Future studies must investigate whether cognitive training improves functioning and how best to integrate it into critical psychosocial interventions .


To explore the possible mechanisms for improving lower extremity motor function in patients with early stroke through combining magnetic resonance diffusion tensor imaging ( DTI ) technology and functional electrical stimulation ( FES ) based on human walking patterns .


From August @ to September @ , a total of @ eligible patients were stratified according to age , gender , disease course , Brunnstrom staging and types of stroke .


And the Minimize software was used to divided them randomly into four-channel FES group ( n = @ ) , dual-channel FES group ( n = @ ) and comfort stimulation group ( n = @ ) .


For all three groups , general medication and standard rehabilitation were provided .


Based on normal walking pattern design of FES treatment , four-channel FES groups received the stimulations of quadriceps , hamstring , anterior tibialis and medial gastrocnemius .


For the dual-channel FES group , the stimulations of tibialis anterior , peroneus longus and peroneus brevis muscles were applied .


In comfort electrical stimulation group , the electrode positions were identical to the stimulation group , but there was no current output during stimulation .


Before and after @-week treatment , three groups received weekly rehabilitation evaluations of Fugl-Meyer assessment ( FMA ) , posture assessment of stroke scale ( PASS ) , Brunel balance assessment ( BBA ) , Berg balance scale ( BBS ) and modified Barthel index ( MBI ) .


Before and after treatment , DTI examination was performed for some patients .


Among three groups , general patient profiles and pre-treatment evaluations showed no significant difference .


For intra-group comparisons versus pre-treatment , at week @ , @ and @ , the scores of PASS , BBA , BBS , FMA and MBI had statistically significant differences ( P < @ ) ; At week @ post-treatment , when four-channel and double-channel FES groups were compared versus pre-treatment , the scores of ipsilateral FA had statistically significant differences ( P < @ ) .


At week @ post-treatment , MBI had statistically significant difference among @ groups ( P = @ ) .


As compared with placebo , four-channel group had statistically significant difference -LSB- ( @ @ ) vs ( @ @ ) , P < @ -RSB- ; At week @ post-treatment , the scores of PASS and MBI were ( @ @ , @ @ ) in four-channel FES group versus ( @ @ , @ @ ) in dual-channel FES group .


And the scores of PASS , BBA , BBS , FMA and MBI were ( @ @ , @ @ , @ @ , @ @ , @ @ ) in four-channel FES group versus ( @ @ , @ @ , @ @ , @ @ , @ @ ) in comfort electrical stimulation group .


When dual-channel FES and comfort stimulation groups were compared , MBI had significant statistical difference -LSB- ( @ @ ) vs ( @ @ ) , P < @ -RSB- .


At week @ post-treatment , four-channel and dual-channel FES groups were compared , there was also statistical significance in FMA -LSB- ( @ @ ) vs ( @ @ ) , P = @ -RSB- .


The scores of PASS , BBS , FMA and MBI were ( @ @ , @ @ , @ @ , @ @ ) in four-channel FES group versus ( @ @ , @ @ , @ @ , @ @ ) in comfort stimulation group respectively .


When dual-channel FES and comfort stimulation groups were compared , the scores of MBI were ( @ @ ) and ( @ @ ) respectively .


And the difference was statistically significant ( P < @ ) .


At week @ post-treatment , the scores of FA significantly increased -LSB- four-channel FES group ( @ @ ) vs comfort stimulation group ( @ @ ) ( P = @ ) -RSB- .


When dual-channel FES group ( @ @ ) and comfort stimulation group ( @ @ ) ( P = @ ) were compared , the differences were statistically significant .


DTI showed that four-channel FES group increased significantly , but contralateral fiber bundle was not obvious .


And the improvements of dual-channel FES and comfort stimulation groups were insignificant .


Compared with traditional dual-channel FES , functional electrical stimulation based on human walking patterns is more efficacious .


And it helps to restore brain structure and function and promote motor function recovery in patients with early stroke .


This study sought to determine the effects of lavender aromatherapy on pain following needle insertion into a fistula in patients undergoing hemodialysis .


This is a randomized controlled clinical trial in which @ patients undergoing hemodialysis with arteriovenous fistulas were randomly divided into two groups .


The experimental-group patients inhaled lavender essence with a concentration of @ % for @min during @ hemodialysis sessions , while the control-group patients received aromatherapy free of lavender essence .


The mean VAS pain intensity score in the experimental and control groups before the intervention was @ and @ , respectively ( p = @ ) .


The mean VAS pain intensity score in the experimental and control groups after three aromatherapy sessions was @ and @ , respectively ( p = @ ) .


Lavender aromatherapy may be an effective technique to reduce pain following needle insertion into a fistula in hemodialysis patients .


Hyperparathyroidism ( HPT ) in multiple endocrine neoplasia ( MEN ) type @ is associated with multiglandular parathyroid disease .


Previous retrospective studies comparing subtotal parathyroidectomy ( SP ) and total parathyroidectomy with autotransplantation ( TP/AT ) have not established clearly better outcomes with either procedure .


Patients were assigned randomly to either SP or TP/AT and data were collected prospectively .


The rates of persistent HPT , recurrent HPT , and postoperative hypoparathyroidism were compared .


The study cohort included @ patients randomized to receive either SP or TP/AT ( mean follow-up , @ @ years ) .


The overall rate of recurrent HPT was @ % ( @/@ ) .


Recurrent HPT occurred in @ of @ patients ( @ % ) treated with SP and @ of @ patients ( @ % ) treated with TP/AT ( P = @ ) .


Permanent hypoparathyroidism occurred in @ of @ patients ( @ % ) overall .


The rate of permanent hypoparathyroidism was @ % in the SP group ( @/@ ) and @ % in the TP/AT group ( @/@ ) .


A second operation was performed in @ of @ patients initially treated with SP ( @ % ) , compared with @ of @ patients undergoing TP/AT ( @ % ; P = @ ) .


This randomized trial of SP and TP/AT in patients with MEN @ failed to show any difference in outcomes when comparing results of SP versus TP/AT .


Both procedures are associated with acceptable results , but SP may have advantages in that is involves only @ surgical incision and avoids an obligate period of transient postoperative hypoparathyroidism .


Adhesions develop in over @ % of patients after intra-abdominal surgery .


Adhesion barriers are rarely used despite the high morbidity caused by intra-abdominal adhesions .


Only one of the currently available adhesion barriers has demonstrated consistent evidence for reducing adhesions in visceral surgery .


This agent has limitations through poor handling characteristics because it is sticky on both sides .


C-Qur Film is a novel thin film adhesion barrier and it is sticky on only one side , resulting in better handling characteristics .


The objective of this study is to assess efficacy and safety of C-Qur Film to decrease the incidence of adhesions after colorectal surgery .


This is a prospective , investigator initiated , randomized , double-blinded , multicenter trial .


Eligible patients undergoing colorectal resection requiring temporary loop ileostomy or loop/split colostomy by laparotomy or hand assisted laparoscopy will be included in the trial .


Before closure , patients are randomized @:@ to either the treatment arm ( C-Qur Film ) or control arm ( no adhesion barrier ) .


Patients will return @ to @ weeks post-colorectal resection for take down of their ostomy .


During ostomy takedown , adhesions will be evaluated for incidence , extent , and severity .


The primary outcome evaluation will be assessment of adhesions to the incision site .


It is hypothesized that the use of C-Qur Film underneath the primary incision reduces the incidence of adhesion at the incision by @ % .


To demonstrate @ % reduction in the incidence of adhesions , a sample size of @ patients ( @ + @ per group ( @ % drop out ) ) is required ( two-sided test , = @ , @ % power ) .


Results of this study add to the evidence on the use of anti-adhesive barriers in open and laparoscopic ` hand-assisted ' colorectal surgery .


We chose incidence of adhesions to the incision site as primary outcome measure since clinical outcomes such as small bowel obstruction , secondary infertility and adhesiolysis related complications are considered multifactorial and difficult to interpret .


Incidence of adhesions at repeat surgery is believed to be the most valuable surrogate endpoint for clinically relevant adhesion prevention , since small bowel obstruction and adhesiolysis at repeat surgery are not likely to occur when complete adhesion reduction in a patient is accomplished .


To assess the impact of empowerment ( health coaching , HC ) on toothbrushing self-efficacy ( TBSE ) and toothbrushing frequency ( TB ) and their effects on diabetes management ( HbA@c , physical activity ) and quality of life in comparison to health education ( HE ) among patients with diabetes type @ ( DM@ ) .


The data ( HbA@c -LSB- glycated haemoglobin -RSB- , TB , physical activity , TBSE , quality of life ) were collected at baseline and at post-intervention at outpatient clinics of two hospitals in Istanbul , Turkey .


Participants were allocated randomly to HC ( n = @ ) and HE ( n = @ ) groups .


At baseline , there were no statistical differences between HC and HE groups in terms of all measures ( P > @ ) .


At post-intervention , there was improvement in oral health - and diabetes-related variables in the HC group , whereas only TBSE and TB slightly improved in the HE group ( P < @ ) .


At post-intervention among patients brushing their teeth at least once a day , HC group patients were more likely to be physically active and to have high self-efficacy than those in HE group ( P < @ ) .


TBSE was correlated with favourable HbA@c levels ( < @ % ) in the HC group and quality of life ( P < @ ) in both groups .


The findings show that HC-based empowerment towards improving self-efficacy is more effective at improving toothbrushing behaviour than is HE and that interaction contributes significantly to diabetes management in terms of reduced HbA@c , increased physical activity and quality of life .


TBSE can be a practical starting point for empowerment and toothbrushing can be used as an effective and practical behaviour to observe personal success in diabetes management .


Previous research has shown limited efficacy of nicotine replacement therapy ( NRT ) among adolescents and generally low compliance rates .


As higher compliance rates are associated with improved abstinence rates , the present study examined predictors of NRT compliance .


This study aims to test whether different NRT compliance trajectories can be distinguished among adolescents , to test whether these trajectories can be predicted by demographic , smoking-related , and personality factors , and to examine abstinence rates for each trajectory .


Data were used from a randomized controlled trial that tested the efficacy of nicotine patches versus placebo patches among @ Dutch adolescents .


During NRT treatment , adolescents filled out six online questionnaires in which they reported on the number of days they used the patches .


Predictors ( i.e. , demographic and smoking-related factors and personality characteristics ) and end-of-treatment abstinence were also administered through these self-reports .


Latent class growth analysis ( LCGA ) was used to analyze compliance data by classifying individuals into similar growth trajectories .


Three compliance trajectories were found ( i.e. , `` compliers '' ( n = @ ) , `` moderate decreasers '' ( n = @ ) , and `` strong decreasers '' ( n = @ ) ) .


The compliers can be characterized by higher levels of conscientiousness and agreeableness and lower levels of extraversion compared with the strong decreasers , and by higher levels of conscientiousness and education compared with the moderate decreasers .


Among the compliers , a substantially higher percentage of adolescents achieved abstinence at end-of-treatment ( @ % ) compared with the moderate decreasers ( @ % ) and the strong decreasers ( @ % ) .


These findings could be the starting point for person-tailored interventions that aim to enhance NRT compliance rates among adolescents .


This study investigates the efficacy of the @-hour REACH Forgiveness intervention among culturally diverse undergraduates .


Female undergraduates ( N = @ ) and foreign extraction ( @ % ) and domestic ( @ % ) students in the United States were randomly assigned to immediate treatment or waitlist conditions .


Treatment efficacy and the effect of culture on treatment response were assessed using measures of emotional and decisional forgiveness across @ time periods .


Students in the treatment condition reported greater improvement in emotional forgiveness , but not decisional forgiveness , relative to those in the waitlist condition .


Gains were maintained at a @-week follow-up .


Although culture did not moderate the effect of treatment , a main effect of culture on emotional forgiveness and marginally significant interaction effect of culture on decisional forgiveness were found .


The REACH Forgiveness intervention was efficacious for college students from different cultural backgrounds when conducted in the United States .


However , some evidence may warrant development of culturally adapted forgiveness interventions .


This study was designed to evaluate the safety and efficacy of a novel , self-cross-linked hyaluronic acid ( HA ) hydrogel compared with carboxymethylcellulose ( CMC ) viscous foam in promoting healing when applied after ethmoidectomy .


A prospective , randomized , controlled , blinded clinical trial was performed .


The study was performed by four surgeons operating in two community hospitals .


Thirty patients with bilateral chronic rhinosinusitis underwent bilateral total ethmoidectomy .


Intraoperatively , each patient received @ mL of HA hydrogel in one ethmoid cavity and @ mL of CMC contralaterally .


The material applied within each ethmoid cavity was randomly assigned before surgery .


An independent surgeon , blinded to the material used to treat each ethmoid cavity , evaluated postoperative endoscopic video at @ and @ weeks for edema , crusting , and mucopurulence and at @ and @ weeks for remucosalization and scarring/synechiae .


Twenty-item Sino-Nasal Outcome Test SNOT-@ data were collected at each visit .


A small sample underwent endoscopic mucosal biopsy .


Twenty-nine of @ patients completed the protocol .


The difference in edema , crusting , and mucopurulence at @ and @ weeks was not statistically significant ; however , at @ and @ weeks , the HA hydrogel showed statistically significant reduction in both overall endoscopic grade ( p < @ ) , as well as synechiae formation ( p < @ ) , with a trend toward superiority in remucosalization ( p = @ ) .


Histological analysis of six subjects at @ weeks showed a nonsignificant trend toward a greater amount of regenerated cilia present with the HA hydrogel ( p = @ ) .


SNOT-@ scores declined @ % from preoperative scores .


Self-cross-linked HA hydrogel provides superior wound healing to CMC after ethmoidectomy .


Although there is scientific evidence that stress adversely affects metabolic control , only a few studies have examined the role of stress management in improving glycemic control in patients with type @ diabetes mellitus ( DM ) .


In this study , we investigated the effect of a relaxation technique on levels of stress and glycemic control .


A total of @ patients with type @ DM were randomly assigned to undergo either an @-week stress management program , consisting of @ min of diaphragmatic breathing and @ min of progressive muscle relaxation twice per day ( n = @ , intervention group ) , or not ( n = @ , control group ) .


Perceived stress , health locus of control and HbA@c were primary outcomes and were measured before and after intervention .


In the intervention group , perceived stress score ( PSS ) and HbA@c had decreased significantly ( P < @ ) by the end of the program .


Specifically concerning the PSS , the higher the initial levels of perceived stress the greater the benefit of the intervention .


No other significant changes were found .


Our results show a beneficial role of stress management for patients with type @ DM , as regards both stress levels and glycemic control .


It is recommended to consider this type of treatment as an adjunct to conventional therapy .


We deem that our study could encourage future studies in this area with larger samples , longer duration and more objective measurements .


Community-based peer support has been shown to be effective in improving exclusive breastfeeding rates in a variety of settings .


We conducted a cost analysis of a community cluster randomised-controlled trial ( Promise-EBF ) , aimed at promoting exclusive infant feeding in three sites in South Africa .


The costs were considered from the perspective of health service providers .


Peer supporters in this trial visited women to support exclusive infant feeding , once antenatally and four times postpartum .


The total economic cost of the Promise-EBF intervention was US$ @ @ , with average costs per woman and per visit of US$ @ and US$ @ , respectively .


The average costs per woman and visit in an operational ` non research ' scenario were US$ @ and US$ @ per woman and visit , respectively .


Investing in the promotion of exclusive infant feeding requires substantial financial commitment from policy makers .


Extending the tasks of multi-skilled community health workers ( CHWs ) to include promoting exclusive infant feeding is a potential option for reducing these costs .


In order to avoid efficiency losses , we recommend that the time requirements for delivering the promotion of exclusive infant feeding are considered when integrating it within the existing activities of CHWs .


This paper focuses on interventions for exclusive infant feeding , but its findings more generally illustrate the importance of documenting and quantifying factors that affect the feasibility and sustainability of community-based interventions , which are receiving increased focus in low income settings .


The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life ( QOL ) in community-dwelling elderly people with history of falling .


Participants were randomly assigned to the water-based exercise group ( n = @ ) or land-based exercise groups ( n = @ ) .


To identify the effects on physical functions , muscle strength , flexibility , and mobility were measured .


QOL and fear of falling were evaluated using the Short Form @-item questionnaire and the modified falls efficacy scale ( M-FES ) .


The measurements were performed before and after the @-week training period .


Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups ( p = @ ; p = @ ) .


However , no statistically significant within-group differences were found in the back scratch test ( p = @ ) and chair sit-and-reach test ( p = @ ) .


QOL was significantly different in both groups ( health transition : p = @ , physical functioning : p < @ , role physical : p < @ , role emotional : p = @ , bodily pain : p < @ , vitality : p < @ , and mental health : p < @ ) .


There was a significant difference in the M-FES in both groups ( p = @ ) .


These results indicate that water-based exercises are beneficial to improve the QOL , as well as physical activities , of community-dwelling elderly compared with land-based exercise .


Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling .


Urinary stone disease is common , with an estimated prevalence among the general population of @ % to @ % .


Ureteric stones can cause severe pain and have a significant impact on quality of life , accounting for over @,@ hospital admissions in England annually .


Uncomplicated cases of smaller stones in the lower ureter are traditionally treated expectantly .


Those who fail standard care or develop complications undergo active treatment , such as extracorporeal shock wave lithotripsy or ureteroscopy with stone retrieval .


Such interventions are expensive , require urological expertise and carry a risk of complications.Growing understanding of ureteric function and pathophysiology has led to the hypothesis that drugs causing relaxation of ureteric smooth muscle , such as the selective - blocker tamsulosin and the calcium-channel blocker nifedipine , can enhance the spontaneous passage of ureteric stones .


The use of drugs in augmenting stone passage , reducing the morbidity and costs associated with ureteric stone disease , is promising .


However , the majority of clinical trials conducted to date have been small , poor to moderate quality and lacking in comprehensive economic evaluation.This trial aims to determine the clinical and cost-effectiveness of tamsulosin and nifedipine in the management of symptomatic urinary stones .


The SUSPEND ( Spontaneous Urinary Stone Passage ENabled by Drugs ) trial is a multicentre , double-blind , randomized controlled trial evaluating two medical expulsive therapy strategies ( nifedipine or tamsulosin ) versus placebo.Patients aged @ to @ with a ureteric stone confirmed by non-contrast computed tomography of the kidney , ureter and bladder will be randomized to receive nifedipine , tamsulosin or placebo ( @ participants per arm ) for a maximum of @days .


The primary clinical outcome is spontaneous passage of ureteric stones at @weeks ( defined as no further intervention required to facilitate stone passage ) .


The primary economic outcome is a reduction in the incremental cost per quality-adjusted life years , determined at @weeks .


The analysis will be based on all participants as randomized ( intention to treat ) .


The trial has @ % power with a type I error rate of @ % to detect a @ % increase in primary outcome between the tamsulosin and nifedipine treatment groups .


The aim of the present study was to evaluate the effects of upper thoracic manipulation on pain in subjects with temporomandibular disorder .


Thirty-two women with a diagnosis of temporomandibular disorder were randomly allocated to an experimental group ( n = @ ) , submitted to upper thoracic manipulation , and a placebo group ( n = @ ) , submitted to a procedure in the thoracic region with no therapeutic effect .


All volunteers underwent an evaluation of pain in the masticatory muscles and the temporomandibular joint using an algometer and the visual analog scale before and immediately after the procedure as well as after @-@ hrs .


Two-way repeated-measures analysis of variance was used for the intragroup and intergroup analyses , with the level of significance set to @ % ( P < @ ) .


Cohen d was calculated for the determination of the effect size .


No significant group-by-time interaction was found ( P > @ ) for algometry in any analysis , and Cohen d revealed no significant effect of the treatment .


Moreover , no significant group-by-time interaction was found for facial pain intensity determined using the visual analog scale ( P > @ ) , and Cohen d also revealed no significant effect of the treatment regarding this variable .


On the basis of the present findings , upper thoracic spinal manipulation does not lead to a reduction in pain in women with temporomandibular disorder .


This study investigates the changes in hemorheologic parameters resulting from exercise followed by a standard meal .


In twelve moderately active men a period of exercise on a bicycle ergometer for @ min at @ % VO@max was followed by a test meal or by @ min rest .


Venous blood was sampled for further analysis at baseline , after exercise , and after the meal/rest period .


The elongation index ( EI ) was reduced and a marked rise in plasma viscosity was observed after exercise .


A significant decrease in half time of total aggregation ( T @/@ ) and a rise in aggregation index ( AI ) after exercise were observed ; however , after the postexercise period these changes were reversed .


The present study demonstrates that physical exercise causes several changes in blood rheology parameters , such as an increase of blood viscosity , a decrease in EI and an increase in AI , and a fall in the T @/@ values .


The meal eaten in the postexercise period caused a further reduction in EI values indicating higher red cell rigidity , but not in plasma viscosity or aggregations indices .


Such alterations in hemorheologic parameters should not impair the function of the cardiovascular system in fit and healthy people but it could constitute a serious risk under various pathophysiological conditions .


Proximal and distal ( mid-thigh ) ultrasound-guided continuous adductor canal block techniques have been described but not yet compared , and infusion benefits or side effects may be determined by catheter location .


We hypothesized that proximal placement will result in faster onset of saphenous nerve anesthesia , without additional motor block , compared to a distal technique .


Preoperatively , patients receiving an ultrasound-guided nonstimulating adductor canal catheter for knee arthroplasty were randomly assigned to either proximal or distal insertion .


A local anesthetic bolus was administered via the catheter after successful placement .


The primary outcome was the time to achieve complete sensory anesthesia in the saphenous nerve distribution .


Secondary outcomes included procedural time , procedure-related pain and complications , postoperative pain , opioid consumption , and motor weakness .


Proximal insertion ( n = @ ) took a median ( @th-@th percentiles ) of @ ( @-@ @ ) minutes versus @ ( @-@ @ ) minutes for distal insertion ( n = @ ; P = @ ) to anesthetize the medial calf .


Only @ of @ ( @ % ) and @ of @ ( @ % ) patients in the proximal and distal groups , respectively , developed anesthesia at both the medial calf and top of the patella ( P = @ ) .


Bolus-induced motor weakness occurred in @ of @ ( @ % ) and @ of @ ( @ % ) patients in the proximal and distal groups ( P = @ ) .


Ten of @ patients ( @ % ) in the distal group required intravenous morphine postoperatively , compared to @ of @ ( @ % ) in the proximal group ( P = @ ) , but there were no differences in other secondary outcomes .


Continuous adductor canal blocks can be performed reliably at both proximal and distal locations .


The proximal approach may offer minor analgesic and logistic advantages without an increase in motor block .


The health-promoting properties of apples are directly related to the biologically active compounds that they contain , such as polyphenols .


The objective of this study was to prepare a low-sugar , fibre - and phlorizin-enriched powder from unripe apples and to gain insight regarding its anti-hyperglycaemic activity in healthy volunteers .


The unripe apples ( Malus domestica Borkh . )


were collected @ days after the full bloom day ; blanched and pressed to obtain apple pomace which was then processed with a food cutter , oven-dried and milled to prepare apple powder .


The concentrations of total sugars , water-soluble pectin and phlorizin in the apple preparation were @ , @ and @ g kg ( -@ ) , respectively .


Acute ingestion of the apple preparation improved glucose metabolism in the oral glucose tolerance test ( OGTT ) in six healthy volunteers by reducing the postprandial glucose response at @ to @ min by approximately two-fold ( P < @ ) and by increasing urinary glucose excretion during the @ - to @-h interval of the OGTT by five-fold ( P < @ ) .


The results obtained indicate that the dried and powdered pomace of unripe apples can be used as a health-promoting natural product for the reduction of postprandial glycaemia and to improve the health of patients with diabetes .


The purpose of this study was to determine parents ' knowledge about pediatric fluoroscopic procedures and potential risk from ionizing radiation before and after being given an informational brochure .


We reviewed responses from @ randomly selected participants who were parents or guardians of pediatric patients undergoing diagnostic fluoroscopic examinations .


A questionnaire assessed participants ' knowledge of the procedure , radiation exposure , and whether their child had a prior examination before and after receiving an informational brochure .


In a feedback survey , participants rated the brochure .


A repeated measures mixed model was used to evaluate the effect of the brochure on the participants ' knowledge .


Participant demographics were women ( @ % ) , English speaking ( @ % ) , white ( @ % ) , and education higher than @th grade ( @ % ) .


The median age of patients undergoing the fluoroscopic examination was @ years .


Participant knowledge increased ( p < @ ) between pre - and postbrochure ( least-squares means ) for those without a previous examination from @ to @ ( total test score ) and from @ to @ for those with a prior examination .


The proportion of correct answers was higher ( p < @ ) postbrochure compared with pre-brochure in areas of examination name ( @ % vs @ % ) , procedure details ( @ % vs @ % ) ; use of radiation ( @ % vs @ % ) , and radiation dose comparison ( @ % vs @ % ) .


Overall , @ % ( @/@ ) rated the brochure `` good '' or `` great '' ( p < @ ) .


An informational brochure given to participants before their child 's fluoroscopic procedure improved their knowledge of the examination and radiation exposure .


No participants refused their child 's examination .


It remains to be determined if perioperative systemic magnesium can improve postoperative quality of recovery of patients undergoing ambulatory procedures .


The main objective of the current investigation was to evaluate the effect of systemic magnesium on postoperative quality of recovery in patients undergoing outpatient segmental mastectomies .


The study was a prospective randomized , double-blind , placebo-controlled , clinical trial .


Female subjects were randomized to receive intravenous magnesium ( MgSO@ @mg/kg in @ mL of normal saline over @ min before anesthesia induction , followed by an infusion of @ mg/kg/hour ) or the same volume of saline .


The primary outcome was the Quality of Recovery @ ( QOR-@ ) questionnaire at @ hours after surgery .


@ subjects were recruited and @ completed the study .


Patients in the magnesium group had better global Quality of Recovery scores compared with the saline group , with a median difference of @ ( @ % CI , @ to @ ) , P < @ .


After discharge from hospital , subjects in the magnesium group required less oral opioids , median ( IQR ) of @ ( @ to @ ) ( oral milligrams of morphine equivalents ) than the saline group , @ ( @ to @ ) ( P < @ ) .


The postoperative systemic magnesium concentrations were substantially higher in the magnesium group , @ @ mmol/L compared to control , @ @ mmol/L , P < @ .


Simple linear regression demonstrated a direct linear relationship between the postoperative systemic magnesium concentrations and @ hour postoperative quality of recovery scores ( P = @ ) , and also an inverse relationship with pain burden in the postoperative care unit ( P = @ ) .


Systemic magnesium improves postoperative quality of recovery in patients undergoing outpatient segmental mastectomy .


Systemic magnesium is a safe , inexpensive , efficacious strategy to improve quality of recovery after ambulatory surgery .


We hypothesized that , after axillary block , positioning the patient in a lateral position with the injected side down and simultaneously in a @ Trendelenburg position will increase the success rate and quality of the block .


Fifty patients with chronic renal failure ( ASA @-@ ) scheduled for arteriovenous fistula surgery were included in this study .


In all patients , @-@ ml of @ % levobupivacaine were injected into the axillary sheath .


The block was performed as three injections ( multiple injection technique ) with the arm in @ abduction and @ flexion in the supine position .


Patients were randomly allocated to two groups .


Group I ( n = @ ) patients were kept in the supine position after the block .


Group II ( n = @ ) patients were positioned laterally after the block with the injected arm down and in a @ Trendelenburg position .


Sensory and motor block were evaluated at @ , @ , @ , @ , @ , @ , @ , and @ min after the administration of the block .


Thus , the patients in group II were evaluated in a lateral position during the first @ min .


Throughout the surgery and the recovery period , sensory and motor block were evaluated at @-min intervals .


There were no significant intergroup differences in the effects on radial , ulnar , median , and musculoskeletal nerve blockade .


Thirty minutes after the injection , the patients in group II had higher levels of sensory axillary nerve blockade .


Subscapular and thoracodorsal nerve motor block were not detected in group I , while @ % of the patients in group II experienced blockade of both of these nerves ( p < @ ) .


We conclude that , for patients undergoing an axillary block , positioning the patient laterally with the injected side down and in a @ Trendelenburg position increases the success rate and quality of the block .


The primary objective was to compare overall survival ( OS ) in patients with colorectal cancer ( CRC ) with nonresectable liver-only metastases treated by liver transplantation or chemotherapy .


CRC is the third most common cancer worldwide .


About @ % of patients will develop metastatic disease primarily to the liver and the lung .


The majority of patients with liver metastases receive palliative chemotherapy , with a median OS of trial patients of about @ years , and less than @ % are alive at @ years .


Patients with nonresectable liver-only CRC metastases underwent liver transplantation in the SECA study ( n = @ ) .


Disease-free survival ( DFS ) and OS of patients included in the SECA study were compared with progression-free survival ( PFS ) and OS in a similar cohort of CRC patients with liver-only disease included in a first-line chemotherapy study , the NORDIC VII study ( n = @ ) .


PFS/DFS and OS were estimated by the Kaplan-Meier method .


DFS/PFS in both groups were @ to @ months .


However , a dramatic difference in OS was observed .


The @-year OS rate was @ % in patients undergoing liver transplantation compared with @ % in patients starting first-line chemotherapy .


The reason for the large difference in OS despite similar DFS/PFS is likely different metastatic patterns at relapse/progression .


Relapse in the liver transplantation group was often detected as small , slowly growing lung metastases , whereas progression of nonresectable liver metastases was observed in the chemotherapy group .


Compared with chemotherapy , liver transplantation resulted in a marked increased OS in CRC patients with nonresectable liver-only metastases .


The I-gel ( IG ) supraglottic airway device is a reliable way to establish an airway .


Its large ventilation lumen allows for easy passage of an endotracheal tube .


With the use of a flexible bronchoscope , the IG offers a good visualization of the laryngeal inlet .


This prospective randomized study aims to compare the success rate of flexible bronchoscope-guided tracheal intubation using either the IG or the LMA-Fastrach ( FT ) laryngeal masks .


One hundred twenty patients requiring general anesthesia were randomized to @ of the @ study groups : IG or FT. After anesthesia induction , the assigned laryngeal mask was inserted to obtain adequate ventilation .


We then proceeded to a flexible bronchoscope-guided intubation through the supraglottic device .


Tracheal intubation and laryngeal mask insertion success rates were noted , as well as the time required for these manipulations .


The view of the laryngeal inlet was graded for each intubation attempt .


Sixty patients were assigned to each study group .


The intubation success rates were similar between the IG and the FT groups ( @ % vs @ % at first attempt ; P = @ ) .


The times required for tracheal intubation were significantly lower in the IG group ( @ @ seconds vs @ @ seconds ; P < @ ) .


Glottic visualization was better in the IG group , with a significantly higher percentage of grade @ visualization ( @ % vs @ % ; P < @ ) and a lower percentage of grade @ visualization ( @ % vs @ % ; P < @ ) , than that in the FT group .


The use of the IG supraglottic airway device as a conduit for flexible bronchoscope-guided tracheal intubation results in a success rate equivalent to the use of the LMA-FT .


However , the IG allows for shorter intubation times and a better visualization of the glottic opening compared with the LMA-FT .


Critically ill patients are at risk of venous thrombosis , and therefore guidelines recommend daily thromboprophylaxis .


Deep vein thrombosis ( DVT ) commonly occurs in the lower extremities but can occur in other sites including the head and neck , trunk , and upper extremities .


The risk of nonleg deep venous thromboses ( NLDVTs ) , predisposing factors , and the association between NLDVTs and pulmonary embolism ( PE ) or death are unclear .


To describe the frequency , anatomical location , risk factors , management , and consequences of NLDVTs in a large cohort of medical-surgical critically ill adults .


A nested prospective cohort study in the setting of secondary and tertiary care intensive care units ( ICUs ) .


The study population comprised @ patients , who were expected to remain in the ICU for at least @ days and were enrolled in a randomized clinical trial of dalteparin vs standard heparin for thromboprophylaxis .


The proportion of patients who had NLDVTs , the mean number per patient , and the anatomical location .


We characterized NLDVTs as prevalent or incident ( identified within @ hours of ICU admission or thereafter ) and whether they were catheter related or not .


We used multivariable regression models to evaluate risk factors for NLDVT and to examine subsequent anticoagulant therapy , associated PE , and death .


RESULTS Of @ trial patients , @ ( @ % ) developed @ or more non-leg vein thromboses ( superficial or deep , proximal or distal ) .


Thromboses were more commonly incident ( n = @ -LSB- @ % -RSB- ) than prevalent ( n = @ -LSB- @ % -RSB- ) ( P < @ ) and more often deep ( n = @ -LSB- @ % -RSB- ) than superficial ( n = @ -LSB- @ % -RSB- ) ( P < @ ) .


Cancer was the only independent predictor of incident NLDVT ( hazard ratio -LSB- HR -RSB- , @ ; @ % CI , @-@ @ ) .


After adjusting for Acute Physiology and Chronic Health Evaluation ( APACHE ) II scores , personal or family history of venous thromboembolism , body mass index , vasopressor use , type of thromboprophylaxis , and presence of leg DVT , NLDVTs were associated with an increased risk of PE ( HR , @ ; @ % CI , @-@ @ ) .


Nonleg DVTs were not associated with ICU mortality ( HR , @ ; @ % CI , @-@ @ ) in a model adjusting for age , APACHE II , vasopressor use , mechanical ventilation , renal replacement therapy , and platelet count below @ @ ( @ ) / L. CONCLUSIONS AND RELEVANCE Despite universal heparin thromboprophylaxis , nonleg thromboses are found in @ % of medical-surgical critically ill patients , primarily in deep veins and proximal veins .


Patients who have a malignant condition may have a significantly higher risk of developing NLDVT , and patients with NLDVT , compared with those without , appeared to be at higher risk of PE but not higher risk of death .


Osteoarthritis is a leading cause of disability in developed nations .


In Australia it afflicts @ % of the adult population .


Total joint arthroplasty is considered the treatment of choice for end stage osteoarthritis .


The number of total joint arthroplasties undertaken in Australia has doubled over the last decade ( more than @,@ procedures in @ ) .


The incidence of pre-operative psychological distress in this group of patients is reported between @ % and @ % and pre-operative psychological distress is associated with poorer pain and functional outcomes after surgery .


This study will use a mindfulness-based psychological intervention to enhance outcomes in people undergoing total joint arthroplasty and , in addition , will test hypotheses about coping with chronic illness in an aged population .


This study is the first of its kind and will provide a greater understanding of the role of a mental health enhancement program on the physical recovery of total joint arthroplasty patients .


One hundred and fifty people with end-stage arthritis on the waiting list for total hip or knee arthroplasty will be recruited and randomly allocated to one of two groups using computer-generated block randomisation .


A randomised controlled trial adhering to CONSORT guidelines will evaluate the efficacy of a mindfulness training program ( weekly group-based classes in mindfulness practice , @ hours , for @weeks plus a @-hour Saturday session in Week @ ) prior to total joint arthroplasty , compared to a `` standard care '' group who will undergo routine total joint arthroplasty .


Primary outcomes will be evaluated by a blinded examiner at baseline , @ and @months post-surgery , using a validated self-reported pain and physical function scale .


Secondary outcomes will include i ) a range of validated measures of psychological wellbeing and ii ) health economic analysis .


All analyses will be conducted on an intention to treat basis using linear regression models .


Health economic modelling will be applied to estimate the potential cost-effectiveness of mindfulness training and total joint arthroplasty .


The objective of this study was to evaluate the effectiveness of nystatin and Biotne ( ) mouthwash Oral Rinse for controlling Candida in total laryngectomy ( TL ) patients with a tracheosophageal voice prosthesis ( TEP ) because Biotne ( ) mouthwash Oral Rinse is a less costly alternative to nystatin and requires less adherence time .


Randomized , unblinded , crossover trial .


Twenty-one TL patients were randomized to receive nystatin followed by Biotne ( ) mouthwash Oral Rinse , or the reverse order , after a basic oral-care phase ( i.e. , brushing teeth , cleaning dentures ) .


A Provox ( ) @ , @ French TEP , which is an indwelling silicone voice prosthesis , was placed at the beginning of each phase .


Patients were provided with oral care instructions at randomization and medication-specific instructions with each treatment 's initiation .


TEPs were processed and evaluated for Candida growth as colony-forming units ( CFUs ) .


Wilcoxon signed-rank tests were used for comparisons between treatments .


Fifteen patients were available for comparisons of Candida counts ( @ received nystatin ; @ received Biotne ( ) mouthwash first ) .


Overall , the median log@ ( CFUs ) remained high regardless of treatment ( no medication : @ ; nystatin : @ ; Biotne ( ) mouthwash : @ ) .


However , the median counts for both nystatin and Biotne ( ) mouthwash Oral Rinse were lower than those for no medication ( difference -LSB- -RSB- : -@ and -@ , respectively ) , although only nystatin was significantly lower ( P = @ ) .


There was no significant difference between the two treatments ( P = @ ) .


Overall , median medication-adherence was high ( @ % ) , and Biotne ( ) mouthwash adherence was significantly higher than that of nystatin ( : @ % ; P = @ ) .


Nystatin and Biotne ( ) mouthwash Oral Rinse had similar CFU levels , with nystatin showing a significant improvement over usual oral care .


Biotne ( ) mouthwash is a less costly alternative to nystatin , with a less complex treatment protocol that might make it preferable to patients and clinicians .


To compare the tolerability of magnifying narrow band imaging endoscopy for esophageal cancer screening with that of lugol chromoendoscopy .


We prospectively enrolled and analyzed @ patients who were at high risk for esophageal cancer .


All patients were divided into two groups : a magnifying narrow band imaging group , and a lugol chromoendoscopy group , for comparison of adverse symptoms .


Esophageal cancer screening was performed on withdrawal of the endoscope .


The primary endpoint was a score on a visual analogue scale for heartburn after the examination .


The secondary endpoints were scale scores for retrosternal pain and dyspnea after the examinations , change in vital signs , total procedure time , and esophageal observation time .


The scores for heartburn and retrosternal pain in the magnifying narrow band imaging group were significantly better than those in the lugol chromoendoscopy group ( P = @ , @ , respectively , ANOVA for repeated measures ) .


The increase in heart rate after the procedure was significantly greater in the lugol chromoendoscopy group .


There was no significant difference between the two groups with respect to other vital sign .


The total procedure time and esophageal observation time in the magnifying narrow band imaging group were significantly shorter than those in the lugol chromoendoscopy group ( @ @ vs @ @ , P = @ , @ @ vs @ @ , P < @ , respectively ) .


Magnifying narrow band imaging endoscopy reduced the adverse symptoms compared with lugol chromoendoscopy .


Narrow band imaging endoscopy is useful and suitable for esophageal cancer screening periodically .


As traditional methods have become increasingly difficult , the Internet offers a mechanism for conducting survey research quickly and efficiently .


However , the validity of this research depends on the ability of respondents to accurately report health status .


We used a large Internet-based inflammatory bowel disease ( IBD ) cohort to validate self-reported IBD against physician reports .


Between June @ , @ , and April @ , @ , all participants of CCFA Partners ( n = @ ) were invited to participate , and @ were selected by random stratified sampling .


We sent physicians a survey to confirm IBD diagnosis and characteristics .


We used descriptive statistics to compare data .


A total of @ participants ( @ % ) indicated interest .


Of @ selected , @ ( @ % ) consented , and physician reports were obtained for @ ( @ % ) .


Physicians confirmed IBD status in @ ( @ % ) and type in @ ( @ % of confirmed ) .


The matching between patient and physician reports for Crohn 's disease ( CD ) was @ % for disease location , @ % for the presence of perianal disease , and @ % for disease behavior .


For ulcerative colitis ( UC ) , disease location matched @ % of the time .


Physician reports confirmed the status of ever having bowel surgery for @ % of CD and @ % for UC and confirmed current pouch or ostomy in @ % of CD and @ % of UC .


Self-reported IBD in CCFA Partners is highly accurate , and participants are willing to release medical records for research .


Self-reported phenotypic characteristics were less valid .


The validity of IBD diagnoses among the participants of CCFA Partners supports the use of this cohort for patient-centered outcome research .


In type @ diabetes mellitus ( T@DM ) , team management using protocols with regular feedback improves clinical outcomes , although suboptimal self-management and psychological distress remain significant challenges .


To investigate if frequent contacts through a telephone-based peer support program ( Peer Support , Empowerment , and Remote Communication Linked by Information Technology -LSB- PEARL -RSB- ) would improve cardiometabolic risk and health outcomes by enhancing psychological well-being and self-care in patients receiving integrated care implemented through a web-based multicomponent quality improvement program ( JADE -LSB- Joint Asia Diabetes Evaluation -RSB- ) .


Between @ and @ , @ of @ Hong Kong Chinese patients with T@DM from @ publicly funded hospital-based diabetes centers were randomized to the JADE+PEARL ( n = @ ) or JADE ( n = @ ) groups , with comprehensive assessment at @ and @ months .


Thirty-three motivated patients with well-controlled T@DM received @ hours of training ( four @-hour workshops ) to become peer supporters , with @ patients assigned to each .


Peer supporters called their peers at least @ times , guided by a checklist .


Changes in hemoglobin A ( @c ) ( HbA ( @c ) ) level ( primary ) , proportions of patients with attained treatment targets ( HbA ( @c ) < @ % ; blood pressure < @/@ mm Hg ; low-density lipoprotein cholesterol < @ mmol/L -LSB- to convert to milligrams per deciliter , divide by @ -RSB- ) ( secondary ) , and other health outcomes at month @ .


Both groups had similar baseline characteristics ( mean -LSB- SD -RSB- age , @ -LSB- @ -RSB- years ; @ % men ; disease duration , @ -LSB- @ -RSB- years ; HbA ( @c ) level , @ % -LSB- @ % -RSB- ; systolic blood pressure , @ -LSB- @ -RSB- mm Hg ; low-density lipoprotein cholesterol level , @ -LSB- @ -RSB- mmol/L ; @ % cardiovascular-renal complications ; and @ % insulin treated ) .


After a mean ( SD ) follow-up period of @ ( @ ) days , @ patients had died , @ had at least @ hospitalization , and @ had repeated comprehensive assessments .


On intention-to-treat analysis , both groups had similar reductions in HbA ( @c ) ( JADE+PEARL , @ % -LSB- @ % CI , @ % -@ % -RSB- , vs JADE , @ % -LSB- @ % CI , @ % -@ % -RSB- -LSB- P = @ -RSB- ) and improvements in treatment targets and psychological-behavioral measures .


In the JADE+PEARL group , @ % of patients maintained contacts with their peer supporters , with a median of @ calls per patient .


Most of the discussion items were related to self-management .


In patients with T@DM receiving integrated care , peer support did not improve cardiometabolic risks or psychological well-being .


Resistance to antibiotics is the major cause of treatment failure of Helicobacter pylori ( HP ) infection .


The culture-guided triple therapy ( chosen on the basis of a preliminary in-vitro susceptibility test ) might help to increase treatment success in high antibiotic resistance regions .


The aim of this study was to evaluate the effectiveness of treatment with clarithromycin in patients with clarithromycin-sensitive culture compared with patients treated empirically .


In this prospective and controlled trial , @ naive HP-positive patients were randomized to receive standard triple therapy omeprazole ( @mg twice daily ) , amoxicillin ( @g twice daily ) , and clarithromycin ( @mg twice daily ) for @ days ( OAC ) after antimicrobial susceptibility testing if there was no resistance to clarithromycin ( ClariS ) or empirical @-day OAC for first-line therapy of HP ( ClariNA ) .


Eradication was confirmed using the C-labelled urea breath test @ weeks after therapy .


Our primary outcome was HP eradication .


Treatment adherence and adverse effects were recorded .


The effectiveness of eradication by protocol with @-day OAC therapy in the ClariS was @ % -LSB- @ % confidence interval ( CI ) : @-@ @ -RSB- , which was @ % higher than ClariNA @ % ( @ % CI : @-@ @ ; P = @ ) .


The odds ratio of eradication in ClariS was @ ( @ % CI : @-@ @ ; P < @ by logistic regression ) and the number needed to treat was @ ( @ % CI : @-@ ) .


We found no significant difference in the occurrence of adverse effects or in compliance between the two groups .


The eradication rate was significantly higher with clarithromycin-based triple therapy for patients with clarithromycin-susceptible HP isolates compared with those for whom no information on the corresponding susceptibility was available ( ClinicalTrials.gov number NCT@ ) .


This study was designed to demonstrate the safety and efficacy of esomeprazole combined with flupentixol/melitracen for the treatment of gastroesophageal reflux disease ( GERD ) patients with emotional disorders .


METHODS Two hundred eighty-nine GERD patients with emotional disorders were divided randomly into two groups : group @ received esomeprazole only ( monotherapy ) and group @ received esomeprazole and flupentixol/melitracen ( combination therapy ) .


The patients ' GERD questionnaire ( GerdQ ) and hospital anxiety and depression ( HAD ) scores were obtained before and after treatment .


Changes in the scores , rates of symptom remission , and adverse effects were compared between the two groups .


After @ weeks of treatment , the average decrease in GerdQ score in the combination group ( @ @ ) was significantly greater than that in the monotherapy group ( @ @ ; P < @ ) .


Significant differences between the two groups were also found for changes in HAD anxiety scores ( @ @ vs @ @ , P < @ ) , depression scores ( @ @ vs @ @ , P < @ ) , and anxiety-depression scores ( @ @ vs @ @ , P < @ ) .


The remission of symptoms ( eructation , abdominal pain , anorexia , and other accompanying symptoms ) in the combination group was significantly better than that in the monotherapy group , and no significant difference in the incidence of adverse events was observed between the two groups .


The combination therapy has better efficacy than the monotherapy in improving the symptoms of gastroesophageal reflux in patients with emotional disorders .


In addition , this combination treatment is safe , with a low incidence of adverse events .


Management of acute sore throat poses a significant burden on UK general practices , with almost @ % of registered patients attending their GP with sore throat every year .


Nearly half of all patients presenting with acute sore throat are treated with antibiotics , despite their limited effect .


In a recent systematic review we demonstrated that a single dose of steroids reduced the severity and time to resolution of sore throat .


However , all of the trials included looked at the use of steroids alongside antibiotics and only one was in a primary care setting .


This trial aims to assess the efficacy and cost-effectiveness of a single oral dose of corticosteroids on symptoms of sore throat in patients receiving either a delayed antibiotic prescription or no antibiotics at all in UK primary care .


A double-blind , two arm , randomized , placebo controlled trial in adults ( @ years of age ) presenting to primary care with acute sore throat ( < seven days ) .


Participants are recruited on the day of presentation to their GP practice .


GPs or nurses assess eligibility , record baseline clinical features and obtain a throat swab for bacterial culture .


Participants are being randomized to treatment arms at a ratio of @:@ .


Treatment arms will be stratified according to whether patients are being given a delayed antibiotic prescription or no antibiotic prescription and by recruiting centre ( Oxford , Bristol or Southampton ) .


Outcome data is being collected at @ and @ hours via text message or telephone call , from days @ to @ using a patient symptom diary and at one month via a GP notes review .


This will be the first randomized controlled trial of oral corticosteroids in adults presenting to primary care with sore throat in the UK , and the first to examine the clinical and cost-effectiveness of oral corticosteroids for the treatment of sore throat in the absence of antibiotics .


Postoperative infectious complications in patients undergoing pancreatic surgery are a significant cause for morbidity and mortality .


Although synbiotics have beneficial effects on human health , their clinical value in surgical patients remains unclear given a paucity of applicable clinical studies .


To determine the impact of perioperative synbiotic therapy on postoperative infectious complications , morbidity and mortality in patients undergoing pancreatic surgery for chronic pancreatitis .


A trial was conducted in patients with chronic calcific pancreatitis undergoing Frey 's procedure .


Group A received a specific synbiotic composition , @ days prior and @ days after the surgery .


Group B received a placebo .


Primary study endpoint was the occurrence of postoperative infection during the first @ days .


Secondary outcome measures were mortality , length of hospital stay , days in intensive care unit , and duration of antibiotic therapy .


Using previously accrued data , with of @ and power @ % , the sample size was calculated as @ patients for each group with a dropout rate of @ % .


Of the @ patients enrolled , @ completed the trial -LSB- group A ( n = @ ) and group B ( n = @ ) -RSB- .


The incidence of postoperative infectious complications ( @ % vs @ % ; P < @ ) , duration of antibiotics therapy ( P < @ ) , and length of hospital stay ( P < @ ) were significantly lower in the synbiotic group .


Synbiotics significantly reduce septic complications , hospital stay , and antibiotic requirement in patients undergoing pancreatic surgery for chronic pancreatitis .


Furthermore , basic and clinical research would clarify the underlying mechanisms of their therapeutic effect and define the appropriate conditions for use .


Minimally invasive plate osteosynthesis for humeral shaft fractures has been described recently , but there are no randomized studies comparing the clinical results for shoulder function between this technique and locking intramedullary nailing .


A prospective randomized study was performed .


Forty-one humeral shaft fractures ( @ patients ) were randomized to be treated with a minimally invasive plate ( n = @ ) or a locking intramedullary nail ( n = @ ) .


Clinical and radiographic outcome assessments were conducted at @year postoperatively .


Shoulder function was the primary outcome , as measured by the University of California , Los Angeles Shoulder Scale .


Elbow function was measured by the Broberg-Morrey score , and fracture consolidation and complications were the main secondary outcomes .


At @year postoperatively , no significant difference was found with regard to shoulder function according to the University of California , Los Angeles scale between the minimally invasive plate and locking intramedullary nail ( @ points vs @ points , P = @ ) .


There was also no difference in elbow function ( @ points vs @ points , P = @ ) .


Complications were similar between the groups , without significant differences regarding infection ( P > @ ) , symptomatic shoulder stiffness ( P = @ ) , and neurapraxia of the lateral cutaneous nerve of the forearm ( P = @ ) .


Fracture union was achieved in all but @ patient ( @ % ) in the intramedullary nail group within @year after the surgical procedure .


There is no significant difference in shoulder function between antegrade intramedullary nailing and minimally invasive plate osteosynthesis for the treatment of displaced humeral shaft fractures , despite the limited power of our study .


Exposure to particulate matter ( PM ) air pollution especially derived from traffic is associated with increases in cardiorespiratory morbidity and mortality .


In this study , we evaluated the ability of novel vehicle cabin air inlet filters to reduce diesel exhaust ( DE ) - induced symptoms and markers of inflammation in human subjects .


Thirty healthy subjects participated in a randomized double-blind controlled crossover study where they were exposed to filtered air , unfiltered DE and DE filtered through two selected particle filters , one with and one without active charcoal .


Exposures lasted for one hour .


Symptoms were assessed before and during exposures and lung function was measured before and after each exposure , with inflammation assessed in peripheral blood five hours after exposures .


In parallel , PM were collected from unfiltered and filtered DE and assessed for their capacity to drive damaging oxidation reactions in a cell-free model , or promote inflammation in A@ cells .


The standard particle filter employed in this study reduced PM@ mass concentrations within the exposure chamber by @ % , further reduced to @ % by the inclusion of an active charcoal component .


In addition use of the active charcoal filter was associated by a @ % and @ % reduction in NO@ and hydrocarbon concentrations , respectively .


As expected , subjects reported more subjective symptoms after exposure to unfiltered DE compared to filtered air , which was significantly reduced by the filter with an active charcoal component .


There were no significant changes in lung function after exposures .


Similarly diesel exhaust did not elicit significant increases in any of the inflammatory markers examined in the peripheral blood samples @hour post-exposure .


Whilst the filters reduced chamber particle concentrations , the oxidative activity of the particles themselves , did not change following filtration with either filter .


In contrast , diesel exhaust PM passed through the active charcoal combination filter appeared less inflammatory to A@ cells .


A cabin air inlet particle filter including an active charcoal component was highly effective in reducing both DE particulate and gaseous components , with reduced exhaust-induced symptoms in healthy volunteers .


These data demonstrate the effectiveness of cabin filters to protect subjects travelling in vehicles from diesel exhaust emissions .


Treatment of breast cancer with aromatase inhibitors is associated with damage to bones .


NCIC CTG MA @ was an open-label , phase @ , randomised controlled trial in which women with breast cancer were assigned to one of two adjuvant oral aromatase inhibitors-exemestane or anastrozole .


We postulated that exemestane-a mildly androgenic steroid-might have a less detrimental effect on bone than non-steroidal anastrozole .


In this companion study to MA @ , we compared changes in bone mineral density ( BMD ) in the lumbar spine and total hip between patients treated with exemestane and patients treated with anastrozole .


In MA @ , postmenopausal women with early stage hormone ( oestrogen ) receptor-positive invasive breast cancer were randomly assigned to exemestane @ mg versus anastrozole @ mg , daily .


MA @ B recruited two groups of women from MA @ : those with BMD T-scores of -@ or more ( up to @ SDs below sex-matched , young adult mean ) and those with at least one T-score ( hip or spine ) less than -@ .


Both groups received vitamin D and calcium ; those with baseline T-scores of less than -@ also received bisphosphonates .


The primary endpoints were percent change of BMD at @ years in lumbar spine and total hip for both groups .


We analysed patients according to which aromatase inhibitor and T-score groups they were allocated to but BMD assessments ceased if patients deviated from protocol .


This study is registered with ClinicalTrials.gov , NCT@ .


Between April @ , @ , and May @ , @ , @ patients with baseline T-scores of -@ or more were accrued ( @ allocated exemestane , @ anastrozole ) ; and @ patients with baseline T-scores of less than -@ ( @ exemestane , @ anastrozole ) .


For patients with T-scores greater than -@ at baseline , mean change of bone mineral density in the spine at @ years did not differ significantly between patients taking exemestane and patients taking anastrozole ( -@ % , @ % CI -@ to @ vs -@ % , @ % CI -@ to -@ ; p = @ ) .


Respective mean loss in the hip was -@ % ( @ % CI -@ to -@ ) versus -@ % ( @ % CI -@ to -@ ; p = @ ) .


Likewise for those who started with T-scores of less than -@ , mean change of spine bone mineral density at @ years did not differ significantly between the exemestane and anastrozole treatment groups ( @ % , @ % CI -@ to @ vs @ % , @ % CI @ to @ ; p = @ ) , nor did hip bone mineral density ( @ % , @ % CI -@ to @ vs @ % , @ % CI -@ to @ ; p = @ ) .


Patients with baseline T-score of -@ or more taking exemestane had two fragility fractures and two other fractures , those taking anastrozole had three fragility fractures and five other fractures .


For patients who had baseline T-scores of less than -@ taking exemestane , one had a fragility fracture and four had other fractures , whereas those taking anastrozole had five fragility fractures and one other fracture .


Our results demonstrate that adjuvant treatment with aromatase inhibitors can be considered for breast cancer patients who have T-scores less than -@ .


To determine whether medical student intubation proficiency with a neonatal mannequin differs according to weekly or consecutive day practice sessions during a six-week pediatric clerkship .


From July @ through June @ , the authors prospectively randomized @ third-year medical students into three neonatal intubation practice groups : standard ( control ; no practice sessions ) , weekly ( practice once/week for four consecutive weeks ) , or consecutive day ( practice once/day for four consecutive days ) .


At baseline , students performed intubation during individual sessions using a neonatal mannequin ( SimNewB ) .


Two reviewers , blinded to practice group , viewed videotapes of intubations and independently scored students on equipment selection , procedural skill steps , length of intubation attempts ( in seconds ) , and the number of attempts ( up to three ) needed for a successful intubation .


Videotaped individual final assessment intubation sessions during week six were evaluated in the same manner .


Students in the weekly and consecutive day practice groups performed better at the final assessment on all variables than students in the standard group ( P < @ ) , but over six weeks , the authors detected no differences between the two distributed practice formats for any outcomes of interest .


Practice improved all aspects of neonatal intubation performance , including choosing the correct equipment , properly performing the skill steps , length of time to successful intubation , and success rate , for novice health care providers in a simulation setting .


Over six weeks , neither practice format proved superior , but it remains unclear whether one format is superior for learning and skill retention over the long term or in actual practice .


Obesity and reduced muscle strength are associated with increased blood pressure ( BP ) .


We examined the impact of milk proteins and combined exercise training ( CET ) on BP , arterial function , and muscle strength ( one-repetition maximum ( @-RM ) ) .


Thirty-three obese sedentary women ( age = @ @ years ; body mass index = @ @ kg/m ( @ ) ; systolic BP ( SBP ) = @ @ mm Hg ) were randomized to control carbohydrate ( n = @ ) , whey ( n = @ ) , and casein ( n = @ ) supplementation for @ weeks .


All participants performed moderate-intensity CET @ days/week .


Brachial and aortic SBP , augmentation index adjusted for @ beats/minute ( AIx@@ ) , arterial stiffness ( brachial-ankle pulse wave velocity ( baPWV ) ) , and @-RM were measured before and after the interventions .


There were significant ( P < @ ) time-by-group interactions for brachial SBP ( bSBP ) , aortic SBP ( aSBP ) , AIx@@, and baPWV .


Whey and casein supplementation significantly ( P < @ ) decreased bSBP ( approximately @mm Hg for both ) , aSBP ( approximately @ mm Hg and approximately @mm Hg , respectively ) , AIx@@ ( approximately @ % and approximately @ % , respectively ) and baPWV ( approximately @ cm/s and approximately @ cm/s , respectively ) compared with no changes in the control group .


Upper - ( approximately @ % ) and lower-body @-RM ( approximately @ % ) increased similarly in all groups .


Changes in arterial function and @-RM were not correlated .


Milk protein supplementation with CET reduced SBP , wave reflection , and arterial stiffness in young obese women with prehypertension and hypertension .


Because CET did not affect arterial function , milk proteins may have an antihypertensive effect by improving arterial function , as shown by reduced AIx@@ and baPWV .


Muscle strength improvements after CET did not affect BP and arterial function .


Management of moderate acute malnutrition ( MAM ) is , currently , focused on food supplementation approaches .


However , the sustainability of these strategies remains weak in low - and middle-income countries .


In food-secure settings , an educational/behavioral intervention could be an alternative for improving MAM management .


This study compared the effectiveness of weekly context-appropriate child-centered counseling ( CCC ) , with an improved corn-soy blend -LSB- corn-soy blend with added micronutrients ( CSB + + ) -RSB- or a locally produced ready-to-use supplementary food ( RUSF ) , in treating MAM through first-line rural health services .


We used a cluster randomized controlled trial design with @ arms , involving @ rural health centers ( @ by arm ) and children aged @-@ mo with uncomplicated MAM .


In the first arm ( CCC ) , trained health workers provided weekly personalized counseling to caretakers .


In the @ other arms , children received weekly either @ g CSB + + or @ g locally produced soy-based RUSF .


Both food supplements provided @ kcal/d .


The recovery rate after @ mo of treatment was significantly lower with CCC ( @ % ) than with CSB + + ( @ % ) and RUSF ( @ % ) ( P < @ ) .


Mothers ' attendance at health facilities was also substantially lower in the CCC arm ( P < @ ) ; this arm had a high defaulter rate ( P < @ ) .


When the analysis was adjusted for attendance , we did not find a significant difference between the @ arms , with incidence rate ratios of @ ( @ % CI : @ , @ ) and @ ( @ % CI : @ , @ ) for the CSB + + and RUSF arms , respectively , compared with the CCC arm .


Whereas supplement-based treatment of MAM was found to be more effective than the provision of CCC , we hypothesize that appropriate and specific nutrition counseling centered on children 's needs , through primary health facilities , might be an alternative strategy for MAM treatment in rural food-secure areas , provided that attendance at counseling sessions by the caregiver is ensured .


This trial was registered at clinicaltrials.gov as NCT@ .


To evaluate the efficacy and safety of arsenic trioxide transarterial chemoembolization and intravenous administration in unresectable hepatocellular carcinoma with lung metastasis .


A single-blind , two-parallel group , randomized trial was conducted at three medical centers ( Guangzhou , China ) , including patients with both biopsy-confirmed hepatocellular carcinoma and lung metastasis .


The experimental group received arsenic trioxide transarterial chemoembolization and intravenous administration of arsenic trioxide , while the control group only received arsenic trioxide transarterial chemoembolization .


We compared overall survival ( OS ) , time to progression ( TTP ) , disease control rate ( DCR ) , and objective response rate ( ORR ) between the groups .


Between April @ and June @ , @ patients received the allocated intervention , @ of whom were in the experimental group and @ of whom were in the control group .


No patient was lost to follow-up .


The median OS was @ ( @ % CI = @-@ @ ) months in the experimental group and @ ( @ % CI = @-@ @ ) months in the control group ( P < @ ) .


The median TTP was @ ( @ % CI = @-@ @ ) months in the experimental group and @ ( @ % CI = @-@ @ ) months in the control group ( P = @ ) .


In the experimental group , the DCR was @ % and the ORR was @ % , while in the control group , the DCR was @ % and the ORR was @ % .


DCR and ORR differed significantly between the two groups ( P < @ and P = @ , respectively ) .


Arsenic trioxide transarterial chemoembolization and intravenous administration were safe and effective in unresectable hepatocellular carcinoma with lung metastasis .


To evaluate the efficacy and safety of dexmedetomidine for post-operative elder patients on mechanical ventilation ( MV ) .


For this randomized controlled trial , @ cases of post-operative patients on MV were enrolled and assigned into either dexmedetomidine group ( n = @ ) or propofol group ( n = @ ) for sedation .


And propofol was used for rescue .


The dose of sedation was regulated by Ramsay score for maintaining a sedative score of @-@ .


In both groups , fentanyl was provided intravenously continually for analgesia .


The amount of fentanyl was adjusted according to the numerical rating scale ( NRS ) score for maintaining an analgesic score of @-@ .


The average Ramsay score , the frequency of propofol , the highest score of NRS , the total dosage of fentanyl and recovery time were compared .


Additional outcomes included duration of mechanical ventilation and intensive care unit ( ICU ) length .


And the incidence of delirium and cardiovascular adverse events were compared for two groups .


No significant inter-group difference existed in the effectiveness of sedation .


Compare with propofol group , the highest score of NRS decreased ( @ @ vs @ @ , P < @ ) , the total dosage of fentanyl significantly decreased ( @ @ vs @ @ g , P < @ ) and recovery time became significantly shortened ( @ @ h vs @ @ h , P < @ ) in dexmedetomidine group .


Median duration of mechanical ventilation in dexmedetomidine group ( @ h , @ % CI : @-@ @ h ) was significantly shorter than that in propofol group ( @ h , @ % CI : @-@ @ h ) ( P < @ ) .


No inter-group differences existed in the ICU length of stay and the incidence of delirium .


Two cases in dexmedetomidine group developed bradycardia while hypotension occurred in two cases of propofol group .


Sedative effects of dexmedetomidine are safe and effective for post-operative elder patients on MV .


And it offers a better efficacy of analgesia and shorter durations of MV and recovery time .


But dexmedetomidine had no significant influence on the ICU length of stay or the incidence of delirium .


Similarly to a wrestling match , upper-body intermittent sprint performance ( UBISP ) test elicits severe acidosis .


This study aimed to determine whether sodium citrate ( CIT ) ingestion would help to better maintain peak power ( PP ) and mean power ( MP ) output across four consecutive UBISP tests simulating wrestling matches of a competition-day .


In a double-blind , counterbalanced , crossover manner , @ trained wrestlers ingested either placebo ( PLC ) or CIT ( @ mg kg ( -@ ) ) within a @-h supplementation period .


Thereafter they completed four ( T@-T@ ) @-min UBISP tests interspersed with @-min recovery periods .


Compared with PLC , CIT supplementation resulted in a persistent increase ( P < @ ) in blood HCO@ ( - ) concentration and pH : pre-T@ @ % and @ units , post-T@ @ % and @ units , respectively .


Post-T@ blood lactate concentration in CIT ( @ @ mmol L ( -@ ) ) was higher ( P = @ ) than that in PLC ( @ @ mmol L ( -@ ) ) .


Decrease in plasma volume across the supplementation period and UBISP tests was greater ( P = @ ) in PLC ( -@ @ % ) than in CIT ( -@ @ % ) .


There was an overall decrease ( P = @ ) in ratings of perceived exertion in CIT compared with PLC , but no between-trial difference ( P > @ ) in PP or MP in any UBISP test occurred .


In trained wrestlers , CIT ingestion induces alkalosis , counteracts reduction in plasma volume , increases post-test blood lactate concentration and reduces perceived exertion , but does not improve PP or MP attained in consecutive UBISP tests simulating four wrestling matches of a competition-day .


In short-term randomized trials ( duration , @ to @ years ) , bariatric surgery has been associated with improvement in type @ diabetes mellitus .


We assessed outcomes @ years after the randomization of @ obese patients with uncontrolled type @ diabetes to receive either intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy .


The primary end point was a glycated hemoglobin level of @ % or less .


The mean ( SD ) age of the patients at baseline was @ years , @ % were women , the mean baseline glycated hemoglobin level was @ % , and the mean baseline body-mass index ( the weight in kilograms divided by the square of the height in meters ) was @ .


A total of @ % of the patients completed @ months of follow-up .


At @ years , the criterion for the primary end point was met by @ % of the patients in the medical-therapy group , as compared with @ % of those in the gastric-bypass group ( P < @ ) and @ % of those in the sleeve-gastrectomy group ( P = @ ) .


The use of glucose-lowering medications , including insulin , was lower in the surgical groups than in the medical-therapy group .


Patients in the surgical groups had greater mean percentage reductions in weight from baseline , with reductions of @ % in the gastric-bypass group and @ % in the sleeve-gastrectomy group , as compared with a reduction of @ % in the medical-therapy group ( P < @ for both comparisons ) .


Quality-of-life measures were significantly better in the two surgical groups than in the medical-therapy group .


There were no major late surgical complications .


Among obese patients with uncontrolled type @ diabetes , @ years of intensive medical therapy plus bariatric surgery resulted in glycemic control in significantly more patients than did medical therapy alone .


Analyses of secondary end points , including body weight , use of glucose-lowering medications , and quality of life , also showed favorable results at @ years in the surgical groups , as compared with the group receiving medical therapy alone .


( Funded by Ethicon and others ; STAMPEDE ClinicalTrials.gov number , NCT@ . )


The aims of the study were to evaluate the long-term effects of a home-based smoking prevention program ` Smoke-free Kids ' during preadolescence on smoking initiation during adolescence and to test the potential moderating role of parental smoking , socioeconomic status , and asthma .


In @ , @ @-@year old children and their mothers were recruited from @ elementary schools in the Netherlands .


An independent statistician randomly allocated schools to one of the two conditions using a @:@ ratio ( single blind ) : @ children in the intervention and @ in the control condition .


The intervention condition received five activity modules , including a communication sheet for mothers , by mail at four-week intervals and one booster module one year after baseline .


The control condition received a fact-based intervention only .


Intention-to-treat analysis was performed on @ non-smoking children at baseline .


In the intervention @ % of the children started smoking compared to @ % in the control condition .


This difference was non-significant ( odds ratio = @ , @ % confidence interval = @-@ @ ) .


No moderating effects were found .


No effects on smoking initiation after @months were found .


Perhaps , the program was implemented with children that were too young .


Programs closer to the age of smoking onset should be tested .


To investigate the influence of normal saline nasal irrigation with different temperature on allergic rhinitis ( AR ) and to confirm the appropriate temperature of nasal irrigation .


Sixty patients with AR were randomly divided into @ groups ( according to random number table ) and received @ C , @ C or @ C normal saline nasal irrigation respectively , and @ healthy controls received no treatment .


Visual analogue scale ( VAS ) was used to assess the symptoms among the control group and the various intervention groups and the enzyme linked immunosorbent assay ( ELISA ) was applied to detect the contents of histamine , leukotriene C@ ( LTC@ ) , house dust mite D@ specific IGE ( sIGE ) and eosinophil cationic protein ( ECP ) among the control group and the various intervention groups .


GraphPad Prism @ software was used to analyze the data .


There was no statistical difference between @ C normal saline nasal irrigation group and @ C normal saline nasal irrigation group .


Pre-intervention and post intervention whether is VAS scores of rhinorrhea , sneezing , nasal obstruction and nasal pruritis or in contents of histamine , LTC@ , sIgE and ECP showed no difference ( all P > @ ) .


However , the symptoms of ( sneezing VAS score : @ @ ; nasal obstruction VAS score : @ @ ) .


The difference was significant ( t = @ , P < @ ; t = @ , P < @ ) .


The contents of histamine -LSB- ( @ @ ) ng/ml -RSB- and LTC@ ( @ @ ng/ml ) were also decreased after intervention of @ C normal saline nasal irrigation -LSB- histamine content : ( @ @ ) ng/ml ; LTC@ content : ( @ @ ) ng/ml -RSB- .


Nonetheless , there were no statistical differences in VAS scores of rhinorrhea ( t = @ , P = @ ) and nasal pruritis ( t = @ , P = @ ) and in contents of sIgE ( t = @ , P = @ ) and ECP ( t = @ , P = @ ) .


There were statistical differences between the @ C group and the @ C group normal saline nasal irrigation group in symptoms of sneezing ( t = @ , P = @ ) and nasal obstruction ( t = @ , P = @ ) .


and inflammatory factors of histamine ( t = @ , P = @ ) and LTC@ ( t = @ , P = @ ) .


In symptoms of rhinorrhea and nasal pruritis and local production of sIgE and ECP , there was no statistical difference ( all P > @ ) .


@ C normal saline nasal irrigation can improve the symptoms of sneezing and nasal obstruction and can alleviate the local levels of inflammatory factors like histamine and LTC@ in AR patients , and is the appropriate irrigation temperature .


Individual-based cognitive-behavioural therapy ( CBT ) is in short supply and expensive .


The aim of this randomised controlled trial ( RCT ) was to compare mindfulness-based group therapy with treatment as usual ( primarily individual-based CBT ) in primary care patients with depressive , anxiety or stress and adjustment disorders .


This @-week RCT ( ClinicalTrials.gov ID : NCT@ ) was conducted during spring @ at @ general practices in Southern Sweden .


Eligible patients ( aged @-@ years ) scored @ on the Patient Health Questionnaire-@ , @ on the Hospital Anxiety and Depression Scale or @-@ on the Montgomery-sberg Depression Rating Scale ( self-rated version ) .


The power calculations were based on non-inferiority .


In total , @ patients were randomised .


Ordinal mixed models were used for the analysis .


For all scales and in both groups , the scores decreased significantly .


There were no significant differences between the mindfulness and control groups .


Mindfulness-based group therapy was non-inferior to treatment as usual for patients with depressive , anxiety or stress and adjustment disorders .


To determine if a new , single-sample device ( ESwab ; Copan Diagnostics , Inc ) can simplify the traditional multi-sample approach to specimen collection in infectious keratitis .


Prospective , diagnostic test evaluation .


In this institutional study , patients with suspected infectious keratitis meeting traditional criteria for diagnostic corneal specimen collection and culture were randomized to the order of first specimen collection method : ESwab or a sample directly plated for growth on chocolate agar .


This was followed by standard samples for blood agar , Gram stain , Sabouraud agar , thioglycolate broth , and brain heart infusion broth in all cases .


The specimens collected using the @ approaches were analyzed separately by the laboratory in a masked fashion .


The main outcome measure was positive growth on cultured media .


Eighty-one eyes from @ consecutive patients were sampled .


Culture positivity rate for the multi-sample method and ESwab was @ % and @ % , respectively , with a @ % agreement rate .


ESwab sensitivity was @ % ( @ % confidence interval -LSB- CI -RSB- : @ % -@ % ) , with a specificity of @ % ( @ % CI : @ % -@ % ) .


Positive and negative predictive values of the ESwab were @ % ( @ % CI : @ % -@ % ) and @ % ( @ % CI : @ % -@ % ) , respectively .


There was no difference in positive culture reports with respect to the order of specimen collection technique used .


The single-sample ESwab method is a more accessible and less cumbersome approach to corneal culturing for ophthalmologists , particularly those in the community setting who do not have access to the full set of traditional culture materials .


Culture results using this single-sample approach were comparable to the multi-sample method .


The management of open tibia fractures remains controversial despite increase in its incidence .


Some surgeons avoid internal fixations for fear of infection while others have demonstrated its superiority .


Identifying an optimal management modality is of utmost benefit to our patients .


Study objectives were to compare the rate of infection and mean duration to healing in the management of open tibia fractures using unreamed interlocking intramedullary nail and external fixation .


The study was an interventional study comparing two known standard methods of managing open tibia fractures conducted in the orthopaedic and trauma department of a tertiary health institution in South west , Nigeria .


Forty patients who presented with open tibia fractures were allocated alternately into primary interlocking nailing group and external fixation group .


Follow-up was for two years .


Incidences of deep wound infection in both groups were @ % ( external fixation ) and @ % ( interlocking nailing ) respectively .


The relative risk of developing infection in external fixation group was @ .


Mean duration to union was @ weeks and @ weeks in the external fixation and interlocking nailing groups respectively , difference in mean was not statistically significant , ( t = @ , p = @ ) .


The risk of wound infection was observed to be higher in this study with the use of external fixation in the management of open tibia fractures compared with unreamed interlocking intramedullary nail .


To determine if concomitant CT-guided biopsy and percutaneous fiducial seed placement in the lung can be performed in a selective patient population without increased complication or decreased success rates compared to either procedure alone .


An IRB approved retrospective analysis of @ consecutive patients that underwent CT-guided placement of fiducial seeds in the lung alone ( N = @ ) , with concomitant core biopsy ( N = @ ) or only core biopsy ( N = @ ) was performed .


Variables compared included : patient demographics , lesion size , depth from pleura , needle size , number of passes through pleura , number and size of core biopsies , number of seeds placed and technical success rates .


Statistical analysis was performed using univariate and multivariate pair-wise comparisons .


A pathologic diagnosis of malignancy was confirmed in all cases undergoing seed placement alone and seed placement with concurrent biopsy , and in @ of the biopsy alone lesions .


On univariate analysis , major complication rates were similar for all three groups as were lesion size , depth , number of pleural passes , and technical success .


Pair-wise comparisons of the remaining variables demonstrated a significant younger age and smaller needle size in the biopsy only group , and less minor complications in the fiducial only group .


Overall there were @/@ ( @ % ) minor and @/@ ( @ % ) major complications .


All major complications leading to admission consisted of either pneumothorax or hemothorax , while minor complications included asymptomatic stable or resolving pneumothoraces , transient hemoptysis or small hemothoraces .


A combined procedure of percutaneous pulmonary core biopsy and stereotactic seed placement can be performed without additional risk of a major complication when compared to performing these separately .


The day-to-day causes of stress are called daily hassles .


Daily hassles are correlated with ill health .


Biofeedback ( BF ) is one of the tools used for acquiring stress-coping skills .


However , the anatomical correlates of the effects of BF with long training periods remain unclear .


In this study , we aimed to investigate this .


PARTICIPANTS WERE ASSIGNED RANDOMLY TO TWO GROUPS : the intervention group and the control group .


Participants in the intervention group performed a biofeedback training ( BFT ) task ( a combination task for heart rate and cerebral blood flow control ) every day , for about @ min once a day .


The study outcomes included MRI , psychological tests ( e.g. , Positive and Negative Affect Schedule , Center for Epidemiologic Studies Depression Scale , and Brief Job Stress Questionnaire ) , and a stress marker ( salivary cortisol levels ) before ( day @ ) and after ( day @ ) the intervention .


We observed significant improvements in the psychological test scores and salivary cortisol levels in the intervention group compared to the control group .


Furthermore , voxel-based morphometric analysis revealed that compared to the control group , the intervention group had significantly increased regional gray matter ( GM ) volume in the right lateral orbitofrontal cortex , which is an anatomical cluster that includes mainly the left hippocampus , and the left subgenual anterior cingulate cortex .


The GM regions are associated with the stress response , and , in general , these regions seem to be the most sensitive to the detrimental effects of stress .


Our findings suggest that our BFT is effective against the GM structures vulnerable to stress .


Recent reports have questioned the adequacy of self-report measures of dietary intake as the basis for scientific conclusions regarding the associations of dietary intake and health , and reports have recommended the development and evaluation of better methods for the assessment of dietary intake in free-living individuals .


We developed a procedure that used pre - and post-meal digital photographs in combination with dietary recalls ( DP+R ) to assess energy intake during ad libitum eating in a cafeteria setting .


To compare mean daily energy intake of overweight and obese young adults assessed by a DP+R method with mean total daily energy expenditure assessed by doubly labeled water ( TDEE ( DLW ) ) .


Energy intake was assessed using the DP+R method in @ overweight and obese young adults ( age = @ years , body mass index -LSB- BMI ; calculated as kg/m ( @ ) -RSB- = @ , female = @ % ) over @ days of ad libitum eating in a university cafeteria .


Foods consumed outside the cafeteria ( ie , snacks , non-cafeteria meals ) were assessed using multiple-pass recall procedures , using food models and standardized , neutral probing questions .


TDEE ( DLW ) was assessed in all participants over the @-day period .


The mean energy intakes estimated by DP+R and TDEE ( DLW ) were not significantly different ( DP+R = @ kcal/d ; TDEE ( DLW ) = @ kcal/d , P = @ ) .


The DP+R method overestimated TDEE ( DLW ) by @ kcal/d ( @ % ) .


Results suggest that the DP+R method provides estimates of energy intake comparable to those obtained by TDEE ( DLW ) .


To investigate the onset and analgesic effect of adding dexmedetomidine to levobupivacaine for caudal block in young children .


Randomized , prospective , double-blind study .


Women and Children Medical Center and university hospital .


Two hundred twelve children , American Society of Anesthesiologists physical status I or II , aged between @ and @ years and weighing between @ and @ kg , who were scheduled for elective inguinal hernia repair or hydrocele .


Children were randomly allocated , using a computer-generated sequence of numbers , into @ of @ groups : caudal @ % levobupivacaine ( Group L ( @ ) ) , caudal @ % levobupivacaine ( Group L ( @ ) ) , or caudal @ % levobupivacaine plus @ g/kg dexmedetomidine ( Group LD ) .


The primary end point of the study was the onset time of caudal levobupivacaine in children .


The secondary end points of the study were the duration of analgesia and the degree of motor block in children .


The @ % and @ % effective onset time ( @ % confidence interval ) values of levobupivacaine were @ minutes ( @-@ @ ) and @ minutes ( @-@ @ ) in Group L ( @ ) , @ minutes ( @-@ @ ) and @ minutes ( @-@ @ ) in Group L ( @ ) , and @ minutes ( @-@ @ ) and @ minutes ( @-@ @ ) in Group LD , respectively .


The mean durations of analgesia in these children were @ , @ , and @ hours in Groups L ( @ ) , L ( @ ) , and LD , respectively .


There were no significant differences in postoperative residual motor block among the @ groups .


Dexmedetomidine added to levobupivacaine does not have a significant effect on the onset time ; however , it prolongs the duration of analgesia during caudal block in children .


This study 's objective was to investigate whether use of an electronic dietary recording system improves nutrition knowledge , eating attitudes and habitual physical activity levels compared to use of a food diary and no self-monitoring .


Sixty adults aged @-@ with a body mass index @ were recruited and randomly assigned to one of three groups : a group using an electronic system ( EG ) , a group using a food diary ( FD ) and a control group using nothing ( CG ) to record food intake .


All participants took part in three @-@ nutrition seminars and completed three questionnaires on general nutrition knowledge , habitual physical activity levels and eating attitudes at the beginning and end of the @-week study .


The pre - and post-test scores for each questionnaire were analysed using a paired sample t-test .


Significant improvements in the domain of ` dietary recommendations ' were found in the EG ( p = @ ) and FD groups ( p = @ ) .


Great improvements were found in ` sources of nutrients ' , ` choosing everyday foods ' and ` diet-disease relationships ' in EG and FD groups .


EG group showed greater improvement in the work index and sport index .


An electronic dietary recording system may improve eating and exercise behaviour in a self-monitoring process .


To investigate whether an early rehabilitation intervention initiated during acute admission for exacerbations of chronic respiratory disease reduces the risk of readmission over @ months and ameliorates the negative effects of the episode on physical performance and health status .


Prospective , randomised controlled trial .


An acute cardiorespiratory unit in a teaching hospital and an acute medical unit in an affiliated teaching district general hospital , United Kingdom .


@ patients aged between @ and @ who within @ hours of admission to hospital with an exacerbation of chronic respiratory disease were randomised to an early rehabilitation intervention ( n = @ ) or to usual care ( n = @ ) .


The primary outcome was readmission rate at @ months .


Secondary outcomes included number of hospital days , mortality , physical performance , and health status .


The primary analysis was by intention to treat , with prespecified per protocol analysis as a secondary outcome .


Participants in the early rehabilitation group received a six week intervention , started within @ hours of admission .


The intervention comprised prescribed , progressive aerobic , resistance , and neuromuscular electrical stimulation training .


Patients also received a self management and education package .


Of the @ participants , @ ( @ % ) had a primary diagnosis of chronic obstructive pulmonary disease .


@ ( @ % ) were readmitted at least once in the following year ( @ % in the intervention group and @ % in the control group ) .


No significant difference between groups was found ( hazard ratio @ , @ % confidence interval @ to @ , P = @ ) .


An increase in mortality was seen in the intervention group at one year ( odds ratio @ , @ % confidence interval @ to @ , P = @ ) .


Significant recovery in physical performance and health status was seen after discharge in both groups , with no significant difference between groups at one year .


Early rehabilitation during hospital admission for chronic respiratory disease did not reduce the risk of subsequent readmission or enhance recovery of physical function following the event over @ months .


Mortality at @ months was higher in the intervention group .


The results suggest that beyond current standard physiotherapy practice , progressive exercise rehabilitation should not be started during the early stages of the acute illness.Trial registration Current Controlled Trials ISRCTN@ .


Pediatric sleep disordered breathing is often caused by hypertrophy of the tonsils and is commonly managed by tonsillectomy .


There is controversy regarding which postsurgical analgesic agents are safe and efficacious .


This prospective randomized clinical trial recruited children who had sleep disordered breathing who were scheduled for tonsillectomy + / - adenoid removal .


Parents were provided with a pulse oximeter to measure oxygen saturation and apnea events the night before and the night after surgery .


Children were randomized to receive acetaminophen with either @-@ @ mg/kg oral morphine or @ mg/kg of oral ibuprofen .


The Objective Pain Scale and Faces Scale were used to assess effectiveness on postoperative day @ and day @ .


The primary endpoint was changes in respiratory parameters during sleep .


A total of @ children aged @ to @ years were randomized .


On the first postoperative night , with respect to oxygen desaturations , @ % of children did not show improvement in the morphine group , whereas @ % of ibuprofen patients did show improvement ( @ % vs @ % ; P < @ ) .


The number of desaturation events increased substantially in the morphine group , with an average increase of @ @ desaturation events per hour ( P < @ ) .


There were no differences seen in analgesic effectiveness , tonsillar bleeding , or adverse drug reactions .


Ibuprofen in combination with acetaminophen provides safe and effective analgesia in children undergoing tonsillectomy .


Post-tonsillectomy morphine use should be limited , as it may be unsafe in certain children .


We tested the hypothesis that higher-intensity interval training ( HIIT ) could be deployed into a standard cardiac rehabilitation ( CR ) setting and would result in a greater increase in cardiorespiratory fitness ( ie , peak oxygen uptake , ( ) VO ) versus moderate-intensity continuous training ( MCT ) .


Thirty-nine patients participating in a standard phase @ CR program were randomized to HIIT or MCT ; @ patients and @ patients in the HIIT and MCT groups , respectively , completed CR and baseline and followup cardiopulmonary exercise testing .


No patients in either study group experienced an event that required hospitalization during or within @ hours after exercise .


The changes in resting heart rate and blood pressure at followup testing were similar for both HIIT and MCT .


( ) VO at ventilatory-derived anaerobic threshold increased more ( P < @ ) with HIIT ( @ @ mLkgmin ) versus MCT ( @ @ mLkgmin ) .