Kornimate/medical-research-clean huggingface dataset:
intrauterine insemination with letrozole versus in natural cycle

Conditions: Infertility; Intrauterine Insemination

Summary: rationale: intrauterine insemination (iui) is the treatment of first choice for couples with unexplained and mild male factor infertility in many countries, but it is controversial whether ovarian stimulation improves fertility outcomes. in recent retrospectively collected data, investigators found that in couples with unexplained and mild male factor infertility undergoing iui, ovarian stimulation with letrozole increased live birth rate as compared to natural cycle iui without substantially increasing the multiple pregnancy rate. investigators therefore perform a randomized clinical trial (rct) on the subject in the centre of reproductive medicine, peking university third hospital, beijing, china. objective: to test the hypothesis that in couples with unexplained or mild male factor infertility scheduled for an iui program ovarian stimulation with letrozole increases the live birth rate as compared to natural cycle treatment. study design randomized clinical trial. study population women diagnosed with unexplained or mild male factor infertility scheduled for treatment with iui. intervention women will be randomized for ovarian stimulation with letrozole or to natural cycle iui. in the group allocated to ovarian stimulation, women will receive oral tablets letrozole 5 mg daily from cycle day 3-5 for 5 days. investigators will treat the couples for 3 cycles, with a time horizon of 4 months. main study parameters/endpoints primary outcome is ongoing pregnancy leading to live birth. secondary endpoints are clinical pregnancy, multiple pregnancy, miscarriage rates, pregnancy complications and patients' costs. nature and extent of the burden and risks associated with participation, benefit and group relatedness the strategies compared are already broadly applied in current practice. no additional risks are expected. there is no benefit for participants, but the results may benefit future subfertile couples.


Eligibility criteria:
inclusion criteria: * being diagnosed with unexplained or mild male subfertility * at least one sided tubal patency, established according to local protocol * normal or mild impairment of semen quality defined as a tmsc of 3 million or more based on at least one semen analysis exclusion criteria: * woman with double sided tubal pathology * women with irregular cycles, pcos or other endocrine disorders * impaired semen quality: pre-wash tmsc \<3 million.
characteristics of disseminated her2+ breast cancer patients treated with trastuzumab that have reached complete, partial remission or stabilization of disease during more than 3 years

Conditions: HER-2 Positive Breast Cancer

Summary: main objective: to analyze the clinical and biological characteristics of patients with disseminated breast cancer her2 + treated with trastuzumab that have achieved a complete remission, partial or stable disease for a period exceeding 3 years. in addition, there will be a sub-genetic analysis of patients in whom there is availability a sample of primary tumor preserved in paraffin. this sub-analysis will not interfere with routine clinical practice, as the tumor samples based on which will be held on genetic profile, have been preserved in paraffin was extracted from the primary tumor to the patient.

secondary objectives: * to determine the frequency of patients achieving partial response or stable disease for a period exceeding 3 years. * know the time to complete or partial remission or to achieve stabilization of the disease. * know the length of the complete or partial remission or time to disease stabilization of patients. * knowing the pattern of treatment that has achieved complete or partial remission or stabilization of disease and duration. * knowledge of overall survival. * knowing the toxicity of prolonged administration of trastuzumab. * identify the primary tumor genes her-2 associated with such prolonged responses. the source document will be in all cases the clinical history and in the case of patients selected for the sub-genetic analysis, the report resulting from it. the study is carried out by filling a notebook of electronic data collection that gathers all available information contained in medical records. the sub-genetic analysis will be performed at the hospital de la paz. both, the processing of samples and conducting the analysis using qrt-pcr, will be performed in this hospital. all data are stored, ensuring the confidentiality, security and authenticity .the forms must be reviewed by the monitor. once recorded the data, the database will be revised and monitored to submit those records in which there are inconsistencies or missing information . following the closure of the database will be a report which will present the results of the analysis of the data.

Eligibility criteria:
inclusion criteria: 1. women older than 18. 2. patients with disseminated breast cancer with overexpression of her-2 (ihc 3 + or fish +). 3. patients who have been treated with trastuzumab (herceptin ®). 4. complete remission, partial or stable disease for a period exceeding 3 years, except for exclusive cerebral progression. 5. patients who have given their written informed consent. exclusion criteria: 1- patients with remission achieved with surgery or less than three months of treatment with trastuzumab.

Keywords: breast cancer. trastuzumab. complete remission.
mepivacaine vs. bupivacaine spinal anesthetic in total knee arthroplasty

Conditions: Anesthesia, Spinal; Arthroplasty, Replacement, Knee; Pain Management; Early Ambulation; Ambulatory Surgical Procedures

Summary: the purpose of this study is to determine if a shorter-acting spinal anesthetic called mepivacaine has advantages over a longer-acting medication called bupivacaine.

different medications last for different amounts of time and can be changed depending on the length of the procedure. a short acting spinal is generally used for procedures lasting less than 90 minutes. a longer acting medication would be any that lasts longer than 90 minutes. these medications not only block the signals that travel along the pain nerves, they also prevent the signals that tell the patients muscles to move. this means that after a total knee replacement a patient may delayed in their ability to get up and start walking early after surgery. walking early in the recovery has been shown to decrease the rate of pulmonary embolism and death. ambulating early is also important to prevent loss of strength, constipation, pneumonia and urinary retention.

Eligibility criteria:
inclusion criteria: * adult patients undergoing primary total knee arthroplasty exclusion criteria: * chronic opioid users * unable to give informed consent * forego the use of a foley catheter * those with hypersensitively to amide local anesthetics or opioids * those with contraindications to spinal anesthesia * conversion to general anesthesia will be excluded.
characterization of myocardial infarction scar using magnetic resonance imaging

Conditions: Myocardial Infarction

Summary: the goal of this monocentric observationnal study is to describe the characteristics of the myocardial infarction scar in terms of transmurality in residual lvef\>35% patients. the primary objective is to determine the frequency of the criterion "intramural scar ≥1.47cm2" (measured by mri) in patients who presented with myocardial infarction with residual lvef≥35%.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years ; * history of acute coronary syndrome prior to inclusion and having undergone cardiac mri; * lvef \>35% measured at least 6 weeks post-idm by echocardiography or mri; exclusion criteria: - patient with an implantable cardiac device (implantable cardioverter defibrillator or pacemaker) prior to mri.

Keywords: cardiac magnetic resonance sudden cardiac death risk stratification
study of enbrel (etanercept) for the treatment sub-acute pulmonary dysfunction after allogeneic stem cell transplant

Conditions: Lung Injury, Acute; Respiratory Distress Syndrome, Adult; Bronchiolitis Obliterans

Summary: the purpose of this study is to determine the effectiveness of etanercept in the treatment of patients with sub-acute lung injury following a bone marrow transplant. this study will also examine the toxicity of treatment with etanercept as well as whether there is an improved quality of life in these patients.

lung or breathing problems can develop several months to years following a bone marrow transplant. in some cases, these breathing problems develop without any signs of germs or infection in the lungs. the name for this type of breathing problem is called "sub-acute lung injury". sub-acute lung injury often develops many months, even years following a bone marrow transplant. it is often characterized by shortness of breath, cough, wheezing and fatigue. sub-acute lung injury can either lead to the formation of scar tissue in the lungs (making it difficult to take deep breaths), or it can cause the lungs to get weak (making people feel out of breath easily). approximately 25 - 50% of patients with sub-acute lung injury may eventually die from the damage in their lungs. typically, such patients die from infections that develop inside the damaged lungs. in this study, treatment with an experimental drug called etanercept will be used. (enbrel). the physicians feel there is the possibility that etanercept may help improve breathing. breathing ability will be assessed prior to treatment as well as during and after treatment so that comparisons can be made.

Eligibility criteria:
inclusion criteria: * recipients of allogeneic bone marrow, cord blood, or peripheral blood stem cell transplants are eligible * age \>6 years and able to complete pulmonary function testing * patients with evidence of sub-acute, non-infectious pulmonary dysfunction (old or rld) * recipients of sub-ablative transplant regimens are eligible * recipients of donor leukocyte infusions (dli) post-transplant are eligible * patients must be \> 100 days post transplant exclusion criteria: * patients with hypotension requiring inotropic agents other than dopamine \< 5mcg/ kg/ minute for blood pressure support. * patients with a positive quantitative bacterial culture from the bal fluid (≥ 104 cfu/ ml is considered positive) * patients whose bal fluid is positive for significant bacterial pathogens or pathogenic nonbacterial microorganisms (as defined by protocol) by special stain, culture or pcr analysis * patients who are enrolled on a phase i or phase ii trial for the prophylaxis or treatment of gvhd (acute or chronic) within 7 days of study entry. * patients with known hypersensitivity to etanercept. * patients who are pregnant. * patients with cmv seropositivity at the time of study entry. testing may include wither cmv pcr analysis or cmv pp65 testing. * evidence for multi-system organ failure.

Keywords: enbrel stem cell transplantation lung injury
effect of virtual reality for pain management during intracervical balloon placement for artificial childbirth induction

Conditions: Delivery Problem; Labor Pain

Summary: the labor induction concerns 22% of births in france. in the event of labor induction, in almost two thirds of cases, a cervical ripening method is used and the use of mechanical methods is observed for 8% of cervical ripening. intra-cervical balloon placement is generally well tolerated but is frequently associated with pain and acute anxiety. there are few options for pain relief. virtual reality, a relatively new intervention, has been studied as a distraction technique for pain relief, but never in the context of the induction of childbirth.

it's prospective single-center, randomized, single-blind, prospective study (1:1, 2 group randomization) comparing a group of patients who benefited from the use of the virtual reality headset to a group of patients who received standard care during balloon insertion. two groups of patients will be formed: a "standard care" group and a "standard care + virtual reality" group. the study will take place at the saint-etienne university hospital center in the gynecology-obstetrics department. the principal objective is to evaluate the effectiveness of the use of a virtual reality helmet on the reduction of pain during the insertion of an intra-cervical balloon for childbirth induction versus the use of standard care.

Eligibility criteria:
inclusion criteria: * any pregnant woman presenting to the gynecology-obstetrics department of the saint-etienne university hospital for an induction by cook's balloon. * patients affiliated or entitled to a social security system * patients having given their agreement to participate and after signing the consent form exclusion criteria: * woman refusing to participate in the study (lack of consent) * non french-speaking woman (impossibility of carrying out a good quality interview of the pregnant woman) * women suffering from blindness, deafness or epilepsy against the use of the virtual reality helmet. * participation in another interventional study. * patient under guardianship or curatorship * patient subject to a legal protection measure or unable to express their consent

Keywords: labor induction intra-cervical balloon pain virtual reality cook®
protective effects of edaravone dexborneol

Conditions: Acute Ischemic Stroke

Summary: the patients of acute ischemic stroke were divided into two groups, edaravone dexborneol treatment group and edaravone treatment group. the purpose of this study was to observe the changes of imaging and the improvement of nihss and mrs in different groups.

a total of 80 patients with acute ischemic stroke of middle cerebral artery were randomly divided into two groups, edaravone dexborneol treatment group and edaravone treatment group. the mismatch area between the low perfusion area of mri 3d-asl and the infarct area of dwi was defined as the ischemic penumbra, and the cbf perfusion pseudo color images with pld of 1.5s and 2.5s were recorded. the above two cbf perfusion images were subtracted, and the residual area was quantitatively analyzed to reflect the establishment of collateral circulation. we aimed to observe whether there were differences in the improvement of ischemic penumbra and the establishment of collateral circulation between two groups after treatment. besides, the improvment of nihss and mrs was also observed in different periods.

Eligibility criteria:
inclusion criteria: 1. aged from 50 to 80 years old; 2. patients diagnosed as acute ischemic stroke according to chinese guidelines for the diagnosis and treatment of acute ischemic stroke 2018 and who met the requirements of middle cerebral artery blood supply area infarction (except deep perforator disease) without treatment; 3. brain mr showed that the low perfusion area of asl was at least 20% larger than that of dwi core infarct area, and the contralateral mirror brain tissue was basically normal; 4. nihss score was between 4 to 24; 5. patient or their legal representatives were willing to sign the informed consent form. exclusion criteria: 1. serious mental abnormality, complicated with heart, lung, liver, renal insufficiency or malignant tumor and other serious diseases; 2. combined with cerebral vascular malformation or cerebral hemorrhage; 3. pregnant or lactating women; 4. allergic to edaravone or dexborneol; 5. there are interactions between the drugs being taken by patients and the study drug or affect the clinical trial parameters.

Keywords: edaravone dexborneol ischemic penumbra nihss mrs
impact of essure devices withdrawal on the symptomatology of patients

Conditions: Quality of Life; Contraceptive Device; Complications

Summary: the essure device is a method of permanent contraception, marketed in france since 2005. multiple side effects have been reported by patients since 2015 and the marketing was stopped in 2017. for several months it was observed an increase in requests for withdrawal of these devices. the principal objective of this study is to evaluate clinical improvement and quality of life after essure removal. this is a multicenter retrospective descriptive study involving the gynecology department of the croix rousse hospital and the gynecology department of the lyon sud hospital over a period of 1 year (1 january 2017-31 december 2017).


Eligibility criteria:
inclusion criteria: * women who underwent essure removal due to suspected adverse effects of the device. * women who agreed to participate in the study exclusion criteria: - women who underwent essure removal to restore their fertility.
iron overload assesment in sickle cell anemia and sickle cell thalassemia

Conditions: Sickle Cell Anemia; Sickle Cell Thalassemia; Iron Overload; MRI

Summary: iron overload is well study in thalassemia patients and it's not only related to blood transfusions, since intestinal iron absorption is also increased in those patients. sickle cell patients didn't develope significant clinical symptoms and signs of iron overload in spite frequent transfusions. the purpouse of this study is to assess the iron overload in sickle cell anemia and sickle cell thalassemia patients using clinical parameters and cardiac t2\*mri in order to determine the cardiac and liver iron.


Eligibility criteria:
inclusion criteria: * all the patients with sickle cell anemia and sickle cell thalasemia that are currently in follow up at the pediatric hematology unit exclusion criteria: * age below 18 years.

Keywords: sickle cell anemia sickle cell thalassemia iron overload mri
hyperbaric versus normobaric oxygen therapy for covid-19 patients

Conditions: Covid19

Summary: at least 1 in 6 covid-19 patients admitted to hospital to receive extra oxygen will die of complications. in patients with covid-19, invasive treatment such as mechanical ventilation (e.g. breathing with a machine) is associated with a 50% increased risk of death. invasive treatments use a lot of healthcare resources in intensive care units and may lead to further deaths if patients do not have access to care. the investigators aim to improve outcomes for covid-19 patients by implementing hyperbaric oxygen therapy (hbot). hbot allows patients to breathe 100% oxygen in a special chamber at a pressure higher than sea level. it is approved by health canada for 14 conditions. hbot is safe when administered by experienced teams. there are two main causes of death in severe covid-19 respiratory infections: (i) a decreased diffusion of oxygen from the lungs to the blood and (ii) an increased inflammatory response (also called a "cytokine storm"). hbot leads to increased oxygen level in blood, has strong anti-inflammatory effects, and may destroy the virus responsible for covid-19 disease. the initial experience with hbot and covid-19 from china, france and the united states is promising in that it prevents further worsening of the condition and need for intensive care. the investigators propose to test the effectiveness of hbot for covid-19 patients who are admitted to hospital to receive extra oxygen. using the most rigorous and innovative research methods, this canadian-led international study will operate at 5 centers across 3 countries (canada: ottawa, toronto, edmonton; switzerland: geneva; uk: rugby/london). the investigators anticipate that when treated by hbot, covid-19 patients needing extra oxygen to breathe will see significant health improvements as well as a decrease in complications, inflammation in the blood, need for invasive care, death, and cost of care.


Eligibility criteria:
inclusion criteria: * male or non-pregnant female patients * age ≥18 years * confirmed covid-19 positive by rt-pcr or another validated method * diagnosed with pneumonia requiring 21%\<fio2≤100% to maintain saturation by pulse oximetry (spo2) ≥90% * able and willing to comply with study procedures and follow-up examinations contained within the written consent form exclusion criteria: * patient clinical status felt to be incompatible with hbot, e.g. respiratory failure requiring mechanical ventilation * pregnancy, determined by a serum or urine test * hemodynamic instability requiring vasopressors * inability to maintain a sitting position during treatment * inability to effectively understand and communicate with the hyperbaric operator, or to give consent * inability to spontaneously equalize ears and refusal of myringotomies * contraindications to hbot (e.g. pneumothorax)

Keywords: hyperbaric oxygen therapy
the evaluation of thiol redox status in conjunctiva of dry eye patients

Conditions: Dry Eye Disease

Summary: dry eye disease is related with oxidative stress at the ocular surface. gsh is one of the key factor of protect from oxidative stress. to evaluate thiol status of ocular surface cells by monitoring gsh concentration, we can evaluate the severity of dry eye.

the conjunctival cells are collected by impression cytology. those cells are stained with 100 mm of monochlorobimane (mcb, m-1381, molecular probes, eugene, or) and propidium iodide (pi). fluorescent intensity, reflecting the amount of icgsh, was inspected under a confocal laser scan microscope. to detect the gsh levels we used a fluorescent mcb probe with excitation and emission wavelengths of 405 nm and 410-480 nm, respectively. the cell-permeating mcb probe is non-fluorescent but forms a fluorescent adduct with gsh in a reaction catalyzed by glutathione-s-transferase.

Eligibility criteria:
inclusion criteria: * dry eye patients * control volunteers exclusion criteria: * young (less than 20) patients * the patients who rejected this study

Keywords: dry eye thiol redox oxidative stress