Kornimate/medical-research-clean huggingface dataset:
anticoagulation in blunt cerebrovascular injuries

Conditions: Carotid Artery Injury; Vertebral Artery Injury

Summary: originally thought to be a rare occurrence, bcvi are now diagnosed in approximately 1% of blunt trauma patients. initially bcvi were thought to have unavoidable devastating neurologic outcomes. but early reports suggested anticoagulation might decrease these events. if untreated, carotid artery injuries (cai) have a stoke rate up to 50% depending on injury grade, with increasing stroke rates correlating with increasing grades of injury. current studies report early treatment with antithrombotics - either heparin or anti-platelet agents - in patients with bcvi markedly reduces stroke rates and resultant neurologic morbidity. as reports of bleeding complications have altered heparin protocols in these patients, the use of antiplatelet agents is attractive. although heparin has been has been proposed as the gold standard treatment due to its initial empiric use, no comparative studies of antithrombotic agents has been performed. in sum, grade i-iii blunt carotid and vertebral arterial injuries (bcvi) have the potential for stroke, and should be treated. heparin has not been shown to clearly improve healing rates compared with antiplatelet therapy. the purpose of this study is to determine whether systemic anticoagulation alters the course of grade i-iii bcvi compared with antiplatelet therapy. the investigators study hypothesis is that grade i-iii bcvi will heal or progress to pseudoaneurysm formation, independent of systemic antithrombotic regimen, and that the combination of aspirin and clopidogrel is equally efficacious in preventing neurologic symptoms compared to systemic heparin associated with grade i-iii bcvi.


Eligibility criteria:
inclusion criteria: * patients greater than 18 years old with documented grade i-iii blunt cerebrovascular injuries. exclusion criteria: * pregnancy * nasal polyps * previous gastrointestinal bleeding secondary to antiplatelet medications * contraindication to systemic anticoagulation.
risk of osteoarthritis of the knee at least 5 years after acl reconstruction: comparative study between an isolated acl reconstruction and a reconstruction combining acl and all

Conditions: ACL; Anterior Curciate Ligament; Anterolateral Ligament; Knee Injuries; ALL

Summary: the main objective of this study is to compare, with a minimum follow-up of 5 years, the prevalence of femoro-tibial osteoarthritis after an isolated acl ligamentoplasty or after an acl ligamentoplasty combining acl and all.


Eligibility criteria:
inclusion criteria: * patients who underwent an isolated anterior cruciate ligament (acl) reconstruction or a combined acl and anterolateral ligament reconstruction (extra articular plasty) between january 1, 2011 and march 31, 2012. * patients affiliated or beneficiaries of a social security scheme * patients who have given their express consent. exclusion criteria: * patients with pediatric acl reconstruction technique * patients with a complex associated gesture such as osteotomy or ligamentoplasty other than extra articular plastic surgery. * contraindication to a radio control (pregnancy) * patient's refusal to participate in the study * protected patients: adults under guardianship, curatorship or other legal protection, deprived of their liberty by judicial or administrative decision; pregnant, breastfeeding or parturient woman; hospitalized without consent.
letrozole pretreatment with misoprostol for second-trimester medical abortion

Conditions: Miscarriage

Summary: to compare the success rate of letrozole and misoprostol versus misoprostol alone for medical termination of pregnancy in second trimester abortion.

this prospective double-blind, randomized, clinical trial, will be conducted at ain shams university maternity hospital. patients fulfilling inclusion and exclusion criteria will be divided into two groups. group (a): 181 women will receive three tablets of letrozole (on december 28, 2005, the u.s. food and drug administration approved letrozole tablets (femara®, made by novartis pharmaceuticals corp.) as a single dose, each tablet 2.5 mg (total dose 7.5 mg per day) for two days at home and will be told to bring back the empty packs. the third dose will be given on admission to hospital on day three and will be followed by 400 mcg vaginal misoprostol soaked with saline every three hours up to maximum five doses on day 3. group (b): 181 women will receive three tablets of placebo (manufactured by egyptian group company for drug industries) as a single dose, for two days at home and will be told to bring back the empty packs. the third dose will be given on admission to hospital on day three and will be followed by 400 mcg vaginal misoprostol soaked with saline every three hours up to maximum five doses on day 3. data recording: 1. duration of complete abortion. 2. post abortion bleeding. 3. incomplete delivery of the placenta necessitates evacuation under anesthesia. 4. hemoglobin and hematocrit after 24 hours from abortion to estimate the decrease in hemoglobin level. 5. recording maternal morbidities. 6. patients that will receive 5 doses and did not abort till 24 hours from the first dose of misoprostol will be considered failed induction and will stop follow up without reporting outcome.

Eligibility criteria:
inclusion criteria: * maternal age more than 18 years old (age of legal consent). * gestational age between 12 weeks and 24 weeks. * hemoglobin \>10 g/dl. * bmi between 25 kg/m2 and 35 kg/m2. * miscarriage . * living fetus with multiple congenital malformations incompatible with life. * pproms with drained liquor and parents are consenting for termination of pregnancy. exclusion criteria: * maternal age less than 18 years old. * gestational age less than 12 weeks or more than 24 weeks. * hemoglobin \<10 g/dl. * scared uterus (previous myomectomy, cesarean section, hysterectomy and ruptured uterus). * polyhydraminos. * anencephaly. * fibroid uterus. * bmi less than 25kg/m2 and more than 35kg/m2. * coagulopathy. * history or evidence of adrenal pathology. * previous attempts for induction of abortion in the current pregnancy.

Keywords: letrozole misoprostol second trimester miscarriage
clinical, laboratory and ultrasound stratification of patients with juvenile idiopathic arthritis

Conditions: Juvenile Idiopathic Arthritis

Summary: juvenile idiopathic arthritis (jia), the most common rheumatologic chronic disease in children, is defined as arthritis persisting for at least 6 weeks with no known cause in a patient under the age of 16. the term jia is an umbrella that includes very different diseases. the current international league of associations for rheumatology (ilar) classification divides jia patients into 7 categories based on number of involved joints and time of involvement, presence of systemic symptoms, psoriatic findings and spondyloarthritis. this classification groups together patients with different disease and divides patients with the same disease. in the first case, unifying distinct diseases could lead to undifferentiated therapeutic choices, moving away from the modern concept of therapeutic personalization. in the second case, similarities between paediatric and adult arthritis could not be found. this involves both a loss of collaboration with the adult rheumatologist and the difficulty in accessing possibly effective therapies approved only for adult arthritis. in clinical practice, it is increasingly evident that the number of affected joints and the speed of joint involvement are not useful criteria for defining the type and severity of disease. joint counts lead to underestimate the importance of joint distribution in the identification of distinct forms of arthritis. a recent study found that patterns of joint involvement represent prognostic features, so grouping patients by joint pattern and degree of localization may help clinicians tailor treatments based on predicted disease trajectories. another important point to differentiate some forms of arthritis is the presence of enthesitis and tenosynovitis. sometimes tendon inflammation can be not clinically evident, so ultrasound evaluation is useful to detect it. musculoskeletal ultrasound (msus) has been used worldwide by adult rheumatologist, but it is beginning a useful tool also in patients with jia. recent studies underline the important role of msus findings to assess disease activity and assist disease classification. in recent years, the need has emerged to replace the ilar criteria with a new nomenclature based on the disease biology. this approach could help clinicians to choose a personalized therapeutic strategy for patients with arthritis.


Eligibility criteria:
inclusion criteria: * subjects under the age of 18 years * arthritis persisting for at least 6 weeks with no known cause exclusion criteria: * no consent from the patients' guardians * patients with systemic onset juvenile idiopathic arthritis * patients who developed arthritis on a pre-existing inflammatory disorder such as inflammatory bowel disease, and had received previous treatments

Keywords: jia classification transition of care
production of ipsc derived rpe cells for transplantation in amd

Conditions: Age Related Macular Degeneration (AMD)

Summary: no treatments exist for age-related macular degeneration (amd) when there is cell loss such as in late wet amd or dry amd. the differentiation of rpe cells from patient derived ipsc will offer valuable source of tissue for transplantation in these forms of amd and may form basis for a future treatment option in terms of cell transplantation.

it has been shown that adult human skin cells or human blood cells can be reprogrammed to become stem cells. this type of stem cell is called an induced pluripotent stem cell (ipsc).it has been shown specifically that this type of stem cell can be produced from adult human skin cells or blood cells can in turn be converted into retinal pigment epithelial (rpe) cells. these rpe cells are a very important cell type in the human retina that are abnormal and ultimately lost in age-related macular degeneration (amd). although it has been shown to be possible to make rpe cells from adult human skin, it has not been done to a level to fulfil regulatory requirements for human transplantation in amd. this is a feasibility study involving 10 patients. the efficiency of creating an ipsc-derived rpe cells from a patient's own skin or blood will be examined. a sample size of 10 patients will allow us to potentially consolidate the safety and efficacy of this method in order to create these cells within the context of a future transplantation trial.

Eligibility criteria:
inclusion criteria: * subjects over the age of 18 years * subjects with the ability to give informed consent * subjects with known amd (both wet and dry) exclusion criteria: * unable to give informed consent * subjects unable to give blood sample for medical reasons * subjects with coagulopathies * subjects who are known to be at risk of keloid scarring
feasibility and functional outcome of laparoscopic nerve sparing radical hysterectomy

Conditions: Cervical Cancer

Summary: the aim of this study is to assess: 1. evaluation of the feasibility of laparoscopic nerve sparing radical hysterectomy type iii/c1 as regard surgical technique, blood loss and operative time. 2. evaluate patients' outcome as regard bladder function. in order to preserve the function of the bladder and the rectum, it is necessary to modify the traditional procedures, so as to identify the precise anatomical information directing the technique for optimal preservation of bladder function at the time of radical hysterectomy. the laparoscopic technique offers several well-known advantages. under the magnified view of the laparoscope, the anatomy can be clearly visualized to allow for the meticulous and precise dissection of the para-cervical structures and areolar tissue, including the blood vessels and the nerves. laparoscopic identification (neurolysis) of the inferior hypogastric nerve and inferior hypogastric plexus is a feasible procedure for trained laparoscopic surgeons who have a good knowledge not only of the retroperitoneal anatomy but also of the pelvic neuro-anatomy as this qualification could prohibit long-term bladder and voiding dysfunction during nerve-sparing radical hysterectomy


Eligibility criteria:
inclusion criteria: 1. age \> 18 years. 2. karnofsky \> 80, or american society of anaethesiology (asa) i-ii 3. stage ia2-ib1-ib2-iia1-iia2-iib cervical cancer according to figo (international federation of gynecology and obstetrics) staging. 4. stage ii, iii endometrial cancer exclusion criteria: 1. non invasive cancer 2. pregnancy 3. bladder dysfunction detected prior to surgery. 4. previous pelvic lymphadenectomy. 5. tumour recurrence 6. incomplete surgery, unresectable lesion.

Keywords: nerve sparing radical hysterectomy
universal genetic testing versus guidelines-directed testing for germline pathogenic variants among non-western patients with breast cancer

Conditions: Breast Cancer

Summary: the study aims to examinethe pattern and frequency of pathogenic variants among all newly diagnosed breast cancer patients in a genetically distinct population. additionally, the uptake rate of "cascade family screening" , frequency of pathogenic variants and barriers against testing will be studied.


Eligibility criteria:
inclusion criteria: * adult patient, age ≥ 18 years at time of cancer diagnosis * pathology proven diagnosis of breast cancer (including dcis); any stage. (prior history of cancer is allowed) * willingness to participate * signed consent form. exclusion criteria: - major psychiatric disorder (defined as: patients followed by a psychiatrist and on antipsychotic medications
prenatal breastfeeding education to reduce nipple pain

Conditions: Nipple Pain During Lactation

Summary: this study is a randomized controlled trial to evaluate the effectiveness of different approaches to prenatal teaching of infant latch.


Eligibility criteria:
inclusion criteria: * pregnant women who intend to breastfeed their infants * single infant * resides in catchment area * has phone * speaks english

Keywords: nipple pain during lactation
low-contrast dose liver ct using lean body weight low monoenergetic images and deep learning-based reconstruction

Conditions: Carcinoma, Hepatocellular; Body Weight

Summary: this study aims to assess whether the acceptable image quality is achievable using low monoenergetic imaging of dual-energy ct with deep learning-based denoising, and low contrast media dose calculated based on lean body weight for the detection of hepatocellular carcinoma.

the use of iodinated contrast media in ct is associated with an immediate hypersensitivity reaction in a dose-dependent manner. therefore, it is important to reduce the contrast dose for ct exams in patients who are required repeated ct examinations, including patients with hepatocellular carcinoma (hcc). low monoenergetic images of dual-energy ct can provide higher iodine contrast than conventional images, thus enabling reduction of contrast media. the high image noise in low monoenergetic images may be improved by using model-based ir techniques and deep learning-based denoising (dld) algorithms. besides, lean body weight (lbw)-based contrast dose determination can be another option to reduce contrast media dose compared with total body weight-based dose determination since the volumes of blood and liver are not strictly proportional to total body weight. therefore, we surmised that 50 kev images reconstructed with dld algorithms with reducing iodine load by 30% based on lbw could produce the comparable image quality and lesion conspicuity compared with standard iodine-dose 120kvp images. in this single-center prospective, randomized clinical trial, we aimed to investigate the effectiveness of low-contrast dose ct using 50 kev and dld technique compared with the standard contrast-dose protocol using model-based ir in patients at high risk of hcc.

Eligibility criteria:
inclusion criteria: * high risk group for developing hcc * scheduled contrast-enhanced ct for hcc diagnosis or surveillance exclusion criteria: * not a high risk group for developing hcc * body mass index is equal to or larger than 30 kg/m\^2 * suspected hcc \> 5cm in diameter * received locoregional treatment or surgery for hcc within 3 months * congestive hepatopathy * no venous access on forearm * anticipated beam hardening artifact due to prosthesis * relative/absolute contraindication of contrast-enhanced ct
a monocenter, open-label glucose clamp study examining the metabolic effect of insulin infusion intervals for basal insulin infusion in patients with type i diabetes

Conditions: Diabetes Mellitus Type 1

Summary: this crossover, glucose-clamp study will investigate the impact of different basal insulin infusion rates on glucose control employing insulin pumps with different insulin delivery regimen. patients will be randomized in one of 2 groups, to receive on the first study day insulin via pumps with pulsatile or quasi-continuous delivery modes. on the second study day they will be switched to treatment with the alternative delivery regimen. the anticipated duration of the trial is 2 study days and the target sample size is 14 individuals.


Eligibility criteria:
inclusion criteria: * male patients 18-65 years of age * type i diabetes mellitus * currently on continuous subcutaneous insulin infusion therapy exclusion criteria: * proliferative retinopathy or maculopathy requiring actue treatment within last 6 months * use of systemic corticoids in last 3 months * treatment with medication known to interfere with glucose metabolism
a phase iii clinical trial assessing the immunogenicity and safety of lyophilized live-attenuated varicella vaccine in healthy subjects aged 13 to 55 years

Conditions: Chickenpox Vaccines

Summary: immunogenicity and safety of a live attenuated varicella vaccine in adolescents and adults aged 13-55 years: a phase iii, randomized, double-blind, active-controlled study


Eligibility criteria:
inclusion criteria: * healthy individuals aged between 13 to 55 years who are permanent residents; have obtained informed consent from the volunteer and/or their legal guardian, and signed the informed consent form; the volunteer and/or their legal guardian can comply with the requirements of the clinical trial protocol; axillary temperature ≤37.0°c. exclusion criteria: * females aged 18 to 55 years with a positive urine pregnancy test, pregnant women, women who are breastfeeding, or women planning to become pregnant within the next 3 months; have a history of varicella vaccination, a history of chickenpox, or a history of herpes zoster infection; allergic to known components of the study vaccine, or a history of severe allergic reactions to any vaccination; a history of epilepsy, seizures, or convulsions, or a family history of psychiatric disorders; individuals with immunodeficiency, undergoing immunosuppressive therapy (e.g., oral corticosteroids), or having hiv-related immunocompromised status, or having close family members with congenital immune diseases; have congenital malformations, developmental disorders, or severe chronic diseases (such as down syndrome, diabetes, sickle cell anemia, neurological disorders, guillain-barré syndrome); known or suspected concurrent diseases including: respiratory diseases, acute infections, or active chronic diseases, cardiovascular diseases, skin diseases, severe hypertension, or during treatment for malignant tumors; diagnosed with coagulation dysfunction (such as coagulation factor deficiencies, coagulopathies, platelet abnormalities) or significant bruising or coagulation disorders; have received blood products in the past 3 months; have received live attenuated vaccines in the past 14 days or subunit or inactivated vaccines in the past 7 days; have had various acute diseases or acute exacerbations of chronic diseases in the past 7 days; have had a fever (axillary temperature ≥38.0°c) in the past 3 days; any other factors deemed by the investigator as unsuitable for participation in the clinical trial.

Keywords: clinical trial phase 3 immunogenicity safety live attenuated varicella vaccine
a study to evaluate the safety , tolerability and efficacy of ibi939 in combination with sintilimab in patients with advanced lung cancer

Conditions: Advanced Lung Cancer

Summary: this study is an open-label, phase i clinical study to evaluate the efficacy, tolerability and safety of recombinant fully human anti-tigit antibody (ibi939) in combination with recombinant fully human anti-programmed cell death receptor 1 (pd-1) antibody (sintilimab) in subjects with advanced lung cancer.


Eligibility criteria:
inclusion criteria: 1. signed the informed consent form; 2. male or female ≥ 18 and≤75 years of age; 3. life expectancy ≥ 12 weeks; 4. eastern cooperative oncology group performance status (ecog ps) score is 0 or 1 5. have at least 1 lesion (not previously irradiated) with an accurately measured longest diameter ≥ 10 mm by computed tomography (ct) or magnetic resonance imaging (mri) (intravenous contrast agent is preferred) at baseline (except lymph nodes which must have short axis ≥ 15 mm) according to recist v1.1 and lesions amenable to repeated accurate measurements. 6. histologically or cytologicallyconfirmed non-small cell lung or small cell lung cancer exclusion criteria: 1. previous exposure to immune-mediated therapy; previous use of antitumor vaccine; 2. received the last anti-tumor therapy within 4 weeks prior to the first dose of study drug; 3. received any investigational agent within 4 weeks prior to the first dose of study drug; 4. received systemic treatment with chinese herbal medicine indicated for cancer or drugs used for immunoregulation (including thymosin, interferon, interleukin, except for local use for pleural effusion) within 2 weeks before the first dose; 5. are participating in another interventional clinical study, or observational (non-interventional) clinical study or in the follow-up phase of an interventional study;
effect of oral administration of a herbarium mixture (guazuma ulmifolia and tecoma stans) on metabolic profile in type 2 diabetic patients

Conditions: Type 2 Diabetes Mellitus

Summary: to evaluate the effect of oral administration of herbarium mixture guazuma ulmifolia (gu) and tecoma stans (ts) on metabolic profile in type 2 diabetic patients.

a randomized, double blind, placebo controlled, clinical trial was carried out 40 type 2 diabetic patients independently of their basal hypoglycemic treatment. at beginning and at end of the study, bmi, waist circumference, a metabolic profile (fasting glucose, hba1c, lipids and biosecurity profile), were measured. the patients were randomly assigned to receive the herbarium mixture (gu/ts) 1 g before each meal, or placebo for a period of 90 days. all patients received therapy medical nutrition.

Eligibility criteria:
inclusion criteria: * signing of letter of consent under written information. * men and women with serum glucose of ≥126 and \<400 mg / dl and / or hba1c ≥6.5% and \<10%. * age between 30 and 60 years. * bmi between 25 - 39.9 kg / m2. * with or without pharmacological treatment with oral hypoglycemic agents or insulin * stable body weight during the last 3 months (± 5%). * women in the follicular phase of the menstrual cycle (days 3 to 8 of the cycle) at the time of the laboratory tests * women who do not expect to be pregnant within the next 3 months. exclusion criteria: * physical or mental incapacity that makes it impossible to carry out the intervention. * uncontrolled thyroid disease * women with suspicion or confirmation of pregnancy. * women who are breastfeeding. * hepatic disease or elevation to double the upper normal value of tgo and tgp. * diagnosis of renal insufficiency or creatinine\> 1.5 mg / dl or glomerular filtration rate \<60 ml / min). * known hypersensitivity to calcined magnesia or guazuma ulmifolia and / or tecoma stans.