The primary efficacy outcome occurred in @ of @ patients ( @ % ) who received the @-mg dose of FXI-ASO and in @ of @ patients ( @ % ) who received the @-mg dose of FXI-ASO , as compared with @ of @ patients ( @ % ) who received enoxaparin .


The @-mg regimen was noninferior , and the @-mg regimen was superior , to enoxaparin ( P < @ ) .


Bleeding occurred in @ % , @ % , and @ % of the patients in the three study groups , respectively .


This study showed that factor XI contributes to postoperative venous thromboembolism ; reducing factor XI levels in patients undergoing elective primary unilateral total knee arthroplasty was an effective method for its prevention and appeared to be safe with respect to the risk of bleeding .


( Funded by Isis Pharmaceuticals ; FXI-ASO TKA ClinicalTrials.gov number , NCT@ . )


Inhalation of capsaicin , the extract of hot chili peppers , induces coughing in both animals and human subjects through activation of transient receptor potential vanilloid @ ( TRPV@ ) on airway sensory nerves .


Therefore the TRPV@ receptor is an attractive target for the development of antitussive agents .


We sought to assess the antitussive effect of TRPV@ antagonism in patients with refractory chronic cough .


Twenty-one subjects with refractory chronic cough ( > @ weeks ) attending a specialist clinic were recruited to a randomized , double-blind , placebo-controlled crossover trial assessing a TRPV@ antagonist ( SB-@ ) .


Cough reflex sensitivity to capsaicin ( concentration of capsaicin inducing at least @ coughs ) and @-hour cough frequency were coprimary end points assessed after a single dose of SB-@ ( @ mg ) and matched placebo .


Cough severity and urge to cough were reported on visual analog scales , and cough-specific quality of life data were also collected .


Treatment with SB-@ produced a significant improvement in cough reflex sensitivity to capsaicin at @ hours and a borderline significant improvement at @ hours compared with placebo ( adjusted mean difference of +@ doubling doses at @ hours -LSB- @ % CI , +@ to +@ ; P = @ -RSB- and +@ doubling doses at @ hours -LSB- @ % CI , +@ to +@ ; P = @ -RSB- ) .


However , @-hour objective cough frequency was not improved compared with placebo .


Patient-reported cough severity , urge to cough , and cough-specific quality of life similarly suggested no effect of SB-@ .


This study raises important questions about both the role of TRVP@-mediated mechanisms in patients with refractory chronic cough and also the predictive value of capsaicin challenge testing in the assessment of novel antitussive agents .


To develop an optimal model and age-specific centiles for the decline in antimllerian hormone ( AMH ) as measured by the new Beckman Coulter AMH Generation II ( Gen II ) assay and compare this to the previous nomogram derived for the Diagnostics Systems Laboratory ( DSL ) assay .


Multicenter retrospective population study , with validation of linear , biphasic linear , differential , power , and quadratic equations .


Two clinical pathology laboratories .


A new cohort of @,@ women aged @ to @ years old attending infertility clinics , randomly divided into a training cohort of @,@ women and a validation cohort of @,@ women , and an existing cohort of @,@ women , who had contributed to the development and validation of a nomogram for AMH measured by the DSL assay .


Serum measurement of AMH as determined by the Beckman Coulter AMH Generation II assay in @,@ women .


Optimal model for the decline in AMH as measured by the AMH Gen II assay with age , with age-specific @th , @th , @th , @th , @th , @th , and @th percentiles .


A quadratic model defined as ( @ + @ * Age + -@ * Age ( @ ) ) fitted the decline in AMH with age .


The anticipated @ % increase in age-specific population values relative to the previously validated DSL assay nomogram was not observed .


Age-specific reference ranges for the AMH gen II assay suggest a systematic shift in assay calibration since initial evaluation and commercial release of the AMH Gen II assay .


Mild cognitive impairment ( MCI ) is a condition characterized by memory problems that are more severe than the normal cognitive changes due to aging , but less severe than dementia .


Reduced working memory ( WM ) is regarded as one of the core symptoms of an MCI condition .


Recent studies have indicated that WM can be improved through computer-based training .


The objective of this study is to evaluate if WM training is effective in improving cognitive function in elderly patients with MCI , and if cognitive training induces structural changes in the white and gray matter of the brain , as assessed by structural MRI .


The proposed study is a blinded , randomized , controlled trail that will include @ elderly patients diagnosed with MCI at a hospital-based memory clinic .


The participants will be randomized to either a training program or a placebo version of the program .


The intervention is computerized WM training performed for @minutes of @ sessions over @weeks .


The placebo version is identical in duration but is non-adaptive in the difficulty level of the tasks .


Neuropsychological assessment and structural MRI will be performed before and @ month after training , and at a @-month folllow-up .


If computer-based training results in positive changes to memory functions in patients with MCI this may represent a new , cost-effective treatment for MCI .


Secondly , evaluation of any training-induced structural changes to gray or white matter will improve the current understanding of the mechanisms behind effective cognitive interventions in patients with MCI .


We compared mindfulness-based cognitive therapy ( MBCT ) with both cognitive psychological education ( CPE ) and treatment as usual ( TAU ) in preventing relapse to major depressive disorder ( MDD ) in people currently in remission following at least @ previous episodes .


A randomized controlled trial in which @ participants were allocated in the ratio @:@:@ to MBCT plus TAU , CPE plus TAU , and TAU alone , and data were analyzed for the @ ( @ % ; MBCT = @ , CPE = @ , TAU = @ ) retained to follow-up .


MBCT was delivered in accordance with its published manual , modified to address suicidal cognitions ; CPE was modeled on MBCT , but without training in meditation .


Both treatments were delivered through @ weekly classes .


Allocated treatment had no significant effect on risk of relapse to MDD over @ months follow-up , hazard ratio for MBCT vs. CPE = @ , @ % CI -LSB- @ , @ -RSB- ; for MBCT vs. TAU = @ , @ % CI -LSB- @ , @ -RSB- .


However , severity of childhood trauma affected relapse , hazard ratio for increase of @ standard deviation = @ ( @ % CI -LSB- @ , @ -RSB- ) , and significantly interacted with allocated treatment .


Among participants above median severity , the hazard ratio was @ , @ % CI -LSB- @ , @ -RSB- , for MBCT vs. CPE , and @ , @ % CI -LSB- @ , @ -RSB- , for MBCT vs. TAU .


For those below median severity , there were no such differences between treatment groups .


MBCT provided significant protection against relapse for participants with increased vulnerability due to history of childhood trauma , but showed no significant advantage in comparison to an active control treatment and usual care over the whole group of patients with recurrent depression .


The aim of this study was to evaluate the patient 's perceived pain response to injection and anesthetic deposition for the greater palatine nerve block .


Heft-Parker Visual Analog Scale ( VAS ) pain scale measurements were used to compare the following techniques for the injection : ( @ ) control ( no concurrent stimulation ) , ( @ ) pressure , ( @ ) pressure and topical anesthetic ( @ % benzocaine ) , and ( @ ) pressure and cold ( TFE ) .


Forty-two volunteers , @ male and @ female , participated in the study .


A bilateral model was used on each patient to give an injection on each side of the palate with two different techniques followed by the next appointment ( > or = two weeks later ) , when the two other injection techniques were used .


Following injection given in the supine position , the patients were returned to an upright position and asked to rate their pain on a VAS .


Pain upon needle insertion appears less than that of anesthetic deposition .


There was no statistically significant difference in perceived pain response among the four techniques , the visit , the order , the side , or patient gender at either time point .


Following the application of Endo Ice , @ % of participants reported a sore on their palate occurring two to @ hours after cold application and persisting for one to @ days .


The pain score for this injection had a mean value of @ % ( @ / @ ) .


This prospective , single-blind study evaluating three injection techniques to reduce posterior palatal injection pain to a control injection method showed no significant reduction in pain with any of the three techniques .


Furthermore , @,@,@,@-tetrafluoroethane placed with pressure for @ seconds appeared injurious to the oral mucosa .


Continuous glucose monitoring ( CGM ) has been shown to improve glucose control in adults with type @ diabetes .


Effectiveness of CGM is directly linked with CGM adherence , which can be challenging to maintain in children and adolescents .


We hypothesize that initiating CGM at the same time as starting insulin pump therapy in pump nave children and adolescents with type @ diabetes will result in greater CGM adherence and effectiveness compared to delaying CGM introduction by @ months , and that this is related to greater readiness for making behaviour change at the time of pump initiation .


The CGM TIME Trial is a multicenter randomized controlled trial .


Eligible children and adolescents ( @-@ years ) with established type @ diabetes were randomized to simultaneous initiation of pump ( Medtronic Veo ) and CGM ( Enlite ) or to standard pump therapy with delayed CGM introduction .


Primary outcomes are CGM adherence and hemoglobin A@C at @ and @ months post pump initiation .


Secondary outcomes include glycemic variability , stage of readiness , and other patient-reported outcomes with follow-up to @ months .


@ ( @ % ) of the @ eligible patients were enrolled and randomized .


Allowing for @ % withdrawals , this will provide @ % power to detect a between group difference in CGM adherence and @ % power to detect a between group difference in hemoglobin A@C .


Baseline characteristics were similar between the treatment groups .


Analysis of @ month primary outcomes will begin in September @ .


The CGM TIME Trial is the first study to examine the relationship between timing of CGM initiation , readiness for behaviour change , and subsequent CGM adherence in pump nave children and adolescents .


Its findings will advance our understanding of when and how to initiate CGM in children and adolescents with type @ diabetes .


Early statin therapy after acute coronary syndrome reduces atherothrombotic vascular events .


This study aimed to compare the effects of hydrophilic and hydrophobic statins on myocardial salvage and left ventricular ( LV ) function in patients with ST-elevated myocardial infarction ( STEMI ) .


Seventy-five STEMI patients who had received emergency reperfusion therapy were enrolled and randomized into the hydrophilic statin group ( rosuvastatin ; @ mg/day , n = @ ) and hydrophobic statin group ( atorvastatin ; @ mg/day , n = @ ) for @ months .


LV ejection fraction ( LVEF ) , and B-type natriuretic peptide ( BNP ) and co-enzyme Q@ ( CoQ@ ) levels were measured at baseline and the end of treatment .


The myocardial salvage index was assessed by single photon emission computed tomography with ( @ - ) I -- methyl-iodophenylpentadecanoic acid ( ischemic area-at-risk at onset of STEMI : AAR ) and ( @ - ) thallium scintigraphy ( area-at-infarction at @ months : AAI ) -LSB- myocardial salvage index = ( AAR-AAI ) @/AAR ( % ) -RSB- .


Onset-to-balloon time and maximum creatine phosphokinase levels were comparable between the groups .


After @ months , rosuvastatin ( -@ % @ % ) and atorvastatin ( -@ % @ % ) equally reduced low-density lipoprotein-cholesterol ( LDL-C ) levels ( p = @ ) .


However , rosuvastatin ( +@ % @ % , p < @ ) , but not atorvastatin ( +@ % @ % , p = @ ) , improved LVEF .


Rosuvastatin reduced BNP levels compared with atorvastatin ( -@ % @ % versus -@ % @ % , p < @ ) .


The myocardial salvage index was significantly higher in the rosuvastatin group than the atorvastatin group ( @ % @ % versus @ % @ % , p < @ ) .


CoQ@/LDL-C levels at @ months were increased in the rosuvastatin group ( +@ % , p < @ ) and percent changes in CoQ@/LDL-C were correlated with the myocardial salvage index ( r = @ , p < @ ) .


Rosuvastatin shows better beneficial effects on myocardial salvage than atorvastatin in STEMI patients , including long-term cardiac function , associated with increasing CoQ@/LDL-C .


Laparoscopic common bile duct exploration ( LCBDE ) is now one of the main methods for treating choledocholithiasis accompanied with cholelithiasis .


The objective of our study was to assess the safety and effectiveness of laparoscopic primary closure for the treatment of common bile duct ( CBD ) stones compared with T-tube drainage .


Patients who underwent CBD stones were studied prospectively from @-@ in a single center .


A total of @ patients were randomly assigned to group A ( LCBDE with primary closure ) with @ cases and group B ( LCBDE with T-tube drainage ) with @ cases .


Intraoperative cholangiography and choledochoscopy were performed in all patients .


Patient demographics , intraoperative findings , postoperative stay , complications , and hospital expenses were recorded and analyzed .


There was no mortality in the two groups .


Four patients ( @ % ) of group A were converted to open surgery , and three patients ( @ % ) in group B.


The mean operating time was much shorter in group A than in group B ( @ @ min versus @ @ min , P < @ ) .


The length of postoperative hospital stay was longer in group B ( @ @ d ) than in group A ( @ @ d ) .


The hospital expenses were significantly lower in group A. Three patients experienced postoperative complications , which were related to the usage of the T-tube in group B.


The incidences of overall postoperative complications were insignificantly lower in group A.


Laparoscopic primary closure of CBD is safe and effective for the management of CBD stones , and can be performed routinely as an alternative to T-tube drainage .


A recently discovered myokine , irisin , may have an important role in energy metabolism .


This study aimed to evaluate the relationship between this hormone and the lipid profile of patients with metabolic syndrome ( MetS ) following a hypocaloric diet .


Ninety-three Caucasian adults ( @ men/@ women ) diagnosed with MetS followed an @-week-long energy-restricted programme ( -@ % of the energy requirements ) .


Anthropometric measurements , biochemical markers and plasma irisin levels were analysed before and after the nutritional intervention .


Global plasma irisin levels were significantly reduced at the end of the study ( -@ @ ng/ml , P < @ ) accompanying the weight loss ( -@ % ) .


The depletion of irisin significantly correlated with changes in some atherogenic-related variables : total cholesterol ( B = @ , P = @ ) , total cholesterol/high-density lipoprotein cholesterol ratio ( B = @ , P = @ ) , low-density lipoprotein cholesterol ( B = @ , P = @ ) and apolipoprotein B ( B = @ , P = @ ) , independently of changes in body weight .


An association between the reduction in plasma irisin levels and the depletion of important lipid metabolism biomarkers was observed in patients with MetS undergoing an energy-restricted programme .


The @-valent pneumococcal polysaccharide vaccine is recommended for elders , especially those with chronic conditions .


The aim of this study was to determine if an additional multi-component health education intervention increases the uptake rate of the pneumococcal vaccination among older patients with chronic diseases .


A cluster randomized controlled trial was conducted from @ December @ to @ March @ .


The clusters were the individual weeks within five Hong Kong outpatient clinics over a @-week period .


A sample of @ patients aged @ or above with chronic diseases was recruited .


Intervention group received a @-min brief telephone education intervention before and a @-min face-to-face intervention during scheduled medical appointments at the respective clinics .


All subjects received standard care including health education leaflets and/or a video show at the clinics .


Pneumococcal vaccination rate and awareness of the vaccination at @-month follow up were measured .


The vaccination rate was higher in the intervention group compared to the control group ( @ % vs @ % ; relative risk = @ , @ % CI = @-@ @ ) , but the two groups did not differ significantly in their awareness of the vaccination at @-month follow up ( @ % vs @ % , relative risk = @ , @ % CI = @-@ @ ) .


A nurse-delivered brief health education intervention was effective in increasing uptake of pneumococcal vaccination among older patients with chronic diseases .


In assessing quality of care in developing countries , retrospectively collected data are usually used given their availability .


Retrospective data however suffer from such biases as recall bias and non-response bias .


Comparing results obtained using prospectively and retrospectively collected data will help validate the use of the easily available retrospective data in assessing quality of care in past and future studies .


Prospective and retrospective datasets were obtained from a cluster randomized trial of a multifaceted intervention aimed at improving paediatric inpatient care conducted in eight rural Kenyan district hospitals by improving management of children admitted with pneumonia , malaria and diarrhea and/or dehydration .


Four hospitals received a full intervention and four a partial intervention .


Data were collected through @ two weeks surveys conducted at baseline , after @ and @ months .


Retrospective data was sampled from paediatric medical records of patients discharged in the preceding six months of the survey while prospective data was collected from patients discharged during the two week period of each survey .


Risk Differences during post-intervention period of @ quality of care indicators were analyzed separately for prospective and retrospective datasets and later plotted side by side for comparison .


For the prospective data there was strong evidence of an intervention effect for @ of the indicators and weaker evidence of an effect for one indicator , with magnitude of effect sizes varying from @ % to @ % difference .


For the retrospective data , @ process ( these include the @ indicators found to be statistically significant in prospective data analysis ) indicators had statistically significant differences with magnitude of effects varying from @ % to @ % .


The bar-graph comparing results from the prospective and retrospective datasets showed similarity in terms of magnitude of effects and statistical significance for all except two indicators .


Multifaceted interventions can help improve adoption of clinical guidelines and hence improve the quality of care .


The similar inference reached after analyses based on prospective assessment of case management is a useful finding as it supports the utility of work based on examination of retrospectively assembled case records allowing longer time periods to be studied while constraining costs .


Poor patient understanding of their diagnosis and treatment plan can adversely impact clinical outcome following hospital discharge .


Discharge summaries are primarily written for the doctor rather than the patient .


We determined patient understanding of the reasons for hospitalisation , in-hospital tests , treatments and post-discharge recommendations , and whether a brief patient-directed discharge letter ( PADDLE ) delivered during a brief discussion prior to discharge would improve understanding .


A prospective randomised controlled trial was conducted , including @ hospitalised patients .


After a baseline questionnaire , patients were randomised to receive the PADDLE letter or usual care .


Those receiving the letter had an immediate follow-up questionnaire .


Patient understanding was compared with a summary letter written by the treating clinician , using a @-point Likert scale ranging from none to full understanding .


A questionnaire was administered at @ and @ months .


At baseline , patients had almost full understanding ( median score @ ) of reasons for hospitalisation and treatments .


However , despite high self-appraisal , patients objectively had very little understanding of tests performed and post-discharge recommendations ( median @ ) .


Those receiving the letter had an immediate increase to almost full understanding ( median @ ) of tests performed ( P < @ ) and to full understanding ( median @ ) of post-discharge recommendations .


This increase did not persist at @ or @ months .


A simple patient-directed letter delivered during a brief discussion improves patient understanding of their hospitalisation and post-discharge recommendations , which is otherwise limited .


Further evaluation of this brief and well-received intervention is indicated , with the goal of improving patient understanding , satisfaction and clinical outcomes .


Patient reported outcome measures ( PROMs ) are used to evaluate lifestyle interventions but little is known about differences between patients returning valid and invalid responses , or of potential for bias in evaluations .


We aimed to examine the characteristics of patients who returned valid responses to lifestyle questionnaires compared to those whose responses were invalid for evaluating lifestyle change .


We conducted a secondary data analysis from the SPHERE Study , a trial of an intervention to improve outcomes for patients with coronary heart disease in primary care .


Postal questionnaires were used to assess physical activity ( Godin ) and diet ( DINE ) among study participants at baseline and @ month follow-up .


Three binary response variables were generated for analysis : ( @ ) valid Godin score ; ( @ ) valid DINE Fibre score ; and ( @ ) valid DINE Total Fat score .


Multivariate analysis comprised generalised estimating equation regression to examine the association of patients ' characteristics with their return of valid responses at both timepoints .


Overall , @ % of participants ( @/@ ) returned questionnaires at both baseline and @ months .


Relatively fewer valid Godin scores were returned by those who left school aged < @ years ( @ % ) than aged @ and over ( @ % ) , manual workers ( @ % ) than non-manual ( @ % ) and those with an elevated cholesterol ( > @ mmol ) ( @ % ) than those with a lower cholesterol ( @ % ) but multivariate analysis identified that only school leaving age ( p = @ ) was of statistical significance.Relatively fewer valid DINE scores were returned by manual than non-manual workers ( fibre : @ % v @ % ; fat : @ % v @ % ) , smokers ( fibre : @ % v @ % ; fat : @ % v @ % ) , patients with diabetes ( fibre : @ % v @ % ; fat : @ % v @ % ) and those with cholesterol > @ mmol ( fat : @ % v @ % ) but multivariate analysis showed statistical significance only for smoking ( fibre : p = @ ; fat : p = @ ) , diabetes ( fibre : p = @ ; fat : p = @ ) , and cholesterol ( fat : p = @ ) .


Our findings illustrate the importance of detailed reporting of research methods , with clear information about response rates , respondents and valid outcome data .


Outcome measures which are relevant to a study population should be chosen carefully .


The impact of methods of outcome measurement and valid response rates in evaluating healthcare requires further study .


Previous studies have shown that a calcium ( Ca ) pre-rinse given before a @ ppm fluoride ( F ) rinse greatly increased salivary fluoride .


Objectives .


The aim of this randomized controlled trial is to examine if Ca pre-rinse could increase the fluoride concentration in the overnight unstimulated saliva after a @ ppm F-rinse .


Pre-rinses containing @ mM , @ mM or @ mM Ca-lactate prepared by a validated pharmaceutical cGPM procedure were tested by nine subjects in a randomized order immediately followed by a @ ppm F-rinse .


The fluoride concentration was measured in unstimulated saliva collected @ h later .


The Ca pre-treatment significantly increased F level in overnight saliva following the @ ppm fluoride rinse by @ relative to the @ ppm F-rinse alone ; however , a significant effect was only observed with the highest ( @ mM ) Ca concentration as pre-rinse .


Clinical relevance .


High concentration F rinses ( @ ppm ) are commonly recommended for patients at high-risk of caries .


A pre-treatment with high levels of Ca may further improve the cariostatic effect of this ion .


Social media sites , such as Facebook , merge two factors that influence risk for eating disorders : media and peers .


Previous work has identified cross-sectional and temporal associations between Facebook use and disordered eating .


This study sought to replicate and extend these findings using an experimental design .


In Study @ , @ women completed self-report surveys regarding Facebook use and disordered eating .


In Study @ , @ women were randomly assigned to use Facebook or to use an alternate internet site for @ min .


More frequent Facebook use was associated with greater disordered eating in a cross-sectional survey .


Facebook use was associated with the maintenance of weight/shape concerns and state anxiety compared to an alternate internet activity .


Facebook use may contribute to disordered eating by maintaining risk for eating pathology .


As such , targeting Facebook use may be helpful in intervention and prevention programs .


Oritavancin is a lipoglycopeptide antibiotic with rapid bactericidal activity against gram-positive bacteria .


Its concentration-dependent activity and long half-life allow for single-dose treatment .


In a randomized , double-blind trial , adults with acute bacterial skin and skin structure infections ( ABSSSIs ) received either a single intravenous @-mg dose of oritavancin or @-@ days of twice-daily vancomycin .


Three efficacy endpoints were tested for noninferiority : ( @ ) primary composite endpoint at @-@ hours ( cessation of spreading or reduction in lesion size , absence of fever , and no rescue antibiotic ) ; ( @ ) investigator-assessed clinical cure @-@ days after end of treatment ; and ( @ ) @ % reduction in lesion area at @-@ hours .


A total of @ and @ patients comprised the modified intent-to-treat population for oritavancin and vancomycin , respectively .


All @ efficacy endpoints met the @ % noninferiority margin : the primary composite endpoint ( @ % vs @ % ; @ % confidence interval -LSB- CI -RSB- , -@ to @ ) , investigator-assessed clinical cure ( @ % vs @ % ; @ % CI , -@ to @ ) , and proportion of patients attaining @ % reduction in lesion area ( @ % vs @ % ; @ % CI , -@ to @ ) for oritavancin vs vancomycin , respectively .


Efficacy outcomes by pathogen , including methicillin-resistant Staphylococcus aureus and the frequency of adverse events , were similar between treatment groups .


A single @-mg dose of oritavancin was noninferior to @-@ days of vancomycin in treating ABSSSIs caused by gram-positive pathogens , and was well tolerated .


Oritavancin provides a single-dose alternative to multidose therapies for the treatment of ABSSSIs .


Clinical Trials Registration .


NCT@ .


To test a combination of dexamethasone intravitreal implant with macular grid laser for macular edema in patients with branch retinal vein occlusion ( BRVO ) .


Prospective interventional , randomized , multicenter study .


Patients with macular edema secondary to BRVO underwent an Ozurdex intravitreal implant at baseline .


After @ month , patients were randomly assigned to @ study groups .


Patients in Group @ were followed up monthly and retreated with Ozurdex implant whenever there was a recurrence of macular edema or a decrease in best-corrected visual acuity ( BCVA ) .


In Group @ patients macular grid laser was performed between weeks @ and @ .


After that , patients were followed up and retreated as for Group @ .


In Group @ at @ months , mean BCVA was @ @ logMAR and central retinal thickness ( CRT ) was @ @ m ; both improved significantly at @ months , to @ @ logMAR and @ @ m , respectively .


In Group @ , CRT was reduced significantly to @ @ m at @ months , and BCVA improved to @ @ logMAR .


At the final visit , BCVA was @ @ logMAR and mean CRT was @ @ m.


The number of Ozurdex implants at @ months was @ of @ ( @ % ) in Group @ patients vs @ of @ ( @ % ) in Group @ patients ( P = @ ) .


At @ months @ of @ patients ( @ % ) in Group @ vs @ of @ ( @ % ) in Group @ ( P = @ ) were retreated .


The combination of Ozurdex implant and macular grid laser is synergistic in increasing BCVA and lengthening the time between injections .


Pulmonary arterial hypertension ( PAH ) is a progressive disease with high rates of morbidity and mortality .


Current therapies improve symptoms , functional capacity , and , in select cases , survival .


Little is known about patient factors that may predict the likelihood of patient-important , clinically relevant responses to therapy such as the @-min walk distance ( @MWD ) and health-related quality of life ( HRQoL ) .


Data from the randomized clinical trial of tadalafil in PAH were used .


Adjusted logistic regression models were created to examine the relationship between baseline characteristics and odds of achieving the minimal important difference ( MID ) in three parameters , defined as either a > @-m increase in @MWD , a > @-unit increase in physical component summary score of the Medical Outcomes Study Short Form-@ ( SF-@ ) , or a > @-unit increase in mental component summary score of the SF-@ .


The study included @ subjects .


Younger age , male sex , lower baseline @MWD , and disease etiology were associated with greater odds of achieving the MID for the @-min walk test .


Active treatment , younger age , and male sex were associated with greater odds of achieving the MID for the physical component summary score .


Male sex was associated with greater odds of achieving the MID for the mental component summary score .


Age , sex , baseline functional capacity , and disease etiology are variably associated with the likelihood of achieving clinically relevant responses in patient-important outcomes to PAH-specific therapy such as @MWD and HRQoL .


The increased likelihood of response in men compared with women is a novel finding and may reflect pathophysiologic differences between sexes .


Vascular calcification is a potent predictor of plaque instability and cardiac events .


Osteoprotegerin ( OPG ) , well-known vascular calcification mediator , is a signaling molecule involved in bone remodeling , which has been implicated in the regulation of vascular calcification and atherogenesis .


The purpose of this study was to compare the combination treatments of olmesartan/azelnidipine and olmesartan/diuretics on serum bone-related markers in patients with essential hypertension .


A total of @ patients with hypertension treated with @ mg olmesartan were randomized to receive combination treatment with @ mg azelnidipine ( O/A group ) or diuretics ( @ mg indapamide ; O/D group ) for @ months .


Osteoprotegerin , matrix metalloproteinase @ ( MMP-@ ) , and high-sensitive CRP ( hs-CRP ) were measured after @ and @ months of treatment .


Cardio-ankle vascular index ( CAVI ) was measured as the arterial stiffness using a VaSera CAVI instrument at the same time points .


In both groups , the systolic and diastolic blood pressure reduction is similar .


Serum OPG , MMP-@ , and hs-CRP were significantly decreased at @ months in the O/A group ( P < @ ) , while there were no significant reductions in the O/D group .


CAVI was significantly improved at @ months in both the treatment groups .


The improvement in CAVI was significantly greater in the O/A group than in the O/D group .


Azelnidipine , but not indapamide , combined with olmesartan , improved arterial stiffness and were associated with significant decrease in OPG , MMP-@ , and hs-CRP concentrations .


These results suggest that the beneficial effects of the combination treatments of olmesartan/azelnidipine on arterial stiffness are mediated by alteration in bone-remodeling and inflammatory markers .


Excessive alcohol use is a prevalent and worldwide problem .


Excessive drinking causes a significant burden of disease and is associated with both morbidity and excess mortality .


Prototype alteration and provision of a cue reminder could be useful strategies to enhance the effectiveness of online tailored interventions for excessive drinking .


Through a Web-based randomized controlled trial , @ strategies ( ie , prototype alteration and cue reminders ) within an existing online personalized feedback intervention ( Drinktest ) aimed to reduce adults ' excessive drinking .


It was expected that both strategies would add to Drinktest and would result in reductions in alcohol consumption by intrinsic motivation and the seizure of opportunities to act .


Participants were recruited online and through printed materials .


Excessive drinking adults ( N = @ ) were randomly assigned to @ conditions : original Drinktest , Drinktest plus prototype alteration , Drinktest plus cue reminder , and Drinktest plus prototype alteration and cue reminder .


Evaluation took place at @-month posttest and @-month follow-up .


Differences in drinking behavior , intentions , and behavioral willingness ( ie , primary outcomes ) were assessed by means of longitudinal multilevel analyses using a last observation carried forward method .


Measures were based on self-reports .


All conditions showed reductions in drinking behavior and willingness to drink , and increased intentions to reduce drinking .


Prototype alteration ( B = -@ , P < @ ) and cue reminder usage ( B = -@ , P < @ ) were both more effective in reducing alcohol consumption than when these strategies were not provided .


Combining the strategies did not produce a synergistic effect .


No differences across conditions were found regarding intentions or willingness .


Although individuals ' awareness of their cue was reasonable , their reported alcohol consumption was nevertheless reduced .


Individuals appeared to distance their self-image from heavier drinking prototypes .


Thus , prototype alteration and cue reminder usage may be feasible and simple intervention strategies to promote reductions in alcohol consumption among adults , with an effect up to @ months .


Evidence suggests depression increases hospital readmission risk .


Determine whether depressive symptoms are associated with unplanned readmission within @ days of discharge of general medical patients .


Secondary analysis of the Project Re-Engineered Discharge ( RED ) randomized controlled trials .


Urban academic safety-net hospital .


A total of @ hospitalized adult English-speaking patients .


The @-Item Patient Health Questionnaire ( PHQ-@ ) was used to screen patients for depressive symptoms .


Hospital readmission within @ days of discharge .


Poisson regression was used to control for confounding variables .


There were @ ( @ % ) patients who screened positive for mild depressive symptoms ( @ PHQ-@ @ ) and @ ( @ % ) for moderate or severe depressive symptoms ( PHQ-@ @ ) .


After controlling for confounders , a higher rate of readmission was observed in subjects with mild depressive symptoms compared to subjects with PHQ-@ < @ , incidence rate ratio ( IRR ) @ ( @ % confidence interval -LSB- CI -RSB- : @-@ @ ) .


The adjusted IRR of readmission for those with moderate-to-severe symptoms was @ ( @ % CI : @-@ @ ) compared to those with no depression .


Screening positive for mild and moderate-to-severe depressive symptoms during a hospitalization on a general medical service is associated with an increased dose-dependent readmission rate within @ days of discharge in an urban , academic , safety-net hospital .


Further research is needed to determine whether treatments targeting the reduction of depressive symptoms reduce the risk of readmission .


Gaucher disease type @ is characterized by hepatosplenomegaly , anemia , thrombocytopenia , and skeletal disease .


A safe , effective oral therapy is needed .


To determine whether eliglustat , a novel oral substrate reduction therapy , safely reverses clinical manifestations in untreated adults with Gaucher disease type @ .


Phase @ , randomized , double-blind , placebo-controlled trial conducted at @ sites in @ countries from November @ to July @ among eligible patients with splenomegaly plus thrombocytopenia and/or anemia .


Of @ patients screened , @ were enrolled .


Patients were stratified by spleen volume and randomized @:@ to receive eliglustat ( @ or @ mg twice daily ; n = @ ) or placebo ( n = @ ) for @ months .


The primary efficacy end point was percentage change in spleen volume in multiples of normal from baseline to @ months ; secondary efficacy end points were change in hemoglobin level and percentage changes in liver volume and platelet count .


All patients had baseline splenomegaly and thrombocytopenia ( mostly moderate or severe ) , most had mild or moderate hepatomegaly , and @ % had mild anemia .


Least-square mean spleen volume decreased by @ % ( @ % CI , -@ % to -@ % ) in the eliglustat group ( from @ to @ multiples of normal ) vs an increase of @ % ( @ % CI , -@ % to @ % ) in the placebo group ( from @ to @ multiples of normal ) for an absolute treatment difference of -@ % ( @ % CI , -@ % to -@ % ; P < @ ) .


For the secondary end points , the least-square mean absolute differences between groups all favored eliglustat , with a @-g / dL increase in hemoglobin level ( @ % CI , @-@ @ g/dL ; P < @ ) , @ % decrease in liver volume ( @ % CI , -@ % to -@ % ; P = @ ) , and @ % increase in platelet count ( @ % CI , @ % -@ % ; P < @ ) .


No serious adverse events occurred .


One patient in the eliglustat group withdrew ( non-treatment related ) ; @ of the @ patients transitioned to an open-label extension study .


Among previously untreated adults with Gaucher disease type @ , treatment with eliglustat compared with placebo for @ months resulted in significant improvements in spleen volume , hemoglobin level , liver volume , and platelet count .


The clinical significance of these findings is uncertain , and more definitive conclusions about clinical efficacy and utility will require comparison with the standard treatment of enzyme replacement therapy as well as longer-term follow-up .


To investigate urine excretion of nephrin in patients with proteinuric nephropathies associated with rheumatoid arthritis ( RA ) .


We enrolled in the study @ patients with seropositive RA and proteinuria , the control group ( @ persons ) was formed from healthy blood donors , the comparison group ( @ persons ) was formed from RA patients without proteinuria .


Kidney biopsy was performed in @ patients ( glomerulonephritis was diagnosed in @ patients , - amyloidosis in @ patients and tubulointerstitial nephritis in @ patients ) .


Urine nephrin concentration in patients with RA and proteinuria was @ ( @ ; @ ) ng/ml and significantly differed in its levels both in controls - @ ( @ ; @ ) ng/ml ( p = @ ) and RA patients without proteinuria - @ ( @ ; @ ) ng / ml ( p = @ ) group .


In RA patients with proteinuria , we found a positive correlation between urine nephrin and protein concentrations ( r = @ ; p = @ ) .


Urine nephrin levels in patients of the glomerulonephritis - @ ( @ ; @ ) and amyloidosis groups - @ ( @ ; @ ) ng/ml were higher than in the controls ( p = @ ; p = @ ) and in the group of patients without proteinuria ( p = @ ; p = @ ) .


In the patients with tubulointerstitial nephritis urine nephrin concentration did not differ significantly with the values in both the control and the RA patients without proteinuria groups .


According to our data , proteinuria in the overall cohort of patients with seropositive RA is associated with increased levels of urine nephrin excretion , the highest levels of nephrin excretion were registered in patients with glomerulonephritis and amyloidosis .


Depression is one the most common mental disorders that can be seen all over the world .


In traditional Persian medicine , some medicinal herbs are recommended for depression treatment .


This study aimed to evaluate the effects of Cuscuta planiflora Ten .


and Nepeta menthoides Boiss .


& Buhse in patients with major depression .


This study is a randomized triple-blind controlled clinical trial conducted in the year @ in Shiraz University of Medical Sciences on patients with major depression .


Pharmaceutical capsules of Cuscuta planiflora ( @ mg ) and Nepeta menthoides ( @ mg ) were prepared by a pharmacist .


Patients were randomly assigned to @ groups : group A ( treated with Nepeta menthoides capsules and conventional drugs ) , group B ( treated with Cuscuta planiflora capsules and conventional drugs ) , and group C ( treated only with conventional drugs ) .


The study period was @ weeks and depression was measured before and after the study by Beck Depression Inventory and Hamilton Depression Inventory .


The data were analyzed by SPSS version @ and the P < @ was considered statistically significant .


A total of @ subjects participated in this study , of whom @ % were females ( n = @ ) and @ % were males ( n = @ ) .


The mean standard deviation of age of the participants was @ @ years .


The majority of patients ( @ % , n = @ ) were married .


There were @ patients ( @ % ) in group A , @ ( @ % ) in group B , and @ ( @ % ) in group C.


There was a significant decrease in mean scores of Beck and Hamilton depression inventories in the @ groups after treatment ( P < @ ) ; moreover , there was more decrease in scores of the Beck and Hamilton depression inventories in groups A and B compared with group C after treatment ( P < @ ) .


Despite the paucity of the population under study , the findings showed that Cuscuta planiflora and Nepeta menthoides capsules could be effective , affordable herbal medicines with improved cost-benefit in treatment of major depression and it is worth designing further and more extensive studies to get to a more accurate conclusion .


To evaluate the effect of side-cut angle profile on corneal biomechanical properties after femtosecond laser in situ keratomileusis ( FS-LASIK ) .


Ninety-six myopic eyes of @ patients underwent FS-LASIK .


One eye of each patient was randomized to flap creation with a side-cut angle of @ .


The fellow eye flap side-cut angle was adjusted to @ .


Mean absolute error of flap diameter and mean change in Goldmann-correlated intra-ocular pressure ( IOPg ) , corneal-compensated IOP ( IOPcc ) , corneal hysteresis ( CH ) , corneal resistance factor ( CRF ) , p@ area , p@ area , p@ area @ and p@ area @ were compared between both groups .


Overall , the mean IOPg and CRF showed significant reduction at the end of @ and @months , as well as between @ and @months postoperatively ( p@ @ ) .


The mean IOPcc and CH showed significant reduction ( p < @ ) at the end of @months postoperatively .


The parameters p@ area , p@ area , p@ area @ and p@ area @ changed significantly at the end of @ and @months postoperatively ( p < @ ) .


There was no significant difference between both groups with regards to the mean change of IOPg , IOPcc , CH , CRF , p@ area , and p@ area @ .


In @ group , the mean absolute error in flap diameter was greater compared with @ group ( p = @ ) .


The stability of IOP and corneal biomechanical properties were not enhanced in FS-LASIK flaps with an inverted side-cut angle .


The size of corneal flap created with @ side-cut angle was more accurate compared with @ side-cut angle .


To study post-operative pain and blood loss after intraoperative periarticular injection with the multimodal drugs diclofenac , adrenaline , marcaine ( bupivacaine ) and morphine in total knee arthroplasty .


A prospective randomized controlled trial of knee osteoarthritis patients age more than @ years undergoing total knee arthroplasty at Maharat Nakhon Ratchasima hospital from January @ through June @ was performed .


A group receiving intra-operative periarticular injections was compared to a control group receiving no injections .


Half of a group of forty-two patients , @ males and @ females , average age @ years ( range @-@ years ) , were randomly assigned to receive the periarticular injection ( the injection group ) , the others to the control group .


Pain was measured by two methods : visual analog score at @ , @ , @ and @ hours post-operation and by patient controlled analgesia ( PCA ) measuring the daily amount of intravenous morphine used .


The amount of blood loss post operation ( in the redivac drain ) , degree of knee flexion , time to onset of assisted ambulation , length of hospital stay and any complications were also analyzed .


The mean VAS at @ and @ hours post operation of the injection group were @ and @ , whereas the values for the control group were @ and @ , respectively ( p < @ ) .


Mean quantities of morphine used by PCA by the injection group during the first day was @ mg , significantly lower than the @ mg used by the control group .


Average blood loss of the injection group at @ ml was also significantly below the @ ml of the control group ( p < @ ) .


The degree of knee flexion , time to onset of assist ambulation , length of hospital stay and complications , however were not significantly different between the groups .


Multimodal drugs , periarticular injections consisting of diclofenac , adrenaline , Marcaine plus a patient controled anesthetic machine ( PCA ) with morphine can significantly reduce post-operative pain and blood loss in total knee arthroplasty without significant adverse effects .


Most primary care clinicians lack the skills and resources to offer effective lifestyle and medication ( L&M ) counseling to reduce coronary heart disease ( CHD ) risk .


Thus , effective and feasible CHD prevention programs are needed for typical practice settings .


To assess the effectiveness , acceptability , and cost-effectiveness of a combined L&M intervention to reduce CHD risk offered in counselor-delivered and web-based formats .


A comparative effectiveness trial in @ diverse family medicine practices in North Carolina .


Participants were established patients , aged @ to @ years , with no known cardiovascular disease , and at moderate to high risk for CHD ( @-year Framingham Risk Score -LSB- FRS -RSB- , @ % ) .


Participants were randomized to counselor-delivered or web-based format , each including @ intensive and @ maintenance sessions .


After randomization , both formats used a web-based decision aid showing potential CHD risk reduction associated with L&M risk-reducing strategies .


Participants chose the risk-reducing strategies they wished to follow .


The primary outcome was within-group change in FRS at @-month follow-up .


Other measures included standardized assessments of blood pressure , blood lipid levels , lifestyle behaviors , and medication adherence .


Acceptability and cost-effectiveness were also assessed .


Outcomes were assessed at @ and @ months .


Of @ screened patients , @ were randomized ( @ counselor ; @ web ) : mean age , @ years ; @ % African American ; and mean FRS , @ % .


Follow-up at @ and @ months included @ % and @ % of the randomized participants , respectively .


There was a sustained reduction in FRS at both @ months ( primary outcome ) and @ months for both counselor-based ( -@ % -LSB- @ % CI , -@ % to -@ % -RSB- and -@ % -LSB- @ % CI , -@ % to -@ % -RSB- , respectively ) and web-based groups ( -@ % -LSB- @ % CI , -@ % to -@ % -RSB- and -@ % -LSB- @ % CI , -@ % to -@ % -RSB- respectively ) .


At @ months , the adjusted difference in FRS between groups was -@ % ( @ % CI , -@ % to -@ % ) ( P = @ ) , and at @ months , it was -@ % ( @ % CI , -@ % to @ % ) ( P = @ ) .


The @-month costs from the payer perspective were $ @ and $ @ per person for the counselor - and web-based interventions , respectively .


Both intervention formats reduced CHD risk through @-month follow-up .


The web format was less expensive .


This randomized , double-blind @ week study compared the efficacy and tolerability of fixed-dose treatment with vortioxetine ( @mg/day ) and venlafaxine extended release ( XR ) ( @mg/day ) in major depressive disorder ( MDD ) patients .


Patients aged @-@ years with a primary diagnosis of recurrent MDD , a Montgomery-sberg Depression Rating Scale ( MADRS ) total score @ and a Clinical Global Impression-Severity ( CGI-S ) score @ were randomized ( @:@ ) to treatment with either vortioxetine or venlafaxine XR .


The primary endpoint was change from baseline to Week @ in MADRS total score ( analysis of covariance -LSB- ANCOVA -RSB- , full-analysis set -LSB- FAS -RSB- , last observation carried forward -LSB- LOCF -RSB- ) , using a non-inferiority margin of +@ points .


Pre-specified secondary endpoints included MADRS response and remission rates , anxiety symptoms ( HAM-A ) , CGI , overall functioning ( SDS ) , and health-related quality of life ( Q-LES-Q ) .


This study ( SOLUTION ) has the www.ClinicalTrials.gov identifier : NCT@ .


On the primary efficacy endpoint at Week @ , non-inferiority was established with a difference of -@ MADRS points in favor of vortioxetine ( @ % CI : -@ to @ ) .


The MADRS total score decreased ( improved ) from @ at baseline to @ ( vortioxetine : n = @ ) and from @ to @ ( venlafaxine XR : n = @ ) ( FAS , LOCF ) .


At Week @ , the HAM-A and SDS total scores , CGI and Q-LES-Q scores , and response and remission rates demonstrated similar improvement for vortioxetine and venlafaxine XR , with remission rates ( MADRS @ ) of @ % ( vortioxetine ) versus @ % ( venlafaxine XR ) ( LOCF ) .


Fewer vortioxetine than venlafaxine XR patients withdrew for any reason ( @ % versus @ % ) or for adverse events ( @ % versus @ % ) .


The most frequent adverse events ( @ % ) for both treatments were nausea , dizziness , headache , and dry mouth .


In addition , accidental overdose , decreased appetite , constipation and insomnia were reported by ( @ % ) of patients treated with venlafaxine XR .


The inclusion and exclusion criteria may limit the generalizability of the study .


Since patients with a history of lack of response to venlafaxine XR were excluded from this study , there is a selection bias in favor of venlafaxine XR .


Vortioxetine was at least as efficacious as venlafaxine XR and was safe and better tolerated than venlafaxine XR .


Empiric antibiotic monotherapy is considered the standard of treatment for febrile neutropenic patients with cancer , but this approach may be inadequate because of the increasing prevalence of infections caused by multidrug resistant ( MDR ) bacteria .


In this multicenter , open-label , randomized , superiority trial , adult , febrile , high-risk neutropenic patients ( FhrNPs ) with hematologic malignancies were randomly assigned to receive piperacillin/tazobactam ( @ g intravenously every @ hours ) with or without tigecycline ( @ mg intravenously every @ hours ; loading dose @ mg ) .


The primary end point was resolution of febrile episode without modifications of the initial allocated treatment .


Three hundred ninety FhrNPs were enrolled ( combination/monotherapy , @/@ ) and were included in the intention-to-treat analysis ( ITTA ) .


The ITTA revealed a successful outcome in @ % v @ % of patients who had received combination therapy and monotherapy , respectively ( @/@ v @/@ ; absolute difference in risk ( adr ) , @ % ; @ % CI , @ % to @ % ; P < @ ) .


The combination regimen proved better than monotherapy in bacteremias ( adr , @ % ; @ % CI , @ % to @ % ; P < @ ) and in clinically documented infections ( adr , @ % ; @ % CI , @ % to @ % ; P < @ ) .


Mortality and number of adverse effects were limited and similar in the two groups .


The combination of piperacillin/tazobactam and tigecycline is safe , well tolerated , and more effective than piperacillin/tazobactam alone in febrile , high-risk , neutropenic hematologic patients with cancer .


In epidemiologic settings characterized by a high prevalence of infections because of MDR microorganisms , this combination could be considered as one of the first-line empiric antibiotic therapies .


To compare pregabalin versus placebo and pramipexole for reducing restless legs syndrome ( RLS ) - related sleep disturbance .


Randomized , double-blinded , crossover trial .


Twenty-three US sleep centers .


Eighty-five individuals with moderate to severe idiopathic RLS and associated sleep disturbance .


Participants were randomized across @ treatment sequences comprising three @-week periods on pregabalin @ mg/day ( n = @ ) , pramipexole @ mg/day ( n = @ ) , or placebo ( n = @ ) .


Polysomnography was conducted over @ nights at the end of each period .


Primary ( wake after sleep onset -LSB- WASO -RSB- , pregabalin vs placebo ) and key secondary endpoints were analyzed for statistical significance , with descriptive statistics for other endpoints .


Pregabalin improved sleep maintenance , demonstrated by reductions in WASO ( -@ min vs placebo -LSB- P < @ -RSB- ; -@ vs pramipexole ) and number of awakenings after sleep onset ( -@ vs placebo ; -@ vs pramipexole -LSB- P < @ -RSB- ) by polysomnography , and an increase in subjective total sleep time ( @ min vs placebo -LSB- P < @ -RSB- ; @ vs pramipexole ) .


Pregabalin also increased slow wave sleep duration ( @ min vs placebo ; @ vs pramipexole -LSB- P < @ -RSB- ) .


Reduction in periodic limb movement arousal index ( PLMAI ) with pregabalin was similar to pramipexole and greater than placebo ( -@ PLMA/h -LSB- P < @ -RSB- ) , although reduction in total PLM in sleep was less than for pramipexole .


This study demonstrated improvements in objective and subjective measures of sleep maintenance and sleep architecture with pregabalin compared with placebo and pramipexole .


Effects of pregabalin on periodic limb movement arousal index were comparable to pramipexole .


Limited data exist on radial access in carotid artery stenting .


This multicentre prospective randomised study was performed to compare the outcome and complication rates of transradial and transfemoral carotid artery stenting .


The clinical and angiographic data of @ consecutive patients with high risk for carotid endarterectomy , treated between @ and @ by carotid stenting with cerebral protection , were evaluated .


Patients were randomised to transradial ( n = @ ) or transfemoral ( n = @ ) groups and several parameters were evaluated .


Primary combined endpoint : major adverse cardiac and cerebral events , rate of access-site complications .


Secondary endpoints : angiographic outcome of the procedure , fluoroscopy time and X-ray dose , procedural time , crossover rate to another puncture site and hospitalisation in days .


Procedural success was achieved in all @ patients ( @ % ) , the crossover rate was @ % in the TR and @ % in the TF group ( p < @ ) .


A major access-site complication was encountered in one patient ( @ % ) in the TR group and in one patient ( @ % ) in the TF group ( p = ns ) .


The incidence of major adverse cardiac and cerebral events was @ % in the TR and @ % in the TF group ( p = ns ) .


Procedure time ( @,@ -LSB- @,@-@ ,@ -RSB- vs. @,@ -LSB- @,@-@ ,@ -RSB- sec , p = ns ) and fluoroscopy time ( @ -LSB- @-@ -RSB- vs. @ -LSB- @-@ -RSB- sec , p = ns ) were not significantly different , but the radiation dose was significantly higher in the TR group ( @ -LSB- @-@ -RSB- vs. @ -LSB- @-@ -RSB- Gy * cm@ , p < @ ) by per-protocol analysis .


Hospitalisation days were significantly lower in the TR group ( @ vs. @ , p < @ ) .


By intention-to-treat analysis there was a significantly higher radiation dose in the TR group ( @ -LSB- @-@ -RSB- vs. @ -LSB- @-@ -RSB- , p < @ ) , but no difference in major events ( @ vs. @ , p = ns ) and length of hospitalisation in days ( @ vs. @ , p = ns ) .


The transradial approach for carotid artery stenting is safe and efficacious ; however , the crossover rate is higher with transradial access .


There are no differences in the total procedure duration and fluoroscopy time between the two approaches but the radiation dose is significantly higher in the radial group , and the hospitalisation is shorter with the use of transradial access by per-protocol analysis .


By evaluating the patient data according to intention-to-treat analysis we found no difference in major adverse events and hospitalisation .


In both groups , vascular complications rarely occurred .


Here , we evaluated the safety and immunogenicity of hepatitis B virus ( HBV ) DNA vaccine , HB-@ , in mice and Korean patients with chronic hepatitis B ( CHB ) undergoing adefovir dipivoxil ( ADV ) treatment .


For animal study , mice ( BALB/c or HBV transgenic ) were immunized with mHB-@ , and T-cell and antibody responses were evaluated .


For clinical study , @ patients randomly received either ADV alone or ADV in combination with HB-@ .


Liver function tests , serum HBV DNA levels and the presence of HBeAg/anti-HBe were analysed .


T-cell responses were estimated by ELISPOT and FACS analysis .


mHB-@ induced higher T-cell and antibody responses than mHB-@ in mice .


No adverse effects were observed by HB-@ cotreated with ADV. HBV-specific T-cell responses were induced in a portion of patients in medium to high dose of HB-@ .


Interestingly , HB-@ exhibited positive effects on ALT normalization and maintenance of HBeAg seroconversion .


One patient , who received high dose of HB-@ exhibited HBeAg seroconversion during vaccination , which correlated with vaccine-induced T-cell responses without ALT elevation .


HB-@ was safe and tolerable in CHB patients .


In contrast to results in animal models , HB-@ in Korean patients exhibited weaker capability of inducing HBV-specific T-cell responses and HBeAg seroconversion than HB-@ in Caucasian patients .


As Asian patients , who are generally infected via vertical transmission , appeared to have higher level of immune tolerance than Caucasian , novel approaches for breaking immune tolerance rather than enhancing immunogenicity may be more urgently demanded to develop effective therapeutic HBV DNA vaccines .


We assessed the efficacy , safety , and tolerability of ponesimod , an oral , selective , reversible modulator of sphingosine @-phosphate receptor @ , in patients with moderate to severe chronic plaque psoriasis .


Between Sept @ , @ , and Oct @ , @ , patients with psoriasis area and severity index ( PASI ) scores higher than @ were enrolled into this multicentre double-blind , phase @ study .


They received @ mg or @ mg ponesimod or placebo once daily for @ weeks .


Those with at least @ % reduction in PASI score at @ weeks and who were receiving ponesimod were rerandomised to receive maintenance ponesimod therapy or placebo until week @ .


The primary endpoint was reduction in PASI score from baseline of at least @ % ( PASI@ ) at week @ .


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


Of @ patients initially randomised ( @ mg ponesimod n = @ , @ mg ponesimod n = @ , and placebo n = @ ) PASI@ was achieved at week @ in @ ( @ % ) , @ ( @ % ) , and nine ( @ % ) , respectively .


The treatment effect was significant for the two ponesimod doses ( both p < @ ) .


Of @ patients who entered the maintenance period , PASI@ was achieved by week @ in @ ( @ % ) of @ who continued on @ mg ponesimod and @ ( @ % ) of @ on @ mg ponesimod , and in @ ( @ % ) of @ who swapped from @ mg to placebo and @ ( @ % ) of @ from @ mg to placebo .


Ponesimod was associated with dyspnoea , raised liver enzyme concentrations , and dizziness .


Significant clinical benefit was seen at week @ that increased with maintenance therapy .


We have previously reported excellent cecal intubation rates using a short double-balloon endoscope in patients with a history of incomplete colonoscopy .


However , data on the endoscopic treatment of colorectal tumors using a double-balloon endoscope are limited .


The aim of the present study was to evaluate the efficacy and safety of endoscopic intervention of colorectal tumors using a short double-balloon endoscope .


We analyzed data from a multicenter , prospective study on @ patients ( @ men , median age @ years ) who underwent total colonoscopy after incomplete colonoscopy to assess the characteristics of colorectal tumors , endoscopic interventions , and complications .


In all , @ colorectal tumors were detected in @ patients ; @ of the tumors were adenomas ( @ advanced adenomas ) and two each were intramucosal and advanced cancers .


Locations of the lesions were eight in the cecum , @ in the ascending colon , @ in the transverse colon , @ in the descending colon , @ in the sigmoid colon , five in the rectosigmoid and six in the rectum .


Average tumor diameter was @ mm .


Fifty-nine polypectomies , @ endoscopic mucosal resections , four hot biopsies , and six cold biopsies were done .


All endoscopic interventions were successfully completed and no complications were noted .


Two advanced cancers were located in the ascending colon and only a double-balloon endoscope could reach them to take a biopsy sample .


Double-balloon endoscopy is effective and safe for endoscopic intervention of colorectal tumors , irrespective of the location , in patients after incomplete colonoscopy .


The commonality between chronic conditions that are treated with low-dose ketamine , such as specific chronic pain conditions , depression , and post-traumatic stress disorder , can be found in relation to the stress system , particularly the hypothalamus-pituitary-adrenal axis .


In this study we assess the effect of ketamine on the stress system by measuring plasma and saliva cortisol production during and following exposure to low-dose ketamine .


In a double-blind , randomized , placebo-controlled study , the influence of subanaesthetic ketamine ( @ mg kg ( -@ ) h ( -@ ) for @ h , followed by @ mg kg ( -@ ) h ( -@ ) for another hour ) was studied with repeated plasma and saliva cortisol samples in @ healthy male volunteers .


A pharmacokinetic-pharmacodynamic model was used to describe the circadian rhythm-dependent ketamine-induced production of cortisol .


The endogenous mean baseline cortisol production was @ ( SE @ ) nM min ( -@ ) .


Consistent with the circadian rhythm , cortisol production decayed by @ nM min ( -@ ) h ( -@ ) .


Ketamine doubled the cortisol production at a concentration of @ ( SE @ ) ng ml ( -@ ) .


The salivary cortisol concentration closely mirrored the plasma concentration and was exponentially related to the plasma concentration with , at @ ng ml ( -@ ) ketamine , a saliva : plasma ratio of @ ( se @ ) .


Ketamine has an appreciable effect on cortisol production .


This may impact on critical physiological and psychological functions .


The purpose of this randomized controlled study was to compare knee stability , kneeling pain , harvest site pain , sensitivity loss , and subjective clinical outcome after primary anterior cruciate ligament ( ACL ) reconstruction with either bone-patellar tendon-bone ( BPTB ) or quadriceps tendon-bone ( QTB ) autografts in a noninferiority study design .


From @ to @ , a total of @ patients were included in the present study .


Inclusion criteria were isolated ACL injuries in adults .


Twenty-five patients were randomized to BPTB grafts and @ to QTB grafts .


An independent examiner performed follow-up evaluations @ and @ years postoperatively .


Anteroposterior knee laxity was measured with a KT-@ arthrometer ( MEDmetric , San Diego , CA ) .


Anterior knee pain was assessed clinically and by knee-walking ability .


Knee Injury and Osteoarthritis Outcome Score ( KOOS ) and subjective International Knee Documentation Committee ( IKDC ) score were used for patient-evaluated outcome .


Anterior knee laxity was equal between the @ groups with KT-@ values of @ @ mm and @ @ mm standard deviation ( SD ) at follow-up in QTB and BPTB groups , respectively ( P = @ ) , whereas positive pivot shift test results were seen less frequently ( @ % compared with @ % , respectively ; P = @ ) .


Anterior kneeling pain , evaluated by the knee walking ability test , was significantly less in the QTB group , with only @ % of patients grading knee walking as difficult or impossible compared with @ % in the BPTB group .


At @ and @ years ' follow-up , there was no difference between the @ groups in subjective patient-evaluated outcome .


The IKDC score was @ @ patients and @ @ SD at @-year follow-up in QTB and BPTB groups , respectively ( P = @ ) .


At @ years , @ patients were lost to follow-up , resulting in @ in the BPTB group and @ in the QTB group .


The use of the QTB graft results in less kneeling pain , graft site pain , and sensitivity loss than seen with BPTB grafts ; however , similar anterior knee stability and subjective outcomes are seen .


The results of this study show that QTB is a viable option for ACL reconstruction .


Level II , randomized controlled clinical trial .


This study was aimed to investigate the effects of raloxifene on intact parathyroid hormone ( PTH ) level and bone mineral density ( BMD ) for @ months in women on hemodialysis and women with chronic kidney disease stage @ not dependent on dialysis to determine its effect on secondary hyperparathyroidism and osteoporosis .


Fifty-one women on hemodialysis and @ with chronic kidney disease stage @ were randomly assigned to receive oral raloxifene , @ mg/d , or placebo for @ months .


Baseline blood determinations and BMD were done and repeated after @ months .


Serum levels of total calcium , phosphorus , alkaline phosphatase , and intact PTH were measured .


Serum levels of intact PTH significantly decreased in both groups , and there was no difference between the two groups after @ months ( P = @ ) .


Serum phosphorus levels also decreased by @ % in the two groups .


After @ months of treatment , the BMD of the lumbar spine and femural neck decreased by @ % in the control group , while an increase in BMD was observed in the raloxifene group , with an average increase in both BMDs of the lumbar spine and the femural neck by @ % ( significant in the lumbar spine ; P = @ ) .


Raloxifene has proven to be an effective medication in terms of improving BMD , with no adverse effects .


However , it had no effect on controlling hyperparathyroidism in our patients .


Long-term studies should be done to investigate the effects of raloxifene in chronic kidney disease and dialysis patients .


To determine whether the addition of @ mg dexamethasone to axillary brachial plexus block would prolong the duration of sensory and motor block in patients undergoing hand and forearm surgery .


The prospective , randomised , double-blinded study was conducted at the Eskisehir Osmangazi University Medical School , Turkey , from October @ to December @ .


It comprised @ American Society of Anaesthesiologists grade I and II patients under elective surgery of the hand and forearm .


The patients were randomly divided into @ groups : @ mg/kg of @ % prilocaine was applied to Group @ ; @ mg/kg of @ % prilocaine +@ mg of dexamethasone ( @ ml ) was applied to Group @ ; and @ mg/kg @ % levobupivacaine was applied to Group @ .


Sensory and motor block onset time as well as the duration of motor and sensory block of those were monitored and recorded .


SPSS @ was used for statistical analysis .


Of the @ patients , @ ( @ % ) were men and @ ( @ % ) were women .


There was no significant difference among the groups in terms of demographic data .


Based on the duration of motor and sensory block , similar periods of time in Group @ and Group @ were noted , whereas this period was statistically different and significantly longer in Group @ ( p < or = @ ) .


There were no complications encountered .


The addition of dexamethasone to prilocaine prolonged the duration of sensory and motor block .


It could be used as an effective adjuvant agent .


Levobupivacain could be a more appropriate local anaesthetic in postoperative analgesia and prolonged surgical procedures .


To investigate the effect of @ weeks of aerobic training performed at two different intensities on nitric oxide ( tNOx ) availability and iNOS/nNOS expression , oxidative stress ( OS ) and inflammation in obese humans with or without type @ diabetes mellitus ( T@DM ) .


Twenty-five sedentary , obese ( BMI > @ kg/m@ ) males ( @ @ years ) ; @ controls versus @ T@DM were randomly allocated to four groups that exercised for @ min , three times per week either at low ( Fat-Max ; @-@ % VO ( @max ) ) or moderate ( T ( vent ) ; @-@ % VO ( @max ) ) intensity .


Before and after training , blood and muscle samples ( v. lateralis ) were collected .


Baseline erythrocyte glutathione was lower ( @ @ vs. @ @ nmol/ml ) and plasma protein oxidative damage and IL-@ were higher in T@DM ( @ @ vs. @ @ nmol/ml ) .


Plasma catalase increased in T@DM after T ( vent ) training ( from @ @ to @ @ nmol/min/ml ) .


T@DM groups demonstrated evidence of oxidative damage in response to training ( elevated protein carbonyls ) .


Baseline serum tNOx were higher in controls than T@DM ( @ @ vs. @ @ mol/l ) .


Training at T ( vent ) increased muscle nNOS and tNOx in the control group only .


Pre-training muscle nNOS was higher in controls than in T@DMs , while the opposite was found for iNOS .


No differences were found after training for plasma inflammatory markers .


Exercise training did not change body composition or aerobic fitness , but improved OS markers , especially when performed at T ( vent ) .


Non-diabetics responded to T ( vent ) training by increasing muscle nNOS expression and tNOx levels in skeletal muscle while these parameters did not change in T@DM , perhaps due to higher insulin resistance ( unchanged after intervention ) .


To verify the efficacy of Jianpi-xingniao needling therapy on prevention and treatment of motion sickness .


Sixty volunteers of motion sickness were randomized into an acupuncture group and a delayed acupuncture group , @ cases in each one .


In the acupuncture group , acupuncture was given at Baihui ( GV @ ) , Sishencong ( EX-HN @ ) , Neiguan ( PC @ ) , Zusanli ( ST @ ) and Hegu ( LI @ ) .


The needles were retained for @ min .


The treatment was given twice a week and @ treatments were required .


In the delayed acupuncture group , acupuncture was postponed , meaning no acupuncture during observation stage .


Graybel scale was adopted to observe the score of symptoms and physical signs of the subjects of motion sickness before and after intervention .


The efficacy was compared between the two groups .


Twenty-five cases in the acupuncture group and @ cases in the delayed acupuncture group were included in the statistical analysis .


The score of symptoms and physical signs of motion sickness was reduced significantly after treatment in the acupuncture group as compared with that before treatment ( @ + / - @ vs @ + / - @ , P < @ ) .


The score in the acupuncture group was lower apparently than that in the delayed acupuncture group ( @ + / - @ vs @ + / - @ , P < @ ) .


The difference was not significant before and after treatment in the self-comparison of the delayed acupuncture group ( P > @ ) .


The total effective rate was @ % ( @/@ ) in the acupuncture group , which was significantly better than @ % ( @/@ ) in the delayed acupuncture group ( P < @ ) .


Jianpixingniao needling therapy relieves the symptoms of motion sickness in the patients and achieves a better clinical efficacy .


Rapid HIV testing in high-risk populations can increase the number of persons who learn their HIV status and avoid spending clinic resources to locate persons identified as HIV infected .


We determined the cost to sexually transmitted disease ( STD ) clinics of point-of-care rapid HIV testing using data from @ public clinics that participated in a randomized trial of rapid testing with and without brief patient-centered risk reduction counseling in @ .


Costs included counselor and trainer time , supplies , and clinic overhead .


We applied national labor rates and test costs .


We calculated median clinic start-up costs and mean cost per patient tested , and projected incremental annual costs of implementing universal rapid HIV testing compared with current testing practices .


Criteria for offering rapid HIV testing and methods for delivering nonrapid test results varied among clinics before the trial .


Rapid HIV testing cost an average of US $ @/patient without brief risk reduction counseling and US $ @/patient with counseling in these @ clinics .


Median start-up costs per clinic were US $ @ and US $ @,@ without and with counseling , respectively .


Estimated incremental annual costs per clinic of implementing universal rapid HIV testing varied by whether or not brief counseling is conducted and by current clinic testing practices , ranging from a savings of US $ @,@ to a cost of US $ @,@ without counseling and a cost of US $ @,@ to US $ @,@ with counseling .


Universal rapid HIV testing in STD clinics with same-day results can be implemented at relatively low cost to STD clinics , if brief risk reduction counseling is not offered .


The risk of persistent tardive dyskinesia ( TD ) was compared in patients with acute psychosis or agitation aged @ years or older who were treated with olanzapine ( OLZ ) or conventional antipsychotic ( CNV ) drug therapy .


Patients without TD were randomized to treatment with OLZ ( @-@ mg/d ; n = @ ) or CNV ( dosed per label ; n = @ ) .


Following a @-week drug tapering/initiation period , patients without TD were treated with OLZ or CNV for up to @ year .


The a priori defined primary outcome end point was persistent TD defined as Abnormal Involuntary Movement Scale ( AIMS ) scores = @ on at least @ items or @ on at least @ item ( items @-@ ) lasting at least for @ month ( Criterion A ) .


Post hoc analyses assessed persistent TD meeting the criterion of moderate severity defined as AIMS score @ on at least @ item persisting for @ month ( Criterion B ) and probable TD defined as elevated AIMS scores ( Criterion A or B ) not persisting for @ month .


Treatment groups were compared using Kaplan-Meier curve with log-rank exact test .


On average , patients were @ years of age ; the predominant diagnosis was dementia ( @ % in the OLZ group and @ % in the CNV group ) .


Approximately , @ % of patients in the CNV group received haloperidol .


No significant difference in time to developing persistent TD was observed during treatment with OLZ or CNV ( cumulative incidence : OLZ , @ % -LSB- @ % confidence interval -LSB- @ % CI -RSB- : @-@ @ -RSB- ; CNV , @ % -LSB- @ % CI : @-@ @ -RSB- , P = @ ) .


The exposure-adjusted event rates per @ person-years were not significantly different between treatment groups : OLZ ( @ ) and CNV ( @ ; ratio : @ ; @ % CI : @-@ @ ) .


Post hoc analyses revealed a significantly lower risk of at least moderately severe persistent TD persisting for @ month ( P = @ ) and probable TD not persisting for @ month ( Criterion A , P = @ ; Criterion B , P = @ ) in OLZ-treated patients .


For those patients without significant extrapyramidal symptoms at baseline , significantly more patients in the CNV treatment group developed treatment-emergent parkinsonism than for patients in the OLZ treatment group ( CNV : @ % , @ of @ patients ; OLZ @ % , @ of @ patients ; P = @ ) .


No significant difference between the groups was observed for treatment-emergent akathisia ( CNV : @ % , @ of @ patients ; OLZ : @ % , @ of @ patients ; P = @ ) .


The cumulative incidence of persistent TD was low and the risk of persistent TD did not differ significantly among predominantly older adult patients having dementia with acute psychosis or agitation treated with OLZ or CNV .


The effect of anaesthesia on postoperative outcome is unclear .


Cardioprotective properties of volatile anaesthetics have been demonstrated experimentally and in haemodynamically stable patients undergoing coronary artery bypass grafting .


Their effects in patients undergoing high-risk cardiac surgery have not been reported .


We performed a multicentre , randomized , parallel group , controlled study among patients undergoing high-risk cardiac surgery ( combined valvular and coronary surgery ) in @-@ .


One hundred subjects assigned to the treatment group received sevoflurane for anaesthesia maintenance , while @ subjects assigned to the control group received propofol-based total i.v. anaesthesia .


The primary outcome was a composite of death , prolonged intensive care unit ( ICU ) stay , or both .


Thirty day and @ yr follow-up , focused on mortality , was performed .


All @ subjects completed the follow-up and were included in efficacy analyses , conducted according to the intention-to-treat principle .


Death , prolonged ICU stay , or both occurred in @ out of @ subjects ( @ % ) in the propofol group and in @ out of @ subjects ( @ % ) in the sevoflurane group ; relative risk @ , @ % confidence interval @-@ @ ; P = @ .


No difference was identified in postoperative cardiac troponin release -LSB- @ ( @-@ ) compared with @ ( @-@ @ ) ng ml ( -@ ) , P = @ -RSB- , @ yr all-cause mortality -LSB- @/@ ( @ % ) compared with @/@ ( @ % ) , P = @ -RSB- , re-hospitalizations -LSB- @/@ ( @ % ) compared with @/@ ( @ % ) , P = @ -RSB- , and adverse cardiac events -LSB- @/@ ( @ % ) compared with @/@ ( @ % ) , P = @ -RSB- .


There was no observed beneficial effect of sevoflurane on the composite endpoint of prolonged ICU stay , mortality , or both in patients undergoing high-risk cardiac surgery .


Characteristics and outcomes of patients with heart failure and reduced ejection fraction receiving care at Veterans Affairs ( VA ) versus non-VA hospitals have not been previously reported .


In the randomized controlled Beta-blocker Evaluation of Survival Trial ( BEST ; @-@ ) , of the @ ( bucindolol = @ ; placebo = @ ) patients with heart failure and left ventricular ejection fraction @ % , @ received care at VA hospitals , of which @ % ( n = @ ) were male .


Of the @ receiving care at non-VA hospitals , @ % ( n = @ ) were male .


Our analyses were restricted to these @ male patients .


VA patients were older with higher symptom and comorbidity burdens .


There was no significant between-group difference in unadjusted primary end point of @-year all-cause mortality ( @ % VA versus @ % non-VA ; hazard ratio associated with VA hospitals , @ ; @ % confidence interval , @-@ @ ) , which remained unchanged after adjustment for age and race ( hazard ratio , @ ; @ % confidence interval , @-@ @ ) or multivariable adjustment , including cardiovascular morbidities ( hazard ratio , @ ; @ % confidence interval , @-@ @ ) .


There was no between-group difference in cause-specific mortalities or hospitalizations .


Chronic kidney disease , pulmonary edema , left ventricular ejection fraction < @ % , and peripheral arterial disease were significant predictors of mortality for both groups .


African America race , New York Heart Association class IV symptoms , atrial fibrillation , and right ventricular ejection fraction < @ % were associated with higher mortality among non-VA hospital patients only ; however , these differences from VA patients were not significant .


Patients with heart failure and reduced ejection fraction receiving care at VA hospitals were older and sicker ; yet their risk of mortality and hospitalization was similar to younger and healthier patients receiving care at non-VA hospitals .


The aim of this study was to assess the effectiveness and safety of different strategies of ivabradine therapy by comparing the effects on heart rate ( HR ) , blood pressure ( BP ) , and image quality of coronary CT angiography ( CTA ) .


A total of @ consecutive patients were randomly assigned to @ groups of oral premedication with ivabradine @ mg ( single dose ) , @ mg ( single dose ) , and @ mg twice daily for @ days , prospectively .


Patients using HR-lowering drugs and patients with - blockade contraindication were excluded .


The target HR was @ beats/min .


In addition @ to @ mg of intravenous metoprolol was administered to the patients at the CT unit , if required .


The systolic and diastolic blood BP values and the HRs were recorded .


Image quality was assessed for @ of @ coronary segments with a @-point grading scale .


Results were compared with the Kruskal-Wallis test , one-way ANOVA , and @ test .


Reductions in mean HR after the treatment were @ @ , @ @ , and @ @ beats/min for groups @ , @ , and @ , respectively .


With the total additional therapies , @ % , @ % , and @ % of the patients achieved HR < @ beats/min in groups @ , @ , and @ , respectively .


The mean BP values before coronary CTA were not significantly changed except for patients in group @ .


Unacceptable ( score @ ) image quality was obtained in only @ % , @ % , and @ % of all the coronary segments , in groups @ , @ , and @ , respectively .


Our study indicates that coronary CTA with premedication with oral ivabradine in all @ strategies is safe and effective in reducing HR , in particular with a - blockade combination .


All @ ivabradine regimes may be an alternative strategy for HR lowering in patients undergoing coronary CTA .


Ivabradine @ mg ( single dose ) and ivabradine @ mg twice daily for @ days are superior to the ivabradine @-mg single-dose regime for HR lowering without adjunctive intravenous - blocker usage .


There has been no systematic investigation of the individual and combined effects of impaired glucose tolerance ( IGT ) and obesity on cognitive function in the absence of ageing .


The aims were to examine the effects of IGT and increased waist circumference on cognitive function in ostensibly healthy adults , and to investigate whether a low glycaemic load ( GL ) breakfast can attenuate cognitive impairments in these populations .


Sixty five females aged @-@ years were classified into one of four groups following waist circumference ( WC ) measurements and an oral glucose tolerance test : NGT/low WC ( n = @ ) , NGT/high WC ( n = @ ) , IGT/low WC ( n = @ ) , IGT/high WC ( n = @ ) .


Memory , psychomotor and executive functions were examined @ and @ min after consuming low GL , high GL and water breakfasts according to a randomised , crossover , counterbalanced design .


IGT was associated with impairment of verbal and spatial memory , and psychomotor function relative to females with NGT , independent of waist circumference .


Increased waist circumference was associated with impairment of verbal memory and executive function relative to females with low WC , independent of IGT .


Consumption of the LGL breakfast attenuated verbal memory impairment in the IGT/high WC group relative to the HGL breakfast and no energy control .


Increased central adiposity and abnormalities in glucose tolerance preceding type @ diabetes can have demonstrable negative effects on cognitive function , even in ostensibly healthy , middle-aged females .


The potential for GL manipulations to modulate glycaemic response and cognitive function in type @ diabetes and obesity merits further investigation .


Tracheal intubation with Macintosh laryngoscope is taught to medical students as it is a lifesaving procedure .


However , it is a difficult technique to learn and the consequences of intubation failure are potentially serious .


The Airtraq optical laryngoscope is a relatively novel intubation device , which allows visualization of the glottic plane without alignment of the oral , pharyngeal , and tracheal axes , possessing advantages over Macintosh for novice personnel .


We introduced a teaching mode featured with a progressive evaluation scheme for preparation and performance of tracheal intubation with medical students in this prospective randomized crossover trial who had no prior airway management experience to find the superior one .


Twenty-six medical students of the @-year programme in the @th year participated in this trial , when they did their one-week rotation in the department of anaesthesiology .


Each of the students intubated @ patients , who were scheduled for surgeries under general anaesthesia , each laryngoscope for @ patients respectively .


One hundred and forty-nine consecutive patients scheduled for surgical procedures requiring tracheal intubation were enrolled .


Patients were randomly allocated to undergo tracheal intubation using Macintosh ( n = @ ) or Airtraq ( n = @ ) laryngoscope .


The progressive evaluation scheme was applied to each intubation attempt .


Intubation success rate was significantly higher in Airtraq group than Macintosh group ( @ % vs. @ % , P < @ ) .


Duration of glottis exposure was significantly shorter in Airtraq group compared to Macintosh group ( @ @ s vs. @ @ s , P < @ ) .


A grade I Cormack and Lehane glottic view was obtained in @ % of patients in the Airtraq group versus @ % of patients in the Macintosh group ( P < @ ) .


Duration of intubation in Airtraq group was significantly shorter ( @ @ s vs. @ @ s , P < @ ) compared to Macintosh group .


Airtraq laryngoscope is easier to master for novice personnel with a higher intubation success rate and shorter intubation duration compared with the Macintosh laryngoscope .


Previously considered as a disease of the affluent , west or urban people and not of public health importance , diabetes mellitus is increasingly becoming a significant cause of morbidity and mortality in sub-Saharan Africa .


However , population-based data to inform prevention , treatment and control are lacking .


Using the WHO STEPwise approach to chronic disease risk factor surveillance , a population-based , nationwide cross-sectional survey was conducted between July and September @ on participants aged @-@ years .


A multi-stage cluster sample design and weighting were used to produce a national representative data for that age range .


Detailed findings on the magnitude of diabetes mellitus and impaired fasting blood glucose are presented in this paper .


Fasting blood glucose measurement was conducted on @ participants ( @ % females , @ % from rural areas ) .


The age - sex standardised population-based mean fasting blood glucose was @ mmol/L ( @ % CI @-@ @ mmol/L ) with no significant differences by age , sex and location ( urban/rural ) .


The overall prevalence of impaired fasting blood glucose was @ % ( @ % CI @ % -@ % ) .


Prevalence of impaired blood glucose was higher in men than in women , @ % ( @ % CI @ % -@ % ) vs @ % ( @ % CI @ % - @ % ) , p < @ .


In both men and women , prevalence of raised fasting blood glucose or currently on medication for diabetes was @ % ( @ % CI @ % - @ % ) .


Although the prevalence of diabetes was higher in men than women , @ % ( @ % CI @ % -@ % ) vs @ % ( @ % CI @ % -@ % ) , in rural than urban , @ % ( @ % CI @ % -@ % ) vs @ % ( @ % CI @ % -@ % ) and in males in rural than males in urban , @ % ( @ % CI @ % -@ % ) vs @ % ( @ % CI @ % -@ % ) , the differences were not statistically significant , p > @ .


Compared to previous estimates , prevalence of diabetes increased from < @ % in @s to @ % in @ ( this study ) .


High prevalence of impaired fasting blood glucose and diabetes mellitus call for the implementation of primary healthcare approaches such as the WHO package for essential non-communicable diseases to promote healthy lifestyles , early detection , treatment and control .


Malaria rapid diagnostic tests ( RDTs ) are a valid alternative to malaria testing with microscopy and are recommended for the testing of febrile patients before prescribing an antimalarial .


There is a need for interventions to support the uptake of RDTs by health workers .


To evaluate the cost-effectiveness of introducing RDTs with basic or enhanced training in health facilities in which microscopy was available , compared with current practice .


A three-arm cluster randomized trial was conducted in @ facilities in central and northwest Cameroon .


Basic training had a practical session on RDTs and lectures on malaria treatment guidelines .


Enhanced training included small-group activities designed to change health workers ' practice and reduce the consumption of antimalarials among test-negative patients .


The primary outcome was the proportion of febrile patients correctly treated : febrile patients should be tested for malaria , artemisinin combination therapy should be prescribed for confirmed cases , and no antimalarial should be prescribed for patients who are test-negative .


Individual patient data were obtained from facility records and an exit survey .


Costs were estimated from a societal perspective using project reports and patient exit data .


The analysis used bivariate multilevel modeling and adjusted for imbalance in baseline covariates .


Incremental cost per febrile patient correctly treated was $ @ for the basic arm and $ @ for the enhanced arm .


On scale-up , it was estimated that RDTs with enhanced training would save $ @ per additional febrile patient correctly treated .


Introducing RDTs with enhanced training was more cost-effective than RDTs with basic training when each was compared with current practice .


Functional decline and frailty are common in community dwelling older adults , increasing the risk of adverse outcomes .


Given this , we investigated the prevalence of frailty-associated risk factors and their distribution according to the severity of perceived risk in a cohort of community dwelling older adults , using the Risk Instrument for Screening in the Community ( RISC ) .


A cohort of @ community dwelling older adults were scored for frailty by their public health nurse ( PHN ) using the Clinical Frailty Scale ( CFS ) and for risk of three adverse outcomes : i ) institutionalisation , ii ) hospitalisation and iii ) death , within the next year , from one ( lowest ) to five ( highest ) using the RISC .


Prior to scoring , PHNs stated whether they regarded patients as frail .


The median age of patients was @years ( interquartile range @ ) , of whom @ % were female and @ % were living alone .


The median Abbreviated Mental Test Score ( AMTS ) was @ ( @ ) and Barthel Index was @/@ ( @ ) .


PHNs regarded @ % of patients as frail , while the CFS categorized @ % ( scoring @ ) as frail .


Dividing patients into low-risk ( score one or two ) , medium-risk ( score three ) and high-risk ( score four or five ) using the RISC showed that @ % were considered high risk of institutionalization , @ % for hospitalization , and @ % for death , within one year of the assessment .


There were significant differences in median CFS ( @/@ versus @/@ versus @/@ , p < @ ) , Barthel Index ( @/@ versus @/@ versus @/@ , p < @ ) and mean AMTS scores ( @ versus @ versus @ , p < @ ) between those considered low , medium and high risk of institutionalisation respectively .


Differences were also statistically significant for hospitalisation and death .


Age , gender and living alone were inconsistently associated with perceived risk .


Frailty most closely correlated with functional impairment , r = -@ , p < @ .


The majority of patients in this community sample were perceived to be low risk for adverse outcomes .


Frailty , cognitive impairment and functional status were markers of perceived risk .


Age , gender and social isolation were not and may not be useful indicators when triaging community dwellers .


The RISC now requires validation against adverse outcomes .


Currently , there is limited data on the prevention of chemotherapy-induced nausea and vomiting ( CINV ) in Indian patients .


This post hoc study assessed the efficacy and safety of fosaprepitant compared with aprepitant for prevention of CINV in the Indian population .


A subgroup analysis was performed from data collected in a phase @ study of intravenous ( IV ) fosaprepitant or oral aprepitant , plus the @-HT @ antagonist ondansetron and the corticosteroid dexamethasone , in cisplatin-nave patients with solid malignancies .


Patients scheduled to receive cisplatin ( @ mg/m @ ) were administered a single IV dose of fosaprepitant dimeglumine ( @ mg ) on day @ or a @-day dosing regimen of oral aprepitant ( day @:@ mg , days @ and @:@ mg ) with standard doses of ondansetron and dexamethasone .


Patients recorded nausea and/or vomiting episodes and their use of rescue medication and were monitored for adverse events ( AEs ) and tolerability .


Differences in response rates between fosaprepitant and aprepitant were calculated using the Miettinen and Nurminen method .


In the Indian subpopulation ( n = @ ) , efficacy was similar for patients in both the fosaprepitant or aprepitant groups ; complete response in the overall , acute , and delayed phases and no vomiting in all phases were approximately @ percentage points higher in the fosaprepitant group compared with the aprepitant group .


Fosaprepitant was generally well-tolerated ; common AEs were similar to oral aprepitant .


IV fosaprepitant is as safe and effective as oral aprepitant in the Indian subpopulation and offers an alternative to the oral formulation .


Collaborative stepped care ( CSC ) may be an appropriate model to provide evidence-based treatment for anxiety disorders in primary care .


In a cluster randomised controlled trial , the effectiveness of CSC compared to care as usual ( CAU ) for adults with panic disorder ( PD ) or generalised anxiety disorder ( GAD ) in primary care was evaluated .


Thirty-one psychiatric nurses who provided their services to @ primary care practices in the Netherlands were randomised to deliver CSC ( @ psychiatric nurses , @ practices ) or CAU ( @ psychiatric nurses , @ practices ) .


CSC was provided by the psychiatric nurses ( care managers ) in collaboration with the general practitioner and a consultant psychiatrist .


The intervention consisted of @ steps , namely guided self-help , cognitive behavioural therapy and antidepressants .


Anxiety symptoms were measured with the Beck Anxiety Inventory ( BAI ) at baseline and after @ , @ , @ and @ months .


We recruited @ patients with a DSM-IV diagnosis of PD or GAD , of whom @ received CSC and @ received usual primary care .


On the BAI , CSC was superior to CAU -LSB- difference in gain scores from baseline to @ months : -@ , @ % confidence interval ( CI ) -@ to -@ ; @ months : -@ , @ % CI -@ to -@ ; @ months : -@ , @ % CI -@ to -@ ; @ months : -@ , @ % CI -@ to -@ -RSB- .


CSC , with guided self-help as a first step , was more effective than CAU for primary care patients with PD or GAD .


Optimizing assessments of rate of progression in Parkinson disease ( PD ) is important in designing clinical trials , especially of potential disease-modifying agents .


To examine the value of measures of impairment , disability , and quality of life in assessing progression in early PD .


Inception cohort analysis of data from @ patients with early , untreated PD who were enrolled in @ multicenter , randomized , double-blind clinical trials .


Participants were randomly assigned to @ of @ treatments ( @ received creatine , @ received minocycline , @ received coenzyme Q@ , @ received GPI-@ , and @ received placebo ) .


We assessed the association between the rates of change in measures of impairment , disability , and quality of life and time to initiation of symptomatic treatment .


Time between baseline assessment and need for the initiation of symptomatic pharmaceutical treatment for PD was the primary indicator of disease progression .


After adjusting for baseline confounding variables with regard to the Unified Parkinson 's Disease Rating Scale ( UPDRS ) Part II score , the UPDRS Part III score , the modified Rankin Scale score , level of education , and treatment group , we assessed the rate of change for the following measurements : the UPDRS Part II score ; the UPDRS Part III score ; the Schwab and England Independence Scale score ( which measures activities of daily living ) ; the Total Functional Capacity scale ; the @-item Parkinson 's Disease Questionnaire , summary index , and activities of daily living subscale ; and version @ of the @-item Short Form Health Survey Physical Summary and Mental Summary .


Variables reaching the statistical threshold in univariate analysis were entered into a multivariable Cox proportional hazards model using time to symptomatic treatment as the dependent variable .


More rapid change ( ie , worsening ) in the UPDRS Part II score ( hazard ratio , @ -LSB- @ % CI , @-@ @ -RSB- for @ scale unit change per @ months ) , the UPDRS Part III score ( hazard ratio , @ -LSB- @ % CI , @-@ @ -RSB- for @ scale unit change per @ months ) , and the Schwab and England Independence Scale score ( hazard ratio , @ -LSB- @ % CI , @-@ @ -RSB- for @ percentage point change per @ months ) was associated with earlier need for symptomatic therapy .


AND RELEVANCE In early PD , the UPDRS Part II score and Part III score and the Schwab and England Independence Scale score can be used to measure disease progression , whereas the @-item Parkinson 's Disease Questionnaire and summary index , Total Functional Capacity scale , and the @-item Short Form Health Survey Physical Summary and Mental Summary are not sensitive to change .


To examine the effects of complex cognitive ( mahjong ) and physical ( Tai Chi ) activities on dementia severity in nursing home residents with dementia .


Cluster-randomized open-label controlled design .


@ residents were randomized by nursing home into three conditions : mahjong , Tai Chi , and simple handicrafts ( control ) .


Activities were conducted three times a week for @ weeks .


Clinical Dementia Rating ( CDR ) was taken at @ ( baseline ) , @ ( post-treatment ) , @ , and @ months .


The outcome measure was CDR sum-of-box , which is a composite measure of both cognitive and functional deterioration in dementia .


Intent-to-treat analyses were performed using multilevel regression models .


Apolipoprotein E @ allele and education were included as covariates .


Neither treatments had effects on the cognitive and functional components of the CDR , but mahjong had a significant interaction with time on the CDR sum-of-box total , suggesting a slower rate of global deterioration in the mahjong group as compared with the control group .