Kornimate/medical-research-clean huggingface dataset:
the use of gnrh agonist trigger in the prevention of ohss

Conditions: Ovarian Hyperstimulation Syndrome

Summary: to compare the incidence of ovarian hyperstimulation syndrome (ohss) and implantation rate between high responder patients using gonadotropin releasing gnrh) agonist or human chorionic gonadotropin (hcg) to trigger final oocyte maturation.

ohss is an iatrogenic complication of controlled ovarian hyperstimulation, which in its severe form, may result in significant morbidity. although, there have been significant advances in in-vitro fertilization (ivf) protocols over the years, the incidence of ohss have remained stable and there is currently no effective way of preventing this disorder. hcg is commonly used as a substitute for the endogenous lh surge to induce final oocyte maturation in ivf. unfortunately, hcg results in a prolonged luteotropic effect because of its long half-life which may result in a potential risk of ohss in high-risk patients. in contrast, induction of endogenous lh surge with a gnrh agonist may result in a reduced risk of ohss. this is due both to the shorter half-life of the endogenous lh surge and the subsequent pituitary suppression leading to early luteolysis. however, previous studies have suggested that this approach may impair implantation rates. there are no randomized studies assessing the effect of gnrh agonist to induce oocyte maturation on the occurrence of ohss and implantation rates in high-risk patients. the aims of this study are to compare the incidence of ohss and implantation rates among high-risk patients who used either gnrh agonist or hcg to trigger oocyte maturation after prevention of premature lh surge with either a gnrh antagonist protocol or the dual pituitary suppression protocol, respectively. high risk patients include women with polycystic ovarian syndrome (pcos) or pco morphology (pcom) on ultrasound without the clinical or biochemical evidence of the syndrome, and patients with previous high response to gonadotropins.

Eligibility criteria:
inclusion criteria: * age 20-39 * normal early follicular phase serum fsh (≤10.0 iu/l) * patients with either pcos or pcom undergoing their first cycle of ivf or patients with high response in a previous ivf cycle. exclusion criteria: * hypogonadotropic hypogonadism

Keywords: ohss pcos previous high response gnrh antagonist gnrh agonist ivf
generalized versus core stabilization antenatal exercises for lumbopelvic pain

Conditions: Low Back Pain; Pelvic Pain

Summary: core stability training has gained popularity as a fitness trend and is now being used in rehabilitation programs as well the patient adherence to this intervention has been low due to its complex nature, particularly pregnant females .limited literature is available to present the effect of core stabilization exercises in comparison to the other handful simplified techniques and exercises this study compares two interventions for this particular condition to identify a feasible and enjoyable therapeutic intervention for the pregnant women who suffer lumbopelvic pain.

this is a randomized control trial to compare the effects of core stabilization versus generalized antenatal exercises for lumbopelvic pain in pregnant women. females meeting the inclusion and exclusion criteria will be divided into three groups by convenient sampling technique. a sample size of 48 females with 16 females in each group. group a will be treated by core stability exercises and group b will be treated by generalized antenatal exercises and group c will receive basic antenatal education. group a and b will have three treatment sessions per week for 4 weeks. females will be evaluated at baseline and 2nd and 4th week . females will be screened by patricks faber test, piriformis /fair test, p4/posterior pelvic pain provocation test and assessed by visual analogue scale (vas) and pregnant women quality of life questionnaire (qol- grav).

Eligibility criteria:
inclusion criteria: * 2nd trimester of pregnancy * multigravida * patients having lumbopelvic pain * working women and housewives exclusion criteria: * hx of metabolic disease * hx of pelvic fracture and surgery * radiculopathy * participants with absolute contraindications for the exercise
lipase levels and coronavirus disease 2019

Conditions: Pancreatitis; Lipase Increased

Summary: although covid-19 disease due to severe acute respiratory syndrome coronavirus 2 (sars-cov-2) affects the respiratory tract, heart and coagulation system, symptoms of gastrointestinal system involvement such as abdominal pain, nausea, vomiting and diarrhea are also common. in this study, it was aimed retrospective analysis of clinical and laboratory data of patients who developed pancreatic injury and acute pancreatitis in the course of covid 19 disease.


Eligibility criteria:
inclusion criteria: * patients with lipase levels measured during covid-19 exclusion criteria: patients with age \<18 years patients with pregnancy patients whose lipase levels were not measured in the course of covid-19 patients with known solid organ malignacy patients with known hematologic malignacy
prospective comparison of the four biopsy methods for prostate cancer detection

Conditions: Prostate Cancer; Prostate Adenocarcinoma

Summary: the aim of this study is to compare clinically significant prostate cancer detection rate by the 4 biopsy methods: trus-guided, cognitive, fusion and transperineal template mapping biopsy. it is recommended to combine mri-guided biopsy with systematic (trus-guided or transperineal template mapping biopsy) biopsy for high yield of prostate cancer diagnosis. nevertheless, it remains unclear which biopsy combination is more precise for prostate cancer detection.

taking into consideration the variety of prostate biopsy methods (trus-guided, cognitive, fusion and transperineal template mapping biopsy), the issue of indications for each of them remains unresolved. current eau guidelines recommend combining mri-guided biopsy with systematic (trus-guided or transperineal template mapping biopsy) one for high yield of prostate cancer diagnosis. nevertheless, it also remains unclear which biopsy combination is more precise for prostate cancer detection. this is a prospective single-arm study. all patients underwent prostate trus examination and mpmri. suspicious lesion found on mri were classified with the pi-rads v2.1. first step: the "unblinded" urologist №1 performed a fusion and transperineal template mapping biopsy. second step: the "blinded" urologist №2 performed trus-guided and cognitive biopsy. objectives of the study: to determine clinically significant prostate cancer detection rate, overall cancer detection rate, clinically insignificant prostate cancer detection rate, sampling efficiency (positive biopsy cores' number, maximum cancer core length (mccl)). results were calculated for each biopsy method separately and for combinations of trus-guided and cognitive biopsy (combination №1) and fusion and transperineal template mapping biopsy (combination №2).

Eligibility criteria:
inclusion criteria: * psa \>2 ng/ml, and/or positive digital rectal examination (dre), and/or suspicious lesion on trus * pi-radsv2.1 ≥3 score exclusion criteria: * previously diagnosed pca; * acute prostatitis within the last 3 months; * 5-α reductase inhibitors therapy within the last 6 months; * extracapsular extension; * prostate volume ≥80 cc; * contraindications for mpmri.

Keywords: prostate cancer fusion biopsy cognitive biopsy transrectal ultrasound biopsy transperineal template mapping biopsy
plasmapheresis before rituximab in cryoglobulinemia

Conditions: Cryoglobulinemic Vasculitis

Summary: initial worsening following initiation of rituximab therapy in patients with cryoglobulinemic vasculitis was described in 3.6% of cases. this worsening is often a serious condition, with high levels of mortality. the objective of our study is to evaluate the efficacy of preventive plasmapheresis prior to the introduction of rituximab performed in montpellier france since 2013 by assessing the frequency and severity of this flare effect in these patients compared to those reported in the literature.


Eligibility criteria:
inclusion criteria: * cryoglobulinemic vasculitis requiring rituximab treatment * patient ≥18 years old exclusion criteria: * patient who reject the study protocol * patient \< 18 years old

Keywords: cryoglobulinemic vasculitis requiring rituximab therapy
a study of the drug interactions between a hormonal emergency contraception and an hiv medication

Conditions: HIV Infections; Contraception; Pharmacokinetics

Summary: the purpose of this study is to determine if blood levels of the hormonal emergency contraceptive agent, plan b, are altered by concomitant use with the hiv medication, efavirenz.

the use of hormonal contraceptive pills in women with hiv is complex due to potential interactions between these agents and hiv medications. hiv-infected women taking efavirenz have an even greater need for effective birth control as this medication may cause severe brain damage to a developing fetus. the use of an emergency contraceptive agent in cases of unprotected sex or condom failure can prevent pregnancy. this study seeks to establish that plan b can be used effectively and safely in women taking efavirenz.

Eligibility criteria:
inclusion criteria: * healthy, hiv-1 seronegative women of child-bearing age. exclusion criteria: * current use of hormonal contraception * pregnancy/breast feeding * post-menopausal status * obesity * hepatitis b or c * psychiatric illness * active substance abuse

Keywords: hiv contraception antiretroviral agents pharmacokinetics
oat beta-glucan as a supplement in chilean type 2 diabetics

Conditions: Type2 Diabetes

Summary: objective: to evaluate the effect of oat β-glucans on the satiety perception, metabolic control and intestinal microbiota of type 2 diabetics from talca, chile. methodology: clinical trial, controlled, randomized, double blind and parallel design. the recruited (40 subjects) were randomized into two groups, placebo (pl) and ß-glucan (bg). 5 gr of oat ß-glucan or placebo were delivered for 12 weeks to be added in breakfast. blood and stool samples were requested at the beginning and at the end of the intervention. the investigators quantify: hba1c in whole blood, fasting blood glucose, basal insulin, c-peptide, tumor necrosis factor alpha (tnf-a), interleukin (il) 6, il-8, il-10, il1β, cortisol, ghrelin, glucagon-like peptide type 1 (glp -1), yy peptide (pyy), resistin, leptin and serum lipid profile. the subjective perception of hunger / satiety were established through an analogous visual survey. calorie intake was determined by 24-hour recall survey. were analyzed the phylum: firmicutes, bacteroidetes and verrucomicrobia, and the populations of bifidobacteria spp, lactobacillus spp, butyrate producing bacteria, akkermansia muciniphila and total bacteria of fecal microbiota, using quantitative polymerase chain reaction (qpcr) with specific primers. all participants were instructed not to make changes in their usual eating habits, physical activity and pharmacological treatments.


Eligibility criteria:
inclusion criteria: * subjects with type 2 diabetes mellitus * use of oral hypoglycemic agents (metformin) * 30 to 45 years * more than one year and less than 10 diabetes * no major chronic complications * hb a1c between 7 to 9% * bmi between 30-35 kg / mt2. exclusion criteria: * pregnant women * acute and / or chronic intestinal pathologies (malabsorption syndrome, celiac disease, chronic inflammatory bowel diseases, among others.), * drugs that interfere with the microbiota (antibiotics, anti-inflammatories, laxatives, prokinetics), * organic insufficiencies (cardiac, hepatic, renal, respiratory), or with immunodeficiencies (hiv, chemotherapy, radiotherapy, transplanted). * presence of smoking habit. * regular probiotic or prebiotic intake (more than 2 months) * dipeptidyl peptidase 4 inhibitors (dpp4) and α-amylase inhibitor drugs.

Keywords: beta-glucans diabetes mellitus, type 2 chile
spi-guided vs prd-guided analgesia during fess for intraoperative blood loss

Conditions: Endoscopic Sinus Surgery

Summary: the aim of this randomized trial is to assess the efficacy of analgesia , compare the utility of pupillary dilatation reflex (prd), surgical pleth index (spi) for monitoring pain perception intraoperatively and their influence on intraoperative blood loss, quality of surgical field using boezaart bleeding scale (bbs) in patients undergoing functional sinus surgery (fess)

intraoperative blood loss during fess constitutes a major problem for a surgeon because it influences quality of surgical field. each incident of haemorrhage makes the operator stop the procedure in order to bring back the optimal visualization of the intranasal anatomy. in the end it prolongs the time of procedure. currently, intraoperative blood loss is estimated based on boezaart bleeding scale (bbs) (0 - no bleeding (cadaveric conditions), 1 - slight bleeding, no suctioning required, 2 - slight bleeding, occasional suctioning required, 3 - slight bleeding, frequent suctioning required; bleeding threatens surgical field a few seconds after suction is removed, 4 - moderate bleeding, frequent suctioning required, and bleeding threatens surgical field directly after suction is removed, 5 - severe bleeding, constant suctioning required; bleeding appears faster than can be removed by suction; surgical field severely threatened and surgery usually not possible). recently, the surgical pleth index (spi) and pupillary dilatation reflex (prd) were added as a surrogate variable showing the nociception-antinociception balance into above mentioned parameters constituting a novel approach in monitoring patients intraoperatively, known as adequacy of anaesthesia (aoa) or tailor-made anaesthesia. prd value \>5% reflects increased sensitivity to painful stimulus as well as delta spi\>10 or any spi\>50, and they constitute the indication for administration of rescue analgesia intraoperatively. this study aims at evaluating utility of spi-directed analgesia or prd-directed analgesia or boezaart scale-directed analgesia using remifentanil on the intraoperative blood loss, haemodynamic stability and time duration of surgery. currently, fess is most often performed using total intravenous anaesthesia (tiva) which is by majority of anaesthesiologists believed to reduce the intraoperative blood loss compared to general anaesthesia using volatile anaesthetics, but literature provides conflicting findings in this area.

Eligibility criteria:
inclusion criteria: * written consent to participate in the study * written consent to undergo functional endoscopic sinus surgery under total intravenous anaesthesia * asa (american society of anesthesiologists) i-iii exclusion criteria: * age under 18 years old * allergy to propofol * pregnancy * any anatomical malformation making prd or se measurement impossible

Keywords: surgical pleth index (spi) pupillary dilatation reflex (prd) intraoperative blood loss (ibl) boezaart bleeding scale (bbs) spectral entropy (se) adequacy of anaesthesia (aoa) total intravenous anaesthesia (tiva)
effects of trunk stability exercises on hand function in children with cerebral palsy

Conditions: Cerebral Palsy

Summary: rationale of this research is to evaluate the outcome of trunk stabilizing exercises on the fine motor skills of subjects with hemiplegic cp. the significance of this study is to identify how much core stability exercises improve hand function. this study will help gather evidence on the practice of core stabilizing exercises to improve hand function so that it can help both physicians and patients.

cerebral palsy is a permanent damage in early brain in fetus which leads to movement disorder. the most frequent reason of bodily incapacity is cerebral palsy in pediatric population. cp children have difficulty maintaining dynamic and static trunk stability, which leads to affect sitting, standing, reaching and walking. hemiplegic cerebral palsy patients are challenged by fine motor skills, like gripping or object handling, which are essential for activities of daily life.the purpose of the study was to evaluate the effects of trunk stability exercises on hand function in children with cerebral palsy.it was a randomized, controlled trial, conducted among hemiplegic cerebral palsy patients. sample size was 26 by using epitool software. participants were randomly assigned to the intervention or control group after a baseline assessment with a lottery ticket and an opaque envelope. all participants in both groups were evaluated on three occasions: (i) baseline (ii) post-intervention and (iii) after 4 weeks follow to assess long term effects.

Eligibility criteria:
inclusion criteria: * both male and female were included * age group 6 to 18 years. * medical diagnosis of hemiplegic cerebral palsy assured. * unilateral movement deficit (less than 2.5) on amount of use scale on mal (motor activity log). * level 1 to 3 on manual ability classification system (macs). * mild to moderate spasticity of upper extremity (mas grade 1 to 2.) * gmcs level i-ii. * subjects were cognitively capable and competent to follow the instructions exclusion criteria: * patients with altered conscious level. * previous surgery or pain in upper limbs. * rigid contracture and fixed deformities in the spine * auditory / vision problem. * previous botulinum toxin-a injections in upper limb. * cardio-respiratory problem

Keywords: trunk stability hand function
secondary prevention of dug-related problems through digital health

Conditions: Drug-Related Problems

Summary: the purpose of this study is to evaluate the clinical impact of a program for the secondary prevention of drug-realted problems (drp) focused on the patient empowerment through digital health in patients who visit the emergency department (ed) of the hospital de la santa creu i sant pau (hscisp) for a health problem related to medication in terms of readmissions, revisits and quality of life.

after being infomed about the estudy and potential risks, all patients who meet the eligibility requirements and giving written informed consent, will be randomized. the project is structured in two consecutive phases. 1. st phase: 3-month randomized pilot study. patients will be randomized with a 1:1 distribution to be included in the drug code active patient or dcap (intervention group) or to receive usual care (control group). the pilot study will confirm whether the proposed methodology is feasible to implement it on a large scale, as well as providing the information necessary to calculate the sample of patients according to the main objective of the study. 2. nd phase: randomized clinical trial lasting 18 months (6 of which will be recruitment and 12 months follow-up) following the methodology described for the pilot in a larger sample of patients until the calculated sample size is achieved.

Eligibility criteria:
inclusion criteria: * age greater than or equal to 18 years. * visit ed for a drp caused bu a drug of the atc groups a, b, c or n. * be independent for activities of daily living (equivalent to barthel 100). * have a chalson comorbidity index 2 \<= 3. * not present cognitive impairment. * be directly responsible for pharmacotherapy. * have a mobile device compatible with the myplan mobile application and access to wi-fi or mobile data, enabling the use of the technology platform from home. exclusion criteria: * important language barrier. * impossibility of carrying out the necessary questionnaires or interviews defined in the methods of this study. * mental pathology that makes the autonomous use of technology impossible or that represents a safety problem for the patient according to clinical criteria. * patients not residing in the territory who cannot be followed-up later.

Keywords: drp digital health
influence of different physical therapy resources application after reduction stomach surgery

Conditions: Pulmonary Atelectasis; Respiratory Tract Diseases; Pathological Conditions, Signs and Symptoms

Summary: the aim of this study will be to investigate the effects of using physical therapy resources in the postoperative morbidly obese individuals undergoing gastroplasty. it is believed that the application of these various features of physiotherapy after abdominal surgery may contribute differently in restoring lung function and prevention of pulmonary complications and can thus identify the resources that can contribute more effectively in post-operative bariatric surgery.

the aim of this study will be to investigate the effects of using physical therapy resources in the postoperative morbidly obese individuals undergoing roux-en-y gastric by-pass with regard to: lung volumes and capacities, prevalence of atelectasis, thoracoabdominal mobility and evaluation of peak flow of cough, evaluated pre and post operative. individuals with bmi between 40 and 55 kg/m², aged between 25 and 55 years, underwent the surgical procedure roux-en-y type gastric by-pass by laparotomy and normal preoperative pulmonary function will be included. the volunteers will be divided into seven different groups, according to the treatment received during hospitalization after surgery: g control: subjects treated with conventional physiotherapy according to the routine service of physiotherapy of the hospital; g voldyne: subjects treated with incentive spirometry, voldyne model 5000® (sherwood medical, usa); g cpap: subjects treated with "continuous positive airway pressure"; g epap: subjects treated with "expiratory positive airway pressure"; g ippb: subjects treated with "intermittent positive pressure breathing"; g bipap: subjects treated with "bi-level positive airway pressure"; g bs: subjects treated with "breath stacking" (siliconized mask connected to a unidirectional valve allowing only inspiration). the application of resources will be held twice a day in the immediate and in the first postoperative sessions in 6 sets of 15 reps or 30 continuous minutes, with an interval of 4 hours between sessions. the researcher will remain alongside the volunteers, following them and monitoring vital signs and respiratory comfort.

Eligibility criteria:
inclusion criteria: * bmi between 40 and 55 kg/m² * aged between 25 and 55 years * submitted to roux-en-y type gastric by-pass by laparotomy * normal preoperative pulmonary function test exclusion criteria: * hemodynamic instability * hospital stay longer than three days * presence of postoperative complications * smoking

Keywords: morbid obesity bariatric surgery pulmonary atelectasis spirometry continuos positive airway pressure physical therapy speciality