Kornimate/medical-research-clean huggingface dataset:
ultrasound guided embryo transfer: abdominal versus transvaginal, a rct

Conditions: Infertility; in Vitro Fertilization

Summary: ultrasound (us) guided embryo transfer (et) appears to improve pregnancy outcomes in ivf-et. most reports are done using a transabdominal (tas) approach, in contrast to a transvaginal ultrasound (tvs) which does not require a full bladder. we sought to determine if either approach was better with respect to clinical outcomes.


Eligibility criteria:
inclusion criteria: - all patients undergoing assisted reproductive cycles including autologous ivf, oocyte donation, and frozen embryo transfer (fet) cycles exclusion criteria: - cases of severe ovarian hyper-stimulation requiring embryo cryopreservation and gestational surrogate cycles

Keywords: ultrasound-guided embryo transfer in-vitro fertilization
evaluation of hepatic function using gadoxetic acid enhanced mri

Conditions: Cirrhosis

Summary: liver function is a key factor that can help predict the clinical outcome in patients with cirrhosis. traditionally, liver function was measured using either indocyanine green (icg) or other radionucleotides. recently, gadoxetic acid has been reported to show liver function in several studies. there have been several approaches to measure liver function using gadoxetic acid, and hepatocyte fraction is one of the promising methods. since gadoxetic acid enhanced liver mri is clinically used world widely, it would be valuable if we can measure liver function using hepatocyte fraction.


Eligibility criteria:
inclusion criteria: * patients with chronic liver disease or liver cirrhosis * clinically scheduled for gadoxetic acid enhanced liver mri * signed informed consent exclusion criteria: * under 18 years * transarterial chemoembolization, radiation therapy for liver or bile duct within 2 weeks * systemic chemotherapy within 6 weeks * any contraindication for contrast enhanced mri * hepatic iron deposition at prior imaging * bile duct obstruction

Keywords: gadoxetic acid t1 map mri
comparison of real-time and shear wave elastography

Conditions: Breast Diseases

Summary: tissue elasticity is being increasingly used as diagnostic parameter, since at the macroscopic level benign breast lesions tend to be stiffer than normal breast tissue but softer than breast cancers. ultrasound elastography allows to probe the elasticity of breast lesions in clinics. real time elastography (rte) and shear wave elastography (swe) are the two most widely used elastography modalities. assessment of breast lesions by either rte or swe improve the diagnostic performance of standard b-mode ultrasound (us) and have the potential to assist the decision about whether to perform a breast biopsy or not.

tissue elasticity is being increasingly used as diagnostic parameter, since at the macroscopic level benign breast lesions tend to be stiffer than normal breast tissue but softer than breast cancers. ultrasound elastography allows to probe the elasticity of breast lesions in clinics. real time elastography (rte) and shear wave elastography (swe) are the two most widely used elastography modalities. assessment of breast lesions by either rte or swe improve the diagnostic performance of standard b-mode ultrasound (us) and have the potential to assist the decision about whether to perform a breast biopsy or not. however, employing rte and swe using the same equipment to directly compare elasticity measurements of a breast lesion has not been done. investigators propose to prospectively investigate inter-observer agreement of each modality. the study will investigate and compare the accuracy and reproducibility of swe and rte in the characterization of breast lesions. furthermore, we plan to establish learning curves for rte and swe. in this project, investigators will compare rte and swe concerning their potential to discriminate benign breast lesions from breast cancer. investigators aim is to identify which modality will allow clinicians the best possible patient care.

Eligibility criteria:
inclusion criteria: * female patients at least 18 years of age with a known breast lesion * signed informed consent exclusion criteria: * male * younger than 18 years of age * pregnant or lactating women
effect of postpartum hemorrhage management education given with kahoot method on knowledge, self-confidence in intervention and motivation levels of midwifery students

Conditions: Game-based Education

Summary: this study was planned to investigate the effect of postpartum hemorrhage management training given with the kahoot method on the knowledge, self-confidence in intervention and motivation levels of midwifery students. the research population will consist of third-year students studying at the department of midwifery, hamidiye faculty of health sciences (hsbf), health sciences university (sbu) in the spring semester of the 2024-2025 academic year (n: 80). in this semi-experimental pre-test and post-test design and control group planned study, in order to determine the sample size; the data were normally distributed, the standard deviation of the main mass was estimated as 1 and the effect size (effect size, difference) was estimated as 0.8. for the analysis to be conducted, it was calculated that the highest power value of the study would be 0.942182 if two independent n₁=40, n₂=40 samples were taken at a significance level of 5%. in addition, the adequacy of the sample size in the study will be evaluated with post hoc power analysis after the data are collected. students who volunteer to participate in the study will be assigned to the intervention and control groups using the computer-aided simple random sampling method. computer-aided randomization will be used in the study, and the number of cases will be entered through the program with the url address https://www.randomizer.org and random assignment will be made to the intervention and control groups. before the data collection forms begin training, the "informed voluntary consent form" will be shared with the students participating in the study and their approval will be requested. the "introductory information form", "postpartum hemorrhage management information form", "self-confidence/competence scale in patient intervention" and "motivation scale regarding the teaching material" will be applied to the students who agree to participate in the study.


Eligibility criteria:
inclusion criteria: * volunteering to participate in the research. * having internet access, * having a smart phone, * being an active student in the 3rd year of the department of midwifery at hamidiye health sciences faculty, university of health sciences. exclusion criteria: * being a passive student in the 3rd year of the midwifery department of hamidiye health sciences faculty, university of health sciences. * not meeting the inclusion criteria.
effect of vitamin d supplementation on metabolic parameters of patients with psoriasis

Conditions: Psoriasis; Metabolic Syndrome; Vitamin D Deficiency

Summary: the purpose of this study is to determine whether supplementation with oral vitamin d (cholecalciferol) improves metabolic parameters in patients with moderate to severe psoriasis.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of moderate to severe psoriasis. * being treated with methotrexate with stable doses for al least 1 month. exclusion criteria: * phototherapy within the past 2 months. * history of psoriatic arthritis, rheumatoid arthritis, type 1 diabetes mellitus or inflammatory bowel disease. * use of vitamin d supplements or fish oil supplements in the past 2 months. * use of hypolipidemic drugs, hypoglycemic drugs, glucose sensitizers, oral corticosteroids, orlistat, cholestyramine, phenobarbital or phenytoin within the past 2 months. * pregnancy or lactation.

Keywords: psoriasis vitamin d metabolic syndrome insulin resistance cholesterol methotrexate dyslipidemia pasi psoriasis area severity index
can we use a simple blood test to reduce unnecessary adverse effects from radiotherapy by timely identification of radiotherapy-resistant rectal cancers? med-seq rectal study

Conditions: Pathological Response Rate, Circulating Tumour DNA

Summary: chemoradiation therapy (crt) followed by surgery is currently the standard of care to treat patients with locally advanced rectal cancer (larc). crt reduces local recurrences, but is associated with significant damage to the surrounding healthy tissue that can severely impact quality of life. additionally, a proportion of patients (hardly) benefit from crt. we aim to develop a diagnostic innovation, which can enable a more selective and thereby more effective use of the available therapies for rectal cancer patients. the objective of this study is to investigate whether patients can be identified who will response to crt prior to start of the crt in rectal cancer and therefore avoid possible severe side effects in patients who will not reponse on crt.


Eligibility criteria:
inclusion criteria: * age ≥18 years * histologically confirmed rectal adenocarcinoma * scheduled for neoadjuvant chemoradiation * written informed consent. exclusion criteria: * scheduled to another neoadjuvant schedule that comprises systemic chemotherapy or short-course radiation * not able to read or understand dutch language or mentally not capable.
cough assist device in mechanically ventilated patients

Conditions: Mechanically Ventilated Patients

Summary: aspiration of respiratory secretions is a frequently needed procedure in intubated patients . cough is an important defence mechanism to clear mucus from the upper and lower airways . the presence of an endotracheal tube impairs the ability to cough.there are a number of techniques to mobilise sputum and optimise airway clearance for invasively ventilated patients. endotracheal suctioning is the most common intervention used to remove retained airway secretions from within the endotracheal tube, trachea and upper airways .mechanical insufflation-exsufflation (mi-e) aids sputum clearance from upper and lower airways. this technique augments inspiratory and expiratory flows to improve sputum mobilisation, through the application of rapidly alternating positive and negative pressure, which approximates a normal cough

critically ill patients under invasive ventilation are at risk for sputum retention . aspiration of respiratory secretions is a frequently needed procedure in intubated patients . cough is an important defence mechanism to clear mucus from the upper and lower airways . the presence of an endotracheal tube impairs the ability to cough. this prevents the enhancement of cough velocity . furthermore, critically ill patients frequently have an impaired or no cough reflex due to depressed levels of consciousness, sedation, muscle weakness or muscle paralysis. sputum retention, resulting from an inability to cough effectively, is one cause of extubation failure which in turn is associated with increased mortality. there are a number of techniques to mobilise sputum and optimise airway clearance for invasively ventilated patients. endotracheal suctioning is the most common intervention used to remove retained airway secretions from within the endotracheal tube, trachea and upper airways . endotracheal suctioning though is not effective for clearing secretions from the lower airways . new technologies and advanced methods have been developed to increase the effectiveness of mucus clearance in patients with acute respiratory failure, including mechanical insufflation-exsufflation devices. this technique has been described as an effective aid for mucus clearance in patients with chronic muscle weakness or neuromuscular disease. mechanical insufflation-exsufflation (mi-e) aids sputum clearance from upper and lower airways. this technique augments inspiratory and expiratory flows to improve sputum mobilisation, through the application of rapidly alternating positive and negative pressure, which approximates a normal cough .

Eligibility criteria:
inclusion criteria: adult patients of both sexes on mechanical ventilation in ricu with any respiratory disease mechanically ventilated patients without facial trauma mechanically ventilated patients hemodynamically stable exclusion criteria: patients diagnosed with barotrauma patients diagnosed with pneumothorax history of bullous emphysema known susceptibility to pneumothorax or pneumo-mediastinum
different peribulbar blocks with spi-guided anaesthesia for vrs (p&mspivrs)

Conditions: Vitreoretinal Surgeries; Postoperative Nausea and Vomiting; Postoperative Pain; Oculocardiac Reflex

Summary: the aim of this randomized trial is to assess the efficacy of preventive analgesia using different peribulbar blocks (pbb) under spi-guided anaesthesia for vitreoretinal surgery (vrs), presence of ponv (postoperative nausea and vomiting) and oculocardiac reflex (ocr) and compare numerical rating scale (nrs) with surgical pleth index (spi) for monitoring pain perception postoperatively. patients will receive general anaesthesia combined with either preventive pbb using either lidocaine with bupivacaine or bupivacaine or ropivacaine

monitoring depth of anaesthesia using spectral entropy (se) and quality of neuromuscular block are routine in modern anaesthesia, whereas monitoring of analgesia still requires further studies. recently, the surgical pleth index (spi) was added as a surrogate variable showing the nociception-antinociception balance into abovementioned parameters constituting a novel approach in monitoring patients intraoperatively, known as adequacy of anaesthesia (aoa) or tailor-made anaesthesia. different options of local anesthetic mixtures used for peribulbar block result in different analgetic potency. pbb is supposed to reduce requirement for intraoperative narcotic analgesics when used together with general anaesthesia and therefore may reduce the rate of ponv, ocr and perception of postoperative pain. the aim of the study is to investigate the influence of different pbbs on abovementioned outcomes.

Eligibility criteria:
inclusion criteria: * written consent to participate in the study written consent to undergo general anaesthesia alone or combined with different techniques of pre-emptive analgesia and vitreoretinal surgery exclusion criteria: * history of allergy to local anaesthetics or paracetamol necessity of administration of vasoactive drugs influencing spi monitoring pregnancy

Keywords: surgical pleth index (spi) general anaesthesia (ga), numerical rating scale (nrs) adequacy of anaesthesia (aoa) peribulbar block (pbb) bupivacaine ropivacaine lidocaine
an algorithm to decide on antibiotic prescription in lower respiratory tract infection in primary care

Conditions: Lower Resp Tract Infection

Summary: the study is randomized clustered pragmatic trial whose objective is to decrease unnecessary antibiotic prescription in adult patients with lower respiratory tract infection managed at primary care level in switzerland, using a simple algorithm based on 2 point of care test results

the study will have two distinct phases: the first phase will test the feasibility of the intervention (ultrapro) along a pilot study. following the setup of a lung ultrasound training curriculum for general practitioners, the practicality of the whole ultrapro algorithm will be evaluated at primary care level. the second phase will be a pragmatic randomized three-arm intervention study using an algorithm based on the results of procalcitonin and lung ultrasound to manage patients with lower respiratory tract infections at primary care level. the procalcitonin-ultrasound algorithm will be compared to procalcitonin-guided management alone and usual care.

Eligibility criteria:
all patients presenting to a participating gp's office for a consultation for an acute respiratory infection (ari) will be screened for inclusion in the study inclusion criteria: * informed consent as documented by signature (informed consent form) * patients aged 18 years or more * no antibiotics prescribed for the current episode * acute cough of up to 21 days duration and at least one of the following symptom or sign: * history of fever for more than 4 days * dyspnoea * tachypnoea (≥ 22 cycles per minutes) * abnormal focal finding during auscultation exclusion criteria: * previous prescription of antibiotics for the current episode * working diagnosis of acute sinusitis or a non-infective disorder * cystic fibrosis * previous episode of chronic obstructive pulmonary disease exacerbation treated with antibiotics during the last 6 months * known pregnancy * severe immunodeficiency (untreated hiv infection with cd4 count \ 28 * admission of the patient * gp not available for performing study * patient unable to provide informed consent

Keywords: pneumonia procalcitonin lung ultrasound point of care testing antibiotic prescription respiratory pathogens host biomarkers
docetaxel in squamous cell carcinoma of the head and neck (tax + cisplatin in scchn)

Conditions: Head and Neck Neoplasms

Summary: study objectives: * to determine the mtd (maximal tolerated dose) and recommended dose of a weekly docetaxel and cisplatin combination regimen for locoregional recurrent/metastatic squamous cell carcinoma of the head and neck (scchn) * to determine the response rate of the recommended dose * to determine the safety and tolerability of the recommended dose


Eligibility criteria:
inclusion criteria: * histologically confirmed (of original primary tumor) locoregional recurrent and/or metastatic following prior radiotherapy and/or surgery and not amenable to further curative local therapy for scchn * measurable disease as defined by at least the longest diameter measured as 20 mm by conventional ct or 10 mm by spiral ct. physical measurements are allowed if longest diameter is 20 mm by caliper measurements. * ecog performance status 0-2 * adequate bone marrow and hepatic function as evidenced by the following: * hematology (bone marrow): * neutrophils ≥ 1.50 x 10\^9/l * platelets ≥ 100 x 10\^9/l * hemoglobin ≥ 10 g/dl * hepatic function: * ast and/or alt: \< 2x uln (upper limit of normal) * bilirubin \< 1x uln * adequate renal function with calculated or measured glomerular filtration rate of \> 60 ml/min calculated by the cockcroft- gault method * no severe intercurrent illness or other serious illness or medical conditions including but not limited to: * unstable cardiac disease despite treatment, myocardial infarction within 6 months prior to study entry. * active uncontrolled infection * active peptic ulcer * chronic obstructive pulmonary disease requiring hospitalization during the year preceding study entry * no prior chemotherapy for recurrent/advanced scchn with platinum or taxane regimen (primary radiosensitizing platinum allowed). * no other diagnosed malignancy other than basal cell carcinoma of the skin or cervix carcinoma in situ exclusion criteria: * prior therapy with taxanes either adjuvant, neoadjuvant, concurrent or in advanced stage disease * prior chemotherapy for locoregional recurrent/metastatic scchn with palliative intent * contraindications from * the medical history (i.e. known hepatitis, hiv) and physical exam * laboratory tests (hematology, biochemistry) * 12-lead electrocardiogram * blood pressure and pulse * pregnancy * breast-feeding * treatment with any investigational product in the last 4 weeks before study entry * likelihood of requiring treatment during the study period with drugs not permitted by the clinical study protocol * presence or sequelae of gastrointestinal, liver or kidney disease, or other conditions known to interfere with the absorption, distribution, metabolism, or excretion of drugs * history of hypersensitivity to the study drug(s) or to drugs with a similar chemical structure * impaired hepatic function, as shown by bilirubin greater than upper limits of normal and/or ast greater than 2 times upper limits of normal * impaired renal function, as shown by measured or calculated creatinine clearance of \ 1.5 upper limit of normal
joint use of database to identify risk factors of cardio-vascular toxicity induced by immune checkpoint inhibitors

Conditions: Myocarditis; Cardiomyopathies; Heart Diseases; Cardiovascular Diseases; Pericarditis; Vasculitis

Summary: immune checkpoint inhibitors (icis) might induce high grade immune-related adverse events (iraes) involving the cardio-vascular system. this study investigates reports of cardio-vascular toxicity associated with treatment including anti-pd1, anti-pdl-1, and anti ctla4 classes using the world health organization (who) database vigibase, assistance publique hopitaux de paris entrepot de données de santé (aphp.eds), french système national des données de santé (snds) databases and a retrospective international multicenter registry of ici-associated myocarditis

icis have dramatically improved clinical outcomes in multiple cancer types and are increasingly being tested in earlier disease settings and in combination. thus, iraes can occur and risk factors for such events have been scarcely described. here, the investigators will use vigibase (http://www.vigiaccess.org/), the world health organization (who) database of individual safety case reports, to identify risk factors for cases of cardiovascular adverse drug reaction following treatment with icis, the investigators will also use two french databases : aphp entrepot de données de santé (eds), french système national des données de santé (snds) databases and a retrospective international multicenter registry of ici-associated myocarditis

Eligibility criteria:
inclusion criteria: * case reported in the world health organization (who) database of individual safety case reports to 01/01/2025 * case reported in the aphp entrepot de données de santé (eds) database of individual safety case reports to 01/01/2025 * case reported in the système national des données de santé (snds) database of individual safety case reports to 01/01/2025 * case reported in a retrospective international multicenter registry of ici-associated myocarditis to 01/01/2025 * adverse event reported were including the meddra terms: cardiac and vascular investigations (excl enzyme tests) (hlgt), vascular disorders (soc), skeletal and cardiac muscle analyses (hlt), sudden death (pt), sudden cardiac death (pt), cardiac disorders (soc), cardiac arrhythmias (hlgt), cardiac disorder signs and symptoms (hlgt), cardiac neoplasms (hlgt), cardiac valve disorders (hlgt), congenital cardiac disorders (hlgt), coronary artery disorders (hlgt), endocardial disorders (hlgt), heart failures (hlgt), myocardial disorders (hlgt), pericardial disorders (hlgt) * patients treated with icis included in the atc: ipilimumab (l01xc11), nivolumab (l01xc17), pembrolizumab (l01xc18), durvalumab (l01xc28), avelumab (l01xc31), atezolizumab (l01xc32), cemiplimab (l01xc33) exclusion criteria: * chronology not compatible between the drug and the toxicity

Keywords: drug-induced cardiotoxicity immune checkpoint inhibitors anti-pd-1 anti-pd-l1 anti ctla-4