Kornimate/medical-research-clean huggingface dataset:
transperineal ultrasound and the place of sonopartograph in travay follow-up in term pregnancy

Conditions: Intrapartum; Transperineal Ultrasound

Summary: investigators aimed to determine the progression of the descent angle and head symphysis distance measured by intrapartum transperineal ultrasound as an alternative to vaginal examination and bishop score, according to time and cervical dilatation and to draw a sonopartograph as a new indicator also aimed to evaluate the success of the use of transperineal ultrasound in the active phase of labor in predicting prolonged labor, duration and mode of of delivery.

descent angle and head symphysis distances by transperineal ultrasound of pregnant women who are in the active phase of labor was measured hourly in the first phase of the active phase (the period from 4 cm to full dilation of the cervical opening); every 15 minutes in the second phase of the active phase (time from full dilation to delivery of the baby) cervical dilatation and head levels were noted by simultaneous digital vaginal examination. the physician who performed the imaging and the physician who made the vajinal examination worked independently of each other and did not see each other's results.

Eligibility criteria:
inclusion criteria: * multiparous pregnancy * active phase in labor * vertex position exclusion criteria: * multiple pregnancy * bmi over 35 * preterm labor * congenital anomalies

Keywords: head symphysis distance angle of progression sonopartograph
terlipressin on effect of renal function in cirrhotic patients with acute gastrointestinal hemorrhage

Conditions: Variceal Hemorrhage; Cirrhosis, Liver; Kidney Injury

Summary: terlipressin and somatostatin/octreotide are the first-line choices for the treatment of acute variceal bleeding in liver cirrhosis. acute kidney injury can develop in patients presenting with acute variceal bleeding. on the other hand, evidence suggests that terlipressin can reverse hepatorenal syndrome. it has been hypothesized that terlipressin can protect the renal function in cirrhotic patients with acute variceal bleeding, except for control of bleeding.


Eligibility criteria:
inclusion criteria: 1. cirrhotic patients who were admitted between january 2010 and december 2018. 2. a diagnosis of acute gastrointestinal bleeding. 3. patients who received terlipressin or somatostatin/octreotide. 4. age or sex was not limited. 5. use of endoscopy was not limited. 6. comorbidity was not limited. 7. malignancy was not limited. exclusion criteria: 1. renal parenchymal diseases. 2. absence of baseline serum creatinine. 3. absence of serum creatinine 3-5 days after terlipressin or somatostatin/octreotide. 4. duration of terlipressin or somatostatin/octreotide was less 3 days. 5. patients who underwent transjugular intrahepatic portosystemic shunt. 6. patients who underwent surgical shunt, splenectomy with or without devascularization, or liver transplantation.
self-assessment triage in inflammatory arthritis

Conditions: Inflammatory Arthritis

Summary: there are benefits to early, intensive treatment of ia. but getting to treatment depends on timeline and accurate case identification. the longest delays occur in persons self-identifying the need to see care for ia, recognition of these cases by primary care providers (pcps), and appropriate, timely referral to rheumatology. current methods of improving time to referral and consultation are effective, but costly and unsustainable, so there is need to look for alternatives. one solutions may be the use of patient self-administered tools. in this study, we will test whether the use of validated, self-administered patient questionnaires (self-assessment) can advance the urgency rating of referrals for people with inflammatory arthritis (ia). if urgency ratings can be advanced then self-assessment may have the potential to reduce wait times to see a rheumatologist. in canada, one in every hundred people has ia and hundreds of new patients are diagnosed each year. wait times to see a rheumatologist are long, so anything that has the potential to reduce these wait times would have a significant impact.


Eligibility criteria:
inclusion criteria: * new patient referral exclusion criteria: * under 18 years of age * confirmed diagnosis of inflammatory condition * seen/managed by another rheumatologist within the last five years * unable to speak english * on disease modifying antirheumatic drugs. * referrals from the emergency department

Keywords: new referrals triage self-assessment
intensvih: impact of therapy intensification by an integrase inhibitor +/- ccr5 inhibitor on the lymphoid reservoir for hiv-1 in chronically infected patients

Conditions: HIV Infections

Summary: to determine the efficacy of adding isentress®, with or without celsentri®, to effective conventional antiretroviral therapy (comprising at least 2 reverse transcriptase inhibitors and one boosted protease inhibitor), on residual hiv replication and blood cell and gut-associated lymphoid tissue reservoirs (reverse transcriptase inhibitors: rtis, boosted protease inhibitors: pi/r). to evaluate the effect of therapy intensification by means of an integrase inhibitor with or without ccr5 inhibitor treatment on the lymphoid reservoir in patients chronically infected with hiv-1, successfully treated with "conventional triple therapy", measured by: * residual plasma replication between 0 and 50 copies/ml * intracellular hiv rna levels in circulating lymphocytes (pbmc) and lymphocytes in gut-associated rectal lymphoid tissue (rl). * proviral hiv dna levels in pbmc and rl.


Eligibility criteria:
inclusion criteria: * male or female patients, aged over 18 years * hiv infection confirmed by western blot * karnofsky score \> 80% * treatment-experienced patients having received combined antiretroviral therapy including at least 2 rti and 1 pi/r for at least 12 months with plasma viral load \<50 copies/ml for at least 6 months * stable first-line treatment (or other, if changes were not made for reasons relating to viral resistance) with 2 rtis and 1 pi/r * proper safety and compliance for the ongoing combination; * patient agreeing to undergo 3 proctosigmoidoscopy examinations over a 12-month period; * plasma hiv-1 rna \<50 copies/ml at inclusion; * circulating cd4 \>200/mm3 at inclusion; * isentress® and celsentri®-naïve patients * no contraindications to the use of the investigational products * written, informed consent, obtained from the patient or his/her legal representative. exclusion criteria: 1. opportunistic infection or active tumor disease 2. chronic diarrhea, malabsorption, progressive enteric infection 3. aged under 18 years 4. pregnancy - breast-feeding ( a pregnancy test will be done at the inclusion visit) 5. co-infection with hiv-2 6. history of immunomodulator treatment (interleukin-2, alpha-interferon) 7. ongoing treatment of hbv or hcv co-infection 8. blood constitution disorders 9. contraindications to the administration of raltegravir or maraviroc 10. circulating cd4 nadir \<100/mm3 in the natural history of hiv-1 infection.

Keywords: hiv integrase inhibitor inhibitor on the lymphoid reservoir residual hiv replication treatment experienced
glycemic control using insulin levemir versus insulin nph for diabetes in pregnancy

Conditions: Diabetes, Gestational; Diabetes, Type 2

Summary: the aim of this study is to compare glycemic control in pregnant women treated with insulin detemir and pregnant women treated with nph insulin. these women are diagnosed with gestational diabetes (gdm) in the current pregnancy or have a preexisting diagnosis of type 2 diabetes (t2dm) at the onset of pregnancy. our hypothesis is that there is no difference between these two treatment modalities in terms of glycemic control in diabetes.

the experimental method will be a randomized controlled trial performed at roosevelt hospital in our diabetes in pregnancy program (dipp). perinatologists managing the patient in dipp determine when patients need further treatment with medical therapy. patients undergoing care at dipp may require medical intervention in the following clinical scenarios: failure of diet alone to control glycemic indices and grossly abnormal glucose tolerance screening test results suggesting disease of such severity that diet alone would not be sufficient. after verbally counseling the patient, she will be recruited for the study by the investigators. an extensive explanation of the objectives of the study will be presented to the patient, as well as written copies of the protocol and consent. after informed consent is given, patients will be randomized to management with either insulin nph or detemir together with rapid acting insulin aspart (novolog) with meals, as necessary. the primary outcome will be level of glycemic control defined as overall mean blood glucose in pregnancy. this is a well established measure of overall glycemic control that has been used in numerous publications in the obstetric literature on diabetes in pregnancy. participants will be followed until they deliver, with an expected range of 6-16 weeks depending on when the patient was enrolled in the study. the mean glucose will be determined by the sum of average glucose at each visit divided by the number of visits).

Eligibility criteria:
inclusion criteria: * all pregnant women with a viable singleton or multiple gestation at ≤34 weeks with gestational diabetes diagnosed in their current pregnancy requiring medical therapy. "early diagnosis" gdm patients will also be included; which is defined as a diagnosis made prior to 24 weeks. * women with known preexisting type 2 diabetes that are in need of medical therapy. exclusion criteria: * patients \<18 years of age * a diagnosis of gdm outside of the gestational age stated above * known allergy/prior adverse reaction to insulin nph or insulin detemir. * type 1 diabetes

Keywords: insulin, long-acting
effect of electrostimulation on glucose profile of patients with type 2 diabetes

Conditions: Type 2 Diabetes; Physical Activity

Summary: prevalence of type 2 diabetes (t2d) is increasing worldwide. lifestyle remains the cornerstone treatment for patients with t2d who are often overweight and sedentary. physical activity improves glucose metabolism of patients with t2d : increased glucose utilization during acute muscle activity and improved insulin sensitivity after regular training. the molecular mechanism underlying the effects of exercise on glucose metabolism involves the glucose transporter glut-4 which is regulated by physical activity. several studies and meta-analysis have showed that physical activity reduces hba1c by 0.6% on average. in addition, other data suggest a decrease in cardiovascular morbidity and mortality through physical activity. recent recommendations for t2d management call for the practice of a structured type of endurance 150 minutes per week and muscle building 2 times per week. however, implementation of these recommendations is low, even when integrated into a therapeutic education program. adherence is often transient and / or partial. in addition, many t2d subjects are unable to initiate a physical activity because of disabling complications or comorbidities or because of a major cardiorespiratory deconditioning. neuro-myo electrical stimulation (nmes) is a physical treatment routinely used in functional rehabilitation to improve muscle strength and volume. the metabolic effect of nmes has been little studied. a pilot study conducted by our team on a population of 18 subjects with t2d showed that a week of daily nmes sessions significantly improved insulin sensitivity of about 25% and up to 50 % for good responders. this result contrasted with the low induced energy expenditure by each 20-minute session of bi-quadricipital nmes, suggesting the possibility of a humoral or neural mechanism associated with nmes. to complete this work, we plan a randomized cross-over trial with 3 periods (6 weeks without nmes (control), 6 weeks with 3 sessions of nmes per week and 6 weeks with 5 sessions of nmes per week) to assess the glucose profile of sedentary t2d subjects during these different periods. we hypothesize that the bi-quadricipital nmes could improve glycemic control in t2d subjects and thus represent an alternative to traditional physical activity.


Eligibility criteria:
inclusion criteria: * type 2 diabetes treated with lifestyle, oral hypoglycemic agents and/or glp-1 agonists. * hba1c : 7 to 10% * low physical activity (ricci and gagnon score below 27) * insulin-resistance (at least one criteria out three): * waist circumference \> 80cm in women and \> 94cm in men * triglycerides \> 150 mg/dl * hdl-c \< 50 mg/dl for women, \< 40 mg/dl for men exclusion criteria: * type 1 diabetes * pregnancy * intense usual physical activity * pace maker * seizure * knee or neuromuscular pathology

Keywords: glucose profile continuous glucose monitoring electrostimulation
functional and performance effects of a 4-week weightlifting program in highly trained adolescent basketball athletes

Conditions: Athletic Injuries

Summary: weightlifting is an increasingly used intervention in the sport field to improve both function and performance outcomes. however, the effects in a pediatric and adolescent population are not well described, and require further research to elucidate the benefits and potential adverse effects compared to other strength training methods, such as plyometric training.

highly trained male and female adolescent basketball athletes aged 12-16 years will be recruited for the study. participants will be randomly assigned to a 4-week program (12 sessions) of weightlifting or plyometric training. the training programs will be identical in sets and repetitions, progressively evolving each week towards fewer sets and fewer repetitions. the training intensity will be the same in both groups, calculated from the rm, starting at 70% in the first week and progressing by 5% each week until a final intensity of 85% in the last week. therefore, both interventions evolve towards sessions with fewer sets and repetitions and higher loads. the weightlifting intervention refers to the performance of highly technical and explosive multi-joint strength exercises. the program consists of six basic weightlifting maneuvers (hang power clean, overhead squat, hang power snatch, clean, split jerk, snatch), two of which are performed in each of the three weekly sessions. the order of execution of the exercises in the weekly sessions is always the same. to ensure the correct execution of the maneuvers, before starting the intervention, a brief familiarization program will be carried out. this consists of an explanation of the exercises by the research staff and practice by the participants with simultaneous correction. the plyometric program follows the same structure, consisting in a total of 6 exercises (max countermovement jump, double leg side jump, maximum squat jump, dropjump (20cm), single leg hurdle jump, doble leg multi hop) performed in groups of 2 for each weekly training session. the design of the intervention program is based on previously published related articles.training sessions will be supervised by a member of the research team with expertise in strength and conditioning in basketball athletes.

Eligibility criteria:
inclusion criteria: * healthy highly-trained basketball athletes exclusion criteria: * current injury or complaining limiting sports activity * no histoy of injury receiving non-operative treatment in the last 3 months * no history of injury receiving operative treatment in the last 9 months * subjects who have previously carried out weightlifting training for at least 4 weeks of duration. * subjects physically unable to perform a strength training program

Keywords: weighlifting strength functional outcomes adolescent basketball
the prognostic value of post thyroidectomy 99mtcpertechnetate thyroid scan in patient with differentiated thyroid cancer

Conditions: Differentiated Thyroid Cancer

Summary: the aim of this study is to evaluate the prognostic value of postoperative99mtc-pertechnetate scanning in patients with dtc.

the incidence of thyroid cancer in several affluent countries has markedly increased (1). although mortality from thyroid cancer has remained relatively low and stable or has steadily declined in these and other countries (2). therefore, it is still important to identify markers for prognosis prediction and decision-making before radioactive iodine therapy (rit). various factors have been reported to be associated with the clinical outcome of rit. these include preablative stimulated thyroglobulin (ps- tg), tumor size, extrathyroidal invasiveness, cervical lymph node metastasis and tsh \[3,4\]. 99mtc pertechnetate is a radiopharmaceutical used for thyroid scintigraphy. the photon energy of 140kev is ideally suited for use with gamma camera. it has short half life of about 6-hoursand no particulate emissions. 99mtc-pertechnetate scintigraphy is a simple, economic and rit non-interfering technique to evaluate the volume of residual thyroid tissue(rtt). the 99m tc-pertechnetate uptake of the thyroid bed can be used as a marker of rtt. although negative uptake doesn't indicate the absence of rtt, it could suggest a small volume. on the other hand, positive uptake can be considered as a large volume of rtt. several studies have reported that patients with negative 99mtc-pertechnetate uptake have a much higher chance of successful ablation\[5, 6\]. we hypothesized that negative 99mtc-pertechnetate scintigraphy is a significant predictor for excellent response (er) to rit in american thyroid association 2015(ata) low- and intermediate risk dtc patient according to .

Eligibility criteria:
inclusion criteria: * • this study will include pathologically proved dtc patients in low and intermediate risk according to ata who presented to nuclear medicine unit during the period from 2015 until the end of the study. exclusion criteria: * • high risk patient according to ata * pregnancy
palmitoylethanolamide and luteolin in patients with acute ischemic stroke

Conditions: Acute Ischemic Stroke AIS

Summary: acute ischemic stroke is caused by reduced blood supply to the brain associated with neuroinflammation. this mechanism contributes to acute neuronal death and persists even after reopening of the closed vessel, with consequent limitation of clinical and functional improvement. experimental and clinical evidence demonstrated the anti-inflammatory and neuroprotective effect of micronized and ultramicronized palmitoylethanolamide (pea). the aim of this study is to evaluate the effect of co-ultramicronized pea and luteolin (700 mg + 70 mg in 10 ml) on the clinical outcomes of patients with acute ischemic stroke undergoing mechanical thrombectomy.


Eligibility criteria:
inclusion criteria: * age ≥ 60 years * both genders * first acute ischemic stroke in the middle cerebral artery area confirmed by angio-ct and ctp, eligible for mechanical thrombectomy according to national guidelines * nihss \> 6 * compliant patients * signed informed consent exclusion criteria: * hemorrhagic stroke * previous stroke (tia, ischemic or hemorrhagic stroke) * presence of clinically evident neurodegenerative diseases (alzheimer's disease, parkinson's disease) * presence of psychiatric comorbidity (schizophrenia, bipolar disorder, depressive syndrome) * presence of chronic inflammatory diseases (chronic inflammatory bowel disease, vasculitis etc.) * current or previous neoplasia * uncontrolled diabetes mellitus (glycemia on admission \>400 mg/dl or \<50 mg/dl) * dysphagia, with inability to feed orally * inability to provide informed consent * pre-existing disability (pre-stroke mrs \>2) * allergy or hypersensitivity to the study treatment

Keywords: stroke neuroinflammation palmitoylethanolamide luteolin
growth hormone releasing hormone (ghrh) treatment for age-related sleep disturbances

Conditions: Sleep Disorders

Summary: the purpose of this study is to examine the effects of giving growth hormone releasing hormone (ghrh) to treat sleep disorders in older men and in older women who are on estrogen replacement therapy (ert). many older men and women complain of sleep disturbances. ghrh has been used successfully to treat sleep disorders in young men and may help older men and women. 40 healthy older men and 40 healthy older women on ert will receive either ghrh or an inactive placebo. an individual may be eligible for this study if he/she is a healthy older man or woman with sleep disturbances, and is on estrogen replacement therapy (women).

to examine the effects of synthetic growth hormone releasing hormone (ghrh) versus placebo on the sleep quality, 24-hour secretory pattern of growth hormone (gh), and insulin-like growth factor 1 (igf-1) concentrations of 40 healthy older men and 40 healthy older women on estrogen replacement therapy (ert). to determine if augmenting the gh-igf-1 axis can improve the objective sleep quality of the older population. to determine if treatment-related changes in sleep quality are correlated with changes in gh and/or igf-1 concentrations. nearly 40% of the geriatric population complain of poor sleep quality, a complaint that is validated by objective findings. the physiological consequences of age-impaired sleep are poorly understood, but may include damped circadian rhythms and impaired anabolic hormone status. poor sleep may also account for the disproportionate prescription of sedative hypnotics to older adults which may exacerbate sleep apnea, lead to daytime carryover effects such as sedation, falls, fractures, cognitive impairment, and anterograde amnesia, and has been associated with increased morbidity and mortality. the recent nih consensus conference on the treatment of sleep disorders in older people concluded that nonsedative interventions to improve sleep quality in the elderly population are obviously needed. one such intervention may be stimulation of the gh-igf-1 axis by ghrh administration. clinical evidence indicates sleep quality can be affected by extremes of gh status and several recent studies report acute ghrh administration improves sleep quality in young men. we have recently demonstrated that measures of sleep quality correlate with basal igf-1 concentrations in healthy older men and ert women. 40 healthy older men and 40 healthy older women on ert receive either ghrh or placebo.

Eligibility criteria:
inclusion criteria: - patients must have: age-related sleep impairment. - required: estrogen replacement therapy for women.

Keywords: adult estrogen replacement therapy female hormone replacement therapy human insulin-like growth factor i male placebos sleep disorders somatotropin-releasing hormone somatotropin insulin-like growth factor i -- secretion sleep disorders -- *drug therapy somatotropin-releasing hormone -- *therapeutic use somatotropin -- secretion
the relationship between time perspective, fear of cancer recurrence, rumination, and catastrophizing in gastric cancer survivors

Conditions: Gastric Cancer Patient

Summary: the temporal perspective provides a theory oriented to temporal insights that can shed light on the role of cognitive coping styles in the formation of fear of cancer recurrence. the self-regulatory executive function model elucidates the central role of rumination thinking, catastrophizing cognitive coping styles in the formation of cancer recurrence fear. therefore, this study will rely on both theoretical models to construct a cognitive appraisal coping model to explore the formation pathway of cancer recurrence fear


Eligibility criteria:
inclusion criteria: * preoperative gastroscopy and pathological diagnosis of gastric cancer; * aged 18 years or older * there is no history of recurrent disease or new primary cancer * received surgical resection of cancerous tissues or radiotherapy treatment * conscious, with normal communication and comprehension ability * the patients were aware of their own condition and diagnosis, and informedly agreed to participate in this study exclusion criteria: ● history of mental or cognitive impairment prior to cancer diagnosis