Kornimate/medical-research-clean huggingface dataset:
amh predicts postchemotherapy menopause in premenopausal breast cancer patients

Conditions: Breast Cancer

Summary: to determine the accuracy of amh postchemotherapy in predicting permanent menopause after chemotherapy in breast cancer patients who did not use ofs before menopause

for early breast cancer women who are premenopausal, after receiving chemotherapy (neoadjuvant chemotherapy or adjuvant chemotherapy), not using ofs as ovarian suppression, amh, e2 and fsh levels will be measured by blood sampling before chemotherapy, at the end of chemotherapy and 1 month, 3 months, 6 months, 12 months, 18 months and 24 months after chemotherapy. the menstrual status of patients will be also followed up. at several timing, investigators will analyze amh level, e2 level, fsh level, proportion of unmeasured amh (amh≤0.02ng/ml), proportion of e2 that conforms to menopausal status (e2≤30ng/l), proportion of fsh that conforms to menopausal status (fsh \> 30u/l), proportion of persistent amenia (no menstruation from the end of chemotherapy to the evaluation time) and incidence of adverse reactions

Eligibility criteria:
inclusion criteria: 1. age over 40(include 40 years old), or before 60, female 2. primary invasive breast cancer diagnosed by histopathology, except of occult breast cancer, inflammatory breast cancer and paget's disease 3. operable patients with no distant metastases at diagnosis (stage t1-t3, any n, m0) 4. the patient was at premenopausal status when first diagnosed (had menstruation in the last 12 months or hormone levels not reached menopause when diagnosed, e2 \> 30ng/l, fsh≤30u/l) 5. the patient has used chemotherapy (neoadjuvant chemotherapy or adjuvant chemotherapy) after diagnosis exclusion criteria: 1. age before 40, or over 60(include 60 years old) 2. patient who accepted bilateral ovariectomy or ovarian radiotherapy 3. patient who used gonadotropin-releasing hormone agonist ( gnrha) 4. stage iv (metastatic) breast cancer 5. the patient was at postmenopausal status when first diagnosed (no menstruation in the past 12 months or hormone levels reached menopause when diagnosed, e2≤30ng/l, fsh \> 30u/l) 6. the patient has not used chemotherapy (neoadjuvant or adjuvant chemotherapy) since diagnosis 7. the investigator determines that the patient has any other condition that make her unfit to participate in the study
the effect of virtual reality on pulmonary recovery and mobility in patients with blunt chest trauma

Conditions: Blunt Chest Trauma

Summary: blunt chest trauma comprises over 10% of all trauma patients presenting to emergency departments worldwide and is the most frequent injury in polytrauma patients. it is associated with high risk (\>10%) of pulmonary complications such as pneumonia. pillars of treatment are adequate pain relief, respiratory function exercises and rapid mobilisation through physiotherapy. inadequate pain control can result in restricted ventilatory function and in reduced mobility, both resulting in a higher risk of particularly pulmonary complications. virtual reality (vr) might be an easy to use, individualized, and harmless technique that can facilitate pulmonary recovery and aid in the prevention of complications through reducing pain and promoting exercising. the investigators hypothesize that vr improves respiratory function and mobilisation in the post-acute phase of blunt chest trauma by distracting patients from pain and stress, and by stimulating pulmonary and physical exercise.


Eligibility criteria:
inclusion criteria: * admitted to the trauma ward with sustained blunt chest trauma * age≥16 * patient is willing and able to comply with the study protocol exclusion criteria: * neurotrauma with gcs ≤13 * history of dementia, seizures, epilepsy * severe hearing/visual impairment not corrected * head wounds or damaged skin with which comfortable and hygienic use is not possible. * stay at intensive care unit (icu) during current hospital admission. * erect position in bed not possible/allowed.

Keywords: virtual reality trauma pulmonary recovery
ataxia and exercise disease using mri and gait analysis

Conditions: Ataxia; Spino Cerebellar Degeneration; Spinocerebellar Ataxias

Summary: the first aim is to show balance training improves dcd individual's ability to compensate for their activity limitations, but does not impact disease progression. the second aim is to demonstrate aerobic exercise improves balance and gait in dcd persons by affecting brain processes and slowing cerebellar atrophy.

individuals with degenerative cerebellar disease (dcd) exhibit gradual loss of coordination resulting in impaired balance, gait deviations, and severe, progressive disability. with no available disease-modifying medications, balance training is the primary treatment option to improve motor skills and functional performance. there is no evidence, however, that balance training impacts dcd at the tissue level. aerobic training, on the other hand, may modify dcd progression as evident from animal data. compared to sedentary controls, aerobically trained dcd rats have enhanced lifespan, motor function, and cerebellar purkinje cell survival. numerous animal studies also document that aerobic training has a direct, favorable effect on the brain that includes production of neurotrophic hormones, enhancement of neuroplasticity mechanisms, and protection from neurotoxins. the effects of aerobic training in humans with dcd are relatively unknown, despite these encouraging animal data. a single study to date has evaluated the benefits of aerobic exercise on dcd in humans, and this was a secondary outcome of the study. although participants performed limited aerobic training during the study, modest functional benefits were still detected. the main objective of this project will be to compare the benefits of aerobic versus balance training in dcd. we hypothesize that both aerobic and balance training will improve function in dcd subjects, but that the mechanisms in which these improvements occur differ. 1) balance training improves dcd individual's ability to compensate for their activity limitations, but does not impact disease progression. 2) aerobic exercise improves balance and gait in dcd persons by affecting brain processes and slowing cerebellar atrophy.

Eligibility criteria:
inclusion criteria: * diagnosed with spinocerebellar ataxia * cerebellar atrophy on mri * prevalence of ataxia on clinical exam * ability to safely ride a stationary exercise bike exclusion criteria: * other neurologic conditions * heart disease * cognitive impairment * medical instability

Keywords: ataxia, exercise, spinocerebellar disease, neuroimaging
afatinib in previously treated escc with egfr overexpression or egfr amplification (escc-a01)

Conditions: Esophageal Squamous Cell Carcinoma

Summary: this is a phase 2 trial investigating the effect and safety of afatinib in previously treated recurrent or metastasic esophageal squamous cell carcinoma with egfr overexpression or egfr amplification.


Eligibility criteria:
inclusion criteria: 1. having signed informed consent. 2. age 18 to 70 years old. 3. histologically confirmed esophageal squamous carcinoma 4. immunohistochemistry confirmed egfr(3+) or egfr-fish-amplification or next generation sequencing confirmed egfr-amplification. 5. computed tomography (ct) or magnetic resonance imaging (mri) confirmed unresectable metastasic or recurrent escc. 6. refractory or intolerant to at least one regimen. 7. measurable disease according to the response evaluation criteria in solid tumors (recist) 1.1 criteria(diameter of the lesion should be more than 10mm by spiral ct or mri, more than 20mm by common ct, the date of image should be less than 21 days before enrollment) 8. life expectancy of ≥3 month 9. eastern cooperative oncology group (ecog) 0-2 10. wbc\>3,000/mm3, absolute neutrophil count ≥1500/mm3, platelet\>100,000/mm3, hb\>9g/dl，bilirubin level \< 1.5 times uln，serum creatinine \<1.5 times uln，alt and ast\<2.5 times uln ，akp \< 2.5 times uln ，(≤5 times uln in patients with liver metastases)(within 7 days before enrollment) 11. no sever complication, such as active gastrointestinal bleeding, perforation, jaundice, obstruction, non-cancerous fever\>38℃. 12. good compliance exclusion criteria: 1. contraindications of afatinib. 2. unable to take afatinib orally because of esophageal stenosis. 3. currently receiving other effective regimens. 4. previous anticipate other clinical trial within 4 weeks before entering this study. 5. no measurable lesions, eg. pleural fluid and ascites. 6. with other malignancy within 5 year, except non-melanoma skin cancer and cervical carcinoma in situ. 7. heart failure or other sever organ dysfunction, eg. coronary artery disease, myocardial infarction within the last 6 months. 8. mentally abnormal or disable cognition,including central nervous system (cns) metastasis. 9. hiv infection, active hepatitis b or hepatitis c. 10. unstable systemic diseases such as poorly controlled diabetes. 11. interstitial lung disease, such as interstitial pneumonia, pulmonary fibrosis, or evidence of interstitial lung disease showed in x-ray/ct. 12. keratitis, ulcerative keratitis or severe dry eye syndrome. known hypersensitivity to study drug. 13. pregnancy or lactation period. 14. active severe infection within 14 days.

Keywords: afatinib egfr overexpression egfr amplification
near infrared technology for the detection of proximal caries

Conditions: Caries,Dental

Summary: this study aims to determine the effectiveness of an intraoral scanner with near-infrared imaging (niri) for the diagnosis of proximal caries.

a total of 639 proximal surfaces (mesial-distal) of 22 volunteers without restoration of premolars and molars were examined. results were scored for 4 different examination methods; intraoral examination by visual-tactile method (vtm), bitewing radiography (bwr), panoramic radiography (pr) and near-infrared imaging (niri). scoring was made according to the type of lesion (0:no caries, 1:early enamel lesion(eel), 2:lesion involving the dentin-enamel-junction (dej). data were analyzed with ibm-spss-v23. mcnemar-test was used for comparison between the methods. the kappa test was used to examine the agreement between two methods in categorical data, and the fleiss-kappa test was used to assess the agreement between more than two methods. the analysis results are presented as frequency(percentage).the significance level was considered p\<0.05.

Eligibility criteria:
inclusion criteria 1. presence of premolar and molar tooth 2. having an appointment for restorative treatment exclusion criteria 1. restored proximal surfaces 2. full mouth crowns and removable dental prothesis
cesarean skin incision trial

Conditions: Wound Complication

Summary: the purpose of this study is to determine if there is a difference between pfannenstiel and midline vertical skin incision at time of cesarean section in preventing wound complications in the morbidly obese patient. this is a comparative effectiveness study of two commonly-used skin incisions. the investigators plan to enroll morbidly obese obstetrical patients upon admission and randomize them to one of the above incision types in the operating room. the investigators will follow them for 6 weeks post-op to evaluate for wound complications. there is minimal risk to the participant as both incision types are acceptable in current obstetrical practice. there is no direct benefit to the patient. currently, there is no level i evidence to support either pfannenstiel or midline vertical skin incision in the prevention of wound complications in the obese patient undergoing cesarean section. therefore, current practice is for the surgeon to make the decision based on preference and weighing theoretic risks. therefore, there is clinical equipoise. cesarean section is a very common procedure, with a national rate of 32% of all live births in 2007. not only does obesity increase the expectant mother's risk of a cesarean section, it is also a well recognized risk factor for wound complication. the cesarean wound complication rate in the morbidly obese population at the university of texas at houston - memorial hermann hospital texas medical center in 2011 was roughly twenty times as high as the normal weight population, 28% compared to 1.4%. results from this study could be extrapolated in the future to affect lower post-operative morbidity, higher patient satisfaction, less antibiotic use, shorter hospital stay, and overall lower health care costs.


Eligibility criteria:
inclusion criteria: 1. pregnant women undergoing cesarean delivery for any indication, regardless of number of prior cesarean deliveries 2. age 18-50 years 3. bmi of 40 kg/m2 or more exclusion criteria: 1. underlying infection such as chorioamnionitis 2. rupture of membranes over 18 hours prior to cesarean section ,

Keywords: wound infection cesarean delivery obesity
covid-19 brain injury

Conditions: Sars-CoV2; Severe Neurologic Injury; Ischemic Stroke; Hemorrhagic Stroke; Intracerebral Hemorrhage; Subarachnoid Hemorrhage; Traumatic Brain Injury; Status Epilepticus

Summary: a prospective cohort minimal risk study to determine the impact of the covid-19 crisis on outcomes of neurologically injured icu patients.

covid 19 pandemic has overwhelmed healthcare capacity in many regions around the world. as resources become more limited and we have to triage /ration ventilators, neurologically injured icu patients without covid 19 but with respiratory insufficiency may be triaged to no ventilator care due to their perceived or actual prognosis. this may lead to increased rates of withdrawal of care and mortality. some neurologically injured icu patients with respiratory insufficiency may be simultaneously infected with covid 19. their outcomes are completely unknown. capturing data on the prevalence of limitation of care and prognosis in this patient population will provide important information towards ongoing efforts in patient care and resource utilization as we face the rapidly evolving covid 19 pandemic. given the expected strain on icu resources and limitations in research in icus during covid 19 pandemic, data capture/study design must be targeted and pragmatic. this study is designed to answer the most basic and important questions while minimizing the burden of data collection on already overloaded providers. this study design is comprised of two components: component 1- prospective cohort prevalence study captures data related to treatments offered, limitations of care and patient outcome in 5 select primary neurological diagnoses requiring icu care. component 2- case control study captures the same data elements in the same patient populations during the 3 months prior covid 19 pandemic (sept - dec, 2019).

Eligibility criteria:
inclusion criteria: * patients greater than or equal to 18 * patients who require critical care with primary diagnoses of: acute ischemic stroke (ais), acute intracerebral hemorrhage (ich), acute subarachnoid hemorrhage (sah), acute traumatic brain injury (tbi), status epilepticus (se) patients requiring critical care exclusion criteria: * patients under the age of 18 years old * pre-existing do not resuscitate (dnr), do not intubate (dni), or comfort measures only (cmo) status prior to acute hospitalization * neurologically morbid-bound on hospital arrival (bilateral fix/dilated pupils, catastrophic bleed/tbi) and likely to progress to brain death within 48 hrs
efficacy of school-based, peer-led asthma and smoking prevention program on co1 levels and smoking behavior among early adolescents in jordan

Conditions: Asthma; Tobacco; Waterpipe; Cigarettes

Summary: study hypotheses: 1. adolescents in intervention schools who are given triple a program plus asp will show more awareness in regards to cigarettee smoking health effects and less nicotine dependencethan those in the control schools who are given triple a alone. 2. adolescents with asthma in intervention schools who are given triple a program plus asp will show less asthma symptoms and better control than those in the control schools who are given triple a alone. 3. adolescent smokers and passive smokers will exhibit higher levels of carbon monoxide (co) in their breath than those who are not active or passive smokers. 4. there is a positive correlation between self-report questions regarding student smoking status and levels of co in their breath


Eligibility criteria:
inclusion criteria: students in grades 7 and 8 in irbid city high schools, can speak and read in both arabic and english, obtain parental agreement, attend regular school. - exclusion criteria:students with other chronic diseases (rather than asthma), -

Keywords: asthma tobacco waterpipe cigarettes adolescents peer education jordan
periodontal status and dental behavior of heart trasplant recipients and healthy controls

Conditions: Periodontal Diseases; Heart Transplantation

Summary: forty heart transplant recipients and forty age and sex mathced systemically healthy patients were included. periodontal examination was performed and a questionnaire was applied to record demographic data, systemic health and dental behavior data.

patients who had heart transplantion surgery at between 2003 to 2017 were screened during routine outpatient visits. the patients who have history of periodontal treatment within the previous year, history of antibiotic use during the preceding 6 months, clinically non-stable patients were excluded . 40 cardiac transplant patiets who met these criteria included into this study. each member of the transplant group was mathched with a patient in the systemically healthy control group by age and gender and smoking status. 40 systemically healthy subjects with no history of periodontal treatment within the previous year and no history of antibiotic use during the preceding 6 months were recruited. medical data hospital records were reviewed and data were collected using a standardised form that included demographic information (age, gender) and medical information such as smoking history, presence of systemic disease, post transplant time, medication regimen/dosages. assesment of oral hygeine behaviour patients were also asked to complete a standardised anamnestic questionnaire. questions were about their personal oral hygeine behaviour (toothbrush, dental floss etc.), whether their dental visit was routine or complaint-oriented. for the transplant group one more question about whether a dental check up or comprehensive dental treatment had occured before transplantation was added. clinical examination in both groups, periodontal examination was performed by one calibrated periodontist at the deperatment of periodontology, başkent university. all subjects recieved a comprehensive periodontal examination including plaque index (pi); gingival index (gi); gingival recession (gr); bleeding on probing (bop); probing depth (pd); clinical attachment level (cal). according to the clinical and radiographic evaluation the patients were categorized due to their periodontal status. the patients were diagnosed with periodontally healthy, gingivitis or periodontitis. patients were diagnosed with periodontally healthy if they have \ 10% bleeding sites with probing depths ≤3 mm were diagnosed with gingivitis. patients who had probing depths ≥ 4 mm, interproximal, cal of ≥2 mm or ≥3 mm at ≥2 non-adjacent teeth .9,25,26

Eligibility criteria:
for transplant group: inclusion criteria: * having heart transplantation surgery * be clinically stable exclusion criteria * history of periodontal treatment within the previous year, * history of antibiotic use during the preceding 6 months, * being clinically non-stable for healthy group inclusion criteria * being systemically healthy * no history of periodontal treatment within the previous year * no history of antibiotic use during the preceding 6 months exclusion criteria having a systemic disease
diaphragm thickness by ultrasonography in neurological disorders

Conditions: Guillain-Barre Syndrome; Myasthenia Gravis

Summary: participants will be allocated into three groups, acute neuropathy (guillain barre syndrome) group, neuromuscular junction disorder(myasthenia gravis ) group, and control group(people with neurological disorders not affecting the respiratory system.ultrasonography is done on the diaphragm. the index test (ultrasound imaging of the diaphragm) is used. a high-resolution portable ultrasound machine is used, with a 7- to 13-mhz linear array transducer. patients will be examined in the supine position. diaphragmatic thickness will is measured on both sides during a deep breath in inspiration and during expiration. objectives: primary outcome: to compare diaphragm thickness between the three examined groups. secondary outcome: correlation between clinical scores and reference us values of diaphragm

after irb (institutional research board ) approval, of the faculty of medicine, mansoura university, egypt, written informed consent from all participants will be taken. participants will be allocated into three groups, acute neuropathy (guillain barre syndrome) group, neuromuscular junction disorder(myasthenia gravis ) group, and control group(people with neurological disorders not affecting the respiratory system. inclusion group: age more than 18, both sexes. exclusion criteria: cardiopulmonary disease, chest trauma, diaphragmatic injury, body mass index more than 30. any participant who shows respiratory dysfunction on doing arterial blood gases and pulmonary function tests will not be enrolled in the study. methods: ultrasonography is done on the diaphragm. the index test (ultrasound imaging of the diaphragm) is used. a high-resolution portable ultrasound machine is used, with a 7- to 13-mhz linear array transducer. patients will be examined in the supine position. diaphragmatic thickness will is measured on both sides during a deep breath in inspiration and during expiration. objectives: primary outcome: to compare diaphragm thickness between the three examined groups. secondary outcome: correlation between clinical scores and reference us values of diaphragm

Eligibility criteria:
inclusion criteria: * all adult patients admitted to the neurology department exclusion criteria: * cardiopulmonary diseases * chest trauma * diaphragmatic diseases * body mass index (bmi) \> 30

Keywords: diaphragm thickness
effects of continuous passive motion on the spinal circuitries and its adaptation in patients with spasticity resulting from upper motor neuron lesions

Conditions: Spinal Cord Injury(SCI)

Summary: in animal and human studies, histochemical and physiological evidences showed that the muscle transferred from slow, fatigue-resistant muscle to fast, fatigable muscle after spinal cord injury. the alternation of muscular property was accompanied by the alternation of spinal circuitry property, and was related to the immobilization adaptation. previous study showed that remobilization by continuous passive motion (cpm) for one month would restore the function of spinal circuitry in individual with chronic sci. it is possible that long term application of cpm can reverse the adaptation of contractile properties of the paralyzed muscle after sci. the purpose of this study is to investigate the effect of a four month cpm training on muscular properties in individuals with chronic sci.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of complete spinal cord injury

Keywords: spinal cord injury passive motion fatigue index hypertonia