Parents were interviewed at home on : physical agents ( ELF-MF and ionizing radiation ) , chemicals ( smoking , solvents , traffic , insecticides ) , occupation , medical and personal history of children and parents , infectious diseases , immunizations and associated factors .


Occupational exposure was collected using job specific modules .


ELF-MF was measured in the main rooms ( spot measurement ) and close to child 's bed ( @ hours measurement ) .


The study included : @ leukaemia cases ( @ % ALL , @ % AnLL ) , @ NHL , @ neuroblastomas , and @ controls .


SETIL represents a data source on exposure of Italian children to a broad array of potential carcinogenic factors .


Highly HLA-sensitized ( HS ) patients have difficulty accessing compatible donors , especially deceased donor ( DD ) transplants .


Desensitization protocols ( DES ) have evolved , but rigorous evaluation is lacking .


Here , we examined the efficacy of rituximab as a DES agent in a placebo-controlled trial .


Candidates were randomized to IVIG + placebo versus IVIG + rituximab .


End points included rates of transplantation , antibody-mediated rejection ( ABMR ) , and renal function .


Protocol biopsies were performed at @ year and analysis of patient and graft survival and donor-specific HLA antibodies ( DSA ) were performed .


Initially , @ HS DDs were randomized with @ receiving transplants .


However , we discontinued study entry after five serious adverse events were observed .


The study was un-blinded and attribution of patients was noted ( IVIG + placebo N = @ , IVIG + rituximab N = @ ) .


No significant differences were seen in DSA levels at transplant .


All ABMR episodes occurred in the IVIG + placebo arm and required intense therapy ( P = @ ) .


The two graft losses were in the placebo group .


DSA rebound associated with severe ABMR was seen in three patients in the IVIG + placebo group .


No rebound was seen in the IVIG + rituximab group .


Renal function at @ and @ months showed a significant benefit for IVIG + rituximab ( P = @ ) .


Based on limited assessment with acknowledged limitations , both protocols appear effective in achieving levels of DSA allowable for transplantation .


However , IVIG + rituximab appeared more effective in preventing DSA rebound and , more importantly , preventing ABMR and development of transplant glomerulopathy .


To evaluate the clinical efficacy and safety of tissue-selecting therapy ( TST ) in treatment of mixed hemorrhoids .


A single-blind randomized study was carried out .


A total of @ patients with mixed hemorrhoids from January to December @ were prospectively enrolled in the study and equally divided into two groups , TST group and procedure for prolapse and hemorrhoids ( PPH ) group .


Surgical data , efficacy and postoperative complications were compared between the two groups .


As compared to PPH group , patients in TST group had shorter operation time -LSB- ( @ ) min vs. ( @ ) min , P < @ -RSB- , lower scores of rectal urgency ( @ vs. @ , P < @ ) , and shorter hospital stay -LSB- ( @ ) d vs. ( @ ) d , P < @ -RSB- .


No anastomotic stricture case was found in TST group , while @ cases ( @ % ) developed anastomotic stricture in PPH group .


There were no significant differences in effective rate and pain score of first defecation between the two groups .


TST is reliable and safe for mixed hemorrhoids with the advantage of simple , rapid recovery and less complications .


The surgical removal of mandibular third molars is frequently accompanied by significant postsurgicalsequelae , and different protocols have been described to decrease such adverse events .


The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instrumentsduring mandibular third molar removal .


A single-center , randomized , split-mouth study was performed using a consecutive series of unrelated healthy patients attending the Oral Surgery Unit of the University of Turin for surgical removal of bilateral mandibular third molar teeth .


Each patient was treated , at the same appointment , using bur removal on @ side of the mandible and a piezoelectric device on the contralateral side .


The primaryoutcomes reported were postoperative pain , objective orofacial swelling , and surgical duration ; secondary outcomes were gender , age , and possible adverse events .


Analysis of variance or paired t test was used as appropriate to test any significant differences at baseline according to each treatment subgroup , and categorical variables were analyzed by ( @ ) test .


The study sample consisted of @ otherwise healthy patients .


The mean pain evaluation reportedby patients who underwent surgery with piezosurgery was significantly lower than that reported after bur ( conventional ) removal , reaching statistical difference after @ days ( P = @ ) .


The clinical value oforofacial swelling at day @ , normalized to baseline , was lower in the piezosurgery group ( P < @ ) .


Theaverage surgical duration was significantly shorter in the bur group than in the piezosurgery group ( P < @ ) .


Three patients having bur removal developed short-term complications ( @ dry sockets and @temporaryparaesthesia ) , which totally resolved by @ weeks .


To date , this prospective investigation is the largest reported split-mouth study on piezosurgeryfor lower third molar tooth removal .


This study also compared surgeons with different degreesof experience .


It is evident that using a piezoelectric device can enhance the patient experience and decrease postoperative pain and swelling .


To evaluate efficacy and safety of eszopiclone compared with placebo in children and adolescents with insomnia associated with attention-deficit/hyperactivity disorder ( ADHD ) .


A @-week , randomized , double-blind , placebo-controlled trial evaluated efficacy and safety of high - or low-dose eszopiclone ( @ or @ mg in children aged @-@ years , @ or @ mg in children ages @-@ years ) , given every evening , in @ patients with ADHD-related insomnia .


The primary efficacy variable was change in latency to persistent sleep from baseline to week @ , based on polysomnography .


Key secondary measures were polysomnography-measured wake time after sleep onset , Clinical Global Impression Parent/Caregiver and Child scales , and the Conners ' ADHD rating scales .


The safety of eszopiclone was further studied over @ year of open-label treatment in @ patients who completed the double-blind study , and @ patients with no previous eszopiclone exposure .


Neither low-dose nor high-dose eszopiclone significantly reduced latency to persistent sleep compared with placebo after @ weeks of treatment .


Secondary outcomes were considered nonsignificant based on the hierarchical statistical analysis plan .


The most frequent treatment-emergent adverse events over @ weeks with eszopiclone were headache , dysgeusia , and dizziness .


The study results demonstrated that eszopiclone was well tolerated over @ year of treatment , with @ % of patients discontinuing open-label treatment because of an adverse event .


Eszopiclone ( up to @ mg ) failed to reduce latency to persistent sleep on polysomnography after @ weeks in children aged @ to @ years with ADHD-related insomnia .


Eszopiclone was well tolerated in the @-year study .


Cognitive-behavioral therapy ( CBT ) has demonstrated efficacy and effectiveness for treating mood and anxiety disorders .


Dissemination of CBT via videoconference may help improve access to treatment .


The present study aimed to compare the effectiveness of CBT administered via videoconference to in-person therapy for a mixed diagnostic cohort .


A total of @ primarily Caucasian clients ( mean age @ years , SD @ ) who had a primary Diagnostic and Statistical Manual of Mental Disorders , @th edition text revision ( DSM-IV-TR ) diagnosis of a mood or anxiety disorder were randomly assigned to receive @ sessions of CBT either in-person or via videoconference .


Treatment involved individualized CBT formulations specific to the presenting diagnosis ; all sessions were provided by the same therapist .


Participants were recruited through a university clinic .


Symptoms of depression , anxiety , stress , and quality of life were assessed using questionnaires before , after , and @ weeks following treatment .


Secondary outcomes at posttreatment included working alliance and client satisfaction .


Retention was similar across treatment conditions ; there was one more client in the videoconferencing condition at posttreatment and at follow-up .


Statistical analysis using multilevel mixed effects linear regression indicated a significant reduction in client symptoms across time for symptoms of depression ( P < @ , d = @ ) , anxiety ( P < @ , d = @ ) , stress ( P < @ , d = @ ) , and quality of life ( P < @ , d = @ ) .


There were no significant differences between treatment conditions regarding symptoms of depression ( P = @ , d = @ ) , anxiety ( P = @ , d = @ ) , stress ( P = @ , d = @ ) , or quality of life ( P = @ , d = @ ) .


There were no significant differences in client rating of the working alliance ( P = @ , one-tailed , d = -@ ) , therapist ratings of the working alliance ( P = @ , one-tailed , d = @ ) , or client ratings of satisfaction ( P = @ , one-tailed , d = -@ ) .


Fisher 's Exact P was not significant regarding differences in reliable change from pre - to posttreatment or from pretreatment to follow-up for symptoms of depression ( P = @ , P = @ ) , anxiety ( P = @ , P = @ ) , or quality of life ( P = @ , P = @ ) but was significant for symptoms of stress in favor of the videoconferencing condition ( P = @ , P = @ ) .


Difference between conditions regarding clinically significant change was also not observed from pre - to posttreatment or from pretreatment to follow-up for symptoms of depression ( P = @ , P = @ ) , anxiety ( P = @ , P = @ ) , stress ( P = @ , P = @ ) , or quality of life ( P = @ , P = @ ) .


The findings of this controlled trial indicate that CBT was effective in significantly reducing symptoms of depression , anxiety , and stress and increasing quality of life in both in-person and videoconferencing conditions , with no significant differences being observed between the two .


The aim of this study was to investigate the effects of mass drug administration on Schistosoma mansoni prevalence and associated liver morbidity in treated school-aged children and untreated preschool children .


In April @ , parasitological ( using the Kato-Katz method ) and morbidity ( determined by portal vein score ) data were collected from @ schoolchildren aged @ and @ years .


The children had never received praziquantel .


In March @ , following two annual rounds of mass drug administration , @ children aged @ and @ years old were examined to determine the effect of treatment .


In addition , @ untreated @-year-olds were assessed to compare with the untreated children from @ .


Treatment significantly decreased the prevalence of S. mansoni and associated morbidity in the treated groups .


The untreated preschool children also showed a significant decrease in the prevalence of S. mansoni , from @ % ( @ ) to @ % ( @ ) ( p < @ ) .


The percentage of untreated schoolchildren with a normal portal vein score increased significantly from @ % ( @ ) to @ % ( @ ) ( p = @ ) .


The significantly lower rates of S. mansoni and the decreased liver morbidity in untreated preschool children in @ suggest decreased environmental transmission rates and improved liver morbidity in untreated children following several rounds of mass drug administration .


To evaluate the efficacy of a large capsulorhexis and intraocular lens ( IOL ) in obtaining a larger anterior capsule opening after cataract surgery in patients with diabetes mellitus ( DM ) .


Department of Ophthalmology , University of Fukui , Fukui , Japan .


Prospective clinical trial .


Patients with DM had bilateral cataract surgery with a @ or @ mm scleral incision , a capsulorhexis with a diameter of approximately @ or @ mm , and implantation of a @ mm optic ( Eternity X-@ ) or @ mm optic ( Eternity X-@ ) IOL .


The anterior capsule opening area , aqueous flare intensity , surgically induced astigmatism ( SIA ) , corneal endothelial cell density ( ECD ) , and central corneal thickness ( CCT ) were measured @ day , @ week , and @ , @ , and @ months after surgery .


Thirty-one patients ( @ eyes ) with DM were enrolled .


At all postoperative timepoints , the anterior capsule opening was significantly larger in eyes with the @ mm optic IOL than in eyes with the @ mm optic IOL ( P < @ , Mann-Whitney U test ) .


There were no significant differences in postoperative aqueous flare intensity , SIA , ECD , or CCT based on the size of the capsulorhexis and IOL .


A larger capsulorhexis and implantation of a @ mm IOL resulted in a larger anterior capsule opening after cataract surgery in patients with DM .


We sought to determine the dose-response effects of extended-release ( ER ) dexmethylphenidate ( d-MPH ) and ER mixed amphetamine salts ( MAS ) on objective measures of sleep .


This was an @-week , double-blind , placebo-controlled , randomized , two period , crossover study of youth with attention-deficit hyperactivity disorder ( ADHD ) as confirmed by the Kiddie Schedule for Affective Disorders for School-Age Children-Present and Lifetime version ( K-SADS-PL ) .


Children aged @-@ years were recruited from clinical practice , colleague referrals , and flyers .


Participants were randomized to initially receive either d-MPH or MAS .


During each @-week drug period , children received three dose levels ( @ , @ , and @/@mg ) in ascending order , with placebo substituted for active medication in a randomized fashion during @week of the study .


After @weeks , participants were switched to the alternative medication for another @weeks of treatment .


The main outcome measure was sleep duration as measured by actigraphy .


Children , parents , and researchers were blinded to drug , dose , and placebo status .


Sixty-five participants met the inclusion criteria and were enrolled in the study .


Of these , @ participants with sufficient sleep data for analysis were included .


Sleep schedule measures showed a significant effect for dose on sleep start time ( F ( @,@ ) = @ ; p < @ ) , with a significantly later sleep start time when children were receiving @ - or @-mg doses , compared with placebo ( p < @ ) .


A significant dose effect was found on actual sleep duration ( F ( @,@ ) = @ ; p < @ ) , with significantly shorter actual sleep duration for subjects receiving @mg compared with those receiving placebo ( p < @ ) .


There were no significant differences on sleep duration or sleep schedule between the two stimulant medications .


The trial is complete and closed to follow-up .


Higher stimulant doses were associated with reduced sleep duration and later sleep start times , regardless of medication class .


Survival rates after sudden cardiac arrest could be increased if bystanders could be encouraged to perform CPR until emergency services arrive .


This should be initiated by the dispatcher at the emergency control facility who receives the call .


For the first time the ERC guidelines of @ included instructions to be given to untrained rescuers by the dispatcher .


Rapid recognition of cardiac arrest and initiation of emergency measures is assured by means of specific training for the dispatchers .


The aim of this investigation was to determine whether the time between an emergency call and beginning of cardiopulmonary resuscitation ( CPR ) could be shortened using a simple protocol and whether a relationship exists between the intensity of phone contact between dispatcher and caller and if this improves the results .


In known cases of unconsciousness , group @ ( @ persons ) received short CPR instructions via the phone , where the dispatcher was on the phone for continuous advice until emergency services arrived .


Group @ ( @ persons ) received identical phone instructions like group @ , but the phone call was terminated by the dispatcher after the information was provided .


Group @ ( @ persons ) only received instructions to start CPR .


On average , all test persons in group @ started reanimation after @ s , in group @ after @ s , and in group @ after @ s.


The compression frequency on average was @ / min in group @ , @ / min in group @ , and @ / min in group @ ; therefore , all groups reached an average frequency of > @/min .


The correct compression depth was achieved by @ % of test persons in group @ , by @ % in group @ , and by @ % in group @ .


All volunteers felt well supported .


Of the @ people , @ did not feel that they were missing instructions .


There were no significant differences between the groups regarding the target variables .


The results show that already extremely short instructions or advice by the dispatcher to start CPR is sufficient to encourage bystanders to give assistance in an emergency .


Continuous support over the phone does not appear to be necessary .


To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy .


Evidence obtained from a properly designed , randomized , double-blind , placebo-controlled trial ( Canadian Task Force classification I ) .


Tertiary care center .


One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy .


Patients were randomized to receive either nebulization of @ mg ropivacaine before surgery ( preoperative group ) , nebulization of @ mg ropivacaine after surgery ( postoperative group ) , instillation of @ mg ropivacaine before surgery ( instillation group ) , or instillation of saline solution ( control group ) .


Nebulization was performed using the Aeroneb Pro device .


Pain scores , morphine consumption , and ambulation time were collected in the post-anesthesia care unit and at @ , @ , and @ hours postoperatively .


One hundred eighteen patients completed the study .


Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group ( net difference @ points ; @ % confidence interval -LSB- CI -RSB- , @-@ @ at @ hours , @-@ at @ hours , and @-@ at @ hours ; p = @ ) Patients in the preoperative group consumed significantly less morphine than did those in the control group ( net difference @ mg ; @ % CI , @-@ ; p = @ ) .


More patients who received nebulization walked without assistance within @ hours after awakening than did those in the instillation and control groups ( net difference @ % ; @ % CI , @ % -@ % ; p = @ ) .


Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance .


The purpose of this study was to verify the influence of prebrushing mouthwashes on dental plaque removal in children .


This study had a double-blind , randomized , controlled , crossover , @-day experimental design , including @ @ - to @-year-olds .


Four solutions were used as prebrushing mouthwashes ( Colgate Plax Magic , Listerine Cool Blue Agent , water and dye , and water ) by each participant with seven days ' washout .


The plaque index was evaluated before and after tooth-brushing during the experimental period .


Intergroup comparisons showed no significant differences in plaque reduction among evaluated solutions ( Friedman test , P > @ ) .


Significantly more plaque was present before vs. after tooth-brushing ( Wilcoxon rank test , P < @ ) , independent of the surface ( buccal or lingual/palatal ) .


Use of prebrushing mouthwashes by children does not influence plaque removal by tooth-brushing .


Treatments of eating disorders result too often in partial psychological and physical remission , chronicization , dropout , relapse and death , with no fully known explanations for this failure .


In order to clarify this problem , we conducted three studies to identify the biochemical background of cognitive-behavioural psychotherapy ( CBT ) , individual psychology brief psychotherapy ( IBPP ) , and psychotherapy-pharmacotherapy with CBT + olanzapine in anorexics ( AN ) and bulimics ( BN ) by measuring the levels of plasma homovanillic acid ( HVA ) for dopamine secretion , plasma @-methoxy-@-hydroxy-phenylglycol ( MHPG ) for noradrenalin secretion , and platelet -LSB- @H -RSB- - Paroxetin-binding Bmax and Kd for serotonin transporter function .


The data were then compared with psychopathological and physical alterations .


Study @ investigated the effects of @ months of CBT on plasma HVA , MHPG and -LSB- @H -RSB- - Par-binding in @ AN-restricted , @ AN-bingeing/purging , and @ BN inpatients .


Study @ investigated the effects of @ months of IBPP on plasma HVA in @ AN and @ BN outpatients .


Study @ investigated the effect of @ months of CBT + olanzapine ( @ mg/day ) in @ AN outpatients .


The data were analyzed using one-way ANOVA for repeated measures for the changes between basal and post-treatment biological and psychological parameters , two-way ANOVA for repeated measures for the differences in the psychobiological data in the @ groups , Spearman 's test for the correlations between basal and final changes in the psychological and biological scores .


Study @ revealed significant amelioration of the psychopathology in the AN and BN patients , no effects on HVA , MHPG or Paroxetin binding Kd , and a significant increase in Par-binding Bmax only in the BN patients .


Study @ revealed a significant effect of IBPP on psychopathology in the AN and BN patients , and a significant increase in HVA only in the BN patients .


Study @ revealed a significant positive effect of CBT + olanzapine therapy on the psychopathology and increased HVA values .


No correlations were observed in the @ groups between biological and psychological effects of the three treatments .


Our data advance suggestions on the mechanism of action of the three therapies ; however , the lack of correlations between biochemical and psychological effects casts doubt on their significance .


Clinical Trials.gov .


Identifier NCT@ .


This study explored the interest in genomic testing for modest changes in colorectal cancer risk and preferences for receiving genomic risk communications among individuals with intermediate disease risk due to a family history of colorectal cancer .


Surveys were conducted on @ men and women at intermediate risk for colorectal cancer enrolled in a randomized trial comparing a remote personalized risk communication intervention ( TeleCARE ) aimed at promoting colonoscopy to a generic print control condition .


Guided by Leventhal 's Common Sense Model of Self-Regulation , we examined demographic and psychosocial factors possibly associated with interest in SNP testing .


Descriptive statistics and logistic regression models were used to identify factors associated with interest in SNP testing and preferences for receiving genomic risk communications .


Three-fourths of participants expressed interest in SNP testing for colorectal cancer risk .


Testing interest did not markedly change across behavior modifier scenarios .


Participants preferred to receive genomic risk communications from a variety of sources : printed materials ( @ % ) , oncologists ( @ % ) , primary-care physicians ( @ % ) , and the web ( @ % ) .


Overall , persons who were unmarried ( p = @ ) , younger ( p = @ ) and with greater cancer-related fear ( p = @ ) were more likely to express interest in predictive genomic testing for colorectal cancer risk .


In a stratified analysis , cancer-related fear was associated with the interest in predictive genomic testing in the intervention group ( p = @ ) , but not the control group .


Individuals with intermediate familial risk for colorectal cancer are highly interested in genomic testing for modest increases in disease risk , specifically unmarried persons , younger age groups and those with greater cancer fear .


Despite effective treatments to reduce cardiovascular disease risk , their translation into practice is limited .


Using a parallel arm cluster-randomized controlled trial in @ Australian primary healthcare centers , we tested whether a multifaceted quality improvement intervention comprising computerized decision support , audit/feedback tools , and staff training improved ( @ ) guideline-indicated risk factor measurements and ( @ ) guideline-indicated medications for those at high cardiovascular disease risk .


Centers had to use a compatible software system , and eligible patients were regular attendees ( Aboriginal and Torres Strait Islander people aged @ years and others aged @ years ) .


Patient-level analyses were conducted using generalized estimating equations to account for clustering .


Median follow-up for @,@ patients ( mean age , @ years ; @ % men ) was @ months .


Mean monthly staff support was < @ hour/site .


For the coprimary outcomes , the intervention was associated with improved overall risk factor measurements ( @ % versus @ % risk ratio ; @ ; @ % confidence interval , @-@ @ ; P = @ ) , but there was no significant differences in recommended prescriptions for the high-risk cohort ( n = @,@ ; @ % versus @ % ; P = @ ) .


There were significant treatment escalations ( new prescriptions or increased numbers of medicines ) for antiplatelet ( @ % versus @ % ; P < @ ) , lipid-lowering ( @ % versus @ % ; P < @ ) , and blood pressure-lowering medications ( @ % versus @ % ; P = @ ) .


In Australian primary healthcare settings , a computer-guided quality improvement intervention , requiring minimal support , improved cardiovascular disease risk measurement but did not increase prescription rates in the high-risk group .


Computerized quality improvement tools offer an important , albeit partial , solution to improving primary healthcare system capacity for cardiovascular disease risk management .


The Centre for the AIDS Programme of Research in South Africa ( CAPRISA ) @ trial demonstrated a @ % reduction in HIV infection , with a @ % HIV reduction in women who used tenofovir gel consistently .


A confirmatory trial is expected to report results in early @ .


In the interim , we have a unique window of opportunity to prepare for and devise effective strategies for the future policy and programmatic scale-up of tenofovir gel provision .


One approach is to integrate tenofovir gel provision into family planning ( FP ) services .


The CAPRISA @ implementation trial provides an opportunity to provide post-trial access to tenofovir gel while generating empiric evidence to assess whether integrating tenofovir gel provision into routine FP services can achieve similar levels of adherence as the CAPRISA @ trial .


This is a two-arm , open-label , randomized controlled non-inferiority trial .


A maximum of @ sexually active , HIV-uninfected women aged @ years and older who previously participated in an antiretroviral prevention study will be enrolled from an urban and rural site in KwaZulu-Natal , South Africa .


The anticipated study duration is @ months , with active accrual requiring approximately @ months ( following which an open cohort will be maintained ) and follow-up continuing for approximately @ months .


At each of the two sites , eligible participants will be randomly assigned to receive tenofovir gel through either FP services ( intervention arm ) or through the CAPRISA research clinics ( control arm ) .


As part of the study intervention , a quality improvement approach will be used to assist the FP services to expand their current services to include tenofovir gel provision .


This protocol aims to address an important implementation question on whether FP services are able to effectively incorporate tenofovir gel provision for this at-risk group of women in South Africa .


Provision of tenofovir gel to the women from the CAPRISA @ trial meets the ethical obligation for post-trial access , and helps identify a potential avenue for future scale-up of microbicides within the public health system of South Africa .


Food residue in the remnant stomach after subtotal gastrectomy ( STG ) interferes with endoscopic observation .


We investigated whether intravenous erythromycin improves gastric mucosa visualization in patients with STG .


This study was conducted from April @ to October @ as a double-blinded , placebo-controlled , randomized trial .


Patients who received STG with complete resection ( stage T@-@N@M@ ) were included .


Exclusion criteria were diabetes mellitus , neurologic disease , myopathy , recent viral enteritis history , concomitant therapy influencing gastrointestinal motility and severe comorbidity .


Patients were instructed to consume a soft diet for dinner between @ and @ h , and endoscopies were performed between @ and @ h. Patients were assigned randomly to receive either erythromycin ( @ mg in normal saline @ cc ) or placebo saline .


The endoscopy was performed @ min after infusion .


Grade of residual food was rated as follows : G@ , no residual food ; G@ , a small amount of residual food ; G@ , a moderate amount of residual food ; G@ , a moderate amount of residual food that hinders observation of the entire surface , even with body rolling ; G@ , a great amount of residual food such that endoscopic observation is impossible .


When good visibility was defined as G@ + G@ , visibility was significantly better in the erythromycin group ( @ + @ % ) than in the placebo group ( @ + @ % , p < @ ) .


However , this effect was not seen in patients within @ months after gastrectomy .


The risk factor for food stasis in the placebo group ( n = @ ) was food stasis at last endoscopy .


The only factor predicting erythromycin response in the erythromycin group ( n = @ ) was elapsed time since surgery .


Adverse effects included nausea -LSB- @ ( @ % ) -RSB- and vomiting -LSB- @ ( @ % ) -RSB- in the erythromycin group and vomiting -LSB- @ ( @ % ) -RSB- in the placebo group .


However , they were transient and tolerable .


Premedication with erythromycin improves mucosal visualization during endoscopy in patients with STG .


To test the hypothesis that daily acute intermittent hypoxia ( dAIH ) and dAIH combined with overground walking improve walking speed and endurance in persons with chronic incomplete spinal cord injury ( iSCI ) .


Nineteen subjects completed the randomized , double-blind , placebo-controlled , crossover study .


Participants received @ , @-second hypoxic exposures ( dAIH , fraction of inspired oxygen -LSB- Fio@ -RSB- = @ ) or daily normoxia ( dSHAM , Fio@ = @ ) at @-second normoxic intervals on @ consecutive days ; dAIH was given alone or combined with @ minutes of overground walking @ hour later .


Walking speed and endurance were quantified using @-Meter and @-Minute Walk Tests .


The trial is registered at ClinicalTrials.gov ( NCT@ ) .


dAIH improved walking speed and endurance .


Ten-Meter Walk time improved with dAIH vs dSHAM after @ day ( mean difference -LSB- MD -RSB- @ seconds , @ % confidence interval -LSB- CI -RSB- @-@ @ seconds , p = @ ) and @ weeks ( MD @ seconds , @ % CI @-@ @ seconds , p = @ ) .


Six-Minute Walk distance increased with combined dAIH + walking vs dSHAM + walking after @ days ( MD @ m , @ % CI @-@ @ m , p = @ ) and @-week follow-up ( MD @ m , @ % CI @-@ @ m , p = @ ) .


dAIH + walking increased walking distance more than dAIH after @ day ( MD @ m , @ % CI @-@ @ m , p = @ ) , @ days ( MD @ m , @ % CI @-@ @ m , p = @ ) , and @-week follow-up ( MD @ m , @ % CI @-@ @ m , p < @ ) .


dAIH walking improved walking speed and distance in persons with chronic iSCI .


The impact of dAIH is enhanced by combination with walking , demonstrating that combinatorial therapies may promote greater functional benefits in persons with iSCI .


This study provides Class I evidence that transient hypoxia ( through measured breathing treatments ) , along with overground walking training , improves walking speed and endurance after iSCI .


Pulmonary coagulopathy is a hallmark of lung injury following inhalation trauma .


Locally applied heparin attenuates lung injury in animal models of smoke inhalation .


Whether local treatment with heparin benefits patients with inhalation trauma is uncertain .


The present trial aims at comparing a strategy using frequent nebulizations of heparin with standard care in intubated and ventilated burn patients with bronchoscopically confirmed inhalation trauma .


The Randomized Controlled Trial Investigating the Efficacy and Safety of Nebulized HEParin versus Placebo in BURN Patients with Inhalation Trauma ( HEPBURN ) is an international multi-center , double-blind , placebo-controlled , two-arm study .


One hundred and sixteen intubated and ventilated burn patients with confirmed inhalation trauma are randomized to nebulizations of heparin ( the nebulized heparin strategy ) or nebulizations of normal saline ( the control strategy ) every four hours for @days or until extubation , whichever comes first .


The primary endpoint is the number of ventilator-free days , defined as days alive and breathing without assistance during the first @days , if the period of unassisted breathing lasts for at least @ consecutive hours .


As far as the authors know , HEPBURN is the first randomized , placebo-controlled trial , powered to investigate whether local treatment with heparin shortens duration of ventilation of intubated and ventilated burn patients with inhalation trauma .


People are now living longer , but disability may affect the quality of those additional years of life .


We undertook a trial to assess whether case finding reduces disability among older primary care patients .


We conducted a cluster-randomized trial of the Brief Risk Identification Geriatric Health Tool ( BRIGHT ) among @ primary care practices in New Zealand , assigning them to an intervention or control group .


Intervention practices sent a BRIGHT screening tool to older adults every birthday ; those with a score of @ or higher were referred to regional geriatric services for assessment and , if needed , service provision .


Control practices provided usual care .


Main outcomes , assessed in blinded fashion , were residential care placement and hospitalization , and secondary outcomes were disability , assessed with Nottingham Extended Activities of Daily Living Scale ( NEADL ) , and quality of life , assessed with the World Health Organization Quality of Life scale , abbreviated version ( WHOQOL-BREF ) .


All @,@ community-dwelling patients aged @ years and older were approached ; @,@ ( @ % ) participated , of whom @,@ ( @ % ) completed the trial .


Their mean age was @ ( SD @ ) years , and @ % were women .


Overall , @ % of the intervention group returned a BRIGHT tool ; @ patients were referred .


After @ months , patients in the intervention group were more likely than those in the control group to have been placed in residential care : @ % vs @ % ( hazard ratio = @ ; @ % CI , @-@ @ ; P = @ ) .


Intervention patients had smaller declines in mean scores for physical health-related quality of life ( @ vs @ points , P = @ ) and psychological health-related quality of life ( @ vs @ points , P = @ ) .


Hospitalization , disability , and use of services did not differ between groups , however .


Our case-finding strategy was effective in increasing identification of older adults with disability , but there was little evidence of improved outcomes .


Further research could trial stronger primary care integration strategies .


To investigate the effects of intensive atorvastatin therapy on programmed cell death @ ( PDCD@ ) expression by CD@ + T lymphocytes in patients with unstable angina who received percutaneous coronary intervention ( PCI ) .


Patients with unstable angina were randomized to pretreatment with either an intensive dose ( @ mg/day , n = @ ) or a conventional dose ( @ mg/day , n = @ ) of atorvastatin .


Circulating CD@ + T cells were subsequently obtained prior to PCI , and also @-@ h after PCI , using a magnetic cell sorting system .


Fluorescence-based quantitative real-time PCR was then used to measure levels of PDCD@ mRNA in the isolated CD@ + T lymphocytes , and Western blot analysis was used to detect levels of PDCD@ .


Serum levels of interleukin ( IL ) -@ and TNF - were quantified using enzyme-linked immunosorbent assays .


Of the @ patients with unstable angina that were examined , levels of PDCD@ mRNA and protein were found to dramatically decrease in patients who received an intensive dose of atorvastatin following PCI ( p < @ ) .


In contrast , serum levels of TNF - significantly increased following PCI in both the intensive dose group and the conventional dose group , with the latter being higher than the former ( p < @ ) .


Serum IL-@ levels also markedly increased following PCI for the two groups .


However , higher values were associated with the intensive dose group ( p < @ ) .


Intensive atorvastatin treatment reduced the post-PCI myocardial inflammatory response in patients with unstable angina , possibly by inhibiting PDCD@ expression in CD@ + T lymphocytes .


A randomized and double-blinded study design was implemented to assess the stereo-acuity in patients symmetrically implanted with four types of multifocal intraocular lenses ( MIOLs ) , compared to a monofocal lens ( control group ) .


In addition , the influence of the type of test employed for the evaluation of stereo-acuity was explored .


Six months after cataract intervention , stereo-acuity was measured with the Titmus and TNO stereotests in @ patients implanted with one of the following MIOL lens types : hybrid spherical SN@D@ , hybrid aspheric SN@AD@ , diffractive aspheric ZMA@ and refractive spherical NXG@ .


A control group implanted with the monofocal aspheric ZA@ ( in which stereo-acuity was measured with a near addition ) was also included in the study .


Statistically significant better stereo-acuity was found in the monofocal group with both stereotests ( except for the SN@D@ group with the Titmus test ) ( all p < @ ) .


No significant differences in stereo-acuity between MIOLs were found using the Titmus test .


However , with the TNO , patients implanted with hybrid diffractive MIOLs exhibited statistically significant worse stereo-acuity than those with the refractive design ( SN@D@ , p < @ ; SN@AD@ , p = @ ) .


Patients implanted with MIOLs have worse stereo-acuity than those implanted with monofocal IOLs due to the decrease in retinal image contrast originating in the simultaneous presence of two images .


A wavelength-based stereotest such as the TNO induces large differences in image contrast between fellow eyes implanted with diffractive-based MIOLs , which may result in an underestimation of the real stereo-acuity of the patient .


The effectiveness and durability of endovascular revascularization therapies for chronic critical limb ischemia ( CLI ) are challenged by the extensive burden of infrapopliteal arterial disease and lesion-related characteristics ( e.g. , severe calcification , chronic total occlusions ) , which frequently result in poor clinical outcomes .


While infrapopliteal vessel patency directly affects pain relief and wound healing , sustained patency and extravascular care both contribute to the ultimate `` patient-centric '' outcomes of functional limb preservation , mobility and quality of life ( QoL ) .


IN.PACT DEEP is a @:@ randomized controlled trial designed to assess the efficacy and safety of infrapopliteal arterial revascularization between the IN.PACT Amphirion paclitaxel drug-eluting balloon ( IA-DEB ) and standard balloon angioplasty ( PTA ) in patients with Rutherford Class @-@-@ CLI .


This multicenter trial has enrolled @ patients at @ European centers with independent angiographic core lab adjudication of the primary efficacy endpoint of target lesion late luminal loss ( LLL ) and clinically driven target lesion revascularization ( TLR ) in major amputation-free surviving patients through @-months .


An independent wound core lab will evaluate all ischemic wounds to assess the extent of healing and time to healing at @ , @ , and @ months .


A QoL questionnaire including a pain scale will assess changes from baseline scores through @ months .


A Clinical Events Committee and Data Safety Monitoring Board will adjudicate the composite primary safety endpoints of all-cause death , major amputation , and clinically driven TLR at @ months and other trial endpoints and supervise patient safety throughout the study .


All patients will be followed for @ years .


A literature review is presented of the current status of endovascular treatment of CLI with drug-eluting balloon and standard PTA .


The rationale and design of the IN.PACT DEEP Trial are discussed .


IN.PACT DEEP is a milestone , prospective , randomized , robust , independent core lab-adjudicated CLI trial that will evaluate the role of a new infrapopliteal revascularization technology , the IA-DEB , compared to PTA .


It will assess the overall impact on infrapopliteal artery patency , limb salvage , wound healing , pain control , QoL , and patient mobility .


The @-year results of the adjudicated co-primary and secondary endpoints will be available in @ .


To investigate the efficacy and safety of adjusting the doses of diuretics of different time in the treatment of advanced schistosomiasis ascites .


A total of @ advanced schistosomiasis patients with ascites were randomly divided into an observation group and a control group ( @ cases each ) .


The patients in the observation group received spironolactone and furosemide , and the first doses were @ mg/d and @ mg/d , respectively .


If the efficacy was poor , according to the first doses of the standard increments once every four days , the doses gradually increased to the maximum doses of spironolactone @ mg/d and furosemide @ mg/d , respectively .


The patients in the control group received spironolactone and furosemide , and the first doses were the same as those of the observation group .


If the efficacy was poor , according to the first doses of the standard increments once every seven days , the doses gradually increased to the maximum doses as those of the observation group .


Other conventional treatments were the same in both groups .


In both groups , the reductions of the total amount of the weight were ( @ + / - @ ) kg and ( @ + / - @ ) kg respectively ; the time of efficacy beginning was ( @ + / - @ ) days and ( @ + / - @ ) days respectively ; the average daily amounts of weight loss were ( @ + / - @ ) kg and ( @ + / - @ ) kg respectively ; the efficient rates were @ % and @ % respectively ; and there were no significant differences between the two group ( all P > @ ) .


However , the time of reduction from moderate ascites to mild ascites was ( @ + / - @ ) days ( @-@ days ) in the observation group and the time was ( @ + / - @ ) days ( @-@ days ) in the control group ( u = @ , P < @ ) .


The therapy of diuretic doses adjusted by a four-day cycle is more useful for advanced schistosomiasis patients with ascites .


Preclinical studies suggest that stress potentiates cue-induced cocaine seeking and that this effect is more pronounced in females .


These findings have not been characterized in clinical populations .


The objectives of this study were to examine the impact a pharmacological stressor , alpha-@ adrenergic receptor antagonist yohimbine , on the subjective , endocrine , and physiologic responses to drug-paired cues cocaine-dependent men and women .


In a double-blind placebo-controlled cross-over study , cocaine-dependent men ( n = @ ) , cocaine-dependent women ( n = @ ) , control men ( n = @ ) , and control women ( n = @ ) received either yohimbine or placebo prior to two cocaine cue exposure sessions .


Yohimbine increased ratings of anxiety both before ( p < @ ) and after ( p = @ ) cues , and the post-cue increase in anxiety was more pronounced in women ( p = @ ) .


Yohimbine also significantly increased craving , compared with placebo ( p < @ ) , following the cue presentation , and this effect was greater in women than men ( gender by treatment interaction ; p = @ ) .


Yohimbine also increased salivary cortisol ( p < @ ) and dehydroepiandrosterone ( p = @ ) levels , regardless of diagnostic group .


Women had a significantly greater heart rate response following yohimbine as compared with men ( p < @ ) .


Stress may increase the salience of cocaine cues for cocaine-dependent women as compared with men .


This suggests gender differences in vulnerability to craving and relapse under stressful conditions .


The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status .


Accordingly , this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge .


A secondary analysis of data from a randomized controlled trial with @-month follow-up .


A @-bed medical center in northern Taiwan .


Subjects were included only if they had `` poor nutritional status '' at hospital discharge , including those at risk for malnutrition or malnourished .


The subsample included @ subjects with poor nutritional status in the comprehensive care group , @ in the interdisciplinary care group , and @ in the usual care group .


The @ care models were usual care , interdisciplinary care , and comprehensive care .


Usual care provided no in-home care , interdisciplinary care provided @ months of in-home rehabilitation , and comprehensive care included management of depressive symptoms , falls , and nutrition as well as @ year of in-home rehabilitation .


Data were collected on nutritional status and physical functions , including range of motion , muscle power , proprioception , balance and functional independence , and analyzed using a generalized estimating equation approach .


We also compared patients ' baseline characteristics : demographic characteristics , type of surgery , comorbidities , length of hospital stay , cognitive function , and depression .


Patients with poor nutritional status who received comprehensive care were @ times ( @ % confidence interval @-@ @ ) more likely to recover their nutritional status than those who received interdisciplinary and usual care .


Furthermore , the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge , but not of those who had not yet recovered .


An in-home program using the comprehensive care model with a nutritional component effectively improved the nutritional status of hip-fractured patients with poor nutrition .


This comprehensive care intervention more effectively improved recovery of functional independence and balance for patients with recovered nutritional status .


To determine the effect of vaginal progesterone as luteal support on pregnancy outcomes in infertile patients who undergo ovulation induction with gonadotropins and intrauterine insemination ( IUI ) .


Prospective randomized trial .


Tertiary referral center .


About @ patients with primary infertility were treated during @ ovarian stimulation and IUI cycles from February @ to September @ .


All patients underwent ovarian stimulation with gonadotropins combined with IUI .


Patients in the supported group received vaginal micronized progesterone capsules @mg once daily from the day after insemination until next menstruation or continuing for up to @ weeks of pregnancy .


Women allocated in the control group did not receive luteal phase support .


Livebirth rate , clinical pregnancy rate and early miscarriage rate per cycle .


Of the @ cycles , a total of @ clinical pregnancies occurred .


There were no significant differences between supported with progesterone and unsupported cycle in terms of livebirth rate ( @ % versus @ % , respectively , with a p value = @ ) and clinical pregnancy rate ( @ % compared with @ % in unsupported cycle with a p value = @ ) .


An early miscarriage rate of @ % was observed in the supported cycles and @ % in the unsupported cycles , with no significant differences between the groups ( p value = @ ) .


In infertile patients treated with mildly ovarian stimulation with recombinant gonadotropins and IUI , luteal phase support with vaginal progesterone is not associated with higher livebirth rate or clinical pregnancy rate compared with patients who did not receive any luteal phase support .


Post-burn hyperglycemia leads to graft failure , multiple organ failure , and death .


A hyperinsulinemic-euglycemic clamp is used to keep serum glucose between @ and @ mg/dL .


Because of frequent hypoglycemic episodes , a less-stringent sliding scale insulin protocol is used to maintain serum glucose levels between @ and @ mg/dL after elevations > @ mg/dL .


We randomized pediatric patients with massive burns into @ groups , patients receiving sliding scale insulin to lower blood glucose levels ( n = @ ) and those receiving no insulin ( n = @ ) , to determine the differences in morbidity and mortality .


Patients @ to @ years old with burns covering @ % of the total body surface area and not randomized to receive anabolic agents were included in this study .


End points included glucose levels , infections , resting energy expenditure , lean body mass , bone mineral content , fat mass , muscle strength , and serum inflammatory cytokines , hormones , and liver enzymes .


Maximal glucose levels occurred within @ days of burn injury .


Blood glucose levels were age dependent , with older children requiring more insulin ( p < @ ) .


Daily maximum and daily minimum , but not @ am , glucose levels were significantly different based on treatment group ( p < @ ) .


Insulin significantly increased resting energy expenditure and improved bone mineral content ( p < @ ) .


Each additional wound infection increased incidence of hyperglycemia ( p = @ ) .


There was no mortality in patients not receiving insulin , only in patients who received insulin ( p < @ ) .


Muscle strength was increased in patients receiving insulin ( p < @ ) .


Burn-induced hyperglycemia develops in a subset of severely burned children .


Length of stay was reduced in the no insulin group , and there were no deaths in this group .


Administration of insulin positively impacted bone mineral content and muscle strength , but increased resting energy expenditure , hypoglycemic episodes , and mortality .


New glucose-lowering strategies might be needed .


To determine the pharmacokinetics of doxycycline hyclate administered orally in the form of experimental formulations with different proportions of acrylic acid-polymethacrylate-based matrices .


@ healthy adult dogs .


In a crossover study , dogs were randomly assigned ( in groups of @ ) to receive a single oral dose ( @ mg/kg ) of doxycycline hyclate without excipients ( control ) or extended-release formulations ( ERFs ) containing doxycycline , acrylic acid polymer , and polymethacrylate in the following proportions : @:@:@ ( ERF@ ) or @:@:@ ( ERF@ ) .


Serum concentrations of doxycycline were determined for pharmacokinetic analysis before and at several intervals after each treatment .


Following oral administration to the study dogs , each ERF resulted in therapeutic serum doxycycline concentrations for @ hours , whereas the control treatment resulted in therapeutic serum doxycycline concentrations for only @ hours .


All pharmacokinetic parameters for ERF@ and ERF@ were significantly different ; however , findings for ERF@ did not differ significantly from those for the control treatment .


Results indicated that both ERFs containing doxycycline , acrylic acid polymer , and polymethacrylate had an adequate pharmacokinetic-pharmacodynamic relationship for a time-dependent drug and a longer release time than doxycycline alone following oral administration in dogs .


Given the minimum effective serum doxycycline concentration of @ g/mL , a dose interval of @ hours can be achieved for each tested ERF .


This minimum inhibitory concentration has the potential to be effective against several susceptible bacteria involved in important infections in dogs .


Treatment of dogs with either ERF may have several benefits over treatment with doxycycline alone .


This study compared mid-term functional and radiologic results of syndesmotic transfixation with no fixation in supination external rotation ( SER ) ankle fractures with intraoperatively confirmed syndesmosis disruption .


Our hypothesis was that early-stage good functional results would remain and unfixed syndesmosis disruption in SER IV ankle fractures would not lead to an increased incidence of osteoarthritis .


A prospective study of @ operatively treated patients with Lauge-Hansen SER IV ( Weber B ) ankle fractures was performed .


After bony fixation , the @-Nm standardized external rotation stress test for both ankles was performed under fluoroscopy .


A positive stress examination was defined as a difference of more than @ mm side-to-side in the tibiotalar or tibiofibular clear spaces on mortise radiographs .


The patients were randomized to either syndesmotic screw fixation ( @ patients ) or no syndesmotic fixation ( @ patients ) .


After a minimum of @ years of follow-up ( mean , @ months ) , ankle function and pain ( Olerud-Molander , a @-mm visual analogue scale -LSB- VAS -RSB- for ankle function and pain ) and quality of life ( RAND-@ ) of all @ patients were assessed .


Ankle joint congruity and osteoarthritis were assessed using mortise and lateral projection plain weight-bearing radiographs and magnetic resonance imaging ( MRI ; @T ) scans .


Improvement in Olerud-Molander score , VAS , and RAND-@ showed no significant difference between groups during the follow-up .


In the syndesmotic transfixation group , improvements in all functional parameters and pain measurements were not significant , whereas in the group without syndesmotic fixation , the Olerud-Molander score improved from @ to @ ( P = @ ) and the pain ( VAS ) score improved from @ to @ ( P = @ ) from @ year to last follow-up .


X-ray or MRI imaging showed no difference between groups at the last follow-up visit .


With the numbers available , no significant difference in functional outcome or radiologic findings could be detected between syndesmosis transfixation and no-fixation patients with SER IV ankle fracture after a minimum of @ years of follow-up .


Level II , prospective comparative study .


To observe the impacts on post-stroke spastic hemiplegia treated with temporal three-needle therapy , spastic three-needle therapy , and rehabilitative therapy as well as combined application .


One hundred cases were randomized into a Jin 's three-needle group ( @ cases ) , a rehabilitation group ( @ cases ) and a combined therapy group ( @ cases ) .


Beside the basic treatment , the acupuncture therapy of temporal three-needle and spastic three-needle techniques , rehabilitation training , and the combined therapy of acupuncture and rehabilitation were applied in the Jin 's three-needle group , the rehabilitation group and the combined therapy group , respectively .


Before treatment , in @ days and @ days of treatment , the functional comprehensive assessment scale ( FCA ) , clinical neurological defect score ( NDS ) , four-limb simplified Fugl-Meyer assessment ( FMA ) and clinical spasm index ( CSI ) were adopted to assess the spastic degree and limb function , respectively .


In terms of FCA , NDS and FMA , in @ days of treatment , except the rehabilitation group , the results in the other two groups were all improved as compared with those before treatment ( all P < @ ) .


The results in the Jin 's three-needle group and the combined therapy group were better than those in the rehabilitation group ( all P < @ ) .


In @ days of treatment , the results in the three groups were improved as compared with those before treatment and in @ days of treatment ( P < @ , P < @ ) .


The results in the combined therapy group were better than those in the other two groups ( all P < @ ) .


Regarding CSI assessment , in @ days of treatment , the results of the three groups were all improved significantly as compared with those before treatment ( P < @ , P < @ ) , and the results in the combined therapy group were better than those in the other two groups ( all P < @ ) .


In @ days of treatment , CSI scores were further improved in the three groups , but the difference was not significant in comparison ( all P > @ ) .


The Jin 's three-needle therapy , rehabilitation therapy and the combined application all relieve the symptoms of post-stroke spastic hemiplegia .


The effect in the Jin 's three-needle group and the combined therapy group is achieved in @ days of treatment , which is better than that in the rehabilitation group .


The combined therapy a chieves the best effect on spasm in comparison with the single therapy .


The ` Older People 's Exercise intervention in Residential and nursing Accommodation ' ( OPERA ) cluster randomised trial evaluated the impact of training for care home staff together with twice-weekly , physiotherapist-led exercise classes on depressive symptoms in care home residents , but found no effect .


We report a process evaluation exploring potential explanations for the lack of effect .


The OPERA trial included over @,@ residents in @ care homes in the UK .


We used a mixed methods approach including quantitative data collected from all homes .


In eight case study homes , we carried out repeated periods of observation and interviews with residents , care staff and managers .


At the end of the intervention , we held focus groups with OPERA research staff .


We reported our first findings before the trial outcome was known .


Homes showed large variations in activity at baseline and throughout the trial .


Overall attendance rate at the group exercise sessions was low ( @ % ) .


We considered two issues that might explain the negative outcome : whether the intervention changed the culture of the homes , and whether the residents engaged with the intervention .


We found low levels of staff training , few home champions for the intervention and a culture that prioritised protecting residents from harm over encouraging activity .


The trial team delivered @,@ exercise groups but only @ % of participants attended at least @ group per week and depressed residents attended significantly fewer groups than those who were not depressed .


Residents were very frail and therefore most groups only included seated exercises .


The intervention did not change the culture of the homes and , in the case study homes , activity levels did not change outside the exercise groups .


Residents did not engage in the exercise groups at a sufficient level , and this was particularly true for those with depressive symptoms at baseline .


The physical and mental frailty of care home residents may make it impossible to deliver a sufficiently intense exercise intervention to impact on depressive symptoms .


To compare the effect of different types and concentrations of sweet solutions on neonatal pain during heel lance procedure .


Totally @ full term neonates ( male @ , female @ ) were randomized into @ groups : placebo group ( plain water ) , @ % glucose , @ % glucose , @ % glucose , @ % sucrose , @ % sucrose and @ % sucrose groups.In each group , @ ml corresponding oral solutions were administered through a syringe by dripping into the neonate 's mouth @ minute before heel lance .


The procedure process was recorded by videos , from which to collect heart rate , oxygen saturation and pain score @ min before puncture , @ , @ and @ min after puncture .


The average heart rate increase @ , @ and @ min after procedure in the @ % and @ % glucose groups , @ % and @ % and @ % sucrose groups was significantly lower than those in the placebo group ( P < @ or @ ) .


The average heart rate increase @ min after procedure in the sucrose group was lower than that in the glucose group ( P < @ ) .


Neonates who received @ % sucrose has a significantly lower average heart rate increase than those who received @ % and @ % sucrose @ min after heel lance ( both P < @ ) .


The average oxygen saturation decrease @ , @ , @ min after procedure was significantly lower than those in the placebo group ( P < @ ) .


The average oxygen saturation decrease @ min after procedure in the sucrose groups was significantly lower than that in the glucose groups ( P < @ ) .


The average pain score @ , @ , @ min after procedure was significantly lower than those in the placebo group ( P < @ ) .


The average pain score @ min after procedure in the sucrose groups was significantly lower than that in the glucose groups ( P < @ ) .


Oral administration of sweet solutions is an effective way to relieve neonatal pain on procedure , and sucrose has a better pain relief action than glucose , moreover , @ % sucrose provides better effect in control of heart rate increase @ min after heel lance , but the best concentration of sucrose for pain relief needs further study .


To compare epirubicin , cisplatin , and capecitabine ( ECX ) with fluorouracil , leucovorin , and irinotecan ( FOLFIRI ) as first-line treatments in patients with advanced gastric or esophagogastric junction ( EGJ ) adenocarcinoma .


This open , randomized , phase III study was carried out in @ centers .


Patients with locally advanced or metastatic gastric or EGJ cancer were randomly assigned to receive either ECX as first-line treatment ( ECX arm ) or FOLFIRI ( FOLFIRI arm ) .


Second-line treatment was predefined ( FOLFIRI for the ECX arm and ECX for the FOLFIRI arm ) .


The primary criterion was time-to-treatment failure ( TTF ) of the first-line therapy .


Secondary criteria were progression-free survival ( PFS ) , overall survival ( OS ) , toxicity , and quality of life .


In all , @ patients were included ( median age , @ years ; @ % male ) .


After a median follow-up of @ months , median TTF was significantly longer with FOLFIRI than with ECX ( @ v @ months ; P = @ ) .


There was no significant difference between the two groups in median PFS ( @ v @ months ; P = @ ) , median OS ( @ v @ months ; P = @ ) , or response rate ( @ % v @ % ) .


First-line FOLFIRI was better tolerated ( overall rate of grade @ to @ toxicity , @ % v @ % ; P < @ ; hematologic adverse events -LSB- AEs -RSB- , @ % v @ % ; P < @ ; nonhematologic AEs : @ % v @ % ; P = @ ) .


FOLFIRI as first-line treatment for advanced gastric and EGJ cancer demonstrated significantly better TTF than did ECX .


Other outcome results indicate that FOLFIRI is an acceptable first-line regimen in this setting and should be explored as a backbone regimen for targeted agents .


To observe the effect of Ginkgo Leaves Tablet ( GLT ) on memory quotient ( MQ ) of mild cognitive impairment ( MCI ) patients .


One hundred and thirteen patients were randomly assigned to the control group ( @ cases ) and the treatment group ( @ cases ) .


Patients in the control group received dietetic therapy and physical exercises , while those in the treatment group additionally took GLT , @ mg each time , three times daily .


The treatment course was @ months for all .


The MQ of all the patients was assessed by WMS-RC before treatment , at @-month of treatment , and @-month of treatment .


Compared with the control group , the improvement of MQ increased in the treatment group @ and @ year after treatment ( P < @ ) .


The clinical efficiency of MQ obviously increased in the treatment group ( @ % and @ % ) , showing statistical difference when compared with the control group ( @ % and @ % , P < @ , P < @ ) .


There was statistical difference in added scores of recognition , regeneration , understanding , and recitation test at @-month of treatment and @-month of treatment between the treatment group and the control group ( P < @ , P < @ ) .


GLT was effective in improving MQ of MCI patients , especially in improving recognition , regeneration , understanding , and recitation test .


The current study is the first to examine whether reactivation of fear memory prior to exposure therapy reduces relapse in a randomized clinical sample .


In a standardized treatment protocol combining virtual reality and in-vivo exposure , patients underwent a fear reactivation procedure using a virtual spider @ min prior to a virtual reality ( VR ) exposure ( reactivation group : RG , n = @ ) .


A control group ( CG , n = @ ) was exposed to a virtual plant @ min prior to the VR exposure .


Outcome measures were a VR spontaneous recovery test ( SRT ) and in-vivo a behavioral avoidance test assessed @ h after VR exposure .


One week later an in-vivo exposure session followed .


Additionally , a follow-up using psychometric assessment was conducted six months after the first session .


Both groups benefitted significantly and equally from the combined treatment , and importantly , the SRT revealed no return of fear in both groups .


Furthermore , follow-up tests showed long-term treatment effects with no group differences .


Due to different study components ( VR treatment and in-vivo ) , we were not able to determine which treatment module was mainly responsible for the long-term treatment effect .


Furthermore , no direct measure of memory destabilization was possible in this study .


Our treatment package was highly effective in reducing phobic fear up to @ months following treatment .


Explicit fear reactivation prior to exposure was not beneficial in VR exposure treatment , possibly due to a failure to induce a memory destabilization or due to an implicit fear reactivation prior to treatment in both groups .


Antibiotic prescribing in dentistry accounts for @ % of total antibiotic prescriptions in Scottish primary care .


The Scottish Dental Clinical Effectiveness Programme ( SDCEP ) published guidance in April @ ( @nd edition , August @ ) for Drug Prescribing in Dentistry , which aims to assist dentists to make evidence-based antibiotic prescribing decisions .


However , wide variation in prescribing persists and the overall use of antibiotics is increasing .


RAPiD is a @-month partial factorial cluster randomised trial conducted in NHS General Dental Practices across Scotland .


Its aim is to compare the effectiveness of individualised audit and feedback ( A&F ) strategies for the translation into practice of SDCEP recommendations on antibiotic prescribing .


The trial uses routinely collected electronic healthcare data in five aspects of its design in order to : identify the study population ; apply eligibility criteria ; carry out stratified randomisation ; generate the trial intervention ; analyse trial outcomes .


Eligibility was determined on contract status and a minimum level of recent NHS treatment provision .


All eligible dental practices in Scotland were simultaneously randomised at baseline either to current audit practice or to an intervention group .


Randomisation was stratified by single-handed/multi-handed practices .


General dental practitioners ( GDPs ) working at intervention practices will receive individualised graphical representations of their antibiotic prescribing rate from the previous @ months at baseline and an update at six months .


GDPs could not be blinded to their practice allocation .


Intervention practices were further randomised using a factorial design to receive feedback with or without : a health board comparator ; a supplementary text-based intervention ; additional feedback at nine months .


The primary outcome is the total antibiotic prescribing rate per @ courses of treatment over the year following delivery of the baseline intervention .


A concurrent qualitative process evaluation will apply theory-based approaches using the Consolidated Framework for Implementation Research to explore the acceptability of the interventions and the Theoretical Domains Framework to identify barriers and enablers to evidence-based antibiotic prescribing behaviour by GDPs .


RAPiD will provide a robust evaluation of A&F in dentistry in Scotland .


It also demonstrates that linked administrative datasets have the potential to be used efficiently and effectively across all stages of an randomised controlled trial .


To evaluate the efficacy of tramadol , lidocaine , and a combination of tramadol with lidocaine in pain relief using periprostatic nerve block technique by guidance of transrectal ultrasound ( TRUS ) before the prostate biopsy ( PBx ) .


For the indication of TRUS-PBx , the patients with a prostate-specific antigen ( PSA ) level > @ ng/mL or abnormal digital examination findings were selected .


The patients were randomized through random method .


Group @ : patients were administered @ mL of @ % lidocaine ; group @ : patients were administered @ mL of @-mg tramadol ; and group @ : patients were administered @ mL of @ % lidocaine + @-mg tramadol .


The procedures were completed in @ minutes , and a visual pain scale was administered to the patients to question the pain severity .


TRUS-guided PBx was performed in @ patients with an age range of @-@ years ( mean age , @ @ years ) and a PSA range of @-@ ng/mL .


The mean PSA level of the groups was @ ( @ ) , @ ( @ ) , and @ ( @ ) ng/mL , respectively .


The postprocedural pain scores by visual pain scale were @ @ , @ @ , and @ @ in lidocaine , tramadol , and lidocaine + tramadol groups , respectively .


Periprostatic nerve block is the current golden standard method owing to pain management and comfort provided , independent of the patient age and the number of core biopsies .


We suggest that tramadol may also be used in this field to achieve better pain management by improving lidocaine 's effect or as an alternative to lidocaine .


While Web-based interventions have been shown to assist a wide range of patients successfully in managing their illness , few studies have examined the relative contribution of different Web-based components to improve outcomes .


Further efficacy trials are needed to test the effects of Web support when offered as a part of routine care .


Our aim was to compare in regular care the effects of ( @ ) an Internet-based patient provider communication service ( IPPC ) , ( @ ) WebChoice , a Web-based illness management system for breast cancer patients ( IPPC included ) , and ( @ ) usual care on symptom distress , anxiety , depression , ( primary outcomes ) , and self-efficacy ( secondary outcome ) .


This study reports preliminary findings from @ months ' follow-up data in a @-month trial .


We recruited @ patients recently diagnosed with breast cancer and undergoing treatment from three Norwegian hospitals .


The nurse-administered IPPC allowed patients to send secure e-messages to and receive e-messages from health care personnel at the hospital where they were treated .


In addition to the IPPC , WebChoice contains components for symptom monitoring , tailored information and self-management support , a diary , and communication with other patients .


A total of @ care providers ( @ nurses , @ physicians , and @ social workers ) were trained to answer questions from patients .


Outcomes were measured with questionnaires at study entry and at study months @ , @ , and @ .


Linear mixed models for repeated measures were fitted to compare effects on outcomes over time .


Patients were randomly assigned to the WebChoice group ( n = @ ) , the IPPC group ( n = @ ) , or the usual care group ( n = @ ) .


Response rates to questionnaires were @ % ( @/@ ) at @ months , @ ( @/@ ) at @ months , and @ % ( @/@ ) at @ months .


Attrition was similar in all study groups .


Among those with access to WebChoice , @ % ( @/@ ) logged on more than once and @ % ( @/@ ) sent e-messages to care providers .


In the IPPC group , @ % ( @/@ ) sent e-messages .


Linear mixed models analyses revealed that the WebChoice group reported significantly lower symptom distress ( mean difference @ , @ % CI @-@ @ , P = @ ) , anxiety ( mean difference @ , @ % CI @-@ @ , P = @ ) , and depression ( mean difference @ , @ % CI @-@ @ , P = @ ) compared with the usual care group .


The IPPC group reported significant lower depression scores compared with the usual care group ( mean difference @ , @ % CI @-@ @ , P = @ ) , but no differences were observed for symptom distress or anxiety .


No significant differences in self-efficacy were found among the study groups .


In spite of practice variations and moderate use of the interventions , our results suggest that offering Web support as part of regular care can be a powerful tool to help patients manage their illness .


Our finding that a nurse-administered IPPC alone can significantly reduce depression is particularly promising .


However , the multicomponent intervention WebChoice had additional positive effects .


The aim of the study was to assess the impact of LYM-X-SORB ( LXS ) , an organized lipid matrix that has been shown to be absorbable without pancreatic enzyme therapy on fat-soluble vitamin status in children with cystic fibrosis ( CF ) and pancreatic insufficiency ( PI ) .


Children with CF and PI were randomized to daily LXS or an isocaloric placebo comparison supplement for @ months .


Serum vitamins A ( retinol ) , D ( @-hydroxyvitamin D -LSB- @D -RSB- ) , E ( - tocopherol , - tocopherol : cholesterol ratio ) , and K ( percentage of undercarboxylated osteocalcin -LSB- % ucOC -RSB- and plasma proteins induced by vitamin K absence factor II -LSB- PIVKA II -RSB- ) were assessed at baseline and @ months .


Dietary intake was determined using @-day weighed food records and supplemental vitamin intake by a comprehensive questionnaire .


A total of @ subjects ( @ boys , age @ @ years -LSB- mean standard deviation -RSB- ) with complete serum vitamin , dietary and supplemental vitamin data were analyzed .


After adjusting for dietary and supplemental vitamin intake , serum retinol increased @ @ g/dL ( coefficient standard error ) ( adjusted R@ = @ , P = @ ) and vitamin K status improved as demonstrated by a decreased percentage of undercarboxylated osteocalcin of -@ % @ % by @ months ( adjusted R@ = @ , P < @ ) .


These changes occurred in both the LXS and placebo comparison groups .


No changes in serum @D or - tocopherol were detected .


Both nutrition interventions increased caloric intake a mean of @ @ kcal/day by @ months .


Vitamins A and K status improved , whereas vitamins D and E status was unchanged during @ months of LXS and isocaloric placebo comparison supplement in children with CF and PI .


The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people , including individuals with cognitive impairment or comorbidities .


A randomized , single-blind , parallel-group clinical trial was conducted from January @ to December @ in seven primary health care centers in Baix Llobregat ( Barcelona ) .


Of @ referred people who were born in @ , @ were randomized to an intervention group or a control group .


The intervention model used an algorithm and was multifaceted for both patients and their primary care providers .


Primary outcomes were risk of falling and time until falls .


Data analyses were by intention-to-treat .


Sixty-five ( @ % ) subjects in the intervention group and @ ( @ % ) in the control group fell during follow-up .


The difference in the risk of falls was not significant ( relative risk @ , @ % confidence interval -LSB- CI -RSB- @-@ @ ) .


Cox regression models with time from randomization to the first fall were not significant .


Cox models for recurrent falls showed that intervention had a negative effect ( hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ @ ) and that functional impairment ( HR @ , @ % CI @-@ @ ) , previous falls ( HR @ , @ % CI @-@ @ ) , and cognitive impairment ( HR @ , @ % CI @-@ @ ) had no effect on the assessment .


This multifactorial intervention among octogenarians , including individuals with cognitive impairment or comorbidities , did not result in a reduction in falls .


A history of previous falls , disability , and cognitive impairment had no effect on the program among the community-dwelling subjects in this study .


There is a need to identify novel pharmacologic targets to treat alcoholism .


Animal and human studies suggest a role for ghrelin in the neurobiology of alcohol dependence and craving .


Here , we were the first to test the hypothesis that intravenous administration of exogenous ghrelin acutely increases alcohol craving .


This was a double-blind , placebo-controlled human laboratory proof-of-concept study .


Nontreatment-seeking , alcohol-dependent , heavy-drinking individuals were randomized to receive intravenous ghrelin @ mcg/kg , @ mcg/kg or @ mcg/kg ( placebo ) , followed by a cue-reactivity procedure , during which participants were exposed to neutral ( juice ) and alcohol cues .


The primary outcome variable was the increase in alcohol craving ( also called urge ) for alcohol , assessed by the Alcohol Visual Analogue Scale .


Out of @ screenings , @ individuals received the study drug .


Repeated measures of analysis of covariance revealed a group effect across ghrelin doses in increasing alcohol craving ( p < @ ) .


A dose-specific examination revealed a significant effect of ghrelin @ mcg/kg versus placebo in increasing alcohol craving ( p < @ ) with a large effect size ( d = @ ) .


By contrast , no significant ghrelin effect was found in increasing either urge to drink juice or food craving ( p = ns ) .


No significant differences in side effects were found ( p = ns ) .


Intravenous administration of exogenous ghrelin increased alcohol craving in alcohol-dependent heavy-drinking individuals .


Although the small sample requires confirmatory studies , these findings provide preliminary evidence that ghrelin may play a role in the neurobiology of alcohol craving , thus demonstrating a novel pharmacologic target for treatment .


Various treatments are available for reducible unstable fractures of the distal radius , such as closed reduction combined with fixation by external fixator ( EF ) , and rigid internal fixation using a locked volar plate ( VP ) .


Although there are studies comparing these methods , there is no conclusive evidence indicating which treatment is best .


The hypothesis of this study is that surgical treatment with a VP is more effective than EF from the standpoint of functional outcome ( patient-reported ) .


The study is randomized clinical trial with parallel groups and a blinded evaluator and involves the surgical interventions EF and VP .


Patients will be randomly assigned ( assignment ratio @:@ ) using sealed opaque envelopes .


This trial will include consecutive adult patients with an acute ( up to @ days ) displaced , unstable fracture of the distal end of the radius of type A@ , A@ , C@ , C@ or C@ by the Arbeitsgemeinschaft fr Osteosynthesefragen-Association for the Study of Internal Fixation classification and type II or type III by the IDEAL@ classification , without previous surgical treatments of the wrist .


The surgical intervention assigned will be performed by three surgical specialists familiar with the techniques described .


Evaluations will be performed at @ , and @ weeks , @ , @ and @ months , with the primary outcomes being measured by the Disabilities of the Arm , Shoulder and Hand ( DASH ) questionnaire and measurement of pain ( Visual Analog Pain Scale and digital algometer ) .


Secondary outcomes will include radiographic parameters , objective functional evaluation ( goniometry and dynamometry ) , and the rate of complications and method failure according to the intention-to-treat principle .


Final postoperative evaluations ( @ and @ months ) will be performed by independent blinded evaluators .


For the Student 's t-test , a difference of @ points in the DASH score , with a @ % confidence interval , a statistical power of @ % , and @ % sampling error results in @ patients per group .


Results from this study protocol will improve the current evidence regarding to the surgical treatment these fractures .


Excess sodium intake is associated with high blood pressure , a major risk factor for cardiovascular disease ( CVD ) .


It is unknown whether decreasing sodium intake to < @ mg/d has an effect on CVD or all-cause mortality .


The objective was to assess whether reductions in sodium intake to < @ mg/d were associated with either an increased or a decreased risk of fatal and nonfatal CVD and all-cause mortality .


This observational prospective study of the PREvencin con DIeta MEDiterrnea ( PREDIMED ) trial included @ participants at high CVD risk .


Sodium intake was evaluated with a validated food-frequency questionnaire and categorized as low ( < @ mg/d ) , intermediate ( @ to @ mg/d ) , high ( > @ to @ mg/d ) , or very high ( > @ mg/d ) .


Subsequently , @-y and @-y changes in sodium intake were calculated .


Multivariate relative risks were assessed by using Cox proportional hazards ratios .


Marginal structural models with inverse probability weighting were used to test the effect of changes in sodium intake and the Mediterranean diet ( MedDiet ) .


We documented @ CVD events and @ deaths after a @-y median follow-up .


Sodium intake < @ mg/d was associated with a lower risk of all-cause mortality : @ % ( HR : @ ; @ % CI : @ , @ ; P = @ ) and @ % ( HR : @ ; @ % CI : @ , @ ; P = @ ) after @ and @ y , respectively .


Increasing sodium intake after @ y was associated with a @ % ( HR : @ ; @ % CI : @ , @ ; P = @ ) higher risk of CVD events .


The incidence rate of CVD was reduced for those who reduced their sodium intake and were randomly assigned to MedDiet interventions -LSB- @ / @,@ ( @ % CI : @ , @ ) compared with @ / @,@ ( @ % CI : @ , @ ) person-years ; P = @ -RSB- .


Decreasing sodium intake to < @ mg/d was associated with a reduced risk of all-cause mortality , whereas increasing the intake to > @ mg/d was associated with a higher risk of CVD .


Our observational data suggest that sodium intake < @ mg/d was associated with an enhanced beneficial effect of the MedDiet on CVD .


These results should be interpreted with caution , and other confirmatory studies are necessary .


In patients with ST-segment elevation myocardial infarction ( STEMI ) who undergo primary percutaneous coronary intervention ( pPCI ) , the use of dual antiplatelet therapy is essential to prevent atherothrombotic complications .


Therefore , patients are treated with acetylsalicylic acid and clopidogrel , prasugrel , or ticagrelor .


Clopidogrel , however , shows a major interindividual variation in antiplatelet effect , which is correlated to an increase in atherothrombotic events in patients with high platelet reactivity .


This interindividual variation is partly a result of CYP@C@ genetic variants .


Ticagrelor and prasugrel reduce atherothrombotic events but increase bleeding rate and drug costs , as compared with clopidogrel .


CYP@C@-based tailoring of antiplatelet therapy might be beneficial to STEMI patients .


POPular Genetics ( NCT@ ) is a randomized , open-label , multicenter trial involving @,@ STEMI patients who undergo pPCI .


Patients are randomized to CYP@C@ genotyping or routine ticagrelor or prasugrel treatment .


In the genotyping group , * @ / * @ ( wild-type ) patients receive clopidogrel , and patients carrying @ or @ * @ or * @ loss-of-function alleles receive ticagrelor or prasugrel .


The primary net clinical benefit end point is the composite of death , ( recurrent ) myocardial infarction , definite stent thrombosis , stroke , and Platelet Inhibition and Patient Outcomes ( PLATO ) major bleeding at @ year .


Primary safety end point is the composite of ( PLATO ) major and minor bleeding .


Cost-effectiveness and quality of life will be assessed by calculating quality-adjusted life-years , net costs per life-year , and per quality-adjusted life-year gained .


The POPular Genetics study is the first large-scale trial comparing CYP@C@ genotype-guided antiplatelet therapy to a nontailored strategy in terms of net clinical benefit , safety , and cost-effectiveness .


Head and neck cancer ( HNC ) patients are prone to have a poor health-related quality of life after cancer treatment .


This study investigated the effect of the nurse counselling and after intervention ( NUCAI ) on the health-related quality of life and depressive symptoms of HNC patients between @ and @ months after cancer treatment .


Two hundred and five HNC patients were randomly allocated to NUCAI ( N = @ ) or usual care ( N = @ ) .


The @-month nurse-led NUCAI is problem-focused and patient-driven and aims to help HNC patients manage with the physical , psychological and social consequences of their disease and its treatment .


Health-related quality of life was evaluated with the EORTC QLQ-C@ and QLQ H&N @ .


Depressive symptoms were evaluated with the CES-D .


At @ months the intervention group showed a significant ( P < @ ) improvement in emotional and physical functioning , pain , swallowing , social contact , mouth opening and depressive symptoms .


At @ months , global quality of life , role and emotional functioning , pain , swallowing , mouth opening and depressive symptoms were significantly better in the intervention group than in the control group , and at @ months emotional functioning and fatigue were significantly better in the intervention group .


The NUCAI effectively improved several domains of health-related quality of life and depressive symptoms in HNC patients and would seem a promising intervention for implementation in daily clinical practice .


To compare the efficacy and safety of the levonorgestrel-releasing intrauterine device ( LNG-IUD ) with dydrogesterone applied for the same duration in patients having endometrial hyperplasia ( EH ) without atypia .


One hundred thirty eight women aged between @ and @ years with abnormal uterine bleeding and diagnosed as EH by transvaginal ultrasound were randomized to receive either LNG-IUD or dydrogesterone for @ months .


Primary outcome measures were regression of hyperplasia after @ months of therapy .


Secondary outcome measures were occurrence of side effects during treatment or recurrence of hyperplasia during follow-up period .


After @ months of treatment , regression of EH occurs in @ % of women in the levonorgestrel-releasing intrauterine system ( LNG-IUS ) group versus @ % of women in the oral group ( P < @ ) .


Adverse effects were relatively common with minimal differences between the @ groups .


Intermenstrual vaginal spotting and amenorrhea were more common in the LNG-IUD group ( P value @ and @ ) .


Patient satisfaction was significantly higher in the LNG-IUS group ( P value @ ) .


Hysterectomy rates were lower in the LNG-IUS group than in the oral group ( P = @ ) .


Recurrence rate was @ % in the LNG-IUD group compared to @ % in the oral group .


In management of EH without atypia , LNG-IUS achieves a higher regression and a lower hysterectomy rate than oral progesterone and could be used as a first-line therapy .


To observe the effect of Sancaijiangtang powders on plasma nitric oxide and endothelin-@ levels .


We sought to identify the common pathological link and mechanism of action for Traditional Chinese medicine in type @ diabetes mellitus and vascular dementia , and to explicate the material basis for treating the different diseases with the same method in Traditional Chinese Medicine .


In total , @ patients with type @ diabetes mellitus and vascular dementia were enrolled in the study , and randomly divided into two groups by simple randomization .


Patients in the treatment group received oral Sancaijiangtang powders with pioglitazone hydrochloride three times daily , while patients in the control group received pioglitazone hydrochloride alone .


The treatment course was for @ weeks .


Mini-mental state examinations ( Chinese version ) and Montreal Cognitive Assessments ( Beijing version ) were performed , and fasting plasma glucose , fasting insulin , hemoglobin A@c , homeostasis model assessment of insulin resistance , plasma nitric oxide and endothelin-@ levels were measured before and after the treatment .


The post-treatment levels for all measurements in both groups were better than pre-treat - ment levels ( P < @ ) .


The post-treatment levels for all measurements in the treatment group were better than the levels measured in the control group ( P < @ ) .


Type @ diabetes mellitus and vascular dementia have common pathological mechanisms for insulin resistance and endothelium dysfunction .


Sancaijiangtang powders could improve the release of nitric oxide and inhibit the secretion of endothelin-@ .


Therefore , the material basis exists for treating the different diseases with the same method in Traditional Chinese Medicine .


The objectives of this prospective study were to compare the advantages of single-port laparoscopic cholecystectomy ( SPLC ) versus the classical four-port laparoscopic cholecystectomy ( CLC ) and to discuss these advantages in the light of current literature .


Forty eligible patients were randomized to receive SPLC ( Group A , N. = @ ) and CLC ( Group B , N. = @ ) , and investigated with regard to age , sex , BMI ( body mass index ) , ASA ( American Society of Anesthesiologists ) score , type of surgery , operative time , per-operative complication , indication for conversion to open surgery , indication for additional trocar placement in SPLC technique , post-operative pain score , additional narcotic analgesic requirement , nausea and vomiting , post-operative complication and length of hospital stay .


Visual analogue scale ( VAS ) was used for pain scoring in all cases .


No significant difference was found among patients in Group A and Group B in terms of age , sex , weight/BMI , ASA score , VAS scores , additional analgesic requirement and length of hospital stay ( P > @ ) .


On the other hand , mean operative time in Group A was significantly ( P < @ ) greater than that in Group B. Mean operative time in Group A was observed to be reduced after the first @ operations .


Conversion to open surgery was not required in any of the patients ; however , additional trocar placement was required in two patients in Group A due to body habitus and adhesions , and operations were completed laparoscopically .


We conclude that SPLC is equally effective as CLC .


Patient comfort is increased and pain is decreased as the surgeon gets experienced with the technique .


The pediatric diffuse intrinsic pontine glioma ( DIPG ) outcome remains dismal despite multiple therapeutic attempts .


To compare the results of treatment of pediatric diffuse intrinsic pontine glioma ( DIPG ) using hypofractionated versus conventional radiotherapy .


Seventy-one newly diagnosed DIPG children were randomized into hypofractionated ( HF ) ( @Gy/@ fractions in @ weeks ) and conventional ( CF ) arm ( @Gy/@ fractions in @weeks ) .


The median and one-year overall survival ( OS ) was @ months and @ % for the hypofractionated arm , and @ and @ % for the conventional arm respectively .


The @-month OS difference was @ % .


The OS hazard ratio ( HR ) was @ ( @ % CI : @-@ @ ) ( p = @ ) .


The hypofractionated arm had a median and one-year progression-free survival ( PFS ) of @ months and @ % , compared to @ and @ % for the conventional arm .


The PFS HR was @ ( @ % CI : @-@ @ ) ( p = @ ) .


The @-month PFS difference was @ % .


These differences exceed the non-inferiority margin .


The immediate and delayed side effects were not different in the @ arms .


Hypofractionated radiotherapy offers lesser burden on the patients , their families and the treating departments , with nearly comparable results to conventional fractionation , though not fulfilling the non-inferiority assumption .


Pregnancy rates in US contraceptive clinical trials are increasing due to decreased treatment compliance .


This study compared compliance with a new low-dose levonorgestrel ( LNG ) and ethinyl estradiol ( EE ) contraceptive patch ( CP , Twirla ) with that of a low-dose combination oral contraceptive ( COC ) in a demographically diverse population .


This analysis was part of an open-label , parallel-group , multicenter phase @ study that randomized healthy sexually active women ( @-@years ) to @cycles of LNG/EE CP or @cycles of COC , then @cycles of LNG/EE CP .


We defined self-reported compliance as cycles that , according to diaries , show @days of patch wear without missed days or any patch worn > @days or @days of pill-taking without missed pill days .


We verified compliance by detectable plasma presence of LNG and EE at cycles @ , @ , and @ .


Of the intention-to-treat population with diary information ( N = @ , mean age @ years , @ % minorities , @ % obese ) , @ % of the CP ( n = @ ) versus @ % of the COC group ( n = @ ) self-reported noncompliance after @cycles ( p < @ ) .


Laboratory assessments verified @-@ % of participants in both groups as noncompliant .


Self-reported perfect use did not vary between obese -LSB- body mass index ( BMI ) @kg/m ( @ ) -RSB- versus nonobese ( BMI < @kg/m ( @ ) ) participants in both groups or when stratified by age , education , or race/ethnicity in the CP group .


Self-reported compliance was significantly greater in the CP than COC group and did not vary by obesity status .


Discrepancies between self-reported and verified compliance question reliability of patient diaries .


This paper , based on an analysis of a phase @ trial , shows that compliance was significantly greater with a new weekly transdermal CP than with a once-daily COC in obese as well as nonobese participants .


Discrepancies between self-reported compliance and laboratory-verified compliance raise questions regarding the reliability of patient diaries .


Pediatric respiratory infections caused by antibiotic-nonsusceptible Streptococcus pneumoniae ( ANSP ) continue to present an important challenge , even after introduction of @-valent pneumococcal conjugate vaccine ( PCV@ ) .


This randomized double-blind trial assessed the potential additional impact of PCV@ over PCV@ on reducing ANSP carriage .


Healthy infants were randomly assigned to receive PCV@ ( n = @ ) or PCV@ ( n = @ ) at ages @ , @ , @ , or @ months .


Eight nasopharyngeal specimens were collected by swabbing between ages @ and @ months .


S. pneumoniae isolates were serotyped and tested for antimicrobial susceptibility by the disk-diffusion method and the Etest .


Nasopharyngeal acquisition and prevalence of ANSP during ages @-@ months were compared between the @ vaccine groups .


In general , new acquisition of pneumococci nonsusceptible to penicillin , erythromycin , clindamycin , penicillin plus erythromycin , and multiple drugs ( @ antibiotics ) was significantly lower in the PCV@ group compared with the PCV@ group ; the main serotypes contributing to this significant decrease were serotype @F , present in PCV@ and PCV@ , and serotypes @A and @A , present in PCV@ only .


PCV@ has a significant added benefit over PCV@ in reducing carriage of ANSP .


Because carriage determines transmission , these results suggest that PCV@ will provide protection against ANSP disease that exceeds protection provided by PCV@ .


Homeless adults are more likely to smoke tobacco and are less likely to successfully quit smoking than smokers in the general population , despite comparable numbers of cessation attempts and desire to quit .


To date , studies that have examined smoking cessation in homeless samples have used traditional lab/clinic-based assessment methodologies .


Real-time assessment of key variables may provide new insights into the process of quitting among homeless smokers .


The purpose of the current study was to identify predictors of a quit attempt using real-time assessment methodology during the @ days prior to a scheduled quit attempt among homeless adults seeking care at a shelter-based smoking cessation clinic .


Parameters for multiple variables ( i.e. , motivation for quitting , smoking expectancies , quit self-efficacy , smoking urges , negative affect , positive affect , restlessness , hostility , and stress ) were calculated and were used as predictors of biochemically verified quit date abstinence ( i.e. , @hr abstinent ) using logistic regression analyses .


Participants ( n = @ ) were predominantly male ( @ % ) , non-White ( @ % ) , and smoked an average of @ cigarettes per day .


A total of @,@ ecological momentary assessments ( @ % completion rate ) were collected at random times ( i.e. , up to @ assessments/day ) during the @ days prior to a scheduled quit attempt .


Results indicated that declining ( negative slope ) negative affect , restlessness , and stress predicted quit date abstinence .


Additionally , increasing positive coping expectancies across the prequit week predicted quit date abstinence .


Study findings highlight multiple variables that may be targeted during the precessation period to increase smoking cessation attempts in this difficult to treat population of smokers .


The goal of this research was to evaluate nutrition education targeting Latinas , a group at particular risk of obesity and diabetes , which predict to later life cardiovascular disease and dementia .


Culturally tailored , theory-based nutrition education was provided to Mexican origin Latinas aged @ to @ .


The randomized design compared participants in workshops incorporating the connection between dietary fat and brain health , participants in workshops focusing only on dietary fat and heart health , a waitlist control group , and a posttest only control group .


Among those assigned to either intervention , there was statistically significant gain in health literacy , knowledge about dietary fat , and behaviors to reduce dietary fat compared with waitlist control .


There was no difference in outcomes between those given the module about diet and brain health and those not provided that module .


A program to encourage dietary fat modification in Latinas proved feasible and modestly effective .


Umbilical cord milking ( UCM ) improves blood pressure and urine output , and decreases the need for transfusions in comparison to immediate cord clamping ( ICC ) .


The immediate effect of UCM in the first few minutes of life and the impact on neonatal resuscitation has not been described .


Women admitted to a tertiary care center and delivering before @ weeks gestation were randomized to receive UCM or ICC .