There was no association between treatment with candesartan and risk of vascular events ( @ of @ -LSB- @ % -RSB- versus @ of @ -LSB- @ % -RSB- ; hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


For functional outcome we found evidence of a negative effect of candesartan ( common odds ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


There was no evidence that blood pressure-lowering treatment with candesartan is beneficial during the first week of hemorrhagic stroke .


Instead , there were signs that such treatment may be harmful , but this needs to be verified in larger studies .


The prognostic significance of long-term visit-to-visit blood pressure variability ( BPV ) has not yet been validated in `` real world '' hypertensive patients .


The aim of the current study is to explore the prognostic value of BPV on stroke in hypertensive patients .


This was a dynamic prospective cohort study based on electronic medical records in Shanghai , China .


Hypertensive patients ( N = @,@ ) without history of stroke at baseline , were followed up from @ to @ .


The cohort comprised of @ stroke patients and @,@ non-stroke patients during a mean follow-up duration of @ months .


BPV was measured by standard deviation ( SD ) and the coefficient of variation ( CV ) of blood pressure .


The visit-to-visit variability of both systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) was independently associated with the occurrence of stroke -LSB- SD : the hazard ratios ( @ % confidence intervals ) of SBP and DBP were @ ( @ to @ ) and @ ( @ to @ ) ; CV : the hazard ratios ( @ % confidence intervals ) of SBP and DBP were @ ( @ to @ ) and @ ( @ to @ ) , respectively -RSB- .


The hazard ratio values increased along with an increase of the BPV levels of SBP and DBP .


The increment effect remained significant after controlling the blood pressure control status of subjects .


Increased BPV of both SBP and DBP , independent of the average blood pressure , is a predictor of stroke among community hypertensive patients in real-world clinical practice .


The risk of stroke increased along with increased BPV .


Stabilizing BPV might be a therapeutic target in hypertension .


Trichotillomania is a psychiatric condition characterized by the chronic pulling and plucking of one 's own hair .


Cognitive-behavioral therapy shows promise as a treatment for trichotillomania and might be preferable to pharmacotherapy .


However , there have been no randomized , controlled studies of the efficacy of group cognitive-behavioral therapy .


We evaluated @ subjects , recruited from April @ to May @ , all of whom met DSM-IV criteria for a diagnosis of trichotillomania .


Subjects were randomized to receive @ sessions of either group cognitive-behavioral therapy or group supportive therapy ( control ) .


Treatment evaluation was non-blind and used self-report scales .


The primary outcome measure was the improvement of hair-plucking behavior as assessed by the Massachusetts General Hospital Hairpulling Scale .


Secondary measures included scores on the Beck Depression Inventory , the Beck Anxiety Inventory , and the Social Adjustment Scale-Self-Report .


Both groups showed significant posttreatment improvement in the scores from the Massachusetts General Hospital Hairpulling Scale ( F = @ , P < @ ) and the Beck Depression Inventory ( F = @ , P = @ ) .


The decrease in hair-plucking behavior over time was significantly greater in the study group than in the control group ( F = @ , P < @ ) .


There were no significant differences between the pretreatment and posttreatment time points or between the groups in the scores from the Beck Anxiety Inventory and the Social Adjustment Scale-Self-Report .


We conclude that group cognitive-behavioral therapy is a valid treatment for trichotillomania .


This treatment model should be further revised and expanded to address comorbidities such as anxiety and social maladjustment .


Longitudinal data on bone mineral density ( BMD ) in children and adolescents with Prader-Willi Syndrome ( PWS ) during long-term GH treatment are not available .


This study aimed to determine effects of long-term GH treatment and puberty on BMD of total body ( BMDTB ) , lumbar spine ( BMDLS ) , and bone mineral apparent density of the lumbar spine ( BMADLS ) in children with PWS .


This was a prospective longitudinal study of a Dutch PWS cohort .


Seventy-seven children with PWS who remained prepubertal during GH treatment for @ years and @ children with PWS who received GH treatment for @ years participated in the study .


The children received GH treatment , @ mg/m ( @ ) / day ( @ mg/kg/d ) .


BMDTB , BMDLS , and BMADLS was measured by using the same dual-energy x-ray absorptiometry machine for all annual measurements .


In the prepubertal group , BMDTB standard deviation score ( SDS ) and BMDLSSDS significantly increased during @ years of GH treatment whereas BMADLSSDS remained stable .


During adolescence , BMDTBSDS and BMADLSSDS decreased significantly , in girls from the age of @ years and in boys from the ages of @ and @ years , respectively , but all BMD parameters remained within the normal range .


Higher Tanner stages tended to be associated with lower BMDTBSDS ( P = @ ) and a significantly lower BMADLSSDS ( P = @ ) .


After @ years of GH treatment , lean body mass SDS was the most powerful predictor of BMDTBSDS and BMDLSSDS in adolescents with PWS .


This long-term GH study demonstrates that BMDTB , BMDLS , and BMADLS remain stable in prepubertal children with PWS but decreases during adolescence , parallel to incomplete pubertal development .


Based on our findings , clinicians should start sex hormone therapy from the age of @ years in girls and @ years in boys unless there is a normal progression of puberty .


To examine disordered eating and associations with health-related quality of life ( HRQOL ) in rural overweight/obese ( OW/OB ) children .


Cross-sectional analyses were conducted with @ rural OW/OB children aged @-@ years ( M = @ ; SD = @ ) .


Child anthropometrics , demographics , disordered eating attitudes , unhealthy weight control behaviors ( UWCBs ) , and HRQOL were measured .


Relationships between these variables were analyzed using bootstrapped multiple linear regressions .


Clinically significant disordered eating attitudes were endorsed by @ % of the sample , and the majority endorsed UWCBs .


Disordered eating attitudes and weight status were the most common predictors of HRQOL .


Disordered eating attitudes and UWCBs were negatively related to emotional HRQOL but were unrelated to social , school , or physical HRQOL .


Disordered eating is a serious and relevant problem in OW/OB children living in rural areas and may be indicative of impairments in emotional functioning .


Early intervention may reduce the risk for eating disorders and associated negative sequelae .


From @ to @ , the International Berlin-Frankfurt-Mnster Study Group conducted a prospective randomized clinical trial ( ALL IC-BFM @ ) for the management of childhood acute lymphoblastic leukemia ( ALL ) in @ countries on three continents .


The aim of this trial was to explore the impact of differential delayed intensification ( DI ) on outcome in all risk groups .


For this trial , @,@ eligible patients were divided into three risk groups according to age , WBC , early treatment response , and unfavorable genetic aberrations .


DI was randomized as follows : standard risk ( SR ) , two @-week intensive elements ( protocol III ) versus one @-week protocol II ; intermediate risk ( IR ) , protocol III @ versus protocol II @ ; high risk ( HR ) , protocol III @ versus either protocol II @ ( Associazione Italiana Ematologia Oncologia Pediatrica -LSB- AIEOP -RSB- option ) , or @ HR blocks plus single protocol II ( Berlin-Frankfurt-Mnster -LSB- BFM -RSB- option ) .


At @ years , the probabilities of event-free survival and survival were @ % ( @ % ) and @ % ( @ % ) for all @,@ eligible patients , @ % and @ % for the SR ( n = @,@ ) , @ % and @ % for the IR ( n = @,@ ) , and @ % and @ % for the HR ( n = @ ) groups , respectively .


No improvement was accomplished by more intense and/or prolonged DI .


The ALL IC-BFM @ trial is a good example of international collaboration in pediatric oncology .


A wide platform of countries able to run randomized studies in ALL has been established .


Although the alternative DI did not improve outcome compared with standard treatment and the overall results are worse than those achieved by longer established leukemia groups , the national results have generally improved .


To evaluate the efficacy and safety of azithromycinfor treatment of uncomplicated pediatric scrub typhus .


A randomized controlled trial was performed .


We compared azithromycin with doxycycline or chloramphenicol in uncomplicated pediatric scrub typhus from inpatient pediatric department of Chiangrai Prachanukroh Hospital .


The primary outcome was cure rate at day @ .


The secondary outcomes were timing to defervescence within @ hours , side effects , and relapsed rate .


We compared data between both groups with Fisher 's exact test or Mann-Whitney U test , and failure rate was demonstrated by Kaplan-Meier survival curve and Log-rank test .


We included @ patients , ofwhom , @ were assigned to doxycycline or chloramphenicol ( control group ) and @ to azithromycin ( study group ) .


The baseline characteristics of both groups were similar The cure rate was @ % in the doxycycline or chloramphenicol group , as compared to @ % in the azithromycin group ( p = @ ) , and a median time to defervescence was @ hours ( IQR @ , @ ) vs. @ hours ( IQR @ , @ ) respectively ( p = @ ) .


There was a little minor side effect in azithromycin group .


No relapsed was found in either groups .


Azithromycin was as effective as doxycycline or chloramphenicol in treatment of uncomplicated pediatric scrub typhus .


Obesity in youth remains a major public health issue .


Yet no effective long-term preventive strategy exists .


We previously showed that a school-based socio-ecological approach targeting behavior and social/environmental influences on physical activity ( PA ) prevented @-year excessive weight gain in @-year olds .


In this study , we investigated if this efficacy persists @ months after intervention cessation .


The program targeted students , family , school and the living environment to promote/support PA and prevent sedentary behavior ( SB ) .


A total of @ students from eight randomized middle schools completed the @-year trial .


At the @-month post-trial follow-up , body mass index ( BMI ) , fat mass index ( FMI ) , leisure PA ( LPA ) , home/school/workplace active commuting , TV/video time ( TVT ) , and attitudes toward PA were measured in @ adolescents .


The beneficial effects of the intervention on the excess BMI increase ( +@ vs +@ kgm ( -@ ) in the intervention and control groups , respectively ) and on the overweight incidence in initially non-overweight students ( @ % vs @ % ; odds ratio = @ ( @ % confidence interval : @-@ @ ) ) were maintained at the post-trial follow-up .


LPA was not maintained at the level achieved during the trial .


However , we still observed a prevention of the age-related decrease of the adolescents ' percentage reporting regular LPA ( -@ % vs -@ % ) and a higher intention to exercise in the intervention group .


The intervention promoted lower TVT ( -@ vs +@ min per day ) and higher active commuting changes ( +@ % vs -@ % ) .


Trends in higher BMI reduction in students with high initial TVT and in the least wealthy group were noted .


TVT changes throughout the follow-up predicted excess BMI and FMI changes .


Long-term multilevel approach targeting PA and SB prevents excessive weight gain up to @ months after intervention cessation .


The efficacy may be higher in the most sedentary and least wealthy adolescents .


Healthy PA-related behavior inducing long-lasting weight effects can be promoted in youth providing that an ecological approach is introduced in the prevention strategy .


Adolescents with chronic disease ( ACD ) must develop independent disease self-management and learn to communicate effectively with their health care team to transition from pediatric to adult-oriented health care systems .


Disease-specific interventions have been implemented to aid specific ACD groups through transition .


A generic approach might be effective and cost-saving .


Eighty-one ACD , aged @ to @ years , were recruited for a randomized clinical trial evaluating an @-month transition intervention ( MD@Me ) .


MD@Me recipients received a @-month intensive Web-based and text-delivered disease management and skill-based intervention followed by a @-month review period .


MD@Me recipients also had access to a texting algorithm for disease assessment and health care team contact .


The intervention was applicable to adolescents with diverse chronic illnesses .


Controls received mailed materials on general health topics .


Disease management , health-related self-efficacy , and health assessments were performed at baseline and at @ and @ months .


Frequency of patient-initiated communications was recorded over the study period .


Outcomes were analyzed according to assigned treatment group over time .


MD@Me recipients demonstrated significant improvements in performance of disease management tasks , health-related self-efficacy , and patient-initiated communications compared with controls .


Outcomes in ACD improved significantly among recipients of a generic , technology-based intervention .


Technology can deliver transition interventions to adolescents with diverse chronic illnesses , and a generic approach offers a cost-effective means of positively influencing transition outcomes .


Further research is needed to determine whether improved short-term outcomes translate into an improved transition for ACD .


NK cells have anti-HIV activity mediated through killer cell immunoglobulin-like receptors ( KIRs ) .


The current prospective cohort study evaluated whether variation in KIR genes is associated with HIV infection in discordant couples ( DCs ) , where one spouse remains seronegative ( HSN ) despite repeated exposure to the HIV .


KIR was genotyped using PCR SSP .


Viral load and CD@ counts were estimated using commercially available reagents .


Data were analyzed using SPSS software .


Among the @ DCs , HSN spouses had significantly ( P = @ ) higher frequencies of KIR@DS@ .


Regression analysis revealed significant ( P = @ ) association of KIR@DS@ with low viral load .


KIR@DS@ variant was associated ( P = @ ) with high viral load .


Three pairs of KIR genes were in strong LD in HSNs and two pairs in HSPs .


There were @ KIR genotypes , and @ are reported the first time in the Indian population .


Exclusive genotypes were present either in HSPs ( N = @ , @ unique genotypes ) or in HSNs ( n = @ , @ unique genotypes ) .


This study highlights for the first time in the Indian population an association of KIR genes in HIV infection where presence of exclusive and unique genotypes indicates possible association with either HIV infection or with protection .


Allergic rhinitis ( AR ) is an inflammatory condition of the nasal mucosa characterized by symptoms of nasal discharge , itching , sneezing , and congestion .


Ocular symptoms are commonly associated with AR and include itching or burning , tearing or watering , and redness .


Intranasal corticosteroids are a mainstay of treatment , and their effect on nasal symptoms is well described .


To demonstrate that a @-day course of @ g/d of nasal fluticasone propionate is superior to placebo in relieving ocular symptoms associated with AR .


This was a randomized , double-blind , parallel group , multicenter study comparing @ g/d of fluticasone propionate with placebo in patients with seasonal allergic rhinitis .


The primary end point was mean change from baseline in patient-rated reflective total ocular symptom score ( rTOSS ) .


Key secondary end points included mean change from baseline in the morning and evening rTOSS , end-of-treatment assessment of response , and effect on activities of daily living .


The primary analysis was performed using analysis of covariance with a linear fixed-effects model .


Fluticasone was statistically significantly more efficacious in reducing the ocular symptoms of AR than placebo .


The least squares mean difference in the change from baseline of rTOSS was -@ ( P = @ ) .


A statistically significant difference in mean change from baseline was observed in favor of fluticasone for morning and evening rTOSS .


Significantly more patients taking fluticasone achieved an overall response compared with placebo .


Fluticasone had a significantly greater effect on daily living activities and was well tolerated .


This study supports the efficacy of fluticasone in treating ocular symptoms associated with AR .


The Checklist During Multidisciplinary Visits for Reduction of Mortality in Intensive Care Units ( Checklist - ICU ) trial is a pragmatic , two-arm , cluster-randomised trial involving @ intensive care units in Brazil , with the primary objective of determining if a multifaceted qualityimprovement intervention with a daily checklist , definition of daily care goals during multidisciplinary daily rounds and clinician prompts can reduce inhospital mortality .


To describe our trial statistical analysis plan ( SAP ) .


This is an ongoing trial conducted in two phases .


In the preparatory observational phase , we collect three sets of baseline data : ICU characteristics ; patient characteristics , processes of care and outcomes ; and completed safety attitudes questionnaires ( SAQs ) .


In the randomised phase , ICUs are assigned to the experimental or control arms and we collect patient data and repeat the SAQ .


Our SAP includes the prespecified model for the primary and secondary outcome analyses , which account for the cluster-randomised design and availability of baseline data .


We also detail the multiple mediation models that we will use to assess our secondary hypothesis ( that the effect of the intervention on inhospital mortality is mediated not only through care processes targeted by the checklist , but also through changes in safety culture ) .


We describe our approach to sensitivity and subgroup analyses and missing data .


We report our SAP before closing our study database and starting analysis .


We anticipate that this should prevent analysis bias and enhance the utility of results .


The aim of this study is to investigate if therapeutic weight loss reduces P wave dispersion .


@ obese patients ( @ males and @ females ) , part of a randomized clinical trial , were examined over a @ month period .


They were treated with a diet , aiming at @ % weight loss at the @th month .


After physical examination , they underwent laboratory tests , bioelectrical impedance analysis and a electrocardiogram ( ECG ) .


ECGs were transferred to a personal computer via a scanner and then magnified @ times .


We examined at baseline and at the @th month , maximum and minimum P-wave duration , P-wave dispersion and heart rate .


Comparing responders ( patients who lost @ % of weight at t@ ) and not responders ( who lost less than @ % ) , responders showed a significant reduction of P wave dispersion value ( -@ -LSB- SD : @ -RSB- mm equal to -@ -LSB- SD : @ -RSB- % p = @ ) .


All responders present a reduction of P wave dispersion , while for not-responders this is no longer evident .


Finally , a good degree of correlation ( r = @ ) between P wave dispersion difference and the decrease of weight was noticed .


Females have a better response in P dispersion reduction strictly connected with their weight loss with a good correlation , ( r = @ , p = @ ) , versus a moderate correlation evidenced in males ( r = @ , p = @ ) .


P wave duration and dispersion are significantly reduced in patients who lost more than @ % of weight and this decrease is highly related to the extent of weight loss .


To evaluate the efficacy and safety of iron protein succinylate ( IPS ) oral solution in preventing and treating anemia of prematurity ( AOP ) .


Sixty premature infants less than @ weeks of gestation were randomly divided into IPS ( n = @ ) and polysaccharide iron complex ( PIC ) groups ( n = @ ) .


Treatment began at two weeks after birth .


The infants received IPS or PIC in addition to recombinant human erythropoietin .


On days @ , @ , @ , and @ after treatment , hemoglobin ( Hb ) , red blood cell count ( RBC ) , hematocrit ( HCT ) , percentage of reticulocytes , serum iron , and serum ferritin were determined .


Liver and renal functions were evaluated before and after treatment .


There were significant differences in the changing trends of RBC and HCT between the two groups ( P < @ ) .


In the IPS group , RBC and HCT gradually decreased after birth , but began to rise gradually on days @ and @ of treatment ; in the PIC group , RBC and HCT kept decreasing from birth to day @ of treatment .


On day @ of treatment , the IPS group had significantly higher levels of Hb , RBC , HCT , serum iron , and serum ferritin than the PIC group ( P < @ ) .


No notable adverse events occurred in either group .


IPS oral solution has good efficacy and tolerability in preventing and treating AOP .


To compare the features of capsulotomy obtained during femtosecond laser-assisted cataract surgery with those of continuous curvilinear capsulorhexis ( CCC ) obtained using a standard manual technique .


Ophthalmology Clinic , Department of Medicine and Science of Ageing , University G. D'Annunzio Chieti-Pescara , Chieti , Italy .


Prospective randomized clinical study .


Candidates for cataract extraction were randomized into @ of @ groups as follows : Lensx femtosecond laser-assisted cataract surgery capsulotomy ( laser group @ ) , Lensar femtosecond laser-assisted cataract surgery capsulotomy ( laser group @ ) , and manual CCC ( manual group ) .


Each group comprised @ eyes ( @ patients ) .


The capsulotomies in laser group @ and laser group @ showed significantly better circularity than the manual CCCs at @ days ( P < @ ) .


There was a significant correlation between the intended versus achieved capsulotomy size in the @ laser groups .


Both laser groups had better intraocular lens ( IOL ) centration than the manual group at all timepoints ( P < @ ) .


Between-group differences in uncorrected and corrected distance visual acuities were not statistically significant .


The residual spherical equivalent and mean absolute error were statistically significantly smaller in the @ laser groups than in the manual group ( P = @ ) and increased significantly over time in all the groups ( P < @ ) .


Femtosecond laser capsulotomies showed better circularity with more predictable size than manual CCCs .


In addition , IOL centration was better immediately after surgery and over time with better refractive results in the @ laser groups .


To evaluate the effect of automated tube voltage selection on radiation dose and image quality at cardiovascular CT angiography ( CTA ) .


We retrospectively analysed paired studies in @ patients ( @ male , @ years ) , who had undergone CTA acquisitions of the heart or aorta both before and after the implementation of an automated x-ray tube voltage selection algorithm ( ATVS ) .


All other parameters were kept identical between the two acquisitions .


Subjective image quality ( IQ ) was rated and objective IQ was measured by image noise , signal-to-noise ratio ( SNR ) , contrast-to-noise ratio ( CNR ) and figure of merit ( FOM ) .


Image quality parameters and effective dose were compared between acquisitions .


Overall subjective image quality improved with the percentage of cases scored as adequate or higher increasing from @ % to @ % after implementation of ATVS ( P = @ ) .


SNR ( @ , @ , P = @ ) , CNR ( @ , @ , P = @ ) , and FOM ( @ , @ , P < @ ) were significantly higher after implementation of ATVS .


Mean image noise ( @ HU , @ HU , P = @ ) and mean effective dose ( @ mSv , @ mSv , P = @ ) were significantly lower after implementation of ATVS .


Automated tube voltage selection can operator-independently optimize cardiovascular CTA image acquisition parameters with improved image quality at reduced dose .


Automatic tube voltage selection optimizes tube voltage for each individual patient .


In this population , overall radiation dose decreased while image quality improved .


This tool may become valuable for improving dose/quality ratio .


Inhaled corticosteroids ( ICSs ) are widely used in asthma control .


Ciclesonide ( CIC ) is an ICS with on-site lung activation for potent anti-inflammatory activity .


This study aimed to compare the clinical benefit of CIC with budesonide ( BUD ) in step-down therapy .


A total of @ patients with mild-to-moderate asthma well controlled by a combination of ICS and long-acting @-agonist were randomised to receive either CIC @g ( n = @ ) once daily or @ inhalations of BUD @g ( n = @ ) twice daily for @ weeks .


The forced expiratory volume in @s ( FEV@ ) , maximum mid-expiratory flow ( MMEF ) and asthma control test ( ACT ) scores were measured .


Ranked stratification of patients and physicians was assessed .


Drug adherence was significantly higher in the CIC group than in the BUD group ( @ % vs. @ % , P = @ ) .


The FEV@ and MMEF remained stable throughout the @-week CIC treatment .


In the BUD group , FEV@ significantly decreased at weeks @ and @ .


MMEF had a higher value in the CIC group than in the BUD group .


Both patients and physicians ranked CIC over BUD .


CIC is more effective and has better drug adherence than BUD as step-down treatment when asthma is well controlled by combination therapy .


The efficacy of psychodynamic therapy ( PDT ) for depression is debated due to a paucity of high-quality studies .


We compared short psychodynamic supportive psychotherapy ( SPSP ) to cognitive behavioral therapy ( CBT ) in a randomized clinical trial .


We used therapist-rated outcomes to examine how the course of change during treatment could be best represented and to compare treatment efficacy , hypothesizing non-significant differences .


Three hundred and forty-one adults meeting DSM-IV criteria for a depressive episode and with Hamilton Depression Rating Scale ( HAM-D ) scores @ were randomized to @ sessions of individual manualized CBT or SPSP .


Severely depressed patients ( HAM-D > @ ) received additional antidepressant medication .


After each session , therapists rated the Clinical Global Impression Scale subscales ` Severity of Illness ' ( CGI-S ) and ` Global Improvement ' ( CGI-I ) , and the DSM-IV Axis V Global Assessment of Functioning Scale ( GAF ) .


We fitted growth curves using mixed model analyses with intention-to-treat samples .


CGI-S and GAF scores during treatment were best represented by a linear symptom decrease .


CGI-I scores were best represented by an S-shaped curve with relative more improvement in the first and last phases than in the middle phase of treatment .


No significant post-treatment treatment differences were found .


A non-significant trend for a treatment effect on CGI-S scores vanished when controlling for therapist gender and profession .


Therapists were not specifically trained for CGI and GAF assessments .


These findings add to the evidence-base of PDT for depression .


Therapist characteristics and differences between severity and improvement measures might influence ratings and need to be taken into account when using therapist-rated outcome measures .


To compare asthma control assessment using the Asthma APGAR system , a tool developed by primary care clinicians , in a multicenter primary care sample with the Asthma Control Test ( ACT ) / Childhood Asthma Control Test ( CACT ) , a tool developed by asthma specialists .


This is a substudy of a multicenter , randomized , controlled pragmatic trial that tests the effectiveness of the Asthma APGAR system in primary care practices .


As part of the study , enrolled patients completed both the ACT/CACT and the Asthma APGAR system between March @ , @ , and December @ , @ .


Kappa and McNemar statistics were used to compare the results of questionnaires .


Of the @ patients in our sample , @ ( @ % ) were classified as not controlled by the ACT/CACT or the Asthma APGAR system .


The overall agreement was @ % , with a kappa value of @ ( substantial agreement ) and a McNemar test P value of @ ( suggesting no significant difference in the direction of disagreement ) .


Of those with poor control as defined by the Asthma APGAR system , @ % ( @ ) had no controller medications and @ % ( @ ) were seldom or sometimes able to avoid identified triggers for their asthma .


Of those who stated that they had been prescribed controller medications , @ of @ ( @ % ) stated that they did not use the controller medication on a daily basis .


The Asthma APGAR system and the ACT/CACT similarly assess asthma control in a multicenter primary care-based sample .


The Asthma APGAR system identified an `` actionable item '' in more than @ % ( @ ) of the individuals with poor asthma control , thus linking an assessment of poor asthma control with a management strategy .


To evaluate the applicability of magnetic resonance imaging ( MRI ) as a method for monitoring the activity of otospongiotic lesions before and after clinical treatment .


Prospective , randomized , controlled , double-blind study .


One single tertiary care institution in a large , cosmopolitan city .


Twenty-six patients ( n = @ ears ) with clinical , audiometric , and tomographic diagnosis of otosclerosis were enrolled .


If computed tomography ( CT ) demonstrated active lesions , these patients underwent MRI to detect otospongiotic foci , seen as areas of gadolinium enhancement .


Patients were divided into @ groups and received treatment with placebo , sodium alendronate , or sodium fluoride for @ months .


After this period , clinical and audiometric evaluations and a second MRI were performed .


Each MRI was evaluated by both a neuroradiologist and an otolaryngologist in a subjective ( visual ) and objective ( using specific eFilm Workstation software ) manner .


Otospongiosis was most predominantly identified in the region anterior to the oval window , and this site was reliable for comparing pre - and posttreatment scans .


The patients in the alendronate and sodium fluoride groups had MRI findings that suggested a decrease in activity of otospongiotic lesions , more relevant in the alendronate group .


These findings were statistically significant for both subjective and objective MRI evaluations .


MRI shows higher sensitivity than clinical or audiometric assessment for detecting reduction in activity of otospongiosis .


The objective MRI evaluation based on software analysis was the most accurate method of monitoring clinical treatment response in otospongiosis .


The PLATINUM randomized trial enrolled @ patients treated with either the platinum chromium PROMUS Element everolimus-eluting stent ( PtCr-EES ; Boston Scientific , Natick , MA , USA ) or the predicate cobalt chromium PROMUS/XIENCE V EES ( CoCr-EES ; manufactured as XIENCE V by Abbott Vascular , Santa Clara , CA , USA also distributed as PROMUS by Boston Scientific ) , including @ patients from Japanese sites .


This substudy examines @-year outcomes in the Japanese and non-Japanese cohorts .


Patients with @ or @ de novo native coronary artery lesions ( baseline vessel diameter @ mm to @ mm and length @mm ) were randomized @:@ to PtCr-EES ( N = @ patients in Japan ) versus CoCr-EES ( N = @ patients in Japan ) .


Several significant differences were noted in baseline demographics , lesion characteristics , and procedural technique between Japanese and non-Japanese patients , including longer fluoroscopy time , less use of contrast , and greater post-dilatation usage and maximum pressure in Japan .


Dual antiplatelet usage at @ years was also higher in Japan .


Despite these differences , the @-year rates of target lesion failure were comparable in patients treated with PtCr-EES and CoCr-EES both in Japan ( @ % vs @ % respectively , p = @ ) and outside Japan ( @ % vs @ % respectively , p = @ ; p for interaction = @ ) .


This PLATINUM study subanalysis suggests that the PtCr-EES and CoCr-EES provide comparable safety and efficacy in both Japanese and non-Japanese patients .


Postoperative sore throat ( POST ) is a frequent consequence following ETT intubation , which may negatively affect the postoperative course and patient satisfaction .


Benzydamine hydrochloride is a topically-applied non-steroidal anti-inflammatory drug ( NSAID ) .


The authors evaluated the analgesic effect of benzydamine hydrochloride dripping on the ETT cuff on POST .


Eighty-six patients participated in this randomized controlled trial .


They were assigned into either the benzydamine hydrochloride or the control group .


The whole ETT cuff was dripped either with @ ml ( @ mg ) of benzydamine hydrochloride or nothing five minutes prior to anesthesia induction .


The incidence and severity of POST at @ , @ , @ , @ , @ and @ hours postoperatively were assessed .


The potential adverse effects of benzydamine hydrochloride ( throat numbness throat burning sensation , dry mouth , and thirst ) were also evaluated .


Twenty-five patients ( @ % ) in each group had POST ( p-value = @ ) .


The severity of POST ( calculated from affected patients ) in both groups at different time points was not significantly different .


Patients in the benzydamine hydrochloride group did not have a higher incidence of adverse effects .


We found that dripping benzydamine hydrochloride on the ETT cuff neither reduced the incidence of POST nor increased the incidence of adverse effects in comparison with no intervention .


Inflammatory bowel diseases impose on patients a broad spectrum of somatic and psychosocial burden .


We hypothesized that patients ' self-responsibility in planning and initiating adequate usually multimodal health care can be supported by self-assessment and proactive information , thus improving health-related quality of life and social participation .


We conducted a randomized controlled trial among a random sample of adult members of a German statutory health insurance with Crohn 's disease or ulcerative colitis with at least @ inflammatory bowel diseases-related hospital stay or sick leave in @ or @ .


Five hundred fourteen patients completed a postal screening questionnaire inquiring about @ problems .


The intervention group ( IG ) received an automated data analysis with individualized written advice on appropriate health services , and the control group received usual care .


Main outcomes were health-related quality of life and social participation .


Secondary outcomes included health care utilization , number of screened problems , and self-management skills .


After @ months , small beneficial effects were seen for all primary outcomes in the IG : EuroQol visual analog scale score ( difference between IG and control group : @ ; @ % confidence interval , @-@ @ ; P = @ ) , index for measuring participation restriction ( IMET ) score ( difference between IG and control group : @ ; @ % confidence interval , @-@ @ ; P = @ ) .


The number of disability days improved only in the IG .


The IG reported significantly fewer outpatient visits , fewer disease-related problems , and improved self-management skills ( health education impact questionnaire scores ) with no increase in disease activity , hospital stays , or consultations with allied health professionals .


Our activation and information procedure is effective and beneficial .


Further studies might show its usefulness in comprehensive management of patients with inflammatory bowel diseases .


To investigate the significance of dynamic monitoring of procalcitonin ( PCT ) in guiding the use of antibiotics for treating patients with sepsis in intensive care unit ( ICU ) .


Eighty-two patients with sepsis from January @ to June @ hospitalized in ICU of First Hospital of Jilin University were enrolled , and they were randomly divided into regular antibiotic therapy group ( RAT group , n = @ ) and PCT monitoring in guiding the use of antibiotics group ( PCT group , n = @ ) .


Patients in RAT group were treated according to principle of antibiotics usage , while in PCT group patients ' PCT value was observed everyday .


When no active symptoms of infection were shown , and acute physiology and chronic health evaluation II ( APACHEII ) scores declined , PCT value decreased over @ % or PCT value lower than @ g/L time point were selected as drug withdrawal indication .


The general status of the patient , antimicrobial drug use time , and prognosis were compared between the two groups , and Kaplan-Meier method was used for survival curve analysis .


Variance analysis was used for repeating measurement to observe dynamic serum PCT level of the two groups of patients for survival and death during @ days .


Mann-Whitney U test or ( @ ) test showed that there were no statistical significance in age , gender , APACHEII score , blood culture positive rate , sputum culture positive rate , cardiac insufficiency , renal failure , respiratory failure , and ventilator and hemofiltration usage ( all P > @ ) .


Log Rank test results showed that the time of antimicrobial drug usage was significantly reduced in PCT group than that in RAT group -LSB- days : @ , @ % confidence interval ( @ % CI @-@ @ ) vs. @ ( @ % CI @-@ @ ) , P = @ -RSB- .


Kaplan-Meier univariate survival curves showed that the speed of curve declination in PCT group was faster significantly than that in RAT group , suggesting that the time of using antimicrobial drug was shortened .


There was no significant difference in length of hospital stay , ICU stay time , number of death in @ days , number of cases of recurrence in @ days and clinical cure rate between two groups ( all P > @ ) .


PCT level in non-survivors in both groups was significantly higher than that in the survivors , exceeding more than @ g/L in the early and late stages of treatment .


Dynamic monitoring of PCT can effectively reduce antimicrobial drug use in ICU patients with sepsis , but there is no significant difference in patients ' prognosis .


The PDY@ study evaluated efficacy , safety and pharmacodynamics of lixisenatide in Japanese and Caucasian patients with type @ diabetes mellitus ( T@DM ) insufficiently controlled with sulphonylureas with/without metformin .


This randomized , double-blind , placebo-controlled trial comprised a single-dose assessment of lixisenatide @ and @g , and a @ - to @-week repeated dose-escalation assessment of lixisenatide @ to @g once ( QD ) or twice daily ( BID ) .


The primary endpoint was change in postprandial plasma glucose ( PPG ) area under the curve ( AUC ) -LSB- @:@ -@:@ h -RSB- after a standardized breakfast at the highest tolerated lixisenatide dose .


Change from baseline in glycated haemoglobin ( HbA@c ) , @-h PPG and fasting plasma glucose ( FPG ) were assessed , as were adverse events .


Change from baseline in PPG AUC -LSB- @:@ -@:@ h -RSB- with lixisenatide QD and BID was significantly greater than placebo ( p < @ for all study populations ) , with particularly prominent effects in Japanese patients .


Greater reductions in PPG AUC -LSB- @:@ -@:@ h -RSB- were seen with lixisenatide QD versus BID , while the totality of evidence suggested that the lixisenatide @g dose was optimal .


In the overall population , changes from baseline for @-h PPG , HbA@c and FPG were significant with lixisenatide QD and BID versus placebo ( p < @ for all ) .


Lixisenatide was well tolerated .


Lixisenatide significantly reduced PPG AUC -LSB- @:@ -@:@ h -RSB- versus placebo at the highest well-tolerated dose in patients with T@DM treated with sulphonylureas with/without metformin and had a good safety and tolerability profile .


Japanese patients experienced particular benefits with lixisenatide in terms of reductions in PPG excursions .


Relatively low radioiodine uptake ( RAIU ) represents a common obstacle for radioiodine ( ( @ ) I ) therapy in patients with multinodular goiter complicated by hyperthyroidism .


To evaluate whether thiamazole ( MTZ ) pretreatment can increase ( @ ) I therapeutic efficacy .


Twenty-two patients with multinodular goiter , subclinical hyperthyroidism , and RAIU < @ % were randomized to receive either a low-iodine diet ( LID ; n = @ ) or MTZ @ mg/d ( n = @ ) for @ days .


Thyroid function and @-hour RAIU were measured before and after treatment .


Thyroid volume was evaluated by either magnetic resonance imaging or single photon emission computed tomography .


Mean @-hour RAIU increased significantly from @ @ % to @ @ % in the MTZ group ( P < @ ) .


Consequently , there was a @ % decrease in the calculated median therapeutic ( @ ) I activity after MTZ ( P < @ ) .


No significant changes in @-hour RAIU were observed after diet .


In the MTZ group , median serum TSH levels increased significantly by @ % and mean serum free T@ and free T@ concentrations decreased by @ % and @ % , respectively , whereas no changes in thyroid function were observed in the LID group .


Thyroid volume did not significantly change in either of the two groups .


At @ months after radioiodine treatment , median serum TSH was within the normal range in both groups .


MTZ treatment before ( @ ) I therapy resulted in an average @-fold increase in thyroid RAIU and enhanced the efficiency of radioiodine therapy assessed at @ months .


MTZ pretreatment is therefore a safe , easily accessible alternative to recombinant human TSH stimulation and a more effective option than LID .


To evaluate pregnancy rates based on the route of progesterone replacement in frozen embryo transfer ( FET ) cycles .


A randomized controlled trial and retrospective analysis .


In the randomized group @ FET cycles were randomized .


In the retrospective group @ FET cycles were reviewed .


Intramuscular ( IM ) proges-erone in oil @ mg daily or oral micronized progesterone prior to transfer followed by compounded vaginal proges-erone @ mg @ times daily ( OV ) .


The main outcome measure was the clinical pregnancy rate ( CPR ) .


Baseline characteristics did not vary be-ween groups in either cohort .


In the randomized group there were no significant differences in CPR ( @ % vs. @ % ) or live birth rate ( LBR ) ( @ % vs. @ % ) for IM and OV progesterone replacement , respectively .


In the retrospective cohort patients there wore also no significant differences in CPR ( @ % vs. @ % ) or LBR ( @ % vs. @ % ) f or the IM and OVp rogester-ne replacement groups , respectively .


This study demonstrates that either OV or IM progesterone is effective for luteal phase support for FETs .


Surgically assisted rapid palatal expansion ( SARPE ) is the procedure of choice for treatment of adults with transverse maxillary deficiency greater than @ mm .


There is no consensus about the dentoskeletal effect of an orthodontic retainer on the outcome of SARPE .


Our objective was to assess the effectiveness of an orthodontic retainer on dentoskeletal stability .


Ninety digitized dental casts of @ adults undergoing SARPE were divided into @ groups-no retention ( n = @ ) and retention ( n = @ ) - and assessed .


The dental casts were obtained at @ checkpoints : ( @ ) @ days on average before SARPE ( preoperatively ) , ( @ ) @ months after expansion , and ( @ ) @ months after expansion was completed .


The retention patients received a transpalatal arch just after expander removal , at checkpoint @ .


The transpalatal arch was kept for @ months after completion of the expansion ( checkpoint @ and end of the study ) .


The dental casts were scanned with a Vivid @i @D laser scanner ( Konica Minolta , Wayne , NJ ) .


The distances measured were premolar and molar intercusp distances , premolar and molar intercervical distances , premolar and molar inter-WALA ( Will Andrews and Lawrence Andrews ) ridge distances , and palate height at the maxillary first molar .


The planned maxillary expansion was within the expected amount ( P < @ ) .


Palatal height at the @-month checkpoint decreased by @ mm ( @ % ) ( P < @ ) and again at the @-month checkpoint by @ mm ( @ % ) ( P > @ ) but not significantly in both groups .


The premolar intercusp distance had a relapse at checkpoint @ of @ mm ( @ % ) ( P < @ ) in the no-retention group .


Both groups had average relapses of @ mm in the premolar intercervical distances , of @ mm in the premolar inter-WALA ridge distances , of @ mm in the molar intercusp distances , of @ mm in the molar intercervical distances , and of @ mm in the molar inter-WALA ridge distances ( P < @ ) at checkpoint @ .


The analysis of relapse in both groups suggests that the use of a transpalatal arch as a retaining device does not improve dento-osseous stability .


Acellular dermal matrix ( ADM ) has been used for antiadhesion formation along with wound healing in various surgical fields .


The aim is to assess the efficacy of ADM implantation in the prevention of postoperative scars and adhesions after conventional , open , total thyroidectomy .


Forty-four patients with papillary thyroid carcinoma undergoing thyroidectomy were randomly assigned to the study ( ADM implantation ) or control group ( without ADM ) .


Global photographic assessment , Vancouver scar scale ( VSS ) , objective scar assessment , and swallowing impairment index were assessed at baseline , immediately after surgery , and at @ and @ months after surgery .


Nineteen control and @ study group participants completed the study .


The mean VSS score of the study group was significantly lower than the controls at both @ month ( @ @ vs @ @ , respectively ) and @ months ( @ @ vs @ @ , respectively ) after surgery .


Scar quality measures ( mean melanin and erythema indexes ) were significantly lower in the study group compared with controls .


Study group participants had significantly lower swallowing impairment scores than controls .


The mean postoperative hospitalization of both groups was not significantly different .


Acellular dermal matrix-assisted implants appear to improve post-thyroidectomy scar and swallowing impairments without delays in operation time .


Heart failure with preserved ejection fraction ( HFpEF ) is associated with substantial morbidity and mortality .


Existing data on cardiac structure and function in HFpEF suggest significant heterogeneity in this population .


Echocardiograms were obtained from @ patients with HFpEF ( left ventricular ejection fraction @ % ) enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist ( TOPCAT ) trial before initiation of randomized therapy .


Average age was @ years , @ % were women , @ % were of African descent , and comorbidities were highly prevalent .


Centralized quantitative analysis in a blinded core laboratory demonstrated a mean left ventricular ejection fraction of @ % , with prevalent concentric left ventricular remodeling ( @ % ) and hypertrophy ( @ % ) , and left atrial enlargement ( @ % ) .


Diastolic dysfunction was present in @ % of gradable participants and was significantly associated with greater left ventricular hypertrophy and a higher prevalence of left atrial enlargement .


Doppler evidence of pulmonary hypertension was present in @ % .


At least @ measure of structural heart disease was present in @ % of patients .


Patients enrolled in TOPCAT demonstrated heterogeneous patterns of ventricular remodeling , with high prevalence of structural heart disease , including left ventricular hypertrophy and left atrial enlargement , in addition to pulmonary hypertension , each of which has been associated with adverse outcomes in HFpEF .


Diastolic function was normal in approximately one third of gradable participants , highlighting the heterogeneity of the cardiac phenotype in this syndrome .


These findings deepen our understanding of the TOPCAT trial population and expand our knowledge of the diversity of the cardiac phenotype in HFpEF .


This study examined the relationships between treatment fidelity and treatment outcomes in a community-based trial of a @-Step Facilitation ( TSF ) intervention .


In a prior multi-site randomized clinical trial , @ participants in @ outpatient drug treatment clinics were assigned to receive the Stimulant Abuser Groups to Engage in @-Step ( STAGE-@ ) intervention .


A secondary analysis reviewed and coded all STAGE-@ sessions for fidelity to the protocol , using the Twelve Step Facilitation Adherence Competence Empathy Scale ( TSF ACES ) .


Linear mixed-effects models tested the relationship between three fidelity measures ( adherence , competence , empathy ) and six treatment outcomes ( number of days of drug use and five Addiction Severity Index ( ASI ) composite scores ) measured at @ months post-baseline .


Adherence , competence and empathy were robustly associated with improved employment status at follow up .


Empathy was inversely associated with drug use , as was competence in a non-significant trend ( p = @ ) .


Testing individual ASI drug composite score items suggested that greater competence was associated with fewer days of drug use and , at the same time , with an increased sense of being troubled or bothered by drug use .


Greater competence and empathy in the delivery of a TSF intervention were associated with better drug use and employment outcomes , while adherence was associated with employment outcomes only .


Higher therapist competence was associated with lower self-report drug use , and also associated with greater self-report concern about drug use .


The nature of TSF intervention may promote high levels of concern about drug use even when actual use is low .


Clinical activity of chemotherapy plus trastuzumab in HER@ overexpressing advanced breast cancer has been documented .


We report the activity and safety results of biweekly combination of trastuzumab , docetaxel and gemcitabine as first-line therapy in HER@-positive advanced breast cancer .


Patients were biweekly treated with trastuzumab ( @ mg/kg ) , gemcitabine ( @ mg/m ( @ ) ) and docetaxel ( @ mg/m ( @ ) ) .


The primary end point was overall response rate , secondary time to progression , clinical benefit rate ( partial response plus complete response plus stable disease for @ weeks ) and tolerability .


A total of @ patients with HER@-positive advanced breast cancer have been enrolled .


In total , @ patients responded ( @ % ; @ % CI , @-@ ) , @ achieved complete response ( @ % ; @ % CI : @-@ @ ) , @ achieved partial response ( @ % ; @ % CI : @-@ @ ) .


The clinical benefit rate was @ % ( @ % CI : @-@ ) .


Three patients ( @ % ) experienced progressive disease .


The median time to progression was @ months ( @ % CI : @-@ @ ) , the median overall survival was @ months and the @-month survival rate was @ % ( @ % CI : @-@ ) .


The worst toxicities were grade @ neutropenia ( @ % ) , thrombocytopenia ( @ % ) and diarrhea ( @ % ) .


No cardiac toxicity was reported .


As first-line therapy , this combination allowed the delivery of polychemotherapy in association to targeted therapy , with clinical activity and mild toxicity .


The promising results should be further explored in Phase III randomized clinical trials .


To assess whether in early ( rheumatoid ) arthritis ( RA ) patients , metacarpal bone mineral density ( BMD ) loss after @months predicts radiological progression after @year of antirheumatic treatment .


Metacarpal BMD was measured @ monthly during the first year by digital X-ray radiogrammetry ( DXR-BMD ) in patients participating in the IMPROVED study , a clinical trial in @ patients with recent onset RA ( @ criteria ) or undifferentiated arthritis , treated according to a remission ( disease activity score < @ ) steered strategy .


With Sharp/van der Heijde progression @ points after @year ( yes/no ) as dependent variable , univariate and multivariate logistic regression analyses were performed .


Of @ patients with DXR-BMD results and progression scores available , @ ( @ % ) had radiological progression after @year .


Independent predictors for radiological progression were presence of baseline erosions ( OR ( @ % CI ) @ ( @ to @ ) ) and early DXR-BMD loss ( OR ( @ % CI ) @ ( @ to @ ) ) .


In @ ( @ % ) patients without baseline erosions , early DXR-BMD loss was the only independent predictor of progression ( OR ( @ % CI ) @ ( @ to @ ) ) .


In early RA patients , metacarpal BMD loss after @months of treatment is an independent predictor of radiological progression after @year .


In patients without baseline erosions , early metacarpal BMD loss is the main predictor of radiological progression .


To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support .


Baseline distress was hypothesized as a moderator of intervention effect .


Randomized trial .


Community-based cancer helplines in Queensland and New South Wales , Australia .


@ patients with cancer and @ caregivers .


Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone .


Assessments were undertaken at baseline ( preintervention ) and at @ , @ , and @ months .


Psychological and cancer-specific distress and post-traumatic growth .


No significant moderation by baseline cancer-specific distress was noted .


For low-education patients , only the psychologist intervention was associated with a significant drop in distress .


For all other participants , distress decreased over time in both arms with small to large effect sizes ( Cohen 's ds = @-@ @ ) .


Post-traumatic growth increased over time for all participants ( Cohen 's ds = @-@ @ ) .


Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials .


Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services .


Survivors and caregivers with low education and low literacy may require more in-depth and targeted support .


Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care .


To compare the effectiveness of controlled-released carbamazepine ( CR-CBZ ) to levetiracetam ( LEV ) and to lamotrigine ( LTG ) in elderly patients with newly diagnosed focal epilepsy .


Randomized , double-blind , parallel-group trial conducted between January @ and August @ , in @ ambulatory or hospital sites in Germany , Austria , or Switzerland .


Eligible participants were aged @ , had new-onset epilepsy , had no acute illness as the cause of their seizures , and had no contraindication to the drugs in the trial .


Patients were randomized @:@:@ to CR-CBZ , LTG , or LEV .


Doses were up-titrated for @ weeks and could be maintained or adjusted depending on seizure relapse or tolerability over an additional period of @ weeks .


Primary outcome was the retention to treatment at week @ ; secondary measures related to seizure and adverse event frequency .


Of @ randomized patients , @ were included ( CR-CBZ n = @ , LTG n = @ , LEV n = @ ) in the modified intent-to-treat population ( mean age -LSB- range -RSB- @ -LSB- @-@ -RSB- years ) .


At week @ , the retention rate for LEV was significantly higher than for CR-CBZ ( @ % vs. @ % , p = @ ) , and similar to LTG ( @ % ) .


Seizure freedom rates at weeks @ and @ were not different across the groups .


Twice as many patients receiving CR-CBZ discontinued due to adverse events or death compared to those in the LEV group ( @ % vs. @ % ; odds ratio @ , @ % confidence interval -LSB- CI -RSB- @-@ @ , p = @ ) , whereas discontinuation was intermediate for LTG ( @ % ) .


Median daily doses of completers ( n = @ ) were CR-CBZ @ mg/day ( @-@ @ ) , LTG @ mg/day ( @-@ @ ) , and LEV @ mg/day ( @-@ @ ) .


In the initial monotherapy of focal epilepsy in the elderly , @-year retention to LEV was higher compared to CR-CBZ due to better tolerability .


Retention of LTG was intermediate and close to LEV , but did not differ significantly from either comparators .


NCT@ , www.clinicaltrials.gov .


To determine whether an evidence-based pediatric outpatient intervention for parents who smoke persisted after initial implementation .


A cluster randomized controlled trial of @ pediatric practices in @ states that received either Clinical and Community Effort Against Secondhand Smoke Exposure ( CEASE ) intervention or usual care .


The intervention provided practices with training to provide evidence-based assistance to parents who smoke .


The primary outcome , assessed by the @-month follow-up telephone survey with parents , was provision of meaningful tobacco control assistance , defined as discussing various strategies to quit smoking , discussing smoking cessation medication , or recommending the use of the state quitline after initial enrollment visit .


We also assessed parental quit rates at @ months , determined by self-report and biochemical verification .


Practices ' rates of providing any meaningful tobacco control assistance ( @ % vs @ % ) , discussing various strategies to quit smoking ( @ % vs @ % ) , discussing cessation medication ( @ % vs @ % ) , and recommending the use of the quitline ( @ % vs @ % ) were all significantly higher in the intervention than in the control groups , respectively ( P < @ for each ) , during the @-month postintervention implementation .


Receiving any assistance was associated with a cotinine-confirmed quitting adjusted odds ratio of @ ( @ % confidence interval : @-@ @ ) .


After controlling for demographic and behavioral factors , the adjusted odds ratio for cotinine-confirmed quitting in intervention versus control practices was @ ( @ % confidence interval : @-@ @ ) .


Intervention practices had higher rates of delivering tobacco control assistance than usual care practices over the @-year follow-up period .


Parents who received any assistance were more likely to quit smoking ; however , parents ' likelihood of quitting smoking was not statistically different between the intervention and control groups .


Maximizing parental quit rates will require more complete systems-level integration and adjunctive cessation strategies .


To examine the feasibility , acceptability , and initial efficacy of a technology-based weight loss intervention for urban , low-income mothers .


Eighteen obese , ethnic minority , socioeconomically disadvantaged mothers in the first year after childbirth were randomly assigned to either : @ ) technology-based intervention , which included empirically supported behavior-change strategies , daily skills , and self-monitoring text messages with personalized feedback , biweekly counseling calls from a health coach , and access to a Facebook support group , or @ ) usual-care control .


After @ weeks of treatment , the technology-based intervention participants had significantly greater weight loss ( -@ @ kg ) than usual care ( @ @ kg ; adjusted mean difference : -@ kg , @ % confidence interval -@ to -@ kg , P = @ ) .


One-third of intervention participants ( @ of @ ) and no control participants lost > @ % of their initial body weight at follow up .


Results suggest the potential for using technology to deliver a postpartum weight loss intervention among low-income racial/ethnic minorities .


A let-@ microRNA-complementary site ( LCS@ ) polymorphism in the @ ' untranslated region of the KRAS gene has been shown to disrupt let-@ binding and upregulate KRAS expression .


We evaluated the LCS@ genotype and its association with KRAS mutation status , clinicopathologic features , and disease-free survival ( DFS ) in patients with stage III colon cancer who enrolled in a phase III clinical trial ( NCCTG N@ ) .


The LCS@ genotype was assayed by real-time PCR in DNA extracted from whole blood ( n = @,@ ) and compared with paired tumor tissue ( n = @ ) .


( @ ) and two-sample t tests were used to compare baseline factors and KRAS mutation status between patients defined by LCS@ variant status .


Log-rank tests and multivariate Cox models assessed associations between LCS@ status and DFS , respectively .


We identified @ ( @ % ) blood samples and @ ( @ % ) tumor samples heterozygous or homozygous for the LCS@ G-allele , and @,@ of @,@ ( @ % ) blood samples and @ of @ ( @ % ) tumor samples homozygous for the LCS@ T-allele .


Genotype results were highly concordant ( @ % ) in cases with paired blood and tumor tissue ( n = @ ) .


G-allele carriers were significantly more frequent in Caucasians versus other races ( ( @ ) test , P < @ ) .


The LCS@ genotype was not associated with KRAS mutation status , clinicopathologic features ( all P > @ ) , or DFS ( log-rank P = @ ; HR , @ ; @ % confidence interval , @-@ @ ) , even after combining LCS@ genotype with KRAS mutation status .


In the largest association study investigating the LCS@ polymorphism in colon cancers , the germline LCS@ genotype was not associated with KRAS mutation status or with clinical outcome in patients with stage III tumors .


To assess whether an interdisciplinary intervention is more effective than usual care for improving the health-related quality of life ( HRQoL ) among patients with fibromyalgia ( FM ) , and to identify variables that were predictors of improvement in HRQoL .


In a randomized controlled clinical trial carried out on an outpatient basis in a hospital pain management unit , @ patients with FM were randomly allocated to an experimental group ( EG ) or a control group ( CG ) .


Participants completed the Fibromyalgia Impact Questionnaire ( FIQ ) at baseline and @months after the intervention .


The EG received an interdisciplinary treatment ( @ sessions for @weeks ) which consisted of coordinated psychological , medical , educational , and physiotherapeutic interventions while the CG received standard-of-care pharmacologic treatment .


Descriptive statistics , ANOVA , Chi square and Fisher tests and generalized linear models were used for data analysis .


Six months after the intervention , statistically significant improvements in HRQoL were observed in physical functioning ( P = @ ) , pain ( P = @ ) and total FIQ score ( P = @ ) in the EG compared to the CG .


The number of physical illnesses was identified as a predictor for improvement .


This interdisciplinary intervention has shown effectiveness in improving the HRQoL of this sample of patients with FM .


The number of physical illnesses was identified as a predictor of that improvement .


To determine the short-term efficacy of oral glucosamine supplementation by evaluating structural lesions in the knee joints , as assessed using @T magnetic resonance imaging ( MRI ) .


This study was designed as a randomized , double-blind , placebo-controlled trial .


Recruitment was performed via mass mailings and an arthritis registry in southwestern Pennsylvania .


In total , @ participants with mild-to-moderate pain in one or both knees , as defined by a Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) pain score @ and @ , were enrolled .


Of these subjects , @ % had a Kellgren/Lawrence grade @ in at least @ knee .


Participants received @ weeks of treatment with @,@ mg glucosamine hydrochloride in beverage form or a placebo beverage .


The primary outcome was decreased worsening of cartilage damage on @T MRI of both knees , assessed according to a validated scoring system , the Whole-Organ MRI Score ( WORMS ) .


Secondary outcomes included change in bone marrow lesion ( BML ) scores in all knees and change in excretion of urinary C-terminal crosslinking telopeptide of type II collagen ( CTX-II ) .


The adjusted odds ratio ( OR ) for the likelihood of decreased cartilage damage over @ weeks in any WORMS-scored subregion of the knee in the glucosamine treatment group compared to the control group was @ ( @ % confidence interval -LSB- @ % CI -RSB- @ , @ ) .


Compared to subjects treated with glucosamine , control subjects showed more improvement in BMLs ( adjusted OR @ , @ % CI @ , @ ) but no difference in worsening BMLs ( adjusted OR @ , @ % CI @ , @ ) over @ weeks .


There was no indication that treatment with glucosamine decreased the excretion of urinary CTX-II ( = -@ , @ % CI -@ , @ ) .


The results of this short-term study provide no evidence of structural benefits ( i.e. , improvements in MRI morphologic features or urinary CTX-II excretion ) from glucosamine supplementation in individuals with chronic knee pain .


Polymorphisms of genes encoding the Fcy receptors ( Fc fragment of IgG receptor @A ( FCGR@A ) and @A ( FCGR@A ) ) , which influence their affinity for the Fc fragment , have been linked to the pharmacodynamics of monoclonal antibodies .


Most studies have been limited by small samples sizes and have reported inconsistent associations between the FCGR@A and the FCGR@A polymorphisms and clinical outcome in metastatic colorectal cancer ( mCRC ) patients treated with cetuximab .


We investigated the association of these polymorphisms and clinical outcome in a large cohort of mCRC patients treated with first-line @-fluorouracil/folinic acid and oxaliplatin ( Nordic FLOX ) + / - cetuximab in the NORDIC-VII study ( NCT@ ) .


@ and @ mCRC patients were evaluable for the FCGR@A and FCGR@A genotyping , respectively .


Genotyping was performed on TaqMan ABI HT @ ( Applied Biosystems , Foster City , CA , USA ) with pre-designed SNP genotyping assays for FCGR@A ( rs@ ) and FCGR@A ( rs@ ) .


The response rate for patients with the FCGR@A R/R genotype was significantly increased when cetuximab was added to Nordic FLOX ( @ % versus @ % , interaction P = @ ) , but was not significantly different compared to the response rate of patients with the FCGR@A H/H or H/R genotypes given the same treatment .


A larger increase in response rate with the addition of cetuximab to Nordic FLOX in patients with KRAS mutated tumors and the FCGR@A R/R genotype was observed ( @ % versus @ % , interaction P = @ ) .


None of the FCGR@A polymorphisms were associated with altered response when cetuximab was added to Nordic FLOX ( interaction P = @ ) .


Neither of the FCGR polymorphisms showed any significant associations with progression-free survival or overall survival .


Patients with KRAS mutated tumors and the FCGR@A R/R polymorphism responded poorly when treated with chemotherapy only , and experienced the most benefit of the addition of cetuximab in terms of response rate .


There is a large body of evidence for the involvement of the parietal cortex in orientation and navigation in space .


This has been supplemented by investigation of the contribution of a number of subregions using transcranial magnetic stimulation .


The role of the precuneus area , located in the medial plane of posterior parietal cortex ( PPC ) , in visuospatial functions is not well understood .


We investigated the contribution of this area using the landmark task .


Participants were asked to make forced-choice judgments of which side of prebisected line was longer for near and far viewing conditions ( @ and @cm , respectively ) .


Online @Hz , repetitive transcranial magnetic stimulation ( rTMS ) was delivered for @ms over the right precuneus , rPPC and vertex ( control ) , in separate blocks of trials .


The rPPC stimulation was used as a positive control , having previously resulted in `` neglect like '' spatial bias effects in a number of studies .


A no-TMS condition showed a leftward spatial bias ( pseudoneglect ) for near space judgments but not for far space and was used as the baseline .


Precuneus stimulation resulted in rightward spatial bias from the midpoint in near space similar to the rPPC neglect-like effect .


No significant effects were seen with vertex stimulation .


This study shows that precuneus , like other parietal areas , is involved in visuospatial functions .


Further work is required to clarify how the contribution of this area differs from other parietal regions .


To determine whether Care Navigation ( CN ) , a nurse-led hospital-based coordinated care intervention , reduced the use of hospital services and improved quality of life for patients with chronic illness .


Randomised controlled trial ; participants were allocated to CN or standard care .


Patients with chronic illness presenting to the emergency department of Nepean Hospital , Sydney , New South Wales .


High-risk status for an unplanned admission was defined as i ) three or more unplanned hospital admissions in @ months for patients aged @ or at least one admission for cardiac or respiratory disease in patients aged @-@ years ; or ii ) judged by a CN nurse to be high risk and likely to benefit .


Numbers of re-presentations or readmissions , quality of life , time to re-presentation , readmission or death , length of stay , and access to hospital and community health services .


@ participants were randomised between May @ and February @ ; @ by previous unplanned admission and @ by clinical impression .


The CN group received more community health services ( rate ratio , @ ; @ % CI , @-@ @ ; P < @ ) than participants receiving standard care ; however , this did not result in statistically significant differences in number of re-presentations ( rate ratio , @ ; @ % CI , @-@ @ ; P = @ ) , number of readmissions ( rate ratio , @ ; @ % CI , @-@ @ ; P = @ ) , quality of life at @ months ( mean difference , @ ; @ % CI , -@ to @ , P = @ ) , or other measures .


CN did not improve quality of life or reduce unplanned hospital presentations or admissions despite community health services almost doubling .


Future service development should explore potential benefits of linking navigated intrahospital care to ongoing , proactive care planning and delivery in the community .


For people with chronic low back pain , does Kinesio Taping , applied according to the treatment manual to create skin convolutions , reduce pain and disability more than a simple application without convolutions ?


Randomised trial with concealed allocation , intention-to-treat analysis and blinded assessment of some outcomes .


@ participants with chronic non-specific low back pain .


Experimental group participants received eight sessions ( over four weeks ) of Kinesio Taping applied according to the Kinesio Taping Method treatment manual ( ie , @ to @ % tension applied in flexion to create skin convolutions in neutral ) .


Control group participants received eight sessions ( over four weeks ) of Kinesio Taping with no tension , creating no convolutions .


The primary outcome measures were pain intensity and disability after the four-week intervention .


Secondary outcomes were pain intensity and disability @ weeks after randomisation , and global perceived effect at both four and @ weeks after randomisation .


Applying Kinesio Tape to create convolutions in the skin did not significantly change its effect on pain ( MD-@ @ points , @ % CI-@ @ to @ ) or disability ( MD-@ @ points , @ % CI-@ @ to @ ) at four weeks .


There was a small difference in favour of the experimental group for the secondary outcome of global perceived effect ( MD @ points , @ % CI @ to @ ) at four weeks .


No significant between-group differences were observed for the other secondary outcomes .


Kinesio Taping applied with stretch to generate convolutions in the skin was no more effective than simple application of the tape without tension for the outcomes measured .


These results challenge the proposed mechanism of action of this therapy .


The estimation of effect size in clinical trials commonly disregards recurrent outcomes .


We investigated the effectiveness of a complex intervention on recurrent outcomes in patients with type @ diabetes .


In the Diabetes Care in General Practice ( DCGP ) randomised controlled trial , @,@ patients newly diagnosed with type @ diabetes were randomised to @ years of structured personal care or routine care ( ClinicalTrials.gov NCT@ ) .


The trial had @ years of registry-based follow-up and was analysed with Cox regression models .


Repeated occurrences in the same patient of outcomes ( any diabetes-related endpoint , myocardial infarction -LSB- MI -RSB- , stroke , peripheral vascular disease and microvascular disease ) were accounted for with the Wei , Lin and Weissfeld method .


As previously shown , the intervention reduced the rates of first occurrence of both MI and any diabetes-related endpoint .


However , for all outcomes , the HR for a second event showed a statistically non-significant tendency to be increased .


We estimated a combined HR for all marginal failure times , regardless of whether they were first , second or later events .


This showed that the intervention had no effect on the rate of any of the outcomes , including MI ( HR @ , @ % CI @ , @ ) and any diabetes-related endpoint ( HR @ , @ % CI @ , @ ) .


In the DCGP study , a smaller proportion of patients who received structured care experienced a first occurrence of MI or any diabetes-related endpoint compared with patients who received routine care .


However , the patients who received structured care tended to experience more recurrent outcomes , so the total outcome rate was not affected by the intervention .


This study sought to report additional safety results from the ROCKET AF ( Rivaroxaban Once-daily oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation ) .


The ROCKET AF trial demonstrated similar risks of stroke/systemic embolism and major/nonmajor clinically relevant bleeding ( principal safety endpoint ) with rivaroxaban and warfarin .


The risk of the principal safety and component bleeding endpoints with rivaroxaban versus warfarin were compared , and factors associated with major bleeding were examined in a multivariable model .


The principal safety endpoint was similar in the rivaroxaban and warfarin groups ( @ vs. @ events/@ patient-years ; hazard ratio : @ ; @ % confidence interval : @ to @ ) .


Major bleeding risk increased with age , but there were no differences between treatments in each age category ( < @ , @ to @,@ years ; pinteraction = @ ) .


Compared with those without ( n = @,@ ) , patients with a major bleed ( n = @ ) were more likely to be older , current/prior smokers , have prior gastrointestinal ( GI ) bleeding , mild anemia , and a lower calculated creatinine clearance and less likely to be female or have a prior stroke/transient ischemic attack .


Increasing age , baseline diastolic blood pressure ( DBP ) @ mm Hg , history of chronic obstructive pulmonary disease or GI bleeding , prior acetylsalicylic acid use , and anemia were independently associated with major bleeding risk ; female sex and DBP < @ mm Hg were associated with a decreased risk .


Rivaroxaban and warfarin had similar risk for major/nonmajor clinically relevant bleeding .


Age , sex , DBP , prior GI bleeding , prior acetylsalicylic acid use , and anemia were associated with the risk of major bleeding .


( An Efficacy and Safety Study of Rivaroxaban With Warfarin for the Prevention of Stroke and Non-Central Nervous System Systemic Embolism in Patients With Non-Valvular Atrial Fibrillation : NCT@ ) .


To compare the efficacy of laryngeal mask airway-Supreme ( TM ) versus common laryngeal mask airway in children with general anesthesia .


With local research ethics committee 's approval and written informed parental consent , @ children were randomly divided into groups L ( size @ common laryngeal mask airway ) and S ( size @ laryngeal mask airway-Supreme ( TM ) ) according to random number ( n = @ each ) .


After anesthesia induction , a common laryngeal mask airway or laryngeal mask airway-Supreme ( TM ) was inserted and mechanically ventilated .


Time and ease for insertion , insertion success rate , airway leak pressure , success rate and ease of disposal sputum collecting tube insertion in group S , quality of airway during anesthetic maintenance , abdominal circumference changes and complications within @ h post-operation were measured .


Compared with group L , abdominal circumference increased less in group S ( @ @ vs @ @ cm , n = @ , P < @ ) .


No significant inter-group differences existed for other measurements .


Disposal sputum collecting tube was successfully placed in group S ( @ % ) .


In children with mechanical ventilation , laryngeal mask airway-Supreme ( TM ) can be effectively applied to maintain a good airway .


And the incidence of gastric insufflation is lower .


It is particularly useful for those requiring evacuation of gastric contents during general anesthesia .


The purpose of this trial was to evaluate crestal bone level changes radiographically in a standardized fashion over a period of @ months in humans for implants with a @-mm machined collar ( implant type A ) versus type B implants with a @-mm machined collar .


Twenty-five patients with multiple missing teeth in posterior sectors were randomly assigned to one of the two groups : A ( @-mm machined-collar implants ) or B ( @-mm machined-collar implants ) .


Changes at crestal bone level were assessed by measuring the shoulder-crest distance ( SCD ) on the mesial and distal aspects of each implant on customized periapical radiographs , which were taken on the day of surgery and @ , @ , and @ months after surgery .


Eighty-one implants were included in the study .


Mean SCD was @ @ mm at baseline and @ @ mm after @ months .


For @-mm-collar implants , mean SCD was @ @ mm , while it was @ @ mm for @-mm-collar implants .


Statistically significant differences were found only between the two types of implants for distal measurements at @ and @ months after placement .


Both @ - and @-mm machined-collar implants can be used with predictable results , as changes in peri-implant crestal bone levels are similar for both implant types and do not seem to be significant from a clinical point of view .


The SCD may well depend more on the location of the abutment-implant interface than on machined-collar height .


To explore the early childhood pulmonary outcomes of infants who participated in the National Institute of Child Health and Human Development 's Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial ( SUPPORT ) , using a factorial design that randomized extremely preterm infants to lower vs higher oxygen saturation targets and delivery room continuous positive airway pressure ( CPAP ) vs intubation/surfactant .


The Breathing Outcomes Study , a prospective secondary study to the Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial , assessed respiratory morbidity at @-month intervals from hospital discharge to @-@ months corrected age ( CA ) .


Two prespecified primary outcomes-wheezing more than twice per week during the worst @-week period and cough longer than @ days without a cold-were compared for each randomized intervention .


One or more interviews were completed for @ of the @ eligible infants .


The incidences of wheezing and cough were @ % and @ % , respectively , and did not differ between the study arms of either randomized intervention .


Infants randomized to lower vs higher oxygen saturation targets had a similar risk of death or respiratory morbidity ( except for croup and treatment with oxygen or diuretics at home ) .


Infants randomized to CPAP vs intubation/surfactant had fewer episodes of wheezing without a cold ( @ % vs @ % ; P < @ ) , respiratory illnesses diagnosed by a doctor ( @ % vs @ % ; P < @ ) , and physician or emergency room visits for breathing problems ( @ % vs @ % ; P < @ ) by @-@ months CA .


Treatment with early CPAP rather than intubation/surfactant is associated with less respiratory morbidity by @-@ months CA .


Longitudinal assessment of pulmonary morbidity is necessary to fully evaluate the potential benefits of respiratory interventions for neonates .


To evaluate whether a polyethylene total body wrapping ( covering both the body and head ) is more effective than conventional treatment ( covering up to the shoulders ) in reducing perinatal thermal losses in very preterm infants .


This was a multicenter , prospective , randomized , parallel @:@ , unblinded , controlled trial of infants < @ weeks ' gestation age , comprising two study groups : experimental group ( total body group ; both the body and head covered with a polyethylene occlusive bag , with the face uncovered ) and control group ( only the body , up to the shoulders , covered with a polyethylene occlusive bag ) .


The primary outcome was axillary temperature on neonatal intensive care unit admission immediately after wrap removal .


One hundred randomly allocated infants ( @ in the total body group and @ controls ) completed the study .


Mean axillary temperature on neonatal intensive care unit admission was similar in the two groups ( @ C total body vs @ C controls ; P = @ ) .


The rate of moderate hypothermia ( temperature < @C ) was @ % in the total body group and @ % in the control group ( P = @ ) .


Three subjects in each group ( @ % ) had an axillary temperature > @ C on admission , and one subject in control group had an axillary temperature > @C .


Total body wrapping is comparable with covering the body up to the shoulders in preventing postnatal thermal losses in very preterm infants .


Available preclinical and phase @ clinical data suggest that the addition of cetuximab , a monoclonal antibody directed against the epidermal growth factor receptor ( EGFR ) , to chemotherapy might improve outcome in patients with advanced non-small-cell lung cancer ( NSCLC ) .


We aimed to assess whether the addition of cetuximab to chemotherapy improved progression-free survival in patients with recurrent or progressive NSCLC after platinum-based therapy .


In this unmasked , open-label randomised phase @ trial we enrolled patients with metastatic , unresectable , or locally advanced NSCLC from @ sites in Canada and the USA .


Eligible patients were those aged @ years or older who had experienced progressive disease during or after one previous platinum-based regimen .


Initially , patients were randomly assigned to receive either pemetrexed ( @ mg/m ( @ ) ) or docetaxel ( @ mg/m ( @ ) ) and then randomly assigned within each group to receive their chemotherapy with or without cetuximab ( @ mg/m ( @ ) at first dose and @ mg/m ( @ ) weekly thereafter ) until disease progression or unacceptable toxicity .


However , after a change in the standard of care , investigators chose whether to treat with pemetrexed or docetaxel on a patient-by-patient basis .


The primary analysis was changed to compare progression-free survival with cetuximab plus pemetrexed versus pemetrexed , on an intention-to-treat basis .


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


Between Jan @ , @ , and Feb @ , @ , we enrolled @ patients ; data for one patient was accidentally discarded .


Of the remaining @ patients , @ received pemetrexed ( @ patients with cetuximab and @ alone ) and @ received docetaxel ( @ in combination with cetuximab and @ alone ) .


Median progression-free survival with cetuximab plus pemetrexed was @ months ( @ % CI @-@ ) versus @ months ( @-@ ) with pemetrexed ( HR @ , @ % CI @-@ ; p = @ ) .


The most common grade @-@ adverse events with cetuximab plus pemetrexed were fatigue ( @ -LSB- @ % -RSB- of @ patients ) , acneiform rash ( @ -LSB- @ % -RSB- ) , dyspnoea ( @ -LSB- @ % -RSB- ) , and decreased neutrophil count ( @ -LSB- @ % -RSB- ) , and with pemetrexed alone were dyspnoea ( @ -LSB- @ % -RSB- of @ patients ) , decreased neutrophil count ( @ -LSB- @ % -RSB- ) , and fatigue ( @ -LSB- @ % -RSB- ) .


A significantly higher proportion of patients in the cetuximab plus pemetrexed group ( @ -LSB- @ % -RSB- of @ patients ) experienced at least one serious adverse event than those patients in the pemetrexed group ( @ -LSB- @ % -RSB- of @ patients ; p = @ ) .


Nine ( @ % ) of @ treated patients in the cetuximab and pemetrexed group died of adverse events compared with five ( @ % ) of @ treated patients in the pemetrexed alone group .


The use of cetuximab is not recommended in combination with chemotherapy in patients previously treated with platinum-based therapy .


Some studies suggest better overall outcomes when right unilateral electroconvulsive therapy ( RUL ECT ) is given with an ultrabrief , rather than brief , pulse width .


The aim of the study was to test if ultrabrief-pulse RUL ECT results in less cognitive side effects than brief - pulse RUL ECT , when given at doses which achieve comparable efficacy .


One hundred and two participants were assigned to receive ultrabrief ( at @ times seizure threshold ) or brief ( at @ times seizure threshold ) pulse RUL ECT in a double-blind , randomized controlled trial .


Blinded raters assessed mood and cognitive functioning over the ECT course .


Efficacy outcomes were not found to be significantly different .


The ultrabrief group showed less cognitive impairment immediately after a single session of ECT , and over the treatment course ( autobiographical memory , orientation ) .


In summary , when ultrabrief RUL ECT was given at a higher dosage than brief RUL ECT ( @ versus @ times seizure threshold ) , efficacy was comparable while cognitive impairment was less .


We compared the effects of intravenous lidocaine ( IVL ) with lumbar epidural lidocaine analgesia ( LEA ) on pain and ileus after open colonic surgery .


Between December @ and February @ , @ patients were randomly allocated to IVL , LEA , or control group .


The IVL group received intraoperatively lidocaine @ % intravenously ( @ mg/kg bolus , @ mg/kg/h infusion ) and normal saline ( NS ) epidurally .


The LEA group received lidocaine epidurally ( @ mg/kg bolus , @ mg/kg/h infusion ) and NS intravenously .


The control group received NS both intravenously and epidurally , as bolus and infusion .


All NS volumes were calculated as if containing lidocaine @ % at the aforementioned doses .


We assessed pain intensity at rest/cough at @ , @ , @ , @ , @ , and @ h postoperatively ( numerical rating scale @-@ ) , @-h analgesic consumption , and time to first flatus passage .


Data from @ patients ( @ per group ) were analyzed .


The IVL group had significantly lower pain scores at rest and cough compared to LEA or control group only at @ , @ , and @ h postoperatively ( P < @ for all comparisons ) .


The @-h analgesic requirements and time to first flatus passage did not differ significantly between IVL group and LEA or control group ( P > @ ) .


Compared with LEA-lidocaine or placebo , intravenous lidocaine offered no clinically significant benefit in terms of analgesia and bowel function .


To compare patient satisfaction between telemedicine and in-person follow-up appointments for orthopedic trauma .


Prospective randomized controlled trial ( pilot study ) .


Level I trauma center .


Twenty-four patients were enrolled and randomized into @ groups .


Eight patients who had telemedicine follow-up appointments and @ who had in-person follow-up visits were included in a per-protocol analysis .


In the telemedicine group , @ patients left the study because of nonadherence , @ patient withdrew because of a weak Internet connection , and @ patient sustained an open fracture .


Three control patients left the study because of nonadherence .


The patients had @ follow-up appointments during a @-month period .


Patients either had their @-week and @-month follow-ups through video calls or in the clinic .


After @-week and @-month follow-up appointments , the patients were given survey questions that were developed using literature-supported methods to compare follow-up experiences .


The patients were monitored for complications .


There was no significant difference in patient satisfaction between telemedicine and in-person clinic visits ( telemedicine : @ % satisfied ; control : @ % satisfied ; P = @ ) .


Zero percent of patients in the telemedicine group took time off their work for their appointment compared with @ % in the control ( P = @ ) .


Telemedicine patients spent significantly less time on their visits ( P = @ ) .


The majority of the patients in the telemedicine group reported clear visual ( @ % ) and sound quality ( @ % ) through and agreed to future follow-up visits through telemedicine ( @ % ) .


One patient in each group developed complications .


Telemedicine may be a viable alternative to some in-person clinic visits because of similar measures of patient satisfaction but with significantly less time and distance traveled .


Therapeutic level II .


See Instructions for authors for a complete description of levels of evidence .


Chronic hepatitis B ( CHB ) is a major public health concern , particularly in endemic areas like Asia-Pacific .


Sustained virologic suppression correlates with regression of histologic fibrosis and cirrhosis .


This study evaluated efficacy and safety of tenofovir disoproxil fumarate ( TDF ) in Asian patients through @ weeks of treatment .


Post hoc analysis of the Asian subpopulation from two phase @ clinical studies was performed .


Following a @-week randomized , double-blind evaluation of once-daily TDF versus once-daily adefovir dipivoxil , open-label TDF for up to @ weeks was evaluated .


Patients with both baseline and week @ liver biopsies were evaluated for histologic changes .


At baseline , @/@ ( @ % ) patients randomized were Asian .


Sixty-eight percent of Asian patients were male ; @ % were hepatitis B e antigen ( HBeAg ) - positive .


At week @ , similar proportions of Asian ( @ % ) and non-Asian ( @ % ) patients demonstrated improvement in liver histology , and @/@ ( @ % ) Asian patients with baseline cirrhosis were no longer cirrhotic .


By modified intent-to-treat analysis , @ % of Asian patients and @ % of non-Asian patients had HBV DNA < @ copies/mL at the end of week @ ( P = @ ) .


No differences were seen in HBeAg loss or seroconversion in Asian versus non-Asian patients .


No Asian patient experienced hepatitis B surface antigen loss .


Safety and tolerability of TDF through week @ , including changes in renal function and in hip/spine bone mineral density ( from weeks @ to @ ) , were comparable between Asian and non-Asian patients .


Long-term virologic and histologic efficacy and safety of TDF are comparable in Asian and non-Asian CHB patients .


To study the effect of exogenous i.m. glucagon on recovery from controlled insulin-induced hypoglycaemia in patients with type @ diabetes treated with the novel glucokinase activator AZD@ , in combination with metformin .


This was a single-centre randomized , open , two-way crossover phase I , automated glucose clamp ( Biostator ( ) ; Life Science Instruments , Elkhart , MD , USA ) study ( NCT@ ) in eight patients ( seven men and one woman , mean age @ years , body mass index @ kg/m ( @ ) ) .


All patients received a stable dose of metformin twice daily , ranging from @ to @ mg .


A @-day titration phase commenced with @ mg AZD@ twice daily , escalating to @ mg twice daily if tolerated .


This was followed by a single dose of @ or @ mg AZD@ , administered on days @ and @ when metabolic studies were performed .


After an overnight fast on days @ and @ , controlled hypoglycaemia was induced using an exogenous i.v. infusion of insulin .


Plasma glucose was lowered in a stepwise fashion over @ h to attain a target nadir of @ mmol/l .


This was sustained for @ min , at the end of which the hypoglycaemic clamp was released .


In random sequence , patients either received an i.m. injection of @ mg glucagon or were allowed to recover from hypoglycaemia by endogenous counter-regulation .


To avoid prolonged hypoglycaemia , a reverse glucose clamp was applied from @ to @ h post-dose .


Three patients received @ mg AZD@ twice daily and five patients @ mg twice daily .


Mean plasma glucose at @ min after release of the hypoglycaemic clamp was significantly lower ( @ @ mmol/l ) for AZD@ alone than for AZD@ + glucagon ( @ @ mmol/l ; p < @ between the groups ) .


Catecholamine and cortisol responses were similar on the AZD@ + glucagon and AZD alone study days .


Growth hormone response was @ % lower for AZD@ alone ( p = @ ) , consistent with the effect of a pharmacological dose of glucagon on growth hormone secretion .


No safety or tolerability concerns were observed during treatment with AZ@ .


Exogenous glucagon was effective as a rescue treatment for hypoglycaemia induced during treatment with AZD@ , given in combination with metformin in patients with type @ diabetes .


Retrograde intrarenal surgery ( RIRS ) involves a minimally invasive stone surgery , lending itself potential to combined spinal-epidural anesthesia ( CSEA ) , although it is performed preferably under general anesthesia ( GA ) .


This prospective randomized study was undertaken to evaluate the feasibility and efficacy of CSEA for patients undergoing RIRS .


Seventy consecutive patients who were scheduled for RIRS were randomized to receive CSEA ( n = @ ) or GA ( n = @ ) .


Operative time , stone clearance rate , visual analog scale ( VAS ) of pain , complication rate , anesthetic cost , and hospital stay were compared between the two groups .


A total of @ patients randomized to CSEA ( @ ) or GA ( @ ) completed the study .


In the CSEA group , each procedure was completed and there was no anesthetic conversion .


Although based on the prospective randomized method , the GA group still had a little larger stone size ( p = @ ) and more multiple caliceal stones ( p = @ ) .


Overall , there were no statistically significant differences in operative time ( p = @ ) , stone fragmentation time ( p = @ ) , postoperative VAS pain score at @ and @ hours ( p = @ , @ ) , incidence of complications ( p = @ ) , stone-free rate ( p = @ ) , and hospital stays ( p = @ ) between the two groups .


The patients in the GA group experienced a higher mean hemoglobin drop ( @ vs @ g/L , p = @ ) .


In addition , the anesthetic cost was much cheaper in the CSEA group ( @ vs @ dollars , p < @ ) .


RIRS with CSEA can be completed with no anesthetic conversions and with the same efficacy and safety compared with GA. .


When considering economical aspects , CSEA appears to be a preferable alternative to GA for the patient whose general health status permits it .


Progesterone is effective treatment for hot flushes/night sweats .


The cardiovascular effects of progesterone therapy are unknown but evidence suggests that premenopausal normal estradiol with also normal progesterone levels may provide later cardiovascular protection .


We compared the effects of progesterone to placebo on endothelial function , weight , blood pressure , metabolism , lipids , inflammation and coagulation .


We conducted a randomized , double-blind , @-month placebo-controlled trial of progesterone ( @ mg daily ) among @ healthy postmenopausal women in Vancouver , Canada from @-@ .


Endothelial function by venous occlusion plethysmography was a planned primary outcome .


Enrolled women were @-@ y since last menstruation , not using hormones ( for > @ months ) , non-smoking , without diabetes , hypertension , heart disease or their medications .


Randomized ( @ ) women ( @ @ years , body mass index @ @ ) initially had normal blood pressure , fasting lipid , glucose and electrocardiogram results .


Endothelial function ( % forearm blood flow above saline ) was not changed with progesterone ( @ @ % , n = @ ) compared with placebo ( @ @ % , n = @ ) ( @ % CI diff -LSB- -@ to @ -RSB- , P = @ ) .


Progesterone ( n = @ ) and placebo ( n = @ ) groups had similar changes in systolic and diastolic blood pressure , resting heart rate , weight , body mass index , waist circumference , total cholesterol , low-density lipoprotein cholesterol and triglyceride levels .


High-density lipoprotein was lower ( -@ mmol/L , P = @ ) on progesterone compared with placebo .


Fasting glucose , hs-C-reactive protein , albumin and D-dimer changes were all comparable to placebo .


Framingham General Cardiovascular Risk Profile scores were initially low and remained low with progesterone therapy and not statistically different from placebo .


Results indicate that progesterone has short-term cardiovascular safety .


Endothelial function , weight , blood pressure , waist circumference , inflammation and coagulation were unchanged as were lipids except for HDL-C .


The statistically significant decrease in HDL-C levels was not clinically important ( based on lack of Cardiovascular Risk Profile change ) .


Fluralaner ( Bravecto ; Merck/MSD Animal Health ) is a novel systemic ectoparasiticide for dogs providing long-acting flea and tick control after a single oral dose .


Milbemycin oxime and praziquantel are routinely used to control Dirofilaria immitis and intestinal worm infections in dogs .


The safety of concurrent use of fluralaner and a commercially available milbemycin oxime plus praziquantel combination tablet , in particular with regard to gastrointestinal symptoms , was investigated using oral doses at or above the maximum recommended rates .


Some minor and transient clinical findings were observed during the study period ; however , none of these was considered to be related to concurrent treatment with fluralaner and milbemycin oxime plus praziquantel , or to the use of either product alone .


Concurrent treatment with fluralaner , milbemycin oxime and praziquantel is well tolerated in dogs .


Afterschool programs can be health-promoting environments for children .


Written policies positively influence nutrition and physical activity ( PA ) environments , but effective strategies for building staff capacity to write such policies have not been evaluated .


This study measures the comprehensiveness of written nutrition , PA , and screen time policies in afterschool programs and assesses impact of the Out of School Nutrition and Physical Activity ( OSNAP ) intervention on key policies .


Twenty afterschool programs in Boston , MA participated in a group-randomized , controlled trial from September @ to June @ .


Intervention program staff attended learning collaboratives focused on practice and policy change .


The Out-of-School Time ( OST ) Policy Assessment Index evaluated written policies .