

          -  Major mechanical axis deviation of more than 50% into either compartment (varus or
             valgus )

          -  Have had a corticosteroid injection within 3 months or a hyaluronic acid injection
             within 6 months

          -  History of the following medical conditions:

          -  diabetes

          -  autoimmune disorders

          -  disorders requiring immunosuppression

          -  rheumatoid arthritis

          -  hemophilic arthropathy

          -  infectious arthritis

          -  Charcot's knee

          -  Paget's disease of the femur or tibia

          -  Cancer

          -  Ongoing infectious disease

          -  Significant cardiovascular, renal or hepatic disease
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 80 Years

Eligibility (NLI label): Entailment