Kornimate/medical-research-clean huggingface dataset:
the effects of two endometrium preparation protocols in frozen-thawed embryo transfer in women with irregular cycles

Conditions: Infertility

Summary: there are two main cycle regimens used for endometrial preparation for frozen embryo transfer （fet) in women with irregular cycles: hormone replacement therapy cycles (hrt) in which the endometrium is artificially prepared by estrogen and progesterone hormones with/without a gonadotrophin releasing hormone agonist (gnrh-a) down regulation, and ovulation induced cycles (oi) in which follicular development is supported with increasing doses of gonadotrophin hormones and ovulation is induced. at present, there is still no sufficient evidence that which kind of frozen embryo transfer cycle regimen to plan more advantage. the purpose of this study was to compare the pregnancy outcome of hormone replacement therapy cycles (hrt) and ovulation induced cycles (oi) in women with irregular cycles.

this study is a prospective randomized controlled trial. patients with irregular cycles undergoing fet in reproductive medicine renter of sun yat-sen memorial hospital will be recruited who should not be elder than 40 and had more than 3 frozen embryos. they will be randomized to receive either the oi-fet cycle (group oi-a) or the hrt-fet cycle (group hrt-b). in group oi-a, the follicular development is supported by letrozole(le) 2.5mg,once daily,is introduced on cycle day 3 .and on cycle day 10 , a vagina ultrasound is introduced to monitor the development of the follicular ,following by intramuscular gonadotrophin 37.5\~75 iu/d until there is a luteinizing hormone(lh) surge or ovulation .on the day appearing luteinizing hormone surge，patient is always introduced intramuscular human chorionic gonadotrophin(hcg) 10000 iu.if there is sill no luteinizing hormone surge when the follicle is 20-24mm ,the ovulation will be induced by hcg.then the luteum is supported by hcg 2000-2500 iu/3d.transfer of thawed embryos will be performed 3 days after ovulation is observed. in group hrt-b, oral estradiol, 2 mg, once daily, is introduced on cycle day 3 with an increasing doses protocol. if the endometrial thickness is greater than 7mm, progesterone 40-60 mg in oil will be administered via intramuscular injection. transfer of thawed embryos will be performed 3 days later.

Eligibility criteria:
inclusion criteria: * age forty years old or less * has irregular menstruation (cycle more than 35 days or less than 24 days ) or has regulation menstruation but previous data suggest that abnormal ovulation * frozen embryos number more than three exclusion criteria: * has chocolate cyst or adenomyosis of uterus * clear hydrosalpinx * uterine scar or intrauterine adhesion and endometrial thickness \<7mm before ovulation * recur thick endometrium（\<7mm） * repeated implantation failure（≥3 times） * cancel the cycle because of having no dominant follicle in the ovulation induction（oi)+fet before or the growth of endometrium not good in the hrt+fet before

Keywords: endometrium preparation protocols frozen-thawed embryo transfer irregular cycle randomized controlled trial
abc survey - do we meet the needs of patients with advanced breast cancer?

Conditions: Metastatic Breast Cancer

Summary: the study will follow a descriptive design involving a survey. data collection will involve paper based questionnaires. the questionnaires have been developed in conjunction with breast cancer support groups associated with the irish cancer society and patients.

the purpose of the study is to identify and categorise the need of metastatic breast cancer (mbc) patients in ireland with particular focus on; quality of life, symptom burden and access to and value of support available. the study also aims to evaluate future service developments that will provide support to these patients.

Eligibility criteria:
inclusion criteria: * signed written informed consent * clinical diagnosis of mbc * female aged 18 years or older * able to complete the questionnaires independently exclusion criteria: * any patient who does not meet the above mentioned inclusion criteria.
evaluating the efficacy of erector spinae block in routine hip arthroscopy

Conditions: Hip Disease; Postoperative Pain

Summary: the aim of this project is to evaluate the efficacy of preoperative erector spinae blocks in arthroscopic hip surgery. this will be a prospective randomized controlled trial.

the aim of this project is to evaluate the efficacy of preoperative erector spinae blocks in arthroscopic hip surgery. this will be a prospective randomized controlled trial. the control group will not receive a preoperative block prior to surgery, but will receive local anesthetic at the surgical site at the conclusion of the surgery. the study group will receive a preoperative block and local anesthetic. the primary outcomes will be pain levels and opioid consumption in the post-operative care unit. the secondary outcomes will be pain levels and opioid consumption post-operatively, and functional outcome measures.

Eligibility criteria:
inclusion criteria: * all patients undergoing hip arthroscopy for femoroacetabular impingement * ages 13-50 * individuals who have the capacity to provide consent or assent for themselves exclusion criteria: * hip arthroscopy for any other reason (not undergoing labral repair, acetabuloplasty, and femoral osteochondroplasty) * revision surgery * known narcotic use in the 6 months prior to surgery * workman's compensation patient * pregnancy

Keywords: hip pain arthroscopy
the effect of a levonorgestrel-releasing intrauterine device (iud) versus a copper containing iud on risk of blood clots

Conditions: Blood Coagulation Disorders

Summary: this is a randomized controlled trial to assess the effect of a levonorgesterel-releasing intrauterine device (lng iud, mirena®) versus a copper iud (paraguard®) on coagulation parameters known to be associated with risk of thrombosis (blood clots). both the lng iud and the copper iud are fda approved devices for contraception. women enrolled in this study will be randomized to receive either the lng iud or the copper iud. they will complete a one month bleeding diary prior to insertion of the iud and again for one month while the iud is in place. they will undergo phlebotomy (blood draw) at baseline (prior to insertion of the iud), two and four months. stored samples will be used to measure d-dimer, c-reactive protein (crp), antithrombin (at), factor viiic, activated partial thromboplastin time (aptt) and activated partial thromboplastin time plus activated protein c (aptt + apc). both groups will undergo a gyn exam with screening for bacterial vaginosis and gonorrhea/chlamydia cultures prior to insertion of the iud. a brief survey to assess the women's experience with the iud, including symptomatology and satisfaction with the device, will be conducted at the four months after insertion.


Eligibility criteria:
inclusion criteria: * women who desire long-term, reversible contraception exclusion criteria: * women with coagulopathies * history of thrombotic events * pregnancy * active pelvic infection * known hypersensitivity to progestin * undiagnosed vaginal bleeding * wilson's disease * sensitivity to copper * uterine anatomy that precludes insertion of an iud * women with multiple sexual partners and history within the last 5 years of alcoholism or drug abuse. * additionally, women must be greater than 3 months postpartum and have had two months without oral contraceptive pills or 6 months without depo provera prior to enrollment.

Keywords: women's health
hemostatic profile in patients affected by covid-19

Conditions: Covid19; Thrombosis

Summary: coronavirus disease-2019 (covid-19), a viral respiratory illness caused by the severe acute respiratory syndrome-coronavirus-2 (sars-cov-2), has been associated with the occurrence of cardiovascular adverse events including acute myocardial injury, acute heart failure, cardiac arrhythmias, and thromboembolic disease. these complications represent an important issue in covid-19 patients accounting for the increased morbidity and mortality of this syndrome. according to a scoping review, venous thromboembolism and stroke occurred in approximately 20% and 3% of patients, respectively, with higher frequency observed in severely ill patients admitted to intensive care units. despite the use of pharmacological thromboprophylaxis, the thrombotic risk still remained elevated in severe covid-19 patients, and the optimal doses and timing of anticoagulation are not yet defined. the pathogenesis of covid-19 associated thrombosis recognizes a prominent role of endothelial damage induced by both direct viral injury and an excessive and aberrant hyper-inflammatory host immune response associated to an increase in infection-related cytokines and chemokines. the occurrence of a hypercoagulable state in covid-19 patients associated to a profound endothelial cell activation/dysfunction can result in the pathological phenomenon of immunothrombosis. in this study, in a prospective cohort of consecutive covid-19 hospitalized patients, an extensive characterization of the hemostatic alterations were performed, in order to: 1) clarify mechanisms underlying the coagulopathy in these patients; 2) how and to what extent the concomitant infection with sars-cov-2 affect this coagulopathy; and 3) identify biomarkers potentially predictive of disease outcome (i.e. any thrombotic recurrence and death).


Eligibility criteria:
inclusion criteria: * age\> 18 years * adult patients admitted with severe acute respiratory syndrome coronavirus-2 (sars-cov-2) positivity (by real time-pcr) from nasal swab or deep respiratory specimen or with clinical signs suggestive of sars-cov-2 * patients who have signed informed consent. if there is no possibility of obtaining informed consent for the clinical picture (eg adult patients sedated and curarized for acute respiratory failure and consequent mechanical ventilation), the patient's consent will be assumed until the contrary will be manifested. exclusion criteria: -

Keywords: covid19 hospitalized patients coagulation
the effectiveness of transcranial magnetic stimulation of supplementary motor area (sma) in patients with bladder hypersensitivity and bladder pain

Conditions: Bladder Hypersensitivity

Summary: the main hypothesis of this study is that transcranial magnetic neuromodulation can correct the symptoms of hypersensitivity and bladder pain. the investigators assume that under the influence of transcranial magnetic stimulation, both the subjective state of patients assessed by standardized questionnaires and the objective parameters assessed by invasive and non-invasive urodynamic studies will be improved. in this study, two protocols for magnetic stimulation of the supplementary motor area (sma) will be compared with each other and with placebo. the investigators expect to determine the dependence of the therapeutic effect on the applied stimulation protocol.

the aim of the study is to test the hypothesis that the use of the magnetic stimulation method sma in patients with symptoms of bladder hypersensitivity and bladder pain will help to reduce the clinical and urodynamic signs of these pathological conditions.

Eligibility criteria:
inclusion criteria: 1. age \> 18 years; 2. signed informed consent; 3. the presence of oab symptoms: urinary frequency, nocturia, urgency and urge incontinence; discomfort during filling the bladder, pain in the projection of the bladder over the womb. 4. resistance to standard therapy for bladder hypersensitivity and bladder pain. exclusion criteria: 1. the patient, who have been implanted devices that control physiological functions (a pacemaker, a device for deep brain stimulation and chronic epidural brain stimulation, a cochlear implant). 2. convulsive attacks in the anamnesis; 3. taking medications that may trigger the risk of seizures; 4. pregnancy or suspicion on it; 5. the presence in the patient's body of metal elements or objects made with the use of ferromagnets (joint prostheses, eye prostheses, tattoos made using metal ink, surgical clips, staples and other metal suture materials, etc.) 6. chronic cardiovascular and cerebrovascular diseases in the stage of decompensation or recent acute conditions (myocardial infarction, brain stroke, etc.) 7. a history of injuries associated with impaired conduction along the pathways of the brain and spinal cord; 8. the presence of detrusor hyperactivity patterns according to the preliminary multichannel urodynamic study; 9. the presence of infravesical obstruction in men, determined by uroflowmetry (obstructive urination curve according to the liverpool nomogram); 10. the postvoid residual volume (more than 100 ml); 11. the presence of urinary tract infection; 12. a history of cancer;
effects of emdr therapy in patients with severe obesity

Conditions: Obesity; Emotional Trauma

Summary: the aims of the study are to perform psychological intervention using emdr therapy (eye movement desensitization and reprocessing therapy) in the preoperative period, evaluate the personality of each patient through the pfb test (personality factor battery test) at different times, compare the results obtained in the pfb test at different times of application and verify the existence of changes in the five major personality factors: neuroticism, extroversion, socialization, realization and openness.

obesity is a multi-factorial disease requiring a multi-professional approach. psychological causes also contribute to the development and maintenance of obesity. traumatic experiences may be a risk factor for it as well. emotional issues of obese patient often interfere with the results of bariatric surgery, where a large number of bariatric patients regain the weight or change symptoms. the aim of the effects of emdr therapy with severe obesity bariatric surgery patients randomized controlled trial is to determine the effects of 11 sessions of emdr therapy, prior to surgery as compared to a control group. the big five personality factors will be used to evaluate the results. both groups of patients will complete the factorial personality battery, before the surgery, and 6 months and 12 months following bariatric surgery. the initial hypothesis is that emdr therapy will provide sufficient changes after surgery in the personality dynamics of obese patients, which will in turn favor emotional balance and weight maintenance as compared to the control group.

Eligibility criteria:
inclusion criteria: * both sexes * bmi between 40 kg/m2 and 50 kg/m2 * ages between 30 and 55 years, * minimum level of elementary school, previously evaluated psychologically by the psychology service - university of são paulo medical school exclusion criteria: * history of severe personality disorders: psychotic symptoms or schizophrenia; bipolar disorder or dementia - groups a and b (dsm - iv); * patients who present severe dissociative disorders (score above 25%), evaluated through the dissociative experiences scale (des); * patients with heart problems and current pregnancy, with information obtained through the participants' reports.

Keywords: emdr therapy bariatric surgery obesity
the pre-d trial: effect of dapagliflozin, metformin and physical activity in pre-diabetes

Conditions: Prediabetic State; Obesity

Summary: the overall objective is to compare the short-term (3 months) effectiveness of three glucose-lowering interventions (dapagliflozin, metformin and physical activity) on glucose variability, body composition, and cardiometabolic risk factors in overweight or obese individuals with pre-diabetes (hba1c 5.7-6.4% / 39-47 mmol/mol).

different medical therapies and lifestyle modification for the prevention of type 2 diabetes have yet to be compared head-to-head in individuals with pre-diabetes. this research project will compare different glucose-lowering interventions in overweight and obese individuals with hba1c levels in the pre-diabetic range.

Eligibility criteria:
inclusion criteria: * hba1c: from ≥5.7% (39 mmol/mol) to ≤6.4% (47 mmol/mol) * age: from ≥30 to ≤70 years of age * bmi ≥25 kg/m2 exclusion criteria: * uncontrolled medical issues including but not limited to cardiovascular pulmonary, rheumatologic, hematologic, oncologic, infectious, gastrointestinal or psychiatric disease; diabetes or other endocrine disease; immunosuppression; * current treatment with hormones which affect glucose metabolism; * current treatment with loop diuretics or thiazolidinediones; * current treatment with beta blockers or peroral steroids; * bariatric surgery within the past 2 years; * impaired renal function defined as an estimated gfr\<60 ml/min/1.73m2; * neurogenic bladder disorders; * alcohol/drug abuse or in treatment with disulfiram (antabus) at time of inclusion; * pregnant or lactating women; * fertile women not using birth control agents including oral contraceptives, gestagen injection, subdermal implants, hormonal vaginal ring, transdermal application, or intra-uterine devices; * allergic to one or more of the medications used in the study; * concomitant participation in other intervention study; * unable to understand the informed consent and the study procedures.
macra part b in nigeria

Conditions: Malaria

Summary: this study aims to evaluate the effectiveness of monthly malaria rapid diagnostic test (rdt) validation meetings at district level on reducing the proportion of rdt results recorded as positive in health facility registers in nigeria.

pmi insights supported a multi-country evaluation of the accuracy of the recording and reporting of rapid diagnostic test (rdt) results at health facilities in benin, côte d'ivoire, nigeria, and uganda (macra part a). the evaluation found a high degree of agreement between rdt results recorded in health facilities and an objective panel reading of the same rdts. however, the changes in test positivity rate (tpr) after the start of the study suggest that some of this agreement may have been a result of the hawthorne effect: in all countries except benin, tpr declined after the start of the evaluation in facilities where evaluation staff were present, compared with control facilities. this suggests that the presence of evaluation staff caused health care workers to change their behavior with respect to reporting positive rdt results. the study evaluated the durability of rdt results and found that 95% of rdt cassettes retained their original reading over a one-month period. this provides evidence that stored rdt cassettes may be compared to health facility registers at monthly validation meetings, as long as a certain margin of error is used to account for the proportion of tests that may change. the results from the first phase of the study were used to identify potential interventions to improve rdt reporting and recording accuracy in health facilities. the second phase of the study aims to evaluate the effectiveness of monthly district-level rdt result validation meetings on reducing the proportion of rdt results recorded as positive in health facility registers and reported to the national health management information system. this is a two-arm cluster-randomized controlled effectiveness evaluation. districts will serve as the clusters and will be assigned using restricted randomization to the intervention or control arm. in the intervention arm, the ministry of health will lead monthly district-level rdt validation meetings facilitated by a digital phone-based app which uses ai to record rdt results (healthpulse, audere, johannesburg, south africa). there will be no study activities in the control facilities. monthly rdt validation meetings will take place over a four-month period (april to july 2025), after which a cross-sectional survey and in- depth interviews will be conducted.

Eligibility criteria:
inclusion criteria: * healthcare workers responsible for testing or interpreting malaria rdts in the selected study facilities * lga health teams involved in the monthly rdt validation meetings from lgas selected for the study.
dv 100 as a framework for the hospital incident command system

Conditions: Disaster; Crisis Response Plan; Emergency; Communication

Summary: there is limited scientific research on the organizational structure of the hospital incident command system. the hospital alarm and emergency planning manual by the german federal office of civil protection and disaster assistance (bbk) recommends a continental staff system-based organization, as outlined in the service regulation dv 100, similar to military, fire, and police structures. this approach is frequently discussed at professional conferences, but evidence on its functionality in hospitals is lacking. this study aims to generate new insights into the use of a continental staff system-based hospital incident command system and qualitatively analyze transition and communication processes within the command structure.


Eligibility criteria:
inclusion criteria: * participation in at least one hospital incident command system (ics) training and, if applicable, in a ics exercise. written informed consent from the employee for participation in the second part of the study (semi-structured interview) exclusion criteria: * decline of study participation

Keywords: hospital incident command system continental staff system service regulation dv 100 disaster management emergency planning hospital alarm and emergency planning organizational structure crisis management communication processes transition processes healthcare emergency response civil protection disaster assistance incident command structure emergency management systems
lidocaine and ketamine in abdominal surgery

Conditions: Abdominal Hysterectomy (& Wertheim)

Summary: this study is being done to determine if combined infusions of lidocaine and ketamine is better than a lidocaine or ketamine infusion alone, or to placebo in improving recovery after abdominal hysterectomy. participants will be randomized into one of four groups. evaluations will be done through walking tests, pain and fatigue questionnaires and blood tests.

subjects undergoing abdominal hysterectomy surgery are randomized into one of four groups: intravenous lidocaine, intravenous ketamine, intravenous lidocaine and ketamine or placebo. subjects will perform a six-minute walk test prior to surgery and on the second day postoperatively. after surgery and on days 1 and 2 after surgery, subjects will rate their pain. on day 1 postoperatively, subjects will rate their fatigue. on postoperative days 1 and 2 incisional pain will be analysed using von frey filaments. two hours after surgery, 10 ml of venous blood will be sampled for cytokine analysis. telephone follow up will take place 6 and 12 months postoperatively to access pain and quality of life.

Eligibility criteria:
inclusion criteria: * age greater than 18 years old and less than 75 years years old * horizontal abdominal incision exclusion criteria: * emergency or urgent procedure * preexisting chronic pain (at any site) requiring treatment * contraindication to any study medication (ketamine or lidocaine) * history of significant axis i psychiatric disease (major depressive disorder, bipolar disorder, schizophrenia, etc.) * significant hepatic (alt or ast \> 2 times normal) or renal (serum creatinine \> 2 mg/dl) impairment * seizure disorder requiring medication within past 2 years * planned spinal or epidural anesthesia or analgesia

Keywords: pain control nausea surgery recovery