Kornimate/medical-research-clean huggingface dataset:
immediate breast reconstruction with acellular dermal matrix

Conditions: Breast Cancer; Breast Carcinoma in Situ; Mammaplasty; Acellular Dermis

Summary: the aim of this study is to contribute to the knowledge regarding immediate implant-based br by investigating whether the one-stage technique with adm is superior to the two-stage expander to implant technique. primary endpoint in first publication is postoperative complications, secondary endpoint is patient and investigator assessed aesthetic outcome. primary endpoint in second publication is cost, secondary endpoint is patient reported outcome measures.


Eligibility criteria:
inclusion criteria: * skin sparing mastectomy due to breast cancer, ductal carcinoma in situ or high genetic risk of developing breast cancer * mastectomy weight ≤ 600 g * patient older than 18 years * ability to complete the study questionnaire * only for the two-stage group no later than 2 years and 4 months from breast reconstruction exclusion criteria: - smokers
right ventricular pulmonary vascular interaction in pulmonary hypertension

Conditions: Pulmonary Arterial Hypertension (PAH)

Summary: the goals of this study were two-fold. first, the attempt to quantify the relationships between pulmonary arterial stiffness, right ventricular function and the efficiency of ventricular-vascular interactions in patients with pulmonary arterial hypertension (pah). second, the attempt to quantify the effects of exercise on pulmonary arterial stiffness, pulmonary vascular resistance, right ventricular function and the efficiency of ventricular-vascular interactions in patients with pah.

the goals of this study are to quantify right ventricular-pulmonary vascular interactions in different types of pah, to determine the temporal changes in these interactions with pah progression and to quantify the effects of exercise on right ventricular function. the inclusion of the subpopulation of pah patients with systemic sclerosis (ssc) was a result of the anticipation that this group has worse arterial stiffening than other groups, and consequently more inefficient right ventricular-pulmonary vascular interactions, which account for their worse prognosis.

Eligibility criteria:
inclusion criteria: 1. diagnosis of pulmonary arterial hypertension or a subtype 2. referred for right heart catheterization 3. age between 18 and 80 years 4. new york heart association (nyha) functional class i, ii, or iii exclusion criteria: 1. recent syncope (within 1 year) 2. severe skeletal or muscle abnormalities prohibiting exercise 3. mixed etiology pulmonary arterial hypertension 4. severe lung disease 1. test results indicating severe obstruction 2. total lung capacity \< 60% 5. pregnancy or breastfeeding 6. nyha class iv patient 7. contraindications to magnetic resonance imaging 8. kidney dysfunction as determined by an estimated glomerular filtration rate (egfr) of \< 30 ml/min/1.73m2 9. contraindication to gadolinium
fibroblast growth factor 21 in systemic lupus erythematosus

Conditions: Systemic Lupus Erthematosus

Summary: systemic lupus erythematosus (sle) is a chronic disorder characterized by profound immune and metabolic disturbances. it emerges due to a complex interplay of genetic and environmental factors. alteration in immune cell metabolism is another feature of sle. mitochondria, serving as the main regulator of cell metabolism, exhibits pronounced dysfunction in sle patients. kidneys are among the most frequently affected organs in sle, with 30-40% of patients developing lupus nephritis (ln) over the course of their disease. ln patients exhibit varying degrees of renal injury, significantly reducing their survival rate. usually, ln originates from abnormal immune responses, resulting in the formation and deposition of immune complexes in the kidneys, triggering the release of pro-inflammatory cytokines, cell adhesion molecules, and chemokines, thereby inducing inflammation. extensive glomerular mitochondrial damage has been reported in kidney biopsies obtained from patients with ln. so, identifying peripheral immune markers of mitochondrial dysfunction may be beneficial in assessing sle activity and the extent of organ involvement. among these markers, fibroblast growth factor 21 (fgf-21) is one of the circulating immune markers which is expressed in response to mitochondrial stress. fgf-21 is known to be primarily produced in the liver, but under stress conditions, it can also be produced by the kidneys. in addition, it correlates with the degree of renal impairment in various kidney diseases.


Eligibility criteria:
inclusion criteria: - 1- patients who will be diagnosed as sle according to the 2019 eular/acr classification criteria for systemic lupus erythematosus. 2-sle patients \> 18 years old. exclusion criteria: * 1-sle patients \< 18 years old. 2- patients with other rheumatic diseases or overlap syndromes. 3- patients with malignancy. 4- patients with liver diseases.

Keywords: sle fibroblast growth factor 21
linus health cds retrospective validation study

Conditions: Cognitive Impairment; Motor Disorders; Dementia

Summary: this study is a retrospective validation study of deidentified clinical decision support (cds) recommendations generated by the linus health core cognitive evaluation (cce) for patients who have completed the cce. site investigators consist of clinical experts including neurologists and geriatricians in the u.s. after signing the study agreements, the experts will receive batches of anonymized cce outputs of patients and will rate the appropriateness of each cds recommendation for each patient based on their review of the cce results and their clinical judgment and expertise. the experts will also rate the clinical appropriateness of various parts of cds pathways that form the lh cds decision tree.


Eligibility criteria:
inclusion criteria: * age 55 and above * has already completed the linus health cce exclusion criteria: * incomplete cces * cces that are flagged as "requires clinician review"
managment of cardiorespiratory arrest

Conditions: Assess the Quality Ofmanagement of Children With Cardiorespiratory Arrest in Assuit University Children Hospital According to the( A H A)Guidelines

Summary: cpr will be done based on american heart association guidelines for cardiopulmonary resuscitation (2015) and emergency cardiovascular care of pediatric and neonatal patients.

the present study is to assess the quality of care and management of children with cardiorespiratory arrest admitted to assuit university children hospital according to the american heart association guidelines for cardiopulmonary resuscitation (2015) and emergency cardiovascular care of pediatric and neonatal patients searching for defect,obstacles,or need to improve health service. cpr will be done based on american heart association guidelines for cardiopulmonary resuscitation (2015) and emergency cardiovascular care of pediatric and neonatal patients.

Eligibility criteria:
inclusion criteria: * seriously ill patients who will be admitted with or will be developed cardiorespiratory arrest and undergo cpr. age2 month to 18 years. both sex. exclusion criteria: * traumatic cause (blunt, penetrating, burn) of arrest
postural and anthropometric properties of foot and ankle of patients with dmd

Conditions: Duchenne Muscular Dystrophy; Ambulation Difficulty; Posture Disorders in Children; Ambulation Disorder, Neurologic

Summary: introduction: progressive muscle weakness, joint contractures and body alignment disorders seen in patients with duchenne muscular dystrophy (dmd) adversely affect the foot structure of the patients. objective: the aim of this study is to examine the relationship between foot posture, performance and ambulation in patients with dmd. method: the patient with ambulatory dmd will be included in the study. the foot postures of the patients will be evaluated with the foot posture index. relationships between the foot posture index and performance tests (6 minute walk test, timed performance tests (10m walking, gower's, climb/descend 4 stair)) and the north star ambulation evaluation, an ambulation evaluation, will be examined.


Eligibility criteria:
inclusion criteria: 1.5 to 18 years old 2. not to have lost his ambulation 3. agreeing to participate in the research voluntarily exclusion criteria: 1. having serious mental and psychological problems, 2. having lost his ambulation 3. inability to cooperate adequately with the physiotherapist who made the evaluations, 4. any injury and/or surgery to the lower extremities in the last 6 months.

Keywords: duchenne muscular dystrophy foot posture performance ambulation
stratifying endometrial cancer patients using a pet/mri prognostic model

Conditions: Endometrium Cancer

Summary: endometrial cancer (ec) is the most common gynecological malignancy in high-income countries. prognosis and treatment are dictated by cancer histological subtype and grade coupled with surgical staging as described by surgical international federation of gynecology and obstetrics (figo) staging system. surgery is the elective standard treatment and used for staging of ec. the purpose of this study is to collect images from a simultaneous pet/mri study from which to extrapolate a preoperative, non-invasive, prognostic model.

magnetic resonance imaging (mri) is the most frequently used imaging tool in preoperative staging of endometrial cancer. fdg-pet has demonstrated higher sensitivity than mri in detecting nodal involvement and metastatic disease and is currently used in adjunction to mri. distinct mri and fdg-pet parameters correlate well with tumor aggressiveness and can and have been used as prognostic factors. the investigators believe that the combination of data from these two imaging techniques, from which different derived tumor features can be extrapolated, can stratify patients in high-risk and low-risk groups already preoperatively. the aim of combined techniques is to collect large amounts of data leveraging advantages of both modalities (mr's strengths in local staging and pet's strengths in nodal staging) in a single scan from which to extrapolate a preoperative, non-invasive, prognostic model.

Eligibility criteria:
inclusion criteria: * histopathological confirmation of a primary endometrial cancer * age \> 18 years * no contraindication to surgery (comorbidity, contraindication or lack of consent) * no contraindication to preoperative imaging * visible tumor at imaging * signed inform consent. exclusion criteria: * patients unsuitable for surgical intervention (comorbidity, contraindication or lack of consent, poor performance status) * age \< 18 years, c) inability to complete the needed imaging examination (ie, severe claustrophobia) * any additional medical condition that may significantly interfere with study compliance * all the contraindication for mri (ie, pacemaker).

Keywords: endometrium cancer pet-mri stratification
micronized progesterone in frozen embryo transfer cycles

Conditions: Infertility

Summary: this randomized trial was designed as non-inferiority trial aiming to compare ongoing pregnancy rates following lps with 600 mg/day vs 800 mg/day vaginal vmp. all patients will undergo an artificial cycle frozen embryo transfer (ac-fet) with transdermal estradiol 6mg/day patients undergoing an artificial cycle fet will start estrogen priming with transdermal estradiol 6mg/day (estrogel®) on cycle d1-d3. following 10-12 days of estrogen priming, patients will be randomized to luteal phase support with a standard formulation (200mg tid, utrogestan®) or a new formulation (400mg bid) vmp. all patients will undergo a serum p measurement on the day before embryo transfer (et). patients with p\<10 ng/ml will receive a supplement of oral micronized progesterone 300mg, while patients with p≥10ng/ml will maintain the previous luteal phase support (lps) protocol


Eligibility criteria:
inclusion criteria: * endometrial preparation with hormone replacement therapy * age 18-43 years following an autologous ivf cycle (with or without preimplantation genetic testing for aneuploidy) * age \< 50 years following an egg donation cycle * bmi \> 18 and \< 30 kg/m2 * blastocyst embryo transfer * willing to participate in the study * able to come to the center to comply with the procedures of the study: blood tests, appointments and drug dispensation. exlusion criteria: * • uterine diseases (e.g. submucosal fibroids, polyps, previously diagnosed müllerian abnormalities) * hydrosalpinx * recurrent pregnancy loss (≥ 3 previous miscarriages) * recurrent implantation failure (≥ 3 previously failed embryo transfers of good-quality blastocysts) * allergy to study medication * pregnancy or lactation * contraindication for hormonal treatment * personalized initiation of exogenous progesterone according to a previous endometrial receptivity assay test * recent history of severe disease requiring regular treatment (clinically significant concurrent medical condition that could compromise subject safety or interfere with the trial assessment).
multicenter automatic defibrillator implantation trial - reduce inappropriate therapy

Conditions: Primary Prevention of Sudden Cardiac Arrest

Summary: this study will assess the impact of higher rate cutoffs and longer delays than standard programming on inappropriate therapy in primary prevention icd and crt-d patients.

the purpose of the madit-rit trial is to compare the time to first inappropriate therapy using high rate cutoff and/or long delay in primary prevention patients receiving an icd or crt-d device compared to standard programming.

Eligibility criteria:
inclusion criteria: * primary prevention patient with ischemic or non-ischemic heart disease who meets current guidelines for dual-chamber icd or crt-d device therapy * patient in sinus rhythm * patient on stable optimal pharmacologic therapy for the cardiac condition or who has developed a recent icd indication that necessitates icd therapy concurrent with the optimization of pharmacologic therapy * patient ≥ 21 years of age, or legal representative, willing and capable of giving informed consent exclusion criteria: * patient with an implanted pacemaker or crt-p * patient with existing icd or crt-d device components * patient with a history of vt or vf * patient with permanent or chronic af, or cardioversion for af, within the past three calendar months before enrollment * patient with coronary artery bypass graft surgery or percutaneous coronary intervention within the past three calendar months prior to enrollment * patient with enzyme-positive myocardial infarction within the past three calendar months prior to enrollment * patient with angiographic evidence of coronary disease who are candidates for coronary revascularization and are likely to undergo coronary artery bypass graft surgery or percutaneous coronary intervention in the foreseeable future * patient with second or third degree heart block * patient in nyha class iv * patient who is pregnant or plans to become pregnant during the course of the trial * patient with irreversible brain damage from preexisting cerebral disease * patient with presence of any disease, other than the patient's cardiac disease, associated with a reduced likelihood of survival for the duration of the trial, e.g., cancer, uremia, liver failure, etc. * patient with chronic renal disease with bun ≥ 50mg/dl or creatinine ≥ 2.5 mg/dl * patient participating in any other clinical trial * patient unwilling or unable to cooperate with the protocol * patient who lives at such a distance from the clinic that travel for follow-up visits would be unusually difficult * patient who does not anticipate being a resident of the area for the scheduled duration of the trial * patient unwilling to sign the consent for participation * patient whose physician does not allow participation

Keywords: inappropriate therapy icd therapy primary prevention
the effect of screen time on recovery from concussion

Conditions: Concussion, Brain

Summary: this study will prospectively examine the effect of screen time on recovery from concussion. patients 12 to 25 years of age presenting to the ed with a concussion will be randomized to allow for screen time as tolerated or to abstain from screen time for the first 48 hours of recovery. the amount of screen time use and duration of concussive symptoms will be assessed through daily surveys and a daily post-concussive symptom score (pcss).


Eligibility criteria:
inclusion criteria: * individuals presenting to the emergency department with a traumatic head injury sustained in the last 24 hours and diagnosed concussion as defined by acute concussion evaluation tool (ace-ed) * between 12 and 25.99 years of age * english-speaking * subject (and parent/guardian when applicable) is able and willing to provide informed consent and assent * pregnant women, exclusion criteria: * individuals who have a glasgow coma scale score of 13 or less; * have brain abnormalities on imaging; * have severe preexisting neurological conditions; * a concussion diagnosed within the last 2 weeks; * have significant developmental delay; * are intoxicated; * require neurosurgical intervention, intubation, or hospital admission * individuals who do not meet the age criteria; * non-english speaking; * prisoners; * unable or unwilling to provide informed consent; * are under the age of 18 and do not have a parent/guardian with them who is willing and able to consent.

Keywords: screen time
genius toothbrushes on periodontal status of orthodontic patients

Conditions: Periodontal Inflammation; Toothbrushing; Orthodontic Treatment

Summary: this study evaluates the effects of genius toothbrushes on periodontal status of patients during fixed orthodontic treatment.half of the patients received manual orthodontic toothbrushes (oral b ortho, procter \& gamble, usa) with v-shaped bristles and rounded ends. the others received genius orthodontic toothbrush (oral b genius 8900, procter \& gamble, usa) with oral-b crossaction brush head, procter \& gamble, usa).

powered (genius) toothbrush with position detection technology provides patient to clean all areas of the mouth during the required time. by connecting phone to the oral-b app, the genius toothbrush uses facial recognition technology to guide patient's brushing, zone to zone. pressure control and personalization are another characteristics of these toothbrushes. pressure sensor alerts patient if the brushing is too hard and helps her/him not to put too much pressure by reducing the speed of brush head. due to the bluetooth technology, toothbrushing can be performed more efficiently among orthodontic adolescent patients. in addition, the position detection and timer can be used to control which area is brushed in the mouth and how much total brushing time is continued. the application allows patient to see all the days brushing activity and real-time feedback on brushing habits can be received by this way.

Eligibility criteria:
inclusion criteria: * permanent dentition with no missing teeth * no systemic or severe periodontal problems * indication of non-extraction fixed orthodontic treatment * no use of drugs in the past two months * absence of physical problems that prevent brushing * right handedness for brushing * same bracket type (0.022 slot metal, conventional) and ligation technique (wire ligature) * finishing of leveling phase (use of rectangular wires) * initial total score was between 3 and 10 for the labial surface of each tooth according to the modified silness and löe plaque index exclusion criteria: * missing teeth * systemic or severe periodontal problem * indication of extraction treatment * use of drugs in the past two months * levelling phase of fixed orthodontic treatment

Keywords: genius toothbrush orthodontic treatment periodontal health
the immunomodulation effect of blood transfusion in operative spine surgery patients

Conditions: Infection After Transfusion

Summary: the purpose of this study is to investigate the effect of transfusion of allogeneic (homologous) red cells on the immunologic parameters such as t-cells as well as natural killer cell count/function, various interleukins, tnf alpha and other immunologic relevant parameters on postoperative day 1,3 and 5-7 in patients undergoing spine surgery.


Eligibility criteria:
inclusion criteria: * age \> 18 - \< 60 years * patients underwent elective spine surgery * asa classification 1-3 exclusion criteria: * patients who have the concomitant condition * cancer * history of heart disease including, heart failure, coronary artery disease, hypertension treated with more than one medicament. * serum creatinine \> 1.5 mg/dl * stroke, neurologic and mental deficits, epilepsy * general or local infection (site of surgery), * coagulation disorders. * intraoperative massive bleeding * infection of the spine * rheumatoid arthritis * patients who had either of the following drug (aspirin, methotrexate, cyclosporine, qualaquin)
hormonal contraceptive health education for adolescent males

Conditions: Contraception Behavior

Summary: prospective randomized control trial of an educational electronic application on female hormonal contraception for adolescent males in the pediatric emergency department.

unintended pregnancy among adolescents is a significant public health issue and u.s. adolescents have one of the highest unintended pregnancy rates among industrialized nations. an estimated 9% of male adolescents becoming fathers by the time they are 20 years old. over 14 million adolescents use emergency departments every year and many of the adolescent males that present to the ed are engaged in high risk sexual behaviors which puts them at high risk for unintended pregnancy. this presents an opportunity to educate males that are at high risk about pregnancy prevention. this study is a prospective randomized control trial of education about female hormonal contraception for these higher risk adolescent males, 15-21 years old, that present to the saint louis children's hospital pediatric emergency department. an electronic application will be used to take a sexual history and ask questions about patients' current attitudes and use of hormonal contraception with their partners. they will then be randomized to watch a video on female hormonal contraception (experimental group) or no video (control group). the video will be an overview with brief pros and cons of all available types of hormonal contraception. the app emphasizes importance of condom use as part of dual method protection throughout. all patients will be followed up in 3 months to complete a survey with similar questions on sexual history, discussions with partners, and current contraceptive practices. the hypothesis of the study is that this will lead to increased rates of discussion about hormonal contraception between male adolescents and their sexual partners. this may lead to increased contraceptive use rates and a decrease in unintended pregnancy.

Eligibility criteria:
inclusion criteria: * male adolescents 15-21 years of age that are sexually active and have ever had vaginal sex that present to the st louis children's hospital pediatric emergency department. exclusion criteria: * males that have never had vaginal sex * require activation of the trauma system * triage as high severity (level 1 or level 2) * present for evaluation of abuse, sexual assault, or psychiatric issues * unable to speak english * wards of the state * disabilities that prevent independent use of a tablet device * have not completed the electronic adolescent health questionnaire that is standard of care in our emergency department as this is needed for screening purposes

Keywords: contraception education male adolescents emergency department unintended pregnancy