Patients were treated with topical smear common atropine ( CA ) and modified atropine ( MA ) gels ( intervals @ day ) .


The control effect of atropine gels was observed for @ hours .


Tear flow was quantified in resting and stimulated ( after exercise ) states using the Schirmer I test .


With the CA gel , tear flow decreased significantly at @ , @ , and @ minutes .


Average epiphora reduction rates ( AERRs ) were @ % , @ % , and @ % , respectively ( P < @ ) .


With the MA gel , tear flow decreased significantly from @ minutes to @ hours ; AERRs increased from @ % to @ % ( P < @ ) ; Maximum efficacy was maintained from @ minutes to @ hours ( P < @ ) ; Tear flow gradually increased from @ to @ hours but was still lower than that before atropine use ( P < @ ) .


According to results of the Schirmer I test and AERRs , the control efficacy of the MA gel was significantly better than that of the CA gel ( P < @ ) .


Topical application of atropine gel could effectively control mild epiphora for patients with SMG transplantation for severe keratoconjunctivitis sicca .


The efficacy of MA gel was much better than that of the CA gel .


Eye drops of aganirsen , an antisense oligonucleotide preventing insulin receptor substrate-@ expression , inhibited corneal neovascularization in a previous dose-finding phase II study .


We aimed to confirm these results in a phase III study and investigated a potential clinical benefit on visual acuity ( VA ) , quality of life ( QoL ) , and need for transplantation .


Multicenter , double-masked , randomized , placebo-controlled phase III study .


Analysis of @ patients with keratitis-related progressive corneal neovascularization randomized to aganirsen ( @ patients ) or placebo ( @ patients ) .


Patients applied aganirsen eye drops ( @ g/day/eye ) or placebo twice daily for @ days and were followed up to day @ .


The primary end point was VA. .


Secondary end points included area of pathologic corneal neovascularization , need for transplantation , risk of graft rejection , and QoL .


Although no significant differences in VA scores between groups were observed , aganirsen significantly reduced the relative corneal neovascularization area after @ days by @ % ( P = @ ) .


This improvement persisted after @ days ( @ % , P = @ ) .


Aganirsen tended to lower the transplantation need in the intent-to-treat ( ITT ) population at day @ ( P = @ ) .


In patients with viral keratitis and central neovascularization , a significant reduction in transplantation need was achieved ( P = @ ) .


No significant differences between groups were observed in the risk of graft rejection .


However , aganirsen tended to decrease this risk in patients with traumatic/viral keratitis ( P = @ ) at day @ .


The QoL analyses revealed a significant improvement with aganirsen in composite and near activity subscores ( P = @ and @ , respectively ) at day @ in the per protocol population .


Ocular and treatment-related treatment-emergent adverse events ( TEAEs ) were reported in a lower percentage with aganirsen compared with placebo .


Only @ serious TEAEs ( @ with aganirsen and @ with placebo ) were considered treatment-related .


This first phase III study on a topical inhibitor of corneal angiogenesis showed that aganirsen eye drops significantly inhibited corneal neovascularization in patients with keratitis .


The need for transplantation was significantly reduced in patients with viral keratitis and central neovascularization .


Topical application of aganirsen was safe and well tolerated .


Structural learning theory suggests that experiencing motor task variation enables the central nervous system to extract general rules regarding tasks with a similar structure - rules that can subsequently be applied to novel situations .


Complex minimally invasive surgery ( MIS ) requires different port sites , but switching ports alters the limb movements required to produce the same endpoint control of the surgical instrument .


The purpose of the present study was to determine if structural learning theory can be applied to MIS to inform training methods .


A tablet laptop running bespoke software was placed within a laparoscopic box trainer and connected to a monitor situated at eye level .


Participants ( right-handed , non-surgeons , mean age = @ years ) used a standard laparoscopic grasper to move between locations on the screen .


There were two training groups : the M group ( n = @ ) who trained using multiple port sites , and the S group ( n = @ ) who trained using a single port site .


A novel port site was used as a test of generalization .


Performance metrics were a composite of speed and accuracy ( SACF ) and normalized jerk ( NJ ; a measure of movement ` smoothness ' ) .


The M group showed a statistically significant performance advantage over the S group at test , as indexed by improved SACF ( p < @ ) and NJ ( p < @ ) .


This study has demonstrated the potential benefits of incorporating a structural learning approach within MIS training .


This may have practical applications when training junior surgeons and developing surgical simulation devices .


The Randomized Olmesartan and Diabetes Microalbuminuria Prevention ( ROADMAP ) study showed that @ mg Olmesartan medoxomil ( OM ) versus placebo delayed microalbuminuria onset in patients with type @ diabetes and normoalbuminuria .


One thousand seven hundred and fifty-eight ROADMAP patients ( placebo arm : @ ; OM arm : @ ) participated in the observational follow up ( OFU ) with an average of @ years .


They received standard medical care and micro - and macrovascular events were documented .


During observational follow-up @ % and @ % in the former OM and placebo group , respectively , received treatment with a RAS blocking agent .


During the OFU period the systolic blood pressure ( SBP ) increased to mean values of @ mm Hg in both groups .


Patients who had developed microalbuminuria during ROADMAP had a higher incidence of cardio - and cerebrovascular events ( OR @ , CI @ to @ , P = @ ) during the OFU period compared with patients in whom this was not the case .


Diabetic retinopathy was significantly reduced in the former OM group ( @ -LSB- @ % -RSB- versus @ -LSB- @ % -RSB- , OR : @ , CI @ to @ , P = @ ) and the rate of microalbuminuria was numerically reduced .


Congestive heart failure requiring hospitalization ( @ -LSB- @ % -RSB- versus @ -LSB- @ % -RSB- , OR : @ , CI @ to @ , P = @ ) was reduced and there was a trend of reduced cardio - / cerebrovascular events ( OM versus Pb : @ -LSB- @ % -RSB- versus @ -LSB- @ % -RSB- patients ) .


Seven ( @ % ) deaths ( including @ CV events ) were reported in former placebo patients versus @ ( @ % ) ( non-CV events ) in former OM patients .


Development of microalbuminuria is a valid marker for future CV events .


RAS blockade with Olmesartan might cause sustained reduction ( legacy effect ) of micro - and macrovascular events .


Early mobilisation after stroke is thought to contribute to the effects of stroke-unit care ; however , the intervention is poorly defined and not underpinned by strong evidence .


We aimed to compare the effectiveness of frequent , higher dose , very early mobilisation with usual care after stroke .


We did this parallel-group , single-blind , randomised controlled trial at @ acute stroke units in five countries .


Patients ( aged @ years ) with ischaemic or haemorrhagic stroke , first or recurrent , who met physiological criteria were randomly assigned ( @:@ ) , via a web-based computer generated block randomisation procedure ( block size of six ) , to receive usual stroke-unit care alone or very early mobilisation in addition to usual care .


Treatment with recombinant tissue plasminogen activator was allowed .


Randomisation was stratified by study site and stroke severity .


Patients , outcome assessors , and investigators involved in trial and data management were masked to treatment allocation .


The primary outcome was a favourable outcome @ months after stroke , defined as a modified Rankin Scale score of @-@ .


We did analysis on an intention-to-treat basis .


The trial is registered with the Australian New Zealand Clinical Trials Registry , number ACTRN@ .


Between July @ , @ , and Oct @ , @ , we randomly assigned @ patients to receive either very early mobilisation ( n = @ ) or usual care ( n = @ ) ; @ ( @ % ) patients were included in the @ month follow-up assessment .


@ ( @ % ) patients were mobilised within @ h in the very early mobilisation group compared with @ ( @ % ) patients in the usual care group .


Fewer patients in the very early mobilisation group had a favourable outcome than those in the usual care group ( n = @ -LSB- @ % -RSB- vs n = @ -LSB- @ % -RSB- ; adjusted odds ratio -LSB- OR -RSB- @ , @ % CI @-@ ; p = @ ) .


@ ( @ % ) patients died in the very early mobilisation group compared with @ ( @ % ) patients in the usual care group ( OR @ , @ % CI @-@ , p = @ ) .


@ ( @ % ) patients in the very early mobilisation group and @ ( @ % ) of those in the usual care group had a non-fatal serious adverse event , with no reduction in immobility-related complications with very early mobilisation .


First mobilisation took place within @ h for most patients in this trial .


The higher dose , very early mobilisation protocol was associated with a reduction in the odds of a favourable outcome at @ months .


Early mobilisation after stroke is recommended in many clinical practice guidelines worldwide , and our findings should affect clinical practice by refining present guidelines ; however , clinical recommendations should be informed by future analyses of dose-response associations .


To assess the short-term efficacy and safety of corneal collagen cross-linking ( CXL ) in preventing the progression of keratoconus ( KCN ) .


This randomized controlled clinical trial enrolled @ patients diagnosed with bilateral progressive KCN and were eligible for CXL .


In each patient , one eye was randomly selected for treatment , and the contralateral eye served as the control .


The patients underwent CXL with riboflavin drops and ultraviolet radiation in the treated eye .


One year follow-up data are presented .


Postoperatively , patients were assessed for progression of KCN , visual changes , and other findings .


The main outcome measures were maximum simulated keratometry ( K-max ) , best spectacle-corrected visual acuity ( BSCVA ) , and average simulated keratometry .


P < @ was considered as statistically significant .


In the treated eyes , the mean K-max values decreased by @ D at @-year postoperatively and increased by @ D in the control group .


This difference was statistically significant ( P < @ ) .


BSCVA improved slightly ( a decrease of @ LogMAR ) and decreased slightly in the control group ( a @ LogMAR increase ) .


The difference between groups was statistically significant ( P = @ ) .


There was no decrease in visual acuity attributable to complications of CXL in the treated eyes .


At @-year , the keratometry in @ ( @ % ) treated eyes increased by more than @ D and were considered cases of failed treatment .


Preliminary and @-year results indicate CXL can halt the progression of KCN in most cases without causing serious complications .


We describe the organization of a prospective , randomized , multicenter trial comparing the effectiveness of open popliteal artery aneurysm repair ( OPAR ) and endovascular popliteal artery aneurysm repair ( EPAR ) of asymptomatic popliteal artery aneurysms ( PAAs ) as an example for how to use the Vascular Quality Initiative ( VQI ) framework .


Given that many centers participate in the VQI , this model can be used to perform multicenters ' prospective trials on very modest budget .


VQI prospectively collects data on many vascular procedures .


These data include many important perioperative , intraoperative , and postoperative details regarding both patients and their procedures .


We describe a study where minimal changes to the collected data by participating centers can provide level-@ evidence regarding a significant clinical question .


Data will be collected using modified VQI forms within the existing VQI data reporting structure .


We plan to enroll @ patients with asymptomatic PAAs into the open and endovascular surgery cohorts .


Patients from participating VQI centers will be randomized @:@ to either OPAR or EPAR and will be followed for an average of @ years .


Our primary hypothesis is that major adverse limb event-free survival is lower in the EPAR cohort and that EPAR is associated with more secondary interventions , improved quality of life , and decreased length of stay .


The budget for this trial is fixed at $ @,@ / year for the course of the study , and the trial is judged to be feasible because of the functionality of the VQI platform .


Using the existing VQI infrastructure , Open versus Endovascular Repair of Popliteal Artery Aneurysm will provide level @ data for PAA treatment on a modest budget .


The proposed trial has an adequately powered comparative design that will use objective performance goals to describe limb-related morbidity and procedural reintervention rates .


Many minimally invasive interventional techniques as well as expectant treatment exist for the management of lower ureteric calculi .


This study was conducted to evaluate th efficacy of tamsulosin as an expulsive pharmacologic therapy for the treatment of distal uretern stone .


This randomized control trial included @ patients over @ years of age wit stone Size > or = mm in distal @/@ of ureter .


Patients were randomly assigned into two groups ( A & B Group A Patients were given Capsule Tamsulosin @ mg , @ daily up to @ weeks while group B patients were given placebo , @ Capsule daily up to @ weeks .


The primary endpoint was expulsio rate .


A written informed consent was taken from all the patients .


Expulsion time , need for analgesics , need for hospitalization and drug side effects were secondary endpoints .


A total of @ patients in group A and @ patients in group B reported back , therefore @ out of @ patients were evaluated .


Mean age of the patients was @ years ( range @-@ years ) .


Mea stone size was @ mm ( range @-@ mm ) in greatest dimension .


A stone expulsion rate of @ C ( @ patients ) was noted in group A and @ % ( @ patients ) in group B. Group A revealed statistically significant advantage in term of stone expulsion rate ( p = @ ) .


Considering expulsio time in days group A showed statistically significant advantage ( p = @ ) .


Regarding age , se ) stone size and stone lateralization ( right/left ) , there was no significant difference between th group A and B. No drug side effects were noted in both the groups .


By usin tamsulosin a higher stone expulsion rates can be achieved in a shorter time .


More randomize control trials are required to establish tamsulosin as a standard medical expulsive treatment fc


Despite improvements in liver surgery over the past decades , hemostasis during hepatic resections remains challenging .


This multicenter randomized study compares the hemostatic effect of a collagen hemostat vs. a carrier-bound fibrin sealant after hepatic resection .


Patients scheduled for elective liver resection were randomized intraoperatively to receive either the collagen hemostat ( COLL ) or the carrier-bound fibrin sealant ( CBFS ) for secondary hemostasis .


The primary endpoint was the proportion of patients with hemostasis after @ min .


Secondary parameters were the proportions of patients with hemostasis after @ and @ min , the total time to hemostasis , and the complication rates during a @ months follow-up period .


A total of @ patients were included .


In the COLL group , @ out of @ patients ( @ % ) achieved complete hemostasis within @ min after application of the hemostat compared to @ out of @ patients ( @ % ) in the CBFS group .


The @ % confidence interval for this difference -LSB- -@ % , @ % -RSB- does not include the lower noninferiority margin ( -@ % ) .


Thus , the COLL treatment can be regarded as noninferior to the comparator .


The proportions of patients with hemostasis after @ , @ , and @ min were not significantly different between the two study arms .


Postoperative mortality and morbidity were similar in both treatment groups .


The collagen hemostat is as effective as the carrier-bound fibrin sealant in obtaining secondary hemostasis during liver resection with a comparable complication rate .


Several studies emphasise that arabinoxylan and - glucan have more beneficial effects on glucose metabolism than low-dietary fibre ( DF ) meals .


Less attention has been paid to the effects of concentrated DF compared with whole grain .


We compared the effects of DF and whole grain on glucose , hormone responses and appetite in subjects with the metabolic syndrome ( MetS ) .


Fifteen subjects with MetS participated in this acute , randomised , cross-over intervention study .


The test breads provided @ g of digestible carbohydrate : wheat bread with concentrated arabinoxylan ( AX ) or - glucan ( BG ) , rye bread with kernels ( RK ) and wheat bread ( WB ) as control .


Blood samples were drawn for @ min to determine glucose , insulin , glucagon-like peptide-@ , glucose-dependent insulinotropic peptide ( GIP ) and ghrelin .


Appetite score was addressed every @ min .


Ad libitum energy intake ( EI ) was measured @ min after test meals .


Compared with WB , BG and RK induced lower initial glycaemic responses ( P < @ ) , whereas AX only reduced the glucose peak value ( P < @ ) .


RK reduced insulin ( P < @ ) and GIP responses ( P < @ ) compared with the other breads .


BG lowered insulin responses more than AX ( P < @ ) .


AX , BG and RK increased satiety feeling ( P < @ ) more than WB , but did not differ significantly in terms of subsequent EI ( P = @ ) .


BG and RK had beneficial impact on the glucose response , whereas AX had only effect on the postprandial glucose peak .


The impact of the AX bread was influenced by higher protein content .


Whether the metabolic effects of the breads are still present to mixed meals remains to be tested .


To evaluate the clinical effect of proton pump inhibitor-based triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori ( Hp ) infection among children in terms of Hp eradication rate and incidence of adverse events .


A prospective randomised controlled study was conducted on @ children with a confirmed diagnosis of Hp infection .


These patients were randomized into triple therapy ( n = @ ) and probiotics groups ( n = @ ) .


The triple therapy group received amoxicillin -LSB- @mg / ( kgd ) , Tid -RSB- , clarithromycin -LSB- @mg / ( kgd ) , Bid -RSB- and omeprazole -LSB- @-@ @ mg / ( kgd ) , Qd -RSB- , while the probiotics group received Saccharomyces boulardii ( @mg , Bid ) in addition to triple therapy .


The course of treatment was @ days in both groups .


The adverse events in subjects were recorded by their parents during treatment .


Hp eradiation was evaluated by ( @ ) C breath test at @ weeks after treatment , and the eradication rate and incidence of adverse events were compared between the two groups .


The Hp eradication rates were @ % ( @/@ ) in the triple therapy group and @ % ( @/@ ) in the probiotics group ( P > @ ) .


Compared with the triple therapy group , the probiotics group had nonsignificantly lower incidence of nausea , vomiting , and abdominal pain ( P > @ ) and significantly lower incidence of stomatitis , constipation and diarrhea ( P < @ ) .


Triple therapy combined with Saccharomyces boulardii can not significantly increase Hp eradication rate , but can significantly reduce the incidence of stomatitis , constipation , and diarrhea during treatment .


Little is known about the differences between standard-dose statins effects on glucose level and lipids in Japanese patients with diabetes mellitus ( DM ) .


The @,@ patients were randomly assigned to either the rosuvastatin group or atorvastatin group .


There were no significant differences between the @ groups in the effect on non-high-density lipoprotein cholesterol ( non-HDL-C ) and HbA@c at @ months .


However , physicians tended to switch to more intensive therapy for DM in the atorvastatin group .


Rosuvastatin @ mg and atorvastatin @ mg have a similar lowering effect on non-HDL-C , but might be different in terms of adverse effect on glucose levels .


Oral feeding is likely to have an impact on early return of normal bowel function after uncomplicated surgery including cesarean section .


This study compared postoperative outcomes of early versus late oral feeding regimes after cesarean section .


In this clinical trial , @ pregnant women who underwent elective cesarean section with regional anesthesia were randomized into two feeding groups .


In the early oral and delayed oral feeding groups , liquid diets were commenced @ and @ h after surgery , respectively .


Patients able to tolerate the liquid diet were then gradually introduced to the regular diet .


Main clinical outcomes included duration of hospital stay , time to return of normal bowel function and postoperative gastrointestinal complications .


Time to return of bowel movement ( @ @ vs @ @ h , P < @ ) and time to mobilization ( @ @ vs @ @ h , P = @ ) occurred significantly earlier in the early feeding group .


Early oral feeding reduces the time required for return of normal bowel function .


This is without significant detrimental effects on the incidence of gastrointestinal complications .


Hepatitis C virus ( HCV ) infection is common among prisoners , particularly those with a history of injecting drug use ( IDU ) .


Incarcerated people who inject drugs frequently report high-risk injecting practices both in prison and in the community .


In spite of rising morbidity and mortality , utilisation of HCV-related services in Australia has been persistently low .


This study aimed to describe the incidence , prevalence and correlates of HCV seropositivity in a large cohort of prisoners who have injected drugs , and to identify correlates of receiving confirmation of active infection .


Data-linkage to a State-wide statutory notifiable diseases surveillance system was used to investigate the incidence of notified HCV seropositivity , seroconversion and confirmed HCV infection in a cohort of @ prisoners with a history of IDU , over @ years of follow up .


Hepatitis C test results from prison medical records were used to identify correlates of testing positive in prison .


The crude incidence of HCV notification was @ cases per @ person-years .


By the end of follow up , @ % of the cohort had been the subject of a HCV-related notification , and @ % of those tested in prison were HCV seropositive .


In multivariable analyses , injecting in prison was strongly associated with HCV seropositivity , as was opioid use compared to injection of other drugs .


The rate of reported diagnostic confirmation among those with notified infections was very low , at @ confirmations per @ seropositive participants per year .


Injecting drugs in prison was strongly associated with HCV seropositivity , highlighting the need for increased provision of services to mitigate the risk of transmission within prisons .


Once identified as seropositive through screening , people with a history of IDU and incarceration may not be promptly receiving diagnostic services , which are necessary if they are to access treatment .


Improving access to HCV-related services will be of particular importance in the coming years , as HCV-related morbidity and mortality is increasing , and next generation therapies are becoming more widely available .


Data comparing the efficacy and safety of combination therapy with peginterferon plus low-dose ribavirin and peginterferon monotherapy in treatment-naive haemodialysis patients with hepatitis C virus genotype @ ( HCV-@ ) infection are limited .


In this randomised trial , @ patients received @weeks of peginterferon alfa-@a @g/week plus ribavirin @mg/day ( n = @ ) or peginterferon alfa-@a @g/week ( n = @ ) .


The efficacy and safety endpoints were sustained virological response ( SVR ) rate and adverse event ( AE ) - related withdrawal rate .


Compared with monotherapy , combination therapy had a greater SVR rate ( @ % vs @ % , relative risk ( RR ) : @ -LSB- @ % CI @ to @ -RSB- ; p < @ ) .


The beneficial effect of combination therapy was more pronounced in patients with baseline viral load @,@ IU/mL than those with baseline viral load < @,@ IU/mL ( RR : @ -LSB- @ % CI @ to @ -RSB- vs. RR : @ -LSB- @ % CI @ to @ -RSB- ; interaction p = @ ) .


Patients receiving combination therapy were more likely to have a haemoglobin level of < @ g/dL ( @ % vs. @ % , risk difference ( RD ) : @ % -LSB- @ % CI @ % to @ % -RSB- ; p < @ ) and required a higher dosage -LSB- mean : @,@ vs. @ IU/week , p = @ -RSB- of epoetin to manage anaemia than those receiving monotherapy .


The AE-related withdrawal rates were @ % and @ % in combination therapy and monotherapy groups , respectively ( RD : @ % -LSB- @ % CI -@ % to @ % -RSB- ) .


In treatment-naive haemodialysis patients with HCV-@ infection , combination therapy with peginterferon plus low-dose ribavirin achieved a greater SVR rate than peginterferon monotherapy .


Most haemodialysis patients can tolerate combination therapy .


The secreted protein acidic and rich in cysteine-like @ ( SPARCL@ ) is expressed in various normal tissues and many types of cancers .


The function of SPARCL@ and its relationship to a patient 's prognosis have been studied , whereas its relationship to radiation therapy ( RT ) is not known .


Our aim was to investigate the expression of SPARCL@ in rectal cancer patients who participated in a clinical trial of preoperative RT. .


The study included @ rectal cancer patients who were randomized to undergo preoperative RT and surgery ( n = @ ) or surgery alone ( n = @ ) .


The expression levels of SPARCL@ in normal mucosa ( n = @ ) , primary tumor ( n = @ ) , and lymph node metastasis ( n = @ ) were determined by immunohistochemistry .


Tumors with RT had stronger SPARCL@ expression than tumors without RT ( P = @ ) .


In the RT group , strong SPARCL@ expression was related to better survival than weak expression in patients with stage III tumors , independent of sex , age , differentiation , and margin status ( P = @ ; RR = @ ; @ % confidence interval , @-@ @ ) .


No such relationship was found in the non-RT group ( P = @ ) .


Further analysis of interactions among SPARCL@ expression , RT , and survival showed statistical significance ( P = @ ) .


In patients with metastases who received RT , strong SPARCL@ expression was related to better survival compared to weak expression ( P = @ ) but not in the non-RT group ( P = @ ) .


SPARCL@ expression increases with RT and is related to better prognosis in rectal cancer patients with RT but not in patients without RT. .


This result may help us to select the patients best suited for preoperative RT. .


Relatively few treatment programs have been developed specifically for smokeless tobacco ( ST ) users who want to quit .


Their results suggest that self-help materials , telephone counseling , and nicotine lozenges are efficacious .


This study provides the first direct examination of the separate and combined effects of telephone counseling and lozenges .


We recruited ST users online ( N = @ ) and randomly assigned them to @ of @ conditions : ( a ) a lozenge group ( n = @ ) , who were mailed @-mg nicotine lozenges ; ( b ) a coach calls group ( n = @ ) , who were offered @ coaching phone calls ; or ( c ) a lozenge + coach calls group ( N = @ ) , who received both lozenges and coaching calls .


Additionally , all participants were mailed self-help materials .


Self-reported tobacco abstinence was assessed at @ and @ months after randomization .


Complete-case and intention-to-treat ( ITT ) analyses for all tobacco abstinence were performed at @ months , @ months , and both @ and @ months ( repeated point prevalence ) .


ITT analyses revealed a highly similar result : the lozenge + coach calls condition was significantly more successful in encouraging tobacco abstinence than either the lozenge group or the coach calls group , which did not differ .


Combining nicotine lozenges and phone counseling significantly increased tobacco abstinence rates compared with either intervention alone , whereas coach calls and lozenges were equivalent .


The study confirms the high tobacco abstinence rates for self-help ST cessation interventions and offers guidance to providing tobacco treatment to ST users .


The authors conducted a randomized , controlled , parallel-arm , superiority study to test the hypothesis that a continuous adductor canal block decreases the time to attain four discharge criteria compared with a continuous femoral nerve block after tricompartment knee arthroplasty .


Subjects undergoing tricompartment knee arthroplasty were randomized using computer-generated lists to either an adductor canal or femoral perineural catheter ( @-day ropivacaine @ % infusion ) in an unmasked manner .


The primary outcome was the time to attain four criteria : ( @ ) adequate analgesia ; ( @ ) intravenous opioids independence ; ( @ ) ability to stand , walk @ m , return , and sit down ; and ( @ ) ambulate @ m.


Subjects with an adductor canal catheter ( n = @ ) reached all four criteria in a median of @h ( interquartile , @ to @h ) compared with @h ( @ to @h ) for those with a femoral catheter ( n = @ ; @ % CI , -@ to @h ; P = @ ) .


The percentage of subjects who reached the two mobilization criteria on postoperative days @ and @ were @ and @ % for those with an adductor canal catheter ( n = @ ) , but only @ and @ % in subjects with a femoral catheter ( n = @ ; both P < @ ) .


Differences in pain scores at rest and intravenous opioid requirements were minimal , but femoral infusion improved dynamic analgesia ( P = @ to @ ) .


Compared with a continuous femoral nerve block , a continuous adductor canal block did not appreciably decrease the time to overall discharge readiness even though it did decrease the time until adequate mobilization , primarily because both groups experienced similar analgesia and intravenous opioid requirements that -- in most cases -- exceeded the time to mobilization .


To our knowledge , only a few double-blind randomized controlled trials with antipsychotic drugs have been conducted to examine the treatment of methamphetamine-induced psychosis ( MAP ) .


The aims of this study are to compare the antipsychotic and adverse events of quetiapine , an atypical antipsychotic drug , to haloperidol , a standard treatment for primary psychotic disorder , in individuals with MAP .


Eighty individuals with MAP were randomly assigned into two groups , i.e. treatment with quetiapine ( n = @ ) and haloperidol ( n = @ ) .


Sixty-eight patients ( @ % ) completed the study protocol , i.e. treatment with quetiapine at least @ mg per day or haloperidol at least @ mg per day orally once a day for @ weeks .


The doses were increased every @ days until no psychotic symptom was observed from the Positive and Negative Syndrome Scale ( PANSS ) .


Data were analysed by survival analysis with Cox 's proportional regression analysis , general estimating equations and log-rank tests .


Thirty-two ( @ % ) subjects from the quetiapine group and @ subjects ( @ % ) from the haloperidol group met the remission criteria at the end of the study .


Baseline PANSS total scores of quetiapine and haloperidol groups were @ @ and @ @ , respectively ( mean SD ; p = @ ) .


The change-from-baseline scores were -@ for the quetiapine group and -@ for the haloperidol group .


There were no significant differences between the antipsychotic effects ( coefficient value = -@ , p = @ , @ % CI = -@ , @ ) and the adverse effects of quetiapine and haloperidol .


Quetiapine may be used as an antipsychotic treatment for MAP with comparable therapeutic effects and adverse events to treatment with classical antipsychotic drugs .


Despite the important role that health professionals have in reducing tobacco use , many have a smoking habit themselves .


The prevalence of smoking is particularly high among nurses .


To test the efficacy , acceptability and feasibility of a motivational interviewing ( MI ) based smoking cessation intervention with nurses .


Two group parallel experimental design with random allocation to groups .


A large teaching hospital in the North of Spain .


Nurses who smoked ( n = @ ) were randomised into two groups : motivational interviewing based intervention ( n = @ ) and usual care ( n = @ ) .


Motivational interviewing based intervention consisted of four individual MI sessions .


Usual care consisted of brief advice .


Variables considered to assess efficacy were biochemically verified smoking cessation , mean cigarettes smoked , stages of change , self-efficacy and depression score .


Variables to assess acceptability and feasibility included participant satisfaction , adherence to MI , and duration of sessions .


Data were collected at : baseline , end of intervention and three months after the end of the intervention .


At three month follow up , compared with the control group , more nurses in the intervention group had quit ( absolute difference @ % ; @ % confidence interval -LSB- CI -RSB- @-@ @ ) .


In the nurses who did not quit , there was no significant difference between the intervention and control groups in the number of cigarettes smoked per day , although progress in the stages of change was greater in the intervention group compared to the control group .


Measures of acceptability and feasibility indicated good satisfaction with the intervention , with high levels of attendance and completion .


This study found a beneficial effect of motivational interviewing on nurses ' smoking cessation .


The intervention was acceptable for nurses and a number of aspects were identified that need to be considered prior to conducting a larger scale in order to optimise the intervention .


Using MI might be a novel approach to the problem of health professionals who smoke .


The traditional treatment after closed reduction of distal radius ( DR ) and distal both bone ( DBB ) forearm fractures has been application of a long-arm cast ( LAC ) or a short-arm cast ( SAC ) .


Splinting is another option that avoids the potential complications associated with casting .


The purpose of this study is to evaluate the maintenance of reduction of DR or DBB fractures placed in a double-sugar-tong splint ( DSTS ) compared with a LAC in a pediatric population .


This is an IRB-approved , prospective , randomized trial .


Patients aged @ to @ years with DR or DBB fractures treated at a single institution between @ and @ were enrolled .


After reduction , fractures were placed into either a LAC or a DSTS .


Radiographs were reviewed at initial injury , postreduction , and at set intervals for angulation , displacement , and apposition , as well as cast index and @-point index .


The DSTS was overwrapped into a cast after week @ .


The immobilization device was changed to a SAC at week @ or @ .


Total duration of immobilization was @ to @ weeks .


Seventy-one patients were enrolled with @ in the LAC and @ in the DSTS .


Average age was @ years ( range , @ to @ ) with @ being males .


There were @ isolated DR and @ DBB fractures .


There were no week-to-week differences between the @ groups in regards to sagittal alignment , coronal alignment , apposition , or displacement .


Sagittal alignment at immediate postreduction and week @ showed that the DSTS was slightly better ( average @ vs. @ degrees , respectively , P = @ ) .


For the entire treatment period there was an increased risk of loss of reduction of @ degrees in the LAC group versus the DSTS group ( @ patients vs. @ patients , respectively , P = @ ) , and of meeting the criteria for remanipulation ( @ patients vs. @ patients , respectively , P = @ ) .


At cast removal , there was no difference between groups .


Although there were significant differences between the @ groups with regards to risk of reduction loss , the DSTS and LAC were comparable in maintenance of reduction at the time of cast removal .


Both the DSTS and LAC are appropriate immobilization devices for these pediatric fractures .


Level II-prospective , comparative study .


Pancreatic ductal adenocarcinoma ( PDAC ) is one of the most common malignant tumours and is still associated with a poor prognosis in advanced disease .


To improve the standard therapy with gemcitabine , we initiated a prospective randomised phase-II trial with gemcitabine ( GEM ) versus gemcitabine plus sunitinib ( SUNGEM ) based on data of in vitro trials and phase-I data for the combination treatment .


The rational of adding sunitinib was its putative antiangiogenic mechanism of action .


A total of @ eligible patients with locally advanced , unresectable or metastatic PDAC without previous system therapy were randomised to receive GEM at a dosage of @ mg/m ( @ ) d@ , @ , @ q@ versus a combination of SUNGEM at a dosage of GEM @ mg/m ( @ ) d@ +@ and sunitinib @mg p.o. d@-@ , q@d .


The primary end-point was progression free survival ( PFS ) , secondary end-points were overall survival ( OS ) , toxicity and overall response rate ( ORR ) .


The confirmatory analysis of PFS was based on the intend-to-treat ( ITT ) population ( N = @ ) .


The median PFS was @ weeks ( @ % confidence interval ( @ % - CI ) : @-@ @ weeks ) for GEM and @ weeks for SUNGEM ( @ % - CI : @-@ @ weeks ; p = @ one-sided log-rank ) .


The ORR was @ % ( @ % - CI : @-@ @ % ) for GEM and for @ % ( @ % - CI : @-@ @ % ) for SUNGEM ( p = @ ) .


The median time to progression ( TTP ) was @ weeks ( @ % - CI : @-@ @ weeks ) for GEM and @ weeks ( @ % - CI : @-@ @ weeks ) for SUNGEM ( p = @ ; two-sided log-rank ) .


The median OS was @ weeks ( @ % - CI : @-@ @ weeks ) for the GEM arm and @ weeks ( @ % - CI : @-@ @ weeks ) for the SUNGEM ( p = @ , one-sided log-rank ) .


In regard to toxicities , suspected SAEs were reported in @ % in the GEM arm and @ % in the SUNGEM arm .


Grade @ and @ neutropenia was statistically significantly higher in the SUNGEM arm with @ % versus @ % in the GEM arm ( p = @ , two sided log-rank ) .


The combination SUNGEM was not sufficient superior in locally advanced or metastatic PDAC compared to GEM alone in regard to efficacy but was associated with more toxicity .


DHA is accumulated in the central nervous system ( CNS ) before birth and is involved in early developmental processes , such as neurite outgrowth and gene expression .


To determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants .


A risk reduction model using a randomized prospective study of term gestation single birth healthy infants born to women ( n = @ ) given a placebo or @ mg/day DHA from @ wk gestation to delivery .


Fetal DHA deficiency sufficient to constrain CNS development was assessed based on increased risk that infants in the placebo group would not achieve neurodevelopment scores in the top quartile of all infants in the study .


Infants in the placebo group were at increased risk of lower language development assessed as words understood ( OR @ , CL @-@ @ , P = @ ) and produced ( OR @ , CL @-@ @ , P = @ ) at @ mo , and words understood ( OR @ , CL @-@ @ , P = @ ) and sentences produced ( OR @ , CL @-@ @ , P = @ ) at @ mo using the McArthur Communicative Developmental Inventory ; receptive ( OR @ , CL @-@ @ , P = @ ) and expressive language ( OR @ , CL @-@ @ , P = @ ) at @ mo using the Bayley Scales of Infant Development III ; and visual acuity ( OR @ , CL @-@ @ , P = @ ) at @ mo. .


Although screening , brief intervention , and referral to treatment ( SBIRT ) has shown promise for alcohol use , relatively little is known about its effectiveness for adult illicit drug use .


This randomized controlled trial assessed the effectiveness of the SBIRT approach for outcomes related to drug use among patients visiting trauma and emergency departments ( EDs ) at two large , urban hospitals .


A total of @ ED patients who admitted using illegal drugs in the past @days were recruited , consented , provided baseline measures of substance use and related problems measured with the Addiction Severity Index-Lite ( ASI-Lite ) , and then randomized to the Life Shift SBIRT intervention or to an attention-placebo control group focusing on driving and traffic safety ( Shift Gears ) .


Both groups received a level of motivational intervention matched to their condition and risk level by trained paraprofessional health educators .


Separate measurement technicians conducted face-to-face follow-ups at @months post-intervention and collected hair samples to confirm reports of abstinence from drug use .


The primary outcome measure of the study was past @-day drug abstinence at @months post-intervention , as self-reported on the ASI-Lite .


Of @ participants , @ ( @ % ) completed follow-up .


There were no significant differences in self-reported abstinence ( @ % vs. @ % , p = @ ) for Life Shift and Shift Gears groups , respectively .


When results of hair analyses were applied , the abstinence rate was @ percent for Life Shift and @ percent for Shift Gears ( p = @ ) .


In an analysis in which results were imputed ( n = @ ) , there was no significant difference in the ASI-Lite drug use composite scores ( Life Shift +@ vs. Shift Gears +@ , p = @ ) .


In this randomized controlled trial , there was no evidence of effectiveness of SBIRT on the primary drug use outcome .


This study aimed to compare the effects of different local anesthetic solutions on postoperative pain of anal surgery in adult patients .


In this randomized double-blind prospective clinical trial , @ adult patients ( @ to @ years old ) with physical status class I and class II that had been brought to a university hospital operating room for fistula anal surgery with spinal anesthesia were selected .


Patients were randomly divided into @ equal groups according to table of random numbers ( created by Random Allocation Software @ ) .


Group @ received @ mL of normal saline , group @ , @ mL of normal saline plus @ mL of bupivacaine @ % , group @ , @ mL of ketamine plus @ mL of bupivacaine @ % , and group @ , no infiltration .


Intensity of pain in patients was measured using visual analogue scale ( VAS ) at @ ( transfer to ward ) , @ , @ , @ , and @ hours after surgery .


Time interval to administration of drugs and overall dose of drugs were measured in @ groups .


Mean level of pain was the lowest in group @ at all occasions with a significant difference , followed by groups @ , @ , and lastly @ ( P < @ ) .


Furthermore , groups @ and @ compared to groups @ and @ had the least overall dose of analgesics and requested them the latest , with a significant difference ( P < @ ) .


Local anesthesia ( @ mL of ketamine plus @ mL of bupivacaine @ % or @ mL of normal saline plus @ mL of bupivacaine @ % ) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients .


This study investigated inter-rater agreement ( IRA ) among EEG experts for the identification of electrographic seizures and periodic discharges ( PDs ) in continuous ICU EEG recordings .


Eight board-certified EEG experts independently identified seizures and PDs in thirty @-h EEG segments which were selected from ICU EEG recordings collected from three medical centers .


IRA was compared between seizure and PD identifications , as well as among rater groups that have passed an ICU EEG Certification Test , developed by the Critical Care EEG Monitoring Research Consortium ( CCEMRC ) .


Both kappa and event-based IRA statistics showed higher mean values in identification of seizures compared to PDs ( k = @ vs. @ ; p < @ ) .


The group of rater pairs who had both passed the ICU EEG Certification Test had a significantly higher mean IRA in comparison to rater pairs in which neither had passed the test .


IRA among experts is significantly higher for identification of electrographic seizures compared to PDs .


Additional instruction , such as the training module and certification test developed by the CCEMRC , could enhance this IRA .


This study demonstrates more disagreement in the labeling of PDs in comparison to seizures .


This may be improved by education about standard EEG nomenclature .


The aim of this study was to comparatively evaluate three different stabilization methods with regards to the amount of shrinkage in free gingival graft .


Forty-five patients were included in three study groups : where stabilization was achieved with conventional technique , cyanoacrylate or microsurgery .


In the conventional group standardized @-@ sutures were used .


In the microsurgery group grafts were stabilized with @-@ sutures and loupe .


In the third group , graft was stabilized with cyanoacrylate .


Keratinized tissue width , graft area , gingival recession were calculated by a specific software on standard photographs at baseline , @ - , @ - , @-month follow-ups .


Duration of surgery was also recorded .


Pain in recipient and donor sites was assessed using visual analogue scale within the first postoperative week .


Change in keratinized tissue width was similar in the study groups at all times .


Graft shrinkage was significantly less ( p < @ ) in the cyanoacrylate group than the other groups , whereas those in the conventional and microsurgery groups were similar .


Significantly less pain in the recipient site was reported by the patients in the cyanoacrylate group ( p < @ ) .


Duration of surgery was significantly less in the cyanoacrylate group than the other groups ( p < @ ) .


Less graft shrinkage in the free gingival graft , together with shorter surgery time and less pain in the recipient site obtained in the cyanoacrylate group , suggest that cyanoacrylate may be considered as an alternative for stabilization of free gingival grafts .


ECAR ( Endovasculaire ou Chirurgie dans les Anvrysmes aorto-iliaques Rompus ) is a prospective multicentre randomized controlled trial including consecutive patients with ruptured aorto-iliac aneurysms ( rAIA ) eligible for treatment by either endovascular ( EVAR ) or open surgical repair ( OSR ) .


Inclusion criteria were hemodynamic stability and computed tomography scan demonstrating aorto-iliac rupture .


Randomization was done by week , synchronously in all centers .


The primary end point was @ day mortality .


Secondary end points were post-operative morbidity , length of stay in the intensive care unit ( ICU ) , amount of blood transfused ( units ) and @ month mortality .


From January @ to January @ , @ patients ( @ men , @ women ; median age @ years ) were enrolled in @ centers : @ ( @ % ) in the EVAR group and @ ( @ % ) in the OSR group .


The groups were similar in terms of age , sex , consciousness , systolic blood pressure , Hardman index , IGSII score , type of rupture , use of endoclamping balloon , and levels of troponin , creatinine , and hemoglobin .


Delay to treatment was higher in the EVAR group ( @ vs. @ hours ; p < @ ) .


Mortality at @ days and @ year were not different between the groups ( @ % in the EVAR group vs. @ % in the OSR group at @ days , and @ % vs. @ % , respectively , at @ year ) .


Total respiratory support time was lower in the EVAR group than in the OSR group ( @ hours vs. @ hours ; p = @ ) , as were pulmonary complications ( @ % vs. @ % , respectively ; p = @ ) , total blood transfusion ( @ vs. @ , respectively ; p = @ ) , and duration of ICU stay ( @ days vs. @ days , respectively ; p = @ ) .


In this study , EVAR was found to be equal to OSR in terms of @ day and @ year mortality .


However , EVAR was associated with less severe complications and less consumption of hospital resources than OSR .


Interferon ( IFN ) - therapy for chronic hepatitis C virus infection is frequently associated with depression .


The routine prophylaxis with antidepressants might expose patients to adverse effects , hence , the need for alternative preventive interventions .


Omega-@ polyunsaturated fatty acids are safe and effective essential nutritional compounds used for the treatment of depression , putatively through an anti-inflammatory action .


In addition , lower erythrocyte levels of omega-@ polyunsaturated fatty acids have been associated with an increased risk of IFN-induced depression .


We conducted a @-week , double-blind , placebo-controlled trial comparing eicosapentaenoic acid ( EPA ) , docosahexaenoic acid ( DHA ) , and placebo for the prevention of IFN -- induced depression .


A total of @ patients consented to participate and were randomized to the study .


All of the patients completed the @-week trial ; @ participants were followed throughout the @ weeks of IFN - treatment and were included in the analysis .


Compared with placebo , the incident rates of IFN -- induced depression were significantly lower in EPA-treated but not in DHA-treated patients ( @ % and @ % , respectively , versus @ % for placebo , p = @ ) .


Both EPA and DHA significantly delayed the onset of IFN-induced depression ( week of onset : @ and @ , respectively , versus @ for placebo , p = @ ) .


EPA and DHA were both well tolerated in this population .


EPA treatment increased both EPA and DHA erythrocyte levels , but DHA only increased DHA erythrocyte levels .


EPA is effective in the prevention of depression in hepatitis C virus patients received IFN - therapy .


Our study confirms the notion that anti-inflammatory strategies are effective antidepressants in the context of depression associated with inflammation .


Some children have residual amblyopia after treatment with atropine eyedrops for amblyopia due to strabismus and/or anisometropia .


We conducted a randomized clinical trial to evaluate the effectiveness of augmenting the effect of atropine by changing the lens over the fellow eye to plano in children with residual amblyopia .


A total of @ children @ to < @ years of age ( mean , @ years ) with stable residual amblyopia ( range , @/@ to @/@ , mean @/@ ( +@ ) ) were enrolled after at least @ weeks of atropine treatment of the fellow eye .


Participants were randomly assigned to continuing weekend atropine alone or wearing a plano lens over the fellow eye ( while continuing atropine ) .


The primary outcome was assessed at @ weeks , and participants were followed until improvement ceased .


At the @-week primary outcome visit , amblyopic-eye visual acuity had improved an average of @ lines with the plano lens and @ lines with atropine only ( difference adjusted for baseline visual acuity = + @ line ; @ % CI , -@ to +@ ) .


At the primary outcome or later visit when the best-measured visual acuity was observed , the mean amblyopic-eye improvement from baseline was @ lines with the plano lens and @ lines with atropine only .


When amblyopic-eye visual acuity stops improving with atropine treatment , there may be a small benefit to augmenting atropine therapy with a plano lens over the fellow eye .


However , the effect was not statistically significant , and the large confidence interval raises the possibility of no benefit or a benefit larger than we observed .


A larger study would be necessary to get a more precise estimate of the treatment effect .


To assess the efficacy and safety of heated humidified high-flow nasal cannula ( HHHFNC ) ventilation compared with nasal continuous positive airway pressure ( NCPAP ) on prevention of extubation failure in the NICUs .


A prospective randomized , controlled un-blinded study was conducted in @ tertiary hospitals in Hebei Province from December @ , @ to May @ , @ .


Neonates were eligible for this study if they were admitted to the participating NICUs within @ days of postnatal age , and needed noninvasive respiratory support after a period of mechanical ventilation with an endotracheal tube .


Infants were randomly assigned to either HHHFNC or NCPAP group .


The primary outcome measures included : the incidence of extubation failure , bronchopulmonary dysplasia and the mortality before discharge .


Among the @ cases included , @ were in the HHHFNC group , and @ were in the NCPAP group .


There was no significant difference in gestational age , birth weight , and age at randomization , and male/female ratio between the two groups ( P > @ ) .


There were no significant differences between groups for days on ventilation , noninvasive respiratory support , oxygen requirement , hospital stay and time to full oral feedings ( P > @ ) .


The overall mortality of the studied population was @ % ( @/@ ) .


The occurrence of extubation failure within @ days was @ % whereas @ % in very low birth weight infants .


There was no significant difference in the extubation failure for HHHFNC ( @/@ , @ % ) versus NCPAP ( @/@ , @ % ) ( P > @ ) , or in mortality for HHHFNC ( @/@ , @ % ) versus NCPAP ( @/@ , @ % ) ( P > @ ) .


No significant difference was found between the study groups in the occurrence of bronchopulmonary dysplasia ( BPD ) and most of severe adverse outcomes analyzed , including air leak syndrome and nasal trauma .


The occurrence of abdominal distention during treatment was higher in NCPAP than HHHFNC group ( @ % vs. @ % , P < @ ) .


Among infants @ d of postnatal age , HHHFNC appears to have efficacy and safety similar to those of NCPAP group when applied immediately post-extubation to prevent extubation failure .


Despite concerns on unmonitored pressure delivery during HHHFNC support , no increase of the occurrence of BPD , air leak syndrome or mortality was found .


Randomized trials found that use of erythropoiesis-stimulating agents to target normal hematocrit ( Hct ) levels ( > @ % ) compared with @ % -@ % increases cardiovascular risk and mortality among chronic kidney disease patients .


However , the effects of the most widely used Hct target in the past @ decades , @ % -@ % , have never been examined .


To compare the effects of @ Hct target strategies-@ @ % -@ % ( low ) and @ % -@ % ( mid ) in a high-risk population : elderly dialysis patients with significant comorbidities .


Observational data from the US Renal Data System were used to emulate a randomized trial in which patients were assigned to either Hct strategy .


Follow-up started after completing @ months of hemodialysis and ended @ months later .


We conducted the observational analogs of intention-to-treat and per-protocol analyses .


Inverse-probability weighting was used to adjust for measured time-dependent confounding by indication .


A total of @,@ elderly patients with both diabetes and cardiovascular disease who initiated hemodialysis in @-@ .


Hazard ratios ( HRs ) and survival probabilities for all-cause mortality and a composite cardiovascular and mortality endpoint .


The intention-to-treat HR ( @ % confidence interval ) for mid versus low Hct strategy was @ ( @-@ @ ) for all-cause mortality and @ ( @-@ @ ) for the composite endpoint .


The per-protocol HR ( @ % confidence interval ) for mid versus low Hct strategy was @ ( @-@ @ ) for all-cause mortality and @ ( @-@ @ ) for the composite outcome .


Among hemodialysis patients , we did not find differences in @-month survival or cardiovascular risk between clinical strategies that target Hct at @ % -@ % versus @ % -@ % .


Few cancers pose greater challenges than head and neck ( H&N ) cancer .


Residual effects following treatment include body image changes , pain , fatigue and difficulties with appetite , swallowing and speech .


Depression is a common comorbidity .


There is limited evidence about ways to assist patients to achieve optimal adjustment after completion of treatment .


In this study , we aim to examine the effectiveness and feasibility of a model of survivorship care to improve the quality of life of patients who have completed treatment for H&N cancer .


This is a preliminary study in which @ patients will be recruited .


A prospective randomised controlled trial of the H&N Cancer Survivor Self-management Care Plan ( HNCP ) involving pre - and post-intervention assessments will be used .


Consecutive patients who have completed a defined treatment protocol for H&N cancer will be recruited from two large cancer services and randomly allocated to one of three study arms : ( @ ) usual care , ( @ ) information in the form of a written resource or ( @ ) the HNCP delivered by an oncology nurse who has participated in manual-based training and skill development in patient self-management support .


The trained nurses will meet patients in a face-to-face interview lasting up to @ minutes to develop an individualised HNCP , based on principles of chronic disease self-management .


Participants will be assessed at baseline , @ and @ months .


The primary outcome measure is quality of life .


The secondary outcome measures include mood , self-efficacy and health-care utilisation .


The feasibility of implementing this intervention in routine clinical care will be assessed through semistructured interviews with participating nurses , managers and administrators .


Interviews with patients who received the HNCP will explore their perceptions of the HNCP , including factors that assisted them in achieving behavioural change .


In this study , we aim to improve the quality of life of a patient population with unique needs by means of a tailored self-management care plan developed upon completion of treatment .


Delivery of the intervention by trained oncology nurses is likely to be acceptable to patients and , if successful , will be a model of care that can be implemented for diverse patient populations .


Antiviral therapy with interferon-alpha ( IFN - ) for hepatitis C virus ( HCV ) infection is associated with increased risk for depression .


To identify clinical predictors for IFN -- induced depression during antiviral therapy for HCV infection .


Depression ( defined with the Montgomery-sberg Depression Rating Scale ( MADRS ) ) was evaluated before and during antiviral treatment in @ people with chronic HCV infection without a history of psychiatric disorders .


Cognitive function was evaluated using the Trail Making Test A/B ( TMT A/B ) .


( Trial registration at ClinicalTrials.gov : NCT@ . )


Depression during antiviral therapy was significantly associated with a baseline MADRS score of @ or higher ( P = @ ) .


In total , @ % ( n = @ ) of patients who had a baseline score > @ for the single item sadness developed depression .


Poor baseline performance in the TMT A ( P = @ ) and TMT B ( P = @ ) was predictive for severe depression .


Pre-treatment screening for subthreshold depressive and cognitive symptoms will help to identify those at risk for IFN -- associated depression among patients with chronic hepatitis C.


To study the effects of closure vs nonclosure of buccal mucosal graft harvest site .


Patients were randomized to either primary closure or nonclosure of buccal mucosal harvest site during urethroplasty .


Graft widths were standardized to @ cm .


Prospective data were collected via patient visual analog scales ( @-@ ) of @ domains examining pain , numbness , tightness , drinking , and eating at postoperative day @ and @ and then at @ weeks and @ months until @ year .


There were @ patients who underwent randomization and completed the study .


The preoperative demographics between both groups were comparable with no significant differences .


The median age is @ years .


There were @ patients in the closure group and @ patients in the nonclosure group .


The results show an improvement in the domains of pain ( P = @ ) , drinking ( P = @ ) , and eating ( P = @ ) in favor of the closure group at postoperative day @ and @ .


There are no significant differences in all @ domains between both groups after @ weeks postoperatively


This study shows that primary closure of buccal mucosal graft bed improves pain as well as oral intake in the immediate postoperative period .


There are no long-term differences .


Uncertainty exists about the most effective route for delivery of early nutritional support in critically ill adults .


We hypothesized that delivery through the parenteral route is superior to that through the enteral route .


We conducted a pragmatic , randomized trial involving adults with an unplanned admission to one of @ English intensive care units .


We randomly assigned patients who could be fed through either the parenteral or the enteral route to a delivery route , with nutritional support initiated within @ hours after admission and continued for up to @ days .


The primary outcome was all-cause mortality at @ days .


We enrolled @ patients ; @ ( @ % ) were included in the analysis ( @ in the parenteral group and @ in the enteral group ) .


By @ days , @ of @ patients ( @ % ) in the parenteral group and @ of @ patients ( @ % ) in the enteral group had died ( relative risk in parenteral group , @ ; @ % confidence interval , @ to @ ; P = @ ) .


There were significant reductions in the parenteral group , as compared with the enteral group , in rates of hypoglycemia ( @ patients -LSB- @ % -RSB- vs. @ patients -LSB- @ % -RSB- ; P = @ ) and vomiting ( @ patients -LSB- @ % -RSB- vs. @ patients -LSB- @ % -RSB- ; P < @ ) .


There were no significant differences between the parenteral group and the enteral group in the mean number of treated infectious complications ( @ vs. @ ; P = @ ) , @-day mortality ( @ of @ patients -LSB- @ % -RSB- vs. @ of @ patients -LSB- @ % -RSB- , P = @ ) , in rates of @ other secondary outcomes , or in rates of adverse events .


Caloric intake was similar in the two groups , with the target intake not achieved in most patients .


We found no significant difference in @-day mortality associated with the route of delivery of early nutritional support in critically ill adults .


( Funded by the United Kingdom National Institute for Health Research ; CALORIES Current Controlled Trials number , ISRCTN@ . )


To evaluate the effect of the intravenous ( i.v. ) L-alanyl-L-glutamine dipeptide supplementation during @ days on clinical outcome in trauma patients admitted to the intensive care unit ( ICU ) .


This was a prospective , randomized , double-blind , multicenter trial .


Glutamine was not given as a component of nutrition but as an extra infusion .


The primary outcome variable was the number of new infections within the first @ days .


We included @ patients .


There were no differences between groups in baseline characteristics .


Up to @ % of the patients in the placebo group and @ % in the treatment group presented confirmed infections ( p = @ ) .


ICU length of stay was @ days in both groups ( p = @ ) .


Hospital length of stay was @ days in the placebo group and @ in the treatment group ( p = @ ) .


ICU mortality was @ % in both groups ( p = @ ) .


Sixty percent of the patients presented low glutamine levels before randomization .


At the end of the treatment ( @th day ) , @ % of the patients maintained low glutamine levels ( @ % of treated patients vs. @ % in the placebo group ) .


Patients with low glutamine levels at day @ had more number of infections ( @ vs. @ % ; p = @ ) and longer ICU ( @ vs. @ days ; p < @ ) and hospital length of stay ( @ vs. @ days ; p = @ ) .


There was no benefit with i.v. L-alanyl-L-glutamine dipeptide supplementation ( @ g/kg body weight/day of the dipeptide ) during @ days in trauma patients admitted to the ICU .


The i.v. glutamine supplementation was not enough to normalize the plasma glutamine levels in all patients .


Low plasma glutamine levels at day @ were associated with a worse outcome .


Dietary sodium restriction is a key management strategy in chronic kidney disease ( CKD ) .


Recent evidence has demonstrated short-term reduction in blood pressure ( BP ) and proteinuria with sodium restriction , however the effect on other cardiovascular-related risk factors requires investigation in CKD .


The LowSALT CKD study involved @ hypertensive Stage III-IV CKD patients counselled by a dietitian to consume a low-sodium diet ( < @mmol/day ) .


The study was a randomised crossover trial comparing @weeks of high-sodium ( additional @mmol sodium tablets ) and low-sodium intake ( placebo ) .


Measurements were taken after each crossover arm including BP ( peripheral and central ) , adipokines ( inflammation markers and adiponectin ) , volume markers ( extracellular-to-intracellular -LSB- E/I -RSB- fluid ratio ; N-terminal pro-brain natriuretic peptide -LSB- NT-proBNP -RSB- ) , kidney function ( estimated Glomerular Filtration Rate -LSB- eGFR -RSB- ) and proteinuria ( urine protein-creatinine ratio -LSB- PCR -RSB- and albumin-creatinine ratio -LSB- ACR -RSB- ) .


Outcomes were compared using paired t-test for each cross-over arm .


BP-lowering benefits of a low-sodium intake ( peripheral BP ( meanSD ) @/@/@mmHg ) from high-sodium ( @/@/@mmHg ) intake were reflected in central BP and a reduction in eGFR , PCR , ACR , NTproBNP and E/I ratio .


There was no change in inflammatory markers , total or high molecular weight adiponectin .


Short-term benefits of sodium restriction on BP were reflected in significant change in kidney function and fluid volume parameters .


Larger , long-term adequately powered trials in CKD are necessary to confirm these results .


Endoscopic submucosal dissection ( ESD ) is a standard treatment for gastric neoplasia limited to the mucosa without lymph node metastasis .


However , there are neither standardized guidelines nor studies on the best time to start oral intake after ESD .


The aim of this study was to compare patient satisfaction , safety , length of hospital stay , and economic feasibility between an early post-ESD diet and the conventional immediate fasting protocol .


A total of @ patients with @ gastric epithelial neoplasias who underwent ESD by a single expert endoscopist were consecutively and prospectively enrolled .


Enrolled patients were randomized to an early diet group or a control group .


The early diet group started meals as a clear liquid diet on day @ , and a soft diet and general diet in sequence on day @ .


The fasting group was fasted for @ days .


Patients in both groups underwent second-look endoscopy within @ days following ESD and follow-up endoscopy after @ months .


In the course of the study , ten patients were excluded .


The total number of patients in the early diet group and control group was @ and @ , respectively .


Mean age was @ years ( @ ) .


There were no significant differences in clinicopathologic conditions or endoscopic results such as procedure time or size of lesions between the two groups .


There were no significant differences in abdominal pain score , rate of post-ESD bleeding or healing rate of ESD-induced ulcer between the two groups .


However , the early diet protocol led to significantly higher patient satisfaction ( p = @ ) , lower hospital costs ( p < @ ) , and shorter hospital stay ( p < @ ) than the conventional fasting protocol .


An early post-ESD diet protocol provides higher patient satisfaction , is more cost effective , decreases hospital stay , and does not influence complication rates such as post-ESD bleeding , abdominal pain , or ulcer healing compared with the conventional fasting protocol .


Internet-based applications are becoming more common in our modern world .


While electronic health records ( EHR ) are available for patients and health care providers outside of Germany , most of the available data on EHR address only monetary advantages.This study explores whether or not internet-based communication between family physicians ( FP ) and patients is as safe as traditional oral communication and if it may lead to further benefits .


@ patients from @ family doctors ' offices were included in this @ months RCT .


Both groups were treated in the same manner by their respective physicians , but members of the study group ( SG ) were able to access an individual developed web-based software where they could view their diagnosis and medication , and send an electronic message to their doctors who would respond .


Their satisfication with the FP , certain health data and the FP 's workload were recorded .


a ) Patients ' satisfaction : When e.g. asked about the organization of the family practice or trust in the doctor , there were no significant differences between the control ( CG ) and the SG ( p = @ ; p = @ ) .


However , patients of the SG felt better informed ( p = @ ) , and generally more satisfied with their FP ( p = @ ) .


b ) FP workload : Members of the CG had @ contacts with their doctors during the study , while the SG only had @ recorded contacts ( including web-based contacts , p = @ ) .


It took physicians @:@ minutes less to read and respond to an electronic message than to see a patient during the consultation hours .


c ) Changes in patients ' health : During the study the blood pressure ( BP ) in the CG rose @ / @ mmHg , while it dropped @ / @ mmHg in the SG ( p = @ / @ ) .


The HbA ( @C ) dropped in both groups ( p = @ ) .


One week after the first visit to the family doctor , patients of the SG rated their pain @ points lower on a VAS than the CG ( p = @ ) .


@ % from the CG and @ % from the SG requested the re-prescription of long-term medication on time ( p = @ ) .


Using an optional web-based communication platform is as safe as traditional consultations can be .


Both patients and doctors may benefit from using the internet in this context .


Many transfusion services are keeping thawed plasma ( TP ) ready for trauma patients .


According to Chinese guidelines , once thawed , fresh frozen plasma ( FFP ) should be used within @h .


This may increase plasma wastage and delay plasma administration to critical patients .


However , it can be avoided by being relabeled as TP .


In this study we evaluated coagulation-related proteins in thawed apheresis FFP during @ days of storage at @-@ C.


Thirty apheresis fresh plasma units were aliquot and stored at -@ C. Aliquots were thawed at @ C and stored at @-@ C for @ , @ , @ , @ , @ and @ days , respectively .


Prothrombin time ( PT ) , activated partial thromboplastin time ( aPTT ) , thrombin time ( TT ) , fibrinogen ( Fbg ) , factor ( F ) II , FV , FVII , FVIII , FIX , FX , FXI , FXII , protein C ( PC ) , protein S ( PS ) , antithrombin III ( ATIII ) and ADAMTS@ levels were assessed at Days @-@ , respectively .


For @ days of refrigerated storage , no significant differences were observed in Fbg , PC , PS , ATIII and ADAMTS@ .


FII , FV , FVII , FVIII , FIX , FX , FXI and FXII declined significantly over time .


The storage presented major decrease for FVIII , with a drop of @ % .


However , at least @ % levels of all measured proteins were remained on Day @ , when compared to Day @ .


All measured proteins in TP for @ days of refrigerated storage were adequate .


These could provide evidence that thawed FFP could be relabeled as TP , which is a potential to ensure rapid plasma availability in emergency situations in China .


To explore the clinical efficacy and safety of acupuncture and moxibustion for copracrasia .


By prospective live randomized controlled trial , @ cases with copracrasia were randomly divided into an acupuncture-moxibustion group and a medication group , @ cases in each one .


In the acupuncture-moxibustion group , acupuncture was applied at Ciliao ( BL @ ) , Changqiang ( GV @ ) and Tianshu ( ST @ ) and mild moxibustion was used at Qihai ( CV @ ) .


Treatment was given for @ weeks and @ times , @ times a week in the front @ weeks , @ times a week in the latter @ weeks .


In the medication group , conventional symptomatic treatment , support therapy , and complications preventing and treating were adopted for @ weeks .


Anal incontinence score ( Vaizey incontinence score ) , effective rate and self-rating score for satisfaction were observed before and after treatment and in the follow-up period .


After @ weeks ' treatment in the two groups , Vaizey incontinence ' scores were both decreased ( both P < @ ) , and after treatment and in the follow-up period the scores in the acupuncture-moxibustion group were lower than those in the corresponding period in the medication group ( both P < @ ) .


The effective rate of the acupuncture-moxibustion group was @ % ( @/@ ) , which was statistically different from @ % ( @/@ ) in the medication group ( P < @ ) .


The effective rate in the follow-up period of the acupuncture-moxibustion group was @ % ( @/@ ) and it was not statistically different from @ % ( @/@ ) in the medication group ( P > @ ) .


The self-rating scores for satisfaction in the acupuncture-moxibustion group were superior to those in the medication group after treatment and in the follow-up period ( both P < @ ) .


Acupuncture and moxibustion could improve copracrasia and the acupuncture-moxibustion rules and characteristics for the disorder should be paid attention to in the further research .


Potential benefits of single-port laparoscopic surgery may include improved cosmetic results , less postoperative pain , surgical trauma and faster recovery .


Results of randomized prospective studies with a focus on single-port rectal surgery have not yet been presented .


The aim of the present study was to compare single-port and conventional laparoscopic surgery for rectal cancer in terms of short-term outcomes including postoperative pain and trauma-induced changes in certain bioactive substances .


Patients with non-metastasized rectal cancer were prospectively randomized to single-port ( n = @ ) or conventional laparoscopic rectal surgery ( n = @ ) .


Postoperative pain was assessed at rest , at coughing and during mobilization , with a numeric pain ranking score and was recorded at @ h after the operation and subsequently every morning daily for @ days .


Levels of C-reactive protein ( CRP ) , interleukin-@ ( IL-@ ) and tissue inhibitor of metalloproteinases-@ ( TIMP-@ ) were determined .


Blood samples were collected preoperatively ( baseline ) , and @ , @ , @ , @ and @ h after skin incision .


Pain scores were significantly reduced in the single-port group on postoperative days @ , @ and @ during coughing and mobilization .


In addition , the patients in the single-port group suffered significantly less pain at rest at @ h after surgery and on postoperative days @ , @ and @ .


The levels of the three markers increased significantly after surgery .


The increase was similar between groups for plasma IL-@ and TIMP-@ at all time points , while the CRP levels were significantly lower in the single-port group at @ ( p < @ ) and @ h ( p < @ ) after skin incision .


Abdominal incisions lengths were significantly shorter in the single-port group ( p = @ ) .


There was no significant difference between groups in operating time and blood loss , morbidity or mortality rate .


The short-term oncological outcome in the two groups was similar .


Single-port rectal surgery may reduce postoperative pain .


Although CRP levels were lower at some time points , results of the present randomized , pilot study suggest that the trauma-induced inflammatory response of single-port operations may be similar to the trauma-induced inflammatory response of conventional laparoscopic surgery .


To compare in dual-energy CT ( DECT ) conventionally reconstructed polyenergetic images ( PEI ) at @ kVp to virtual monoenergetic images ( MEI ) at different kiloelectron volt ( keV ) levels for evaluation of liver and gastrointestinal stromal tumor ( GIST ) hepatic metastases with regard to objective ( IQob ) and subjective image quality ( IQsub ) assessed by two readers of varying experience .


Image quality was correlated to patient size and compared between PEI and MEI .


From @ examinations of @ GIST patients ( @ with hepatic metastases ) undergoing abdominal dual-source DECT for staging , therapy monitoring or follow-up , PEI and nine MEI in @-keV intervals from @ to @ keV were reconstructed .


Liver contrast-to-noise ratios ( CNR ) and metastasis-to-liver ratios were calculated .


MEI reconstructions with the highest IQob were compared to PEI for IQsub by one experienced reader ( ER ) and one inexperienced reader ( IR ) .


Patients ' diameters were correlated to IQob and IQsub ratings .


MEI at @ keV had the highest IQob with equal liver CNR and metastasis-to-liver ratio compared to PEI .


The ER rated @-keV MEI and PEI equally high ( median @ ) , whereas the IR rated IQsub best in @-keV MEI ( median @ ) .


Unlike in PEI , IQsub ratings in @-keV MEI were not correlated to patient size .


MEI at @ keV provided an IQob equivalent to PEI .


Regarding the IR , IQsub was improved in @-keV MEI compared to PEI and less dependent on patient size .


Therefore , IRs might improve their diagnostic confidence in the assessment of hepatic GIST metastases by evaluating MEI reconstructions at @ keV .


Current stroke risk schemes need improvement of predictive value in patients with atrial fibrillation .


Transoesophageal echocardiography ( TEE ) may facilitate stroke risk assessment in such patients and guide antithrombotic treatment .


We randomised @ patients with non-valvular atrial fibrillation and a moderate stroke risk to aspirin or adjusted vitamin K antagonist therapy after TEE had ruled out thrombogenic features in the atria and aorta .


The primary outcome was a composite of stroke , major bleeding , peripheral embolism and all-cause mortality .


Mean CHA@DS@-VASc score was @ .


The incidences of the composite primary outcome at a mean follow-up of @ years were @ % ( @ % per year ) in the aspirin group compared to @ % ( @ % per year ) in the vitamin K antagonists group with an absolute advantage of @ percentage points .


Aspirin was non-inferior to vitamin K antagonists ( p < @ ) because the upper limit of the @ % CI did not exceed the @ % absolute difference in event rate between the two treatment arms .


This hypothesis-generating pilot trial has found that TEE may be used for refinement of stroke risk in paroxysmal atrial fibrillation patients .


A larger trial is needed to confirm these data .


( ClinicalTrials.gov number NTC@ ) .


Insecticide-treated nets ( ITNs ) and indoor residual spraying ( IRS ) of houses provide effective malaria transmission control .


There is conflicting evidence about whether it is more beneficial to provide both interventions in combination .


A cluster randomised controlled trial was conducted to investigate whether the combination provides added protection compared to ITNs alone .


In northwest Tanzania , @ clusters ( village areas ) were randomly allocated to ITNs only or ITNs and IRS .


Dwellings in the ITN+IRS arm were sprayed with two rounds of bendiocarb in @ .


Plasmodium falciparum prevalence rate ( PfPR ) in children @-@ y old ( primary outcome ) and anaemia in children < @ y old ( secondary outcome ) were compared between study arms using three cross-sectional household surveys in @ .


Entomological inoculation rate ( secondary outcome ) was compared between study arms .


IRS coverage was approximately @ % .


ITN use ranged from @ % to @ % .


In intention-to-treat analysis , mean PfPR was @ % in the ITN+IRS arm and @ % in the ITN only arm , odds ratio = @ ( @ % CI @-@ @ , n = @,@ ) .


The strongest effect was observed in the peak transmission season , @ mo after the first IRS .


Subgroup analysis showed that ITN users were additionally protected if their houses were sprayed .


Mean monthly entomological inoculation rate was non-significantly lower in the ITN+IRS arm than in the ITN only arm , rate ratio = @ ( @ % CI @-@ @ ) .


This is the first randomised trial to our knowledge that reports significant added protection from combining IRS and ITNs compared to ITNs alone .


The effect is likely to be attributable to IRS providing added protection to ITN users as well as compensating for inadequate ITN use .


Policy makers should consider deploying IRS in combination with ITNs to control transmission if local ITN strategies on their own are insufficiently effective .


Given the uncertain generalisability of these findings , it would be prudent for malaria control programmes to evaluate the cost-effectiveness of deploying the combination .


The OPTION ( Optimal Anti-Tachycardia Therapy in Implantable Cardioverter-Defibrillator Patients Without Pacing Indications ) trial sought to compare long-term rates of inappropriate shocks , mortality , and morbidity between dual-chamber and single-chamber settings in implantable cardioverter-defibrillators ( ICDs ) patients .


The use of dual-chamber ICDs potentially allows better discrimination of supraventricular arrhythmias and thereby reduces inappropriate shocks .


However , it may lead to detrimental ventricular pacing .


This prospective multicenter , single-blinded trial enrolled @ patients with de novo primary or secondary prevention indications for ICD placement and with left ventricular ejection fractions @ % despite optimal tolerated pharmacotherapy .


All patients received atrial leads and dual-chamber defibrillators that were randomized to be programmed either with dual-chamber or single-chamber settings .


In the dual-chamber setting arm , the PARAD + algorithm , which differentiates supraventricular from ventricular arrhythmias , and SafeR mode , to minimize ventricular pacing , were activated .


In the single-chamber setting arm , the acceleration , stability , and long cycle search discrimination criteria were activated , and pacing was set to VVI @ beats/min .


Ventricular tachycardia detection was required at rates between @ and @ beats/min , and ventricular fibrillation detection was activated above @ beats/min .


During a follow-up period of @ months , the time to the first inappropriate shock was significantly longer in the dual-chamber setting arm ( p = @ , log-rank test ) , and @ % of patients in the dual-chamber setting group compared with @ % in the single-chamber setting group experienced inappropriate shocks ( p = @ ) .


Rates of all-cause death or cardiovascular hospitalization were @ % for the dual-chamber setting group and @ % for the single-chamber setting group and satisfied the pre-defined margin for equivalence ( p < @ ) .


Therapy with dual-chamber settings for ICD discrimination combined with algorithms for minimizing ventricular pacing was associated with reduced risk for inappropriate shock compared with single-chamber settings , without increases in mortality and morbidity .


( Optimal Anti-Tachycardia Therapy in Implantable Cardioverter-Defibrillator -LSB- ICD -RSB- Patients Without Pacing Indications -LSB- OPTION -RSB- ; NCT@ ) .


The purpose of this study is to compare clinical outcomes in the treatment of deep non-contained intrabony defects ( i.e. , with @ % @-wall component and a residual @ - to @-wall component in the most apical part ) using deproteinized bovine bone mineral ( DBBM ) combined with either enamel matrix protein derivative ( EMD ) or collagen membrane ( CM ) .


Forty patients with multiple intrabony defects were enrolled .


Only one non-contained defect per patient with an intrabony depth @ mm located in the interproximal area of single - and multirooted teeth was randomly assigned to the treatment with either EMD + DBBM ( test : n = @ ) or CM + DBBM ( control : n = @ ) .


At baseline and after @ months , clinical parameters including probing depth ( PD ) and clinical attachment level ( CAL ) were recorded .


The primary outcome variable was the change in CAL between baseline and @ months .


At baseline , the intrabony component of the defects amounted to @ @ mm for EMD + DBBM and @ @ mm for CM + DBBM sites ( P = @ ) .


The mean CAL gain at sites treated with EMD + DBBM was not statistically significantly different ( P = @ ) compared with CM + DBBM ( @ @ versus @ @ mm ) .


No statistically significant difference ( P = @ ) was observed comparing the frequency of CAL gain @ mm between EMD + DBBM ( @ % ) and CM + DBBM ( @ % ) or comparing the frequency of residual PD @ mm between EMD + DBBM ( @ % ) and CM + DBBM ( @ % ) ( P = @ ) .


Within the limitations of the present study , regenerative therapy using either EMD + DBBM or CM + DBBM yielded comparable clinical outcomes in deep non-contained intrabony defects after @ months .


To compare the differences in the clinical function and lumbar and abdominal myodynamia in patiants of lumbar disc herniation treated with moxibustion at Dazhui ( GV @ ) and Guanyuan ( CV @ ) and acupuncture .


Forty cases were randomized into a moxibustion group and an acupuncture group , @ cases in each group .


In the moxibustion group , the warm moxibustion was applied alternatively at Dazhui ( GV @ ) and Guanyuan ( CV @ ) once every other day , @ h each time , once every day .


In the acupuncture group , acupuncture was applied to the corresponding acupoints based on the affected lumbar vertebras , such as Jiaji ( EX-B @ ) , Shens-hu ( BL @ ) , Dachangshu ( BL @ ) and Huantiao ( GB @ ) , etc. , once evey day @ min each time .


The treatment for @ weeks was taken as one session in each group .


Totally , one session treatment was required .


Surface electromyography ( SEMG ) of bilateral paraspinal muscle and rectus muscle , and JOA score of low back pain were observed in the two groups .


( @ ) JOA score : the score of subjective symptoms , score of activity of daily living ( ADL ) and total score were improved obviously as compared with those before treatment in the two groups ( P < @ , P < @ ) .


The results of subjective symptoms score , score of ADL and total score in the acupuncture group were superior to those in the moxibustion group after treatment ( @ + / -@ vs @ + / -@,@ + / -@ vs @ + / - @,@ + / - @ vs @ + / - @ , all P < @ ) .


( @ ) SEMG comparison : root-mean-square value ( RMS ) was all reduced in SEMG of the anteflexion , rear protraction , orthostatism , bilateral bending and neck and leg rear flexion for strengthening lumbar muscle as compared with those before treatment in the two groups ( P < @ , P < @ ) .


RMS of the anteflexion and bilateral bending in the acupunture group were reduced much obviously as compared with the moxibustion group .


In terms of sitting position anteflexion , rear protraction , orthostatism , bilateral bending and neck and leg rear flexion for strengthening lumbar muscle , median frequency ( MF ) after treatment was all improved as compared with that before treatment in the two groups ( P < @ , P < @ ) .


In terms of anteflexion , the electrode MF after treatment was improved much obviously in the acupuncture group ( P < @ ) .


Moxibustion at Dazhui ( GV @ ) and Guanyuan ( CV @ ) and conventional acupuncture all improve muscle function , relieve muscle fatigue , increase the ability of anti-muscle fatigue , strengthen lumbar vertebral stability , release subjective symptoms and improve ADL .


But , the effects of moxibustion are slightly lower than those of acupuncture .


The aim of this study was to compare clinical outcomes and stability following immediate loading of two types of tapered implants in the partially edentulous posterior maxilla and mandible .


A randomized controlled trial with @ year of follow-up was performed on participants missing two consecutive teeth in a posterior quadrant with tapered implants with a hybrid textured surface .


Group @ received Osstem TSIII HA implants , and group @ received Zimmer TSV implants .


Group @ implants were @ or @ mm in diameter , and group @ implants were @ mm in diameter ; all implants were @ mm long .


Subjects received provisional restorations within @ hours .


Definitive restorations were provided @ months ( mandible ) or @ months ( maxilla ) later .


Outcome measures were survival and success rates , marginal bone level change , implant stability quotient , and peri-implant soft tissue indices .


Fifty participants completed the trial ( group @ : @ implants in @ patients ; group @ : @ implants in @ patients ) .


The success rates were similar -- @ % in group @ and @ % in group @ -- at @ months after immediate loading , but marginal bone loss was significantly different according to the implant design .


Implant stability increased significantly in both arches .


There were no significant differences in soft tissue indices between implant systems .


If high primary stability is acquired , tapered implants with hybrid textured surfaces are predictable for immediate loading in the posterior maxilla and mandible .


In spite of the influence of implant design on marginal bone loss , all tapered implants showed successful clinical outcomes and stability in immediate loading .


Cardiac surgery and sternotomy are procedures accompanied by substantial postoperative pain which is challenging to treat .


In general , intravenous ( IV ) opioids are used in the immediate postoperative phase , followed by oral opioids .


Oral opioids are easier to use and generally less expensive .


Our goal was thus to determine whether a new opioid preparation provides adequate analgesia after sternotomy .


In particular , we tested the primary hypothesis that total opioid use ( in morphine equivalents ) is not greater with oral opioid compared with patient-controlled IV morphine .


Our secondary hypothesis was that analgesic efficacy is similar with oral and IV opioids .


A total of @ patients having elective cardiac surgery were enrolled in this study .


After rapid postoperative respiratory weaning , the patients were randomised into one of two groups receiving different types of analgesia : oral Targin ( a combination of oxycodone-hydrochloride and the opioid antagonist naloxone hydrochloride-dihydrate ) or patient-controlled IV morphine .


Pain score ( visual analogue scale ) , sedation ( Ramsey score ) , respiratory rate and side effects were assessed at @ , @ , @ , @ and @ h after surgery , and every @ h throughout the third postoperative evening .


The total opioid dose in morphine equivalent doses was significantly lower with oral opioid than with IV morphine ( adjusted geometric means -LSB- @ % confidence interval -RSB- : @ -LSB- @ ; @ -RSB- vs. @ -LSB- @ ; @ -RSB- mg , respectively ) .


Pain scores were similar in each group .


Analgesic quality was comparable with oral and IV opioids , suggesting that postoperative pain even after very painful procedures can be sufficiently managed with oral opioids .


To evaluate the safety and feasibility of percutaneous tract dilation by the one-stage method in preschool children .


Between April @ and February @ , all preschool ( < @ years ) children who were candidates for percutaneous nephrolithotomy were enrolled in this prospective study .


Patients were randomly assigned to dilation by serial metallic dilators ( group I , @ patients ) or dilation by one-stage Amplatz according to Frattini et al. -LSB- J Endourol @ ; @:@ -@ -RSB- ( group II , @ patients ) .


The primary endpoint of interest was fluoroscopy time .


Secondary endpoints included tract creation and dilation time , success rate and complications .


Stone-free status was defined as residuals @ mm .


Age , stone size , operation success and operation time were not significantly different between the studied groups .


The most common stone composition was calcium oxalate in both groups .


The mean standard deviation of access and fluoroscopy times in groups I and II were @ @ min vs. @ @ min ( p > @ ) and @ @ s vs. @ @ s ( p < @ ) , respectively .


Postoperative complications included one case of postoperative fever lasting less than @ h in group I.


Percutaneous tract dilation by the one-stage method is safe and effective .


Also , it is associated with considerably less radiation exposure in preschool children .


To evaluate the effect of dehydroepiandrosterone ( DHEA ) on infertility patients with diminished ovarian reserve undergoing in vitro fertilization .


This is a prospective study .


Ninety-five patients with diminished ovarian reserve were included in this study .


Of them , @ patients were randomly allocated to the DHEA group , who received DHEA @ mg daily for three consecutive menstrual cycles prior to IVF cycles , and @ patients were allocated to the control group , who entered IVF cycles directly .


All patients were treated with the same ovarian stimulation protocol .


Follicular fluid samples from both groups were collected for bone morphogenetic protein-@ ( BMP-@ ) and growth differentiation factor-@ ( GDF-@ ) .


Fluid from the first aspirated follicle without any visible blood contamination was carefully collected .


In addition , day @ Blood samples were collected pre - and post-treatment of DHEA for serum anti-Mullerian hormone ( AMH ) , follicle stimulating hormone ( FSH ) and estradiol ( E@ ) in the DHEA group .


The level of BMP-@ in follicular fluid samples from the DHEA group was significantly higher than that of the control samples ( P = @ ) .


Patients after DHEA treatment demonstrated a significantly higher level of AMH and a significantly lower level of FSH , E@ compared to themselves prior to DHEA therapy ( P = @ ; P = @ ; P = @ ; respectively ) .


Moreover , the accumulated score of embryos was significantly higher in the DHEA group ( P = @ ) .


These observations confirm the beneficial effect of DHEA for infertility patients with diminished ovarian reserve .


To compare subjective and objective visual performance of the Air Optix Aqua Multifocal lens to monovision in a group of subjects requiring a medium level of reading-addition power .


Fifty participants with reading additions between @ and @ diopters ( inclusive ) were randomized into a prospective , crossover clinical trial .


They wore monovision and multifocals for @ weeks in a randomized order .


High - and low-contrast logMAR ( logarithm of the minimum angle of resolution ) acuity and stereopsis were measured at the beginning and end of each period .


During each phase , participants performed specific tasks followed by subjective rating surveys and also completed satisfaction rating surveys on days @ , @ , and @ ; all were transferred in real time using BlackBerry smartphones .


A general rating survey was completed at the dispensing and @-week visits .


Forty-nine participants completed the study ( mean age , @ years ) .


Distance and near high - and low-contrast acuities were significantly better ( p < @ ) with monovision at all visits .


High-contrast intermediate acuity was only better ( p < @ ) with multifocals after @ weeks .


Stereopsis was equivalent after @ weeks , but better ( p < @ ) with multifocals at dispensing .


Subjective ratings were generally equivalent between modalities although there was a trend for multifocals to be rated higher for focus changing and driving , whereas monovision tended to be rated higher for near tasks .


For both corrections , the satisfaction survey showed no significant change between days @ , @ , and @ , and the general survey showed that comfort was maintained but subjective vision ratings decreased significantly over the @ weeks .


Twenty-five participants ( @ % ) preferred multifocals , @ ( @ % ) preferred monovision , and the remaining @ ( @ % ) declared both unacceptable .


In this cohort , distance and near acuities were better with monovision , whereas the subjective ratings tended to favor the Air Optix Aqua Multifocal , with the exception of near performance .


Preference was statistically similar between both corrections , with a trend toward preferring the multifocal .


Natural orifice transluminal endoscopic surgery ( NOTES ) is the consequence of further development of minimally invasive surgery to reduce abdominal incisions and surgical trauma .


The potential benefits are expected to be less postoperative pain , faster convalescence , and reduced risk for incisional hernias and wound infections compared to conventional methods .


Recent clinical studies have demonstrated the feasibility and safety of transvaginal NOTES , and transvaginal access is currently the most frequent clinically applied route for NOTES procedures .


However , despite increasing clinical application , no firm clinical evidence is available for objective assessment of the potential benefits and risks of transvaginal NOTES compared to the current surgical standard .


The TRANSVERSAL trial is designed as a randomized controlled trial to compare transvaginal hybrid NOTES and laparoscopic-assisted sigmoid resection .


Female patients referred to elective sigmoid resection due to complicated or reoccurring diverticulitis of the sigmoid colon are considered eligible .


The primary endpoint will be pain intensity during mobilization @ hours postoperatively as measured by the blinded patient and blinded assessor on a visual analogue scale ( VAS ) .


Secondary outcomes include daily pain intensity and analgesic use , patient mobility , intraoperative complications , morbidity , length of stay , quality of life , and sexual function .


Follow-up visits are scheduled @ , @ , and @ months after surgery .


A total sample size of @ patients was determined for the analysis of the primary endpoint .


The confirmatory analysis will be performed based on the intention-to-treat ( ITT ) principle .


The TRANSVERSAL trial is the first study to compare transvaginal hybrid NOTES and conventionally assisted laparoscopic surgery for colonic resection in a randomized controlled setting .


The results of the TRANSVERSAL trial will allow objective assessment of the potential benefits and risks of NOTES compared to the current surgical standard for sigmoid resection .


Aetiology of childhood leukaemia and childhood neoplasm is poorly understood .


Information on the prevalence of risk factors in the childhood population is limited .


SETIL is a population based case-control study on childhood leukaemia , conducted with two companion studies on non-Hodgkin Lymphoma ( NHL ) and neuroblastoma .


The study relies on questionnaire interviews and @ Hz magnetic field ( ELF-MF ) indoor measurements .


This paper discusses the SETIL study design and includes descriptive information .


The study was carried out in @ Italian regions ( @ % of Italian population aged @-@ ) .


It included leukaemia , NHL and neuroblastoma cases incident in @-@ year olds in @-@ , registered by the Italian Association of Paediatric Haematology and Oncology ( AIEOP ) ( accrual over @ % of estimated incidence ) .


Two controls for each leukaemia case were randomly sampled from the Local Health Authorities rolls , matched by gender , birthdate and residence .


The same controls were used in NHL and neuroblastoma studies .