There were no statistically significant differences in caries prevalence among the groups either at baseline or after @ years .


The caries increment for Group @ was @ ( meanSD ) , @ for Group @ , @ for Group @ and @ for Group @ , with no statically significant differences either between Bifluorid @ and Duraphat with the same frequency of F varnish applications or between the F groups and the control group .


In an area with low caries prevalence in Sweden , the supplementary caries-preventive effect of school-based F varnish applications , to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics , appears to be nonsignificant regarding approximal caries increment .


Dexmedetomidine and midazolam both modulate spinal analgesia by different mechanisms , and yet , no human studies are available to compare them for postoperative analgesia after neuraxial administration .


We investigated the addition of dexmedetomidine or midazolam to intrathecal bupivacaine on the duration of effective analgesia and clinical safety profile .


Prospective , randomized , double blind , placebo controlled study .


University teaching hospital .


The study cohort included a consecutive and prospective series of patients , referred for endourological procedures .


The patients were randomly allocated into @ groups ( @ patients each ) to receive intrathecally @ mL of @ % hyperbaric bupivacaine in combination with @ mcg of dexmedetomidine ( dexmedetomidine group ) , @ mg of midazolam ( midazolam group ) or @ mL of @ % saline ( control group ) .


The groups were compared to the regression time of sensory block , duration of effective analgesia ( defined as the time interval between administration of intrathecal drug to the time of first analgesic request or a numeric rating scale = @ ) , sedation score , and side effects in the first @ hours .


One way-ANOVA , Kruskal Wallis test , and Chi-square test ( ) , significance level : P < @ .


The duration of effective analgesia ( time to first analgesic request ) was significantly prolonged in the dexmedetomidine group ( @ @ minutes , P < @ ) when compared with midazolam group ( @ @ minutes ) and the control group ( @ @ minutes ) .


Pairwise comparisons among the @ groups with Bonferroni adjustment revealed that patients from the dexmedetomidine group were more sedated in comparison to the midazolam and control groups at the end of the first @ minutes after intrathecal injection -LSB- ( @ ) = @ , P = @ -RSB- , with a mean rank sedation score of @ for dexmedetomidine , @ for midazolam , and @ for control .


No significant differences in the side effects were observed during the study period .


Midazolam did not lengthen the time of the two segment sensory regression or the time to first request analgesia .


The study can not be extrapolated to muscle cutting surgeries under spinal anaesthesia .


The addition of dexmedetomidine ( @ mcg ) to @ mL of intrathecal hyperbaric bupivacaine ( @ % ) significantly prolongs the duration of effective analgesia in comparison to @ mg midazolam or placebo ( @ % normal saline ) with a comparable incidences of side effects .


Several studies have presented evidence suggesting that dairy consumption has beneficial effects on blood pressure ( BP ) in healthy subjects ; however , only a few studies have examined this possibility in patients with established essential hypertension using ambulatory blood pressure monitoring .


The objective of this study was to investigate how consuming dairy products impacts mean daytime systolic and diastolic BP in men and women with mild to moderate essential hypertension .


Eighty-nine men and women with systolic BP@mm Hg and@mm Hg and diastolic BP@mm Hg were enrolled in this single-blind , randomized , cross-over , controlled study .


Participants had to incorporate three daily servings of dairy products or control products equivalent in macronutrients and sodium during four-week treatment phases .


Twenty-four hour ambulatory BP and endothelial function were assessed at screening and at the end of each dietary phase .


The consumption of three daily servings of dairy products led to a significant reduction in mean daytime ambulatory systolic BP ( -@ mm Hg ; P = @ ) in men compared with readings after the control phase .


In women , dairy consumption had no effect on ambulatory systolic BP .


Moreover , endothelial function was significantly improved by dairy consumption in the whole cohort .


These data indicate that the consumption of three daily servings of dairy products have beneficial effects on daytime systolic ambulatory BP compared to a heart-healthy , dairy-free , diet in men with mild to moderate essential hypertension .


The Age-Related Eye Disease Study @ ( AREDS @ ) has shown that nutritional supplementation with antioxidants and zinc modifies the natural course of AMD .


It is presumed that the supplements exert their beneficial effects by ameliorating oxidative stress due to the scavenging of reactive oxygen species ( ROS ) .


We have shown in a human model that under oxidative stress induced by administration of lipopolysaccharide ( LPS ) the vasoconstrictor response of retinal vessels to oxygen breathing is diminished .


This reduced vascular response to hyperoxia was previously shown to be normalized by the AREDS @ supplements .


In the present study , we tested the hypothesis that the response can also be restored by a different antioxidant formulation .


This randomized , double-masked , placebo-controlled parallel group study included @ healthy volunteers .


On each study day , retinal red blood cell ( RBC ) flow and the reactivity of retinal RBC flow to hyperoxia were investigated in the absence and presence of @ ng/kg LPS .


Between the two study days , subjects received either the supplement or placebo for @ days .


Before supplementation LPS reduced retinal arterial vasoconstriction ( P < @ ) and reactivity of retinal RBC flow ( P = @ ) in response to @ % oxygen breathing .


Two weeks of supplementation did not affect baseline retinal RBC flow , but normalized the LPS-induced change in the response to hyperoxia .


The arterial vasoconstrictor response during LPS and @ % oxygen breathing was @ @ % after administration of placebo and @ @ % after supplementation ( P = @ ) .


The response of RBC flow to @ % oxygen breathing during LPS was @ @ % after administration of placebo and @ @ % after supplementation ( P = @ ) .


Our data show that the supplement used in the present study can normalize the response of retinal RBC flow to hyperoxia under LPS administration .


This indicates that supplementation can prevent endothelial dysfunction induced by oxidative stress , which is assumed to play a role in the pathophysiology of AMD .


( ClinicalTrials.gov number , NCT@ . )


The aim of this clinical study was to identify changes in pulpal blood flow ( PBF ) in human central incisors resulting from short - and long-term intrusive orthodontic forces from mini-implants .


A total of @ sound upper central and lateral incisors in @ patients scheduled for intrusion for orthodontic reasons were divided into two groups .


From each group , @ teeth were subjected to intrusive force from mini-implants ( Group @ = Light Force : @ g ; Group @ = Heavy Force : @ g ) , whereas the remaining @ contralateral teeth were not subjected to forces from mini-implants and served as controls .


Laser-Doppler flowmetry ( LDF ) measurements were recorded at baseline and at @ days and @ weeks following intrusion .


PBF decreased significantly at @ days ( Light Force Group : @ @ ; Heavy Force Group : @ @ ) and then increased towards baseline at @ weeks ( Light Force Group : @ @ ; Heavy Force Group : @ @ ) following intrusion .


In other words , despite slight regressive changes in pulpal tissue in the short-term , PBF improved after @ weeks following intrusion by mini-implants , indicating that the changes observed in PBF is reversible , even following radical incisor intrusion .


Depression during pregnancy has been demonstrated to be predictive of low birthweight , prematurity , and postpartum depression .


These adverse outcomes potentially have lasting effects on maternal and child well-being .


Socio-economically disadvantaged women are twice as likely as middle-class women to meet diagnostic criteria for antenatal major depression ( MDD ) , but have proven difficult to engage and retain in treatment .


Collaborative care treatment models for depression have not been evaluated for racially/ethnically diverse , pregnant women on Medicaid receiving care in a public health system .


This paper describes the design , methodology , culturally relevant enhancements , and implementation of a randomized controlled trial of depression care management compared to public health Maternity Support Services ( MSS ) .


Pregnant , public health patients , > @ years with a likely diagnosis of MDD or dysthymia , measured respectively by the Patient Health Questionnaire-@ ( PHQ-@ ) or the Mini-International Neuropsychiatric Interview ( MINI ) , were randomized to the intervention or to public health MSS .


The primary outcome was reduction in depression severity from baseline during pregnancy to @-months post-baseline ( one-year postpartum ) .


@ women with likely MDD ( @ % ) and/or dysthymia ( @ % ) were randomized .


Average age was @ years and gestational age was @ weeks ; @ % racial/ethnic minority ; @ % unmarried ; @ % no high school degree/GED ; @ % unemployed ; @ % making < $ @,@ annually ; @ % having recurrent depression ; @ % PTSD , and @ % unplanned pregnancy .


A collaborative care team , including a psychiatrist , psychologist , project manager , and @ social workers , met weekly , collaborated with the patients ' obstetrics providers , and monitored depression severity using an electronic tracking system .


Potential sustainability of the intervention within a public health system requires further study .


This pilot trial evaluated the feasibility and safety of an early discharge strategy ( EDS : @ h , followed by outpatient lifestyle interventions ) , in comparison with a conventional discharge strategy ( CDS ) for low-risk ( Zwolle risk score @ ) ST-elevation myocardial infarction ( STEMI ) patients treated with primary angioplasty .


One hundred patients were randomized to an EDS ( n = @ ) or a CDS ( n = @ ) .


The primary end point was the feasibility of the EDS : ( @ ) @ % of EDS patients discharged @ h , ( @ ) @ % visited by a nurse @ days after discharge , ( @ ) @ % with @ visits by the nurse and ( @ ) @ % visited by a cardiologist @ months .


The mean age was @ @ years and ejection fraction @ @ % .


Eighty-six percent were male ( @ % diabetics ) .


Vascular access was radial in @ % .


Ischemic time was @ h in @ % .


Length of stay was shorter in EDS as compared with CDS ( @ @ vs. @ @ h , p < @ ) .


EDS feasibility was : ( @ ) @ % ; ( @ ) @ % ; ( @ ) @ % ; ( @ ) @ % .


There were no adverse events or differences in intervention goals and quality of life between groups .


An EDS in low-risk STEMI patients is feasible and seems to be safe .


A shorter hospital stay could benefit patients and health care systems .


ICU-acquired weakness ( ICU-AW ) has immediate and long-term consequences for critically ill patients .


Strategies for the prevention of weakness include modification of known risk factors , such as hyperglycemia and immobility .


Intensive insulin therapy ( IIT ) has been proposed to prevent critical illness polyneuropathy .


However , the effect of insulin and early mobilization on clinically apparent weakness is not well known .


This is a secondary analysis of all patients with mechanical ventilation ( N = @ ) previously enrolled in a randomized controlled trial of early occupational and physical therapy vs conventional therapy , which evaluated the end point of functional independence .


Every patient had IIT and blinded muscle strength testing on hospital discharge to determine the incidence of clinically apparent weakness .


The effects of insulin dose and early mobilization on the incidence of ICU-AW were assessed .


On logistic regression analyses , early mobilization and increasing insulin dose prevented the incidence of ICU-AW ( OR , @ , P = @ ; OR , @ , P = @ ; respectively ) independent of known risk factors for weakness .


Early mobilization also significantly reduced insulin requirements to achieve similar glycemic goals as compared with control patients ( @ units/kg/d vs @ units/kg/d , P < @ ) .


The duel effect of early mobilization in reducing clinically relevant ICU-AW and promoting euglycemia suggests its potential usefulness as an alternative to IIT .


The prevalence of chronic diseases such as type @ diabetes and chronic low back pain is rising .


Patient empowerment is a key strategy in the management of chronic diseases .


Patient empowerment can be fostered by Web-based interactive health communication applications ( IHCAs ) that combine health information with decision support , social support , and/or behavioral change support .


Tailoring the content and tone of IHCAs to the needs of individual patients might improve their effectiveness .


The main objective was to test the effectiveness of a Web-based , tailored , fully automated IHCA for patients with type @ diabetes or chronic low back pain against a standard website with identical content without tailoring ( control condition ) on patients ' knowledge and empowerment .


We performed a blinded randomized trial with a parallel design .


In the intervention group , the content was delivered in dialogue form , tailored to relevant patient characteristics .


In the control group , the sections of the text were presented in a content tree without any tailoring .


Participants were recruited online and offline and were blinded to their group assignments .


Measurements were taken at baseline ( t@ ) , directly after the first visit ( t@ ) , and at @-month follow-up ( t@ ) .


The primary hypothesis was that the tailored IHCA would have larger effects on knowledge and patient empowerment ( primary outcomes ) than the control website .


The secondary outcomes were decisional conflict and preparation for decision making .


All measurements were conducted by online self-report questionnaires .


Intention-to-treat ( ITT ) and available cases ( AC ) analyses were performed for all outcomes .


A total of @ users agreed to participate in the study .


Of these , @ ( @ % ) had type @ diabetes and @ ( @ % ) had chronic low back pain .


Usage was significantly higher in the tailored system ( mean @ minutes ) than in the control system ( mean @ minutes ; P < @ ) .


Three months after system use , @ % of the sample was retained .


There was no significant intervention effect in the ITT analysis .


In the AC analysis , participants using the tailored system displayed significantly more knowledge at t@ ( P = @ ) and more emotional well-being ( subscale of empowerment ) at t@ ( P = @ ) .


The estimated mean difference between the groups was @ ( @ % CI @-@ @ ) points for knowledge and @ ( @ % CI @-@ @ ) points for emotional well-being on a @-@ points scale .


The primary analysis did not support the study hypothesis .


However , content tailoring and interactivity may increase knowledge and reduce health-related negative effects in persons who use IHCAs .


There were no main effects of the intervention on other dimensions of patient empowerment or decision-related outcomes .


This might be due to our tailored IHCA being , at its core , an educational intervention offering health information in a personalized , empathic fashion that merely additionally provides decision support .


Tailoring and interactivity may not make a difference with regard to these outcomes .


In this study , we tested the hypothesis that pulmonary artery venting would decrease the incidence of atrial fibrillation after coronary artery bypass surgery .


This prospective study included @ patients who underwent complete myocardial revascularization with cardiopulmonary bypass in our department during a @-year period .


The patients were randomly divided into @ groups : group I included @ patients who underwent aortic root venting and group II included @ patients who underwent pulmonary arterial venting for decompression of the left heart .


Pre - , peri - , and postoperative risk factors for atrial fibrillation were assessed in both groups .


The mean age was similar in the @ groups .


The mean number of anastomoses was significantly higher in group I ( @ @ ) than in group II ( @ @ ) ( P = @ ) .


The mean cross-clamp time was @ @ minutes in group I and @ @ minutes in group II ( P = @ ) .


The mean cardiopulmonary bypass time was @ @ minutes in group I and @ @ minutes in group II ( P = @ ) .


The incidence of atrial fibrillation was @ % ( n = @ ) in group I and @ % ( n = @ ) in group II ( P = @ ) .


Multivariate regression analysis showed that pulmonary artery venting decreased the postoperative incidence of atrial fibrillation by @ % .


Pulmonary arterial venting may be used as an alternative to aortic root venting during on-pump coronary bypass surgery , especially in patients at high risk of postoperative atrial fibrillation .


Biapenem is a newly developed carbapenem to treat moderate and severe bacterial infections .


This multicenter , randomized , parallel-controlled clinical trial was conducted to compare the clinical efficacy , bacterial eradication rates and safety of biapenem and meropenem in the treatment of bacterial lower respiratory tract infections and urinary tract infections ( UTIs ) at nine centres in China .


Patients diagnosed with bacterial lower respiratory tract infections or UTIs were randomly assigned to receive either biapenem ( @ mg every @ h ) or meropenem ( @ mg every @ h ) by intravenous infusion for @ to @ days according to their disease severity .


The overall clinical efficacy , bacterial eradication rates and drug-related adverse reactions of biapenem and meropenem were analyzed .


A total of @ enrolled cases were included in the intent-to-treat ( ITT ) analysis and safety analysis .


There were no differences in demographics and baseline medical characteristics between biapenem group and meropenem group .


The overall clinical efficacies of biapenem and meropenem were not significantly different , @ per cent ( @/@ ) vs. @ per cent ( @/@ ) .


The overall bacterial eradication rates of biapenem and meropenem showed no significant difference , @ per cent ( @/@ ) vs. @ per cent ( @/@ ) .


Drug-related adverse reactions were comparable in biapenem and meropenem groups with the incidence of @ per cent ( @/@ ) and @ per cent ( @/@ ) , respectively .


The most common symptoms of biapenem-related adverse reactions were rash ( @ % ) and gastrointestinal distress ( @ % ) .


Biapenem was non-inferior to meropenem and was well-tolerated in the treatment of moderate and severe lower respiratory tract infections and UTIs .


Early negative postoperative behavior ( e-PONB ) is common in children and manifests itself as emergence agitation ( EA ) , emergence delirium ( ED ) , and pain .


The objective of this prospective double blind , randomized , placebo-controlled trial was to determine whether IV clonidine or IV fentanyl prior to surgery modifies e-PONB in children .


Ninety children scheduled for subumbilical surgery under sevoflurane anesthesia supplemented with regional anesthesia were randomized to either receive IV clonidine @mcgkg ( -@ ) , IV fentanyl @mcgkg ( -@ ) or placebo ( IV saline ) before surgery .


Primary outcome measures were the incidence of EA , ED and pain during the first hour after awakening .


Secondary outcome measures were side effects such as nausea and vomiting and delayed discharge from PACU .


Eighty-seven children ( n = @ per group ) completed the study .


EA was present in @ children ( six clonidine , none fentanyl , and four placebo , P = @ ) whereas ED was observed in @ children ( nine clonidine , three fentanyl , and eight placebo P = @ ) .


Sixteen children who received placebo had a CHIPPS score of @ compared with nine children in fentanyl group and @ children receiving clonidine ( P = @ ) .


Ten children receiving fentanyl vomited during the first postoperative day , compared with six children in placebo group and none in clonidine group ( P = @ ) .


Discharge from PACU was not affected .


IV fentanyl before surgery but not IV clonidine modifies e-PONB in children undergoing lower abdominal surgery under general anesthesia supplemented with regional anesthesia .


The use of fentanyl in this population was also associated with reduced pain scores after awakening but with significantly greater incidence of PONV .


Although pain is a common complication of endoscopic submucosal dissection ( ESD ) , management strategies are inadequate .


The aim of this study was to evaluate the efficacy of topical bupivacaine and triamcinolone acetonide for abdominal pain relief and as a potential method of pain control after ESD for gastric neoplasia .


In this randomized , double-blind , placebo-controlled trial , @ eligible patients with early gastric neoplasm were randomized into one of three groups : bupivacaine ( BV ) only , bupivacaine with triamcinolone ( BV-TA ) , or placebo .


The present pain intensity ( PPI ) score and the Short-Form McGill Pain Questionnaire ( SF-MPQ ) were used to evaluate pain at @ , @ , @ , and @ h after ESD .


The mean values for the @-hour PPI in the BV-TA and BV groups were lower than those of the placebo group ( @ @ and @ @ vs. @ @ , p < @ ) .


The @-hour PPI of the BV-TA group ( @ @ ) was the lowest among the three groups ( p = @ ) .


The total @-hour SF-MPQ score , especially in the sensory domain , was higher in the placebo group than in BV and BV-TA groups .


The @-hour SF-MPQ score was the lowest in the BV-TA group .


Multivariate analysis demonstrated that BV-TA injection protocol , fibrosis , and size of residual ulcer were independently associated with the PPI score at @ h.


Bupivacaine after ESD was effective for pain relief at @ h postoperatively .


Particularly , topical infiltration of bupivacaine mixed with triamcinolone acetonide was helpful for producing a more long-lasting benefit of pain relief after gastric ESD .


Physical activity is a cornerstone in therapy for patients with metabolic syndrome .


Walking and hiking in a mountain scenery represents an ideal approach to make them move .


The Austrian Moderate Altitude Study ( AMAS ) @ main study is a randomized controlled trial to investigate the cardiovascular effects of hiking at moderate altitude on patients with metabolic syndrome compared with a control group at low altitude , to assess a potential altitude-specific effect .


Seventy-one male patients with metabolic syndrome were randomly assigned to a moderate altitude group ( at @ m ) , with @ participants , or to a low altitude group ( at @ m ) , with @ participants .


The @-week vacation program included @ hiking tours ( @ per week , average duration @ hours , intensity @ % to @ % of heart rate maximum ) .


Physical parameters , performance capacity , @-hour blood pressure , and heart rate profiles were obtained before , during , and after the stay .


In both groups , we found a significant mean weight loss of -@ kg ; changes in performance capacity were minor .


Systolic , diastolic , and mean arterial pressures and circadian heart rate profiles were significantly reduced in both groups , with no differences between them .


Consequently , the pressure-rate product was reduced as well .


All study participants tolerated the vacation well without any adverse events .


A @-week hiking vacation at moderate or low altitude is safe for patients with metabolic syndrome and provides several improvements in their cardiovascular parameters .


The cardiovascular benefits achieved are more likely to be the result of regular physical activity than the altitude-specific effect of a mountain environment .


Isolated limb perfusion ( ILP ) is a treatment option most commonly used in the treatment of melanoma in-transit metastases of the extremities .


The principle idea is to surgically isolate a region of the body and then deliver a high concentration of a chemotherapeutic agent together with hyperthermia .


There have been three randomised trials exploring whether adjuvant ILP to patients with recurrent or high-risk primary melanomas increases survival ; one of these trials has now been updated with a @-year follow-up .


The original study randomised @ patients ( between @ and @ ) with their first satellite or in-transit recurrence to either wide excision ( WE group , n = @ patients ) or to WE and adjuvant ILP ( WE+ILP group , n = @ patients ) .


Follow-up data @ years later concerning survival and cause of death was retrieved from the Swedish National Cause of Death Register .


In the WE+ILP group there were @ deaths ( @ % ) due to melanoma compared with @ deaths ( @ % ) in the WE group ( p = @ ) .


Median melanoma-specific survival was @ months for WE+ILP compared to @ months for the WE group , an almost @ year benefit without statistical significance ( p = @ ) .


There is no evidence that adjuvant ILP prolongs survival in patients with high-risk or recurrent melanoma ; however , the existing randomised trials are largely underpowered to detect such a difference .


New studies are exploring systemic immunological effects of ILP , and a combination of regional therapy and immunotherapy may serve as a rationale for new trials using ILP in the future .


Automated health behavior change interventions show promise , but suffer from high attrition and disuse .


The Internet abounds with thousands of personal narrative accounts of health behavior change that could not only provide useful information and motivation for others who are also trying to change , but an endless source of novel , entertaining stories that may keep participants more engaged than messages authored by interventionists .


Given a collection of relevant personal health behavior change stories gathered from the Internet , the aim of this study was to develop and evaluate an automated indexing algorithm that could select the best possible story to provide to a user to have the greatest possible impact on their attitudes toward changing a targeted health behavior , in this case weight loss .


An indexing algorithm was developed using features informed by theories from behavioral medicine together with text classification and machine learning techniques .


The algorithm was trained using a crowdsourced dataset , then evaluated in a @ between-subjects randomized pilot study .


One factor compared the effects of participants reading @ indexed stories vs @ randomly selected stories , whereas the second factor compared the medium used to tell the stories : text or animated conversational agent .


Outcome measures included changes in self-efficacy and decisional balance for weight loss before and after the stories were read .


Participants were recruited from a crowdsourcing website ( N = @ ; @ % , @/@ female ; mean age @ , SD @ years ; @ % , @/@ precontemplation ; @ % , @/@ contemplation for weight loss ) .


Participants who read indexed stories exhibited a significantly greater increase in self-efficacy for weight loss compared to the control group ( F@ ,@ = @ , P = @ ) .


There were no significant effects of indexing on change in decisional balance ( F@ ,@ = @ , P = @ ) and no significant effects of medium on change in self-efficacy ( F@ ,@ = @ , P = @ ) or decisional balance ( F@ ,@ = @ , P = @ ) .


Personal stories of health behavior change can be harvested from the Internet and used directly and automatically in interventions to affect participant attitudes , such as self-efficacy for changing behavior .


Such approaches have the potential to provide highly tailored interventions that maximize engagement and retention with minimal intervention development effort .


Many patients with asthma or chronic obstructive pulmonary disease ( COPD ) routinely receive a combination of an inhaled bronchodilator and anti-inflammatory glucocorticosteroid , but those with severe disease often respond poorly to these classes of drug .


We assessed the efficacy and safety of a novel inhaled dual phosphodiesterase @ ( PDE@ ) and PDE@ inhibitor , RPL@ for its ability to act as a bronchodilator and anti-inflammatory drug .


Between February , @ , and January , @ , we undertook four proof-of-concept clinical trials in the Netherlands , Italy , and the UK .


Nebulised RPL@ was examined in study @ for safety in @ healthy men who were randomly assigned ( @:@:@ ) to receive an inhaled dose of RPL@ ( @ mg/kg or @ mg/kg ) or placebo by a computer-generated randomisation table .


Subsequently , six non-smoking men with mild allergic asthma received single doses of RPL@ ( three received @ mg/kg and three received @ mg/kg ) in an open-label , adaptive study , and then ten men with mild allergic asthma were randomly assigned to receive placebo or RPL@ ( @ mg/kg ) by a computer-generated randomisation table for an assessment of safety , bronchodilation , and bronchoprotection .


Study @ examined the reproducibility of the bronchodilator response to a daily dose of nebulised RPL@ ( @ mg/kg ) for @ consecutive days in a single-blind ( patients masked ) , placebo-controlled study in @ men with clinically stable asthma .


The safety and bronchodilator effect of RPL@ ( @ mg/kg ) was assessed in study @ , an open-label , placebo-controlled crossover trial , in @ men with mild-to-moderate COPD .


In study @ , a placebo-controlled crossover trial , the effect of RPL@ ( @ mg/kg ) on lipopolysaccharide-induced inflammatory cell infiltration in induced sputum was investigated in @ healthy men .


In studies @ and @ , randomisation was done by computer-generated permutation with a block size of two for study @ and four for study @ .


Unless otherwise stated , participants and clinicians were masked to treatment assignment .


Analyses were by intention to treat .


All trials were registered with EudraCT , numbers @-@-@ , @-@-@ , @-@-@ , and @-@-@ .


Safety was a primary endpoint of studies @ and @ and a secondary endpoint of studies @ and @ .


Overall , RPL@ was well tolerated , and adverse events were generally mild and of equal frequency between placebo and active treatment groups .


Efficacy was a primary endpoint of study @ and a secondary endpoint of studies @ and @ .


Study @ measured change in forced expiratory volume in @ s ( FEV@ ) and provocative concentration of methacholine causing a @ % fall in FEV@ ( PC@MCh ) in participants with asthma .


RPL@ produced rapid bronchodilation in patients with asthma with an FEV@ increase at @ h of @ mL ( @ % CI @-@ ; p < @ ) , which was a @ % increase from placebo , and increased the PC@MCh by @ doubling doses ( @ % CI @-@ ; p = @ ) compared with placebo .


The primary endpoint of study @ was maximum FEV@ reached during @ h after dosing with RPL@ in patients with asthma .


RPL@ produced a similar maximum mean increase in FEV@ from placebo on day @ ( @ mL , @ % CI @-@ ) , day @ ( @ mL , @-@ ) , and day @ ( @ mL , @-@ ; overall p < @ ) .


A secondary endpoint of study @ ( patients with COPD ) was the increase from baseline in FEV@ .


RPL@ produced bronchodilation with a mean maximum FEV@ increase of @ % ( SE @ ) .


In healthy individuals ( study @ ) , the primary endpoint was percentage change in neutrophil counts in induced sputum @ h after lipopolysaccharide challenge .


RPL@ ( @ mg/kg ) did not significantly reduce the percentage of neutrophils in sputum ( @ % in the RPL@ group vs @ % in the placebo group ; difference -@ % , @ % CI -@ to @ , p = @ ) , since RPL@ significantly reduced neutrophils ( p = @ ) and total cells ( p = @ ) to a similar degree .


In four exploratory studies , inhaled RPL@ is an effective and well tolerated bronchodilator , bronchoprotector , and anti-inflammatory drug and further studies will establish the full potential of this new drug for the treatment of patients with COPD or asthma .


Intensified repetitive transcranial magnetic stimulation ( rTMS ) applied to the left dorsolateral prefrontal cortex ( DLPFC ) may result in fast clinical responses in treatment resistant depression ( TRD ) .


In these kinds of patients , subgenual anterior cingulate cortex ( sgACC ) functional connectivity ( FC ) seems to be consistently disturbed .


So far , no de novo data on the relationship between sgACC FC changes and clinical efficacy of accelerated rTMS were available .


Twenty unipolar TRD patients , all at least stage III treatment resistant , were recruited in a randomized sham-controlled crossover high-frequency ( HF ) - rTMS treatment study .


Resting-state ( rs ) functional MRI scans were collected at baseline and at the end of treatment .


HF-rTMS responders showed significantly stronger resting-state functional connectivity ( rsFC ) anti-correlation between the sgACC and parts of the left superior medial prefrontal cortex .


After successful treatment an inverted relative strength of the anti-correlations was observed in the perigenual prefrontal cortex ( pgPFC ) .


No effects on sgACC rsFC were observed in non-responders .


Strong rsFC anti-correlation between the sgACC and parts of the left prefrontal cortex could be indicative of a beneficial outcome .


Accelerated HF-rTMS treatment designs have the potential to acutely adjust deregulated sgACC neuronal networks in TRD patients .


Screening Tool of Older Person 's Prescriptions ( STOPP ) and the Screening Tool to Alert doctors to Right Treatment ( START ) have been increasingly used to evaluate potentially inappropriate prescriptions ( PIPs ) and potentially prescription omissions ( PPOs ) .


The impact of hospitalization on PIPs/PPOs has not been investigated in depth .


To compare the prevalence of PIPs/PPOs in elderly patients on hospital admission and discharge and to identify associated risk factors .


An acute medical geriatric division of the Tel Aviv Medical Center ( Israel ) .


This retrospective cross-sectional study included patients admitted from @/@ to @/@ aged @ years .


Data from patients ' records included demographic details , diagnoses and medications at admission and discharge .


STOPP/START criteria were applied to each patient 's record .


Prevalence of PIPs/PPOs on hospital admission and discharge .


Three hundred patients were included ( mean SD age @ @ years ) .


Admission PIPs prevalence was @ % ( @ patients , @ PIPs ) and it increased to @ % ( @ patients , @ PIPs ) at discharge ( P = @ ) .


Admission PPOs prevalence was @ % ( @ patients , @ PPOs ) and it decreased to @ % ( @ patients , @ PPOs ) at discharge ( P < @ ) .


Having at least one PIP/PPO at discharge but not at admission was associated with length of hospital stay ( OR @ , @ % CI @-@ @ ) .


History of falls increased the risk of being a `` new PIP patient '' ( OR @ , @ % CI @-@ @ ) , whereas diabetes increased the risk of being a `` new PPO patient '' ( OR @ , @ % CI @-@ @ ) .


Hospitalization in a geriatric division resulted in an increase in PIPs and a decrease in PPOs .


Strategies to reduce PIPs need to be implemented , especially for patients with longer hospital stay and a history of falls .


Tadalafil is a potent and selective phosphodiesterase type @ inhibitor that provides effective treatment for erectile dysfunction ( ED ) .


The purpose of this study was to explore the effect of a single on-demand dose of tadalafil compared to low-dose continuous administration on regional cerebral blood flow ( rCBF ) , in patients after stroke .


Thirty consecutive male patients ( mean age @ @ years ) with ED and a history of stroke were included in the study .


The baseline single-photon emission computed tomography ( SPECT ) study was performed @ min after iv injection of @ MBq Tc-@m-HMPAO ( Ceretec ; GE Healthcare Ltd. .


Chalfont St. Giles , UK ) .


Fifteen randomized patients received a single dose of @ mg tadalafil in the morning , and a second SPECT study was performed @ h later .


Fifteen other patients received @ mg of tadalafil each morning for seven consecutive days , and the second SPECT study was performed @ h after the last dose .


The imaging data were evaluated using SPM software ( Wellcome Department of Cognitive Neurology , University College , London ) .


Associations between any of the risk factors/comorbidities and the perfusion changes were not detected .


All patients showed areas of reduced relative rCBF in the affected hemisphere after tadalafil administration compared to baseline ( P < @ ) .


No significant difference was found between patients on @ mg tadalafil and @ mg dose .


Tadalafil administration after cerebral stroke may be associated with diminished blood flow to areas adjacent to the stroke .


The alterations in perfusion suggest a need for caution in prescribing tadalafil to patients with a history of stroke , especially with continuous administration that may impose constant stress on the cerebral circulation .


To investigate the short-term effect of a mixed Kinesio taping ( KT ) model on range of ankle motion ( ROAM ) , gait , pain , perimeter of lower limbs , and quality of life in postmenopausal women with chronic venous insufficiency ( CVI ) .


Double-blinded , randomized controlled trial .


Clinical setting .


Consecutive postmenopausal women ( N = @ ; mean age SD , @ y ) with mild CVI .


No participant withdrew because of adverse effects .


Participants were randomly assigned to either ( @ ) an experimental group to receive a mixed KT-compression treatment following KT recommendations for gastrocnemius muscle enhancement and functional correction of the ankle , and adding @ tapes to simulate traditional compression bandages ( no KT guidelines ) ; or ( @ ) a placebo control group for sham KT .


Both interventions were performed @ times a week during a @-week period .


ROAM , gait , pain , perimeter of right and left lower limb , and quality of life were assessed at baseline and @ hours posttreatment .


Quality of life was better in the intervention group by a mean of @ points ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) .


The experimental group also showed significant pre - / posttreatment improvements in both lower limbs in gait dorsiflexion ROAM ( @ % CI , @-@ @ ) , cadence ( @ % CI , @-@ @ ) , stride length ( @ % CI , @-@ @ ) , step length ( @ % CI , @-@ @ ) , stance phase ( @ % CI , @-@ ) , and foot ( @ % CI , @ -@ ) and malleolus ( @ % CI , @-@ @ ) circumference .


None of these variables were significantly modified in the placebo group .


Both groups reported a significant reduction in pain .


Ankle dorsiflexion during gait , walking parameters , peripheral edema , venous pain , and quality of life remain improved in patients with CVI at @ month after mixed KT-compression therapy .


KT may have a placebo effect on pain perception .


The authors compared psychoanalytic psychotherapy and cognitive-behavioral therapy ( CBT ) in the treatment of bulimia nervosa .


A randomized controlled trial was conducted in which @ patients with bulimia nervosa received either @ years of weekly psychoanalytic psychotherapy or @ sessions of CBT over @ months .


The main outcome measure was the Eating Disorder Examination interview , which was administered blind to treatment condition at baseline , after @ months , and after @ years .


The primary outcome analyses were conducted using logistic regression analysis .


Both treatments resulted in improvement , but a marked difference was observed between CBT and psychoanalytic psychotherapy .


After @ months , @ % of patients in CBT ( N = @ ) and @ % of patients in psychoanalytic psychotherapy ( N = @ ) had stopped binge eating and purging ( odds ratio = @ , @ % confidence interval -LSB- CI -RSB- = @-@ @ ; p < @ ) .


At @ years , @ % in the CBT group and @ % in the psychoanalytic psychotherapy group had stopped binge eating and purging ( odds ratio = @ , @ % CI = @-@ @ ; p = @ ) .


By the end of both treatments , substantial improvements in eating disorder features and general psychopathology were observed , but in general these changes took place more rapidly in CBT .


Despite the marked disparity in the number of treatment sessions and the duration of treatment , CBT was more effective in relieving binging and purging than psychoanalytic psychotherapy and was generally faster in alleviating eating disorder features and general psychopathology .


The findings indicate the need to develop and test a more structured and symptom-focused version of psychoanalytic psychotherapy for bulimia nervosa .


Tobacco smoking prevalence continues to be high , particularly among adolescents and young adults with lower educational levels , and is therefore a serious public health problem .


Tobacco smoking and problem drinking often co-occur and relapses after successful smoking cessation are often associated with alcohol use .


This study aims at testing the efficacy of an integrated smoking cessation and alcohol intervention by comparing it to a smoking cessation only intervention for young people , delivered via the Internet and mobile phone .


A two-arm cluster-randomised controlled trial with one follow-up assessment after @months will be conducted .


Participants in the integrated intervention group will : ( @ ) receive individually tailored web-based feedback on their drinking behaviour based on age and gender norms , ( @ ) receive individually tailored mobile phone text messages to promote drinking within low-risk limits over a @-month period , ( @ ) receive individually tailored mobile phone text messages to support smoking cessation for @months , and ( @ ) be offered the option of registering for a more intensive program that provides strategies for smoking cessation centred around a self-defined quit date .


Participants in the smoking cessation only intervention group will only receive components ( @ ) and ( @ ) .


Study participants will be @ students who smoke tobacco daily/occasionally , from vocational schools in Switzerland .


Main outcome criteria are @-day point prevalence smoking abstinence and cigarette consumption assessed at the @-month follow up .


This is the first study testing a fully automated intervention for smoking cessation that simultaneously addresses alcohol use and interrelations between tobacco and alcohol use .


The integrated intervention can be easily implemented in various settings and could be used with large groups of young people in a cost-effective way .


To investigate the effect of intranasal ketamine versus alfentanil in addition to oral midazolam for the prevention of emergence agitation in children .


Children undergoing urological surgery with sevoflurane anaesthesia received oral midazolam @ min before induction and were then randomly assigned to receive @ mg/kg ketamine , @ g/kg alfentanil or @ ml isotonic saline intranasally .


Parental separation status and mask acceptance were assessed preoperatively .


Emergence agitation was evaluated using a paediatric anaesthesia emergence delirium ( PAED ) score .


Data from @ children were evaluated in the study .


There were no significant differences between the groups in demographic characteristics , recovery times or parental separation scores .


Mask acceptance was significantly better in the ketamine group than in the saline group .


The mean PAED score in the ketamine group was significantly better than in the other two groups , but was similar in the saline and alfentanil groups .


The incidence of emergence agitation was @ % , @ % and @ % in the ketamine , alfentanil and saline groups , respectively .


The addition of intranasal ketamine to oral midazolam significantly improved the quality of induction and reduced sevoflurane-induced emergence agitation , in children undergoing urological surgery .


The aim of this study was to examine the effect of chitosan membrane on wound healing .


The effect of chitosan membranes was evaluated in an experimental rat model .


On day @ , circular full-thickness skin sections were excised from the scalps of rats .


The wounds were then measured and the surrounding area tattooed .


Rats were sacrificed either immediately after excision , or randomised into control and chitosan groups and followed up on day @ , @ , @ or @ .


Control group wounds were covered with Aquacel ( wound dressing ) .


Chitosan group wounds were covered with chitosan membranes and the wound dressing .


Wounds and the distances between the tattooed marks were measured on follow-up , the wound sites were harvested and histologically examined , and serum interleukin ( IL-@ ) levels were analysed .


A total of @ rats were examined and all time points included @ control and @ chitosan treated animals , except for day @ which consisted of control animals only .


On day @ , wounds in the chitosan group were significantly ( p < @ ) smaller ( @ % versus @ % of the original wound area ) than in the control group .


Chitosan membranes were found to degrade at the wound sites between days @ and @ .


Leukocyte counts were lower in the chitosan group than in the control group on day seven ( p < @ ) .


IL-@ levels were significantly higher on day @ ( p < @ ) and @ ( p < @ ) in the chitosan group .


According to our results chitosan membrane may promote early wound healing , reduce inflammation and affect the IL-@ pathway , however , the membrane degrades at the wound site after day @ .


The treatment of symptomatic congenital cytomegalovirus ( CMV ) disease with intravenous ganciclovir for @ weeks has been shown to improve audiologic outcomes at @ months , but the benefits wane over time .


We conducted a randomized , placebo-controlled trial of valganciclovir therapy in neonates with symptomatic congenital CMV disease , comparing @ months of therapy with @ weeks of therapy .


The primary end point was the change in hearing in the better ear ( `` best-ear '' hearing ) from baseline to @ months .


Secondary end points included the change in hearing from baseline to follow-up at @ and @ months and neurodevelopmental outcomes , with each end point adjusted for central nervous system involvement at baseline .


A total of @ neonates underwent randomization , of whom @ had follow-up data at @ months that could be evaluated .


Best-ear hearing at @ months was similar in the @-month group and the @-week group ( @ and @ participants , respectively , had improvement ; @ and @ had no change ; and @ and @ had worsening ; P = @ ) .


Total-ear hearing ( hearing in one or both ears that could be evaluated ) was more likely to be improved or to remain normal at @ months in the @-month group than in the @-week group ( @ % vs. @ % , P = @ ) .


The benefit in total-ear hearing was maintained at @ months ( @ % vs. @ % , P = @ ) .


At @ months , the @-month group , as compared with the @-week group , had better neurodevelopmental scores on the Bayley Scales of Infant and Toddler Development , third edition , on the language-composite component ( P = @ ) and on the receptive-communication scale ( P = @ ) .


Grade @ or @ neutropenia occurred in @ % of the participants during the first @ weeks .


During the next @ months of the study , grade @ or @ neutropenia occurred in @ % of the participants in the @-month group and in @ % of those in the @-week group ( P = @ ) .


Treating symptomatic congenital CMV disease with valganciclovir for @ months , as compared with @ weeks , did not improve hearing in the short term but appeared to improve hearing and developmental outcomes modestly in the longer term .


( Funded by the National Institute of Allergy and Infectious Diseases ; ClinicalTrials.gov number , NCT@ . )


To compare the incidence and severity of emergence agitation , recovery profile , and adverse events between desflurane and sevoflurane anesthesia in unpremedicated pediatric ambulatory urologic surgery patients .


The study was conducted among @ healthy children , aged six months to nine years , and randomized to two groups , sevoflurane and desflurane , during maintenance anesthesia with laryngeal mask airway .


Recovery profile and perioperative adverse events were recorded .


The emergence agitation ( EA ) was assessed using a @-point scale by an anesthetist nurse in the recovery room who was blinded to the treatment .


The incidences of EA between sevoflurane/desflurane were not significantly different at @ % / @ % , p = @ , and neither was the median ( IQR ) of severity ( @ ( @ , @ ) / @ ( @ , @ ) , p = @ ) .


The awakening time in the desflurane group was @ + / - @ minutes , faster than in the sevoflurane group of @ + / - @ minutes ( p < @ ) .


The number of children having intraoperative respiratory events was significantly higher in the desflurane group ( @ ) , compared to the sevoflurane group ( @ ) ( p = @ ) .


The occurrence of EA and adverse events between sevoflurane and desflurane were not different , except that the overall of intraoperative respiratory events was higher in desflurane group .


Previous research suggests that African American smokers may have improved outcomes if interventions are culturally specific .


However , few interventions sufficiently address the unique needs of this population in a format with large reach potential .


The purpose of this study was to test the efficacy of a newly developed digital video disc ( DVD ) - based cessation intervention targeting African Americans .


In a @-arm randomized trial , smokers ( N = @ ) were randomly assigned to view either the new Pathways to Freedom ( PTF ) DVD or a standard control DVD .


Participants were assessed at baseline , immediately postviewing the DVD , and at a @-month follow-up .


The primary outcomes were feasibility and process variables , including intervention evaluations , readiness to quit , and risk perceptions , and smoking-related behavior changes were examined as secondary outcomes .


Findings demonstrated the hypothesized positive effects of the PTF DVD compared with the control DVD on content evaluations , risk perceptions , and readiness to quit at follow-up .


We found initial evidence for the efficacy of the PTF DVD as a stand-alone intervention .


Future research will test the efficacy of the DVD for smoking cessation in a larger randomized trial .


The ultimate goal of this research is to validate a new intervention for an underserved community of smokers that can be used in multiple settings , such as community health clinics , primary care , quitlines , cessation clinics , and seminars/workshops .


The aim of this multicenter study was to determine the normal ranges and the clinical relevance of multidirectional systolic parameters to evaluate global left ventricular ( LV ) systolic function .


Three hundred twenty-three healthy adult subjects prospectively included at @ centers and a cohort of @ patients with hypertension were analyzed .


Multidirectional global LV systolic function was analyzed using two-dimensional speckle-tracking echocardiography by means of two indices : longitudinal-circumferential systolic index ( the average of longitudinal and circumferential global systolic strain ) and global systolic index ( the average of longitudinal , circumferential , and radial global systolic strain ) .


The ranges of values of the multidirectional systolic parameters in healthy subjects were -@ @ % for longitudinal-circumferential systolic index and @ @ % for global systolic index .


In addition , the lowest expected values of these multidirectional indices were determined in this population ( calculated as -@ SDs from the mean ) : -@ % for longitudinal-circumferential systolic index and @ % for global systolic index .


Concerning the clinical relevance of these measurements , these indices indicated the presence of subtle LV global systolic dysfunction in patients with hypertension , even though LV global longitudinal systolic strain and LV ejection fraction were normal .


Moreover , in these patients , functional class ( dyspnea -LSB- New York Heart Association classification -RSB- ) was inversely related to both the longitudinal-circumferential index and the global systolic index .


In the present multicenter study analyzing a large cohort of healthy subjects and patients with hypertension , the normal range and the clinical relevance of multidirectional systolic parameters to evaluate global LV systolic function have been determined .


Curcumin revealed various health-beneficial properties in numerous studies .


However its bioavailability is low due to its limited intestinal uptake and rapid metabolism .


The aim of our project was to develop novel curcumin formulations with improved oral bioavailability and to study their safety as well as potential sex-differences .


In this crossover study , healthy subjects ( @ women , @ men ) took , in random order , a single oral dose of @ mg curcuminoids as native powder , micronized powder , or liquid micelles .


Blood and urine samples were collected for @ h and total curcuminoids and safety parameters were quantified .


Based on the area under the plasma concentration-time curve ( AUC ) , the micronized curcumin was @ - , @ - , and @-fold and micellar curcumin @ - , @ - , and @-fold better bioavailable than native curcumin in women , men , and all subjects , respectively .


Thus , women absorbed curcumin more efficiently than men .


All safety parameters remained within the reference ranges following the consumption of all formulations .


Both , the micronized powder and in particular the liquid micellar formulation of curcumin significantly improved its oral bioavailability without altering safety parameters and may thus be ideally suited to deliver curcumin in human intervention trials .


The observed sex differences in curcumin absorption warrant further investigation .


Late adolescence represents a developmental risk period when many youth become involved in multiple forms of high-risk behaviors with adverse consequences .


This study assessed the degree to which two such behaviors , adolescent sexual behaviors and gambling , were associated in a community-based sample with a large African-American presence .


Data are derived from a cohort study .


This study focuses on @ African-American participants with complete information on gambling and sexual behaviors by age @ ( @ % of original cohort ) .


Gambling involvement and related problems were based on responses to the South Oaks Gambling Screen - Revised for Adolescents .


Several questions assessed sexual behaviors , including age of initiation .


Multivariable logistic regression models adjusted for demographics , intervention status , impulsivity , depressive and anxiety symptoms , and alcohol and illegal drug use .


Almost half of the sample ( @ % , n = @ ) had gambled at least once before age @ .


More gamblers than non-gamblers had initiated sexual intercourse by age @ ( aOR : @ -LSB- @ , @ -RSB- ) .


Among those who had initiated sexual activity , more gamblers than non-gamblers with high impulsivity levels at age @ ( vs. low impulsivity levels ) had become pregnant or had impregnated someone .


Among those who had initiated sexual activity by age @ , more male gamblers had impregnated someone by age @ as compared to female gamblers becoming pregnant .


Gambling and sexual behaviors often co-occur among adolescents .


Such findings prompt the need for the inclusion of gambling , an often overlooked risky behavior , in behavioral prevention/intervention programs targeting adolescents .


Laparoscopic and robotic sacrocolpopexy are widely used for pelvic organ prolapse ( POP ) treatment .


Evidence comparing outcomes and costs is lacking .


We compared costs and clinically relevant outcomes in women randomized to laparoscopic sacrocolpopexy compared with robotic sacrocolpopexy .


Participants with symptomatic stage POP II or greater , including significant apical support loss , were randomized to either laparoscopic or robotic sacrocolpopexy .


We compared surgical costs ( including costs for robot , initial hospitalization ) and rehospitalization within @ weeks .


Secondary outcomes included postoperative pain , POP quantification , symptom severity and quality of life , and adverse events .


We randomized @ women ( mean age @ years ) : laparoscopic ( n = @ ) and robotic ( n = @ ) .


The robotic sacrocolpopexy group had higher initial hospital costs ( $ @,@ compared with $ @,@ , P < @ ) and over @ weeks , hospital costs remained higher for robotic sacrocolpopexy ( $ @,@ compared with $ @,@ , P < @ ) .


When we excluded costs of robot purchase and maintenance , we did not detect a statistical difference in initial day of surgery costs of robotic compared with laparoscopic ( $ @,@ compared with $ @,@ ; P = @ ) or hospital costs over @ weeks ( $ @,@ compared with $ @,@ ; P = @ ) .


The robotic group had longer operating room times ( @ minutes compared with @ minutes , P = @ ) and higher pain scores @ week after surgery ( @ compared with @ ; P = @ ) .


There were no group differences in symptom bother by Pelvic Floor Distress Inventory , POP stage , or rate of adverse events .


Costs of robotic sacrocolpopexy are higher than laparoscopic , whereas short-term outcomes and complications are similar .


Primary cost differences resulted from robot maintenance and purchase costs .


Proton pump inhibitor ( PPI ) increases the risk of decrease in bone mineral density ( BMD ) .


However , whether calcitrol improves this situation is unknown .


The current study investigates the effects of calcitriol on BMD in patients with esomeprazole therapy .


Three hundred and eighty-six participants with gastrointestinal ulcerations were enrolled and randomly assigned into controlled and supplemented groups .


Participants in the controlled group were prescribed esomeprazole ( @mg/qd ) , while the supplemented group was prescribed esomeprazole ( @mg/qd ) and calcitriol ( @ g/qd ) .


BMD , serum levels of calcium , carboxy-terminal collagen crosslinks ( CTX ) , and alkaline-phosphatase ( ALP ) were assessed .


( @ ) No significant between-group difference of age , gender , smoking , previous glucocorticoid use and hemoglobin level was found ; ( @ ) after @ d of PPI therapy , BMD T score in the controlled group was slightly increased compared with initial ( -@ versus -@ , p = @ ) , while there was no change in the supplemented group ( -@ versus -@ , p = @ ) ; ( @ ) during study termination , calcium level in the supplemented group was slightly higher than the controlled group ( @ mmol/L versus @ mmol/L , p = @ ) , while no significant differences of CTX ( @ pg/mL versus @ pg/mL , p = @ ) and ALP were found among these two groups ( @ U/L versus @ U/L , p = @ ) .


Patients with gastrointestinal ulcerations with esomeprazole therapy , calcitriol supplement showed no efficacy on BMD changes .


Polycystic ovary syndrome ( PCOS ) is the most common endocrine cause of menstrual irregularities , hirsutism and acne .


Women with PCOS present elevated plasma insulin levels , both fasting and after a glucose load , as an indirect evidence of insulin resistance .


PCOS women may also present hypertension , low levels of HDL cholesterol , hypertriglyceridemia , visceral obesity and a higher level of CRP and fibrinogen that can predict an atherosclerotic risk .


This study was carried out on @ young women with PCOS selected according to the @ diagnostic criteria of The Rotterdam Consensus Statement and @ Control women .


PCOS women were treated with pioglitazone @ mg/day and at the beginning and after @ months of treatment were evaluated : menstrual cycle trend , hirsutism and acne , total cholesterolemia and HDL , triglyceridemia , fibrinogenemia , C-reactive protein , oral glucose tolerance test , glycated hemoglobin , FSH , LH , @OH-progesterone , @-estradiol , free and total testosterone , SHBG , DHEA-S , @-androstenedione and adiponectin .


Treatment with pioglitazone improves the irregularities of menses and hirsutism .


Six months of treatment modify other parameters linked with a higher risk of type @ diabetes mellitus and cardiovascular diseases : adiponectin increased with reduction of insulin resistance while fibrinogen and CRP levels decreased .


To determine the efficacy in reducing dentin hypersensitivity ( DHS ) of a combined in-office and home-use desensitizing system , each product containing @ % arginine and calcium carbonate ( Test ) , following a dental scaling procedure , compared to the combination of a conventional prophylactic paste and a potassium nitrate dentifrice ( Control ) , in a group of patients with known dentin hypersensitivity .


An @-week clinical study , with @ subjects , was conducted in Piracicaba , So Paulo , Brazil , using a double-blind/two treatment design .


Air blast sensitivity assessments were used to compare the efficacy of the two approaches using both the Schiff scale as well as a Visual Analogue Scale ( VAS ) .


Immediately after prophylaxis , the Test treatment provided significant reduction in DHS when compared to baseline values ( VAS = @ % and Schiff = @ % ) , while for Control treatment this difference was not statistically significant ( VAS = @ % and Schiff = @ % ) .


The comparison between groups after prophylaxis showed a greater DHS reduction for the Test treatment ( P < @ ) .


The reductions in DHS after @ , @ and @ weeks were significant for both groups , however , when considering Schiff scale , the Test treatment provided greater DHS reduction after @ weeks ( @ % for Test versus @ % for Control ) and @ weeks ( @ % for Test and @ % for Control ) , while after @ weeks there was no significant difference between groups ( @ % for Test versus @ % for Control ) .


To compare vision quality following phacoemulsification cataract extraction and implantation of a Big Bag or Akreos Adapt intraocular lens ( IOL ) in patients diagnosed with high myopia complicated with cataract .


This was a randomized prospective control study .


The patients with high myopia .


complicated with cataract , with axial length @ mm , and corneal astigmatism @D were enrolled and randomly divided into the Big Bag and Akreos Adapt IOL groups .


All patients underwent phacoemulsification cataract extraction and lens implantation .


At @ months after surgery , intraocular high-order aberration was measured by a Tracey-iTrace wavefront aberrometer at a pupil diameter of @ mm in an absolutely dark room and statistically compared between two groups .


The images of the anterior segment of eyes were photographed with a Scheimpflug camera using Penta-cam three-dimensional anterior segment analyzer .


The tilt and decentration of the IOL were calculated by Image-pro plus @ imaging analysis software and statistically compared between two groups .


In total , @ patients ( @ eyes ) , including @ males and @ females , were enrolled in this study .


The total high-order aberration and coma in the Akreos Adapt group ( @ eyes ) were significantly higher compared with those in the Big Bag ( P < @ ) .


The clover and spherical aberration did not differ between the two groups ( P > @ ) .


The horizontal and vertical decentration were significantly smaller in the Big Bag lens group than in the Akreos Adapt group ( both P < @ ) , whereas the tilt of IOL did not significantly differ between the two groups ( P > @ ) .


Both Big Bag and Akreos Adapt IOLs possess relatively good intraocular stability implanted in patients with high myopia .


Compared with the Akreos Adapt IOL , the Big Bag IOL presents with smaller intraocular high-order aberration .


Coma is the major difference between the two groups .


We hypothesized that the combination of bevacizumab , carboplatin , and pemetrexed will be an effective first-line regimen in fit , elderly patients with nonsquamous non-small-cell lung cancer .


Treatment-nave , stage IIIB/IV nonsquamous non-small-cell lung cancer patients more than @ years old with good performance status ( Eastern Cooperative Oncology Group performance status @-@ ) and adequate organ function were eligible .


Carboplatin area under the curve @ , pemetrexed @ mg/m , and bevacizumab @ mg/kg were administered on day @ of each @-day cycle ( up to six cycles ) followed by maintenance pemetrexed and bevacizumab .


The primary end point of @-month progression-free survival rate of at least @ % was assessed using a one-stage binomial design .


Quality of life ( QOL ) questionnaires were administered .


Polymorphisms in genes encoding relevant proteins ( drug targets , transport , and metabolism proteins ) were correlated with treatment outcome .


Fifty-seven eligible patients were enrolled .


Median age was @ years .


Median treatment cycles received was @ .


The most common grade @ or higher non-hematologic adverse events were fatigue ( @ % ) and hypertension ( @ % ) ; @ % had grade @ neutropenia and @ % had grade @ thrombocytopenia .


Three patients experienced grade @/@ hemorrhagic events ( one pulmonary , two gastrointestinal ) .


Primary end point of PFS@ was @ % ( @ % confidence interval -LSB- CI -RSB- : @-@ % ) .


Median PFS was @ months ( @ % CI : @-@ @ ) , median overall survival was @ months ( @ % CI : @-@ @ ) .


Polymorphic KDR and VEGFA variants correlated with survival and toxicity , respectively .


There was no significant change in overall QOL scores over time .


This regimen is feasible and did not decrease the QOL in this study population .


However , it did not meet the primary efficacy end point .


The aim of this study was to evaluate patient satisfaction and cost in spinal and general anesthesia for lumbar disc surgery .


The study was performed on @ ASA class I-II patients with one level lumbar disc herniation ( LDH ) .


In this prospective study , patients were assigned randomly to either spinal anesthesia or general anesthesia groups .


Hemodynamic variables , intraoperative opioid requirements , postoperative pain scores and analgesic requirements and complications were recorded .


Patients were handed a questionnaire about the procedure they underwent to determine patient satisfaction .


The costs of preoperative and postoperative anesthesia procedures , medications , and hospitalization were calculated individually .


Spinal anesthesia and general anesthesia were similar concerning hemodynamic stability , first urination time , first mobilization time , postoperative analgesic requirement , and pain .


Patients in group S needed less additional dose of fentanyl intraoperatively than the patients in group G. Patient satisfaction was significantly higher in Group S when compared to Group G. Total cost was higher in Group G compared to Group S.


We conclude that successful LDH surgery can be performed using either anesthesia type .


As long as patients are selected carefully , spinal anesthesia is a safe , comfortable , and a more economical alternative .


This study aims to determine the difference between transcervical resection of septum ( TCRS ) and transcervical incision of septum ( TCIS ) in the improvement of reproductive prognosis .


Women with uterine septum in the Affiliated Hospital of Ningxia Medical University were retrospectively analyzed .


A statistical method was used according to operative time , postoperative menstruation , postoperative pregnancy rate , postoperative term delivery rate , and so on .


Compared with TCRS , the TCIS method decreased operative time , blood loss , and consumption of uterus distension medium .


No statistical difference was observed in operative complications between the two methods .


After TCIS , the incidence of uterine adhesion was low and the degree of endometrial epithelialisation was high by hysteroscopy review .


No statistical difference was observed in residual septum after the operation .


The total pregnancy rate after TCIS was higher than that of TCRS .


However , no statistical difference was observed in early and late pregnancy loss rates , preterm birth rate , and term birth rate .


TCIS exhibits advantages of decreasing operative time , blood loss , and consumption of uterus distension medium .


TCIS can reduce the incidence of uterine adhesion and can promote endometrial epithelialisation , which are the key factors to increase pregnancy rate after operation .


Major depressive disorder has been linked with inflammatory processes , but it is unclear whether individual differences in levels of inflammatory biomarkers could help match patients to treatments that are most likely to be beneficial .


The authors tested the hypothesis that C-reactive protein ( CRP ) , a commonly available marker of systemic inflammation , predicts differential response to escitalopram ( a serotonin reuptake inhibitor ) and nortriptyline ( a norepinephrine reuptake inhibitor ) .


The hypothesis was tested in the Genome-Based Therapeutic Drugs for Depression ( GENDEP ) study , a multicenter open-label randomized clinical trial .


CRP was measured with a high-sensitivity method in serum samples from @ adult men and women with major depressive disorder randomly allocated to @-week treatment with escitalopram ( N = @ ) or nortriptyline ( N = @ ) .


The primary outcome measure was the score on the Montgomery-sberg Depression Rating Scale ( MADRS ) , administered weekly .


CRP level at baseline differentially predicted treatment outcome with the two antidepressants ( CRP-drug interaction : = @ , @ % CI = @ , @ ) .


For patients with low levels of CRP ( < @ mg/L ) , improvement on the MADRS score was @ points higher with escitalopram than with nortriptyline .


For patients with higher CRP levels , improvement on the MADRS score was @ points higher with nortriptyline than with escitalopram .


CRP and its interaction with medication explained more than @ % of individual-level variance in treatment outcome .


An easily accessible peripheral blood biomarker may contribute to improvement in outcomes of major depressive disorder by personalizing treatment choice .


Chronic tension-type headache ( CTTH ) is a chronic syndrome characterized by frequent headache occurring more than @ days per month .


The intensity and duration of headache pain can be very distressing and disabling on an individuals ' well-being .


The purpose of this study was to examine the applicability of sauna bathing as a new method of treatment for reducing pain in patients with CTTH .


Thirty-seven people who fulfilled the International Headache Society criteria for CTTH were randomly assigned into two groups .


The control group ( n = @ ) received advice and education while the intervention group ( n = @ ) received the same advice and attended a sauna regularly for @ weeks .


Reductions in subjective pain were determined using the numerical pain rating scale ( NPRS ) .


Disturbance in sleep , depression as assessed by Beckman Disability Index ( BDI ) , and Headache Disability Index ( HDI ) were measured .


Mean change in headache intensity significantly differed between the sauna and control group by @ ( @ % confidence interval , @-@ @ ; F = @ ; df = @ , @ ; p = @ ) .


There was no statistically significant change in duration of headache or improvement in sleep , depression , or HDI between the sauna and control groups .


Regular sauna bathing is a simple , self-directed treatment that is effective for reducing headache pain intensity in CTTH .


Alpha adrenergic drugs are usually used in the treatment of erectile and ejaculatory dysfunction in humans .


The influence of such drugs on the seminal characteristics of wild animals has not been verified ; whereas their impact on the seminal characteristics and erectile and ejaculatory functions of collared peccaries ( Tayassu tajacu ) has already been determined .


This study aimed at investigating and comparing the effects of medetomidine and atipamezole on the seminal variables of collared peccaries undergoing electroejaculation as well as at determining whether these drugs affected the erectile and ejaculatory functions of this species .


A statistically significant difference in sperm concentration was observed between AP ( @ @ @ sperm/ml ) and MP ( @ @ @ sperm/ml ) ; however , both these treatments did not differ from P treatment ( @ @ @ sperm/ml ) .


No statistically significant difference was observed among all treatments with regard to erectile function .


With regard to ejaculation time , no significant difference was observed between the MP and AP treatments ; however , when compared with the P treatment , AP exhibited a significantly higher difference .


When collared peccaries were anesthetized with propofol , neither medetomidine nor atipamezole significantly affected the characteristics of the semen or the erectile function , despite the fact that the AP treatment increased ejaculation time .


Therefore , the data indicate that using propofol alone is an effective anesthetic protocol for collecting semen in collared peccaries .


Other non-injectable anesthetic drugs , such as inhaled anesthetics , may be used in future research to collect semen from peccaries .


The currently proven time window for thrombolysis in ischemic stroke is @ h. Beyond this , the risks and benefits of thrombolysis are uncertain .


To determine whether thrombolysis and reperfusion were beneficial after @ h , we examined clinical and radiological outcomes in patients treated with tissue plasminogen activator or placebo within @-@h , using data from the Echoplanar Imaging Thrombolytic Evaluation Trial .


In the Echoplanar Imaging Thrombolytic Evaluation Trial , ischemic stroke patients presenting three to six-hours after stroke onset were randomized to tissue plasminogen activator or placebo , without knowledge of magnetic resonance imaging results .


This analysis was restricted to patients treated between @ and @h .


The effect of tissue plasminogen activator and reperfusion on infarct growth between baseline diffusion-weighted imaging and day @ T@ imaging was assessed , along with good neurological outcome ( @ point reduction or reaching @-@ at @ days on National Institutes of Health Stroke Scale ) and functional outcome ( modified Rankin scale ) .


The effect of tissue plasminogen activator on reperfusion was also analyzed .


Sixty-nine patients were treated @-@h after onset , and infarct growth was assessed in @ .


Tissue plasminogen activator was associated with lower relative growth ( @ % vs. @ % , P = @ ) and a trend to lower absolute growth ( -@ ml versus @ ml , P = @ ) .


Reperfusion was increased in the tissue plasminogen activator group ( @ % versus @ % , P = @ ) and was associated with increased rates of good neurological ( @ % versus @ % P < @ ) and functional ( modified Rankin scale @-@ @ % versus @ % , P = @ ) outcomes .


Reperfusion was strongly associated with lower relative ( @ % versus @ % , P < @ ) and absolute ( -@ ml versus @ml , P < @ ) infarct growth .


Thrombolysis @-@h after stroke onset reduced infarct growth and increased the rate of reperfusion , which was associated with good neurological and functional outcome .


Tianeptine is widely used for controlling depressive symptoms .


The aim of this study was to evaluate the bioequivalence between the generic ( test ) formulation containing tianeptine sodium @ mg and the branded ( reference ) formulation Stablon with regard to their pharmacokinetic profiles .


A randomized , two-sequence , two-treatment crossover study was conducted in healthy male Korean volunteers .


All of the enrolled subjects were allocated to one of two sequence groups .


They were administered a tablet of the test or reference formulation and then administered the alternative formulation after a @-day washout period .


The blood samples were taken before dosing and at @ , @ , @ , @ , @ , @ , @ , @ , @ , @ , @ , and @ hours after dosing .


The plasma concentrations of tianeptine were analyzed using high-performance liquid chromatography with tandem mass spectrometer .


Tolerability was assessed throughout the study .


The pharmacokinetic parameters were assessed in the @ subjects who completed the study .


The tianeptine C ( max ) for the test formulation was @ @ ng/mL ( mean SD ) and that for the reference formulation was @ @ ng/mL .


The AUC ( last ) of tianeptine was @ @ ngh/mL for the test formulation and @ @ ngh/mL for the reference formulation .


The geometric mean ratio ( % ) of the test to reference formulation was @ ( @ % CI , @ - @ ) for C ( max ) and @ ( @ - @ ) for AUC ( last ) .


Clinically significant adverse events were not reported during the study .


The test and reference formulations of tianeptine were bioequivalent with regard to the pharmacokinetic parameters of Cmax and AUC ( last ) .


Both formulations were tolerated by all of the participants .


Tinnitus is a result of hyper-activity/hyper-synchrony of auditory neurons coding the tinnitus frequency , which has developed to synchronous mass activity owing the lack of inhibition .


We assume that removal of exactly these frequency components from an auditory stimulus will cause the brain to reorganize around tonotopic regions coding the tinnitus frequency .


Based on this assumption a novel treatment for tonal tinnitus - tailor-made notched music training ( TMNMT ) ( Proc Natl Acad Sci USA @:@ -@ , @ ; Ann N Y Acad Sci @:@ -@ , @ ; Frontiers Syst Neurosci @:@ , @ ) has been introduced and will be tested in this clinical trial on a large number of tinnitus patients .


A randomized controlled trial ( RCT ) in parallel group design will be performed in a double-blinded manner .


The choice of the intervention we are going to apply is based on two `` proof of concept '' studies in humans ( Proc Natl Acad Sci USA @:@ -@ , @ ; Ann N Y Acad Sci @:@ -@ , @ ; Frontiers Syst Neurosci @:@ , @ ; PloS One @ ( @ ) : e@ , @ ) and on a recent animal study ( Front Syst Neurosci @:@ , @ ) .


The RCT includes @ participants with chronic , tonal tinnitus who listened to tailor-made notched music ( TMNM ) for two hours a day for three months .


The effect of TMNMT is assessed by the tinnitus handicap questionnaire and visual analogue scales ( VAS ) measuring perceived tinnitus loudness , distress and handicap .


This is the first randomized controlled trial applying TMNMT on a larger number of patients with tonal tinnitus .


Our data will verify more securely and reliably the effectiveness of this kind of completely non-invasive and low-cost treatment approach on tonal tinnitus .


Actinic damage is responsible for the development of multiple , recurrent non-melanoma skin cancers ( NMSCs ) , including actinic keratoses ( AKs ) .


Photodynamic therapy ( PDT ) and imiquimod cream ( IMIQ ) @ % are recommended as field-directed treatment options .


To compare efficacy and safety of methyl aminolevulinate ( MAL ) - PDT vs. IMIQ @ % in the prevention of new NMSCs development patients with field changes .


Patients with field cancerization of the face or scalp were randomized to receive MAL-PDT on one side , and IMIQ @ % on the mirror field .


The primary endpoint was the number of new lesions on the treated fields during a @-month follow-up period .


Secondary assessments included adverse events and patient preference .


Forty-four patients completed the study .


MAL-PDT and IMIQ did not differ concerning the primary endpoint , as there was no statistically significant difference in terms of development of new NMSCs at any point of follow-up .


Both treatment regimens were safe and well tolerated .


Patients ' preference based on the procedure , response rates and future choice favoured MAL-PDT .


MAL-PDT and IMIQ @ % are safe and well-tolerated treatments that equally prevent development of new AKs in patients suffering from field changes .


MAL-PDT treatment appears to be superior in terms of patients ' preference .


DX-@ is a human monoclonal antibody inhibitor of plasma kallikrein under investigation for long-term prophylaxis of hereditary angioedema .


To assess the safety , tolerability , pharmacokinetics , and pharmacodynamics of DX-@ in healthy subjects .


A single-center , double-blinded study was performed in @ healthy subjects randomized @:@ to receive a single subcutaneous administration of DX-@ or placebo within @ of @ sequential , ascending dose cohorts ( n = @ each ) : @ , @ , @ , or @ mg/kg .


No dose-limiting toxicity was observed .


Headache was the most commonly reported treatment emergent adverse event ( AE ) , occurring at a rate of @ % in the DX-@ - and placebo-treated groups ; none were severe and all resolved .


There were no serious AEs , discontinuations owing to an AE , or deaths .


Two subjects had a severe AE reported as related to treatment by the blinded investigator ; the @ AEs were asymptomatic creatinine phosphokinase elevations of @ U/L in @ subject receiving @ mg/kg DX-@ and @,@ U/L in @ subject receiving placebo .


For the @ - , @ - , @ - , and @-mg / kg dose groups , respectively , mean maximum plasma concentrations were @ , @ , @ , and @ g/mL and mean elimination half-lives were @ , @ , @ , and @ days .


Exploratory biomarker assays , involving exvivo activation of the kallikrein pathway , showed dose - and time-dependent inhibition of plasma kallikrein , with evidence of sustained bioactivity consistent with the pharmacokinetics profile .


A single administration of DX-@ in healthy subjects up to doses of @ mg/kg was well tolerated without dose-limiting toxicity .


Pharmacokinetic and pharmacodynamic data provide evidence fora long-acting biological effect relevant to long-term prophylaxis for hereditary angioedema with C@-inhibitor deficiency .


The impact of a text messaging-assisted lifestyle weight loss intervention on weight change among overweight adults in Beijing was examined .


It was a @-month randomized two arm clinical trial .


The control group received a brief advice session after randomization .


The intervention group received three group sessions , five coaching calls , and a daily text message prompting participants to follow predetermined lifestyle goals .


A total of @ participants were randomized .


At @ months , controls gained @ @ kg ( @ % @ % ) ( NS ) while intervention participants lost @ @ kg ( @ % @ % ) ( p < @ ) .


Intervention participants decreased waist circumference ( WC ) ( -@ @ cm , p < @ ) , percent body fat ( % BF ) ( -@ % @ % , p = @ ) , and systolic/diastolic blood pressure ( SBP/DBP ) significantly ( -@ @ / -@ @ mmHg ) , while the controls had no change in WC and % BF and increased SBP/DBP by @ @ / @ @ mmHg ( between groups : p = @ / p = @ ) .


This text message-assisted lifestyle intervention was effective in reducing weight , WC , % BF , and improving BP .


Coupled with the scalable feature of the intervention , this finding is intriguing in light of the potential reach of the intervention for countries like China where mobile phone penetration is high and the obesity rate continues to rise .


Rheumatoid arthritis ( RA ) is a chronic autoimmune disease where TNF - is a central mediator of inflammation , and is cleaved from the cell surface by TACE/ADAM@ .


This metalloproteinase is also responsible for the release of soluble ( s ) CD@ .


Soluble CD@ reflects macrophage activation .


In RA , sCD@ has been suggested as a marker of disease activity and progression .


Our aim is to investigate sCD@ levels in early RA patients .


Soluble CD@ was measured by ELISA from @ RA plasma samples from the OPERA trial .


Averaged disease duration was three months , prior to randomisation with methotrexate ( MTX ) and adalimumab ( DMARD+ADA ) or MTX and placebo ( DMARD+PLA ) .


Soluble CD@ levels were evaluated in relation to clinical disease parameters .


Plasma sCD@ at baseline was @ mg/l ( @ mg/l -@ mg/l ) , mean ( @ % CI ) , vs healthy controls : @ mg/l ( @ mg/l - @ mg/l ) , ( p < @ ) .


After three months of treatment sCD@ levels decreased significantly ( average @ % ) in both treatment groups .


Significant incremental sCD@ levels followed withdrawal of ADA after @ months of treatment .


Baseline sCD@ correlated with CRP and all investigated disease activity markers ( = @-@ @ , p < @ ) .


In the DMARD+PLA group baseline sCD@ also correlated with CRP during the follow-up period .


Soluble CD@ correlated with disease activity markers in early RA before treatment .


Plasma sCD@ may add to currently available disease measures by specifically reflecting changes in macrophage activity as evidenced by increasing levels following anti-TNF withdrawal , despite maintenance of a stable clinical condition achieved by conventional remedies .


It remains to be determined whether sCD@ is an early predictor of disease flare .


Whether patients with early-stage oral cancers should be treated with elective neck dissection at the time of the primary surgery or with therapeutic neck dissection after nodal relapse has been a matter of debate .


In this prospective , randomized , controlled trial , we evaluated the effect on survival of elective node dissection ( ipsilateral neck dissection at the time of the primary surgery ) versus therapeutic node dissection ( watchful waiting followed by neck dissection for nodal relapse ) in patients with lateralized stage T@ or T@ oral squamous-cell carcinomas .


Primary and secondary end points were overall survival and disease-free survival , respectively .


Between @ and @ , a total of @ patients were enrolled .


As prespecified by the data and safety monitoring committee , this report summarizes results for the first @ patients ( @ in the elective-surgery group and @ in the therapeutic-surgery group ) , with a median follow-up of @ months .


There were @ recurrences and @ deaths in the elective-surgery group and @ recurrences and @ deaths in the therapeutic-surgery group .


At @ years , elective node dissection resulted in an improved rate of overall survival ( @ % ; @ % confidence interval -LSB- CI -RSB- , @ to @ ) , as compared with therapeutic dissection ( @ % ; @ % CI , @ to @ ) , for a hazard ratio for death of @ in the elective-surgery group ( @ % CI , @ to @ ; P = @ by the log-rank test ) .


At that time , patients in the elective-surgery group also had a higher rate of disease-free survival than those in the therapeutic-surgery group ( @ % vs. @ % , P < @ ) .


Elective node dissection was superior in most subgroups without significant interactions .


Rates of adverse events were @ % and @ % in the elective-surgery group and the therapeutic-surgery group , respectively .


Among patients with early-stage oral squamous-cell cancer , elective neck dissection resulted in higher rates of overall and disease-free survival than did therapeutic neck dissection .


( Funded by the Tata Memorial Centre ; ClinicalTrials.gov number , NCT@ . )


The goal of this study was to preliminarily test the efficacy of a telephone intervention , Family Intervention : Telephone Tracking , designed to assist stroke survivors and their primary caregivers during the first @ months after stroke .


Forty-nine stroke survivors and their caregivers were randomly assigned to treatment as usual or treatment as usual plus the telephone intervention .


Global outcomes are reported for health care utilization , family functioning , and general functioning .


Family and general functioning were positively and significantly changed at @ and @ months .


Health care utilization was positively and significantly changed at @ months .


Findings suggest that the model has the potential to decrease health care utilization and improve quality of life for stroke survivors and their caregivers .


Further study is warranted .


Transesophageal echocardiography has become a standard tool for evaluating left ventricular function during cardiac surgery .


However , the image quality varies widely between patients and examinations .


The aim of this study was to investigate the influence of the image quality on @ commonly used @-dimensional methods .


Transesophageal real-time @-dimensional echocardiography ( @DE ) served as a reference .


Left ventricular function was evaluated in @ patients with sufficient real-time @DE image quality .


The image quality was rated using the ratio of the visualized border divided by the total endocardial border .


These ratings were used to generate groups of poor ( @ % -@ % ) , fair ( @ % -@ % ) , and good ( @ % -@ % ) image quality .


The ejection fraction ( EF ) , end-diastolic volume , and end-systolic volume were analyzed by the Simpson method of disks ( biplane and monoplane ) , eyeball method , Teichholz method , and speckle-tracking method .


Furthermore , the fractional area change was determined .


Each correlation with real-time @DE was evaluated .


Correlations of the EF and volumes , respectively , as determined by long-axis view methods increased with improving image quality : the Simpson biplane method was found to be the most accurate method , with good image quality for the EF ( r = @ ) and volumes ( end-diastolic volume , r = @ ; end-systolic volume , r = @ ) .


Correlations of the EF and fractional area change by short-axis view methods decreased with improving image quality , with the Teichholz EF found to be most accurate with poor ( r = @ ) in contrast to good ( r = @ ) image quality .


With good image quality , the Simpson biplane method is the most accurate @-dimensional method for assessing the left ventricular EF .


Short-axis view methods , especially the Teichholz method yield better correlations with poor image quality .


The eyeball method was unaffected by image quality .


In this study , we aimed to evaluate the protective effect of tight glucose control during cardiopulmonary bypass on myocardium in adult nondiabetic patients undergoing isolated aortic valve replacement in a prospective and randomized trial .


Sixty-five adult nondiabetic patients undergoing selective isolated aortic valve replacement were enrolled and randomly assigned to an insulin group ( patients received a continuous insulin infusion during surgery ; n = @ ) or a control group ( patients were not administered insulin unless their blood glucose level exceeded @ mg/dL ; n = @ ) .


Cardiac troponin I was assayed preoperatively , and then at @ , @ , @ , @ , and @ hours after aortic cross-declamping .


The pre - , intra - , and postoperative relevant data of all selected patients were analyzed .


Tight glucose control reduced postoperative peak release by @ % for cardiac troponin I compared with the control group ( @ @ vs @ @ ng/mL ; P < @ ) .


Patients with continuous insulin infusion had lower peak inotropic score during the first postoperative @ hours and peak level of blood glucose ( @ @ vs @ @ g/kg/min ; P < @ ; @ @ vs @ @ mg/dL ; P < @ , respectively ) , shorter duration of mechanical ventilation and intensive care unit stay and hospital stay compared with the control group ( @ @ hours vs @ @ hours ; P = @ ; @ @ hours vs @ @ hours ; P < @ ; @ @ days vs @ @ days ; P = @ , respectively ) .


Tight glucose control during cardiopulmonary bypass might provide myocardial protection in adult nondiabetic patients undergoing isolated aortic valve replacement .


The decision of whether to retain or remove a previously placed cervical cerclage in women who subsequently rupture fetal membranes in a premature gestation is controversial and all studies to date are retrospective .


We performed a multicenter randomized controlled trial of removal vs retention of cerclage in these patients to determine whether leaving the cerclage in place prolonged gestation and/or increased the risk of maternal or fetal infection .


A prospective randomized multicenter trial of @ hospitals was performed .


Patients included were those with cerclage placement at @ weeks @ days in singleton or twin pregnancies , with subsequent spontaneous rupture of membranes between @ weeks @ days and @ weeks @ days .


Patients were randomized to retention or removal of cerclage .


Patients were then expectantly managed and delivered only for evidence of labor , chorioamnionitis , fetal distress , or other medical or obstetrical indications .


Management after @ weeks was at the clinician 's discretion .


The initial sample size calculation determined that a total of @ patients should be included but after a second interim analysis , futility calculations determined that the conditional power for showing statistical significance after randomizing @ patients for the primary outcome of prolonging pregnancy was @ % .


Thus the study was terminated after a total of @ subjects were randomized with complete data available for analysis , @ to removal and @ to retention of cerclage .


There was no statistical significance in primary outcome of prolonging pregnancy by @ week comparing the @ groups ( removal @/@ , @ % ; retention @/@ , @ % ) P = @ ; or chorioamnionitis ( removal @/@ , @ % ; retention @/@ , @ % ) P = @ , respectively .


There was no statistical difference in composite neonatal outcomes ( removal @/@ , @ % ; retention @/@ , @ % ) , fetal/neonatal death ( removal @/@ , @ % ; retention @/@ , @ % ) ; or gestational age at delivery ( removal mean @ days ; retention mean @ days ) .


Statistically significant differences were not seen in prolongation of latency , infection , or composite neonatal outcomes .


However , there was a numerical trend in the direction of less infectious morbidity , with immediate removal of cerclage .


These findings may not have met statistical significance if the original sample size of @ was obtained , however they provide valuable data suggesting that there may be no advantage to retaining a cerclage after preterm premature rupture of membranes and a possibility of increased infection with cerclage retention .


To compare the speed and accuracy of answering clinical questions using Google versus summary resources .


In @ and @ , @ internal medicine interns from two classes at Rutgers University Robert Wood Johnson Medical School , who had been trained to use three evidence-based summary resources , performed four-minute computer searches to answer @ clinical questions .


Half were randomized to initiate searches for answers to questions @ to @ using Google ; the other half initiated searches using a summary resource .


They then crossed over and used the other resource for questions @ to @ .


They documented the time spent searching and the resource where the answer was found .


Time to correct response and percentage of correct responses were compared between groups using t test and general estimating equations .


Of @ questions administered , interns found answers for @ ( @ % ) .


Interns initiating searches in Google used a wider variety of resources than those starting with summary resources .


No significant difference was found in mean time to correct response ( @ seconds for Google versus @ seconds for summary resource ; P = @ ) .


Mean correct response rate was @ % for Google versus @ % for summary resource ( mean difference -@ % ; @ % CI -@ % to @ % ; P = @ ) .


The authors found no significant differences in speed or accuracy between searches initiated using Google versus summary resources .


Although summary resources are considered to provide the highest quality of evidence , improvements to allow for better speed and accuracy are needed .


To assess LASIK flaps made by femtosecond laser and mechanical microkeratome .


Clinical , prospective , randomized , masked study of @ eyes ( @ patients ) .


Both eyes of all patients were operated , each patient underwent different techniques for lasik .


Microkeratome Hansatome ( TM ) Bausch & Lomb ( group microkeratome ) was used in one eye and femtosecond laser Femto LDV ( TM ) Ziemer ( group femtosecond ) was used for the fellow eye .


Patients were selected from the Refractive Surgery service of the Eye Hospital of Paran between July @ and September @ .


Inclusion criteria were myopia less than @ D , astigmatism less than @ D , hyperopia less than @ D , stable refraction over one year , corneal diameter smaller than @ mm , discontinuation of contact lenses seven days before the preoperative evaluation , corrected visual acuity of at least @/@ .


Eyes were randomly allocated for each technique .


The studied variables were : visual acuity with and without correction , residual refractive error , high order aberrations , low contrast visual acuity , complications and subjective patient preference .


All studied variables were similar between the two groups .


We could not demonstrate any difference between the studied groups .


Many physicians believe that the most effective way to treat chronic urticaria is to take a nonsedating second-generation H@ - antihistamine in the morning and a sedating first-generation H@ - antihistamine , usually hydroxyzine , at night to enhance sleep .


But is this belief well founded ?


To test this belief by comparing the effectiveness and prevalence of unwanted sedative effects when treating patients with chronic spontaneous urticaria ( CSU ) with levocetirizine @ mg daily plus hydroxyzine @ mg at night ( levocetirizine plus hydroxyzine ) vs. levocetirizine @ mg daily ( levocetirizine monotherapy ) .


In this randomized , double-blind , cross-over study , @ patients with difficult-to-treat CSU took levocetirizine plus hydroxyzine or levocetirizine monotherapy for periods of @ days each .


At the end of each treatment period , assessments were made of quality of life ( Chronic Urticaria Quality of Life Questionnaire , CU-Q@ oL ) , severity of urticaria symptoms ( Urticaria Activity Score , UAS ) , sleep disturbance during the night and daytime somnolence .


Both treatments significantly decreased UAS , night-time sleep disturbances and CU-Q@ oL scores ( P < @ ) without significant differences between the two .


Compared with baseline , daytime somnolence was significantly reduced by levocetirizine monotherapy ( P = @ ) but not by levocetirizine plus hydroxyzine ( P = @ ) .


Direct comparison of the two treatment modalities in terms of daytime somnolence favoured levocetirizine monotherapy ( P = @ ) .


The widespread belief that sleep is aided by the addition of a sedating first-generation H@ - antihistamine , usually hydroxyzine , at night is not supported .


These results are in line with the urticaria guidelines , which state that first-line treatment for urticaria should be new-generation , nonsedating H@ - antihistamines only .


Lignin peroxidase is a cosmetic skin-lightening alternative that breaks down plant cell walls and melanin .


This research examined the topical efficacy of lignin peroxidase in pigment lightening .


Sixty women aged @ to @ years with mild to moderate facial dyspigmentation were enrolled for @ weeks in @ cohorts .


Cohort @ applied lignin peroxidase to @ randomized side of the face and nothing to the opposite side .


Cohort @ applied lignin peroxidase to @ facial side and generic hydroquinone to the other .