Kornimate/medical-research-clean huggingface dataset:
clinicopathological features , outcomes and prognostic factors of high risk patients of gestational trophoblastic neoplasia

Conditions: Gestational Trophoblastic Neoplasias (GTN)

Summary: aim of the study this study aims to investigate the clinical and pathological features, treatment outcomes, and prognostic factors in high-risk patients with gestational trophoblastic neoplasia (gtn). objectives: * identify common clinical and pathological features of high-risk gtn patients. * required surgical treatment as primary or subsequent line. * evaluate how well different treatments work and their side effects. * find factors that can help predict patient outcomes. * compare survival rates and relapse risks among patients.

gestational trophoblastic disease (gtd) and gestational trophoblastic neoplasm (gtn) encompass a heterogeneous family of rare diseases that originate from fetal trophoblast cells during or after pregnancy. these diseases include benign processes with malignant potential (hydatidiform molar pregnancy) and malignancies including choriocarcinoma (cca) and intermediate trophoblastic tumors (pstt, ett) . gtn more specifically includes hydatidiform molar pregnancies that have undergone malignant transformation, as well as cca, placental site trophoblastic tumor (pstt), and epithelioid trophoblastic tumor (ett) . the international federation of gynecology and obstetrics (figo) and the world health organization (who) have developed a staging and scoring system for patients with complete and partial hydatidiform molar pregnancies that have undergone malignant transformation and cca .the scoring system is prognostic and helps guide initial treatment selection: patients with low-risk disease (i.e., a who score from 0 to 6) are treated with single-agent methotrexate (mtx) or dactinomycin, while patients with high-risk disease (i.e., a who score 7-12) are treated with multiagent regimens and ultra-high risk group; where risk score ≥12are treated with ema-co despite advances in diagnosis and treatment, high-risk gtn remains a significant clinical challenge, particularly in predicting treatment response and long-term prognosis. identifying key prognostic factors is crucial to improving therapeutic strategies and optimizing patient outcomes.

Eligibility criteria:
inclusion criteria: * • patients diagnosed as high risk patient according to who classification\[10\] * adequate clinical data available, including demographic, pathological, and treatment-related details. * patients treated at assuit university women's health hospital within a specified period (e.g., observational study covering period from jan 2020 till dec 2025). exclusion criteria: * • previous malignancy - patients with a history of other malignancies that may confound outcomes. * non-gtn gestational trophoblastic disease (gtd) - patients with benign conditions such as complete or partial hydatidiform mole without progression to gtn. * pregnant at diagnosis - patients diagnosed with gtn during an ongoing pregnancy. * severe comorbidities - patients with significant non-gtn-related illnesses that could affect survival outcomes (e.g., severe heart, liver, or renal disease)
inter individual variability in initiation pathway activation and regulation and phenotypic heterogeneity in patients with haemophilia a and b

Conditions: Haemophilia

Summary: severe haemophilia a and b (sha, shb) are x - linked inherited bleeding disorders, characterised by factor viii and ix levels of \<1 iu/dl respectively. the mainstay of treatment in sha and shb is replacement therapy with intravenous infusions of factor viii and ix. however, there is significant variability in the bleeding phenotype within severe haemophiliacs with some presenting with minimal bleeding episodes even on less intensive treatment regimens. a significant contributor to inter-individual variability in the bleeding phenotype is the coagulation phenotype, but there are no established assays in routine clinical practice that can be used to quantify this. this study aims to study novel assays and characterise the observed phenotypic heterogeneity.


Eligibility criteria:
patients inclusion criteria: 1. patients with haemophilia a or b (baseline fviii/fix level \<30%) 2. age ≥ 18 years 3. written informed consent in accordance with local and institutional guidelines. exclusion criteria: 1. patients currently enrolled into a clinical trial of investigational medicinal product for haemophilia. healthy volunteers inclusion criteria: 1. currently not receiving any antiplatelet or anticoagulant therapy or other drugs that can affect the coagulation system. 2. age ≥ 18 years 3. written informed consent in accordance with local and institutional guidelines.
abdominal hypopressive technique on postpartum low back pain

Conditions: Postpartum

Summary: postpartum low back pain (pp-lbp) is more common and can lead to limitations to women's daily activity. pregnancy related low back pain has been reported to occur in 55% to 78% women worldwide.this study is planned to determine the effects of abdominal hypopressive technique on postpartum low back pain, mobility and disability.

literature suggests the use of hypopressive abdominal techniques to be effective in increasing the thickness of the abdominal muscles and hence add to the stability of the spine and alleviation of low back pain in the postpartum period. this will be a randomized controlled trial, with two groups. participants in the experimental group will learn how to perform the "hypopressive maneuver", which consisted of exhaling to their expiratory reserve volume, then holding their breath (apnea), and expanding their rib cage, to draw their abdominal wall inward and cranially without inhalation. control group will perform general exercises. both groups will be assessed at pre and post test (after 6weeks)

Eligibility criteria:
inclusion criteria: * postpartum non-radiating low back pain * lbp severity \>3 on numeric pain rating scale (nprs) * spontaneous vaginal delivery exclusion criteria: * prenatal history of low back pain * caesarean section * hypertension * puerperium period * arterial complications * neurological deficit * disc bulge * lumbar radiculopathy
the effect of blood flow restriction training on glycemic control among type 2 diabetes patients

Conditions: Type 2 Diabetes

Summary: blood flow restriction training (bfrt) combined with resistance or aerobic exercise has been shown to improve the glucose uptake in humans. in addition, bfrt represents a low-load, alternative exercise program for type 2 diabetes patients who often have reduced physical fitness. however, it is not clear to what extent could bfrt improve glycemic control among patients with type 2 diabetes. this pilot randomized-controlled trial aims to investigate the effect of a 12-week, low-intensity bfrt on glycemic control among patients with type 2 diabetes, compared to medium-high intensity aerobic exercise or low-intensity exercise without bfrt.

objectives: the pilot randomized study aims to explore the effects of blood flow restriction combined with aerobic training (bfrt) on the glucose and lipid metabolism indexes and vascular endothelial factors of type 2 diabetes, by comparing it with traditional low-intensity and high-intensity aerobic training. it aims to evaluate the effectiveness of bfrt in glycemic control of type 2 diabetes patients. study population: a total of 60 patients with type 2 diabetes who are 50-65 years old at the maigaoqiao community health service center, qixia district, nanjing, china, with a course of type 2 diabetes of 2-10 years will be included as the participants. randomization: participants will be stratified by baseline hemoglobin a1c (hba1c) and age, they will be randomly assigned into three groups with a block size of six. the study groups are: 1) low-intensity training combined with blood flow restriction group (li-bfr group, 40% heart rate reserve combined with 50% arterial occlusion pressure, n=20) 2)high-intensity aerobic exercise group (hi group, 70% heart rate reserve, n=20) 3) low-intensity group (li group, 40% heart rate reserve, n=20).

Eligibility criteria:
inclusion criteria: * type 2 diabetes patients diagnosed by at least one of these criteria: 1) random blood glucose \>= 11.1mmol/l; 2) fasting blood glucose \>= 7.0 mmol/l; 3) 2-hr post oral glucose tolerance test blood glucose \>= 11.1mmol/l; 4) hemoglobin a1c \>= 6.5%. * aged between 50-65 years at baseline * disease course of type 2 diabetes between at least 1 year exclusion criteria: * type 1 diabetes * fasting blood glucose \> 16.7 mmol/l, or suffers frequent hypoglycemia, or have significant glucose fluctuations considered by the physician * body mass index \> 33 kg/m2 * severe diabetes complications, including cardiovascular diseases, cerebrovascular diseases, diabetic retinopathy, kidney diseases, diabetic ketoacidosis, and diabetic foot ulcers * neuromuscular disorders, sarcopenia, severe osteoporosis, dementia * have regular moderate-intensive exercise habit * resting systolic blood pressure \>= 160 mmhg or resting diastolic blood pressure \>= 100 mmhg * abnormal electrocardiogram * other comorbidities or medications irrelevant to diabetes treatment that may influence glycemia during the past 6 months

Keywords: blood flow restriction training type 2 diabetes aerobic exercise randomized-controlled trial
safety of dotbal® in patients with tuberculosis: conduction of an intensive pharmacovigilance program

Conditions: Tuberculosis

Summary: phase iv, observational, cohort, prospective study. with duration according to the indicated scheme, 6 months of treatment (2 intensive months and 4 months of sotén) for pulmonary tuberculosis. follow-up with patients will continue for a month after completion of the indicated scheme.

the objective of the study was to detect and analyze the adverse events presented during the administration of the drug dotbal® in patients of the health centers of the ministry of health of the municipalities of colima, tecomán and manzanillo, of the state of colima. all patients detected in the selected centers that are indicated treatment with dotbal® under the taes (strictly supervised shortened treatment) regimen or who are already on this drug (according to their clinical record), will be asked to participate in the study explaining to them the same and requesting their informed consent in writing. in the case of minors, they will also be asked to provide their informed assent.

Eligibility criteria:
inclusion criteria: * patients of both genders with a diagnosis of active pulmonary tuberculosis. * over 12 years old. * patients who are being treated with dotbal® under the taes (strictly supervised shorter treatment) regimen. * informed consent (and in the case of minors informed consent) signed. exclusion criteria: * withdrawal of informed consent.

Keywords: tuberculosis tb tuberculosis treatment adverse events pharmacovigilance
iron and vitamin supplementation in hip/knee surgery

Conditions: Orthopedic Disorder; Hip Arthropathy; Knee Arthropathy; Anemia; Iron Poor Blood

Summary: randomized controlled trial to evaluate the efficacy of oral iron supplementation plus cofactors in reducing the prevalence of preoperative anemia in a cohort of 60 patients undergoing elective prosthetic hip or knee surgery.


Eligibility criteria:
inclusion criteria: * males and females * asa 1, 2, or 3 * no neuropsychiatric conditions * acceptance of informed consent * elective prosthetic hip or knee surgery exclusion criteria: * asa 4 * present or past neuropsychiatric conditions * hip or knee revision surgery * use of iron as dietary supplement * known erythrocytosis * incompatible hypersensitivities * iron metabolism disorders * lymphoproliferative disorders
study of pegilodecakin (ly3500518) with pembrolizumab compared to pembrolizumab alone first-line tx in participants with metastatic non-small cell lung cancer

Conditions: Non Small Cell Lung Cancer

Summary: to compare the efficacy of pegilodecakin in combination with pembrolizumab versus pembrolizumab alone in participants with metastatic non-small cell lung cancer as measured by objective response rate.

this is an open-label, multi-center, randomized, phase 2 study designed to compare the efficacy and safety of pegilodecakin in combination with pembrolizumab versus pembrolizumab alone in participants with stage iv / metastatic wild type non-small cell lung cancer and tumors with high expression of pd-l1 (\> 50%).

Eligibility criteria:
inclusion criteria: 1. participants must have histologically or cytologically confirmed wt nsclc that is stage iv / metastatic or recurrent 2. participants with tumor tissue high expression of pd-l1 as defined by tumor proportion score (tps) ≥ 50% 3. eastern cooperative oncology group (ecog) performance status of 0 or 1 4. participants with measurable disease by spiral ct or mri per recist v.1.1 criteria. 5. participants that have completed prior radiotherapy or radiosurgery at least 2 weeks prior to randomization. 6. participants must be naïve to therapy for the advanced stage of the disease. previous neoadjuvant or adjuvant therapy is allowed for participants who successfully underwent complete radical surgery and only if the last treatment was administered more than 12 months prior to the start of the trial treatment exclusion criteria: 1. participants with active central nervous system (cns) metastases or carcinomatous meningitis 2. participants with any serious or uncontrolled medical disorder or active infection with the hepatitis virus or the human immunodeficiency virus (hiv) 3. participants with grade 1 (nci-ctcae v.4.03) toxicities attributed to prior anti-cancer therapy other than alopecia and fatigue prior to randomization 4. participants that have received pembrolizumab 5. participants with a history of severe hypersensitivity reactions to monoclonal antibodies 6. pregnant or lactating women 7. participants receiving any investigational agent within 28 days of first administration of trial treatment 8. participants that have received therapy with anti-tumor vaccines or other immunostimulatory antitumor agents 9. participants that have received therapy with anti-pd-1, anti-pd-l1, anti-pd-l-2, anti-cd-137, and/or anti ctla-4 antibodies
comparison of extensible and inextensible lumbosacral orthoses for lower back pain

Conditions: Low Back Pain

Summary: this study is designed to discern if the use of a lumbosacral orthesis (lso, also call a back support) improves the short-term outcome of lower back pain. participants will receive standard care (physical therapy, physician treatment), with one group also receiving an extensible lso, and another group receiving an inextensible lso. the inextensible lso has been shown to increase stiffness of the trunk in individuals while wearing it. the hypothesis is that the group wearing the inextensible lso will have improved outcomes over the other two groups (standard care or standard care plus the extensible lso).


Eligibility criteria:
inclusion criteria: * chief complaint of lower back pain, with or without lower extremity (le) symptoms * 150 subjects will be recruited from patients seeking treatment for lower back pain from spine specialty orthopaedic clinics, family practice physicians, and out-patient physical therapy clinics exclusion criteria: * exclusion criteria are: * previous spinal surgery * workman's compensation or litigation is involved * neurological disease or injury * systemic inflammatory disease * pulmonary disease which restricts breathing capacity * current pregnancy * acute fracture * tumor or metastatic disease * infection * neurological disease * the presence of pathological reflexes (e.g., babinski) * the presence of lower extremity pain upon cervical motion and / or the presence of two or more of the following signs of nerve compression: diminished lower extremity strength in a myotomal distribution, diminished sensation, and / or absence deep tendon reflexes.

Keywords: low back pain back brace lumbar orthoses lumbosacral orthoses low back pain treatment
congestive heart failure trends in the elderly 1970-94

Conditions: Cardiovascular Diseases; Heart Diseases; Heart Failure, Congestive; Heart Failure

Summary: to investigate trends in the incidence and survival rates of congestive heart failure (chf) in two successive cohorts of elderly people (1970-74, 1990-94) in a health maintenance organization (hmo).

background: the study constituted part of a growing body of research designed to understand not only the secular trends in mortality, morbidity, survival, and disability levels for selected major chronic diseases among older persons in the united states, but also the implications of the findings for health care utilization. design narrative: the design was that of a retrospective study of successive cohorts of a well-defined and well-documented elderly population for the purpose of identifying and explaining trends in congestive heart failure (chf) incidence, survival, comorbidities and health services utilization during the 25-year period 1970-1994. the study sample consisted of two successive period cohorts of elderly people, identified for each of two five-year periods, 1970-1974 and 1990-94. the study tested the following hypotheses: 1) incidence of chf had decreased among the younger old (65-74 years of age); 2) incidence of chf had increased among the older old (75 years of age or above); 3) one-year survival time had increased following onset of incident chf; and 4) prevalence of hypertension had decreased and prevalence of myocardial infarction and other manifestations of coronary artery disease increased among incident cases of chf. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
no eligibility criteria
glycemic load, metabolism & obesity in pregnancy

Conditions: Obesity; Insulin Resistance

Summary: the purpose of the study is to determine if a low glycemic load diet reduces the gain of body fat and insulin resistance during the last half of pregnancy in obese women.

obese women will be recruited to participate in the study between 14-18 weeks gestation. after determining usual dietary intakes, visceral fat thickness, and the metabolic response to a 100g oral glucose tolerance test (ogtt) at 20 weeks gestation, 45 of the women will be randomly assigned to a low glycemic load (gl) diet and 65 women to a regular low fat diet (current standard care). they will follow their assigned diet for the last 20 weeks of gestation. a dietitian will advise the women and will monitor them throughout the study. at 28 and 34 weeks gestation, the women will come to the general clinical research center (gcrc) at san francisco general hospital in the fasting state and the hormonal and metabolic response will be measured to another 100g oral glucose tolerance test (ogtt), and total body fat will be measured. additional measurements include: 1) longitudinal measurements of maternal visceral fat thickness and fetal size and adiposity at 20 and 34 weeks gestation by ultrasound, 2) collection of cord blood and placental tissue, and 3) measurement of neonatal body composition by dual-energy x-ray absorptiometry and anthropometry at 2-3 weeks of age. birth outcome data for mother and infant will be collected. to determine the metabolic response to the study diet, 25 women from each of the two diet groups will be assigned to a metabolic subsample for measuring rates of hepatic glucose production and lipolysis at 34 weeks.

Eligibility criteria:
inclusion criteria: * \>35% body fat * 18 to 40 years of age * speak english or spanish exclusion criteria: * have diabetes prior to pregnancy * diagnosed with gdm in current pregnancy * smoke * abuse alcohol or drugs * have a metabolic disease

Keywords: pregnancy obesity diet glycemic load body composition body fat gestational weight gain insulin resistance
presenting nutrition characteristics, comorbidities and outcomes of covid-19 in african humanitarian settings

Conditions: COVID-19

Summary: this study will characterize risk factors for poor covid-19 outcomes (hospitalization, death) and clinical progression of hospitalized covid-19 patients in south sudan and eastern democratic republic of the congo.

a prospective cohort design will be used to follow suspected, probable, and confirmed covid-19 cases presenting for care at international medical corp \[supported\] health facilities in juba, south sudan and the kivus in eastern democratic republic of the congo (drc). this research seeks to assess risk factors for poor outcomes and characterize clinical disease progression of covid-19 cases in resource-poor humanitarian contexts in africa. specifically, this study aims to characterize risk factors for poor covid-19 outcomes, including both co-morbidities with evidence from high income settings, as well as prevalent conditions in humanitarian settings (e.g., acute malnutrition, malaria, hiv) for which data is not yet available. this research also aims to determine how the progression of confirmed covid-19 cases in resource-poor african settings may differ from other settings where data are available.

Eligibility criteria:
inclusion criteria: * suspected, probable, and confirmed covid-19 cases presenting for care at participating health facilities (either by walk-in, referral or transfer) or identified by mobile contact tracing teams. exclusion criteria: * individuals unable or unwilling to give informed consent (e.g., due to mental impairment)

Keywords: covid-19 risk factors covid-19 outcomes africa south sudan democratic republic of the congo humanitarian