Pooled mean change from baseline on the Clinical Global Impressions-Severity of Illness scale was significantly ( P < @ ) greater with L-methylfolate versus placebo for most genetic markers .


Most combinations of baseline biological and genetic markers predicted significantly ( P @ ) greater reductions in pooled mean change from baseline in HDRS-@ scores with L-methylfolate versus placebo .


Biomarkers associated with inflammation or metabolism and genomic markers associated with L-methylfolate synthesis and metabolism may identify patients with SSRI-resistant depression who are responsive to adjunctive therapy with L-methylfolate @ mg .


Confirmatory studies are needed .


To compare the efficacy difference in treatment of depression in breast cancer between the combined therapy of acupuncture and auricular acupressure and western medication .


Sixty patients were randomized into an observation group and a control group , @ cases in each one .


In the observation group , the combined therapy of acupuncture and auricular acupressure was adopted .


The main acupoints of acupuncture were Hegu ( LI @ ) , Tai-chong ( LR @ ) , Baihui ( GV @ ) , Zusanli ( ST @ ) , Qihai ( CV @ ) , etc. .


The supplementary acupoints were combined according to the syndrome differentiation .


The treatment was given once every day , @ treatments a week , at the interval of @ days among weeks .


The auricular acupressure was applied to gan ( CO@ , liver ) , pi ( CO@ , spleen ) , neifenmi ( CO@ , endocrine ) , etc. , once every @ days , on each side in one treatment .


In the control group , fluoxetine hydrochloride capsules were prescribed for oral administration , @ mg , once a day .


The Hamilton depression rating scale ( HAMD ) was used to assess the disease severity and efficacy before treatment , in @ and @ weeks of treatment separately .


HAMD factor changes were observed before treatment and at the end of the @th week .


The Asberg antidepressants scale ( SERS ) was applied to safety assessment .


The total effective rate was @ % ( @/@ ) in the observation group , better than @ % ( @/@ ) in the control group ( P < @ ) .


At the end of the @th and @th weeks , HAMD scores were all reduced apparently in the two groups ( all P < @ ) .


At the end of the @th week , the scores of the HAMD factor @ ( anxiety/somatic system ) , factor @ ( retardation ) and factor @ ( sleep disturbance ) were all reduced as compared with those before treatment in the two groups ( all P < @ ) ; the results in the observation group were better than those in the control group ( P < @ , P < @ ) .


SERS score in the observation group was lower obviously than that in the control group ( P < @ ) .


The combined therapy of acupuncture and auricular acupressure achieves the antidepression effect in treatment of depression in breast cancer and has less side effects and high safety .


The efficacy is superior to fluoxetine hydrochloride capsules .


To compare intercellular adhesion molecule-@ ( ICAM-@ ) and vascular cell adhesion molecule-@ ( VCAM-@ ) serum levels between patients with stable ( SAP ) and unstable angina pectoris ( USAP ) undergoing coronary angiography ( CAG ) , investigate effects of CAG on ICAM-@ , VCAM-@ levels in SAP , USAP patients ; probable different effects of non-ionic radiocontrast media ( RCM ) , iso-osmotic iodixanol and low osmolar iopamidol , on these adhesion molecules ( AM ) .


In this randomized , prospective study , @ groups consisting of patients with SAP ( n = @ ) and USAP ( n = @ ) undergoing CAG were included .


For halves of each group iopamidol , for the other halves iodixanol were used as RCM , in turn for randomization .


The patients were divided into @ subgroups according to clinical presentations and used RCM ( SAP-iodixanol , SAP-iopamidol USAP-iodixanol , USAP-iopamidol ) .


ICAM-@ , VCAM-@ levels were measured just before and @ hours after CAG .


Repeated measurements were compared with two-way ANOVA test .


Baseline VCAM-@ concentration was higher in USAP group than SAP group ( p = @ ) .


ICAM-@ , VCAM-@ concentrations increased significantly following CAG in SAP , USAP groups .


ICAM-@ , VCAM-@ concentration increments ; did n't reach statistical significance in SAP-iodixanol subgroup , reached a borderline significance in SAP-iopamidol subgroup ( p = @ ) .


In USAP-iodixanol subgroup ; only VCAM-@ ( p < @ ) , in USAP-iopamidol subgroup ; ICAM-@ ( p = @ ) , VCAM-@ ( p = @ ) levels increased significantly following CAG .


No complication was observed .


To our knowledge , this is the first study indicating ICAM-@ , VCAM-@ inducing effect of CAG in patients with SAP , USAP and differential effects of iodixanol and iopamidol on ICAM-@ , VCAM-@ serum levels .


Further studies are needed to clarify the effects of CAG and different RCM on vascular inflammation , vessel injury , serum AM levels and their clinical significance .


This study should be taken as a pilot , hypothesis-generating study .


The subcutaneous ( SC ) route has recently emerged as a rehydration method with potential advantages in the geriatric population .


Nevertheless , little is known about its application during hospitalization .


The objective of the present study is to evaluate the subcutaneous non-inferiority efficacy in hydration against the intravenous ( IV ) route in elderly patients with dehydration .


A prospective , randomized and controlled interventional trial of patients @ years and older admitted to an Acute Geriatric Unit with mild to moderate dehydration and oral intolerance , evaluating the non-inferiority of subcutaneous fluid therapy versus the intravenous route .


The intervention consisted of the administration of up to @ l/day/route for @ hours subcutaneous vs. intravenous , evaluating the variations in biochemical parameters ( urea , creatinine , osmolarity ) , clinical outcome , and route related complications .


Sixty seven patients completed the study ( @ SC , age @ @ years , @ % women , vs. @ IV , @ @ , @ % women , with no significant differences ) .


The amount of fluid administered per day by route was @ ml @ SC vs. @ ml @ IV , P = @ .


During follow similar reductions were observed between groups without any statistical significance , with mean differences pre-postintervention of urea ( @ @ SC vs. @ @ IV , P = @ ) ; creatinine ( @ @ SC vs. @ @ IV , P = @ ) , and osmolarity ( @ @ SC vs. @ @ IV , P = @ ) .


Fewer catheter extraction episodes were observed in the SC group , which also was the group most prone to peri-clysis edema .


The efficacy of subcutaneous rehydration in elderly hospitalized patients with mild-moderate dehydration is not inferior to that obtained intravenously , and may even have additional advantages .


Patients with metastatic colorectal cancer ( mCRC ) previously-treated with oxaliplatin benefit significantly from the addition of aflibercept to FOLFIRI in relation to overall survival , progression-free survival and response rate .


The results for efficacy and safety over the time course of the VEGF Trap ( aflibercept ) with irinotecan in colorectal cancer after failure of oxaliplatin regimen trial were analysed based on data from @ patients randomised to receive FOLFIRI plus either aflibercept ( n = @ ) or placebo ( n = @ ) .


Hazard ratios ( HR ) by @-month time period were estimated using a piecewise Cox proportional hazard model .


Severity of adverse events ( AEs ) was graded using National Cancer Institute Common Terminology Criteria , version @ .


The estimated probabilities of survival were @ % versus @ % at @ months , @ % versus @ % at @ months and @ % versus @ % at @ months , for the aflibercept - and placebo-treated arms , respectively .


The proportional improvement in the HR over time was consistent with the survival probability results ; survival at @ months was improved by @ % and almost doubled at @ months .


The majority of worst-grade AEs occurred within the first four cycles of treatment and in a small percent of treatment cycles and were mostly reversible .


Common chemotherapy - and anti-vascular epithelial growth factor ( VEGF ) - associated AEs occurred rarely and in a small proportion of cycles with the majority being of single occurrence .


The addition of aflibercept to FOLFIRI showed a continued and persistent improvement in overall survival over time in patients with mCRC .


Although grade @-@ AEs were more frequent in the aflibercept arm , they occurred in early treatment cycles and decreased sharply following initial presentation .


Compared to American Whites , African Americans have a higher prevalence of type @ diabetes mellitus ( T@DM ) , experiencing poorer metabolic control and greater risks for complications and death .


Patient-level factors , such as diabetes knowledge , self-management skills , empowerment , and perceived control , account for > @ % of the variance observed in outcomes between these racial groups .


There is strong evidence that self-management interventions that include telephone-delivered diabetes education and skills training are effective at improving metabolic control in diabetes .


Web-based home telemonitoring systems in conjunction with active care management are also effective ways to lower glycosylated hemoglobin A@c values when compared to standard care , and provide feedback to patients ; however , there are no studies in African Americans with poorly controlled T@DM that examine the use of technology-based feedback to tailor or augment diabetes education and skills training .


This study provides a unique opportunity to address this gap in the literature .


We describe an ongoing @-year randomized clinical trial , which will test the efficacy of a technology-intensified diabetes education and skills training ( TIDES ) intervention in African Americans with poorly controlled T@DM .


Two hundred male and female AfricanAmerican participants , @ years of age or older and with a glycosylated hemoglobin A@c level @ % , will be randomized into one of two groups for @ weeks of telephone interventions : ( @ ) TIDES intervention group or ( @ ) a usual-care group .


Participants will be followed for @ months to ascertain the effect of the interventions on glycemic control .


Our primary hypothesis is that , among African Americans with poorly controlled T@DM , patients randomized to the TIDES intervention will have significantly greater reduction in glycosylated hemoglobin A@c at @ months of follow-up compared to the usual-care group .


Results from this study will add to the current literature examining how best to deliver diabetes education and skills training and provide important insight into effective strategies to improve metabolic control and hence reduce diabetes complications and mortality rates in African Americans with poorly controlled T@DM .


To compare the effects of different types of physical and mental activity on self-reported sleep quality over @ weeks in older adults with cognitive and sleep complaints .


Randomized controlled trial .


General community .


Seventy-two inactive community-dwelling older adults with self-reported sleep and cognitive problems ( mean age @ @ ; @ % women ) .


Random allocation to four arms using a two-by-two factorial design : aerobic + cognitive training , aerobic + educational DVD , stretching + cognitive training , and stretching + educational DVD arms ( @ min/d , @ d/wk for physical and mental activity for @ weeks ) .


Change in sleep quality using seven questions from the Sleep Disorders Questionnaire on the @ to @ National Health and Nutrition Examination Survey ( range @-@ , with higher scores reflecting worse sleep quality ) .


Analyses used intention-to-treat methods .


Sleep quality scores did not differ at baseline , but there was a significant difference between the study arms in change in sleep quality over time ( P < @ ) .


Mean sleep quality scores improved significantly more in the stretching + educational DVD arm ( @ points ) than in the stretching + cognitive training ( @ points ) , aerobic + educational DVD ( @ points ) , or aerobic + cognitive training ( @ points ) arms ( all P < @ , corrected for multiple comparisons ) .


Differences between arms were strongest for waking at night ( P = @ ) and taking sleep medications ( P = @ ) .


Self-reported sleep quality improved significantly more with low-intensity physical and mental activities than with moderate - or high-intensity activities in older adults with self-reported cognitive and sleep difficulties .


Future longer-term studies with objective sleep measures are needed to corroborate these results .


The present study examined health and physical performance as mediators of the association between driving cessation and mortality among older residents of small and large cities .


Participants ( N = @,@ ) were from the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) study .


Participants ' driving status and health were measured at baseline , and mortality rates were observed across the subsequent @ years .


Overall , mortality risk was @ times higher for nondrivers versus drivers ; this relationship was significantly mediated by physical performance and social , physical , and general health .


For large-city residents , mediation effects for all mediators were significant and complete .


For small-city residents , only physical and general health were significant mediators , and these effects were partial .


Health difficulties that accompany or follow driving cessation may explain the association between driving cessation and mortality , particularly for residents of large cities , where alternative transportation options may be more numerous .


To determine whether modifying a plastic speculum with a flexible sheath would improve visualization and decrease pain during vaginal examination .


We conducted a prospective randomized controlled trial of @ women undergoing vaginal speculum examination at an outpatient obstetrics and gynecology faculty practice .


Patients underwent examination via a standardized technique with either a medium-sized plastic speculum ( standard ) or an identical speculum modified with a flexible polypropylene sheath ( sheathed ) .


Investigators recorded the percentage of the cervix visualized .


After speculum insertion , patients recorded pain using a @-cm visual analog scale .


There were no substantial demographic differences between the standard ( n = @ ) and the sheathed ( n = @ ) groups .


Investigators were able to visualize a significantly greater percentage of the cervix using the sheathed speculum compared with the standard speculum ( @ % @ % vs. @ % @ % ; P < @ ) , representing a @ % improvement in visualization , and were able to visualize the entire cervix in @ ( @ % ) patients when using the sheathed speculum compared with @ ( @ % ) patients undergoing standard speculum examination ( P < @ ) .


Patients undergoing examination with the sheathed speculum reported a nonsignificant decrease in pain scores ( @ vs @ ; P = @ ) .


A sheathed speculum significantly improves visualization of the cervix , without compromising patient comfort .


ClinicalTrials.gov : NCT@ .


To assess change in physical functioning ( pain , range of motion ( ROM ) , strength , and endurance ) after @ weeks of therapeutic-yoga .


Planned analyses of data from a randomized pilot study of yoga after stroke .


University-based research laboratory .


People with chronic stroke ( N = @ ) randomized to therapeutic-yoga ( n = @ ) or wait-list control ( n = @ ) .


@ sessions of therapeutic yoga ( twice a week/@ weeks ) .


Yoga was delivered in a standardized and progressive format with postures , breathing , and meditation , and relaxation in sitting , standing , and supine .


Pain was assessed with the PEG , a @-item functional measure of the interference of pain .


ROM included neck and hip active and passive ROM measurements ) .


Upper and lower extremity strength were assessed with the arm curl test and chair-to-stand test , respectively .


Endurance was assessed with the @-minute walk and modified @-min step test .


After a Bonferroni Correction , pain , neck ROM , hip passive ROM , upper extremity strength , and the @-min walk scores all significantly improved after @ weeks of engaging in yoga .


No changes occurred in the wait-list control group .


A group therapeutic-yoga intervention may improve multiple aspects of physical functioning after stroke .


Such an intervention may be complementary to traditional rehabilitation .


Prophylactic fluid preloading before spinal anesthesia has been a routine procedure to prevent maternal hypotension during cesarean delivery .


Unlike colloid , timing of infusion of crystalloid may be important because of its short stay in intravascular space .


We hypothesized that crystalloid loading just after intrathecal injection compared to preload would be more effective in preventing maternal hypotension .


In this prospective controlled study , sixty parturients were randomized to receive @ml/kg of crystalloid before ( preload group ) or after ( coload group ) intrathecal drug injection for spinal anesthesia .


Hypotension was defined if systolic arterial pressure decreased below @ % of baseline and ephedrine was administered to treat hypotension .


The incidence of hypotension and the total dose of ephedrine were checked .


Blood pressure , heart rate and nausea before childbirth were assessed .


Neonatal outcomes were evaluated with Apgar scores and umbilical blood gas analysis .


The incidence of hypotension was lower in the coload group compared to the preload group ( @ % vs. @ % , P = @ ) .


The blood pressure showed the bigger drop during spinal anesthesia in the preload group ( @ vs. @mmHg , P = @ ) and smaller dose of ephedrine was required in the coload group ( @ -LSB- @-@ -RSB- vs. @ -LSB- @-@ -RSB- mg , P = @ ) .


The incidence of nausea was also lower in the coload group ( @ % vs. @ % , P = @ ) .


Neonatal outcome measures were comparable between two groups .


In case of using crystalloids for cesarean delivery , coload is more effective than preload for the prevention of maternal hypotension after spinal anesthesia .


To evaluate the effects of benzalkonium chloride ( BAK ) on the blood-aqueous ( BAB ) and blood-retinal barriers ( BRB ) of pseudophakic eyes .


Prospective , randomized , investigator-masked , comparative study .


Patients were randomly assigned to preservative-free artificial tears or BAK-preserved artificial tears .


One drop of artificial tears was instilled @ times a day in the study eye , starting the day after randomization for @ days .


Anterior chamber flare was assessed by a laser flare meter ( LFM ) and macular thickness measurements were obtained with optical coherence tomography , before , @ , and @ days after randomization .


A total of @ healthy eyes of @ pseudophakic volunteers were recruited .


There were no significant differences regarding demographics ( age , gender , and race distributions ) and clinical characteristics ( eye , mean intraocular pressure , and mean best-corrected visual acuity ) between the @ groups ( P > @ ) .


No significant differences in baseline mean LFM values were observed ( P = @ ) .


However , we detected a statistically significant increase in mean LFM measurements in the BAK-preserved group ( @ @ ph/ms ) ( P = @ ) after @ days .


After @ days , the BAK-preserved group maintained significantly higher flare values ( @ @ ph/ms ) compared with baseline ( P = @ ) .


On the other hand , the preservative-free group showed mean flare values of @ @ ph/ms , not significantly different from those obtained at baseline ( P = @ ) .


We observed no statistically significant change in macular thickness measurements at days @ and @ in either group ( P > @ ) .


Cystoid macular edema was not detected in this series .


Our results suggest that a short-term exposure to BAK can cause disruption of the BAB , without altering the BRB in pseudophakic eyes .


Patients with decompensated cirrhosis have significantly reduced survival without liver transplantation .


Granulocyte colony-stimulating factor ( G-CSF ) has been shown to increase survival in patients with acute-on-chronic liver failure , and erythropoietin promoted hepatic regeneration in animal studies .


We performed a double-blind , randomized , placebo-controlled trial to determine whether co-administration of these growth factors improved outcomes for patients with advanced cirrhosis .


In a prospective study , consecutive patients with decompensated cirrhosis seen at the Institute of Liver and Biliary Sciences , New Delhi ( from May @ through June @ ) were randomly assigned to groups given subcutaneous G-CSF ( @ g/kg/d ) for @ days and then every third day ( @ total doses ) , along with subcutaneous darbopoietin ( @ mcg/wk ) for @ weeks ( GDP group , n = @ ) , or only placebos ( control group , n = @ ) .


All patients also received standard medical therapy and were followed for @ months .


Histology was performed on liver biopsies .


The primary end point was survival at @ months .


Baseline characteristics of patients were comparable ; alcohol intake was the most common etiology of cirrhosis .


A higher proportion of patients in the GDP group than controls survived until @ months ( @ % vs @ % ; P = @ ) .


At @ months , Child-Turcotte Pugh scores were reduced by @ % in the GDP group and @ % in the control group , from baseline ( P = @ ) ; Model for End Stage Liver Disease scores were reduced by @ % and @ % , respectively ( P = @ ) .


The need for large-volume paracentesis was significantly reduced in GDP group , compared with controls ( P < @ ) .


A lower proportion of patients in the GDP group developed septic shock ( @ % ) during follow-up compared with controls ( @ % ; P = @ ) .


No major adverse events were observed in either group .


In a single-center randomized trial , a significantly larger proportion of patients with decompensated cirrhosis given a combination of G-CSF and darbopoietin survived for @ months more than patients given only placebo .


The combination therapy also reduced liver severity scores and sepsis to a greater extent than placebo .


Clinicaltrials.gov ID : NCT@ .


The abuse potential of prescription opioids is well established .


This study compared positive , subjective drug effects of single , equal doses of biphasic immediate release ( IR ) / extended release ( ER ) hydrocodone bitartrate ( HB ) / acetaminophen ( acetyl-p-aminophenol -LSB- APAP -RSB- ) @ / @ mg tablets versus IR HB/APAP @ / @-mg tablets and placebo .


Healthy adult recreational users of prescription opioids entered this randomized , double-blind , double-dummy , active - and placebo-controlled , seven-way crossover study .


Participants received single , total doses of IR/ER HB/APAP @ / @ mg ( intact ; three active tablets ) and @/@ mg ( intact and crushed -LSB- encapsulated -RSB- ; six active tablets ) , IR HB/APAP @ / @ mg ( intact ; three active tablets ) and @/@ mg ( intact and crushed -LSB- encapsulated -RSB- ; six active tablets ) , and placebo .


Peak subjective effects ( E ( max ) ) ; time to peak effects ( TE ( max ) ) ; and area under the drug-effect curves for drug liking , high , and good drug effects were measured using visual analog scales .


Median values with @ % confidence interval ( CI ) were compared using analysis of variance .


Among completers ( n = @ ) , IR/ER HB/APAP produced delayed and lower peak effects compared to equal doses of IR HB/APAP .


Comparing intact tablets , the drug liking E ( max ) ( median -LSB- @ % CI -RSB- ) was significantly lower for IR/ER HB/APAP @/@ mg ( @ -LSB- @ , @ -RSB- ) than an equal dose of IR HB/APAP ( @ -LSB- @ , @ -RSB- ; difference , -@ -LSB- -@ , -@ -RSB- ; P < @ ) .


Similar results were observed for intact IR/ER HB/APAP and IR HB/APAP @ / @ mg .


Crushing IR/ER HB/APAP @/@ mg delayed these effects compared with an equal dose of crushed IR HB/APAP and intact IR/ER HB/APAP .


IR/ER HB/APAP resulted in lower subjective positive drug effects than an equal dose of IR HB/APAP .


Crushing IR/ER HB/APAP also delayed the onset of subjective effects compared with intact IR/ER HB/APAP .


These findings suggest that biphasic IR/ER HB/APAP has lower abuse potential than IR HB/APAP in single equal doses .


To examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease .


Action and coping planning strategies are based on implementation intention , which requires self-regulation by the individual , to prioritize intentionally planned responses over learned or habitual ones , from daily routines to stressful situations .


Randomized controlled trial .


Participants ( n = @ ) were randomized into intervention ( use of action and coping planning strategies , n = @ ) or control ( usual care , n = @ ) groups .


The study was conducted between June @-May @ in two in-person visits : baseline and @-month follow-up .


Participants in the intervention group received telephone reinforcement between baseline and @-month follow-up .


Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence , global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and @-month follow-up .


When using the measure of global measure of adherence , participants in the intervention group reported adherence to therapy more often than controls ( odds ratio = @ ) , but no statistically significant change was observed in the other two outcome measures .


This study has shown that individuals who use action and coping planning report higher adherence to drug treatment , when measured by the global adherence evaluation .


Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration .


Intravitreal ranibizumab or bevacizumab are the most used drugs for treatment of neovascular age-related macular degeneration ( nAMD ) .


Repeated intravitreal injections represent an economic burden and may be associated with serious complications .


The aim of this study is to evaluate the number of needed injections within @ year of treatment .


@ patients over @ years of age with nAMD and visual acuity ( VA ) between @/@ and @/@ were included .


Scheduled visits and treatment were performed monthly for @ year .


After a loading dose of three intravitreal injections ( either ranibizumab = group @ or bevacizumab = group @ ) , an `` as needed '' regimen was performed .


Primary endpoint was a difference in the injection frequencies of ranibizumab and bevacizumab .


Secondary endpoints were best corrected visual acuity ( BCVA ) and central retinal thickness ( CRT ) .


Difference in number of injections was not significant ( @ ( ranibizumab group ) vs. @ ( bevacizumab group ) , p = @ ) .


Mean BCVA was @ letters after @ months if patients received ranibizumab ( p = @ ) and @ letters if patients received bevacizumab ( p = @ ) .


There was no statistical significance between the two groups ( p = @ ) .


The mean CRT did not differ significantly between groups after @ months ( @ m for ranibizumab , @ m for bevacizumab , p = @ ) .


There was no difference in number of treatment , BCVA and CRT after @ year between ranibizumab and bevacizumab in patients with nAMD .


Reintroduction of Variola major as an agent of bioterrorism remains a concern .


Time to seroconversion and plaque reduction neutralizing antibody titers ( PRNT ) of @ or @ standard doses ( SD ) were compared to a single high dose ( HD ) of modified vaccinia Ankara ( MVA ) .


Ninety subjects were randomized @:@ to receive @ HD or @ SD of MVA subcutaneously on Days @ and @ in a placebo-controlled trial .


Serum was collected for PRNT and ELISA .


Subjects were followed for safety for the entire study .


The HD was well-tolerated .


Using Bavarian Nordic 's ELISA , subjects in both groups achieved seroconversion by Study Day @ ( HD ) and Day @ ( SD ) .


Before second vaccination , the hazard rate of seroconverting for the HD group was @ times the SD group with a median time for seroconversion of @ days for both groups .


The peak titer of one HD vaccine was superior to one dose of SD vaccine but inferior to the peak titer after the second dose of the SD vaccination regimen .


Using Saint Louis University 's PRNT , peak titers were @ and @ for the HD and SD groups , respectively , prior to second vaccination .


Non-inferiority of the SD group was not established .


The proportions of positives were @ % ( @/@ ) and @ % ( @/@ ) for the HD and SD groups , respectively .


The peak titer after two standard doses was superior to that of the HD .


HD MVA was safe and well-tolerated .


While the hazard rate for seroconverting was significantly higher in the HD group before second dose , the effect was small as the median time to seroconversion was identical .


When comparing PRNT , non-inferiority of one SD was not established and the peak titers were low for both groups .


The HD peak response was inferior to the standard two-dose regimen response based on ELISA and PRNT .


We examined whether and how an HIV prevention diffusion-based intervention spread throughout participants ' online social networks and whether changes in social network ties were associated with increased HIV prevention and testing behaviors .


We randomly assigned @ primarily racial/ethnic minority men who have sex with men ( MSM ) to receive peer-delivered HIV ( intervention ) or general health ( control ) information over @ weeks through closed Facebook groups .


We recorded participants ' public Facebook friend networks at baseline ( September @ ) and follow-up ( February @ ) , and assessed whether changes in network growth were associated with changes in health engagement and HIV testing .


Within-group ties increased in both conditions from baseline to follow-up .


Among the intervention group , we found a significant positive relation between increased network ties and using social media to discuss sexual behaviors .


We found a positive trending relationship between increased network ties and likelihood of HIV testing , follow-up for test results , and participation in online community discussions .


No significant differences were seen within control groups .


Among high-risk MSM , peer-led social media HIV prevention interventions can increase community cohesion .


These changes appear to be associated with increased HIV prevention and testing behaviors .


To assess the efficacy of recombinant human erythropoietin ( rhEPO ) in amyotrophic lateral sclerosis ( ALS ) .


Patients with probable laboratory-supported , probable or definite ALS were enrolled by @ Italian centres and randomly assigned ( @:@ ) to receive intravenous rhEPO @,@ IU or placebo fortnightly as add-on treatment to riluzole @mg daily for @months .


The primary composite outcome was survival , tracheotomy or > @h non-invasive ventilation ( NIV ) .


Secondary outcomes were ALSFRS-R , slow vital capacity ( sVC ) and quality of life ( ALSAQ-@ ) decline .


Tolerability was evaluated analysing adverse events ( AEs ) causing withdrawal .


The randomisation sequence was computer-generated by blocks , stratified by centre , disease severity ( ALSFRS-R cut-off score of @ ) and onset ( spinal or bulbar ) .


The main outcome analysis was performed in all randomised patients and by intention-to-treat for the entire population and patients stratified by severity and onset .


The study is registered , EudraCT @-@-@ .


We randomly assigned @ patients , of whom @ ( @ rhEPO and @ placebo ) withdrew consent and @ ( placebo ) became ineligible ( retinal thrombosis , respiratory insufficiency , SOD@ mutation ) before receiving treatment ; @ receiving rhEPO and @ placebo were eligible for analysis .


At @months , the annualised rate of death ( rhEPO @ , @ % CI @ to @ ; placebo : @ , CI @ to @ ) , tracheotomy or > @h NIV ( rhEPO @ , CI @ to @ ; placebo @ , CI @ to @ ) did not differ between groups , also after stratification by onset and ALSFRS-R at baseline .


Withdrawal due to AE was @ % in rhEPO and @ % in placebo .


No differences were found for secondary outcomes .


RhEPO @,@ IU fortnightly did not change the course of ALS .


To assess the safety and efficacy of dendritic cell vaccination in metastatic uveal melanoma .


Interventional case series .


We analyzed @ patients with metastatic uveal melanoma treated with dendritic cell vaccination .


Patients with metastatic uveal melanoma received at least @ vaccinations with autologous dendritic cells , professional antigen-presenting cells loaded with melanoma antigens gp@ and tyrosinase .


The main outcome measures were safety , immunologic response , and overall survival .


Tumor-specific immune responses were induced with dendritic cell vaccination in @ ( @ % ) of @ patients .


Dendritic cell-vaccinated patients showed a median overall survival with metastatic disease of @ months , relatively long compared with that reported in the literature .


No severe treatment-related toxicities ( common toxicity criteria grade @ or @ ) were observed .


Dendritic cell vaccination is feasible and safe in metastatic uveal melanoma .


Dendritic cell-based immunotherapy is potent to enhance the host 's antitumor immunity against uveal melanoma in approximately one third of patients .


Compared with other prospective studies with similar inclusion criteria , dendritic cell vaccination may be associated with longer than average overall survival in patients with metastatic uveal melanoma .


Catheter-associated urinary tract infection ( CAUTI ) risk is directly related to duration of indwelling urinary catheters ( IUCs ) , rising beyond @ days of catheterization .


We conducted a cluster randomized study in nonintensive care units of Nurses Improving Care for Healthsystem Elders ( NICHE ) hospitals .


Electronic surveillance data were used in an audit and feedback intervention for frontline nurses to reduce IUC duration .


Multivariable methods were used to identify the difference in average IUC duration and proportion of patients with IUC duration < @ days between patients in an early intervention group and a delayed intervention group , adjusting for patient , unit , and hospital characteristics .


A total of @ units at @ NICHE hospitals reported @,@ adult patients with IUCs over @ months .


Early and delayed intervention groups had important baseline differences in IUC utilization .


Use of evidence-based CAUTI prevention measures increased during study participation .


In multivariable analysis , the average IUC duration and proportion of patients with IUC duration < @ days were not improved in the early intervention group compared with the delayed intervention group .


The impact of the audit and feedback intervention was not significant despite the uptake of evidence-based CAUTI prevention practices .


Abdominal pain after cholecystectomy is common and may be attributed to sphincter of Oddi dysfunction .


Management often involves endoscopic retrograde cholangiopancreatography ( ERCP ) with manometry and sphincterotomy .


To determine whether endoscopic sphincterotomy reduces pain and whether sphincter manometric pressure is predictive of pain relief .


Multicenter , sham-controlled , randomized trial involving @ patients with pain after cholecystectomy without significant abnormalities on imaging or laboratory studies , and no prior sphincter treatment or pancreatitis randomly assigned ( August @ , @-March @ , @ ) to undergo sphincterotomy or sham therapy at @ referral medical centers .


One-year follow-up was blinded .


The final follow-up visit was March @ , @ .


After ERCP , patients were randomized @:@ to sphincterotomy ( n = @ ) or sham ( n = @ ) irrespective of manometry findings .


Those randomized to sphincterotomy with elevated pancreatic sphincter pressures were randomized again ( @:@ ) to biliary or to both biliary and pancreatic sphincterotomies .


Seventy-two were entered into an observational study with conventional ERCP managemeny .


Success of treatment was defined as less than @ days of disability due to pain in the prior @ days both at months @ and @ after randomization , with no narcotic use and no further sphincter intervention .


Twenty-seven patients ( @ % ; @ % CI , @ % -@ % ) in the sham treatment group vs @ ( @ % ; @ % CI , @ % -@ % ) in the sphincterotomy group experienced successful treatment ( adjusted risk difference , -@ % ; @ % CI , -@ % to -@ % ; P = @ ) .


Of the patients with pancreatic sphincter hypertension , @ ( @ % ; @ % CI , @ % -@ % ) who underwent dual sphincterotomy and @ ( @ % ; @ % CI , @ % -@ % ) who underwent biliary sphincterotomy alone experienced successful treatment .


Thirty-seven treated patients ( @ % ; @ % CI ,@ % -@ % ) and @ patients ( @ % ; @ % CI , @ % -@ % ) in the sham group underwent repeat ERCP interventions ( P = @ ) .


Manometry results were not associated with the outcome .


No clinical subgroups appeared to benefit from sphincterotomy more than others .


Pancreatitis occurred in @ patients ( @ % ) after primary sphincterotomies and in @ patients ( @ % ) in the sham group .


Of the nonrandomized patients in the observational study group , @ ( @ % ; @ % CI , @ % -@ % ) who underwent biliary sphincterotomy , @ ( @ % ; @ % CI , @ % -@ % ) who underwent dual sphincterotomy , and @ ( @ % ; @ % CI , @ % -@ % ) who did not undergo sphincterotomy had successful treatment .


In patients with abdominal pain after cholecystectomy undergoing ERCP with manometry , sphincterotomy vs sham did not reduce disability due to pain .


These findings do not support ERCP and sphincterotomy for these patients .


Glycosylated proteins partake in multiple cellular processes including inflammation .


We hypothesized that GlycA , a novel biomarker of protein glycan N-acetyl groups , is related to incident cardiovascular disease ( CVD ) , and we compared it with high-sensitivity C-reactive protein ( hsCRP ) .


In @ @ initially healthy women , baseline GlycA was quantified by nuclear magnetic resonance spectroscopy and hsCRP by an immunoturbidimetric assay .


During median follow-up of @ years , @ incident CVD events occurred ( myocardial infarction , ischemic stroke , coronary revascularization , and CVD death ) .


GlycA and hsCRP were moderately correlated ( Spearman r = @ , P < @ ) .


In Cox regression models that included age , ethnicity , smoking , blood pressure , medications , menopausal status , body mass index , and diabetes , hazard ratios for CVD across quartiles @ to @ of GlycA were @ , @ ( @ % CI , @ to @ ) , @ ( @ % CI , @ to @ ) , and @ ( @ % CI , @ to @ ) , similar to hsCRP , for which hazard ratios were @ , @ ( @ % CI , @ to @ ) , @ ( @ % CI , @ to @ ) , and @ ( @ % CI , @ to @ ) ( both Ptrend < @ ) .


Associations were attenuated after additionally adjusting for lipids : the hazard ratio of quartile @ versus @ for GlycA was @ ( @ % CI , @ to @ ; Ptrend = @ ) and for hsCRP was @ ( @ % CI , @ to @ ; Ptrend < @ ) .


Further adjustment for the other biomarker resulted in a hazard ratio of quartile @ versus @ for GlycA of @ ( @ % CI , @ to @ ; Ptrend = @ ) and for hsCRP of @ ( @ % CI , @ to @ ; Ptrend = @ ) .


In this prospective study of initially healthy women , baseline GlycA was associated with incident CVD , consistent with a possible role for protein glycans in inflammation and CVD .


Rifaximin therapy reduced risk of hepatic encephalopathy ( HE ) recurrence and HE-related hospitalisations during a @-month , randomised , placebo-controlled trial ( RCT ) and a @-month open-label maintenance ( OLM ) study .


However , the impact of crossover from placebo to rifaximin therapy is unclear .


To study the impact of crossing over from placebo to rifaximin treatment on breakthrough HE and hospitalisation rates using a within-subjects design .


Adults with cirrhosis and history of overt HE episodes , currently in HE remission , received placebo during the RCT and crossed over to rifaximin @mg twice daily during the OLM study .


Rate of breakthrough overt HE episodes , hospitalisations and incidence and rate of adverse events ( AEs ) were analysed during RCT and first @months of OLM .


Of @ patients randomised to placebo in the RCT who crossed over to the OLM study , @ experienced an HE episode during the RCT compared with @ during the OLM study ( P < @ ) .


Significantly lower rates of HE events were observed with rifaximin treatment compared with placebo treatment ( P < @ ) .


Rates of HE-related hospitalisation were numerically lower during rifaximin treatment compared with placebo treatment , although not significant .


Rates of most common AEs , serious AEs and infection-related AEs were similar between the two treatments .


This analysis confirms the repeatability of results from the RCT on safety and efficacy of rifaximin @mg twice daily in reducing the risk of hepatic encephalopathy recurrence , and suggests these findings are translatable outside of a rigorous , controlled trial setting .


Long-chain polyunsaturated fatty acids ( LC-PUFA ) are regarded as essential for child cognition .


Genetic variation in fatty acid ( FA ) desaturase enzyme ( FADS ) has been recognized as an important effect modifier in the relation between LC-PUFA and child cognitive function .


This study aimed to identify the distribution of genetic variant ( genotype ) SNP rs@ and to assess plasma FA and developmental outcome by the genotype among under-@ year old Sasaknese Indonesian children .


Data was collected at baseline of a randomized trial ( NUPICO , clinicaltrials.gov NCT@ ) in East Lombok district , Indonesia .


Breastfed , @ - @ month old children were recruited and @ subjects were included in the study .


Child cognition was assessed as Bayley Mental Developmental Index ( MDI ) .


From @ subjects whose blood samples can be collected , only two genotypes were found ( @ % GG homozygotes , @ % AG heterozygotes ) , and minor allele AG was significantly associated with higher level of arachidonic acid ( @:@ n-@ ) , n-@ LC-PUFA and FADS@ index .


MDI score was associated with a FADS@ index ( DHA : EPA ratio ) but not genotype ( Adjusted R-square = @ ) .


FADS@ index was associated with cognitive function .


No difference was found between children with GG and AG genotypes who were all breastfed and not low birth weight .


It is important to understand whether eating eggs , which are a major source of dietary choline , results in increased exposure to trimethylamine-N-oxide ( TMAO ) , which is purported to be a risk factor for developing heart disease .


We determined whether humans eating eggs generate TMAO and , if so , whether there is an associated increase in a marker for inflammation -LSB- ie , high-sensitivity C-reactive protein ( hsCRP ) -RSB- or increased oxidation of low-density lipoprotein ( LDL ) .


In a longitudinal , double-blind , randomized dietary intervention , @ volunteers were fed breakfast doses of @ , @ , @ , @ , or @ egg yolks .


Diets were otherwise controlled on the day before and day of each egg dose with a standardized low-choline menu .


Plasma TMAO at timed intervals ( immediately before and @ , @ , @ , @ , and @ h after each dose ) , @-h urine TMAO , predose and @-h postdose serum hsCRP , and plasma oxidized LDL were measured .


Volunteers received all @ doses with each dose separated by > @-wk washout periods .


The consumption of eggs was associated with increased plasma and urine TMAO concentrations ( P < @ ) , with @ % of the total choline in eggs having been converted to TMAO .


There was considerable variation between individuals in the TMAO response .


There was no difference in hsCRP or oxidized LDL concentrations after egg doses .


The consumption of @ eggs results in an increased formation of TMAO .


Choline is an essential nutrient that is required for normal human liver and muscle functions and important for normal fetal development .


Additional study is needed to both confirm the association between TMAO and atherosclerosis and identify factors , microbiota and genetic , that influence the generation of TMAO before policy and medical recommendations are made that suggest reduced dietary choline intake .


Asunaprevir is a selective HCV NS@ protease inhibitor , active against genotypes @ , @ , @ , and @ in vitro .


We evaluated asunaprevir plus peginterferon alfa-@a / ribavirin ( PegIFN/RBV ) for genotype @ and @ chronic HCV .


In this phase @b , double-blind , placebo-controlled study , treatment-naive adults with genotype @ ( n = @ ) or @ ( n = @ ) were randomly assigned ( @:@ ) to asunaprevir @mg or placebo twice daily plus PegIFN/RBV .


Asunaprevir recipients , achieving protocol-defined response ( HCV-RNA below quantification limit at week @ and undetectable at week @ ) , were rerandomized at week @ to continue asunaprevir-based triple therapy or receive placebo plus PegIFN/RBV for weeks @-@ .


Patients without protocol-defined response ( PDR ) and placebo recipients continued PegIFN/RBV through week @ .


Co-primary end points were undetectable HCV-RNA at week @ and @ ( eRVR ) and @ weeks posttreatment ( SVR@ ) .


Most patients were male ( @ % ) , white ( @ % ) , and had non-CC IL@B genotypes ( @ % ) .


Among genotype @ patients , eRVR rates ( asunaprevir vs. placebo ) were @ % ( @ % CI @ , @ ) vs. @ % ( @ % CI @ , @ ) ; corresponding SVR@ rates were @ % ( @ % CI @ , @ ) vs. @ % ( @ % CI @ , @ ) .


SVR@ among genotype @ patients was @ % ( asunaprevir ) vs. @ % ( placebo ) .


Rates of rash and haematologic adverse events were similar between treatment groups .


Five asunaprevir-treated patients had grade @ alanine aminotransferase elevations that resolved following discontinuation ( n = @ ) or with continued dosing ( n = @ ) .


Addition of asunaprevir to PegIFN/RBV in treatment-naive genotype @ - or @-infected patients improves response rates and is well tolerated , with aminotransferase elevations that were manageable with appropriate monitoring .


ClinicalTrials.gov ID : NCT@ .


Depersonalization disorder ( DPD ) includes changes in subjective experiencing of self , encompassing emotional numbing .


Functional magnetic resonance imaging ( fMRI ) has pointed to ventrolateral prefrontal cortex ( VLPFC ) inhibition of insula as a neurocognitive correlate of the disorder .


We hypothesized that inhibition to right VLPFC using repetitive transcranial magnetic stimulation ( rTMS ) would lead to increased arousal and reduced symptoms .


Patients with medication-resistant DSM-IV DPD ( N = @ ) and controls ( N = @ ) were randomized to receive one session of right-sided rTMS to VLPFC or temporo-parietal junction ( TPJ ) .


@ Hz rTMS was guided using neuronavigation and delivered for @ min .


Co-primary outcomes were : ( a ) maximum skin conductance capacity , and ( b ) reduction in depersonalization symptoms ( Cambridge Depersonalisation Scale ( CDS ) -LSB- state version -RSB- ) .


Secondary outcomes included spontaneous fluctuations ( SFs ) and event-related skin conductance responses .


In patients with DPD , rTMS to VLPFC led to increased electrodermal capacity , namely maximum skin conductance deflections .


Patients but not controls also showed increased SFs post rTMS .


Patients who had either VLPFC or TPJ rTMS showed a similar significant reduction in symptoms .


Event-related electrodermal activity did not change .


A single session of right-sided rTMS to VLPFC ( but not TPJ ) significantly increased physiological arousal capacity supporting our model regarding the relevance of increased VLPFC activity to emotional numbing in DPD .


rTMS to both sites led to reduced depersonalization scores but since this was independent of physiological arousal , this may be a non-specific effect .


TMS is a potential therapeutic option for DPD ; modulation of VLPFC , if replicated , is a plausible mechanism .


To determine whether a college of pharmacy curriculum creates a sense of self-efficacy among students with respect to providing medication therapy management ( MTM ) services .


An electronic survey instrument was sent to all pharmacy students to elicit information on their perceived confidence in providing MTM services , and the results were reviewed .


Of the @,@ students targeted , @ ( @ % ) completed the survey instrument .


Responses indicated that overall self-efficacy increased with each successive year of the curriculum that students completed .


Fourth-year students completing an advanced pharmacy practice experience ( APPE ) in medication therapy management ( MTM ) had significantly higher self-efficacy than did other fourth-year students , whose self-efficacy was similar to that of third-year students .


conclusion : In this study population , students ' self-efficacy increased with each successive year in pharmacy school , with those who completed an APPE in MTM exhibiting the highest level of self-efficacy .


These students may be more likely to pursue MTM opportunities in future careers .


To show that patients with intertrochanteric fractures treated with a proximal femoral nail have a better postoperative course than those treated with a DHS plate ( dynamic hip screw ) .


Patients with a Boyd & Griffin type II intertrochanteric fracture were randomly divided into two groups : a group of patients treated with a PFN and another one treated with a DHS plate .


All patients were assessed at @ , @ , @ and @ weeks using the Harris scale and the visual analog scale pre - and postoperatively , as well as the operative time , incision size , intraoperative bleeding , onset of partial and/or total weight bearing , healing time , time to attain prior physical activity level , and radiographic result .


@ patients met our criteria .


The variables that had a significant reduction were : incision , operative time , postoperative pain according to the visual analog scale , onset of mobility , partial weight bearing and pain at @ weeks .


The proximal femoral nail has better short-term outcomes than the DHS plate ; however , in the medium term both implants have the same outcomes .


Completion rate for the three-dose series of the human papillomavirus ( HPV ) vaccine has generally been low .


This study evaluated the effectiveness of a reminder letter intervention on HPV vaccine three-dose series completion .


Female members of Kaiser Permanente Southern California Health Plan who received at least one dose , but not more than two doses , of the HPV vaccine by February @ , @ , and who were between ages @ and @ years at the time of first HPV vaccination were included .


Eighty percent of these females were randomized to receive the reminder letter , and @ % were randomized to receive standard of care ( control ) .


The reminder letters were mailed quarterly to those who had not completed the series .


The proportion of series completion at the end of the @-month evaluation period was compared using chi-square test .


A total of @,@ females were included in the intervention group and @,@ in the control group .


HPV vaccine series completion was @ % in the intervention group and @ % in the control groups ( p < @ ) .


The effect of the intervention appeared to be stronger in girls aged @-@years compared with young women aged @-@years at the first dose and in blacks compared with whites .


Reminder letters scheduled quarterly were effective to enhance HPV vaccine series completion among those who initiated the vaccine .


However , a large gap in series completion remained despite the intervention .


Future studies should address other barriers to series completion , including those at the providers and the health care system level .


To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia .


Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio .


Community .


Participants identified as having low mood on either the Visual Analog Mood Scale sad item ( @ ) or Stroke Aphasic Depression Questionnaire Hospital version @ ( SADQH@ ) ( @ ) were recruited .


Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit .


Outcomes were assessed at six months after randomisation , blind to group allocation .


The costs were assessed from a service use questionnaire .


Effectiveness was defined as the change in SADQH@ scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group .


The cost analysis was undertaken from the perspective of the UK NHS and Social Services .


The greatest difference was in home help costs where there was a saving of @ in the intervention group compared to an increase of @ in the control group .


At six months the SADQH@ score for the intervention group was @ compared to the control group value of @ .


This resulted in a mean increase of @ in the control group , compared to a mean significant different decrease of @ in the intervention group ( P = @ ) .


The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH@ was @ .


Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up .


This study aimed to compare application of the Mller maneuver ( MM ) and application of drug-induced sleep endoscopy ( DISE ) prior to surgery , in addition to MM , to further ascertain the location of an obstruction in the upper airway and whether the location would change the surgical treatment plan in patients with retropalatal obstruction .


Prospective , clinical trial at a tertiary referral hospital .


This study included @ obstructive sleep apnea patients who were recommended for surgical treatment .


Patients were randomly divided into two groups : The first group ( DISE plus MM ) underwent a DISE ( @ patients ) , in addition to the planned procedure according to MM .


Meanwhile , the second group ( MM only ) underwent surgery based only on their MM evaluation ( @ patients ) .


Patients with retrolingual-localized obstructions were excluded , whereas patients withthird-degree obstructions at the retropalatal level , according to DISE and/or MM , were included in the study .


There was a significant improvement between pre - and postoperative polysomnography findings in both groups .


However , the postoperative improvements between the groups were not statistically different .


Because there was a significant change in the planned surgical procedures in the first group , there were significantly more combined surgeries followed by the DISE procedure .


Although the DISE resulted in more changes in the surgical treatment plan and higher rate of combined treatment compared to MM , we determined that this difference did not result in a significant difference in treatment success .


This study investigated improvements in quality of life associated with eight weeks of montelukast and/or intranasal steroid treatment for moderate to severe allergic rhinitis .


A single-centre , prospective , randomised , double-blind , placebo-controlled study was carried out .


Assessments were made using the Rhinoconjunctivitis Quality of Life Questionnaire and symptom scales .


A total of @ patients ( aged @-@ years ) were randomly assigned to one of two groups .


In the montelukast group , patients were treated with montelukast tablets and fluticasone propionate nasal spray ( n = @ ) .


In the placebo group , treatment comprised a placebo and fluticasone propionate .


The results showed significant improvements in symptom scores and quality of life scores for both groups after one month and two months of treatment , compared with baseline values ; these improvements were significantly greater for the montelukast group compared with the placebo group .


The mean number of loratadine tablets taken by each patient during the study period was only @ for the montelukast group compared with @ for the placebo group .


The combination of montelukast tablets and fluticasone propionate nasal spray improved symptom control and overall quality of life for moderate to severe allergic rhinitis patients .


Physical rehabilitation is commonly used in patients with Parkinson 's disease ( PD ) to improve their health and alleviate the symptoms .


We compared the effects of three programs , strength training ( ST ) , aerobic training ( AT ) , and physiotherapy , on motor symptoms , functional capacity , and electroencephalographic ( EEG ) activity in PD patients .


Twenty-two patients were recruited and randomized into three groups : AT ( @ % of maximum heart rate ) , ST ( @ % of one repetition maximum ) , and physiotherapy ( in groups ) .


Subjects participated in their respective interventions twice a week for @ weeks .


The assessments included measures of disease symptoms ( Unified Parkinson 's Disease Rating Scale -LSB- UPDRS -RSB- ) , functional capacity ( Senior Fitness Test ) , and EEG before and after @ weeks of intervention .


The PD motor symptoms ( UPDRS-III ) in the group of patients who performed ST and AT improved by @ % ( effect size -LSB- ES -RSB- = @ , confidence interval -LSB- CI -RSB- = -@ , @ ) and @ % ( ES = @ , CI = -@ , @ ) , respectively , in contrast to the physiotherapy group , which showed a @ % improvement ( ES = @ , CI = -@ , @ ) .


Furthermore , the functional capacity of all three groups improved after the intervention .


The mean frequency of the EEG analysis mainly showed the effect of the interventions on the groups ( F = @ , P = @ ) .


ST and AT in patients with PD are associated with improved outcomes in disease symptoms and functional capacity .


The objective of this study is to determine the effects of a caffeine-containing energy drink on female volleyball players ' performance .


Thirteen elite female volleyball players ingested @ mgkg of caffeine with an energy drink or the same drink without caffeine ( placebo drink ) in a double-blind and randomized study .


Then , participants performed the following : standing spike , jumping spike , spike jump , blocking jump , squat jump , countermovement jump , manual dynamometry , and the agility t-test .


A simulated volleyball game was played , videotaped , and notated afterward .


In comparison to the placebo drink , the ingestion of the caffeinated energy drink increased the ball velocity in the standing spike ( @ @ vs @ @ ms , P = @ ) and in the jumping spike ( @ @ vs @ @ ms , P = @ ) and the jump height in the squat jump ( @ @ vs @ @ cm , P = @ ) , countermovement jump ( @ @ vs @ @ cm , P = @ ) , spike jump ( @ @ vs @ @ cm , P = @ ) , and block jump ( @ @ vs @ @ cm , P = @ ) .


Furthermore , the caffeinated energy drink decreased the time needed to complete the agility t-test ( @ @ vs @ @ s , P = @ ) .


During the game , the volleyball actions categorized as successful were more frequent with the caffeinated energy drink ( @ % @ % vs @ % @ % , P < @ ) , whereas imprecise actions decreased ( @ % @ % vs @ % @ % , P < @ ) when compared with the placebo drink .


Commercially available energy drinks can significantly improve physical performance in female volleyball players .


Increased physical performance led to improved accuracy during an actual volleyball match .


Data on the metabolic effects of GH derived from studies using GH suppression by pharmacological agents may not reflect selective actions .


The purpose of this study was to evaluate the effects of GH antagonism on glucose and lipid metabolism using pegvisomant , a selective GH receptor antagonist in patients with type @ diabetes ( T@D ) .


In a randomized , placebo-controlled , crossover study , @ young adults with T@D were evaluated at baseline and after @ weeks of treatment with either @ mg of pegvisomant or placebo .


The assessments included an overnight euglycemic steady state followed by a hyperinsulinemic euglycemic clamp and used glucose and glycerol cold stable isotopes .


Hepatic and peripheral insulin sensitivity ( IS ) , lipid turnover , and intramyocellular lipid ( IMCL ) were measured .


Compared with placebo , pegvisomant treatment resulted in lower IGF-I levels ( P < @ ) .


During the overnight steady state , insulin requirements for euglycemia ( P = @ ) , insulin levels ( P = @ ) , and glucose production rates ( Ra ) ( P = @ ) were reduced .


During the clamp study , glucose infusion rates ( P = @ ) increased and glucose Ra ( P = @ ) decreased whereas glucose disposal rates were unchanged .


Free fatty acid levels were similar during the steady state but were lower during the clamp ( P = @ ) after pegvisomant .


Soleus muscle IMCL decreased after treatment ( P = @ ) ; however , no change in tibialis anterior muscle was observed .


The study demonstrates that GH antagonism in T@D results in improved hepatic insulin sensitivity .


Lack of consistent changes in free fatty acid levels may suggest a direct effect of GH on IS .


Unchanged peripheral IS despite reductions in IMCL indicate that GH-induced alterations in IMCL may not be causally linked to glucose metabolism .


Patient decision aids have been used in many clinical situations to improve the patient centeredness of care .


A patient decision aid for patients with posttraumatic stress disorder ( PTSD ) has not been developed or tested .


The authors evaluated the effects of a patient decision aid on the patient centeredness of PTSD treatment .


The study was a randomized trial of a patient decision aid for PTSD versus treatment as usual ( control group ) .


The participants were @ male and female veterans who presented to a single U.S. Department of Veterans Affairs hospital with a new diagnosis of PTSD .


Patient centeredness was assessed by knowledge of PTSD and its treatment , level of decisional uncertainty , and ability to state a preferred treatment option .


Secondary outcomes included treatments received and PTSD symptoms in the six months after study entry .


Compared with the control group ( N = @ ) , participants who reviewed the patient decision aid ( N = @ ) had higher scores for PTSD knowledge ( p = @ ) and less conflict about their choice of treatment ( p = @ ) .


In addition , participants who reviewed the patient decision aid were more likely to select and receive an evidence-based treatment for PTSD ( p = @ ) and had superior PTSD outcomes ( p = @ ) compared with the control group .


Use of a patient decision aid was associated with improvements in patient-centered PTSD treatment .


The patient decision aid was also associated with greater use of evidence-based treatments and improvement of PTSD symptoms .


This study suggests that clinics should consider using a patient decision aid for patients with PTSD .


Cocaine addiction continues to be a significant healthcare issue , yet there are no FDA approved medications for the treatment of cocaine use disorder within the United States .


This @-week , prospective , double-blind , randomized , placebo-controlled study examined the effectiveness of quetiapine ( Seroquel XR ) versus matched placebo for the treatment of DSM-IV cocaine dependence in non-psychotic individuals .


Subjects randomized to quetiapine ( N = @ ) were titrated up to a target dose of @mg/day of quetiapine , while those in the placebo arm ( N = @ ) were given a matched placebo .


All subjects had weekly clinic visits and a cognitive-behavioral therapy group session .


Outcome measures included self-report of cocaine use and money spent on cocaine as well as urine drug screens ( UDS ) .


The drop-out rate was substantial at @ % .


Logistic regression analysis did not find significant differences between groups in predicting end-of trial abstinence , defined as three consecutive weekly negative UDS ( @ % in the quetiapine group versus @ % in the placebo group ; p = @ ) .


Based upon a repeated measures analysis of variance , subjects in this study , as a whole , demonstrated reductions in their self-reported use of cocaine , self-reported money spent on cocaine , and number of days per week using cocaine .


However , the quetiapine group did not differ significantly from the placebo group .


This study did not find group differences between the quetiapine and placebo arms , suggesting that quetiapine is not an efficacious treatment for DSM-IV cocaine dependence .


Intraventricular fluid dynamics can be assessed clinically using imaging .


The contribution of vortex structures to left ventricular ( LV ) diastolic function has never been quantified in vivo .


This study sought to understand the impact of intraventricular flow patterns on filling and to assess whether impaired fluid dynamics may be a source of diastolic dysfunction .


Two-dimensional flow velocity fields from color Doppler echocardiographic sequences were obtained in @ patients with nonischemic dilated cardiomyopathy ( NIDCM ) , @ patients with hypertrophic cardiomyopathy ( HCM ) , and @ control healthy volunteers .


Using a flow decomposition method , we isolated the rotational velocity generated by the vortex ring from the surrounding flow in the left ventricle .


The vortex was responsible for entering @ @ % of filling volume in the control group and @ @ % in the NIDCM group ( p = @ ) , but only @ @ % in the HCM group ( p < @ vs. controls ) .


Favorable vortical effects on intraventricular pressure gradients were observed in the control and NIDCM groups but not in HCM patients .


Differences in chamber sphericity explained variations in the vortex contribution to filling between groups ( p < @ ) .


The diastolic vortex is responsible for entering a significant fraction of LV filling volume at no energetic or pressure cost .


Thus , intraventricular fluid mechanics are an important determinant of global chamber LV operative stiffness .


Reduced stiffness in NIDCM is partially related to enhanced vorticity .


Conversely , impaired vortex generation is an unreported mechanism of diastolic dysfunction in HCM and probably other causes of concentric remodeling .


There is growing evidence that Cognitive Simulation Therapy ( CST ) benefits cognition and quality of life of people with dementia , but little is known about the indirect effects of this intervention on family caregivers .


This study sought to investigate the effect of CST on family caregivers general health status of people with dementia living in the community attending the CST intervention .


Eighty-five family caregivers of people with dementia took part in the study .


All the people with dementia received the standard twice weekly seven weeks of the CST intervention plus either @ weeks of a maintenance CST ( MCST ) intervention or @ weeks of treatment as usual .


Family caregivers were assessed before and after their relatives the CST programme , and after @ and @ months of the MCST programme .


A pre and post CST groups comparison was undertaken to evaluate the open trial first phase and an ANCOVA model used to analyse the maintenance phase with its controlled comparison .


We found no evidence for a benefit on the family caregiver outcome measures of the intervention before and after CST groups by using a t-test analysis or any significant differences between intervention and control groups for any of the variables considered at any time point ( @ and @ month follow up ) .


CST seems to have a relatively specific benefit fpr people with dementia that may not carry over to family carers .


Future studies need to further explore and compare the effects that CST might bring to family caregivers of people with dementia attending the intervention .


To compare pharmacokinetics ( PK ) and pharmacodynamics ( PD ) of insulin glargine in type @ diabetes mellitus ( T@DM ) after evening versus morning administration .


Ten T@DM insulin-treated persons were studied during @-h euglycemic glucose clamp , after glargine injection ( @ units/kg s.c. ) , either in the evening ( @ h ) or the morning ( @ h ) .


The @-h glucose infusion rate area under the curve ( AUC@-@h ) was similar in the evening and morning studies ( @,@ @ and @ @ mg/kg @ h , P = @ ) , but the first @ h ( AUC@-@h ) was lower with evening versus morning glargine ( @ @ vs. @ @ mg/kg @ h , P = @ ) , whereas the opposite occurred for the second @ h ( AUC@-@h @ @ vs. @ @ mg/kg @ h , P = @ ) .


The glucose infusion rate differences were totally accounted for by different rates of endogenous glucose production , not utilization .


Plasma insulin and C-peptide levels did not differ in evening versus morning studies .


Plasma glucagon levels ( AUC@-@h @,@ @ vs. @,@ @ ng/L/h , P = @ ) and lipolysis ( free fatty acid AUC@-@h @ @ vs. @ @ mmol/L/h , P = @ ; - OH-butyrate AUC@-@h @ @ vs. @ @ mmol/L/h , P = @ ; glycerol , P < @ ) were overall more suppressed after evening versus morning glargine administration .


The PD of insulin glargine differs depending on time of administration .


With morning administration insulin activity is greater in the first @-@ h , while with evening administration the activity is greater in the @-@ h period following dosing .


However , glargine PK and plasma C-peptide levels were similar , as well as glargine PD when analyzed by @-h clock time independent of the time of administration .


Thus , the results reflect the impact of circadian changes in insulin sensitivity in T@DM ( lower in the night-early morning vs. afternoon hours ) rather than glargine per se .


Varicella-zoster virus ( VZV ) infections increasingly are reported in patients with multiple sclerosis ( MS ) and constitute an area of significant concern , especially with the advent of more disease-modifying treatments in MS that affect T-cell-mediated immunity .


To assess the incidence , risk factors , and clinical characteristics of VZV infections in fingolimod-treated patients and provide recommendations for prevention and management .


Rates of VZV infections in fingolimod clinical trials are based on pooled data from the completed controlled phases @ and @ studies ( @ participants ) and ongoing uncontrolled extension phases ( @ participants ) .


Male and female patients aged @ through @ years ( @-@ years for the phase @ studies ) and diagnosed as having relapsing-remitting MS were eligible to participate in these studies .


In the postmarketing setting , reporting rates since @ were evaluated .


In clinical trials , patients received fingolimod at a dosage of @ or @ mg/d , interferon beta-@a , or placebo .


In the postmarketing setting , all patients received fingolimod , @ mg/d ( total exposure of @,@ patient-years at the time of analysis ) .


Calculation of the incidence rate of VZV infection per @ patient-years was based on the reporting of adverse events in the trials and the postmarketing setting .


Overall , in clinical trials , VZV rates of infection were low but higher with fingolimod compared with placebo ( @ vs @ per @ patient-years ) .


A similar rate was confirmed in the ongoing extension studies .


Rates reported in the postmarketing settings were comparable ( @ per @ patient-years ) and remained stable over time .


Disproportionality in reporting herpes zoster infection was higher for patients receiving fingolimod compared with those receiving other disease-modifying treatments ( empirical Bayes geometric mean , @ -LSB- @ % CI , @-@ @ -RSB- ) ; the proportion of serious herpes zoster infections was not higher than the proportion for other treatments ( empirical Bayes geometric mean , @ -LSB- @ % CI , @-@ @ -RSB- ) .


Corticosteroid treatment for relapses might be a risk factor for VZV reactivation .


Rates of VZV infections in clinical trials were low with fingolimod , @ mg/d , but higher than in placebo recipients .


Rates reported in the postmarketing setting are comparable .


We found no sign of risk accumulation with longer exposure .


Serious or complicated cases of herpes zoster were uncommon .


We recommend establishing the patient 's VZV immune status before initiating fingolimod therapy and immunization for patients susceptible to primary VZV infection .


Routine antiviral prophylaxis is not needed , but using concomitant pulsed corticosteroid therapy beyond @ to @ days requires an individual risk-benefit assessment .


Vigilance to identify early VZV symptoms is important to allow timely antiviral treatment .


Administration of many drugs including magnesium sulfate ( MS ) has considerable influences on pregnancy outcomes .


The present study investigates the effects of MS administration on reaching the active phase of labor in women with premature rupture of membrane ( PROM ) and subsequent fetal complications .


A double blind , randomized , placebo-controlled trial was performed among primipara women referred to the PROM center in Tehran , Iran between March @ and August @ .


Patients were equally allocated into two groups ; the intervention group who received MS ( n = @ ) and the control ( placebo ) group ( n = @ ) .


Both groups received a corticosteroid , @g oral azithromycin ( oral ) and @ g ampicillin ( IV ) every @ hours for @ hours , followed by amoxicillin ( @ mg orally @ times daily ) for an additional @ days .


None of the research staff were aware of the treatment allocation of patients in order for blinding purposes .


Administration of MS in intervention group increases this period @ times compared to the control group .


In women whose gestational age was < @ weeks , MS administration increased the active phase of labor up to @ % .


Administration of magnesium sulfate reduced the risk of respiratory distress syndrome significantly ( p = @ @ ) , without producing any adverse pregnancy outcomes .


Magnesium sulfate increases delay in reaching the active phase of labor in mothers with PROM , without producing adverse birth outcomes .


( Registration ID in IRCT ; IRCT@N@ ) .


The United States has invested substantially in screening and brief intervention for illicit drug use and prescription drug misuse , based in part on evidence of efficacy for unhealthy alcohol use .


However , it is not a recommended universal preventive service in primary care because of lack of evidence of efficacy .


To test the efficacy of @ brief counseling interventions for unhealthy drug use ( any illicit drug use or prescription drug misuse ) - a brief negotiated interview ( BNI ) and an adaptation of motivational interviewing ( MOTIV ) - compared with no brief intervention .


This @-group randomized trial took place at an urban hospital-based primary care internal medicine practice ; @ adult primary care patients with drug use ( Alcohol , Smoking , and Substance Involvement Screening Test -LSB- ASSIST -RSB- substance-specific scores of @ ) were identified by screening between June @ and January @ in Boston , Massachusetts .


Two interventions were tested : the BNI is a @ - to @-minute structured interview conducted by health educators ; the MOTIV is a @ - to @-minute intervention based on motivational interviewing with a @ - to @-minute booster conducted by master 's - level counselors .


All study participants received a written list of substance use disorder treatment and mutual help resources .


Primary outcome was number of days of use in the past @ days of the self-identified main drug as determined by a validated calendar method at @ months .


Secondary outcomes included other self-reported measures of drug use , drug use according to hair testing , ASSIST scores ( severity ) , drug use consequences , unsafe sex , mutual help meeting attendance , and health care utilization .


At baseline , @ % of participants reported their main drug was marijuana , @ % cocaine , and @ % opioids .


At @ months , @ % completed follow-up .


Mean adjusted number of days using the main drug at @ months was @ for no brief intervention vs @ for the BNI group ( incidence rate ratio -LSB- IRR -RSB- , @ ; @ % CI , @-@ @ ) and @ for the MOTIV group ( IRR , @ ; @ % CI , @-@ @ ; P = @ for both comparisons vs no brief intervention ) .


There were also no significant effects of BNI or MOTIV on any other outcome or in analyses stratified by main drug or drug use severity .


Brief intervention did not have efficacy for decreasing unhealthy drug use in primary care patients identified by screening .


These results do not support widespread implementation of illicit drug use and prescription drug misuse screening and brief intervention .


Increasing life expectancy of HIV-@-infected patients raises interest in how trial results apply to older patients .


This post-hoc analysis evaluated potential differences in efficacy and safety in older ( @ years ) versus younger ( < @ years ) patients in the ECHO and THRIVE trials over @ weeks .


HIV-infected , treatment-nave adults were randomized to receive rilpivirine ( RPV ) or efavirenz ( EFV ) , plus a background regimen .


Virologic response rates ( FDA snapshot analysis ; HIV-@ RNA < @ copies/mL ) were assessed at Week @ .


Total-body bone mineral density was evaluated at baseline and Week @ by dual-energy X-ray absorptiometry scans .


Serum concentrations of @-hydroxy vitamin D ( ECHO trial only ) were also measured at baseline , Week @ and Week @ .


@ patients were treated .


At Week @ , virologic response rates were similar between older ( @ % ) and younger ( @ % ) RPV-treated patients and numerically higher in older ( @ % ) versus younger ( @ % ) EFV-treated patients .


No clinically relevant age-related differences were observed in immunologic responses .


Small differences were noted in older versus younger patients in adverse events ( higher rates of depression , insomnia , and rash in older EFV-treated patients ) , laboratory abnormalities ( increased low-density lipoprotein cholesterol and hyperglycemia in older EFV-treated patients and increased amylase in older patients across treatments ) , bone mineral density ( larger decreases in older patients across treatments ) , and progression to severe vitamin D deficiency ( greater in older versus younger EFV-treated patients ) .


Efficacy and safety outcomes were generally similar in older versus younger patients in the ECHO and THRIVE trials .


Although Muslim diabetic patients may be aware of their religious exemption from fasting , many still fast and adjust their medication regimens accordingly .


Pharmacists have a significant potential to identify and prevent harm from medication misuse in Ramadan .


This study examines Egyptian pharmacists ' knowledge regarding management of diabetes during Ramadan .


It also explores pharmacists ' willingness to attend a @ day workshop on medication regimen adjustment during Ramadan .


Community pharmacies throughout Alexandria , Egypt .


A cross-sectional study using a pretested self-administered survey was conducted among a random sample of community pharmacists .


The survey included three knowledge questions relevant to counseling diabetic patients during Ramadan .


Questions covered the recommended timing and dosing for metformin and insulin as well as the safe blood glucose range required for diabetic patients to safely continue their fast .


Using logistic regression , a model was estimated to predict pharmacists ' willingness to attend a workshop on the adjustment of medication regimens during Ramadan .


Content analysis was used to analyze pharmacists ' answers to the question concerning what they would like the workshop to cover .


Pharmacists ' aggregate scores for all three diabetes management knowledge questions and pharmacists ' willingness to attend a workshop on the adjustment of medication regimens during Ramadan .


Ninety three percent of the @ approached pharmacists agreed to participate .


Forty three pharmacists ( @ % ) did not know the correct answer to any question , @ ( @ % ) @ answered one correctly , @ ( @ % ) answered two correctly and only @ ( @ % ) answered all @ three correctly .


Confidence in therapeutic knowledge regarding medication regimen @ adjustment during Ramadan was not associated with the pharmacists ' knowledge of diabetes management during Ramadan .


One hundred seventy five ( @ % ) pharmacists wanted to attend a workshop on adjusting medication regimens during Ramadan .


This was significantly associated with pharmacists being Muslim ( OR @ , CI @-@ @ ) and of younger age ( OR @ = @ , CI @-@ @ ) .


Pharmacists offered specific content and communication process @ suggestions for the workshop content .


This study identifies variability among community pharmacists ' knowledge of diabetes management during Ramadan .


It also shows willingness among the majority of pharmacists to learn more about the topic .


Data regarding long-term outcomes of neonates reaching viability following early preterm premature rupture of membranes ( PPROM ; < @ weeks at rupture ) are limited .


We hypothesized that babies delivered after early PPROM would have increased rates of major childhood morbidity compared with those with later PPROM ( @ weeks at rupture ) .


This was a secondary analysis of a multicenter randomized controlled trial of magnesium sulfate vs placebo for cerebral palsy prevention .


Women with singletons and PPROM of @-@ weeks were included .


All women delivered at @ weeks or longer .


Those with PPROM less than @ weeks ( cases ) were compared with women with PPROM at @-@ @ weeks ( controls ) .


Composite severe neonatal morbidity ( sepsis , severe intraventricular hemorrhage , periventricular leukomalacia , severe necrotizing enterocolitis , bronchopulmonary dysplasia , and/or death ) and composite severe childhood morbidity at age @ years ( moderate or severe cerebral palsy and/or Bayley II Infant and Toddler Development scores greater than @ SD below the mean ) were compared .


A total of @ women ( @ early PPROM cases ) were included .


Demographics were similar between the groups .


Cases delivered earlier ( @ vs @ weeks , P < @ ) and had a longer rupture-to-delivery interval ( @ vs @ days , P < @ ) .


Case neonates had high rates of severe composite neonatal morbidity ( @ % vs @ % , P < @ ) .


Children with early PPROM had higher composite severe childhood morbidity ( @ % vs @ % , P < @ ) .


Early PPROM remained associated with composite severe childhood morbidity in multivariable models , even when controlling for delivery gestational age and other confounders .


Early PPROM is associated with high rates of neonatal morbidity .


Early childhood outcomes at age @ years remain poor compared with those delivered after later PPROM .


Obesity has been associated with changes in the composition and function of the intestinal microbiota .


Modulation of the microbiota by antibiotics also alters bile acid and glucose metabolism in mice .


Hence , we hypothesized that short term administration of oral antibiotics in humans would affect fecal microbiota composition and subsequently bile acid and glucose metabolism .


In this single blinded randomized controlled trial , @ male obese subjects with metabolic syndrome were randomized to @ days of amoxicillin @ mg t.i.d. or @ days of vancomycin @ mg t.i.d.


At baseline and after @ week of therapy , fecal microbiota composition ( Human Intestinal Tract Chip phylogenetic microarray ) , fecal and plasma bile acid concentrations as well as insulin sensitivity ( hyperinsulinemic euglycemic clamp using -LSB- @,@ - ( @ ) H@ -RSB- - glucose tracer ) were measured .


Vancomycin reduced fecal microbial diversity with a decrease of gram-positive bacteria ( mainly Firmicutes ) and a compensatory increase in gram-negative bacteria ( mainly Proteobacteria ) .


Concomitantly , vancomycin decreased fecal secondary bile acids with a simultaneous postprandial increase in primary bile acids in plasma ( p < @ ) .


Moreover , changes in fecal bile acid concentrations were predominantly associated with altered Firmicutes .


Finally , administration of vancomycin decreased peripheral insulin sensitivity ( p < @ ) .


Amoxicillin did not affect any of these parameters .


Oral administration of vancomycin significantly impacts host physiology by decreasing intestinal microbiota diversity , bile acid dehydroxylation and peripheral insulin sensitivity in subjects with metabolic syndrome .


These data show that intestinal microbiota , particularly of the Firmicutes phylum contributes to bile acid and glucose metabolism in humans .


This trial is registered at the Dutch Trial Register ( NTR@ ) .


To evaluate whether ondansetron or the combination of doxylamine and pyridoxine was superior for the treatment of nausea and vomiting of pregnancy .


This was a double-blind , randomized , controlled trial in which women with nausea and vomiting of pregnancy were assigned to @ mg of ondansetron plus a placebo tablet or @ mg pyridoxine plus @ mg of doxylamine for @ days .


The primary outcome was an improvement in nausea as reported on a @-mm visual analog scale ( VAS ) .


Secondary outcomes were a reduction in vomiting on the VAS and the proportion of patients reporting sedation or constipation while using either study regimen .


Thirty-six women ( @ in each group ) were randomized to either ondansetron or pyridoxine and doxylamine , of whom @ ( @ % ) and @ ( @ % ) completed follow-up , respectively .


There were no differences among the groups with regard to demographic characteristics or baseline nausea .


Patients randomized to ondansetron were more likely to have an improvement in their baseline nausea as compared with those using pyridoxine and doxylamine over the course of @ days of treatment ( median VAS score decreased @ mm -LSB- interquartile range @-@ -RSB- compared with @ mm -LSB- @-@ -RSB- ; P = @ ) .


Furthermore , women using ondansetron reported less vomiting ( median VAS decreased @ -LSB- interquartile range @-@ -RSB- compared with @ -LSB- -@ to @ -RSB- ; P = @ ) .


There was no significant difference between the groups regarding sedation or constipation .


Our investigation showed ondansetron to be superior to the combination of pyridoxine and doxylamine in the treatment of nausea and emesis in pregnancy .


Patients with diarrhoea during enteral nutrition ( EN ) have been shown to have low faecal bifidobacteria concentrations .


Oligofructose/inulin selectively stimulate the growth of bifidobacteria in healthy humans .


This study investigates the effect of additional oligofructose/inulin on the gastrointestinal microbiota , short-chain fatty acids ( SCFA ) and faecal output in patients receiving EN .


Adult patients in the intensive care unit ( ICU ) who were starting EN with a formula containing fibre were randomised to receive @g/d of additional oligofructose/inulin or an identically packaged placebo ( maltodextrin ) .


A fresh faecal sample was collected at baseline and following at least @ days of supplementation .


Faecal microbiota were analysed using fluorescent in-situ hybridisation and faecal output was monitored daily .


Twenty-two patients ( mean age @ years ) completed at least @ days of intervention ( mean @ days ) .


At the end of the intervention , there were no significant differences in the concentrations of bifidobacteria between the groups , after adjusting for baseline values ( oligofructose/inulin @ +@ , placebo @ +@ log@cells/g dry faeces , P > @ ) , but there were significantly lower concentrations of Faecalibacterium prausnitzii ( @ +@ vs. @ +@ log@cells/g , P = @ ) and Bacteroides-Prevotella ( @ +@ vs. @ +@ log@cells/g , P = @ ) in patients receiving additional oligofructose/inulin .


There were no differences in faecal concentrations of any SCFA , secretory IgA , daily faecal score or incidence of diarrhoea between the two groups .


Additional oligofructose/inulin did not increase faecal bifidobacteria in critically ill patients receiving EN , although it did result in lower concentrations of F.prausnitzii and Bacteroides-Prevotella .


This trial is registered at http://controlled-trials.com .


Identifier : ISRCTN@ .


To quantify the visual functional changes caused by pinhole glasses .


Healthy subjects underwent ophthalmic examinations including uncorrected distance visual acuity ( UDVA ) and corrected near visual acuity ( CNVA ) , pupil size , depth of focus ( DOF ) , accommodative amplitude , visual field ( VF ) test , contrast sensitivity ( CS ) , and stereopsis .


Subjects underwent the same examinations while wearing pinhole glasses @ week later .


Forty-eight eyes of @ subjects ( @ male and @ female ) with a mean age of @ years and a mean spherical equivalent of -@ diopters ( D ) were enrolled .


The pinhole glasses significantly improved UDVA and CNVA ( logMAR ) from @ and @ to @ and @ , respectively .


The pinhole glasses markedly enlarged pupils from @ mm photopic size to @ mm , very close to the mesopic size of @ mm .


Mean DOF and accommodative amplitude also significantly increased by approximately @ % , while VF featured a general reduction of sensitivity .


Mean deviation ( MD ) significantly decreased from -@ to -@ dB , and visual field index ( VFI ) decreased from @ % to @ % .


The CS decreased significantly at all four spatial frequencies , and stereopsis deteriorated with pinhole glasses .


The pinhole glasses improved visual acuity , DOF , and accommodative amplitude ; however , they resulted in decreased visual quality including general reduction of VF sensitivity , CS , and stereopsis .


Therefore , particular attention is needed when wearing pinhole glasses while driving , playing sports , or working with instruments .


( ClinicalTrials.gov number , NCT@ . )


We compared slow vs fast shock wave frequency rates in disintegration of pediatric renal stones less than @ mm .


Our study included @ children with solitary @ to @ mm radiopaque renal stones treated with shock wave lithotripsy .


Patients were prospectively randomized into @ groups , ie those undergoing lithotripsy at a rate of @ shock waves per minute ( group @ , @ patients ) and those undergoing lithotripsy at a rate of @ shock waves per minute ( group @ , @ patients ) .


The @ groups were compared in terms of treatment success , anesthesia time , secondary procedures and efficiency quotient .


Stone clearance rate was significantly higher in group @ ( @ % ) than in group @ ( @ % , p = @ ) .


A total of @ patients in group @ ( @ % ) were rendered stone-free after @ session , @ required @ sessions and @ needed @ sessions , while shock wave lithotripsy failed in @ patients .


By comparison , @ patients ( @ % ) in group @ were rendered stone-free after @ session , @ ( @ % ) required @ sessions and @ ( @ % ) needed @ sessions to become stone-free .


Mean general anesthesia time was significantly longer in group @ ( p = @ ) .


Postoperatively @ patients in group @ and @ in group @ suffered low grade fever ( Clavien grade II ) .


Significantly more secondary procedures ( percutaneous nephrolithotomy , repeat shock wave lithotripsy ) were required in group @ ( p = @ ) .


The predominant stone analysis was calcium oxalate dihydrate in both groups .


Efficiency quotient was @ and @ for group @ and group @ , respectively ( p = @ ) .


In children with renal stones slow delivery rates of shock wave lithotripsy have better results regarding stone clearance than fast delivery rates .


To assess time to first achievement of clinically significant visual acuity ( VA ) gains from baseline in patients with retinal vein occlusion ( RVO ) receiving ranibizumab versus sham treatment .


Post hoc analyses of @ phase @ clinical trials assessing efficacy and safety of ranibizumab in patients with branch RVO ( Ranibizumab for the Treatment of Macular Edema following Branch Retinal Vein Occlusion : Evaluation of Efficacy and Safety -LSB- BRAVO -RSB- study ; NCT@ ) and central RVO ( Ranibizumab for the Treatment of Macular Edema after Central Retinal Vein Occlusion Study : Evaluation of Efficacy and Safety -LSB- CRUISE -RSB- ; NCT@ ) over @ months .


Seven hundred eighty-nine patients ( BRAVO , n = @ ; CRUISE , n = @ ) .


Randomization to monthly intraocular ranibizumab injections ( @ mg/@ @ mg ) or sham .


After @ monthly injections ( treatment period ) , patients meeting prespecified criteria received as-needed ( pro re nata -LSB- PRN -RSB- ) ranibizumab at their assigned dose ( sham patients , ranibizumab @ mg ) through month @ ( observation period ) .


BRAVO patients meeting specific eligibility criteria could receive rescue laser treatment once during the treatment and once during the observation periods .


Time to first gain of @ letters or more from baseline , analyzed using Kaplan-Meier methods .


To evaluate the effect of delaying ranibizumab treatment , sham patients ' VA data also were analyzed , with month @ considered as baseline to assess vision gains during the @ months of receiving ranibizumab PRN .


Median time to first @-letter or more gain from baseline was @ ( sham ) , @ ( ranibizumab @ mg ) , and @ months ( ranibizumab @ mg ) in BRAVO and @ , @ , and @ months , respectively , in CRUISE .


The cumulative proportion of patients who had ever gained @ letters or more from baseline by month @ was @ % ( sham ) , @ % ( ranibizumab @ mg ) , and @ % ( ranibizumab @ mg ) in BRAVO and @ % , @ % , and @ % , respectively , in CRUISE .


After @ months of ranibizumab PRN treatment , a cumulative @ % ( BRAVO ) and @ % ( CRUISE ) of initially sham-treated patients ever gained @ letters or more .


This retrospective analysis shows that more than @ % of patients treated with monthly ranibizumab achieved clinically significant vision gains during the initial @ months of treatment , which largely were maintained using PRN treatment to @ months .


In comparison , less than @ % of patients initially randomized to sham ( and later receiving ranibizumab @ mg PRN treatment ) ever achieved clinically significant vision gains .


These results suggest that initiating treatment immediately after diagnosis may provide the greatest vision gains .


The potential benefits of early treatment should be evaluated further in prospective clinical studies .


Although some clinical reports suggest patient-specific instrumentation in TKA may improve alignment , reduce surgical time , and lower hospital costs , it is unknown whether it improves pain - and function-related outcomes and gait .


We hypothesized that TKA performed with patient-specific instrumentation would improve patient-reported outcomes measured by validated scoring tools and level gait as ascertained with three-dimensional ( @-D ) analysis compared with conventional instrumentation @ months after surgery .


We randomized @ patients into two groups using either patient-specific instrumentation or conventional instrumentation .


Patients were evaluated preoperatively and @ months after surgery .


Assessment tools included subjective functional outcome and quality-of-life ( QOL ) scores using validated questionnaires ( New Knee Society Score ( ) -LSB- KSS -RSB- , Knee Injury and Osteoarthritis Outcome Score -LSB- KOOS -RSB- , and SF-@ ) .


In addition , gait analysis was evaluated with a @-D system during level walking .


The study was powered a priori at @ % to detect a difference in walking speed of @ m/second , which was considered a clinically important difference , and in a post hoc analysis at @ % to detect a difference of @ points in KSS .


There were improvements from preoperatively to @ months postoperatively in functional scores , QOL , and knee kinematic and kinetic gait parameters during level walking .


However , there was no difference between the patient-specific instrumentation and conventional instrumentation groups in KSS , KOOS , SF-@ , or @-D gait parameters .


Our observations suggest that patient-specific instrumentation does not confer a substantial advantage in early functional or gait outcomes after TKA .


It is possible that differences may emerge , and this study does not allow one to predict any additional variances in the intermediate followup period from @ months to @ year postoperatively .


However , the goals of the study were to investigate the recovery period as early pain and functional outcomes are becoming increasingly important to patients and surgeons .


Level I , therapeutic study .


See the Instructions to Authors for a complete description of levels of evidence .


Inadequate bowel cleaning leads to a suboptimal colonoscopic examination .


Gum chewing has been reported to have a favorable effect on postoperative bowel functions .


We conducted this study to establish if gum chewing added to high-dose senna before colonoscopy promotes bowel cleaning .


In this randomized controlled study , consecutive outpatients scheduled for elective colonoscopy were randomized into two groups .


Group @ patients ( n = @ ) used senna solution @ mL ( @ mg senna ) the night before colonoscopy .


The patients also used sennoside tablet @ mg daily for @ days before the colonoscopy .


Patients in group @ ( n = @ ) were additionally advised to chew sugarless gum half an hour three-times daily after meals for these @ days .


The overall quality of colonoscopy cleaning was evaluated using the Aronchick scale by a single endoscopist who was blinded to the intervention .


Difficulty of procedure , patients ' tolerance , and adverse events were also evaluated .


A total @ patients were enrolled in the study .


Superior cleaning was found in gum chewing group when compared with other group particularly in the cecum and ascending colon .


Cecal intubation time was significantly shorter in the gum-chewing group ( @ @ and @ @ min , P = @ ) .


Adverse events were more common in group @ compared to the gum-chewing group .


Gum chewing enhances colonoscopy bowel preparation quality .


Moreover , it is a physiologically sound , safe , and an inexpensive part of the colonoscopy bowel preparation .


Gum chewing could be advised in addition to high-dose senna containing bowel preparation .


Individuals with borderline personality disorder ( BPD ) and comorbid post-traumatic stress disorder ( PTSD ) have a worse prognosis than individuals with BPD alone .


A common view is that the emotional instability and impulsivity of BPD should be treated before attempting to address trauma .


However , PTSD symptoms may interfere with patients ' ability to benefit from such ` stabilizing ' treatments .


The effect of BPD-PTSD comorbidity on self-harm and BPD symptom outcomes was evaluated in @ patients receiving dialectical behaviour therapy , using multilevel modelling .


Patients with comorbid BPD-PTSD showed a trend towards elevated BPD symptoms throughout the treatment year ( = @ , @ % CI = -@ -@ , p = @ ) .