Kornimate/medical-research-clean huggingface dataset:
number of previous cesarean sections on the results of angiogenic factors.

Conditions: Cesarean Section

Summary: hypertensive disorders of pregnancy (hpt) are an important cause of maternal-feto-neonatal morbidity and mortality, being one of the three leading causes of maternal death in our country and in developing countries. the only cure for the is termination of pregnancy, which ends up being a decision in which gestational age and maternal risks must be balanced. angiogenic factors have come to occupy an indispensable place in the arsenal of tools that can be used to separate the patient with a high likelihood of complications from those in whom prolongation of pregnancy could represent an important neonatal benefit. although the usefulness of angiogenic factors in these scenarios is known, little is known about the effects that other conditions might have on their serum levels, mainly those that have an effect on trophoblastic invasion, the process that initiates implantation of the pregnancy in the endometrium. the purpose of the present study is to assess the effect that a history of uterine surgery, such as caesarean section, might have on angiogenic factor scores in subjects with no history of a hypertensive disorder of pregnancy.


Eligibility criteria:
inclusion criteria: * 36 weeks of gestation or more * singleton pregnancy * previous cesarean section (case) exclusion criteria: * vasculitis * twin pregnancy * chronic endometritis * smoking * lupus * renal failure * liver disease * thrombocytopenia

Keywords: cesarean section angiogenic factors preeclampsia
textbook outcome as a composite outcome measure in laparoscopic pancreaticoduodenectomy

Conditions: Pancreatic Neoplasms

Summary: this is a multicenter, retrospective, observational study. textbook outcome is a composite outcome measure for surgical quality assessment. the aim of this study was to assess textbook outcome following laparoscopic pancreaticoduodenectomy in china, identify factors independently associated with achieving textbook outcome and analyze hospital variations regarding the textbook outcome after case-mix adjustment.

laparoscopic pancreaticoduodenectomy (lpd) remains one of the most complex and technically challenging procedures in pancreatic surgery, although lpd has developed rapidly worldwide in recent years. traditionally, quality assessment of lpd has mainly focused on individual outcome measures such as morbidity, mortality, operative time, operative blood transfusion, readmission rates and length of hospital stay. however, individual outcome parameters do not reflect the multiple facets of the whole surgical procedure and do not measure actual variations among different hospitals. in this context, several outcome experts have suggested that composite measures of surgical quality may be better than individual outcome parameters to compare hospital performance. textbook outcome (to) is such a composite outcome measure of multiple desirable outcome metrics, which was first proposed in 2013 by dutch colorectal surgeons in order to give a comprehensive summary of hospital performance. to is realized when all of the desired outcome parameters are achieved following surgery and represents the optimal ("textbook") hospitalization. although several studies on to in pancreatic surgery have been reported, relevant data on lpd are lacking, especially from china. the objective of this study was to assess to among patients undergoing lpd in china, identify factors independently associated with achieving to and analyze hospital variations regarding the to after case-mix adjustment.

Eligibility criteria:
inclusion criteria: 1. patients underwent laparoscopic pancreaticoduodenectomy. 2. aged 18 to 75 years old. exclusion criteria: 1. peritoneal seeding or metastasis to distant sites. 2. incomplete clinical data

Keywords: textbook outcome laparoscopic pancreaticoduodenectomy composite outcome measure hospital variation
efficacy of apixaban in malignancy with deep venous thrombosis

Conditions: Deep Vein Thrombosis; Malignancy

Summary: the aim of study was to evaluate the efficacy and safety of apixaban in patients with acute deep venous thrombosis and active malignancy compared with weight adjusted subcutaneous (lmwh). it was hypothesised that apixaban could be as effective as rivaroxiban and edoxaban in treatment of patients with acute dvt and active malignancy with a lower risk of bleeding especially in those with git cancer.

patients with active malignancy have hypercoagulable state particularly, those receiving intravenous chemotherapy, with six fold higher risk of venous thromboembolism (vte) \[1\]. anticoagulation for malignancy associated deep venous thrombosis (dvt) can be difficult because of different limitations like bleeding, drug-drug interactions with chemotherapy and inconvenience with repeated subcutaneous injections of low-molecular-weight heparin (lmwh) \[2\]. in comparison with patients without active malignancy, patients with cancer who are on warfarin therapy have 2 to 6 folds more major bleeding events and 2 to 3 times more vte recurrence \[3,4\]. the american college of chest physicians guidelines recommended (lmwh) as standard therapy for management of acute vte in patients with active malignancy \[5\]. recently, rivaroxiban and edoxaban were considered as an alternative to weight-adjusted subcutaneous lmwh after pulmonary embolism in patients with active cancer without gastrointestinal (git) malignancy \[6\]. apixaban is a direct factor xa inhibitor approved by fda for treatment of dvt and vte \[7\]. however its efficacy in management of acute dvt and vte associated with cancer is still unresolved issue. the aim of study was to evaluate the efficacy and safety of apixaban in patients with acute deep venous thrombosis and active malignancy compared with weight adjusted subcutaneous (lmwh).

Eligibility criteria:
inclusion criteria patients with active malignancy presenting with acute deep venous thrombosis and still treated with chemotherapy exclusion criteria: * patients with pulmonary embolism and hemodynamic instability requiring thrombolytic therapy * previous dvt or venous thromboembolism * administration of lmwh or unfractionated heparin before randomization * brain tumours, cerebral metastes, hepatic tumours or impairment child-pugh b or c, -recent or current active or life threating bleeding (e.g. intr acranial haemorrhage or gastrointestinal bleeding) * thrombocytopenia (platelets \<100 x 109l) * severe chronic kidney disease (estimated glomerular filtration rate \<30 ml/minute) * pregnant women
a study on rheumatoid arthritis patients treated with rituximab

Conditions: Rheumatoid Arthritis

Summary: the purpose of the study is to obtain an overall picture of rituximab treatments and treatment responses in ra patients.


Eligibility criteria:
inclusion criteria: * rheumatoid arthritis (ra) patients treated with rituximab in finland exclusion criteria: * not applicable
long term safety of clopidogrel in neonates/infants with systemic to pulmonary artery shunt palliation

Conditions: Heart Defects, Congenital

Summary: this study is the extension of the clarinet study \[nct00396877 -efc5314\] in neonates or infants with cyanotic congenital heart disease palliated with a systemic-to-pulmonary artery shunt. the primary objective was to assess the safety up to 18 months of age of the extended use of clopidogrel 0.2 mg/kg/day in patients for whom the shunt was still in place at one year of age. the secondary objective was to assess the efficacy on the occurrence of shunt thrombosis requiring intervention or any death.

patients remained in the treatment group to which they were originally allocated for the clarinet study and continued blindly their treatment (0.2 mg/kg/day of clopidogrel or placebo) up to the occurrence of shunt thrombosis, next surgical procedure for correction of the congenital heart disease, death, or 18 months of age, whichever came first. the maximum treatment duration were 6 months.

Eligibility criteria:
inclusion criteria: * patients randomized in the clarinet study, * still receiving the study drug, * palliative systemic-to-pulmonary artery shunt still in place at 1 year of age, * investigator's decision to continue based on his/her judgment of the expected benefit / risk of continuing treatment with study drug, * signed informed consent to participate in the long-term safety study.

Keywords: cyanotic congenital heart disease shunt palliation thrombosis clopidogrel
alterations in gait, strength, and power after ruck marching

Conditions: Exercise; Fatigue

Summary: the purpose of this study is to determine change in injury risk and performance variables in males and females after walking unloaded and carrying a load with two different distributions (high-pack placement and mid-pack placement) to identify differences in injury risk


Eligibility criteria:
inclusion criteria: * healthy, physically active individuals * 18-39 years old exclusion criteria: * history of musculoskeletal injury within the last six months or still under a physicians care for an injury occurring more than six month prior * history of spinal disc injury * history of cardiovascular, metabolic, respiratory, neural, or renal disease * no previous history or education of completing resistance exercise * hypertensive or tachycardic during the screening visit (sbp \> 139 mmhg, dbp \> 89 mmhg, heart rate \> 100 bpm) * taking medication or supplements with a known side effect of affecting physiologic responses to exercise (e.g., beta blockers, omega-3 fatty acids, statins, aspirin) * any form of tobacco or nicotine use * a positive pregnancy test at any point in the study * study physician discretion based on any other medical condition or medication * gastrointestinal disease or previous surgery prohibiting internal body temperature pill use. subjects who have any contraindication to internal body temperature pill ingestion will be given the option to insert the pill rectally (as a suppository) or use a rectal probe.
use of artificial intelligence in oral radiology: a multicenter cross-sectional study in egypt

Conditions: Knowledge of AI Applications in Dental Imaging

Summary: the survey aims to assess knowledge and perceptions of ai applications in dental imaging among egyptian dentists. it also aims to identify the needs and challenges of implementing this transformative technology into education, training, and clinical practice.

artificial intelligence (ai) is advancing rapidly in the field of dentistry, particularly in diagnostic imaging. these ai-based tools are aiding dentists by making it easier to detect important structures and identify health issues with greater accuracy. dentists around the world, including those in egypt, are gradually integrating ai into oral radiology. however, the successful use of ai depends heavily on the dentists being aware and prepared to use it effectively. the egyptian government is very keen on incorporating ai into healthcare and has developed programs like the national artificial intelligence strategy to promote its use. despite these efforts, research on egyptian dentists' comprehension and views about ai in oral radiology is still limited. the study seeks to evaluate egyptian dentists' knowledge about ai and to uncover the primary obstacles that prevent them from utilizing ai effectively in clinical settings. a cross-sectional survey was conducted online among egyptian dentists. the questionnaire aimed to assess their knowledge, attitudes, and perceived challenges related to ai in oral radiology. dentists were recruited through academic institutions, professional organizations, and social media platforms. to identify factors influencing respondents' knowledge about ai, a logistic regression analysis was applied.

Eligibility criteria:
inclusion criteria: * graduated dentists with a bachelor's or higher degree from egyptian universities who practiced in egypt. exclusion criteria: * undergraduate students and dentists who obtained their undergraduate qualification abroad or practiced outside egypt were excluded.

Keywords: ai ai knowledge ai perception dentistry oral radiology
nasal calcitonin in the treatment of bone mineral loss in children and adolescents with inflammatory bowel disease

Conditions: Ulcerative Colitis; Crohn's Disease

Summary: the hypothesis underlying this study is that nasally administered calcitonin will stabilize or improve bone mineral density in young patients with ulcerative colitis or crohn's disease. patients who participate will receive either calcitonin or placebo and will have their bone mineral density measured at the start, at nine months, and at 18 months of study. participants will also receive age appropriate doses of vitamin d and calcium supplements. other serological measures of vitamin d status will be obtained every 3 months during the study.

this is an institutional, randomized, placebo-controlled, double-blind clinical trial to compare the efficacy of intranasally administered calcitonin (plus oral supplements of age-appropriate doses of calcium and vitamin d) with that of placebo nasal spray (plus oral supplements of age-appropriate doses of calcium and vitamin d) in maintaining or improving bone mineral density. study subjects will be 8 to 22 year old patients with the diagnosis of inflammatory bowel disease (ulcerative colitis and crohn's disease) and low bone mineral density defined as dxa z score lower than -1.0 sd. study end-point will be at 18 months after the continuous administration of nasal calcitonin or placebo and supplements as above. bone mineral density will be measured by dual energy x-ray absorptiometry (dxa) at the beginning of the study, and then at 9 and 18 months. the study subjects will be evaluated clinically and nutritionally at the beginning of the study, as well as every 3 months for the duration of the study. laboratory values relevant to calcium homeostasis and bone turnover will be obtained every 3 months.

Eligibility criteria:
inclusion criteria: * low bone mineral density as defined * age 8 to 22 years * diagnosis of crohn's disease or ulcerative colitis exclusion criteria: * receiving calcitonin or biphosphonates, androgens or growth hormone * steroid induced fracture in the past * pregnant * diagnosis of kidney failure, polycystic ovaries syndrome, or malignancy

Keywords: bone mineral density osteoporosis osteopenia children adolescents dxa
association between cerebral arterial vascular flow and sleep apnea in neurodegenerative alterations

Conditions: Alzheimer Disease

Summary: obstructive sleep apnea syndrome (osas) is a sleep-disordered breathing characterized by the occurrence of repeated upper airway obstructions leading to airflow reduction (hypopnea) or cessation (apnea). the apnea-hypopnea index (ahi) is the number of apneas and hypopneas per hour of sleep. osa patients often report cognitive complaints. about 25% of the elderly population is affected by this syndrome with a drastic increase of this rate among dementia patients. osas is considered to be an important risk factor for the development of hypertension, heart disease and stroke.

numerous studies pointed out the close relationship between sleep apnea and cognitive impairment. to the investigators' knowledge, no trials have assessed the existence of a relationship between the iah index and the cerebral arterial blood flow rate (macrocirculation). developments in magnetic resonance imaging (mri) provide new insights into the quantitative study of blood flow through phase contrast mri also called "flow mri". the main hypothesis tested in this study is the existence of a relationship between osas and total cerebral arterial vascular inflow measured by pc-mri (in ml/min) in the elderly population. * primary outcome: the apnea/hypopnea index (measured by nocturnal respiratory polygraphy) and total arterial flow rate (measured by pc-mri) * secondary outcomes: 1. measurement of arrhythmia 2. measurement of arterial blood pressure

Eligibility criteria:
inclusion criteria: 1. elderly patients about or over 75 years 2. any gender 3. dementia group: 3.1. mmse (mini mental state examination)\> 15 3.2. diagnosis of dementia established according to dsm-iv 3.3. dementia of the alzheimer type from nincds-adrda (national institute of neurological and communicative disorders and stroke and the alzheimer's disease and related disorders association) 4. control group: preserved cognitive function corresponding to a normal mmse score by the standards of poitrenaud 5. ability to understand and give consent freely (for demented subjects, a legal representative will be delegate) exclusion criteria: 1. elderly patients under 75 years 2. anyone with a classic contraindication to mri 2.1 major behavioral disorders that do not allow the realization of mri in optimal conditions 2.2 claustrophobia 2.3 presence of foreign non-compliant material 2.4 presence of intraocular metal body 3. having a history of chest surgery or neurosurgical 4. chronic respiratory failure 5. suffering from dementia other than that associated with alzheimer's disease 6. patients with a handicap 7. patients under legal protection

Keywords: sleep apnea phase-contrast mri cerebral blood flow vascular risk factor dementia
computerized-adaptive testing: feasibility in women with pelvic floor disorders (cat)

Conditions: Urinary Incontinence

Summary: the objective of this pilot-study is to evaluate the feasibility and acceptability of promis computerized-adaptive testing in women with urinary incontinence.

patient-reported outcomes (pro's) are important to assess treatment progress in the field of pelvic floor disorders (pfds), including urinary incontinence, pelvic organ prolapse, and fecal incontinence. the nih has invested in the patient-reported outcomes measurement system (promis) to revolutionize pro measures. to date, promis instruments and feasibility and acceptability of promis and computerized-adaptive testing (cat) technology has not been well explored in women with pfds and warrant further investigation. in recruiting sixty women, the investigators will conduct pilot-testing on the cat mode of the promis questionnaires, and compare participant's attitudes about the paper short-forms versus the cat modes of administration. the investigators will recruit 60 women with ui to participate in this study. participants will be asked to complete both paper and cat versions of promis questionnaires covering the physical, social and mental health domains (appendix 1). the time it takes to complete each version will be recorded. after completing the questionnaires, all participants will be interviewed, which will include a brief "usability and satisfaction questionnaire"(appendix 2), questions about technical problems, preferences, and the acceptability of each mode.

Eligibility criteria:
inclusion criteria: * female * able to read english * diagnosis of urinary incontinence * age 18 or older exclusion criteria: * unable to read english or cognitive limitations making it difficult for study participants to complete promis questionnaires

Keywords: urinary incontinence
hemodynamic evaluation of levosimendan in patients with ph-hfpef

Conditions: Hypertension Pulmonary Secondary; Heart Failure, Right Sided; Heart Failure With Normal Ejection Fraction

Summary: phase 2 study to evaluate the efficacy and safety of intermittent levosimendan compared with placebo in hemodynamic improvement with exercise in ph-hfpef subjects

levosimendan and its prolonged active metabolite, or-1896, have been shown to have favorable hemodynamic effects in subjects with pulmonary hypertension and right heart failure. clinical studies that have been conducted in subjects with right heart failure and pulmonary hypertension suggest levosimendan may be an effective therapy in treatment of subjects with ph-hfpef. this study will provide demonstration of levosimendan/or-1896's effectiveness in critical measures of hemodynamic response in weekly administration of levosimendan and the concomitant response as measured by exercise capacity, subject quality of life, and changes in functional capacity. these data will support and guide the phase 3 development of levosimendan in ph-hfpef subjects.

Eligibility criteria:
inclusion criteria: criteria to enter open-label, lead-in dose phase: * diagnosis of world health organization (who) group 2 pulmonary hypertension (ph) with heart failure with preserved ejection fraction (hfpef) confirmed at the time of the diagnosis of pulmonary hypertension. * baseline pulmonary arterial pressure (pap) ≥35, pulmonary capillary wedge pressure (pcwp) ≥20, new york heart association (nyha) class iib/iii, left ventricular ejection fraction (lvef) ≥40% * ability to walk at least 50 meters, but not more than 550 meters in a six-minute walk test. * stable oxygen treatment (if applicable), and medications for heart failure, hypertension, and respiratory condition criterion for randomization to double-blind phase: * response to open-label, lead-in levosimendan: patients who demonstrate a ≥4mmhg reduction in pcwp from baseline measured at bicycle exercise (25 watts) with no more than a 10% decrease from baseline in cardiac index exclusion criteria: * subject has a primary diagnosis of ph other than group 2 ph-hfpef * previous percutaneous coronary intervention (pci) or cardiac surgery (cabg), unless they have a negative stress test in the last 12 months) * congenital heart disease * clinically significant lung disease * planned heart or lung surgery * cardiac index \>4.0 l/min/m2 * concomitant administration of pulmonary vasodilator therapy or taken within 14 days * dialysis or glomerular filtration rate (gfr) \<30 ml/min/1.73 m2 * liver dysfunction with child-pugh class b or c * evidence of systemic infection * weight \> 150kg * symptomatic systolic blood pressure (sbp) cannot be managed to ensure sbp \>100 mmhg * heart rate \>= 100 bpm with the study drug, symptomatic and persistent for at least 10 minutes * hemoglobin \< 80 g/l * serum potassium \ 5.5 mmol/l at baseline * patients having severely compromised immune function * pregnant, suspected to be pregnant, or breast-feeding

Keywords: ph-hfpef
comparison between mini implant supported appliance and headgear in treatment of maxillary excess in growing patients

Conditions: Class II Division 1 Malocclusion

Summary: the aim of the study is to compare an infra-zygomatic mini implant supported appliance with headgear in distalization and intrusion of maxillary dentition for treatment of growing patients with class ii malocclusion (maxillary excess)

in this randomized trial, 2 groups will be included. the first group will receive an infra-zygomatic mini implant supported appliance. in the second group, the patient will receive a removable high pull headgear. the follow-up period will be 8 months or till class i canine or incisors relation is obtained. the assessment will be through a lateral cephalogram

Eligibility criteria:
inclusion criteria: 1. growing patients ( cervical vertebrae maturation stage cs2-cs3 ) 2. maxillary excess 3. minimum overjet 4 mm 4. class ii canines or incisors 5. increased incisal show at rest and on smiling 6. normal and increased vertical growth pattern 7. no previous orthodontic treatment 8. no congenitally messing teeth except third molars exclusion criteria: 1. inadequate incisal show 2. class ii with deficient mandible and normal maxilla 3. patients with any syndrome 4. patients with horizontal growth pattern