Subjects who met the International Headache Society criteria for MOH were included in the trial .


The change in headache days and intake of rescue medication were considered as primary outcomes while the change in headache severity defined as a secondary outcome .


Patients treated with celecoxib experienced lower headache intensity during the first @ weeks after withdrawal ( after @ weeks , the median of visual analog scale was @ for patients in celecoxib group vs @ for prednisone group -LSB- P < @ -RSB- ) .


However , headache frequency and the need for rescue medication intake were not different between @ groups .


During withdrawal in MOH , in order to reduce headache days or rescue medication intake , using either of celecoxib or prednisone as a bridge is not different .


Short-term dietary glucose supplementation has been shown to accelerate the gastric emptying rate of both glucose and fructose solutions .


The aim of this study was to examine gastric emptying rate responses to monosaccharide ingestion following short-term dietary fructose supplementation .


The gastric emptying rate of a fructose solution containing @ g of fructose and an equicaloric glucose solution containing @ g glucose monohydrate were measured in @ healthy non-smoking men with and without prior fructose supplementation ( water control ) using a randomized crossover design .


Gastric emptying rate was assessed for a period of @ h using the -LSB- ( @ ) C -RSB- breath test with sample collections at baseline and @-min intervals following drink ingestion .


Additionally , appetite ratings of hunger , fullness , and prospective food consumption were recorded at baseline and every @ min using visual analog scales .


Increased dietary fructose ingestion resulted in significantly accelerated half-emptying time of a fructose solution ( mean = @ , SD = @ versus @ , SD = @ min control ; P = @ ) , whereas the emptying of a glucose solution remained unchanged ( mean = @ , SD = @ versus @ , SD = @ min control ; P = @ ) .


Time of maximal emptying rate of fructose was also significantly accelerated following increased dietary fructose intake ( mean = @ , SD = @ versus @ , SD = @ min control ; P = @ ) , while it remained unchanged for glucose ( mean = @ , SD = @ versus @ , SD = @ min control ; P = @ ) .


No effects of supplementation were observed for appetite measures .


Three d of supplementation with @ g/d of fructose resulted in an acceleration of gastric emptying rate of a fructose solution but not a glucose solution .


To evaluate intraocular lens ( IOL ) axial movements and refractive changes during a @-month follow-up period after femtosecond laser-assisted cataract surgery and conventional cataract surgery , investigate the influence of capsulorhexis features on postoperative IOL axial changes , and assess the prediction error for both techniques .


Eighty eyes of @ candidates for cataract extraction were randomized into two groups : femtosecond laser ( @ eyes ) and manual ( @ eyes ) .


The overall anterior chamber depth variation was significantly lower in the femtosecond laser group compared to the manual group during follow-up ( P < @ ) .


At @ and @ days postoperatively , the mean spherical equivalent showed a hyperopic shift ( @ diopters -LSB- D -RSB- ) in the femtosecond laser group and a myopic shift in the manual group ( -@ D ) .


Median absolute error was not significantly different between the two groups with standard formulas ranging between @ and @ ( Hoffer Q ) in the femtosecond laser group and between @ ( SRK-T ) and @ D ( Hoffer Q ) in the manual group .


There was a significant lower deviation from intended versus achieved capsulotomy/capsulorhexis area in the femtosecond laser group ( P < @ ) compared to the manual group .


The femtosecond laser group showed better IOL centration compared to the manual group at all time periods ( P < @ ) .


Femtosecond laser-assisted cataract surgery was related to a lower overall variability of anterior chamber depth compared to conventional cataract surgery with more stable postoperative refraction .


The two techniques did not show significant differences of prediction error .


Insulin-sensitive tissues ( muscle , liver ) of individuals with obesity and type @ diabetes mellitus are in a state of low-grade inflammation , characterised by increased Toll-like receptor ( TLR ) expression and TLR-driven signalling .


However , the cause of this mild inflammatory state is unclear .


We tested the hypothesis that a prolonged mild increase in plasma NEFA will increase TLR expression and TLR-driven signalling ( nuclear factor B -LSB- NFB -RSB- and mitogen-activated kinase -LSB- MAPK -RSB- ) and impair insulin action in muscle of lean healthy individuals .


Twelve lean , normal-glucose-tolerant participants were randomised to receive a @ h infusion ( @ ml/h ) of saline or Intralipid followed by a euglycaemic-hyperinsulinaemic clamp .


Vastus lateralis muscle biopsies were performed before and during the clamp .


Lipid infusion impaired insulin-stimulated IRS-@ tyrosine phosphorylation and reduced peripheral insulin sensitivity ( p < @ ) .


The elevation in circulating NEFA increased expression of TLR@ , TLR@ and TLR@ , and several MAPK ( MAPK@ , MAP@K@ , MAP@K@ ) and inhibitor of B kinase-NFB ( CHUK -LSB- IKKA -RSB- , c-REL -LSB- REL -RSB- and p@ -LSB- RELA , NFKB@ , p@ -RSB- ) signalling genes ( p < @ ) .


The lipid infusion also increased extracellular signal-regulated kinase ( ERK ) phosphorylation ( p < @ ) and tended to reduce the content of inhibitor of kappa B ( p = @ ) .


The muscle content of most diacylglycerol , ceramide and acylcarnitine species was unaffected .


In summary , insulin resistance induced by prolonged low-dose lipid infusion occurs together with increased TLR-driven inflammatory signalling and impaired insulin-stimulated IRS-@ tyrosine phosphorylation .


A sustained , mild elevation in plasma NEFA is sufficient to increase TLR expression and TLR-driven signalling ( NFB and MAPK ) in lean individuals .


The activation of this pathway by NEFA may be involved in the pathogenesis of insulin resistance in humans .


In children with cerebral palsy , does a @-month physical activity stimulation program improve physical activity , mobility capacity , fitness , fatigue and attitude towards sports more than usual paediatric physiotherapy ?


Multicentre randomised controlled trial with concealed allocation , blinded assessments and intention-to-treat analysis .


Forty-nine walking children ( @ males ) aged @-@ years with spastic cerebral palsy and severity of the disability classified as Gross Motor Function Classification System level I-III .


The intervention group followed a @-month physical activity stimulation program involving counselling through motivational interviewing , home-based physiotherapy , and @ months of fitness training .


The control group continued their usual paediatric physiotherapy .


Primary outcomes were walking activity ( assessed objectively with an activity monitor ) and parent-reported physical activity ( Activity QUESTIONnaire for Adults and Adolescents ) .


Secondary outcomes were : mobility capacity , consisting of Gross Motor Function Measure-@ ( GMFM-@ ) , walking capacity and functional strength , fitness ( aerobic and anaerobic capacity , muscle strength ) , self-reported fatigue , and attitude towards sport ( child and parent ) .


Assessments were performed at baseline , @ months , @ months and @ months .


There were no significant intervention effects for physical activity or secondary outcomes at any assessment time .


Positive trends were found for parent-reported time at moderate-to-vigorous intensity ( between-group change ratio = @ , @ % CI @ to @ ) and GMFM-@ ( mean between-group difference = @ points , @ % CI @ to @ ) at @ months , but not at @ months .


There was a trend for a small , but clinically irrelevant , improvement in the children 's attitudes towards the disadvantages of sports at @ months , and towards the advantages of sports at @ months .


This physical activity stimulation program , that combined fitness training , counselling and home-based therapy , was not effective in children with cerebral palsy .


Further research should examine the potential of each component of the intervention for improving physical activity in this population .


To evaluate glucose-lowering treatment strategies with linagliptin and metformin in people with newly diagnosed type @ diabetes and marked hyperglycaemia , a prevalent population for which few dedicated studies of oral antidiabetes drugs have been conducted .


A total of @ patients , with type @ diabetes diagnosed for @months and with glycated haemoglobin ( HbA@c ) concentration in the range @-@ @ % , were randomized @:@ to double-blind , free-combination treatment with linagliptin @mg once daily and metformin twice daily ( uptitrated to @mg/day maximum ) or to linagliptin monotherapy .


The primary endpoint was change in HbA@c concentration from baseline at week @ ( per-protocol completers ' cohort : n = @ ) .


The mean ( standard deviation ) age and HbA@c at baseline were @ ( @ ) years and @ ( @ ) % , respectively .


At week @ , the meanstandard error ( s.e. ) HbA@c decreased from baseline by -@ % with linagliptin/metformin and -@ % with linagliptin ; a treatment difference of -@ % ( @ % confidence interval -@ to -@ ; p < @ ) .


Similar results were observed in a sensitivity analysis based on intent-to-treat principles : adjusted means.e .


changes in HbA@c of -@ % and -@ % , respectively ; treatment difference of -@ % ( @ % CI -@ to -@ ; p < @ ) .


A treatment response of HbA@c < @ % was achieved by @ and @ % of patients in the linagliptin/metformin and linagliptin groups , respectively .


Few patients experienced drug-related adverse events ( @ and @ % of patients in the linagliptin/metformin and linagliptin groups , respectively ) .


Hypoglycaemia occurred in @ and @ % of patients in the linagliptin/metformin and linagliptin groups , respectively ( no severe episodes ) .


Body weight decreased significantly with the combination therapy ( -@ kg between-group difference ; p = @ ) .


Linagliptin in initial combination with metformin in patients with newly diagnosed type @ diabetes and marked hyperglycaemia , an understudied group , elicited significant improvements in glycaemic control with a low incidence of hypoglycaemia , weight gain or other adverse effects .


These results support early combination treatment strategies and suggest that newly diagnosed patients with marked hyperglycaemia may be effectively managed with oral , non-insulin therapy .


To assess post-operative pain in patients who underwent arthroscopic anterior cruciate ligament ( ACL ) reconstruction by the all-inside technique .


A prospective randomized comparative parallel trial was performed in @-@ including all patients who underwent an ACL reconstruction in an orthopaedic department in accordance with the CONSORT statement @ .


Patients were randomized to the surgical procedure , all-inside or classical , and were blinded to the surgical technique .


Primary evaluation criterion was pain assessed on the Visual Analogical Scale @ month after surgery .


Secondary parameters were analgesic consumption , tunnel positioning on X-ray according to Aglietti 's criteria and functional evaluation at six months with IKDC score .


None of the patients was lost to follow-up .


@ consecutive patients were included , @ in each group , mean age @ years .


Two patients were excluded due to postoperative complications that required early revision surgery .


Forty-four patients were analyzed , @ in each group .


At one month , the pain level was @ for the all-inside group and @ for the classical group , p = @ ( @ % CI @-@ @ ) .


Postoperative analgesic consumption was similar .


The position of the tibial tunnels was better with the all-inside method , p = @ ( @ % CI @-@ @ % ) .


There was no significant difference in the mean IKDC subjective score at six months , p = @ ( @ % CI-@ @ to @ ) .


At one month , the pain level seemed lower in the all-inside group than in the classical group , at the limit of statistical significance because the study was underpowered .


The all-inside technique is a reliable procedure with very good results for pain , stability and knee function .


I ; Therapeutic study .


To evaluate the effect of oral administration of probiotics on intestinal colonization with drug-resistant bacteria among preterm infants in the neonatal intensive care unit ( NICU ) .


A double-blind , randomized , placebo-controlled trial was carried out in the preterm infants who were transferred to the NICU immediately after birth .


These infants were stratified by whether they were breastfed and then randomized into test group and control group .


The test group was given probiotics from the day when enteral feeding began , while the control group was treated conventionally without probiotics .


The two groups were compared in terms of the colonization with extended-spectrum beta-lactamase-producing bacteria , as assessed by rectal swabs on days @ , @ , @ , and @ after birth , and the incidence of diseases .


Rectal colonization with drug-resistant bacteria was found in the test group ( n = @ ) and control group ( n = @ ) on days @ , @ , @ , and @ after birth .


There were no significant differences in the incidence of late-onset sepsis and necrotizing enterocolitis between the two groups ( P > @ ) .


Among non-breastfed infants , the test group had significantly decreased rectal colonization with drug-resistant bacteria compared with the control group on day @ after birth ( @ % vs @ % ; P = @ ) .


No probiotic-related adverse events were observed in the study .


Oral administration of probiotics may reduce rectal colonization with drug-resistant bacteria in preterm infants under certain conditions and shows good safety .


The clinical benefit of adding a macrolide to a - lactam for empirical treatment of moderately severe community-acquired pneumonia remains controversial .


To test noninferiority of a - lactam alone compared with a - lactam and macrolide combination in moderately severe community-acquired pneumonia .


Open-label , multicenter , noninferiority , randomized trial conducted from January @ , @ , through January @ , @ , in @ immunocompetent adult patients hospitalized in @ acute care hospitals in Switzerland for moderately severe community-acquired pneumonia .


Follow-up extended to @ days .


Outcome assessors were masked to treatment allocation .


Patients were treated with a - lactam and a macrolide ( combination arm ) or with a - lactam alone ( monotherapy arm ) .


Legionella pneumophila infection was systematically searched and treated by addition of a macrolide to the monotherapy arm .


Proportion of patients not reaching clinical stability ( heart rate < @/min , systolic blood pressure > @ mm Hg , temperature < @ C , respiratory rate < @/min , and oxygen saturation > @ % on room air ) at day @ .


After @ days of treatment , @ of @ patients ( @ % ) in the monotherapy arm vs @ of @ ( @ % ) in the combination arm had not reached clinical stability ( @ % difference , P = @ ) .


The upper limit of the @-sided @ % CI was @ % , exceeding the predefined noninferiority boundary of @ % .


Patients infected with atypical pathogens ( hazard ratio -LSB- HR -RSB- , @ ; @ % CI , @-@ @ ) or with Pneumonia Severity Index ( PSI ) category IV pneumonia ( HR , @ ; @ % CI , @-@ @ ) were less likely to reach clinical stability with monotherapy , whereas patients not infected with atypical pathogens ( HR , @ ; @ % CI , @-@ @ ) or with PSI category I to III pneumonia ( HR , @ ; @ % CI , @-@ @ ) had equivalent outcomes in the @ arms .


There were more @-day readmissions in the monotherapy arm ( @ % vs @ % , P = @ ) .


Mortality , intensive care unit admission , complications , length of stay , and recurrence of pneumonia within @ days did not differ between the @ arms .


We did not find noninferiority of - lactam monotherapy in patients hospitalized for moderately severe community-acquired pneumonia .


Patients infected with atypical pathogens or with PSI category IV pneumonia had delayed clinical stability with monotherapy .


Olodaterol is a long-acting @-agonist with a @-hour bronchodilator profile .


Two replicate , randomized , double-blind , placebo-controlled , parallel-group , Phase III trials were performed as part of a comprehensive clinical program to investigate the long-term safety and efficacy of olodaterol in patients with moderate to very severe chronic obstructive pulmonary disease ( COPD ) receiving usual-care background therapy .


Patients received olodaterol @ g or @ g or placebo once daily for @ weeks .


Coprimary end points were forced expiratory volume in @ second ( FEV@ ) area under the curve from @ to @ hours ( AUC@-@ ) response ( change from baseline ) , and trough FEV@ response at @ weeks .


Secondary end points included additional lung function assessments , use of rescue medications , FEV@ AUC response from @ to @ hours , and Patient Global Rating over @ weeks .


Overall , @ and @ patients were evaluated in studies @ and @ , respectively .


In both studies , olodaterol @ g and @ g significantly improved the FEV@ AUC@-@ response ( P < @ ) and trough FEV@ ( study @ , P < @ ; study @ , P < @ , post hoc ) at week @ , with an incidence of adverse events comparable with that of placebo .


Secondary end points supported the efficacy of olodaterol .


These studies demonstrate the long-term efficacy and safety of once-daily olodaterol @ g and @ g in patients with moderate to very severe COPD continuing with usual-care maintenance therapy .


WARCEF randomized @,@ patients in sinus rhythm with ejection fraction ( EF ) @ % to warfarin ( INR @-@ @ ) or aspirin @ mg .


Warfarin reduced the incident ischemic stroke ( IIS ) hazard rate by @ % over aspirin in a secondary analysis .


The IIS rate in heart failure ( HF ) is too low to warrant routine anticoagulation but epidemiologic studies show that prior stroke increases the stroke risk in HF .


In this study , we explore IIS rates in WARCEF patients with and without baseline stroke to look for risk factors for IIS and determine if a subgroup with an IIS rate high enough to give a clinically relevant stroke risk reduction can be identified .


We compared potential stroke risk factors between patients with baseline stroke and those without using the exact conditional score test for Poisson variables .


We looked for risk factors for IIS , by comparing IIS rates between different risk factors .


For EF we tried cut-off points of @ , @ and @ % .


The cut-off point @ % was used as it was the highest EF that was associated with a significant increase in IIS rate .


IIS and EF strata were balanced as to warfarin/aspirin assignment by the stratified randomized design .


A multiple Poisson regression examined the simultaneous effects of all risk factors on IIS rate .


IIS rates per hundred patient years ( / @ PY ) were calculated in patient groups with significant risk factors .


Missing values were assigned the modal value .


Twenty of @ ( @ % ) patients with baseline stroke and @ of @,@ ( @ % ) without had IIS .


IIS rate in patients with baseline stroke ( @ / @ PY ) was greater than patients without ( @ / @ PY ) ( rate ratio @ , p < @ ) .


Fourteen of @ ( @ % ) patients with ejection fraction ( EF ) < @ % and @ of @,@ ( @ % ) with EF @ % had IIS .


In the multiple regression analysis stroke at baseline ( p < @ ) and EF < @ % vs. @ % ( p = @ ) remained significant predictors of IIS .


IIS rate was @ / @ PY in patients with EF < @ % and @ / @ PY in patients with EF @ % ( p = @ ) .


IIS rate in patients with baseline stroke and reduced EF was @ / @ PY with EF < @ % decreasing to @ / @ PY with EF < @ % .


In a WARCEF exploratory analysis , prior stroke and EF < @ % were risk factors for IIS .


Further research is needed to determine if a clinically relevant stroke risk reduction is obtainable with warfarin in HF patients with prior stroke and reduced EF .


High intake of added sweeteners is considered to have a causal role in the pathogenesis of cardiometabolic disorders .


Especially , high-fructose intake is regarded as potentially harmful to cardiometabolic health .


It may cause not only weight gain but also low-grade inflammation , which represents an independent risk factor for developing type @ diabetes and cardiovascular disease .


In particular , fructose has been suggested to induce plasminogen activator inhibitor-@ ( PAI-@ ) expression in the liver and to increase circulating inflammatory cytokines .


We therefore aimed to investigate , whether high-fructose diet has an impact on PAI-@ , monocyte chemoattractant protein-@ ( MCP-@ ) , e-selectin and C-reactive protein ( CRP ) concentrations in healthy humans .


We studied @ participants ( @ males and @ females ) of the TUebingen FRuctose Or Glucose study .


This is an exploratory , parallel , prospective , randomized , single-blinded , outpatient , hypercaloric , intervention study .


The participants had a mean age of @ @ years and a mean body mass index of @ @ kg/m ( @ ) and they received @ g of either fructose or glucose per day for @ weeks .


There were neither significant changes of PAI-@ , MCP-@ , e-selectin and CRP after fructose ( n = @ ) and glucose ( n = @ ) intervention nor treatment effects ( all P > @ ) .


Moreover , we did not observe longitudinal associations of the inflammatory parameters with triglycerides , liver fat , visceral fat and body weight in the fructose group .


Temporary high-fructose intake does not seem to cause inflammation in apparently healthy people in this secondary analysis of a small feeding trial .


Studies have demonstrated that plasmakinetic enucleation of the prostate ( PKEP ) and open prostatectomy ( OP ) have equivalent short-term efficacy for large prostates , but no comparison concerning their long-term results was reported .


To demonstrate the noninferiority of PKEP to OP concerning maximum urinary flow rate ( Qmax ) at @ yr postoperatively and to compare the long-term results of both procedures .


From @ to @ , @ patients with prostates > @g were randomized to receive PKEP or OP .


A total of @ patients ( @ % ) completed the noninferiority study , and @ patients ( @ % ) finished a @-yr follow-up assessment .


The PKEP procedures were performed with @F Karl Storz continuous flow resectoscopy and the Gyrus PlasmaKinetic device .


OP was performed by a suprapubic transvesical approach .


The primary end point was Qmax at @ yr postoperatively .


Secondary end points included other perioperative parameters and postoperative micturition variables .


The student t test , Mann-Whitney U test , chi-square test , or Fisher exact probability test was used as appropriate .


PKEP was noninferior to OP regarding Qmax at @ yr postoperatively .


Compared with OP , PKEP was associated with less perioperative hemoglobin decrease , shorter catheterization time , and shorter postoperative hospital stay ( @ vs @ g/dl , @ vs @h , and @ vs @ d , respectively ; p < @ for all ) , as well as fewer short-term complications ( @ % vs @ % , p = @ ) .


On intention-to-treat analysis , both the PKEP and OP groups had equivalent Qmax ( @ ml/s vs @ ml/s , respectively ; p = @ ) , International Prostate Symptom Score ( @ -LSB- @-@ -RSB- vs @ -LSB- @-@ -RSB- , respectively p = @ ) , quality of life ( @ -LSB- @-@ -RSB- vs @ -LSB- @-@ -RSB- , respectively ; p = @ ) , and postvoid residual urine ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ -RSB- ml , respectively ; p = @ ) at @ mo postoperatively .


No patients required reoperation because of recurrence of BPH .


The relatively small sample size is the limitation .


PKEP is a durable procedure with short - to long-term micturition improvement equivalent to OP and significantly lower perioperative morbidity .


We compared PKEP with OP for large prostates and found that PKEP is less invasive , with short - to long-term micturition improvement equivalent to OP .


To evaluate whether treatment of mild gestational diabetes mellitus ( GDM ) confers sustained offspring health benefits , including a lower frequency of obesity .


Follow-up study of children ( ages @-@ ) of women enrolled in a multicenter trial of treatment versus no treatment of mild GDM .


Height , weight , blood pressure , waist circumference , fasting glucose , fasting insulin , triglycerides , and HDL cholesterol were measured .


Five hundred of @ eligible offspring ( @ % ) were enrolled .


Maternal baseline characteristics were similar between the follow-up treated and untreated groups .


The frequencies of BMI @th ( @ % and @ % ) and @th ( @ % and @ % ) percentiles were not significantly different in treated versus untreated offspring ( P = @ and P = @ ) .


No associations were observed for BMI z score , log waist circumference , log triglycerides , HDL cholesterol , blood pressure , or log HOMA-estimated insulin resistance ( HOMA-IR ) .


The effect of treatment was different by sex for fasting glucose and log HOMA-IR ( P for interaction = @ and @ , respectively ) but not by age-group ( @-@ and @-@ years ) for any outcomes .


Female offspring of treated women had significantly lower fasting glucose levels .


Although treatment for mild GDM has been associated with neonatal benefits , no reduction in childhood obesity or metabolic dysfunction in the offspring of treated women was found .


However , only female offspring of women treated for mild GDM had lower fasting glucose .


To evaluate the long-term effects of an illicit drug use prevention program for adolescents that integrates life skills into the theory of planned behavior .


We conducted a cluster-randomized trial in which @ participating schools were randomized to either an intervention group ( @ schools , n = @,@ students ) or a control group ( @schools , n = @ students ) .


Participants were grade @ students .


The intervention comprised a main intervention of @ sessions and two booster interventions .


Booster @ ( four sessions ) and booster @ ( two sessions ) were performed at @months and @months , respectively , after completion of the main intervention .


Assessments were made at baseline , after the main intervention , and after each booster session using specific questionnaires for measuring participants ' attitudes , subjective norms , perceived behavioral control , and life skills .


Retention rates were @ % ( @/@ ,@ ) in the intervention group and @ % ( @/@ ) in the control group after the @-month follow-up .


A significantly lower proportion of intervention group participants reported illicit drug use after the first and second booster sessions compared with control group participants ( @ % vs. @ % and @ % vs. @ % , respectively ; both p < @ ) .


Attitudes , subjective norms , perceived behavioral control , life skills , and behavioral intention scores of theintervention group were significantly higher than those of control group after the first and second booster sessions ( all p < @ ) , suggesting that intervention group students tended to avoid drug use .


A drug use prevention program integrating life skills into the theory of planned behavior may be effective for reducing illicit drug use and improving planned behavior-related constructs in adolescents .


To compare the difference of the clinical efficacy in treatment of nervous tinnitus of kidney deficiency between the combined therapy of Zhuang medicine at Qineihuan point combined with the conventional acupuncture and simple conventional acupancture .


Sixty patients were randomized into an observation group and a control group , @ cases in each one .


In the control group , the conventional acupuncture was applied to Taixi ( KI @ ) , Zhaohai ( KI @ ) , Tinggong ( SI @ ) and Waiguan ( TE @ ) , etc. and the needles were retained for @ min .


In the observation group , on the basic treatment as the control group , Zhuang medicine acupuncture at Qineihuan point was added .


The treatment was given once every day , @ treatments made one session and there were @ days of interval between the sessions .


In @ sessions of treatment , the changes of tinnitus were observed and the clinical efficacy was evaluated .


After treatment , tinnitus score and tinnitus grade were all improved as compared with those before treatment in the two groups ( all P < @ ) and the results in the observation group were better than those in the control group ( all P < @ ) .


The curative and remarkably effective rate was @ % ( @/@ ) and the total effective rate was @ % ( @/@ ) in the observation group , better than @ % ( @/@ ) and @ % ( @/@ ) in the control group ( both P < @ ) .


The combined therapy of Zhuang medicine at Qineihuan point and conventional acupuncture achieves the better efficacy on nervous tinnitus of kidney deficiency as compared with the simple conventional acupuncture .


Presepsin is a soluble fragment of the cluster-of-differentiation marker protein @ ( CD@ ) involved in pathogen recognition by innate immunity .


We evaluated the relation between its circulating concentration , host response , appropriateness of antibiotic therapy , and mortality in patients with severe sepsis .


Plasma presepsin was measured @ , @ , and @ days after enrollment of @ patients with severe sepsis or septic shock in the multicenter Albumin Italian Outcome Sepsis ( ALBIOS ) trial .


They were randomized to albumin or crystalloids .


We tested with univariate and adjusted models the association of single measurements of presepsin or changes over time with clinical events , organ dysfunctions , appropriateness of antibiotic therapy , and ICU or @-day mortality .


Presepsin concentration at baseline ( @ -LSB- @-@ ,@ -RSB- ng/L ) increased with the SOFA score , the number of prevalent organ dysfunctions or failures , and the incidence of new failures of the respiratory , coagulation , liver , and kidney systems .


The concentration decreased in ICU over @ days in patients with negative blood cultures , and in those with positive blood cultures and appropriate antibiotic therapy ; it increased with inappropriate antibiotic therapy ( p = @ ) .


Baseline presepsin was independently associated with , and correctly reclassified , the risk of ICU and @-day mortality .


Increasing concentrations of presepsin from day @ to day @ predicted higher ICU and @-day mortality ( adjusted p < @ and @ , respectively ) .


Albumin had no effect on presepsin concentration .


Presepsin is an early predictor of host response and mortality in septic patients .


Changes in concentrations over time seem to reflect the appropriateness of antibiotic therapy .


The methacholine challenge test quantifies airway hyper-responsiveness , which is measured by the provocative concentration of methacholine causing a @ % decrease in forced expiration volume in @ second ( PC@ ) .


The dose-response effect of inhaled corticosteroids ( ICS ) on PC@ has been inconsistent and within-patient variability of PC@ is not well established .


To determine the effect of high - vs low-dose ICS on PC@ and within-patient variability in those with repeated measurements of PC@ .


A randomized , double-masked , crossover trial was conducted in patients with asthma on controller medications with PC@ of @ mg/mL or lower ( n = @ ) to evaluate the effect of high-dose ( @,@ g/d ) vs low-dose ( @ g/d ) fluticasone for @ weeks on PC@ .


In addition , the variability of PC@ was assessed in participants who underwent @ or @ PC@ measurements on the same dose of ICS ( n = @ ) over a @-week interval .


Because there was a significant period effect , dose comparison of the change in PC@ was assessed in the first treatment period .


There was no significant difference in the change in PC@ for high - vs low-dose ICS ( @ % vs @ % increase , respectively ; P = @ ) .


The within - and between-participant variances for log PC@ were @ and @ , respectively , with an intra-class correlation of @ , and @ % of participants had more than @ doubling dose changes in PC@ in those with repeated measurements .


The effect of ICS on PC@ is not dose dependent at fluticasone levels of @ and @,@ g/d .


Interpersonal variability for PC@ is large .


A lack of precise measurements should be taken into account when interpreting any change in PC@ .


Selenium supplementation for women infected with HIV may increase genital shedding of HIV-@ , however , to our knowledge , no studies have examined the effect on viral shedding in breast milk .


The aim of this study was to determine the effect of selenium supplementation on HIV-@ RNA detection in breast milk of HIV-infected women .


HIV-infected pregnant women enrolled at @ to @ wk gestation in a randomized , double-blind , placebo-controlled trial of daily selenium ( @ g as selenomethionine ) had cell-free HIV-@ RNA quantified in breast milk at @ to @ wk postpartum .


All participants received high-dose multivitamins containing vitamin B complex , C , and E as standard of care .


The proportion of women with detectable ( > @ copies/mL ) HIV-@ RNA in breast milk appeared to be increased in the selenium group ( @ % ) compared with those in the placebo group ( @ % ) among the total cohort ( N = @ ) , but results were borderline statistically significant ( relative risk -LSB- RR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P = @ ) .


In secondary analyses , the proportion of women with detectable HIV-@ RNA in breast milk was significantly greater in the selenium group ( @ % ) compared with placebo group ( @ % ) among women who did not receive highly active antiretroviral therapy ( HAART ; RR , @ ; @ % CI , @-@ @ ; P = @ ) .


This relationship was primarily due to a significant effect of selenium among primiparous women ( RR , @ ; @ % CI , @-@ @ ; P < @ ) , but not multiparous women ( RR , @ ; @ % CI , @-@ @ ; P = @ ) ( P-value for interaction = @ ) .


Too few women received HAART in this study ( n = @ ) to establish the effect of selenium supplementation .


Selenium supplementation appears to increase HIV-@ RNA detection in breast milk among primiparous women not receiving HAART .


Safety studies among pregnant women on HAART need to be conducted before administering selenium-containing supplements .


Published studies have reported conflicting results regarding the effects of cinnamon on glucose , lipids and insulin .


To gain further insight into the metabolic effects of Cinnamomum cassia we performed randomized , double-blinded placebo-controlled study using euglycaemic-hyperinsulinaemic clamp .


Twenty-one subjects with impaired glucose tolerance ( IGT ) were included in the study ( @ or @ subjects in each group ) .


The study groups were matched for age , gender and body mass index ( BMI ) .


Waist-to-hip ratio , BMI , blood pressure , fasting blood glucose , insulin , triglycerides , total cholesterol , low-density lipoprotein , high-density lipoprotein , HbA@c , ASAT , ALAT , bilirubin , ALP , GT and PK were measured before and after the intake of capsules equivalent to @ g cinnamon twice a day for @ weeks .


The changes in insulin resistance were measured by euglycaemic-hyperinsulinaemic clamp .


The Wilcoxon signed rank sum test , the Mann-Whitney U test and Pearson 's chi-squared test were used to analyse the data .


Values of p < @ were considered to indicate statistically significant differences .


At enrolment , the groups were similar in terms of age , gender and BMI .


Of the @ randomized patients with IGT , @ completed the study ( @ controls vs. @ treated ) .


The ingestion of @ g cinnamon twice a day for @ weeks had no significant effect on insulin sensitivity , HbA@c , fasting glucose or BMI .


No significant changes were seen in lipids or liver enzymes .


This study showed that ingestion of @ g C. cassia twice a day for @ weeks did not change the insulin sensitivity or liver enzymes in subjects with IGT .


Up to @ % of patients suffer from long-term functional restrictions following conservative treatment of distal radius fractures .


Whether duration of cast immobilisation influences functional outcome remains unclear .


The aim of the study is to evaluate whether the duration of immobilization of non or minimally displaced distal radial fractures can be safely reduced .


We will compare three weeks of plaster cast immobilization with five weeks of plaster cast immobilization in adult patient with non or minimally displaced distal radial fractures .


a prospective randomized clinical trial .


adult ( > @ years ) ( independent in activities of daily living ) patients with a non/minimal displaced distal radius fracture ( dorsal angulation < @ , volar tilt < @ , radial inclination > @ , ulnar positive variance < @ mm and an articular step off < @ mm ) .


three weeks of plaster cast immobilization versus five weeks of plaster cast immobilization.Main study parameters : primary outcome parameters : Patient related wrist evaluation ( PRWE ) Quick Disability of Arm , Shoulder and Hand ( QUICKDASH ) score after a one year follow-up , and secondary parameters : range of motion , pain level ( VAS ) and complications .


The expectation of this study is that shorter duration of plaster cast immobilisation is beneficial for the patient with a distal radius fracture .


This risk of specific complications is low and generally similar in both treatment options .


Moreover , the burden of the study is not much higher compared to standard treatment .


Follow-up is standardized according to current trauma guidelines .


Literature indicates that both treatment options from the study are accepted for displaced distal radius fractures .


No clear advantage for one treatment options is found at present in the literature , although there is no level I evidence present .


This trial will provide level-@ evidence for the comparison of consolidation and functional outcome between two treatment options for non-displaced distal radial fractures .


The gathered data may support the development of a clinical guideline for conservative treatment of distal radial fractures .


The event-free survival of childhood acute lymphoblastic leukemia ( ALL ) has been reported to be superior when oral methotrexate ( MTX ) and @-mercaptopurine ( @MP ) maintenance therapy ( MT ) is administered in the evening compared to the morning .


In the ALL@ MT study we prospectively registered the intake of MTX/@MP .


The registration was done when blood samples for erythrocyte MTX/@MP metabolite measurements were collected , and referred to the time of intake in the period since last registration .


Nine thousand one hundred ninety-five registrations in total .


The administration of MTX/@MP was scored as morning , midday , or evening .


Of @ patients , @ took their medication consistently in the evening , @ in the evening @-@ @ % of the time , and @ in the evening < @ % of the time , six did not have any registrations .


The circadian schedule did not differ significantly by age , sex , MTX/@MP doses , and average absolute neutrophil counts .


The circadian schedule groups did differ on risk groups ( P = @ ) with fewer HR patients in the @-@ @ % group , and there was a negative correlation between percentage of time on evening schedule and average WBC ( Spearman 's rho -@ ; P = @ ) .


Average WBC was not associated with relapse on ALL@ .


In a Cox multivariate model the circadian schedule of MTX/@MP was not of prognostic significance for the risk of relapse , and the @-year cumulative relapse risk was below @ % in all groups .


An evening schedule may still be recommended based on the previous publications , but in this study morning administration of MTX and @MP does not seem to impact EFS .


To quantify plasma concentrations and determine adverse ocular , renal , or hepatic effects associated with repeated topical ophthalmic application of @ % diclofenac to healthy cats .


@ healthy sexually intact male cats .


A randomized , placebo-controlled crossover study was conducted .


A topical formulation of @ % diclofenac was administered @ times/d for @ days to @ cats , and artificial tear ( control ) solution was administered to the other @ cats .


After a @-day washout period , cats received the other treatment .


Ophthalmic examinations were performed daily .


Plasma samples were obtained on days @ and @ for pharmacokinetic analysis .


A CBC , serum biochemical analysis , urinalysis , determination of urine protein-to-creatinine ratio , and determination of glomerular filtration rate were performed before the start of the study and after each @-day treatment period .


Mild conjunctival hyperemia was the only adverse ocular effect detected .


Maximal drug concentration and area under the curve were significantly higher on day @ than on day @ .


Diclofenac-treated cats had a significantly lower glomerular filtration rate than did control-treated cats after the second but not after the first treatment period , presumably associated with iatrogenic hypovolemia .


Topical ophthalmic administration of @ % diclofenac was well tolerated in healthy cats , with only mild signs of ocular irritation .


Detectable systemic concentrations of diclofenac were achieved with accumulation over @ days .


Systemic absorption of diclofenac may be associated with reduced glomerular filtration rate , particularly in volume-contracted animals .


Topical ophthalmic @ % diclofenac should be used with caution in volume-contracted or systemically ill cats .


Mild primary hyperparathyroidism ( PHPT ) is a common disease especially in middle-aged and elderly women .


The diagnosis is frequently made incidentally and treatment strategies are widely discussed .


To study the effect of parathyroidectomy ( PTX ) compared with observation ( OBS ) on biochemistry , safety , bone mineral density ( BMD ) , and new fractures .


Prospective , randomized controlled study ( SIPH study ) , with a @-year follow-up .


The study was conducted at multicenter , tertiary referral centers .


Of @ randomized patients with mild PHPT , biochemical data were available for @ patients after @ years , with a mean age at inclusion of @ years ( OBS group , @ males ) and @ years ( PTX group , @ males ) .


Parathyroidectomy vs observation .


Biochemistry , BMD , and new radiographic vertebral fractures .


Serum-calcium and PTH-levels normalized after surgery and did not deteriorate by observation .


BMD Z-scores were normal at inclusion in the lumbar spine ( LS ) and femoral neck ( FN ) .


For LS , BMD Z-scores were stable for @ years with observation , but decreased in FN ( P < @ ) .


After surgery , BMD Z-scores increased significantly in both compartments ( P < @ for both ) , with a highly significant treatment effect of surgery compared to observation ( P < @ ) .


During follow-up , five new clinically unrecognized vertebral fractures were found in @ females , all in the OBS group ( P = @ ) .


Even though new vertebral fractures occurred only in the observation group , the frequency was not significantly different from the surgery group .


Longer follow-up is needed before firm conclusions can be drawn about the long-term safety of observation , as opposed to surgery .


The purpose of this multicenter randomly controlled clinical trial was to compare two acellular dermal matrix ( ADM ) materials produced by different processing techniques , freeze-dried ( FDADM ) and solvent-dehydrated ( SDADM ) ADM , in their ability to correct Miller Class I and II recession defects .


Eighty individuals from four study centers , each with a single maxillary anterior Miller Class I or II recession defect were enrolled .


Participants were randomly assigned and treated with coronally advanced flap ( CAF ) + FDADM ( n = @ ) or CAF + SDADM ( n = @ ) .


Gingival thickness , recession depth , recession width , probing depth ( PD ) , clinical attachment level , gingival index , plaque index , patient discomfort , and wound healing index were recorded before surgery ( day @ ) , immediately after surgery ( day @ ) , and @ , @ , @ , @ , and @ weeks postoperatively .


The Student t test , paired t test , and Kruskal-Wallis one-way ANOVA were used to analyze the data .


When evaluating the clinical parameters after @ year , both groups showed significant ( P < @ ) improvement for most of the parameters evaluated when compared to baseline ( day @ ) .


For example , percentage of root coverage was @ % @ % for CAF + FDADM and @ % @ % for CAF + SDADM .


Conversely , no significant differences were observed between the two materials for any clinical parameter tested or for patient satisfaction except PD on the mesial side of the defects ( P = @ ) .


Both FDADM and SDADM can be used successfully to correct Miller Class I or II recession defects .


There were no statistically significant differences between groups for any of the clinical parameters tested .


Total Hip Arthroplasty ( THA ) is being used more commonly in younger higher demand patients .


The purpose of this randomized pilot study was to explore a ) feasibility of comprehensive postoperative rehabilitation compared to usual care following primary THA in subjects < @ years , b ) appropriate outcome measures including performance-based measures and c ) timing of assessments .


@ subjects who underwent primary THA were randomized to receive a three-month out-patient rehabilitation program ( Intervention ) or usual postoperative care ( Control ) .


Subjects were assessed preoperatively , six-weeks postoperatively ( Pre-intervention ) and four and @ months postoperatively ( Post-intervention ) .


Self-report measures were the Western Ontario McMaster Osteoarthritis Index ( WOMAC ) and Rand @-Item Health Survey ( RAND-@ ) .


Performance-based measures included lower extremity strength , walking speed and endurance , and gait laboratory assessment .


Ten Control and @ Intervention subjects with an average age of @ ( SD@ @ ) years were randomized .


All Intervention subjects completed the program without adverse effects .


Although no statistically significantly results were reported , four months postoperatively , Intervention subjects had clinically important differences ( CID ) in strength compared with Control subjects .


Walking endurance , WOMAC and RAND scores improved significantly with no CID noted between groups .


Ten ( @ % ) subjects reported a ceiling effect on the WOMAC ( @ ( @ % ) subjects on Pain ; @ ( @ % ) subject on Function ) .


No group CID were noted in gait measures .


Our recommendations would be that performance-based strength measures should be considered for the primary outcome in this younger cohort .


Because of the ceiling effects with WOMAC Pain , a different pain measure is indicated .


Other more challenging functional performance-based tests should be considered such as a more prolonged endurance test .


There is merit in one-year follow-up as strength improved after four months in both groups .


Long-term complications of cystic fibrosis include osteoporosis and fragility fractures , but few data are available about effective treatment strategies , especially in young patients .


We investigated treatment of low bone mineral density in children , adolescents , and young adults with cystic fibrosis .


We did a multicentre trial in two phases .


We enrolled patients aged @-@ years with cystic fibrosis and low bone mineral density , from ten cystic fibrosis regional centres in Italy .


The first phase was an open-label , @-month observational study of the effect of adequate calcium intake plus calcifediol .


The second phase was a @-month , double-blind , randomised , placebo-controlled , parallel group study of the efficacy and safety of oral alendronate in patients whose bone mineral apparent density had not increased by @ % or more by the end of the observational phase .


Patients were randomly assigned to either alendronate or placebo .


Both patients and investigators were masked to treatment assignment .


We used dual x-ray absorptiometry at baseline and every @ months thereafter , corrected for body size , to assess lumbar spine bone mineral apparent density .


We assessed bone turnover markers and other laboratory parameters every @-@ months .


The primary endpoint was mean increase of lumbar spine bone mineral apparent density , assessed in the intention-to-treat population .


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


We screened @ patients and enrolled @ ( mean age @ years , SD @ , range @-@ ) .


In the observational phase , treatment with calcium and calcifediol increased bone mineral apparent density by @ % or more in @ patients ( @ % ) .


@ patients entered the randomised phase .


Bone mineral apparent density increased by @ % in the alendronate group ( n = @ ) versus @ % in the placebo group ( n = @ ; p = @ ) .


@ of @ young people ( @ % ) receiving alendronate attained a normal-for-age bone mineral apparent density Z score .


In the observational phase , five patients had moderate episodes of hypercalciuria , which resolved after short interruption of calcifediol treatment .


During the randomised phase , one patient taking alendronate had mild fever versus none in the placebo group ; treatment groups did not differ significantly for other adverse events .


Correct calcium intake plus calcifediol can improve bone mineral density in some young patients with cystic fibrosis .


In those who do not respond to calcium and calcifediol alone , alendronate can safely and effectively increase bone mineral density .


The optimal crystalloid solution to use perioperatively in patients undergoing open radical cystectomy remains unclear .


Many of the fluids used for intravenous hydration contain supraphysiologic concentrations of chloride , which can induce hyperchloremia and metabolic acidosis , resulting in renal vasoconstriction and decreased renal function .


In addition , patients receiving less fluid and less sodium show faster recovery of gastrointestinal ( GI ) function after colonic surgery .


This is an investigator-initiated , single-center , randomized , controlled , parallel group trial with assessor-blinded outcome assessment , in the Department of Urology , University Hospital Bern , Switzerland .


The study will involve @ patients with bladder cancer scheduled for radical cystectomy and urinary diversion .


The primary outcome is the duration between the end of surgery and the return of the GI function ( first defecation ) .


Secondary outcomes are fluid balance ( body weight difference postoperatively versus preoperatively ) and the incidence of kidney function disorders according to the Risk-Injury-Failure-Loss-End Stage Renal Disease ( RIFLE classification ) .


An equal number of patients are allocated to receive Ringerfundin solution or a glucose/potassium-based balanced crystalloid solution as baseline infusion during the entire time that intravenous administration of fluid is necessary during the perioperative period .


The randomized crystalloid solution is infused at a rate of @ ml/kg/h until the bladder has been removed , followed by @ ml/kg/h until the end of surgery .


Postoperative hydration is identical in both groups and consists of @,@ ml of the randomized crystalloid solution per @ hours .


Postoperative patient care is identical in both groups ; patients are allowed to drink clear fluids immediately after surgery , and liquid diet is started on postoperative day @ , as well as active mobilization and the use of chewing gum .


Body weight is measured daily in the morning .


Time of first flatus and first defecation are recorded .


This trial assesses the benefits and harms of two different balanced crystalloid solutions for perioperative fluid management in patients undergoing open radical cystectomy with urinary diversion , with regard to return of GI function and effects on postoperative renal function .


Tubal factor accounts for @-@ % of cases of female infertility .


Laparoscopy `` Gold Standard '' for tubal evaluation .


However , it is known that during the initial infection of the fallopian tube mucosal damage occurs , a condition which plays a decisive role in reproduction .


In this prospective randomized study , @ infertile women with evidence of fallopian tube disease were included .


In this , for @ patients ( group @ ) after laparoscopic salpingolysis , salpingostomy we performed an additional step operation transcervical falloposcopy tubal dilatation ( TFTD ) .


@ patients ( group @ ) produced only laparoscopic salpingolysis , salpingostomy .


As a result , TFTD patency of the fallopian tubes for coaxial catheter was restored in @ ( @ % ) of @ tubes with bilateral total occlusion , in @ ( @ % ) of @ with partial occlusion of the bilateral , in @ ( @ % ) of @ total unilateral occlusion and @ ( @ % ) of @ with partial unilateral occlusion .


Total number of pregnancies for one year in the first group of patients was @ ( @ % ) , in the second @ ( @ % ) , of which in the first group @ - intrauterine pregnancies ( @ % ) and in the second - @ ( @ % ) .


Falloposcopy surgeon provides good opportunities for the diagnosis and treatment of intralumen lesions .


Significant increase in the frequency of uterine pregnancy in the case of an additional step - TFTD during salpingolysis , salpingostomy in patients with tubal factor infertility .


To determine clinical and demographic characteristics associated with antimuscarinic treatment response using a regression model .


Adults with overactive bladder ( OAB ) symptoms for > @ months and @ urgency urinary incontinence ( UUI ) episode and @ micturitions per @ hours at baseline were randomized to fesoterodine ( @ mg ) , tolterodine extended-release ( @ mg ) , or placebo in two @-week , double-blind , head-to-head studies .


Fesoterodine-treated patients received @ mg/d during the first week and @ mg/d thereafter .


Patients completed @-day bladder diaries and the Overactive Bladder Questionnaire at baseline and week @ .


Pooled data for changes from baseline to week @ in winsorized UUI episodes , micturitions , and urgency episodes per @ hours and Overactive Bladder Questionnaire Symptom Bother and health-related quality of life scores were analyzed posthoc using a regression model that selects outcome predictors from baseline values and patient characteristics while retaining baseline values and treatment , with stepwise inclusion of significant covariates and assessment of treatment interactions .


Logistic regression was used for analysis of diary-dry rates .


Younger age , lack of previous antimuscarinic treatment , shorter duration of OAB diagnosis , and female gender were common predictors of larger changes in outcomes from baseline to week @ .


Baseline measures often interacted with treatment , such that poorer baseline outcomes were predictive of larger treatment differences .


Longer duration since OAB diagnosis predicted greater treatment differences for UUI episodes and in diary-dry rate , and increased age predicted greater treatment differences for micturitions .


Symptom severity and duration , age , gender , and previous antimuscarinic pharmacotherapy impact the response to antimuscarinic treatment .


To compare long-term functional and radiological outcome following microfracture technique ( MF ) versus osteochondral autologous transplantation ( OAT ) mosaicplasty for treating focal chondral lesions of the knee .


Twenty-five patients ( mean age @ years , SD @ ) with a full-thickness ( International Cartilage Repair Society grade @ or @ ) chondral lesion of the articulating surface of the femur were randomized to either MF ( n = @ ) or OAT mosaicplasty ( n = @ ) .


At a median follow-up of @ years ( range @-@ @ ) , the patients were evaluated using Lysholm score ( n = @ ) , Knee Injury and Osteoarthritis Outcome Score ( KOOS , n = @ ) , isokinetic quadriceps measurement and hamstring strength measurement ( n = @ ) and standing radiographs ( n = @ ) .


There were no significant differences in Lysholm score , KOOS , isokinetic muscle strength or radiographic osteoarthritis between MF-treated patients and OAT mosaicplasty-treated patients at follow-up .


Mean Lysholm score at follow-up was @ -LSB- @ % confidence interval ( CI ) , @-@ @ -RSB- for the MF group and @ ( @ % CI , @-@ @ ) for the OAT mosaicplasty group .


At long-term follow-up , there were no significant differences between patients treated with MF and patients treated with OAT mosaicplasty in patient-reported outcomes , muscle strength or radiological outcome .


Therapeutic study , Level II .


Studies suggest that smokers present more or greater numbers of potential periodontal pathogens than non-smokers .


The aim of this study was to investigate the microbiologic effects of adjunctive aPDT on nonsurgical periodontal treatment in smokers with chronic periodontitis ( CP ) .


Twenty smokers with CP had two contralateral teeth randomly assigned in a split-mouth design to receive SRP ( CG ) or SRP + a single episode of aPDT ( TG ) , with a diode laser and a phenothiazine photosensitizer .


Levels of @ subgingival species were measured using checkerboard DNA-DNA hybridization at baseline and @ , @ and @ weeks after periodontal treatment .


All @ bacterial species evaluated were detected in different levels at baseline , with no statistic significant differences between groups .


After periodontal treatment , the levels of some bacterial species decreased , while some other species presented an increase .


Despite this variation , the statistical analysis was not able to identify significant differences neither at intragroup nor at intergroup comparisons .


Periodontal treatment with SRP or SRP + aPDT was not able to reduce levels of @ subgingival species in smokers with CP .


These outcomes indicate that smoking impairs periodontal healing after nonsurgical treatment even associated with aPDT .


To evaluate whether patients with rheumatoid arthritis who did not respond sufficiently to tocilizumab ( TCZ ) plus disease-modifying antirheumatic drug ( DMARD ) treatment by Week @ responded at later timepoints when continuing to take their original dose of TCZ .


In this posthoc analysis of data from phase III randomized controlled trials of inadequate responders ( IR ) to DMARD or tumor necrosis factor - inhibitors ( anti-TNF ) , percentages of patients meeting early response criteria were calculated by randomized treatment arm ( TCZ @ mg/kg , @ mg/kg , or placebo in combination with DMARD ) .


Percentages of patients achieving certain disease activity thresholds at later timepoints were calculated for patients who had/had not achieved response by Week @ .


In DMARD-IR early nonresponders , @ % , @ % , and @ % of TCZ @ mg/kg-randomized , TCZ @ mg/kg-randomized , and placebo-randomized patients , respectively , achieved @-joint Disease Activity Score ( DAS@ ) @ by Week @ .


Among anti-TNF-IR patients without early response , @ % , @ % , and @ % of TCZ @ mg/kg-randomized , TCZ @ mg/kg-randomized , and placebo-randomized patients , respectively , achieved DAS@ @ at Week @ .


A substantial number of DMARD-IR patients taking TCZ @ or @ mg/kg and anti-TNF-IR patients taking TCZ @ mg/kg who failed to respond by @ weeks benefited from continued TCZ treatment in combination with DMARD .


In contrast , the anti-TNF-IR patients without early responses who continued to take TCZ @ mg/kg were unlikely to experience a cumulative benefit .


ClinicalTrials.gov registration numbers : NCT@ , NCT@ , NCT@ , NCT@ .


The objective of this study was to assess the safety , tolerability , pharmacokinetics , and pharmacodynamics of selexipag , an orally available selective prostacyclin receptor agonist , in development for pulmonary arterial hypertension in healthy subjects .


This was a double-blind , placebo-controlled , randomised , multiple-ascending-dose , up-titration study .


Male subjects received increasing oral doses of selexipag ( @-@ ,@ g ; n = @ ) or placebo ( n = @ ) twice daily for @ days each , using incremental steps of @ g between each dose level .


Standard safety and tolerability data were collected .


Blood samples were taken to assess the pharmacokinetics of selexipag and its active metabolite ACT-@ and possible effects on platelet aggregation .


Dose levels of selexipag up to @,@ g were well tolerated and this dose was identified as the maximum tolerated dose .


Plasma exposure to ACT-@ was approximately @ times higher than that to selexipag .


Steady-state conditions for both compounds were reached on day @ of each dose level , and no accumulation of selexipag or ACT-@ was observed .


Based on the area under the curve and the maximum plasma concentration , the pharmacokinetics of selexipag and ACT-@ were dose proportional .


At the highest dose level , the geometric mean terminal half-life of selexipag and ACT-@ was @ and @ h , respectively .


The observed effects on platelet aggregation were variable without obvious drug - or dose-dependent pattern .


Oral administration of increasing doses of selexipag was well tolerated .


The present results support the conduct of future clinical trials .


The objective of this study was to compare the costs and outcomes of two sexually transmitted infection ( STI ) screening interventions targeted at men in football club settings in England , including screening promoted by team captains .


A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms : ( @ ) captain-led and poster STI screening promotion ; ( @ ) sexual health advisor-led and poster STI screening promotion and ( @ ) poster-only STI screening promotion ( control/comparator ) .


For all study arms , resource use and cost data were collected prospectively .


There was considerable variation in uptake rates between clubs , but results were broadly comparable across study arms with @ % of men accepting the screening offer in the captain-led arm , @ % in the sexual health advisor-led arm and @ % in the poster-only control arm .


The overall costs associated with the intervention arms were similar .


The average cost per player tested was comparable , with the average cost per player tested for the captain-led promotion estimated to be @ compared with @ for the sexual health advisor-led promotion and @ for the poster-only ( control ) arm .


Costs and outcomes were similar across intervention arms .


The target sample size was not achieved , and we found a greater than anticipated variability between clubs in the acceptability of screening , which limited our ability to estimate acceptability for intervention arms .


Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated .


To explore the regulatory effects of established Chinese herbal formulas on inflammatory mediators released during asthma attacks , and to elucidate the molecular mechanism of Traditional Chinese Medicine in the treatment of asthma .


Seventy-five asthmatic children were randomly divided into a Chinese medication group ( @ cases ) and a Western medication control group ( @ cases ) .


Patients in the Chinese medication group were treated with a series of established Chinese herbal formulas , whereas the Western medication control group received a leukotriene receptor antagonist and a bronchial relaxant .


Real-time PCR was used to determine the mRNA expression levels of interleukin ( IL ) -@ , cysteinyl leukotriene receptor @ ( CysLTR@ ) , and interferon ( IFN ) - gamma in peripheral blood mononuclear cells before and after treatment .


Enzyme-linked immunosorbent assay was used to measure the peripheral blood levels of IL-@ , leukotriene ( LTE ) -@ , and INF-gamma before and after treatment .


After treatment , the mRNA expression levels of IL-@ and CysLTR@ were down-regulated ( P < @ ) and the mRNA expression levels of IFN-gamma were up-regulated ( P < @ ) in the Chinese medication and Western medication groups ; no significant difference was found between the two groups .


In the Chinese medication group , IL-@ blood level was decreased and it was significantly different from that in the Western medication group ( P < @ ) ; there was also a significant increase in IFN-gamma blood levels after treatment with Chinese medication ( P < @ ) .


There were no significant differences in LTE-@ blood levels between the two groups before and after treatment ( P > @ ) .


Chinese medication has a regulatory effect on leukotriene receptor gene expression and the imbalance of Th@/Th@ immune cells during asthma attacks in pediatric patients .


To determine inter-rater reliability in identifying a knee extension lag using the sitting active and prone passive lag test ( SAPLT ) .


@ patients with a diagnosis of knee pain were randomly assigned and independently examined by two physical therapists at a time , to determine the presence of an active or a passive extension lag at the knee .


An active lag was determined by the inability of the erectly seated subject to actively extend the involved knee in maximal dorsiflexion of the ankle to the same level as the normal knee held in maximal extension and ankle in maximal dorsiflexion , as seen by the levels of the toes .


A passive lag was determined by placing the subject prone with the knees just past the edge of the table and determining the high position of the heel in a fully resting extension position compared to the heel on the normal side .


For the sitting active lag test , the inter-rater reliability was ` good ' ( Kappa @ , SE of kappa @ , @ % confidence interval ) .


For the prone passive lag test , the inter-rater reliability was ` good ' ( Kappa @ , SE of kappa @ , @ % confidence interval ) .


The SAPLT may be incorporated as a simple yet effective test to determine the presence of a knee extension lag .


It identifies the type of restraint , active , passive or both , and is suggestive of the most appropriate management .


In a large cluster-randomized trial on the impact of a prediction model , presenting the calculated risk of postoperative nausea and vomiting ( PONV ) on-screen ( assistive approach ) increased the administration of risk-dependent PONV prophylaxis by anaesthetists .


This change in therapeutic decision-making did not improve the patient outcome ; that is , the incidence of PONV .


The present study aimed to quantify the effects of adding a specific therapeutic recommendation to the predicted risk ( directive approach ) on PONV prophylaxis decision-making and the incidence of PONV .


A prospective before-after study was conducted in @ elective surgical inpatients .


The before-period included care-as-usual and the after-period included the directive risk-based ( intervention ) strategy .


Risk-dependent effects on the administered number of prophylactic antiemetics and incidence of PONV were analysed by mixed-effects regression analysis .


During the intervention period anaesthetists administered @ -LSB- @ % confidence intervals ( CIs ) : @-@ @ -RSB- more antiemetics for patients identified as being at greater risk of PONV .


This directive approach led to a reduction in PONV -LSB- odds ratio ( OR ) : @ , @ % CI : @-@ @ -RSB- , with an even greater reduction in PONV in high-risk patients ( OR : @ , @ % CI : @-@ @ ) .


Anaesthetists administered more prophylactic antiemetics when a directive approach was used for risk-tailored intervention compared with care-as-usual .


In contrast to the previously studied assistive approach , the increase in PONV prophylaxis now resulted in a lower PONV incidence , particularly in high-risk patients .


When one aims for a truly ` PONV-free hospital ' , a more liberal use of prophylactic antiemetics must be accepted and lower-risk thresholds should be set for the actionable recommendations .


Several field triage systems have been developed to rapidly sort patients following a mass casualty incident ( MCI ) .


JumpSTART ( Simple Triage and Rapid Transport ) is a pediatric-specific MCI triage system .


SALT ( Sort , Assess , Lifesaving interventions , Treat/Transport ) has been proposed as a new national standard for MCI triage for both adult and pediatric patients , but it has not been tested in a pediatric population .


This pilot study hypothesizes that SALT is at least as good as JumpSTART in triage accuracy , speed , and ease of use in a simulated pediatric MCI .


Paramedics were invited and randomly assigned to either SALT or JumpSTART study groups .


Following randomization , subjects viewed a @-minute PowerPoint lecture on either JumpSTART or SALT .


Subjects were provided with a triage algorithm card for reference and were asked to assign triage categories to @ pediatric patients in a simulated building collapse .


The scenario consisted of @ children in moulage and @ high-fidelity pediatric simulators .


Injuries and triage categories were based on a previously published MCI scenario .


One investigator followed each subject to record time and triage assignment .


All subjects completed a post-test survey and structured interview following the simulated disaster .


Forty-three paramedics were enrolled .


Seventeen were assigned to the SALT group with an overall triage accuracy of @ % @ % , an overtriage mean rate of @ @ % , and an undertriage rate of @ @ % .


Twenty-six participants were assigned to the JumpSTART group with an overall accuracy of @ @ % , an overtriage mean of @ @ % , and an undertriage rate of @ @ % .


Ease of use was not statistically different between the two systems ( median Likert value of both systems = @ , p = @ ) Time to triage per patient was statistically faster in the JumpSTART group ( SALT = @ @ seconds , JumpSTART = @ @ seconds , p = @ ) .


Both systems were prone to cognitive and affective error .


SALT appears to be at least as good as JumpSTART in overall triage accuracy , overtriage , or undertriage rates in a simulated pediatric MCI .


Both systems were considered easy to use .


However , JumpSTART was @ seconds faster per patient in time taken to assign triage designations .


To explore the clinical efficacy and effect mechanism on chronic urticaria treated with moving cupping therapy combined with autohemotherapy with acupaint injection for desensitization at acupoints .


One hundred and four patients of chronic urticaria were randomized into a comprehensive therapy group and a medication group , @ cases in each one .


In the comprehensive therapy group , the moving cupping therapy along the governor vessel and bladder meridian of foot-taiyang was applied combined with autohemotherapy with acupaint injection for desensitization at acupoints .


The self-venous blood was injected at bilateral Quchi ( LI @ ) and Zusanli ( ST @ ) , @ mL at each acupoint , once every @ days .


In the medication group , cetirizine tablets , @ mg were prescribed for oral administration , once every day , and the compound dexamethasone acetate cream was used externally , once to twice a day .


The clinical efficacy : was observed in @ days of treatment in the two groups .


The changes of serum interleukin @ ( IL-@ ) and immunoglobulin E ( Ig E ) before and after treatment were observed .


The recurrence rate was compared between the two groups in @ months after treatment .


The cured and markedly effective rate was @ % ( @/@ ) in the comprehensive therapy group , which was higher obviously than @ % ( @/@ , P < @ ) in the medication group .


The levels of serum IL-@ and IgE were reduced in the patients of the two groups , indicating the significant difference in comparison before and after treatment ( all P < @ ) and the reducing degree in the comprehensive therapy group was much more significant than that in the medicine group ( both P < @ ) .


The recurrence rate was @ % ( @/@ ) in the comprehensive therapy group in the @-month follow-up after treatment , and apparently lower than @ % ( @/@ , P < @ ) .


The moving cupping therapy combined with autohemotherapy with acupaint injection for desensitization at acupoints achieves the better efficacy on chronic urticaria compared with the routine western medicine treatment and the recurrence rate is low .


The effect mechanism is possibly related to the down-regulation of serum IL-@ and IgE in the patients .


To investigate the education effect of case-based learning ( CBL ) pattern on clinical internship of conservative dentistry and endodontics .


Forty-one undergraduates were randomly assigned into CBL group and traditional teaching group .


After clinical internship in the department of conservative dentistry and endodontics for @ weeks , each student in the @ groups underwent comprehensive examinations including medical record writing , case analysis , academic knowledge , professional skills and the ability of winning the trust of the patients .


The scores were compared between the @ groups using SPSS @ software package .


There was no significant difference between the @ groups with regard to the scores of academic knowledge and profession skills ( P > @ ) .


However , the results of medical record writing , case analysis and the ability of winning the trust of the patients showed significant difference between the @ groups ( P < @ ) .


Proper application of CBL in clinical internship of conservative dentistry and endodontics contributes to improve students ' ability of clinical thinking , synthetical analysis and adaptability to different patients .


People with dementia living in care homes often have complex mental health problems , disabilities and social needs .


Providing more comprehensive training for staff working in care home environments is a high national priority .


It is important that this training is evidence based and delivers improvement for people with dementia residing in these environments .


Well-being and Health for People with Dementia ( WHELD ) combines the most effective elements of existing approaches to develop a comprehensive but practical staff training intervention .


This optimised intervention is based on a factorial study and qualitative evaluation , to combine : training on person-centred care , promoting person-centred activities and interactions , and providing care home staff and general practitioners with updated knowledge regarding the optimal use of psychotropic medications for persons with dementia in care homes .


The trial will be a randomised controlled two-arm cluster single blind trial that will take place for nine months across @ care homes in the United Kingdom .


The overarching goal of this trial is to determine whether this optimised WHELD intervention is more effective in improving the quality of life and mental health than the usual care provided to people with dementia living in nursing homes .


This study will be the largest and best powered randomised controlled trial ( RCT ) evaluating the benefits of an augmented person-centred care training intervention in care homes worldwide .


To observe the clinical effect of slow-rapid reinforcing-reducing needling manipulation at Jiaji ( EX-B @ ) acupoint for lumbar intervertebral disc protrusion .


Sixty subjects met the inclusion criteria of disc herniation were randomly divided into treatment group ( n = @ ) and control group ( n = @ ) .


In the treatment group , the stimulation mode ( slow or fast , reinforcement or reduction ) of Jiaji acupoints ( EX-B @ ) was based on the status of the patients by an overall analysis of symptoms and signs .


Other acupoints such as Huantiao ( GB @ ) , Weizhong ( BL @ ) , etc. were stimulated with uniform reinforcing-reducing manipulation .


In the control group , all the acupoints were stimulated in uniform reinforcing-reducing mode .


The treatment was conducted once a day , continuously for @ days with @ day 's break between every @ days .


The clinical efficacy appraisal , visual analogue scale ( VAS ) and Japanese orthopaedic association ( JOA ) scores and traditional Chinese medicine ( TCM ) syndrome scores were used for outcome assessment .


In comparison with pretreatment , the VAS scores and TCM syndrome scores were significantly decreased in both control and treatment groups ( P < @ ) , and the JOA scores were markedly increased after the treatment ( P < @ ) .


The therapeutic effects of the treatment group were obviously superior to those of the control group in down-regulating the VAS score and TCM syndome score and up-regulating JOA score ( P < @ ) .


Slow-fast reinforcing-reducing needling manipulation is superior to the routine acupuncture in the management of lumbar intervertebral disc protrusion .


There are limited clinical experiments addressing the effects of photodynamic therapy ( PDT ) as an adjunct to conventional scaling and root planing ( SRP ) on clinical and biologic features of periodontitis .


This trial compares the clinical parameters and cytokine profiles in gingival crevicular fluid of patients with moderate-to-severe chronic periodontitis ( CP ) who have been treated using SRP alone or SRP + PDT .


Twenty-two patients with two contralateral teeth affected with moderate-to-severe CP were selected .


After SRP , the participants ' teeth were randomized to receive either no further treatment or a single application of PDT using a @-nm laser and toluidine blue .


Although the change in probing depth was the primary outcome , bleeding on probing , clinical attachment level , gingival recession , interleukin-@ , tumor necrosis factor ( TNF ) - , and matrix metalloproteinase @ and @ were also evaluated at baseline and @ months postintervention .


An oral rinse assay was also performed to determine the total levels of oral polymorphonuclear cells ( PMNs ) before and @ months after the treatments .


Within each group , significant improvements ( P < @ ) were found for all variables in @-month follow-up compared with baseline .


Only TNF - was significantly improved in the PDT + SRP versus SRP group .


Total levels of PMNs were reduced for all patients compared with baseline levels ( P < @ ) .


In patients with CP , a single application of PDT ( using a @-nm laser and toluidine blue ) did not provide any additional benefit to SRP in terms of clinical parameters or inflammatory markers @ months following the intervention .


The combination of ketamine and remifentanil seems to be associated with better analgesia and duration .


The aim of this study was to evaluate whether a ketamine - remifentanil combination promotes improved postoperative analgesia .


Prospective , randomized , double blind study of @ patients undergoing video laparoscopic cholecystectomy .


Anesthesia was performed with remifentanil , propofol , atracurium , and @ % oxygen .


Group @ ( GI ) patients received remifentanil ( @ mcg.kg ( -@ ) .


min ( -@ ) ) and ketamine ( @ mcg.kg ( -@ ) .


min ( -@ ) ) and Group @ ( G@ ) received remifentanil ( @ mcg.kg ( -@ ) .


min ( -@ ) ) and saline solution .


Morphine @ mg.kg ( -@ ) was administered at the end of the procedure , and postoperative pain was treated with morphine via PCA .


We evaluated the severity of postoperative pain by a numerical scale from zero to @ during @ hours .


We registered the time to the first analgesic supplementation , amount of morphine used in the first @ hours , and adverse effects .


There was a decrease in pain severity between extubation and other times evaluated in G@ and G@ .


There was no significant difference in pain intensity between the groups .


There was no difference between G@ ( @ @ min ) and G@ ( @ @ min ) regarding time to first dose of morphine and dose supplement of morphine consumed in G@ ( @ @ mg ) and G@ ( @ @ mg ) .


The combination of ketamine ( @ mcg.kg ( -@ ) .


min ( -@ ) ) and remifentanil ( @ mcg.kg ( -@ ) .


min ( -@ ) ) for cholecystectomy did not alter the severity of postoperative pain , time to first analgesic supplementation or dose of morphine in @ hours .


To observe the efficacy of integrative medical sequential method in treating cerebral palsy ( CP ) children 's intelligence development , muscular tension , serum interleukin @ ( IL-@ ) , and tumor necrosis factor alpha ( TNF-alpha ) .


Totally @ CP children were randomly assigned to the control group ( @ cases ) and the treatment group ( @ cases ) .


All patients received comprehensive rehabilitation training and intravenous dripping of Monosialotetrahexosylganglioside Sodium Injection for @ days .


But those in the treatment group additionally received Chinese medical enema for brain resuscitation , relieving rigidity of muscles and activating collaterals for @ days .


Then they started another medication cycle and lasted for a total of @ cycles .


Serum IL-@ levels and TNF-alpha contents were determined before treatment .


Scoring for muscular tension , Gesell score for intelligence development , contents of serum IL-@ and TNF-alpha were assessed before and after treatment in the two groups .


Compared with before treatment in this group , muscular tension , Gesell scores for intelligence development all decreased in the two groups ( P < @ ) .


As for inter-group comparison , the decrement was more obvious in the treatment group than in the control group ( P < @ ) .


The total effective rate was @ % in the treatment group and @ % in the control group ( P < @ ) .


The contents of IL-@ and TNF-alpha were obviously reduced in the treatment group and the control group after treatment ( P < @ ) .


The decrement was more obvious in the treatment group ( P < @ ) .


The two treatment methods were effective for CP children , but the efficacy was superior in the treatment group than in the control group , indicating integrative medical methods could play a synergistic effect and optimize the treatment program for CP .


A post-hoc analysis was performed on the data from a @weeks phase III study ( ClinicalTrials.gov identifier : NCT@ ) to measure changes in the health-related quality of life ( HRQoL ) of @,@ patients aged @ with moderate-to-severe hypertension who received one of six doses of olmesartan/amlodipine/hydrochlorothiazide ( OLM/AML/HCTZ ) , using the MINICHAL and EQ-@D instruments .


Descriptive statistics were used to assess blood pressure and HRQoL scores over the study period .


Analysis of covariance ( ANCOVA ) was used to identify those factors that could possibly have influenced HRQoL .


Linear regression was used to assess the relationship between changes in blood pressure and HRQoL scores .


Patients ' baseline MINICHAL mood and somatic domains scores were @ and @ .


Over the study period HRQoL improved as both MINICHAL scores decreased by @-@ % .


Patients ' baseline EQ-@D index and VAS scores were @ and @ respectively , increasing by @ % and @ % over the study period .


Patients ' QALY gain over the @weeks study period was estimated to be @ QALYs .


The ANCOVA showed that changes in patients ' HRQoL was likely to have been influenced by patients ' achievement of blood pressure control , the amount of concomitant medication and patients ' last used dosage strength of antihypertensive .


Linear regression showed that blood pressure improvement may have been associated with improved HRQoL .


This study showed that OLM/AML/HCTZ reduced blood pressure and significantly increased blood pressure control whilst improving patients ' HRQoL .


Achieving blood pressure control , amount of concomitant medication and dosage strength of antihypertensive impacted on patients ' HRQoL .


The effect of anaesthetic drugs on long-term oncological outcomes after cancer surgery is an area of current interest .


Dexamethasone is widely used in anaesthetic practice ; however , its effect on long-term survival and cancer outcomes is not known .


This study presents the results of a @-yr follow-up of patients receiving dexamethasone before elective colectomy as part of a previous randomized clinical trial .


Sixty patients who underwent elective open colonic resection for any indication between June @ and March @ were randomized to receive either @ mg i.v. dexamethasone or placebo before surgery .


A @-yr follow-up analysis was conducted to evaluate overall survival , disease-free survival and recurrence specifically for patients undergoing resection for Stage I-III colon cancer .


Kaplan-Meier analysis was performed and log-rank test was used to evaluate difference in survival between groups .


Forty-three of the @ subjects had Stage I-III colon cancer and were included in the follow-up analysis .


Twenty received preoperative dexamethasone and @ received placebo .


There were no significant differences between groups in baseline or disease characteristics .


No differences were found between groups for overall or disease-free survival .


In the dexamethasone group , there was a significantly higher rate of distant recurrence ( @ compared with @ , P = @ ) .


Preoperative dexamethasone was associated with a higher rate of distant recurrence in patients undergoing colectomy for colon cancer .


Given the small sample size , this finding should be interpreted with caution , but warrants further investigation in a prospective study .


The EXAcerbations of Chronic Pulmonary Disease Tool ( EXACT ) is a patient-reported outcome measure to standardize the symptomatic assessment of chronic obstructive pulmonary disease exacerbations , including reported and unreported events .


The instrument has been validated in a short-term study of patients with acute exacerbation and stable disease ; its performance in longer-term studies has not been assessed .


To test the EXACT 's performance in three randomized controlled trials and describe the relationship between resource-defined medically treated exacerbations ( MTEs ) and symptom ( EXACT ) - defined events .


Prespecified secondary analyses of data from phase II randomized controlled trials testing new drugs for the management of chronic obstructive pulmonary disease : one @-month trial ( United States ) ( n = @ ) and two @-month , multinational trials ( AZ @ -LSB- n = @ -RSB- , AZ @ -LSB- n = @ -RSB- ) .


In each case , the experimental drugs were found to be ineffective , permitting assessment of the EXACT 's performance in three independent studies of moderate to severe high-risk patients on maintenance therapies .


The mean age of subjects was @ to @ years ; @ to @ % were male .


Mean FEV@ % predicted was @ to @ % .


EXACT scores exhibited internal consistency ( Cronbach 's @ ) , reproducibility ( intraclass correlation @ ) , correlation with St. George 's Respiratory Questionnaire ( Spearman rho -LSB- rs -RSB- = @ , @ , @ in the three trials ; P < @ ) , and Breathlessness Cough and Sputum Scale ( AZ @ , rs = @ ; AZ @ , rs = @ ; P < @ ) .


EXACT-defined events had a high correspondence with alternative indicators of worsening ( @ , @ , and @ % ) .


In each trial , unreported events were similar in severity ( mean EXACT score , @ , @ , @ vs. @ , @ -LSB- P < @ -RSB- , @ -LSB- P < @ -RSB- , respectively ; @-point scale ) and longer ( median , @ , @ , @ vs. @ , @ -LSB- P < @ -RSB- , @ days , respectively ) than moderate MTEs .


Data generated through the EXACT offers insight into the symptomatic nature of MTEs and the frequency , severity , and duration of unreported symptom-defined events .


Clinical trials registered with www.clinicaltrials.gov ( MPEX : NCT@ ; AZ @ : NCT@ ; AZ @ : NCT@ ) .


Complex regional pain syndrome is multifactorial .


Exaggerated inflammatory responses to limb injury may be involved .


The authors hypothesized that capsaicin-induced pain and neurogenic inflammation ( skin perfusion and flare area ) are increased in patients with complex regional pain syndrome compared with that in controls .


Twenty patients with unilateral upper-limb complex regional pain syndrome and @ age - , sex - , and body mass index-matched controls participated .


Topical capsaicin @ % was applied to the back of both hands for @ min , and pain intensity was assessed on a visual analogue scale .


A laser Doppler perfusion imager scanner estimated capsaicin-induced skin perfusion and flare area .


Autonomic and small-fiber function was assessed by sensory testing , quantitative sudomotor axon reflex test , and vasoconstrictor responses .


The authors found bilateral hypersensitivity to capsaicin ( P @ ) , skin fold ( P = @ ) , joint pressure ( P < @ ) , cold ( P @ ) , and heat pain ( P @ ) in patients compared with that in controls and thermal and mechanical hyperalgesia in the complex regional pain syndrome-affected hand compared with that in the unaffected hand ( P @ ) .


The patients had normal capsaicin-induced flare areas , thermal detection thresholds , quantitative sudomotor axon reflex test , and vasoconstrictor responses .


The main finding is bilaterally increased capsaicin-induced pain in patients compared with controls .


The flare response to capsaicin was normal , suggesting that the increased pain response was not due to increased neurogenic inflammation .


The bilateral hypersensitivity to painful chemical , thermal , and mechanical stimuli not confined to the innervation area of a peripheral nerve or root can not be explained by a regional change and may partly be due to central sensitization .


Diurnal variation in serum growth hormone ( s-GH ) levels after exogenous GH delivery has previously been reported in patients with no endogenous GH secretion .


Changes in postural position or physical activity , leading to changes in blood flow and/or lymphatic drainage may be underlying explanations .


The primary aim of this study is to study a possible impact of exercise and supine rest on pharmacokinetics ( PK ) and day-to-day variation of subcutaneously ( s.c. ) administered GH in adult GH deficient ( AGHD ) patients .


The secondary aim of this study is to compare s-IGF-I , s-insulin , and plasma ( p ) - glucose profiles after a carbohydrate rich breakfast following s.c. GH injection vs. continuous infusion .


During supine rest eight AGHD males ( @ years , BMI @ kg/m ( @ ) ) were treated with one daily s.c. GH injections of @ mg/@ h for @ h ( treatment sessions A , B ) or a continuous s.c. GH infusion of @ mg/@ h for @ h ( treatment sessions C , D ) .


Exercise comprised @ h bicycling with @ W load on two consecutive days during treatment sessions B and D.


Administration of GH as a bolus injection , but not as a continuous GH infusion , resulted in about @ % higher s-GH levels during exercise ( @ min ) as well as @ min after ( s-GH logAUC ( B-A ) difference was @ ; @ % CI : @-@ @ ; p < @ ) .


However , the total s-GH ( AUC @-@ h ) ( p = @ ) and s-IGF-I ( AUC@-@ h ) levels ( p = @ ) remained unchanged between the two occasions .


P-glucose and insulin profiles were significantly higher after carbohydrate rich breakfast before first and second dosing both following s.c. GH injection and continuous infusion ( p < @ ) .


Moderate exercise intermittently increased s-GH levels .


These changes seem to have no clinical short-term relevance , since total s-GH ( @ h ) and s-IGF-I ( @ h ) levels were unaffected .


The purpose of this prospective , randomised study was to evaluate long-term clinical results , radiographic findings , complications and revision and survivorship rates in patients < @ years at a minimum of @ years after undergoing bilateral , sequential , simultaneous , cemented and cementless total knee arthroplasties ( TKAs ) in the same patients .


Bilateral , sequential , simultaneous TKAs were performed in @ patients ( @ knees ) .


There were @ women and @ men with a mean age of @ years ( range @-@ ) , who received a cementless prosthesis in one knee and a cemented prosthesis in the other .


The mean follow-up was @ years ( range @-@ ) .


At final review , the mean Knee Society ( KS ) knee scores ( @ versus @ ) , Western Ontario and McMaster Universities ( WOMAC ) osteoarthritis ( OA ) index ( @ versus @ ) , range of motion ( ROM ) ( @ versus @ ) , patient satisfaction ( @ versus @ ) and radiological results were similar in both groups .


Femoral component survival rate was @ % in both groups at @ years ; at @ years , the cemented tibial component survival rate was @ % and the cementless tibial component @ % .


No osteolysis was identified in either group .


Long-term results of both cementless and cemented TKAs were encouraging in patients with OA who were < @ years .


However , we found no evidence to prove the superiority of cementless over cemented TKAs .


To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy ( CBT ) and acceptance and commitment therapy ( ACT ) for social anxiety disorder .


Session-by-session changes in negative cognitions ( a theorized mediator of CBT ) and experiential avoidance ( a theorized mediator of ACT ) were assessed in @ adult outpatients randomized to CBT ( n = @ ) or ACT ( n = @ ) for DSM-IV social anxiety disorder .


Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments , with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment .


Curvature ( or the nonlinear effect ) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT , but not in CBT , with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only .


Curvature of negative cognitions during both treatments predicted outcome , with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms .


Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT , whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT .


Although the benefits of physical activity ( PA ) on to prevent and manage non-communicable diseases are well known , strategies to help increase the levels of PA among different populations are limited .


Exercise-referral schemes have emerged as one effective approach to promote PA ; however , there is uncertainty about the feasibility and effectiveness of these schemes in settings outside high-income countries .


This study will examine the effectiveness of a scheme to refer hypertensive patients identified in Primary Health Care facilities ( PHCU ) of the Mexican social security institution to a group PA program offered in the same institution .


We will describe the methods of a cluster randomized trial study designed to evaluate the effectiveness of an exercise referral scheme to increasing physical activity in hypertensive patients compared to a non-referral scheme .


Four PHCU were selected for the study ; the PHCU will take part as the unit of randomization and sedentary hypertensive patients as the unit of assessment .


@ PHCU of control group ( GC ) will provide information to hypertensive patients about physical activity benefits and ways to increase it safely .


@ PHCU of intervention group ( IG ) will refer patients to sports facilities at the same institution , to follow a group-based PA program developed to increase the PA levels with a designed based on the Transtheoretical Model and Social Cognitive Theory .


To evaluate the effects of the intervention as well as short-term maintenance of the intervention 's effects , PA will be assessed at baseline , at @ and @ weeks of follow-up .


The main outcome will be the difference before and after intervention in the percentage of participants meeting recommended levels of PA between and within intervention and control groups .


PA will be measured through self-report and with objective measure by accelerometer .


This study will allow us to evaluate a multidisciplinary effort to link the primary care and community-based areas of the same health care system .


Our findings will provide important information about the feasibility and effectiveness of an exercise-referral scheme and will be useful for decision-making about the implementation of strategies for increasing PA among hypertensive and other clinical populations in Mexico and Latin America .


Rheumatoid arthritis ( RA ) patients display high levels of oxidative stress .


Transient exercise-induced increases in oxidative stress are thought to be adaptive in healthy populations .


This study investigated the effect of exercise on markers of oxidative stress in RA , following acute exercise and a period of exercise training .


Acute exercise study : RA patients ( N = @ , age : @ ) undertook a bout of exercise ( @-@min , @ % VO@MAX ) , and blood samples were taken before and after exercise to assess markers of oxidative stress .


Training study : RA patients ( N = @ , age : @ ) were randomised into either a control or exercise group , who undertook @ exercise sessions per week ( @-@min @ @ % VO@MAX ) for @months .


Plasma markers of oxidative stress ( protein carbonyls ( PC ) , lipid hydroperoxides ( LOOH ) , @-nitrotyrosine ( @-NT ) , total antioxidant capacity ( TAC ) and catalase ( CAT ) activity ) , inflammation ( interleukin-@ ( IL-@ ) and C-reactive protein ( CRP ) ) and nitric oxide metabolites ( NOx ) were assessed before and after training .


Acute exercise study : Protein carbonyls ( PC ) ( +@ % ) and NOx ( +@ % ) were significantly increased following exercise .


Training study : @-nitrotyrosine ( @-NT ) decreased ( @ to @ M ) in the exercise group only , alongside increases in aerobic fitness ( @ to @ ml/kg/min ( -@ ) ) and reductions in disease activity score ( DAS : @ to @ ) .


PC , LOOH , TAC , IL-@ , CRP and NOx concentrations , and CAT activity were unchanged in both groups .


Aerobic exercise training did not increase markers of oxidative stress in RA patients .


@-Nitrotyrosine and disease activity were decreased following exercise training .


The application of internet technology for telerehabilitation in patients with stroke has developed rapidly .


The current study aimed to evaluate the effect of a bidirectional and multi-user telerehabilitation system on balance and satisfaction in patients with chronic stroke living in long-term care facilities ( LTCFs ) .


This pilot study used a multi-site , blocked randomization design .


Twenty-four participants from three LTCFs were recruited , and the participants were randomly assigned into the telerehabilitation ( Tele ) and conventional therapy ( Conv ) groups within each LTCF .


Tele group received telerehabilitation but the Conv group received conventional therapy with two persons in each group for three sessions per week and for four weeks .


The outcome measures included Berg Balance Scale ( BBS ) , Barthel Index ( BI ) , and the telerehabilitation satisfaction of the participants .